Tag Archives: Worker’s Compensation

Putting Amputees Back in the Driver’s Seat

For some people, an automobile is a necessity not a luxury.

To have a full life in America requires mobility -not just the ability to walk or run, but the ability to travel greater distances with more convenience and flexibility than public transportation provides.

For many lower-limb amputees, however, the lack of feet makes driving impossible in a conventionally equipped vehicle. Hand controls along with left foot gas pedals provide the solution. They make it possible for lower-limb amputees and people with other disabilities to enjoy the prosperity and independence that comes with vehicle ownership and use.

Different types of hand controls
Basic hand controls usually consist of a lever attached to a bracket and mounted under the steering column on cars equipped with automatic transmissions. The lever is moved to operate throttle and brakes. Usually the left hand operates the control, allowing the right hand to steer and operate the vehicle’s accessories. The three most common types of hand controls are push/rock, push/twist, right angle pull, and push/pull.

The push rock and push twist hand control works by twisting the handle to apply the gas and pushing it to apply the brakes. The right angle pull hand control works by moving the lever down towards the driver’s lap for acceleration. To apply the brakes, the driver pushes the handle forward towards the front of the car. The push/pull hand control works by pulling on the handle to apply the gas, and pushing for the brakes. Most hand controls, except for a very few, apply the brakes by pushing.

Most hand controls are hand-powered, using linkages or cables to operate the gas and brakes. Some models are power-assisted to make it easier on the hand and arm. Cars are designed for the driver’s foot to operate the gas and brake, so the force required to operate the hand control can be tiring to the hand during long drives. Power-assist options for hand controls range from very complex devices such as an electric joystick, to relatively simple ones that use vacuum power like power brakes. Most hand controls are dual-action devices that permit the simultaneous application of throttle and brake. Dual-action controls are helpful when the car is stopped on a steep hill or when making tight maneuvers on steep grades. The throttle can be applied a little before releasing the brake to prevent the car from coasting backward before moving forward. While most users prefer dual-action, some prefer single-action units because they eliminate the chance of accidentally applying the throttle during braking.

Which is best for you?
The best choice of hand controls for a person depends on a number of factors, such as the car’s layout, expected driving conditions, and the driver’s size, disability, and preference.

Push/twist
Push/twist hand controls are a good choice if either a large driver, a small car, or both, limit space. Economical use of space is achieved because the lever only needs to be moved to apply the brake. Throttle control is achieved by twisting the grip in the same manner as operating a motorcycle.

Push/twist controls provide a precise, sporty feel. By necessity, push/twist hand controls are often power-assisted. Without power-assistance, the twisting motion tends to feel stiff, and the hand tires. With a good quality power-assisted twist control, very little effort is required to maintain a throttle setting; simply resting the hand on the handle should provide enough force. This results in less fatigue on long drives.

Push/twist controls are good in tight turns and on rough roads. Throttle surges, which can be experienced with a push/pull or right angle pull device, as the driver and his or her arm bumps, sways, leans, or lurches going through curves and over bumps tend not to occur with a push/twist. Most push/twist controls are dual-action units.

These controls are not recommended for people with grip problems or those with amputated fingers or hands. Good left-hand dexterity is required for safe driving with push/ twist controls.

Right angle pull
Right angle pull controls are the most widely used form of hand control. They are relatively inexpensive and, usually, easy to install and adjust. Operation is simple and intuitive for these strictly mechanical units.

Space, however, can be a problem. Throttle application requires that the lever be moved down toward the driver’s lap. If the driver is large or the car is small, a push/twist or even a push/pull control may be more suitable. Because the lever is connected to the gas pedal with mechanical linkages, the underside of the dashboard will often require trimming.

For those missing fingers, hands, or with reduced grip strength, various handles, wrist straps, grips, etc., can be adapted for the right angle pull control. Specialized handles can be configured for use with a prosthesis. Right angle pull controls are usually dual-action, but also can be single-action.

Push/pull
Push/pull hand controls are by definition single-action. Since the lever is pulled for gas and pushed for brakes, the gas and brakes can never be operated at the same time.

This is the easiest hand control to learn to use. Senior citizens like the push/pull because there is no confusion when learning, after using the foot pedals all their lives. Power-assisted and non-power-assisted models are available. The driver’s hand can rest directly on the lever without causing the throttle to surge.

As with the right angle pull control, different handles can be adapted to the driver to permit safe and easy operation. Power-assisted push/pull hand controls equipped with handle adaptations are recommended for people with limited arm strength and poor manual dexterity.

Some other factors to consider
When shopping for hand controls, aesthetics is also a factor to consider. Car owners can be surprised to find that a section of the dashboard was cut away during the installation process. Most hand controls are mounted under the dash with a support extending into the driver space under the steering column where the lever is connected. A panel under the dashboard is removed during installation. If the hand control’s design and the dashboard layout permit, the panel can be returned allowing the mounting bracket to be hidden. Sometimes, however, the hand control’s hardware protrudes into the passenger space, and the panel cannot be reinstalled without cutting a window in it. Each installation varies with the model of automobile and the particular hand-control unit. Check with your dealer about what you can expect to see when you get your car back.

Many of us share cars with other family members. It is important that the pedals can still be used with the hand control installed and that there are as few impediments to using them as possible. Most good controls provide room for a pedal-pushing driver. Ask the installer what to expect.

Driving should be fun. Poorly designed hand controls, or a badly performed installation, can cause the driver to be distracted or preoccupied with the control, lead to frustration, and reduce safety. Good hand controls, professionally installed, will allow enjoyable, safe driving.

Installation
No matter what type of hand controls you use, you are making a significant modification to your vehicle. It is, therefore, important to have a trained and qualified person perform the installation.

The installer should cut a minimum amount of the dashboard. The handle should be located in a comfortable position so that the driver can hold on to the hand control and hook a thumb over the steering wheel. This position helps to stabilize the steering wheel and the throttle. The whole assembly should feel solid and sturdy. If the installation is done properly using a high-quality control, driving will be easy and fun.

Everyone is different, and each person is a special case. If you are uncertain about your condition and your abilities, consult a Certified Driving Rehabilitation Specialist (CDRS). A CDRS knows about different disabilities and can advise you about the best solution to your driving needs. Contact a CDRS through your rehabilitation facility or through your local amputee support group.

Whether you are a first-time buyer or already drive with hand controls, it is good to know what is out there and what to look for. High-quality hand controls are available, as are skilled mobility technicians who understand the quality and safety issues involved with their installation.

Spend a few extra dollars to purchase a high-quality product and have it professionally installed. You already have made a significant investment in your vehicle. A quality set of hand controls will surely enhance your driving experience and, above all, your safety.

Adaptive Mobility Equipment Financing Options

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Adaptive equipment describes an installed device, in addition to a structural modification, that is necessary for a person with a permanent physical disability to drive or be transported in a vehicle.

Some equipment not thought of as typical adaptive equipment, or equipment which is not available from the factory, that serves a need to operate or ride in a vehicle for persons with disabilities such as but not limited to: assist handles, keyless entry, keyless ignition switch, lumbar support, headrest adjustment, pedal extensions power seats, remote liftgate opener, running boards, seat belt extenders, seat modifications, and special mirrors may be eligible for reimbursement and require additional documentation. You will be notified if additional documentation is needed such as a letter or prescription clearly describing the permanent physical disability requiring this equipment, prepared by a licensed or certified medical professional.

Factory installed options such as air conditioning, running boards, lumbar seats and power windows are not considered eligible under the terms of the program.

Driving is a privilege for people stroke survivors with limited mobility; it provides a sense of stability in their lives so they can regain their independence. They love the flexibility their adaptive mobility equipment provides, but they often face exorbitant costs when it comes to financing the purchase of the equipment.

“The number one reason people with disabilities don’t have access to adequate transportation is because they cannot afford it.” The good news is that funding assistance to purchase adaptive equipment is becoming increasingly available.

Sources of funding determine a person’s “buying power.” Unlike the financing options provided by original equipment manufacturers, Mobility Equipment Dealers, such as such as ourselves, have access to financing options specifically for adaptive equipment purchases; they offer options and solutions for the customer.

Veterans
The Department of Veterans Affairs (VA) offers grants enabling 100% service related disabled veterans to purchase a new or used modified vehicle and adaptive equipment. Automobile grants are available once in the service member’s lifetime and adaptive equipment grants are available for special equipment that may used more than once. For more information, call 1-800-827-1000 or read the VA’s “Automobile and Special Adaptive Equipment Grants” fact sheet.

State Programs

State Vocational Rehabilitation (Voc Rehab) Agencies may be able to assist with the costs associated with purchasing an adaptive vehicle (or adding adaptive equipment to an existing one) if the vehicle is necessary in order for a person to get to and from work.
State Assistive Technology Loan Programs may also be able to provide assistance to help pay for modifications to the vehicle.
Center for Independent Living (CIL) can provide additional information on programs that may be available in your state.

Government Programs

Medicaid: Medicaid is a jointly administered federal and state program that helps with medical costs for some people with limited income and resources. Medicaid benefits differ by state and are approved on a case-by-case basis when a request for funding is presented through a prior approval.
Medicare: Medicare is a federal program and in some instances they will pay for adaptive equipment following a specialty evaluation performed by a qualified practitioner. For more information, call 1-800-633-4227.
Supplemental Security Income (SSI): SSI offers a Plan to Achieve Self-Support program, or PASS, which helps those with disabilities pay for items or services needed to achieve a specific employment goal – to ultimately return to work.
Internal Revenue Service (IRS): Often sales-tax exemptions on equipment purchases and other out-of-pocket costs can qualify for tax deductions as medical expenses. Contact a tax adviser or get literature from the IRS that outlines the tax code for medical equipment by calling 1-800-829-1040 and asking for publications with extensions 3966, 907 and 502.

Workman’s Compensation:
Your insurance or workman’s compensation policies may also pay for vehicle adaptation. Check with your HR department or workman’s comp. organization for more information.

Fundraisers, Charitable Organizations/Churches
These may not be for everyone, but they can be effective and many people have successfully raised the money to pay for a wheelchair accessible vehicle and adaptive equipment using these options.

Automakers Rebate Programs
Many automobile makers are providing people with disabilities a wide range of rebates and incentive programs to cover adaptive equipment installation. Below is an overview of some programs offering rebates or reimbursements for adaptive mobility equipment.

Ford Motor Company: The Ford Mobility Motoring adaptive equipment reimbursement offers up to $1,000 off for a vehicle modification. You may also qualify for up to $200 for alert hearing devices, lumbar support, or running boards installed on any new Ford or Lincoln vehicle purchased or leased from a U.S. Ford or Lincoln dealer during the program period.
Daimler Chrysler Corporation: Once you have a 2010-2013 Chrysler, Jeep, Dodge, Ram or FIAT vehicle that fits your transportation needs, contact a reputable and qualified adaptive equipment installer to ensure that it can be adapted to meet your needs.
General Motors Company Reimbursement Program: New vehicle purchasers/lessees who install eligible adaptive mobility equipment on their new Chevrolet, Buick or GMC vehicles can receive up to a $1,000 reimbursement for the cost of the equipment.
Toyota: The Toyota Mobility Assistance Program provides cash reimbursement of up to $1,000 of the cost of any aftermarket adaptive equipment or conversion, for drivers and/or passengers, when installed on any eligible purchased or leased new Toyota vehicle within 12 months of vehicle purchase or lease.

The decision to purchase adaptive mobility equipment stems from a need for mobility freedom for people with disabilities, including stroke survivors. The purchase process begins with selecting a reputable dealer to provide the adaptive equipment and installation, locating options to finance the purchase, and ends with insuring the adaptive equipment.

Make sure the after-market mobility modifications are professionally installed by a NMEDA mobility dealer. Once the adaptive mobility equipment is financed and installed, notify your insurance agent with a full disclosure of all adaptive mobility equipment installed in the vehicle.

Make sure your auto insurance company provides coverage for the conversion and adaptive equipment. Make sure you request coverage for “special” equipment, not just “handicapped” equipment.

“Handicapped equipment” covers only basic equipment such as the ramp or lift, not the lowered floor, kneeling system, lockdown system or other adaptive equipment.
“Special equipment” covers the conversion in its entirety. Be sure and send your insurance company an itemized list of every modification (which you can get from the mobility dealership that performed the conversion).

VMi New England Mobility Center is an advocate for mobility and accessibility for drivers with disabilities. If you need help with converting or buying a wheelchair accessible car, truck or van, please contact us at 508-697-6006 info@newenglandwheelchairvan.com

Putting Amputees Back in the Driver’s Seat

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For most of us, an automobile is a necessity rather than a luxury.

Hand Controls putting amputees back in the drivers seat

Different types of hand controls

Basic hand controls usually consist of a lever attached to a bracket and mounted under the steering column on cars equipped with automatic transmissions. The lever is moved to operate throttle and brakes. Usually the left hand operates the control, allowing the right hand to steer and operate the vehicle’s accessories. The three most common types of hand controls are push/rock, push/twist, right angle pull, and push/pull.

Which is best for you?

The best choice of hand controls for a person depends on a number of factors, such as the car’s layout, expected driving conditions, and the driver’s size, disability, and preference.

Push/twist

Push/twist hand controls are a good choice if either a large driver, a small car, or both, limit space. Economical use of space is achieved because the lever only needs to be moved to apply the brake. Throttle control is achieved by twisting the grip in the same manner as operating a motorcycle.

These controls are not recommended for people with grip problems or those with amputated fingers or hands. Good left-hand dexterity is required for safe driving with push/ twist controls.

Right angle pull

Right angle pull controls are the most widely used form of hand control. They are relatively inexpensive and, usually, easy to install and adjust. Operation is simple and intuitive for these strictly mechanical units.

Push/pull

Push/pull hand controls are by definition single-action. Since the lever is pulled for gas and pushed for brakes, the gas and brakes can never be operated at the same time.

Some other factors to consider

When shopping for hand controls, aesthetics is also a factor to consider. Car owners can be surprised to find that a section of the dashboard was cut away during the installation process. Most hand controls are mounted under the dash with a support extending into the driver space under the steering column where the lever is connected. A panel under the dashboard is removed during installation. If the hand control’s design and the dashboard layout permit, the panel can be returned allowing the mounting bracket to be hidden. Sometimes, however, the hand control’s hardware protrudes into the passenger space, and the panel cannot be reinstalled without cutting a window in it. Each installation varies with the model of automobile and the particular hand-control unit. Check with your dealer about what you can expect to see when you get your car back.

Installation

No matter what type of hand controls you use, you are making a significant modification to your vehicle. It is, therefore, important to have a trained and qualified person perform the installation.

Save Big When Purchasing a Dodge Wheelchair Van

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2013 Dodge Grand Caravan SXT VMI Northstar DR552571 front right side
You’ve found the ideal Dodge wheelchair van to meet your needs and now it’s time to determine exactly how you’re going to pay for the vehicle. Here are some things you can do to improve the buying experience.

Are You Purchasing from a Dodge mobility dealer?

If you’re buying a new Dodge wheelchair van, you’ll want to consider these pointers before you even think about opening your wallet.

Time is everything.
You can get the best possible prices on a vehicle in the last two weeks of December and between July and October. If you can hold off on a purchase until one of these date ranges, you’ll pay less.

Do your research.
You can pay less for a new vehicle if you do your homework. Know what other dealers are doing and seek out the best possible deals. Knowing what’s happening in the market can give you real negotiating leverage.

Don’t limit your choices.
You don’t need to restrict your choices to the vehicles on the lot. You can have a mobility dealer order the wheelchair van you want and those vehicles that come from the factory shouldn’t cost you a penny more than the ones that are already at the dealership.

Are You Purchasing from an individual?

Paying for a used Caravan, Grand Caravan sold by an disabled individual or caregiver can pose a few unique challenges. Keep the following advice in mind:

Be careful with cash.
Unless you personally know the seller, you should be cautious about showing up anywhere with a large quantity of cash on your person.

Be prepared to pay with a cashier’s check or money order. Many individual sellers will be wary about accepting a personal check from a buyer.

Stay away from wiring money.
Don’t utilize services like Western Union or Moneygram to buy a used wheelchair van. These outlets are often used in fraudulent activity and may not provide you with adequate protection.

Exercise caution.
If you’re considering using an escrow or shipping service when paying for your Dodge wheelchair van. Many people have lost their money due to criminal behavior on the part of those claiming to offer a legitimate service.

Are You Paying for Dodge Wheelchair Van Conversion?

Buying the underlying vehicle may only be part of your plans. If you’ll be paying for modifications, as well, consider the following:

Look for assistance.
Your state’s Department of Vocational Rehabilitation or development services offices may have a program to provide financial assistance for wheelchair van conversions. The Veteran’s Administration may be able to help vets qualify for funding.

Check with your insurance.
Depending upon your personal situation, you health or worker’s compensation insurance may provide benefits that will pay for part, or all, of the necessary modifications. Thoroughly investigate the opportunity.

Talk with your Dodge dealer.
Some dealers can actually wrap the financing of your mobility package up with your vehicle loan. You’ll end up with a single payment and you may save money on the interest rate in the process.

Get a prescription.
If you can get a doctor’s prescription for your planned modifications, you may be able to exempt the expense from sales tax. If you’re not responsible for those taxes, you’ll be spending less money.

Buying a Dodge wheelchair van requires a little bit of planning, thinking and investigation. If you follow these recommendations, paying for a Caravan, Grand Caravan or Sprinter should be more enjoyable and less expensive.

Paying for Toyota Wheelchair Vans

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Toyota Wheelchair Van Payment Considerations
You’ve found the perfect Sienna. Now you need to think about how you’re going to pay for your Toyota wheelchair van. Different situations call for different actions. Here are some tips that can help you make the payment process easier whether you’re working with a dealer, an individual seller or need to pay for additional wheelchair van modifications.

When purchasing from a Toyota mobility dealer, you want to take smart actions that will protect you against paying too much for your wheelchair van. Here are a few ideas:

Buy at the right time.
Did you know that you can get the best deals during the last few weeks of the year and during the months of July through September? Prices tend to be lower during those periods.

Resist the extras.

Your Toyota dealer will undoubtedly offer you extra features and protections. Some may be great investments. Others may be unnecessary. Be smart and resist sales pitches for the extras you don’t need.

Know the market.
Investigate what other dealers are doing and what is happening overall in the marketplace. Knowledge is power. That information will protect you from paying too much and can help you negotiate the best possible deal.

When purchasing your Toyota wheelchair van from a private seller, you’ll want to use a cashier’s check from your bank or a money order. This protects both parties and avoids risks associated with the three most common alternatives.

Sellers don’t want your personal check. You’re not the only person who will want to make paying for your Toyota wheelchair van safe and convenient. The seller will be interested in protecting himself or herself, too. A personal check requires a leap of faith on the part of the seller. He or she probably won’t take it.

Cash is too risky.
You don’t want to pay for your vehicle in cash. It doesn’t create a paper trail and it’s simply unsafe to visit someone you don’t really know with a large quantity of cash on your person.

Moneygrams and Western Union are not a good idea. These services exist so that people who know one another can send money in a pinch. They’re poorly designed for transactions like this. Additionally, these services are frequently used by those who are less interested in getting you a nice Sienna and more interested in robbing you!

Paying for your Toyota wheelchair van may be only part of a bigger picture. You may also need to pay for conversions to the vehicle in order to make it a perfect wheelchair van for you. Here are a few considerations to keep in mind when paying for conversions.

Look for “free” money.
Before you spend your own money on conversions, find out if you’re eligible for any government assistance. You should also check with your health insurance or worker’s compensation insurance to find out if your situation will compel them to pick up part of the overall modification bill.

Work with the dealer.
In many cases, your Toyota dealer can include the costs associated with wheelchair van modifications into your auto loan. That leaves you with only one monthly payment and may allow you to finance equipment and conversion services at a lower interest rate.

Visit your doctor. See your doctor and find out if you can get a written prescription for your wheelchair adaptations. If you have a prescription, you may be exempt from paying sales tax on your conversion.

Following recommendations like these can make paying for your Toyota less expensive and more convenient.