Life Without Insurance

Life Without Insurance

Sterling man gives 'heart' to helping.

What Howard Wilder wants is something money cannot buy.

The Sterling resident has congestive heart failure, lost his job, broke his neck and shoulder and lost his health insurance all within the past three years.

Wilder needs a heart or heart surgery and to undergo various other surgeries, but he cannot accept money from a fund-raiser that could cause him to lose the money he now receives through Social Security. He needs the heart care first before he can have his shoulder repaired and a gallstone removed, because the surgeries require anesthesia that without a new or healed heart could kill him.

Wilder and his friend, Gail Pueschel, also of Sterling, sat in Pueschel’s living room on a cool Thursday afternoon earlier this month to tell Wilder’s story, hoping it “could help other people,” Pueschel said. “He’s a helper. He doesn’t want other people to go through this.”

Wilder sat in a rocking chair holding his shoulder stiff and wearing a neck brace, a canvas bag filled with his medical story beside his chair. Pueschel sat on the floor as her daughter, Jessica Albright, 10, played with the dog downstairs.

“I’m not trying to embarrass anybody. I’m trying to tell a story about a man who worked all of his life, served in Vietnam and he got nothing,” Pueschel said.

WILDER’S STORY begins on a November evening in 2000. The now 57-year-old man was going to a heating and air-conditioning service call with two more to go when he began to have chest pains. He thought he was having a heart attack, so he went to a Kaiser Permanente facility through his insurance carrier. After an electrocardiogram (EKG) was taken, he was told he was not having a heart attack and to return the next day. When he did, he was taken to Reston Hospital Center for an irregular heart beat and stayed there for more than a week. He was told he had a weak heart and was prescribed heart medication.

“That’s when it started going downhill,” Wilder said. "Almost every six months I was put in the hospital for chest pain. ... I'd come out of the hospital more exhausted than I was before."

Wilder went to hospitals in Loudoun, Fairfax and Reston and was told the chest pains were not heart-related and that a cause could not be identified, except that it might be bone or inter-muscular.

At the end of March 2002, Wilder was rushed to Inova Fairfax Hospital, again for chest pains. There, he was found to have an oversized heart from congestive heart failure, along with two leaky valves and an aneurysm in the aorta. Nearly two weeks later, he was released and told he could return to work in the heating and air-conditioning business, the type of work he has done since 1969. But Wilder was laid off from his job on June 1. He was too tired to do any work and started looking for another job but did not have the energy, he said.

A MONTH LATER on July 24, Jessica, who was 9 at the time, and Wilder’s niece, Annie Battaglia, who was 11, found Wilder semiconscious when he was supposed to be baby-sitting them. They called 911.

“If those two little girls hadn’t been there, he would have died. That’s a big thing for those little girls to know what to do,” Pueschel said. “All he could say was 911. … They were scared as could be, but they pulled it together to make sure to call 911 and to stand outside to direct them to the right home. … I was so proud of them.”

Wilder was taken to Loudoun Hospital Center, where he was placed in intensive care for four to five days then moved to a regular room until mid-August. He was told he was a possible candidate for a heart transplant before he was discharged. He was given $800 worth of prescriptions and released into the care of Pueschel. Pueschel had met him eight years ago when she was living with her brother, Ron Battaglia, and Wilder had moved in as a renter, remaining there since. He stayed with Pueschel and her husband Larry Pueschel until the end of October. They provided his care, doing it “out of love,” she said.

By June 30, Wilder’s insurance had ended. He had $200 he could use to pay for the prescriptions after being out of work for more than two months. In August, Wilder went to the Veterans Affairs (VA) Medical Center in Martinsburg, W. Va. for additional care and received a three-month prescription at no charge. He qualified for the care by meeting income and eligibility criteria.

"He's receiving ongoing treatment at our facility for heart, gall bladder and orthopedic problems," said Rita Grewal, chief of health information management at the VA Medical Center, about Wilder still being a patient of the VA. "We are providing the best care we can in accordance to his condition."

THE PUESCHELS took Wilder to the Department of Social Services following the loss of his job, but he made $26 above the monthly cutoff. Since 1969, Wilder has received $201 a month as a disabled Vietnam War veteran after he cut off three of his fingers using a power saw to build barracks. Out of the available benefits, he could receive monthly food stamps and Medicaid in a spend-down form. Spend down is based on income eligibility and is paid as a deductible for six months, at which time an application would have to be resubmitted.

"His application was valid," said Sandi DuPaul, benefits program specialist with the Department of the Social Services. "The food stamps were immediately granted and the Medicaid was pending on the outcome of his Social Security eligibility. ... I received the disability determination in early April and his spend down began May 1."

Battaglia agreed to take care of Wilder's rent in the meantime.

Wilder filled out more paperwork in an attempt to receive the Social Security disability payments, but he needed to be out of work for five months. He filed for benefits in September 2002 and got on disability seven months later, as DuPaul said.

"We try to assist all of our clients with food stamps," said Lorraine Dolan, chief of the benefits program at the Department of Social Services. "Every case is different. Depending on the regulations, we can help some more than others. Income and resources are considered."

WILDER CONTINUED to receive his medication from the VA center. On Jan. 24, when he was on his way to pick up his prescriptions, he got in an automobile accident. The axles let loose on his truck and it rolled five times, flattening the frame. In the accident, he broke his shoulder and fractured the top-most vertebrae, an injury that could have been fatal. He was taken to Loudoun Hospital Center in Leesburg, then to the one in Lansdowne before he was transferred to Inova Fairfax.

At Inova Fairfax, Wilder was tested to determine if he was a candidate for heart surgery so he could be given anesthesia for surgery or for the use of a neck halo. Though he was a candidate, he was told to get the surgery through the VA and if he could not, to return to Inova Fairfax. When he returned to Inova, he was instead given a new device, a neck brace that lifted his neck, which he wore for three months. After that, he used a removable soft brace for continued support, which he still wears.

“I think Fairfax is avoiding surgery on me because I’m so weak,” Wilder said, adding that now, "I'm doing better."

"It's all because the VA got his medicines regulated," Pueschel said.

This year, Wilder received unemployment back pay and began receiving a monthly Social Security disability payment, allowing him to pay his rent, buy food and upkeep his car. “He’s never wanted to go to Social Services,” Pueschel said. “He never asked for anything from anybody."