• must be unable to ambulate safely within the home, with or without an assistive device, and complete mobility-related activities of daily living (MRADLs) in a reasonable amount of time (i.e. get to bathroom before incontinent episode, get to kitchen for basic meals, get out of the home in the event of an emergencey, etc.); and
• has the upper body strength and endurance to propel a properly configured manual wheelchair throughout a given day and complete MRADLs in a reasonable amount of time.
  • • If the patient is also unable to change his/her position for an adequate pressure relief, and does not have the cognitive abilities to safely use a power wheelchair, he/she would likely qualify for a manual tilt in space wheelchair

• ambulate in the home as his/her primary mode of mobility throughout the day even with an assistive device; or
• propel any type of manual wheelchair as primary mode of mobility to complete his self-care and activities of daily living in a reasonable amount of time.

General Recommendation: Evaluation** and documentation in collaboration with a certified assistive technology professional at the nearest health system or hospital-based outpatient facility or clinic (search here) who can advise on considerations of insurance stipulations, assistive technologies, wheelchair selection, vendor selection, wheelchair fitting, and seating evaluation.

Notes
*In general, most insurances will not authorize a new wheelchair if the current one is not 5 years old. (Exception may be indicated , if it can be shown that the current wheelchair is not medically appropriate due to a medical change in condition or if the cost to repair the current wheelchair outweighs the cost of a new wheelchair, the request for a new wheelchair can be submitted.

**Some insurance will require an evaluation by a licensed PT or OT. Some therapists may be comfortable performing these evaluations but others may not and can help with referring to a qualified therapist to do a thorough evaluation.