I  am  struggling  to complete a Certificate of Medical Necessity (DMERC
form 02.03A) for a power wheel chair.

Question 1: Does the patient require and use a wheelchair to move around
their residence?

The  client in question has an old spinal cord injury that left him with
incomplete  lower  extremity  paralysis.  He  has been ambulating in the
house  via  a  4-wheel  rolling  walker  and/or Lofstrand crutches while
placing  almost  100% of his body weight through his arms/shoulders. His
adapted  form  of  ambulation  has resulted in developing OA in his left
shoulder  with  a  resultant  decrease  in ROM secondary and significant
increase  in  pain.  He  only  uses  a  manual  wheelchair  in the house
infrequently  because  he can't push it secondary to shoulder arthritis.
he has fallen 6-8 times this past year while ambulating with his walker.

It  appears  that  the  answer to question 1 is a 'no'. If this is true,
does  this  mean  that a power wheelchair is not medically necessary for
this client?


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