Leroy needs a power assist system added to his wheelchair to support his disability. The add-on will allow him to travel medium to long distances, increasing his independence and mobility.
Would we typically fund this?
Yes, we would typically fund wheelchair modifications for Leroy as they likely meet the NDIS funding criteria.
He will need to provide evidence, such as a report from an occupational therapist, to show the equipment:
- is appropriate
- is value for money compared with alternatives
- relates to his disability support needs.
Why would we fund this?
To work out whether Leroy’s wheelchair modification is reasonable and necessary for him, we think about the information he gave us against the NDIS funding criteria.
To do this, we need evidence or information that shows the wheelchair modification is a reasonable and necessary support for Leroy.
This evidence needs to show a number of things:
- Why he needs the wheelchair modification.
- Why the modification is appropriate for him.
- How the modification relates to Leroy’s disability support needs, such as a report or written evidence from a registered therapist. We may already have this information.
- The wheelchair modifications can be properly installed and safely operated.
- How the wheelchair modification is value for money. This includes evidence or information to show the cost of the proposed option is reasonable in relation to its benefits as well as the cost of alternatives, and the support is fit for purpose. We will also look at evidence or information about whether the modifications are likely to increase Leroy’s independence and reduce the long-term cost of other supports, such as home care support hours or supports that help him access his community.
- How the wheelchair modifications are effective and beneficial in helping Leroy move around, but not significantly reduce his fitness or ability to travel (e.g. transport the wheelchair in a car or on the bus)
- How the wheelchair modifications help him take part in social and economic activities.
What don’t we fund?
We won’t fund extra items that are not reasonable and necessary. Leroy may however choose to pay for these with his own money. This might be if he wants:
- a particular brand, model or design of an item
- special features not related to his disability needs.
Billy is 9 years old and has congenital muscular dystrophy. While he can walk indoors, he needs a power wheelchair for medium to long distances. Billy’s therapist says Billy is expected to experience more loss of mobility and will need to use a power wheelchair for all activities within 2 years.
Billy is outgrowing his current wheelchair and has asked for funds to replace it. He hopes to actively participate in sports such as basketball and power soccer.
Billy supports his request with a therapist report recommending we fund a new power wheelchair with custom seating, posterior tilt and extra features such as seat elevation, recliner capacity and leg elevation.
In principle, based on available information, this request meets our NDIS funding criteria. Billy has previously had a wheelchair with custom seating and a power tilt. We need more information, however, to work out if the extra features of seat elevation, recliner capacity and leg elevation will:
- be effective and beneficial
- meet Billy’s current and future needs.
To support the request, we need written evidence of a successful trial that shows whether the extra features are effective for Billy’s:
- current and future needs
- range of motion and strength measurements.
The trial also needs to show:
- how the extra features improve Billy’s function when using them
- whether Billy needs supervision to operate the elevated seating or reclining function
- any expected outcomes Billy is more likely to achieve relating to these extra additional features.
To work out whether the funding for the additional wheelchair modifications are reasonable and necessary, the planner considers the information Billy gives us against the NDIS funding criteria. Doing so the planner thinks about things such as:
- the benefits of the requested power wheelchair add-ons in meeting Billy’s desired outcome
- whether the wheelchair is value for money based on Billy’s continued growth and future support needs, as well as the cost compared to other mobility options
- other services available, such as variations to his care support hours, which may also achieve the desired outcome
- if there is enough evidence the extra features will substantially improve Billy’s life stage outcomes, reduce his need for different kinds of supports and be of long-term benefit.
In Billy’s case, following the trial, the planner decides the proposed modifications are likely to:
- meet Billy’s support needs
- represent value for money
- be safe when operating the wheelchair
- be the most suitable option.
The planner assesses Billy’s request for a power wheelchair with custom seating, posterior tilt and the additional features of seat elevation, recliner and leg elevation as reasonable and necessary. We approve funding for this in Billy’s plan.
Billy then gets written advice from his therapist to help him buy the right power wheelchair. He works with his therapist to learn how to use his power wheelchair safely.
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