The Wait to Get a New Wheelchair

After months of frustration, Mike Theobald finally received his needed wheelchair.

Every five years wheelchair users can order a new chair. On occasion, a new chair can be obtained in extreme circumstances if a person’s disability and needs have drastically changed and are well documented. The ordering process is quite involved and takes more time than you can ever imagine. Getting a new chair is not a luxury but a much-needed necessity. My chair’s joystick was being held on by duct tape! I also had four pillows propping me up, so I would have some level of comfort since the chair’s back was horrible. The headrest was out of alignment, so it was unusable. I needed my legs strapped down because they would constantly slip off the footrests. So, starting on this journey of ordering a new chair is usually filled with high expectations! Let me warn you those expectations can be quickly outpaced by many frustrations.

First, you must establish when you are entitled to start the process by tracking the serial number on your current chair with the vendor. Once you have established a timeline, you need your doctor to see you and write a prescription (not an easy task during a pandemic).  Next, you also need a certified physical or occupational therapy evaluation to certify you do need a new chair.  After this, you meet with the wheelchair vendor and PT or OT along with your input on what features would be best on the new chair. Measurements are taken so the chair is “sized” right.  Features such as tilt, recline, joystick, type of leg, arm, headrest features; brand, all need to be decided on.  All these features must be justified in the therapist’s evaluation. It is very important at this juncture to get it right; keep in mind you are in this thing for the next five years.

After all the details are decided on, the paperwork is submitted by the vendor to Medicare if that is the primary insurance or to private insurance if secondary, then finally Medicaid as the final resort which requires denials from the first two insurances. This is where delays usually occur.  In my case, I had a custom-molded back and seat made which, for some reason, took longer to process.  This delay of over six months prompted a need for a new face to face meeting with the doctor and a new PT or OT evaluation! You can imagine the frustration at this news!

Finally, after a ton of phone calls and waiting 13 months my chair arrived! Yes, that is more than a year! It was almost worth the wait!  The seat and back fit very nice and I now have a smile on my face again!

So, my advice for anyone who needs to get a new chair is to start your search one year before you expect delivery to avoid frustrations and delays that are sure to arise. Good Luck!

 

Mike Theobald is a contributing writer to the ARISE Website and a part-time employee. His stories offer a unique perspective on life in Central New York.

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