Thank Goodness Santa Claus doesn’t have Wheels on his Sleigh!

This past August I had to request a new power wheelchair. My chair was very worn after five years of use -- going to work in Manhattan, New York, traveling on aircraft and going about my daily living activities.

Basically, I beat up my wheelchair as I used it 12 hours each day, seven days a week throughout the years.

I had to repair my wheelchair quite a few times during 2018-2019, changing batteries, the wheels, upholstery and armrests. I banged up the chair pretty good in New York City while riding to work in Manhattan for about 3 1/2 years.

Image result for wheelchair storm
Wheelchair Storm Models
My Invacare-Storm wheelchair is durable and gets me around quite well. If you are a wheelchair rider, you know what I mean, because the chair is not only your mobility in the real world, it’s also your unique pair of "legs."And, when you’re working full-time as I am, people expect you to be in the office or at meetings when you are  supposed to be there -- especially when you're leading the  meeting!

When I started working in Boston, Massachusetts this year, I had to find a way to get to work other than "wheelchair walking" (riding) or taking my accessible van. To get to work, I ended up taking the commuter rail (train) every day to Boston. It’s a 45-minute ride each way and it’s accessible, with a great crew of conductors, who help me board the train by placing a metal ramp on the ground, which in effect, "closes the gap" between the platform and rail car. So, this is my routine each day I go to work.

So, after 5-plus years of riding in my power wheelchair that has taken a beating, I decided to order a new chair from my health care plan. Based on what I’ve heard on the "street," it doesn’t much matter which healthcare company is helping you replace your manual or power wheelchair, the system is full of complexity and even bad judgement.

To order a new wheelchair I had to ask my doctor for a prescription to obtain the chair. Then, I had to go see a physical therapy team, along with representatives from a wheelchair company, in my case, Numotion, (who were great in this process), to be re-valuated for a new chair. As you may gather, this process takes several months to complete.

During this complex and tedious evaluation process, I am taping my chair together as parts continue to fall off, and my motors lose power as I traverse slight inclines on the Boston streets or when I go to the park with my granddaughters. I asked my neighbor to strip my back-up wheelchair for spare parts to keep me going. As you know, as readers of View from the Chair, I work like many of you and have things to do, places to go, and people to see as I work to support my family and meet my responsibilities at work – in other words I have stuff to do!

Although I’m sitting on my "tush," I’m still working and people count on me.

Anyway, my wheelchair order finally gets to my healthcare company, and a few months later I get a reply that they will order the chair. The healthcare company, however, decided to remove $6,000 worth of equipment that I use on my chair. Although I was upset with that, I told the wheelchair manufacturer that I still need the parts my healthcare provider denied -- (which was authorized by my doctor and physical therapy experts) --  and I would pay the difference.

Bureaucracy at its Worst

My issue is this: I was evaluated by doctors, physical therapists, and representatives of the wheelchair manufacturer, who all agreed I needed what I now have on my chair -- for the last 5 years -- nothing new was added to the order.

I need the parts for my daily living routines -- at home and at work -- that I’ve always had, given my personal lifestyle. Nonetheless, I received a formal letter telling me I didn’t need what I’ve been using for the last decade.

These faceless "bureaucrats" denied what the  professionals I met with ordered for me, and effectively made a decision without examining or talking to me. "They" just declared that what the first set of experts prescribed for me is "null and void."

This makes absolutely no sense to me. In my disability community, this is what many wheelchair riders experience when they try to obtain  medical equipment for themselves.

Wheelchair Fraud

I know the medical equipment industry is concerned about fraud, I’ve read those articles, and I have no doubt that fraud exists and it is costly.

For example, the United States  Office the Inspector General reported $95 million dollars of fraud for power wheelchairs. This is the amount that Medicare spent on claims for power wheelchairs that were either medically unnecessary or lacked sufficient documentation to determine medical necessity during the first half of 2007 alone.

This represents 61% of Medicare claims for power wheelchairs during this period. The OIG reported on these improper payments in an evaluation about power wheelchairs, the fourth and final of a series. Other key findings from the series include:
  • Medicare and its beneficiaries paid four times the average amount paid by suppliers for standard power wheelchairs.
  • Eight percent of power wheelchair claims were miscoded, meaning the suppliers billed Medicare using codes that did not match the model information on the invoices of the power wheelchairs supplied to beneficiaries.
  • A total of 80% of claims for power wheelchairs did not meet Medicare coverage requirements and should not have been paid by Medicare.
As carried by NBC News, "fifty separate investigations under way in nearly two-dozen states have identified $167 million in fraudulent power wheelchair claims, officials told The Associated Press."

“It certainly is the fastest growing scam in Medicare,” said Dara Corrigan, acting inspector general in the Department of Health and Human Services. “It’s about a wheelchair that is very expensive and about people trying to make a profit.

"The medical equipment industry has aggressively marketed its electric wheelchairs, particularly in television ads targeting senior citizens. The number of Medicare beneficiaries with at least one claim for a motorized wheelchair rose from about 55,000 in 1999 to 168,245 in the first nine months of this year (2019)."

My point, however, is when when you work through an existing process, that is prescribed and assigned to you, and some anonymous person tells you you don’t need what was prescribed, just makes no damn sense to me!

So right now,  I’m taping parts of my wheelchair together, stealing parts from my 10-year-old wheelchair that sits in my garage as a back up, and crossing my fingers so that I can get a new chair before I can’t ride my existing chair at all.

Some Good News: The Mobius IBOT Wheelchair

I am also looking at the new Mobius IBOT wheelchair as well, which climbs stairs and eliminates the need for a ramp or physical help getting up stairs or over other obstacles. I test drove the IBOT chair this fall and loved it. I went up about 12 stairs and was fascinated by the technology, I was also scared to death as I haven’t climbed stairs, literally, in 25 years.
New Mobility Magazine
The new iBOTs™ are poised to roll off manufacturing lines early next year, bringing with them the promise of another leap forward in technology.
I am making plans to buy this new chair, which will give me more mobility around obstacles, e.g. curb cuts, that have been the bane of wheelchair riders around the world.

Naughty and Nice in the World of Wheelchairs

Again, I know the wheelchair industry is trying to do the right thing, but the bureaucracy is ridiculous and doesn’t make sense when you go through a legitimate process they ask you to go through  -- and then don’t like the outcome of your evaluation and make changes arbitrarily.

This is one of the dumbest processes I’ve seen and I can understand why legitimate wheelchair riders are upset at the expense, the bureaucracy, and the lack of common sense and poor oversight of fraud in the wheelchair process.

I dislike wishing this on anyone, but some of those people who make these decisions should sit in a wheelchair for a week and see what it really feels like when you can’t participate in society, go to work, or get to the doctor's office, hospital or emergency room.

So, Merry Christmas Santa Claus, and I hope you actually get to where you have to go because many of us are waiting for the magic of Christmas around the world. Feliz Navidad and Joyeux Noel !

                                                       ####

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