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Thread: When you get fitted for a chair, do you pick the chair or does your insurance?

  1. #1
    Senior Member mr_coffee's Avatar
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    When you get fitted for a chair, do you pick the chair or does your insurance?

    Hi guys!

    So i'm getting a new chair once I visit my docotor he will write up the script and what not. But i'm confused on the ordering process. Does the doc write the script saying I need a light weight chair for blah and blah reason and then the insurance pick it out or can I pick it out and submit it to the insurance?

    I don't want them picking out some random chair that I hate, it seems all of you pick out your chairs and know what you want in the chair. I'm 5 years post had 1 chair and still don't know a whole lot about what I need or want. I just know I hate my current chair Quickie Gt!

    The back rest is higher than I need now that I function more like a para rather than a quad, also the chair is wider than I need becuase there is at least 3 inches on each side that my ass take up

    Do you guys recommend any websites that have nice chairs that I can maybe refer too?
    Injured:10-16-04
    C7/C8, T1 incomplete;


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  2. #2
    I've had a QUickie GT for the last 4 years. I like it okay. I tried several different kinds when I was at Shepherd doing rehab. At the time the Quickie was the one I liked the most. Yours being so big is probably half of the problem. # inches on each side of your arse is absurdly large. Also I assume you have adjusted the back down ass low as it will go. I lowered mine aftered I regained trunk strength. I have had to raise it back up since I had spinal refusion in June. Corey I don't know what kind of insurance you have but I would be surprised if you did not get to make the decision on which chair you want. After all it is your arse that has to sit in it and be comfortable and safe for the next 5 years or so until they buy you another one. When you get a script for a new chair you should be instructed to set up a seating clinic visit somewhere. Shepherd has a seating clinic with all kinds of chairs that I was able to ride around in to try them out. Find the nearest place that does seating evaluations so you can get it "fitted" to your arse. That way it will be more comfortable, usable, and safer. Good Luck buddy..
    L1 Complete - Injury 3/12/06 - Grateful to be alive!!!!

  3. #3
    Senior Member mr_coffee's Avatar
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    Cool thanks for the info!
    The insurance I have is pretty good from what I heard so I hope so!

    Yah I'm not sure why they gave me such a big wheelchair, I guess they thought I would be 400lbs not 120lbs
    Injured:10-16-04
    C7/C8, T1 incomplete;


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  4. #4
    Senior Member CurvySAT05's Avatar
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    You want to make sure that your doctor writes a referral for a ULTRA lightweight wheelchair. I made the mistake of having my doctor write for a "lightweight" wheelchair and he might as well have just written it as a POS hospital chair! The "lightweight" chairs are standard, hospital grade, one size fits "all" chair that weighs less than 40 (or 45) pounds. An Ultra lightweight wheelchair will be custom fitted for you and you should get to pick what you want. The difference will be in the code that your doctor submits. A K0004 or K-4 wheelchair is typically aluminum (like the TiLite AeroZ, Colours wheelchairs, many of the Quickie chairs, Top End Crossfire (I think), etc). If your doctor writes for a K0005 or K-5 wheelchair that is typically a titanium chair such as the TiLite TR, ZR/a, Quickie Ti, etc.
    If you have an HMO your insurance company will authorize you to go to a specific DME provider for the wheelchair fitting. If you don't like that place you can ask your insurance to change the provider to someone else that is in network. If you have a PPO you should be able to pick any wheelchair supplier that is in network with the insurance company. Make sure to do research on chairs before you go so you know what all the different options are, etc. and DEMO DEMO DEMO to make sure you get what you want.
    Good luck getting your new chair. Hope you get a MUCH better fit that your last chair.
    Mandy
    ~Mandy~
    SCI as a result of spinal surgery
    TiLite Aero Z!!!

  5. #5
    Senior Member WolfeMan's Avatar
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    Quote Originally Posted by CurvySAT05 View Post
    You want to make sure that your doctor writes a referral for a ULTRA lightweight wheelchair.
    YES this is very important! I just got my prescription and it specifically says this!!
    Larry
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  6. #6
    Senior Member Foolish Old's Avatar
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    In my experience, docs will listen to you and write what you need - but they don't have time to listen to people who stutter. Know what you want and why you want it. My last script contained language calling for "the lightest wheelchair possible". Arm and shoulder weakness and pain was the medical reason I need an ultra light chair to continue an important activity of daily living. To maintain independence, I must drive. To drive, I must load my chair. To protect my arms and shoulders, the chair must be as light as possible. Usually, the doc describes the need. A PT and DME work together to fill that need with a specific chair. Technically, your preferences have no bearing on anything but no cost options with no medical or performance consequence. Your choice between standard colors would be an example. In practise, you should know exactly what you want, and find a DME who agrees that you have made the correct choices.

    Demo as long as you can. All pretty good chairs seem great if you don't like how you are currently rolling.

    Optional wheels, brakes, and other preferred options are a little harder to get without convincing medical evidence that they are necessary. Your DME provider has to be willing to go to bat for you. Too often, this is not the case.
    Last edited by Foolish Old; 11-18-2009 at 10:57 AM.
    Foolish

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  7. #7
    I would recommend doing your research and determine 1-2 chairs you think you want to get. Then see a good PT or OT who does seating and wheelchair evaluations. Get them to help arrange for you to try out demos from the various vendors and then spec out the exact chair you need. They then write the prescription and letter of medical necessity for you to take you your physician to sign. Most physicians are clueless how to write the letter and detailed prescription and are happy to have this given to them by the therapist.

    Cory, Santa Clara Valley Med Center's SCI Center has expert SCI therapists who could help you with this.

    (KLD)

  8. #8
    Senior Member wheeliecoach's Avatar
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    Cory-

    I discussed with my doctor what chair I wanted and he actually wrote that chair name in the letter of medical necessity. My doctor is a phsyatrist (bad spelling) who specializes in spinal cord injuries and disease...and between his letter of medical justification, and the PT's eval...I was able to get the chair I wanted with no issue.

    Make sure though that everything you want is justified by that letter...down to the wheels and the breaks and even the back rest. Insurance companies like giving the bare minimum if it is not stated as to why it is needed. When I got my first chair, the insurance company was not going to pay for caster wheels because they did not know what they were or why I needed them. It was only when we explained to them what they were that they decided to pay for them.
    "Unless someone like you cares a whole awful lot nothing's going to get better. It's not." - Dr. Seuss

  9. #9
    Like already mentioned have the doc write a prescription for an ultra lightweight manual chair.

    The insurance company will either approve or reject the order but the choice of a chair and accessories is done by you with assistant from a DME. I suggest spending some time reviewing chairs (one source: Ultra Lightweight Rigid) and thinking about the desired setup, ie, 3" vs 5" casters, sling vs hardback, front angle, etc.. Ultimately, you should have a good idea about what you want before going to the DME. I like to go in with a completed Order Form to give the DME a clear idea of what I want.

  10. #10
    Senior Member Foolish Old's Avatar
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    LC makes an important point. Download, study, understand and fill-out that order form. What it says is what you agree to buy. "I thought it meant" doesn't mean squat if the chair you order isn't what you expected.
    Foolish

    "We have met the enemy and he is us."-POGO.

    "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

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