A Seat of Power: Eye on Wheelchairs

Today's power wheelchair innovations put users in the driver's seat like never before

Article Highlights:
  • Hot Pursuit is a new Quest section that will focus on innovative technology, product and service trends.
  • In this issue, author Mark Boatman looks at some helpful wheelchair products that are part of the evolving world of power wheelchair technology, and provides some helpful tips for getting this kind of equipment covered by insurance.
by Mark Boatman on July 7, 2014 - 9:07am

Quest Summer 2014
Lateral Tilt System from Motion Concepts
Dynamic Controls’ iPortal Mouse Mover + Accessibility
Aquila Corp.’s Airpulse PK2 wheelchair cushion
Permobil’s Rehab Series
SmartDrive by Max Mobility

Power wheelchair technology has evolved significantly in the past couple of decades. Gone are the clunky, jerking power wheelchairs of old; in their place today are sleeker chairs equipped with a variety of accessories that afford users a level of comfort, safety and independence that was previously unimaginable. 

The following power wheelchair products, which represent just a sample of recent features to hit the market, are designed above all else to make life easier for those living with neuromuscular disease. 

Tilt and relief

Relieving hip and back pressure is critical for any power wheelchair user. With that simple yet essential need in mind, the Lateral Tilt System from Motion Concepts enables pressure-relieving chair tilt of up to 15 degrees in either lateral direction — while maintaining either an upright seated or reclined position (up to 30 degrees).

The standard lateral tilt module complements most traditional powered-seating configurations; accommodates weights up to 150 pounds; and is available on Invacare, Quickie and Quantum brand power chairs.

Details: motionconcepts.com

Price: Varies by chair model


Whether you’re at home or on the go, staying connected is that much easier with Dynamic Controls’ iPortal Mouse Mover + Accessibility. The unique Bluetooth device allows power wheelchair users to control their favorite personal tech devices — iPhones, iPods, iPads, other tablets, even laptops and PCs — with their wheelchair’s joystick or via an input device, such as a head array.

Once the iPortal is paired with a device, the user can easily navigate the Web, write email, video chat, make phone calls, send text messages, use environmental control apps, read an e-book and more — all from the comfort of their wheelchair.

Details: dynamiccontrols.com

Price: Check with vendor for pricing

Pressure drop

Pressure sores are an unfortunate reality for many wheelchair users. But they might not have to be. Aquila Corp.’s Airpulse PK2 wheelchair cushion can automatically alternate pressure as frequently as every two minutes to help treat and even prevent such sores and ulcers from forming. The cushions can be custom-designed to provide permanent relief to specific problem areas. Cycle length and cushion firmness also can be easily programmed to the desired setting.

A standard rechargeable battery operates the cushion for up to 40 hours, but the cushion also can be paired with other options, like a remote control, a moisture control unit and additional lumbar support. 

Details: aquilacorp.com

Price: Check with vendor for pricing

Rise up

An ability to engage in conversation, face-to-face, at eye level is always desirable, especially in noisy environments. That’s one reason why most manufacturers now offer a power seat elevator as an optional or standard amenity with power wheelchairs. For Permobil’s Rehab Series, for instance, all three seating system options include an elevator that raises the chair up to 8 inches. 

Of course, seat elevators facilitate much more than improved communication; they also aid users in performing a variety of everyday tasks — everything from chair transferring and self-grooming to shopping and meal preparation. The fact that a seat elevator helps with such mobility-related activities of daily living (or MRADLs) has the added benefit of improving the likelihood of a corresponding insurance reimbursement (see the sidebar on this page for more on this topic).

Details: permobilus.com

Price: Varies by model

Conversion kit

For manual wheelchair users who just need an extra boost of power in certain situations, the SmartDrive by Max Mobility provides a convenient solution. By attaching the 11-pound motor to a hitch at the back of a chair and affixing its battery in place under the seat, the wheelchair easily converts to a power-assisted model. 

After it is set up, a SmartDrive-equipped wheelchair can reach speeds of up to 4.5 mph and has a range of up to 10 miles. The intuitive system just enhances the normal function of your chair — push to go, brake to stop. Once in motion, you’ll cruise at a desired pace until you choose to stop. It also includes an anti-rollback feature that comes in handy when going up inclines. 

Details: max-mobility.com

Price: Check with vendor for pricing

Note: The products mentioned in this article are not endorsed by MDA. When choosing a power wheelchair system, always consult with a certified rehabilitation technology supplier (CRTS), preferably an assistive technology professional (ATP), as well as an occupational or physical therapist who specializes in wheelchairs.

As impressive as today’s advanced power wheelchair products are, the associated price tags can be steep. Naturally, one has to ask: What about insurance? Could I be reimbursed for these products? To complement this edition of Hot Pursuit, writer Mark Boatman answers those important questions and more in this Quest Web-exclusive feature. Based on his own experience living with Duchenne muscular dystrophy (DMD) for 38 years, Boatman shares tips on the insurance reimbursement process and how to be a savvy consumer before you buy.

Power wheelchairs provide people a tremendous level of independence, but adding on options like high-tech driving controls or power leg rests quickly adds to the overall price of the chair. Health insurance policies are usually pursued to pay for a variety of specialized options, but that isn’t the only way to get what you need.

Mary O’Connell, an occupational therapist with Community Medical Center in Missoula, Mont., has spent a greater part of her career helping people find the power wheelchair that best meets all of their complex needs. Her job is often challenging, but she shared some tips that will make the process of getting a unique option reimbursed or funded through other sources.

Keep it necessary: Most insurance providers require any wheelchair option or specialized accessory to be medically needed by the user. ”There has to be a reason why you need it and we have to prove through trial or through evaluation that this is going to benefit you in a medical way and not because it’s a cool new technology,” she says.

For example, if a lateral tilt system is suggested for your wheelchair, in what ways will this addition benefit you medically? If you can document that it will provide improved pressure relief, improve breathing function or help your stomach empty better, then you have increased your chances that reimbursement will be provided for this supplemental tilt system.

Get involved: O’Connell treats her patients according to the independent living philosophy that individuals with disabilities know their needs better than anyone else. She says you need to be able to be creative and be part of the puzzle. Showing your involvement in the process not only helps you become a better advocate but it will likely give your health care team extra motivation to help you get what you need.

Doctor discussions: Communicating regularly with your primary physician about all of your adaptive equipment is important. At every visit, you should update your doctor on how your equipment is working. What works well? What problems are you having? What could make life better from a medical standpoint? Having this ongoing conversation documented is vital. “When that (communication) shows up in their office notes, it’s much more important than if shows up in a therapist note,” she says. When your doctor understands your situation, he’ll write better notes and letters on your behalf.

Talking to your doctor about ongoing medical issues is another good habit to start. Let your doctor know about things like lingering shoulder pain, increased swelling or difficulty sitting for more than a couple hours. Describing these changes in detail will help your doctor accurately document what’s going on with your body.

Try before you buy: Getting items like seat elevators paid for by insurance is extremely difficult, especially when you have to document the potential benefit of a high-end item.  Trialing a wheelchair feature may take time to arrange but it’s a great way to see how it will help you before you decide to submit it to your insurance. There’s also another important reason. “Trying it gives us the chance to put evaluation of that exact thing in your documentation,” says O’Connell.

Finding other funding: There are times when insurance won’t cover an adaptive option for your chair, but that doesn’t mean you’re out of luck. Funds can be sought through other nonprofit organizations/foundations, service clubs, churches and even crowdfunding websites. State vocational rehabilitation agencies are a good avenue to pursue if the wheelchair adaptation will help you complete job tasks or assist you in becoming more employable.

If you are paying for the cost out of your own pocket, talk to your vendor and inquire about what kind of payment plan they can arrange for you. Another possibility is taking out a loan for the item. Check with your state’s assistive technology program to see about the low interest loans they offer for adaptive equipment.

Appeal, appeal, appeal: Insurance claims are denied for a variety of reasons. The first thing you must do when you’re denied is to find out why. Request a formal denial letter from the insurance company before planning your response. If fighting the denial looks complex, you may want to involve the insurance regulator in your state or hire a health care advocate. If your appeal is again denied, you may be able to bring your case to court or appear in front of an administrative law judge if the government provides your insurance. Check your policy for further details.

Some additional resources:

Centers for Medicare and Medicaid Services Durable Medical Equipment Center



State Vocational Rehabilitation list

List of State Assistive Technology Programs

Advocates for insurance denials:

Patient Advocate Foundation

Families USA

Note: Be sure to work with your MDA clinic team to help guide you through the process of getting fitted for and purchasing the appropriate assistive technology equipment, including power wheelchairs.

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