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VA Benefits Disqualify World War II Hero From Larger Medicaid Payments

July 20, 1987

ST. PETERSBURG, Fla. (AP) _ An 87-year-old man who applied for Veterans Administration medical benefits received just enough money to disqualify him from much larger Medicaid nursing home payments, his family said.

As a result, Fred Aten, a Marine who served in World War I and World War II and won a presidential citation for heroism on Okinawa, is caught in a Catch- 22 situation, his family says.

Aten, who is paralyzed on one side and is diabetic, was admitted to a nursing home last summer after his 79-year-old wife, Hermina, had to be hospitalized. A month later, she returned home, but she no longer was able to care for him.

To pay his $67-a-day nursing home bill, Mrs. Aten drained half of their $6,000 bank account, cashed his $5,000 life insurance, and sold the car, an organ, the washer, dryer and refrigerator.

By April, Aten qualified for public assistance under Medicaid, a state- federal program that pays nursing home expenses for low-income elderly.

According to regulations, his income had to be below $901 a month. His $562 monthly from Social Security and $319 pension from the Veterans Administration totaled $881.

But in May, a Medicaid worker from the Florida Department of Health and Rehabilitative Services said Aten had to apply for additional benefits from the VA - benefits available only to veterans with large medical expenses, like nursing home bills.

The additional benefits brought Aten $542 a month. And that meant Aten exceeded Medicaid’s income limit.

However, if he had left the nursing home he would have no longer qualified for the extra VA money, and would thus once again satisfy Medicaid’s income limit.

Aten’s augumented income now totals $1,423 - too much for Medicaid but not enough for his $2,000-plus monthly expenses at North Horizon Health Care Center.

″What a Catch-22,″ said John Daily, Mrs. Aten’s brother-in-law. ″If you don’t apply for the VA, you don’t get your Medicaid benefits. If you do apply, and you go over the limit, you don’t get your Medicaid benefits.″

HRS officials aren’t happy with the regulations, but say they have no choice.

Four veterans from Fort Myers have filed a class action suit against HRS seeking to have the regulation declared illegal as it applies to VA medical assistance. Attorney Christine Larson said an estitmated 300 veterans have suffered Aten’s fate.

In California, she said, a similar suit succeeded and 11 Western states no longer disqualify their veterans.

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