Reply to Medicaid long term care eligibility requirements for Virginia (attorney recommendation?)

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]You don't need an attorney.  You can apply for her through the county program.  Long term care medicaid is a separate program from medicaid.  Just call the county and ask them.[/quote]

DP here. Yes, this can work, but it is not always a slam dunk. I worked with someone through my parents' county. She was good, but she wasn't a slam dunk. Our dad was denied twice, but made it through on third time because we hired a lawyer. So I learned a lot about what I needed to do but she wasn't foolproof in knowing what might be possible obstacles to a successful application.

And as per another PP, this is not an area for dabblers. I talked to many on the phone while searching for one to take on my dad's case. It was clear that I knew more than some of them - they wanted to set up all kinds of stuff even though I made it VERY clear that we were long past that phase. Finally got a great person who was worth every cent.[/quote]

Why were they denied.  We had no issues except proving the money was stolen, some I could prove, some not but they worked with us as the amount wasn’t much.  There is no reason to get an attorney.  [/quote]

Denied because the assets were in excess of the community spouse threshold. The assets were below the threshold on the paperwork included in the application, but the state claimed otherwise. Remember, this is all long distance and the state agent handling the app would not take calls. When we finally hired a lawyer, it all changed. I couldn't afford a third rejection.[/quote]

If your parents were over the limit, then it was appropriate you got denied till you did a spend down.  Why was this a surprise?[/quote]

Seriously? Are you always this way? Did I indicate "My dad should've still been approved." No, I didn't. I expressed that the person handling the paper work was not up to it (though I did learn a lot from her).

We had done a spenddown. According to our paper work, we were below the threshold and not just by 100 bucks. The person assisting us didn't have the statements aligning so we did have an excess even if not on the papers we submitted. FWIW, the lawyer we hired believed I had grounds to appeal the decision based on what she thought was shoddy work by the state. Ultimately I elected not to appeal as I couldn't handle one more item on my to-do list.

I was a classic sandwich adult kid here with a DH in a demanding high profile job, 2 kids in grade school, a stressed mother, and a sibling living at home with a developmental disability. And that's not even taking in the heart break of my failing dad. So when he was denied, it wasn't surprising, it was heartbreaking as I was at the end of my bandwidth.

The local senior center recommended this woman. Again, I learned a lot from her and she meant well, but she wasn't up to handling a LTC Medicaid application involving a community spouse. I could've spared myself a lot of anxiety and stress by hiring the lawyer from the outset as well as for DH as I was constantly having to fly home to handle the applications.  And I missed some events for our kids, but DH was there and the kids understood that sometimes parents have to make difficult choices. [/quote]

Oh my.. you could have private paid for a few months till you got it worked out as you are so wealthy.. Bizzare post.  Many of us were actual caregivers, you just did some paperwork and yet are complaining.

You were denied as you didn't do the paperwork properly and there was clearly more to the story.  And you could do it all by phone and email.

Stop telling others to spend money they don't have.  You clearly have a ton of money and are gaming the system but the rest of us the opposite is true which is why approval was easy.[/quote]

You really have no idea what you are talking about. Demanding job =/= always wealthy. We were not wealthy. In addition, I was paying back student loans AND helping my parents. One of my siblings living nearby was handling the caregiving, but was very clear that "papers were not their strong suit," so we divided the labor with me handling the applications, doctors, etc.

We are talking about over ten years ago. The apps in that state at that time had to be submitted in paper form - no scans, nothing electronic, etc. The state caseworker handling my dad's app, as I referred to earlier, refused to take calls from the public. She would, however, speak to an attorney. We learned this once we had an attorney on the case.

Did I not acknowledge that there was a problem with the accounts we submitted? It can be very, very hard to obtain financial statements, even when you have all forms of POA. Our mom was a wreck and we are constructing all of this largely on our own. And again, as I stated, the lawyer thought we had a case for an appeal but I elected not to pursue due to other obligations.

No one was gaming anything. We did some private pay as well as the nursing home banking that there would be back pay once the app was approved. We were trying to conserve as much as we could for our mom - community spouses are entitled to some assets - because our sibling was also at home and needed support over and above what they were receiving from the state. 
[/quote]

Wow, just wow.   Most people don’t need an attorney and maybe your attitude was why the worker would not talk to you. [/quote]

You yourself indicated that maybe it was more complex - it was with a community spouse involved. Part of the reason the attorney thought we had grounds to appeal was because the state caseworker was refusing to interact with the public and that the computation mistakes between the first and second application were probably the state's fault.

Again, most people don't need an attorney, but if you can swing it (this came out of the spend down), then do it, especially if your parent or LO resides in a state with a high rate of Medicaid rejections for LTC. We were fortunate that the nursing home worked with us, but not all do. [/quote]

People applying for Medicaid don’t generally have your money.   So, getting approved is not difficult.  There is clearly a lot more to this.  Encouraging people to spend money they don’t have makes no sense.  The paperwork is not difficult. [/quote]

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