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SweetNora Asked November 2022

Is a letter of incompetence by a nurse practitioner legal in the state of Arizona?

Banking institutions are saying the letter of incompetence is not valid because it was not issued by a doctor.

JoAnn29 Nov 2022
I know, old post and OP has not come back. I was on vacation and missed this one.

I quickly read the responses so if this has been said, sorry.

It all has to do with the POA. If it says that a letter of incompetence has to be done by a doctor or two, then it has to be a doctor with an MD. So a NP signing off is not enough. In my State NPs practise under a physician. They require a Masters Degree. Can take 6 to 8 years. My daughter, RN, says they might as well go on to be Drs. For my daughter to be one, she would need to get her BA degree (her degree is associates) and then her masters.

Isthisrealyreal Nov 2022
Bailey, the problem with a nurse practitioner is that they don't have the same licensing or liability coverage as a doctor and that means they have to work under a licensed physician in AZ. I think everyone understands what a NP is, that's not the real issue.

I am in Arizona and I have dealt with this issue.

The OP has never come back to answer if they have DPOA, so a letter from anyone besides a judge isn't going to do any good if a DPOA doesn't exist. No bank is going to allow questionable access and we should ALL be thankful for that.

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poodledoodle Nov 2022
I don’t think the nurse’s letter is valid, and it looks suspicious (for example to the bank). “Why wasn’t OP able to get a doctor’s letter? The nurse must be a friend of OP,”…kind of thing.

You normally always need a doctor’s letter, and sometimes even a special doctor (not just a GP, general practitioner.)

baileyif Nov 2022
Tell the bank to check az license for the np who signed the order. Or ask the np for her license number her license number might be written on the card competence ordw. Might require signature of 2 doc. I think wi requires 2 doc signature. Np is one of them.. might have to go to ER to get 2nd sign.

baileyif Nov 2022
Az is a full right state for nurse practitioners. So u really need to speak with bank manager.

baileyif Nov 2022
Or thinking an np is as good as a md in Arizona too. Because wi had 3 medical schools as such our doc shortage is less than that in Arizona which doesn't have as many medical schools... Post what u find out, I curious.

baileyif Nov 2022
I think the confusion in the replies is thinking a nurse practimer is just at a nurse.. a nurse practitioner is 4 year degree registered nurse. You then get some experience working as a registered nurse, go back for additional education to get a nurse practionee degree of which give them the right to prescribe and testify n court to Legal mediacal issues..
It is frustrating reading replies that don't recognize the difference in and r not give the respect has np earned. Like docs there r some of that specialized in n kids they become an md pediatrician.. some specialize in old people they become gerintologists ...but it doesn't require a gerontologist to declare incompetence .. same with np... Some np have extra training to treat kids.. a regular doc and a regular np can treat kids...same to with declaring incompetence.. regular doc, psychiatrist gerontologist, regular np, np with additional training in Psychiatry or gerontology ..

This is really an issue of how much medical services r available in ur area
Again drawing on my experience for multiple sclerosis, people in larger cities would tell me I had to see a neurologist specializing in multiple sclerosis only. But I have available to me a general neurologist who treats everything. So although I really like her, these people on message boards are telling me I was getting substandard care and I do not believe that and that's what's happening here with declaring incompetence. People in larger cities who have greater access to a larger diversity of medical attention are telling others that they need what they can get in their larger cities

babsjvd Nov 2022
Did you receive the documentation of incapacitation ? I’m in Wisconsin, when my mom was incapacitated by the nurse practitioner, the dr who oversees nurse practitioner, signed off. Then I received the documentation. If you have not received this, maybe that’s why the bank says no ????
baileyif Nov 2022
Was it a pa or an np. I've been treated by both here in WI and ur description sound like what I have experienced when I see a pa ,physician assistant.. wi DMV acknowledges np the same as doc. It's rather demeaning to imply a np needs a supervising anything . My pa orders have right on them a line for supervising physician signature. if np it was a referral. .. Perhaps the 2nd doc signature required to declare incompetency. An np signature in WI is just as valid as md. Dad was in nursing him when 1 doc signed he incompetent the second doc refused. .he had sepsis second doc was right .. I think ur np signature was the 2nd doc signature. Not a supervising anything. U might want to check ur information on the this belief.
I a wisconsinite too. We have contradictory wi beliefs.
I been treated by both for a chronic illness I have and have looked up why they exist.
I might be more nformed wi poster.
ACaringDaughter Nov 2022
Why would you take a chance?

You should thank the bank.

The bank is rejecting this only for their legal protection (they don’t care about you) but you should recognize they are protecting you as well from technically committing a crime.

After all, withdrawing money from someone’s account without legally approvable permission is, by definition, stealing.

I’m sure you are not intending to do anything wrong and you may simply just be care providing. You may need the money for groceries and Depends and co-pays and toothpaste. But… Imagine that the bank gave you the money despite the fact you did not have the appropriate documentation, and greedy/hateful family members later sued you civilly and made criminal referrals, forcing you to defend yourself in two different legal forums. Maybe they resent you for being the “chosen” one and they want to see you hurt. Have you got a half million plus dollars sitting around to pay for the legal defense of those cases(?), … because that is what it could cost to defend such a civil and criminal case to their conclusion.

You may think this wouldn’t happen to your family, but probate courts and wills exist in the first place because it does. We live in a world where people shoot strangers at the grocery store and others sue their siblings for trivial things associated with care providing for their own parents—-out of deep seeded childhood-based resentment. Unless you are the only possible heir, thank the people at the bank for protecting your future, your money and your freedom. (And saving you from unnecessary stress, wrinkles, gray hair and tears.)

Terminating someone’s legal rights to withdraw/keep control over
their own money is something that is highly protected/coveted (and should be) and that is why you need an MD. Get a credentialed MD who takes the time and clearly documents this analysis according to the state’s medical standard of care. This is for your legal protection. Don’t stop there….

Make sure you get a lawyer too — and follow that lawyer’s advice for Your protection!

Don’t ask anonymous strangers on this forum for legal advice. Clearly some of their advice could land you in trouble. “I read it on the Internet,” is not a valid legal defense.
baileyif Nov 2022
Thats what I said ask to speak to a manager. Or someone higher up in bank.. bank may need to update their policies... Accept MD. DO.doctor of osteopathic medicine. NP nurse practitioner.
Llamalover47 Nov 2022
SweetNora: Perhaps you should pose your query to your elder law attorney.

Countrymouse Nov 2022
If the Nurse Practitioner is competent to conduct an assessment of mental capacity,* then the letter is as valid as anybody else's. It's that specific professional competency that matters, not the courtesy title.

* Who is considered competent to do this will be laid down in your state's applicable legislation. If you have the patience you should be able to find out what the required qualification is - it won't be just anybody, but it probably won't just be doctors either. Social workers, mental health practitioners of various types, clinical psychologists, advocates: what they have in common is specialist training and experience in assessing a person's functional mental abilities.

Luta65 Nov 2022
SweetNora,

I would say that for purposes of overturning any legal docus previously executed, no, and possibly not for legal docus executed after such determination by an NP. For purposes of a Court finding, I would say definitely not.

baileyif Nov 2022
Good that u reference state always a sticky issue

My understanding here in WI is np- nurse practitioner is the same as md/,do for prescribing and legal issues.

A pa physician assistant requires the signature of a supervising md/,do/np for all prescription and legal issues . The MD doesn't have to see the person just sign the order that he/she agrees order that the pa has done.. I think it np order good.. But check, maybe ask np office.
Don't.male this too difficult. np degree developed for MD shortage so wouldn't make sense they couldn't do what doc does. They r required to refer to doc when greater expertise needed.
U weren't referred greater expertise not needed.

Actuslly it is the bank associate who needs to update there knowledge.

Maybe start there ask to talk to their manager

Enlighten Nov 2022
My friend whom I cared for 10 years+ was never diagnosed as incompetent. 
After a serious fall passed away 2 weeks ago.  

Doctors, nurses, PT, technicians and all those working with her just naturally deemed her as incompetent because of her complete disconnect. 
She was always friendly, just mentally disconnected.

RedVanAnnie Nov 2022
Missouri requires two Doctors. You will have to verify the requirement for your own state.

MACinCT Nov 2022
SC requires signiture from 2 doctors

Patathome01 Nov 2022
Follow what Isthisreallyreal said. Is there a physician on board? I think a licensed doctor qualifies.

Isthisrealyreal Nov 2022
Search the AZ Attorney General website for this question.

I do not believe that a NP has the licensing to meet the criteria to write this letter.

A Judge is the only authority that can actually declare anyone incompetent. Doctors can say they have no capacity but, I believe it takes two doctors in agreement. However, that does not equate to legal incompetency unless a Judge rules it does.

Do you have DPOA?

Edit: contact the Maricopa County Counsel on Aging. They are a great resource for you.
AnnReid Nov 2022
We had our LO assessed by a psychiatric team who then produced a letter stating in 2 or 3 short paragraphs, that my LO had been diagnosed one’d as having Alzheimer’s/dementia, and that she was incapable of caring for herself or managing her own affairs.

I carried the document and her POA with me whenever I needed to do banking or anything that required a legal opinion, and I never had a problem using it, including accomplishing having myself established as her Social Security “designated payee”.

I assume that if anyone had questioned my handling of her circumstances, a judge would have been the final authority, but no one EVER DID question the credentials I presented.

I myself would have questioned the value of a document written by a nurse practitioner unless that person was more extensively credentialed in geriatric psychiatry (could be the case, but I’d assume not typical).

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