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Thread: Wheelchair Denied

  1. #11
    I agree with Buzzard, I have bought chairs through EBay and Craiglist. It may take a little time but I've gotten some good deals, got a nice Quickee 2 for $150, an electric for $300. I don't know about your insurance but even if the chair is approved, you will probably have to pay 20% of the cost and you have to go through an approved medical supply company. These companies always seem to charge about twice the price as a private party purchase. I can buy a Quickee GPV myself for around $900. Last time I went through my insurance they charged over $2000.00 for a GPV so I had to pay $400+. The electric chair I bought for $300 would be $5000.00 through my insurance (if they would even approve it) so it would cost me $1000.00.

  2. #12
    Senior Member
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    Mimo, your problems are based upon your attempts of being honest, and trying to retain your independence. Without out and out lying you must paint the worst possible scenario you face daily.

    About 7 years ago I really started to fall down indoors as well as outdoors, I fell quite often. I fell in the night trying to get to the bathroom. I bought my own power chair because my shoulders killed me and I could buy a power chair USED as cheaply, if not more so, than a manual chair. I still do not WANT to access Medicare or other public sources of financing, however, I may have to tuck my pride as well as what I feel is my self respect, and seek assistance.

  3. #13
    Senior Member jschism's Avatar
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    You should also understand the process of getting a chair is difficult for a reason. There are plenty of people out there with chairs that really don't need them, they are just too lazy to walk. If it was a super easy process they would be encouraging some to develop bad habits and many would get a wheelchair and and start using less of what abilities they have, worsening their conditions and health.

  4. #14
    I haven't applied for ssdi because I don't think I'll qualify. I can't work in my career field or in the areas I'm educated in any longer but I'm still capable of at least part time work with the right mobility aids and accommodations. I think proving my decline into my current state is going to be difficult. It has been such a slow decline over the last 10 years. Other than the recent diagnosis of RA nothing major has changed, just a slow progression. And since I didn't have a neurosurgeon during that time I don't really have a way to prove that I'm declining, I don't think. Once my husband and I get moved into our new place, I'll look into it more. My understanding is that the income of the entire household is factored in and right now we live with his mom which would disqualify me on the income level.

    All of the insurance and disability stuff can be so confusing. I'm not new to insurance policies or red tape but this is the first time I've had to deal with it concerning my mobility. This part of it is all new to me. How do I find out exactly what their policies are on manual wheelchairs? I know now getting it all worded correctly makes all the difference. Is there a way I can get that info in writing?

    And yes you all are right about the 20%. Actually, my insurance pays nothing for DME until my deductible is met, so I won't be able to afford the chair even if insurance decides to cover it. My insulin pump supplies (I have type 1 diabetes) cost over $100/month and in a couple months I will have to find somewhere to purchase catheters, my insurance doesn't cover any catheters at all regardless of medical necessity. There is a local Spina Bifida Association with a lending closet, I'm hoping they will have my size.

    I have kept tabs on ebay and on craigslist listings. I've looked all over the state of TX but haven't found anything on Craigslist that was my size/price range/etc. I'm not sure about ebay as I only know my seat size and nothing else as far as measurements and while I've studied wheelchair options and accessories for over a year, I know very little about how they actually work and would not really know if I'm looking at a chair that is worth it or just good for parts. I guess the best I can do is try to save up for one of the tilite demo chairs since they are returnable unless something else opens up. I'll keep trying. Thank you all so much for all your advice, I really appreciate it!

  5. #15
    Quote Originally Posted by Mimo View Post
    I haven't applied for ssdi because I don't think I'll qualify. I can't work in my career field or in the areas I'm educated in any longer but I'm still capable of at least part time work with the right mobility aids and accommodations....
    That is the same mistake I made. As I left the SS office with the form, I thought to myself, well there is something I could do. But in my case I didn't want to work any longer so I just waited for SSI to kick in. But at the time SSDI paid more and of course it would covered a longer period. The clock starts when you apply, not when they approve. So when you get rejected attorneys are willing to help because they can cash in.
    I have had periodic paralysis all my life. I lost my ability to walk in 2011 beginning with a spinal block, which was used for a hip fracture caused by periodic paralysis.

  6. #16
    You're doing it again. You're building a case against yourself. This will never go over well with doctors and case workers. They simply don't have the time to build a case for your when your're providing them with information telling them not to. Your priority must be to educate yourself on your existing insurance policy as well as SSDI and Medicare eligibility requirements. Only then can you approach your doctors with a reasonable request to build a disability case. You can ask your insurance company for your insurance policy in writing. Then understand SSDI eligibility requirements (you're in for a pleasant surprise).

    There was a time when I was overwhelmed too. I was working full-time when I made a disability claim. Fortunately The saving grace was an understanding doctor and help from HR. The last thing you want to do is waste your doctor's time and make the doctor shy away from you. On the other hand, if your doctor sees that you have it under control and all you need from the doctor is some forms filled out, then you have just won some points. That's huge.

    Again, it comes down to being well educated and well prepared. Good luck.
    Last edited by August West; 01-24-2017 at 11:05 PM.

  7. #17
    the only way i got my chair was lying, ok not actual lying but i on my worst days need the chair for mobility both in my home and in the community. as i can walk some still and still do in the house as it is not accessible i have MS, and several health issues which make my breathing and walking almost impossible long distances. and when my MS is active i am basically paralyzed from just below my breasts down. thankfully i have needed several inpatient rehab stays and have braces now for both legs so when i am able to i am able to stand up in them to walk during a MS flare. my advice would be to have the doctor write a script for a wheelchair clinic seating eval and have them see you and justify your need to have one. when you go to the clinic appointment let them see you at your absolutely worst. regardless if it is a good day for you or not.
    T6 Incomplete due to a Spinal cord infarction July 2009

  8. #18
    As a retired Vocational Rehabilitation Counselor, I can tell you that you would have been an eligible client at my office. The program is tasked to assist persons who have a disability that causes problems/limitation regarding career plans, work issue, employment planning, etc. It is imperative that you meet personally with a counselor at your local DVR office and focus on your work-related issues ("I will have to quit work if I don't get a wheelchair soon"). Save any other issues such as pain, functioning at home, etc. when you meet with the counselor. Bring paperwork denying a wheelchair by your insurance company.

    Follow up with your counselor like a wolf on a rabbit. You are responsible to keep the process moving. Remember that the counselors often have caseloads of upwards of 90 clients at a time. They welcome clients who stay in regular touch as eligibility for the program would be the first step, then planning what is needed. If you are told you are not eligible or counselor is not proceeding to help, you absolutely must meet in person with the supervisor. That's what the supervisor is there for - give the system a chance to hear you out. Keep appealing if needed. As stated above, this also applies to insurance decisions.
    You are advocating for yourself and your actions now will make for a successful future. In the process, you will be helping others who come along and need similar help as you have paved the way.
    Best to you!

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