My father-in-law has been receiving the full A&A benefit for about a year. My brother-in-law has been repaying a loan, and the monthly payments are counted as income. My brother-in-law is thinking about paying off the remainder of the loan, $21,000, as a lump sum, but we are worried about how this could affect the A&A benefit. My father-in-law's medical expenses for the year will be about $51,000. Without the lump sum payment, his income would have been around $47,000. With the lump sum, his income will be about $57,000. This looks OK for yearly income, but will getting the $21,000 all at once be a problem?