D. I need clarification because the question is really in two parts.

1. Does the patient require a wheelchair

2. Does the patient use a wheelchair

Ron


===============================================================
On 9/25/2003,[EMAIL PROTECTED] wrote:

dz> To me, it seems that the answer is YES and that you have
dz> justified the reasons.� He is presently ambulating via a walker and
dz> crutches, however this is not safe for him (as he has fallen) and it
dz> has��resulted in OA.� Because of all this, a power chair is
dz> necessary to safely and independently ambulate within his home, not
dz> to mention, to�prevent further damage/deterioration of his
dz> shoulders.�� Did that make any sense?� Let me know if you'd like
dz> alittle more clarification.

dz> D����







>>From: Ron Carson 

>>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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