To me, it seems that the answer is YES and that you have justified the reasons. He is presently ambulating via a walker and crutches, however this is not safe for him (as he has fallen) and it has resulted in OA. Because of all this, a power chair is necessary to safely and independently ambulate within his home, not to mention, to prevent further damage/deterioration of his shoulders. Did that make any sense? Let me know if you'd like alittle more clarification.
D
>From: Ron Carson <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: [EMAIL PROTECTED]
>Subject: [OTlist] Medical Necessity for a Power Wheel Chair
>Date: Wed, 24 Sep 2003 19:58:23 -0400
>
>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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