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Topic: What health promoting activities/community resources are available…
Topic: What health promoting activities/community resources are available for individuals who use wheel chairs?
Subtopic: Physical Support Resources
The Case
Mariana Esposito is a 48 year old paraplegic women due to a spinal cord injury sustained for a boating accident in her teens. She is still able to use her arms and hands. She uses a wheelchair.
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What is the insurance coverage for assistive technologies like powerchairs and what is the physician's role?
The Case
She is experiencing gradual pain in her shoulder from overworking her arms when transferring on and off the wheelchair and pushing herself for a long time. She has likely sprained her rotator cuff as a result.
She has had her current wheelchair for 8 years. Her shoulder makes it difficult to maneuver and it is not as comfortable with her weight gain, but she wants to continue to live independently.
Mariana has employer sponsored insurance. She is not sure if her insurance will cover a powerchair or other assistive technologies.
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Physician's Role (5)
Legal Obligations
Legal obligations for physician's treating disabled patient's are discussed under the ADA which was amended in 2008.
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The practice must make reasonable changes to policies, physical space, and the procedures when necessary to accommodate the patient's needs.
The ADA requires that disabled patients be seen in the most integrated space. They should not be seen in a separate or special clinic.
Ethical Obligations
Physician's have an ethical obligation to help all patient's equally. I think the role that a physician has in helping a patient with disabilities beyond their legal obligations is a choice that is made by them.
The extra steps that a physican takes to help a patient look at insurance coverage is not one that is mandated, but rather expected.
Sources
- Oak Hill Adaptive Sports and Fitness. https://sportsandfitness.oakhillct.org/
- Achilles International Connecticut. https://www.achillesct.org/
- Field, M.J.; Jette, A.M. The Future of Disability in America. Institute of Medicine Committee on Disability in America. 2007. ISBN-13: 978-0-309-10472-2.
- Disability Benefits. Social Security Administration. https://www.ssa.gov/benefits/disability/qualify.html
- Agaronnik ND, Pendo E, Campbell EG, Ressalam J, Iezzoni LI. Knowledge Of Practicing Physicians About Their Legal Obligations When Caring For Patients With Disability. Health Aff (Millwood). 2019 Apr;38(4):545-553. doi: 10.1377/hlthaff.2018.05060. PMID: 30933590; PMCID: PMC7083130.
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