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Adapting Motor Vehicles for People with disAbilities

Introduction

A Proven Process for Gaining Freedom on the Road

The introduction of new technology continues to broaden opportunities for people with disabilities to drive vehicles with adaptive devices. Taking advantage of these opportunities, however, can be time consuming and, sometimes, frustrating.

The information in this brochure is based on the experience of driver rehabilitation specialists and other professionals who work with individuals who require adaptive devices for their motor vehicles. It is centered around a proven process —evaluating your needs, selecting the right vehicle, choosing a qualified dealer to modify your vehicle, being trained, maintaining your vehicle — that can help you avoid costly mistakes when purchasing and modifying a vehicle with adaptive equipment.

Also included is general information on cost savings, licensing requirements, and organizations to contact for help. Although the brochure focuses on drivers of modified vehicles, each section contains important information for people who drive passengers with disabilities.

Investigate Cost Saving Opportunities &Licensing Requirements

Cost Saving Opportunities

The costs associated with modifying a vehicle vary greatly. A new vehicle modified with adaptive equipment can cost from $20,000 to $80,000. Therefore, whether you are modifying a vehicle you own or purchasing a new vehicle with adaptive equipment, it pays to investigate public and private opportunities for financial assistance.

There are programs that help pay part or all of the cost of vehicle modification, depending on the cause and nature of the disability. For information, contact your state’s Department of Vocational Rehabilitation or another agency that provides vocational services, and, if appropriate, the Department of Veterans Affairs. You can find phone numbers for these state and federal agencies in a local phone book. Also, consider the following.

Many nonprofit associations that advocate for individuals with disabilities have grant programs that help pay for adaptive devices.
If you have private health insurance or workers’ compensation, you may be covered for adaptive devices and vehicle modification. Check with your insurance carrier.
Many manufacturers have rebate or reimbursement plans for modified vehicles. When you are ready to make a purchase, find out if there is such a dealer in your area.
Some states waive the sales tax for adaptive devices if you have a doctor’s prescription for their use.
You may be eligible for savings when submitting your federal income tax return. Check with a qualified tax consultant to find out if the cost of your adaptive devices will help you qualify for a medical deduction.

Licensing Requirements

All states require a valid learner’s permit or driver’s license to receive an on–the–road evaluation. You cannot be denied the opportunity to apply for a permit or license because you have a disability. However, you may receive a restricted license, based on your use of adaptive devices.

Evaluate Your Needs

Driver rehabilitation specialists perform comprehensive evaluations to identify the adaptive equipment most suited to your needs. A complete evaluation includes vision screening and, in general, assesses:

Muscle strength, flexibility, and range of motion
Coordination and reaction time
Judgment and decision making abilities
Ability to drive with adaptive equipment

Upon completion of an evaluation, you should receive a report containing specific recommendations on driving requirements or restrictions, and a complete list of recommended vehicle modifications.

Finding a Qualified Evaluator

To find a qualified evaluator in your area, contact a local rehabilitation center or call the Association for Driver Rehabilitation Specialists (ADED). The phone number is in the resource section. The Association maintains a data base of certified driver rehabilitation specialists throughout the country. Your insurance company may pay for the evaluation. Find out if you need a physician’s prescription or other documen-tation to receive benefits.

Being Prepared for an Evaluation

Consult with your physician to make sure you are physically and psychologically prepared to drive. Being evaluated too soon after an injury or other trauma may indicate the need for adaptive equipment you will not need in the future. When going for an evaluation, bring any equipment you normally use, e.g., a walker or neck brace. Tell the evaluator if you are planning to modify your wheelchair or obtain a new one.

Evaluating Passengers with Disabilities

Evaluators also consult on compatibility and transportation safety issues for passengers with disabilities. They assess the type of seating needed and the person’s ability to exit and enter the vehicle. They provide advice on the purchase of modified vehicles and recommend appropriate wheelchair lifts or other equipment for a vehicle you own. If you have a child who requires a special type of safety seat, evaluators make sure the seat fits your child properly. They also make sure you can properly install the seat in your vehicle.

Select the Right Vehicle

Selecting a vehicle for modification requires collaboration among you, your evaluator, and a qualified vehicle modification dealer. Although the purchase or lease of a vehicle is your responsibility, making sure the vehicle can be properly modified is the responsibility of the vehicle modification dealer. Therefore, take the time to consult with a qualified dealer and your evaluator before making your final purchase. It will save you time and money. Be aware that you will need insurance while your vehicle is being modified, even though it is off the road.

The following questions can help with vehicle selection. They can also help determine if you can modify a vehicle you own.

Does the necessary adaptive equipment require a van, or will another passenger vehicle suffice?
Can the vehicle accommodate the equipment that needs to be installed?
Will there be enough space to accommodate your family or other passengers once the vehicle is modified?
Is there adequate parking space at home and at work for the vehicle and for loading/unloading a wheelchair?
Is there adequate parking space to maneuver if you use a walker?
What additional options are necessary for the safe operation of the vehicle?

If a third party is paying for the vehicle, adaptive devices, or modification costs, find out if there are any limitations or restrictions on what is covered. Always get a written statement on what a funding agency will pay before making your purchase.

Choose a Qualified Dealer to Modify Your Vehicle

Even a half inch change in the lowering of a van floor can affect a driver’s ability to use equipment or to have an unobstructed view of the road; so, take time to find a qualified dealer to modify your vehicle. Begin with a phone inquiry to find out about credentials, experience, and references. Ask questions about how they operate. Do they work with evaluators? Will they look at your vehicle before you purchase it? Do they require a prescription from a physician or other driver evaluation specialist? How long will it take before they can start work on your vehicle? Do they provide training on how to use the adaptive equipment?

If you are satisfied with the answers you receive, check references; then arrange to visit the dealer’s facility. Additional information to consider is listed below.

Are they members of the National Mobility Equipment Dealers Association (NMEDA) or another organization that has vehicle conversion standards?
What type of training has the staff received?
What type of warranty do they provide on their work?
Do they provide ongoing service and maintenance?
Do they stock replacement parts?

Once you are comfortable with the dealer’s qualifications, you will want to ask specific questions, such as:

How much will the modification cost?
Will they accept third party payment?
How long will it take to modify the vehicle?
Can the equipment be transferred to a new vehicle in the future?
Will they need to modify existing safety features to install the adaptive equipment?

While your vehicle is being modified, you will, most likely, need to be available for fittings. This avoids additional waiting time for adjustments once the equipment is fully installed. Without proper fittings you may have problems with the safe operation of the vehicle and have to go back for adjustments.

Some State Agencies specify the dealer you must use if you want reimbursement.

Obtain Training on the Use of New Equipment

Both new and experienced drivers need training on how to safely use new adaptive equipment. Your equipment dealer and evaluator should provide information and off-road instruction. You will also need to practice driving under the instruction of a qualified driving instructor until you both feel comfortable with your skills. Bring a family member or other significant person who drives to all your training sessions. It’s important to have someone else who can drive your vehicle in case of an emergency.

Some state vocational rehabilitation departments pay for driver training under specified circumstances. At a minimum, their staff can help you locate a qualified instructor. If your evaluator does not provide on-the-road instruction, ask him or her for a recommendation. You can also inquire at your local motor vehicle administration office.

Maintain Your Vehicle

Regular maintenance is important for keeping your vehicle and adaptive equipment safe and reliable. It may also be mandatory for compliance with the terms of your warranty. Some warranties specify a time period during which adaptive equipment must be inspected. These “check ups” for equipment may differ from those for your vehicle. Make sure you or your modifier submits all warranty cards for all equipment to ensure coverage and so manufacturers can contact you in case of a recall.

For additional copies of this brochure and other important vehicle safety information, you can contact DOT’s web site at www.nhtsa.dot.gov and the DOT Auto Safety Hotline: 888-DASH-2-DOT (888-327-4236).

Resources

The Association for Driver Rehabilitation Specialists (ADED)
2425 N. Center Street # 369, Hickory, NC 28601
(866) 672-9466
www.driver-ed.org
www.aded.net

National Mobility Equipment Dealers Association (NMEDA)
11211 N. Nebraska Ave., Suite A5, Tampa, FL 33612
(800) 833-0427
www.nmeda.org

AAA
1000 AAA Drive, Heathrow, FL 32746-5063
(404) 444-7961
www.aaa.com

Department of Veteran Affairs
(800) 827-1000
www.va.gov

State Departments of Vocational Rehabilitation
Listed in telephone book.

The following manufacturers offer rebates or reimbursements on new vehicle modification.

Daimler Chrysler Corporation
(800) 255-9877
(TDD Users: (800) 922-3826)
www.automobility.daimlerchrysler.com

Ford Motor Company
(800) 952-2248
(TDD Users: (800) TDD-0312)
www.ford.com/mobilitymotoring

General Motors Corporation
(800) 323-9935
(TDD Users: (800) TDD-9935)
www.gmmobility.com

Saturn
(800) 553-6000, Prompt 3
(TDD Users: (800) 833-6000)
www.saturn.com

Volkswagen
(800) 822-8987
www.vw.com

Audi
(800) 822-2834
www.audiusa.com

wheelchair lifts: automatic and semiautomatic MA, RI, CT, VT, NH & ME

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TYPES OF WHEELCHAIR LIFTS

Usage of wheelchair lift can facilitate everyday functioning, eliminating the need to lift the wheelchair and place it into the vehicle with just pulling up to the platform of the lift and be lifted up or down. It is extremely convenient, giving confidence to wheelchair users to go to the places they want to. Wheelchair lifts made a significant and positive change compared to the previous experiences when they didn’t exist.

Wheelchair lifts are advanced mobility systems that have changed the way the disabled move, work and live, being a blessing for users and caregivers equally. They are used for wheelchair accessible vans and other mobility vehicles, known also by the name platform lift, making the travel of wheelchair user much easier and more pleasant. Wheelchair lifts have multiple purposes and can help people with disabilities in many ways, even being adapted according to individual needs in as many ways you need.

They can be automatic and semi-automatic, electric and hydraulic. Automatic one takes care of the folding, unfolding, lowering and raising, while semi-automatic one needs manual operating. Electric wheelchair lifts are easier to maintain than hydraulic ones. They are flexible and easy to install and come with battery back-up. The full benefit of electric wheelchair lift can be felt together with stair and automobile lifts and van ramps. Hydraulic ones don’t need electricity and can function in the case of power failure. However, they require constant maintenance and care.

Wheelchair lifts that are usually used for vans and minivans are called rotary or “swing” lifts because their method of operation involves moving the wheelchair by swinging it up-and-down or inside and outside. There is a great choice of wheelchair lifts, so you should consider all the options, with the respect for your needs and wants, including the decision about whether you want to travel in the wheelchair or in the vehicle seat, which will also mean the difference between installing it inside or outside the van. Both options have advantages and disadvantages.

An outside wheelchair lift is intended for your personal mobile device to be installed outside of the car or wheelchair vans. It will be carried behind, but the way that the driver will have complete road visibility. If you choose an outside lift, it will require very small modifications of the vehicle. The lift is usually attached to a trailer hitch on the rear.

The type of the wheelchair lifts has to be compatible with your van. There are some special features that can make a difference in your everyday functioning, for example having a back-up lifting or lowering mechanism if the main drive system fails. When you sort out your needs, it’s easier to make a decision about the choice of the corresponding advanced mobility system.

Lifts

In this section we explain the various types of lifts available on the market. There are advantages and disadvantages to all of these lifts. It is highly recommended that you get to know the lifts available, the product lines, your nearest dealers and their qualifications. If you purchase a lift only to find that there is no one within a reasonable distance to provide service and repairs you will soon regret that purchase. Always consult experts at VMi New England Mobility Center BEFORE you buy.

There are basically two types of wheelchair lifts:

Platform Lift
Rotary (or Swing) Lift

In addition, these two lifts come in various types. Hydraulic, electrical mechanical, gravity and those that combine hydraulic and electrical.

The hydraulic lift uses a pump and a cylinder filled with fluid pressure, which enables the pump to raise and lower the lift along with the power from the van’s battery.

The electricall mechanical lift operates either by chain or screw rod, with power provided solely by the battery.

The gravity lift has power to lift and fold, while gravity lowers the lift platform to ground level.

All of these lifts depend, at least in part, on the battery. If your battery is weak or dead, the lifts will not work.

If you are a scooter user, measure your scooter’s length. Some scooters are longer than the standard platform on lifts. An extended platform is available to accommodate these longer scooters. Be aware, though, that this could require a raised roof, too.

Platform Lift
This lift is stored either in the side, the rear, or under the floor of a van. The lift requires two doors or a sliding door on the side of a van. The platforms have expanded metal in the upper half of the platform for better visibility when the lift is folded and the van is being driven.

Lifts stored under the van require modifications to the exhaust system, gas tank, etc., depending on the make of the van. Only the pump and motor are located inside vans using under-the-floor lifts.

Platforms may also be different, depending on the lift. There are both solid and fold-in-half platforms. The fold-in-half platform folds to give better accessibility to the doors. Some fold-in-half platform lifts are mounted on a single post.

Be aware of the differences between automatic and semi-automatic lifts. A fully automatic lift will fold, unfold, lower and raise by operating a switch located inside (on the side of the lift) or outside (on the side of the van), and, in most cases, on the dash. A semi-automatic lift requires manual folding and unfolding of the platform. Using a hand-held pendant switch, the platform can be mechanically lowered and raised. You MUST have assistance with this type of lift, as it is designed for passengers who will not be riding alone.

Rotary Lift (or “Swing Lift”)
The platform of this type of lift never folds. Instead it “swings” inside, outside and up-and-down. The rotary lift swings into the van and the lift platform sits on the floor in the middle of the van.

Some individuals like the rotary lift because of the parking convenience. Less room is needed to enter or exit the van. Also, this lift is mounted on one post inside the van. The post controls the swinging action of the lift. One of the drawbacks to the rotary lift, though, is the cross-over bar. On some rotary lifts this bar connects the platform to the swing bar, limiting space for loading and unloading on the platform.

Switches serve very necessary functions in this lift. In most cases there are three switches on the dash. They operate the lift as well as provide an open and close function for the power door openers. The motors fit into or beside the doors and are manufactured to fit only one brand of lift.

Back-up System
You may also want to purchase a back-up system for your lift. Many government agencies require a lift to have a back-up system for use in emergencies. With a back-up system the lift can be manually manuvered and users can exit the van with assistance from an outsider. Most back-up systems are herd to operate alone, so expect to need someone’s help.

Safety Flaps
All lifts have an extension or “curb” at the edge of the platform which is approximately three-to-four inches high. This safety flap is designed specifically to prevent the wheelchair or scooter from rolling past the edge of the platform.

Finally, when purchasing a lift, be sure to check on the use of raised doors. If needed, your lift will have to be ordered for the extended doors. Determine if this is necessary before completing your vehicle equipment decisions. It will help you avoid very costly errors.

Again, be sure to consult the experts at VMi New England Mobility Center BEFORE you buy a wheelchair van or wheelchair vehicle lift to prevent costly and frustrating mistakes.

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ESPN, Ben Affleck To Honor father-son team Hoyt, Yes You Can

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Actor Ben Affleck is set to present an award for perseverance to a father-son team who have competed together in more than 1,000 races despite the younger man’s severe disabilities.

Rick Hoyt, 51, has cerebral palsy and is unable to use his hands or legs. But with the help of a custom-made wheelchair steered by his father — Dick Hoyt, 73 — he’s blazed through finish lines at triathlons, marathons and other endurance events for over 30 years.

Now the duo, known as Team Hoyt, will be honored at the ESPYS, an awards show presented by ESPN highlighting the best in sports for the year. Affleck a Boston, MA native will present the Hoyts with the Jimmy V Perseverance Award at the event July 17, ESPN said.

The Hoyts had indicated that this year’s Boston Marathon would be their last. But after bombs exploded at the event when the men were just one mile shy of the finish line, they vowed to compete again next year. ESPN indicated that the Hoyts’ commitment to race again is testament to the pair’s “determination in the face of adversity.”

“Rick and I are grateful to be receiving this award,” said Dick Hoyt. “Our motto is ‘Yes You Can’ and we strive to always persevere even when others tell you that it cannot be done.”

spinal cord injury rehabilitation program new england

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Spinal Cord Injury Rehabilitation Program

Early rehabilitation treatment is critical to help patients achieve their fullest potential following a spinal cord injury. At New England Rehabilitation Hospital patients learn how to adapt and return to a normal life. Patients learn how to avoid complications and increase independence. New England Rehabilitation Hospital is pleased to offer a primary care practice for individuals with spinal cord injuries. This program provides individuals with spinal cord injury a community based physician that has the expertise and commitment to care for their special needs on an ongoing and proactive basis.

The Spinal Cord Injury Team of experienced clinicians at New England Rehabilitation Hospital may include some or all of the following professionals dependent on the patient’s individual needs:

The Spinal Cord Injury Rehabilitation Team Consists of:

New England Rehabilitation Hospital’s Spinal Cord Rehabilitation Program is designed to help individuals maximize their functional abilities so they can successfully return to the community. This goal is accomplished through development of an individualized treatment plan for each patient by the interdisciplinary staff. New England Rehabilitation Hospital advocates for involvement of the family in all aspects of care, and ensures patient/family education, support and participation in life care planning. New England Rehabilitation Hospital is fortunate to have the Greater Boston Chapter of the National Spinal Cord Injury Association at the hospital. The chapter is an invaluable asset in the rehabilitation and support of individuals with spinal cord injury.

Physiatrist (a physician who specializes in physical medicine and rehabilitation) Board Certified in Spinal Cord Injury Medicine
Psychiatrist
Nurses specializing in 24-Hour Rehabilitation Nursing
Occupational Therapist
Physical Therapist
Speech Language Pathologist
Case Manager
Benefits specialist
Dietician
Other medical specialties to include;
- Neurologist
- Neuropsychologist
- ENT
- Oncologist
- Pulmonologist
- Infectious Disease Specialist
- Wound Specialist

Program Components

The Spinal Cord Rehabilitation Program components include:

24-Hour Rehabilitation nursing to address wound management, pain management, reinforce acquired functional skills, to assist with education of the patient and family.
Intensive and Individualized, goal-oriented treatment plans
Functional Approach to Activities of Daily Living and Community Re-entry
Availability of State-of-the-Art rehabilitation technology to include:
- AutoAmbulator (partial weight support treadmill training)
- Bioness H200 (Functional Electrical Stimulation)
- Bioness L300 (Functional Electrical Stimulation)
- Adaptive equipment for phone, computer and other aspects of communication.
Specialized insurance benefits coordination and management
Family conferences, education and support
Comprehensive case management discharge planning
Nutritional management
Daily Living Skills Training
Community Re-Entry Program
Splinting and Orthotics
Sexual Counseling
Educational Series
Driving Evaluation Program, as well as referrals to vendors for access and training to adaptive driving equipment.
Therapeutic Pool (Woburn only, 96 degrees)
Comprehensive Outpatient Services/Clinics including access to a physiatrist who specialize in the care of individuals with spinal cord injury.

Benefits Management and Coordination

An illness or injury may affect a person’s capacity for returning to work. If one of our patients is likely to be unable to return to work for a short or extended period, New England Rehabilitation Hospital offers the services of a Benefits Specialist to help the patient and family with practical matters of income replacement and health insurance concerns. The Benefits Specialist addresses such matters as: filing for Family and Medical Leave, Short Term Disability, Long Term Disability, Social Security Disability, MassHealth and COBRA assistance. The Benefits Specialist is also able to address social concerns of emergency aid for those persons who may not have worked prior to the injury or illness.

New England Rehabilitation Hospital recognizes the importance of assisting patients back to their homes, communities and places of work. The benefits service is dedicated to achieving those goals by helping patients and families navigate through disability benefits systems and by providing support to patients and families as they go through this often difficult and confusing process. Many patients have commented that they would not have known “where to begin” and that this service completes their overall rehabilitation.

New England Rehab Offers Elder Assist Clinic

New England Rehabilitation Hospital in conjunction with the Senior Resource Center (SRC) now offers complimentary, weekly Elder Assist Clinics in Woburn. These pre-registered private appointments with SRC’s Eldercare Nurse Attorneys help patients and their families with important issues, to include:

How to pay for current and long term health care needs
How to protect your home and your hard assets
Advice on estate planning

These clinics serve as a bridge in helping New England Rehabilitation Hospital patients and their families deal with transition needs for a safe and timely discharge home, to a skilled nursing facility, or an assisted living facility.

Senior Resource Center, Inc. is a full-service eldercare planning advisory group, supporting seniors and their families throughout Massachusetts, and southern New Hampshire.

New England Regional Spinal Cord Injury Center

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The New England Regional Spinal Cord Injury Center (NERSCIC) has developed a long and distinguished history of care, research, education, and service to people with spinal cord injury (SCI) in the New England region. NERSCIC Network headquarters is located at the Boston University Medical Campus, with Network members Gaylord Hospital and Hospital for Special Care located in CT.

The NERSCIC Network serves as an advocate and resource for patients; their families, friends, and caregivers; and health care professionals throughout New England. Our goal is to improve the health and function of people with SCI throughout the lifespan through innovative science and technology in three areas:

1. Consumer-focused Rehabilitation Research, which focuses on topics for people with SCI, such as health care self advocacy training, better ways to measure functioning, and which wheelchairs have the most breakdowns. Learn more about how to participate in studies.

2. Comprehensive, State-of-the-Art Care

NERSCIC offers comprehensive inpatient and outpatient SCI care available through Gaylord Hospital and the Hospital for Special Care in CT.
NERSCIC is leading the development and dissemination of a uniform New England Standard of Care (NESoC) for SCI, a first-ever collaborative effort among area facilities with SCI expertise. Its goal is to enhance learning opportunities for professionals and ensure that all people receive the same level of care throughout New England.

3. Education and Collaboration

In 2012, NERSCIC unveiled a new Consumer Education Program called “Knowledge in Motion,” in partnership with Spaulding Rehabilitation Hospital and modeled after the Stepping Forward- Staying Informed program pioneered by NERSCIC.
The Rehabilitation Research Roundtable joins together leaders of the local SCI community to collaborate on a common research and corresponding service and advocacy agenda.