I think maybe a call to the issuer of the 1099-R is in order.  My guess is that the client is not properly understanding what this is.  I have one client with one of these weird hybrid retirement/LTC policies, the LTC is reported on a 1099-R by itself in box 1 only, box 2a is $0, box 7 code W, box 8 "Other" equals box 1.

@Skylane , our local insurance expert, may be able to shed some light on this.