Personal Wheelchair Budgets

[woodygb]

Well they always try the 5 year trick. But I tell them I am active and kill chairs. I contact them. With my OWN assessement. They know better than to attempt to assess and offer me anything because I embarass them in front of their bosses in a meeting after they try. And I explain every point they got wrong from a big list. I have to explain the differences between motors, controllers, seat positions, wheel and caster types and sizes CG position, seating options and the affect these options have and why. Now they dont attempt. We go through every point one at a time and I explain why they dont know what they are doing.

viewtopic.php?f=2&t=4364&p=150739#p150739

I live in the area of https:// worldpostalcode.com/ united-states/texas/austin.

Not sure how you are getting a U.K. Personal Wheelchair Budget

[Burgerman]

Hes not. Its a spam bot, posting garbage, and will post links soon...

So as usual, it will be removed, and destroyed, IP and name, and email, all banned. Along with 13 others on my list that have not yet posted...

[steves1977uk]

Well, Norwich WCS are refusing to acknowledge the PWB exists! I have a friend who comes in every week to help me deal with stuff like this now. She has phoned them up and asked them why they're not replying to me, and they told her they only look at what's important and ignore letters/e-mails. She is not impressed to say the least! They're even not calling her back when they promised they would.

I told her we need to take this higher up. Will keep this updated, they're not going to like being forced to implement the PWB. Also she recognises a 4MPH chair would be to slow for me and said I should have one that does 12MPH.

Steve

[Burgerman]

Dont mention speed at all. They are only required to supply chairs for indoor use primarily. Their remit says 4mph. If you keep taliking about outdoors or faster speeds they will say those are not covered. You might need 4 pole and 120A for control, esp on a rear drive chair. You might need to explain that you cannot transfer independently, and so it is essential that it allows you to live your life, interests, hobbies, shop, bank, social life too. You might also mention that anything less than grp 24 batts dont last you a day and give you short battery lifespan and range anxiety limiting what you can do. You might list all the chair functions you need. Such as lift to empty a legbag into a loo rather than going outside... And to help to prevent legs swelling. Tilt/recline, centre footrests, etc etc and give the reasons why if you need these. Dont list them if you dont! That just gives a heavy chair. Thats no problem if YOU decide what to buy with the budget... Use brain. Dont talk to the wheelchair services they are idiots. Talk to the hospital administration, and go above them explaining your rights.

[steves1977uk]

Thanks for the advice BM! Looks like challenging times ahead and I'm gonna beat the bastards!

Steve

[expresso]

Its not any better here in the States either now with these Chairs - i just went for new chair and indoor only - is what is required by the insurance - anything outdoors - will be denied - seat lift denied - not even considered - its a luxury they say - not needed - but you can pay for it if you like once they deny it - for seat lift and 8.5 motors $4000 - haha - no thanks -

the only good thing at least is - the group 3 chairs that are covered - can get 6.5mph - will feel very slow to me - basic controls also - unless i get 3 power options that i can get and will - then i can get the Rnet 120 with color display - But not the new Joystick - i was told by sunrise Rep. they are not doing them on those chair because it gave them issuses - i asked what kind of issues - dont understand what would not work - its Rnet - all work together - of course no specifics why - but they dont offer them on the chair -

i dont really believe them - but can get the other color Rnet - so i have to get tilt recline and power center mount in order to get Rnet 120A with color display or else - basic VR2 - or pay for the Rnet $1000 - so i will settle for the 3 power options to get me Rnet 120A but i wont pay for motors or lift - its gotten alot tougher - i barely made it to get the bounder

[Burgerman]

i dont really believe them

You are correct! They work great this side of the atlantic. All the same R-Net regardless of chair or chair manufacturer. The real reason is that theres a big cost difference.

I actually wouldnt want anything but the 6mph motors. They are better for a bunch of reasons. At least if you program the thing to respond. And range, and battery longecity, and torque etc. Faster is ok in straight lines. On flat ground. So you arent losing much.

One thing.
Lift. If you cant empty a leg bag, into a toilet, or if you cant transfer easily to different height surfaces, its a medical need. So can be covered here. Same with power legs, recline, tilt. For pressure sore or swelling reasons. So it may be worth mentioning. Lift adds a lot of weight, and its up high, and it sits you higher. But you really need that on at least one chair. Well I do. I have windows, cupboards, vans to clean, etc. As well as for transfer at different heights. Its useful now and again.

[Burgerman]

You should lobby them to pay the end user rather than the chair company. Then you get the spending power, discounts, choice, etc yourself. Thats what I did a decade ago. Wasnt easy. Its supposed to be available for all. But as steve above shows - some parts of the country dont want to change, dont understand it, and dont realise that you have a legal right now! So they are very reluctant to change. But they are in for a shock! Simon stevens NHS overall boss, told them all to do this from 2016. But it was ignored by some parts of the country. So he made it a legal right starting this year.

[expresso]

i am going back in 3 weeks to see a demo of the Center mount - it wont be on the chair i am getting - what ever chair that has a center mount they will bring - most likely an invacare - which i am told there is a new model of invacare chair to be introduced here - i asked for picture specs etc, of course - no one has that info.

i cant see what difference it will be unless its like the Salsa on your end with a different name here - its too bad - i wont know if i may like that one instead

as it stands - i most likely will get the 636 again - 6.5 with recline tilt and center power mount - this way i get the Rnet 120A with color screen but not new Joystick with larger screen etc, - i have one here in a box with another Rnet 120 PM and ISM 6 - i am curious to see if the Joystick works now on my 646- i will try it one day

i wont get seat lift - i wont get high speed motors - things are harder now here with options that are not covered - the laws have to be changed to get them easily as needed - or else forget it - will just drag on for ever and still get denied - i am looking at a year even after i pick the covered items only - since they always try to wiggle out of paying one way or another - this is the Medicaid part of my insurance - the 20% part - Medicare will cover the covered items no upgrade options - only for indoor use - 80% of what they consider to be fair cost - not the Retail price -

its all bullshit - gimmicks they use with numbers - in the end they know what they will get - but they all play the game - i should get them uniforms

[Burgerman]

cant see what difference it will be unless its like the Salsa on your end with a different name here - its too bad - i wont know if i may like that one instead

While the salsa is still available here (and I prefer it because the casters are further apart allowing the centre fooplate to sit further back by around 2 to 3 inches - along with the seat,) it is being replaced over time with this one:

Which isnt too bad. Just seems to be the same thing, built a little more cheaply, with narrower closer togather casters. So the sunrise chair you will likely get will be this:
https://www.sunrisemedical.co.uk/powere ... -sedeo-pro
https://www.sunrisemedical.co.uk/powere ... sedeo-ergo
Double the price for the one with more fancy seating... BOTH can be centre footrest.
Both will allow 210Ah lithium with a little space left over.
AVOID invacare. Control system and other issues.

Theres also cheaper versions with less power/Amps/lower quality controller/more basic seating etc. Many options. But I would still buy the salsa as it can be configured less nose heavy. And its cheaper slightly.

[Burgerman]

Steve, remenber that by insisting on a 120A 4 pole setup for torque and control, they HAVE to give you the 6mph option, but will not pay for lights. Because the 4 poles are 6mph... At least on the snrise chairs. They will program it down to 4. But you can fix that. But if you are getting a quote as your personal budget include these things. Explain why. Dont mention speed. Because its expensive. Your assessed amount will be higher. So you can get more budget. Dont forget to insist on a cushion, and a back too. And an agreed figure for maintainance. Add them into your personal assesement. Fill in a prescription form, and add it up. Explain why each choice on a seperate sheet. For a Q700R or similar.

[expresso]

the new chair they are talking about here - i was told is a new Invacare model - not sunrise model - the only new sunrise here would be a Midwheel chair - updated seating on a QM720

not going to stress this - when i got back in 3 weeks - i want to just place the order and let them figure out who is paying or not - and take it from there - sunrise chair with all power - no lift - 6.5 motors and Rnet - it be fine - i drop in my 200ah pack sitting here and done - have tires and battery pack waiting for this new chair

[iainsherriff]

West Midlands WCS have written to us confirming that they now have PWB active and Matt can apply when we are ready............

In fact we won't be as he doesn't have any capital to use BUT a year ago when we first asked about it there was a solid denial of any chance that they even needed to think about it !

[Burgerman]

The idea is that they give you some!

as he doesn't have any capital to use

[iainsherriff]

The idea is that they give you some!

as he doesn't have any capital to use

Yes, but (as you know) it still needs topping up and a float for maintenance etc. Point is it IS now available here, as it should be, and next chair we will use it

[Burgerman]

You say this. But you can use this budget flexibly. For e.g you can buy a used chair. Or several. Or you can repair your 3 year old chair. And buy a spare. Used. Or you can maintain and run your 2 used chairs, while adding your budget up so you have almost double. The result of this over time, is that you end up in a better situation altogether. I have 3 home built chairs. 2 are as new and rebuilt. I have 2 tatty used ones in the garage. As a pile of spares. And I have a brand new barely used Salsa that you have seen which I bought for around 70% of the normal retail. I had to add around 1k of my own cash to buy that. And will be getting another in a few months new. So I have a pair. You can do deals £. And as we speak I am already sending my self assessement in for another 3 years budget. So I will have another 6k in the bank awaiting either another top up, or use for parts. I am about to sell 2 used chairs, on ebay. The new budget, and the money recouped from the used sold ones will pay for the new salsa with all the custom mods easily.

The flexibility allows you to use it to your advantage, OR add your own to it to buy something better. And when you have several chairs, you dont wear them out as fast. So my 3 year payments can sit in the bank for 3 years... You have to realise that your existing chair also has value when you get a new budget. They dont take away the old one!

[steves1977uk]

Well here's the proof that Norwich WCS don't have a clue... The PWB do exist!... https://norwichccg.nhs.uk/publications- ... eport/file But they're still saying the budget can't be used to buy a chair that's not on their list.

Steve

[Burgerman]

They are morons. Thats the ENTIRE POINT of having the budget. They still think its the voucher scheme with a different name. Remember that you are supposed to be free to take their assesed budget, and use it as you wish for your mobility needs. The whole thing was originally concieved precisely because NON OF THE CHAIRS ON THEIR LIST WERE ANY GOOD! And the Ministry of health bod, and all the heads of the LA and those involved in the budgets and the WCS bosses themselves all agreed that I could be paid to: BUILD MY OWN SOLUTIONS. Or to buy a chair that I felt was better, modify it as I saw fit, or maintain my existing chairs.

Which is why it says EXACTLY THIS on the NHS leafelet here. Seriously these people are so dumb that it defies belief.
The chair they are assessing you for, is to determine how much they will give you. At this point its NONE OF THEIR DAMNED BUSINESS what you spend it on. The responsibility for your disabled mobility now becomes your CHOICE. Remember that word being plastered all over the gov websites?

Pring it. DRAW A BIG RED LINE around paragraph 1. And give them a copy.

[ex-Gooserider]

Its not any better here in the States either now with these Chairs - i just went for new chair and indoor only - is what is required by the insurance - anything outdoors - will be denied - seat lift denied - not even considered - its a luxury they say - not needed - but you can pay for it if you like once they deny it - for seat lift and 8.5 motors $4000 - haha - no thanks -

the only good thing at least is - the group 3 chairs that are covered - can get 6.5mph - will feel very slow to me - basic controls also - unless i get 3 power options that i can get and will - then i can get the Rnet 120 with color display - But not the new Joystick - i was told by sunrise Rep. they are not doing them on those chair because it gave them issuses - i asked what kind of issues - dont understand what would not work - its Rnet - all work together - of course no specifics why - but they dont offer them on the chair -

i dont really believe them - but can get the other color Rnet - so i have to get tilt recline and power center mount in order to get Rnet 120A with color display or else - basic VR2 - or pay for the Rnet $1000 - so i will settle for the 3 power options to get me Rnet 120A but i wont pay for motors or lift - its gotten alot tougher - i barely made it to get the bounder

FWIW, and a mixed bag given the options for a stander, at least some folks here in MA have been able to get Standing chairs on 'medical necessity' grounds... IMHO a stander and a seat lift give many comparable advantages in terms of reaching things and so forth, with some medical benefits for standing... Only problem is that we don't seem to have any decent RWD standing options...

ex-Gooserider

[jefferso]

Its not any better here in the States either now with these Chairs - i just went for new chair and indoor only - is what is required by the insurance - anything outdoors - will be denied - seat lift denied - not even considered - its a luxury they say - not needed - but you can pay for it if you like once they deny it - for seat lift and 8.5 motors $4000 - haha - no thanks -

It might be worth challenging any denials. It will be a different process depending on whether you have private insurance and/or Medicare and/or Medicaid, but it is possible. Some private insurance companies will be much more flexible if you are persistent and/or have some legal representation or an experienced advocate.

I had Medicaid and Medicare in the U.S. about ten years ago and got a Permobil C500. The medical supply company refused to get it at first, saying Medicare won't cover a standing chair. I ended up paying the difference between what Medicare would typically cover and what I got out of pocket, putting it on a credit card, but asked them to try to bill Medicare anyway (I think it was Group 3 vs Group 4 chair). Medicare rejected the reimbursement so I requested a redetermination and was rejected, then reconsideration and rejected again, finally at the Administrative Law Judge level, I won the case and the judge instructed Medicare to pay about a year later. Medicare did not pay the claim so I eventually got help from the Medicare Rights Center and after a lot of work by them, Medicare finally reimbursed a good portion of the out of pocket costs. The payment finally arrived almost 3 years after I got the chair.

I got some useful documents to support the claim from someone at Permobil. At the ALJ level I also had assistance from a state Disability Rights Advocate.

[Burgerman]

Seat lift 4k?

But you can pick those up on the bay of e too. I actually was about to get one and was offered one on here instead for postage costs. Its just bolt on. Adds 2 inches to seat height. This ones sunrise, but most are pretty much the same.

Adding tilt and lift, is the same basic unit. It is not cheap even here. It adds 1.8k to the price of a brand new chair when ordered new today...
http://www.sunrisedice.com/asset-bank/a ... /31019.pdf So 4k must be buying 2 of them and a bit!

[duke1]

hi all well after 2 years fighting and the need to get another bunch of folks all to apply at the same time to our ccg for the pwb and having had and returned 2 totally unsuitable powerchairs back to the local wcs.
the joint effort along with complaints galore to sir simon stevens head of the nhs and various others (me and 4 others doing same) we got a call from wcs saying we are approved for pwb at just under 4k i am awaiting a letter with details but they say it will be really quick from there end once we find the chair she gets along with
i gather its a choice of a few dealers and theres no buy and build your own,well im not having that after all the fighting if they think they can fob me off with a halfarsed effort they can bloody well think again!,so we halfway there and will see where it leads,tbh i dont think it could be worse if you took a blindfolded person and just choose the first chair they bump into its just as likely to be right type for her than the idiots who claim to know choices!the last one took the biscuit though i swear if you just took the absolute opposite of the assessed needs and prescribe that you would be right on the money for what they gave her! everything wrong.peace

[Burgerman]

i gather its a choice of a few dealers and theres no buy and build your own,well im not having that after all the fighting if they think they can fob me off with a halfarsed effort they can bloody well think again!,so we halfway there and

A powerchair budget is exacty that. They give you money. From that point on, its non of their damned business. They cant tell you to use specific dealer. Thats called the voucher scheme that this takes over from. They are keeping the old system, and calling it something different! Thats NOT what the budget is about.


Again, 4k will buy a suitable chair? WITH a maintainance, and cushions, etc? 3 years or 5? Mines every 3.

[Burgerman]

I told you already theres only 1 way this works.

Write your OWN detailed assessement explaining in step by step the ACTUAL SPECS YOU NEED. And then explain under each bullet point why this is so on clearly directly under the bullet points. Add that X chair allows this option.

Say you need tilt and leg lift or centre footplate or lift or recline, or 4 pole motors, 120A controller, etc.

+++++++++++++++


Do this list:

_ TILT
Because I suffer from pressure sore issues and this allows me to transfer my weight off my rear and onto my back every 20 mins to allow oxygenation of my backside. X chair allows this option.

_RECLINE
As Tilt above. Used in conjunction to further shift my weight off my backside at regular intervals. And in my case it allows me better access to deal with ileostomy appliance during the day. X chair allows this option.

_LIFT
Allows me to empty legbag, into a toilet. Also because I transfer with a board, and my sofa, bed dressing bench etc are all at different heights. This allows me to reach my shelves and cupboards and I live alone and it increases my ability to live independently. X chair allows this customisation.

-ETC
Yada yada yada. For EVERY feature you require for holistic and personal reasons including CLINICAL NEED explaining WHY.

Then make very very sure that THEY COME TO ASSESS YOU. And that you go through every last point in detail along your bullet points and that the assessor writes it down. Give her a copy.

++++++++++++++++



Then if they offer you less, and it wont pay for this chair that fits your needs ask them why, contact PALS and ask for another assessement. Dont give in. This is the ONLY way you will win. Also, explain that you cannot be forced to buy from anywhere. And that once they pay you then its all YOUR choice. NHS CHOICES remember?

[duke1]

I told you already theres only 1 way this works.

Write your OWN detailed assessement explaining in step by step the ACTUAL SPECS YOU NEED. And then explain under each bullet point why this is so on clearly directly under the bullet points. Add that X chair allows this option.

Say you need tilt and leg lift or centre footplate or lift or recline, or 4 pole motors, 120A controller, etc.

+++++++++++++++


Do this list:

_ TILT
Because I suffer from pressure sore issues and this allows me to transfer my weight off my rear and onto my back every 20 mins to allow oxygenation of my backside. X chair allows this option.

_RECLINE
As Tilt above. Used in conjunction to further shift my weight off my backside at regular intervals. And in my case it allows me better access to deal with ileostomy appliance during the day. X chair allows this option.

_LIFT
Allows me to empty legbag, into a toilet. Also because I transfer with a board, and my sofa, bed dressing bench etc are all at different heights. This allows me to reach my shelves and cupboards and I live alone and it increases my ability to live independently. X chair allows this customisation.

-ETC
Yada yada yada. For EVERY feature you require for holistic and personal reasons including CLINICAL NEED explaining WHY.

Then make very very sure that THEY COME TO ASSESS YOU. And that you go through every last point in detail along your bullet points and that the assessor writes it down. Give her a copy.

++++++++++++++++



Then if they offer you less, and it wont pay for this chair that fits your needs ask them why, contact PALS and ask for another assessement. Dont give in. This is the ONLY way you will win. Also, explain that you cannot be forced to buy from anywhere. And that once they pay you then its all YOUR choice. NHS CHOICES remember?

hi bm and all, well after a lot of email and phone calls and excuses about the covid19 (the go too excuse for slackers)
we have wcs coming back to reassess my tina this time there bringing a rehabilitation engineer as well.
i did as bm said in above post full self assessment and have copies printed on hand and ready,i am not sure how much difference this will end up making in the end but im not giving up on getting a sensible pwb that we can use for sorting the right chair ourselves but it seems you have to battle all the way through every hurdle and barrier they can concoct in order not to do there job.
all we want is them to prescribe correctly in the first place but twice so far they have failed dismally.
they offered 4k pwb based on incorrect data despite our self assessment they twice have given her solid tyres which with her spinal stenosis cause so much pain she simply cannot use it from the off,she needs tilt recline etc,and low seat height which neither nhs chair had she has to tiptoe and hurt herself even to mount the seat!
will this rehab engineer understand any better than the wcs? we shall see.
i shall report any news,and throw a party if we win,it feels like a test,peace all

[Burgerman]

No. No he wont... Been there, spoke to several. They are all clueless so far. Wen he gets there, just to see if he understands anything, ask him to explain how motor load compensation works. And ask him why 4 pole motors typically improve range. All you will get are blank looks or waffle.

[rover220]

Rehab engineers tend to be more biased towards posture and seating needs and then special mods.

[duke1]

hi all i been doing a bit of reading up on the pwb before our meeting on the 3rd of next month and think i found what i need here it even says i can buy independently if we want something they say no too but me being me and a stubborn old git im not one for taking no as an answer,linky hope it helps other people do the pwb and do it right,not some halfarsed voucher under another name,peace
https://www.independentliving.co.uk/il- ... -services/

[stevelawiw]

Hi Duke,

Have a look at this one, it's a more positive write-up and it's from the NHS website.
https://www.england.nhs.uk/personal-health-budgets/personal-wheelchair-budgets/

[Burgerman]

Well I was the first. A decade back. We have agreed that its 3 years repeat in my case as I am good at totalling chairs and destruction...

This time they were slow...
I sent them a PERSONAL detailed assessement, in huge detail. After a bunch of calls complaining about lack of action, they sent my assessement to some panel of frankly incompetant people, and they offered me a figure just over 5k that did not include several things that are essential to me.

This was based on the provision of another salsa. Pricing taken from the prescrition form.

These being single post arms, power centre footrest, and 4 pole motors. Not for speed but for torque (I am fat! 2 pole doesent work)
So I am now returning this and mentioning that they failed to include these 3 things. Which will affect the price.

They also included a jay balance cushion and 100 per year for maintainance. Which is rediculously low. So they are getting a copy of the original assesement returned, with red rings around the parts they ignored. And then hopefully they will return a better offer. This happened last time too.

The figures are based on what THEY would pay. So around 40% off, and then some added for maintainance and cushion. Or back.