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Jumping through the g0v h00pz for a chair again...

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    Jumping through the g0v h00pz for a chair again...

    Finally going to medicare to get my manual chair replaced after doing that route 7 years ago. I had also bought(mom paid) a Colours Spazz G (year earlier2007?) and a Ti ZR (2008) on ebay(i paid) then late 2009 got medicare to get the ZRa. Tore the rotator cuff bad and broke the top('knuckle') of the right shoulder in 2009 so that it was impossible to do surgery to anchor the ligaments as the top was broken but not displaced. It was really really painful just moving, let alone getting in and out of a truck every day. Took months to get pain meds prescribed also. Another story. ANYway, I am very hard on chairs and the Ti ZR was too small from the start but it made it easier to get in and out of the car(which I had to trade my truck in for due to shoulder). Good thing I had a GF at the time who didn't mind getting my chair out and in. Wore out the Spazz, Ti ZR and the ZRa is just about to break frame in 2 different spots. So knowing the headache I finally set the appts and got a chair set on paper. Got a smart drive(I think) and ready to go back on 11 August. Recvd a letter Friday saying I had to pay 950 out of pocket for extras. My sister wrote a check and I took it there today. Had the 'reinforced frame' dropped to save 250, I only weigh 125 lbs 6'2" tall. Paid 500 extra to get a titanium frame vs aluminum, I wear holes in AL quick. They are calling wheel locks an extra(w0w), and refuse to give me the spec sheet of the chair I ordered because I might take it to a competitor and bypass them. <dumbfounded> Haven't EVEN set the process in motion YET. Waited this long to tell me they can't start until I pay the 'extras' up front. Took my sister's check to them and got these words straight from the horse's mouth. I was overjoyed when at Patricia Neal seating clinic she suggested/let me try out the smart drive and COMPLETELY forgot to get a copy of the paperwork then. They gave me one set last time. Pat Neal is great, it's the DME... FF to 4-5 days after 11 Aug, I go to my truck to commence removing back seat and planning for a build on my design to get the chair in and out the back seat area. 2002 Tundra SR5, lots of room. Realize I didn't even know what KIND of chair, let alone dimensions. Been emailing and on phone a few times and all I got was a link to Ti Lite's website lol.

    I am going to lay the blame for this fiasco squarely on my own destroyed shoulders. I used to be smart, tough, might as well throw in good looking while I am lying lol. And would have got the paperwork and kept a keen eye on the entire process. Failed to, is all I can say. Yup, the thought of breathing easier from correct posture in a chair, not having to run over my feet, legs dragging me out of the chair at times, shoulders relieved of some pain by the smart drive...I was seeing Unicornz and butterflies again... call me whUpped
    Now I am back to sweating and worrying if they are competent enough to have gotten the measurements right, push the paperwork through AND get my smart drive OR am I going to be waiting 4 months for a misfit clunker set up for Marvin the Munchkin that I not only have to Duct tape myself in but continue to struggle to breathe from being slumped over and breaking my fingers every push of the Eleventy-seven spoked, tiny wheels. This has even got me to the point of thinking about going to the VA for the very first time and asking my uncle sam, who I kicked out of the family(notice, no caps on his name) after I got out, for help. You KNOW it is getting bad when I think like that. WelP, enough whining about my failures, I am going in here and look around at all the things I own that are non-functional for years, waiting on a chair that I can work out of, a mudhole replaced with concrete to work ON and weather (no rain) to cooperate with me, so I can FIX something a sell it. I think I may be needing to scour ebay for used stuff to scrounge up a mobility device such that I can get back to living like a broken human again. Remember folks, weebles wobble and they DO fall down. It just takes us a while to drag ourselves somewhere and push the chair in front of us, until we can get back in again and start over.
    Wedgie Weeble
    Attached Files
    Last edited by CapnGimp; 29 Aug 2016, 8:51 PM. Reason: Know where your enemy is at all times... :)

    https://www.facebook.com/john.baxter.1213986

    #2
    Ahhh me too! I tried two years ago and yelled stop on the entire thing because they were pushing me for this that and the other and misunderstanding my needs; trying to sell me off-brand wheelchairs and I wanted the Smart Drive then but was told no (since then I've learned they can malfunction a bit on an uneven sidewalk or street and am now leaning towards the firefly). Seven years for me in this chair now .. had to replace the camber bar and the upholstery could sure use replacing. Back will no longer fold down and will break soon. Want to keep this as a back-up though.

    I, too, am looking for a better back ... leaning towards a Jay filled back - no more sling backs!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

    Comment


      #3
      HIPAA gives you the right to that information which is considered part of YOUR Medical Record. So if you ask in writing, they cannot refuse to give it to you.

      You have already given them money so make them give you the spec sheets. Call them and go up the chain of command until you get someone that will give it to you. Also I think you can file a complaint with Medicare. Don't know how good that will work but when I did the same regarding my Part D prescription program, they let me change mid year and allowed me to do it twice. The complaint system does work or did for me with Rocky Mountain Health Plans. So try it and see. https://www.medicare.gov/claims-and-...about-dme.html

      I would be worried too as DME's even the best take advantage of us.
      T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

      My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

      Comment


        #4
        Originally posted by lynnifer View Post
        Ahhh me too! I tried two years ago and yelled stop on the entire thing because they were pushing me for this that and the other and misunderstanding my needs; trying to sell me off-brand wheelchairs and I wanted the Smart Drive then but was told no (since then I've learned they can malfunction a bit on an uneven sidewalk or street and am now leaning towards the firefly). Seven years for me in this chair now .. had to replace the camber bar and the upholstery could sure use replacing. Back will no longer fold down and will break soon. Want to keep this as a back-up though.

        I, too, am looking for a better back ... leaning towards a Jay filled back - no more sling backs!
        What kind of chair do you have now? I still have the TiLite with titanium frame hanging on the wall. I use the back wheels on my ZRa. I also removed the right side seat back, pole cover? pad-doohickey. Don't know the name for it. Everything else is in great shape. I would use it except it is to short for my 6'2' skeleton lol. I can ship it to you if you need it. Doesn't have side guards, I'm using them also.
        It has camber which I do not like, I forget if it is 2 or 4 degrees. The upholstery is still tight and adjustable, both seat and back. I had it maxed out for height and my feet still dragged and it was too shallow, I have long legs. Gimme some measurements and I can set it up. Seat pan is 41.5w x42.5 deep but the tubing sticks out beyond that a bit, it goes to the center of the tubes, and the front curves stick out a good bit beyond that also. Looks like a 90deg front. Fully adjustable seat to footplate@47 right now, seat back height way adjustable and seat back to floor adjustable also. I have 5 inch aluminum casters on the front, to get the footplate up high. It is really made for a shorter person but at the time I bought it on ebay, it was the closest I could get and needed it so I could get it in and out of my itty bitty car lol. Crap, hope we can make it work for ya.
        Attached Files
        Last edited by CapnGimp; 31 Aug 2016, 12:38 AM. Reason: I'm an aspiring editor. I want to work for a Propaganda...err, News outlet.

        https://www.facebook.com/john.baxter.1213986

        Comment


          #5
          Thanks for the info Daisy, I was going to ask again in a few days. Talked to the lady that handles all the paperwork for the 'salesmen', or whatever they call them. I have a name for'em, think 'sticks to seating efficiently', if ya catch my drift. I just hate fooling with people who think they have jurisdiction over MY resources. I have issues from brain injuries, and a tumor on my cerebellum that make it difficult to control my temper, and I get agitated easily. I have had to move away from folks and avoid testy situations. I WISH people would play nice but they seldom do. That's a huge part of the reason I have put this off for so long.

          https://www.facebook.com/john.baxter.1213986

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            #6
            Yeah, they are sticking me with an aero T. I don't know what part of LIGHT he doesn't understand. More tubing = more weight, more interference getting it in and out of vehicles. I showed them the worn spots on front tubing and cracked axle retainer inserts. Somehow, THAT is how he wound up saying I needed frame reinforcement and this style chair. Methinks I am going to have a serious talk with him before he eats up more time ordering what I don't need. Did I mention they IMMEDIATELY pulled out a short(kids?) chair and I had to use it to do the entire exam from? Yep, used my bungee cord to force my sprawling legs to stay inside the frame, both feet dragging the ground(foot drop) and the seat was about a foot deep seemed like. Once again, dumbfounded by the smartdrive, a fancy back that I had to tell them they had upside down, lol. More stuff, but I won't complain here. I just pray I am able to get it all straightened out with this guy. If not, I am going to go to medicare and file a complaint, then look into signing up with the VA for the first time, see if they can help in this lifetime.

            Not mentioning any names, BUT, I parked my truck at THIS place when I was paying for 'add-ons' before someone would even order the 'chair'. I take pictures wherever I go, when I get agitated, my memory kinda goes blank for a while. For the record, lol.
            Attached Files

            https://www.facebook.com/john.baxter.1213986

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              #7
              No that's very kind. I'm in Canada so my employer's benefits will pick up the rest after my federal government pays 75%. I'm good that way ... it's just trying to convince the middle people of what I need. So frustrating!

              Kind offer - but save it for someone in need! You're a good one Captain!
              Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

              T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

              Comment


                #8
                Do they still have a low exercise mat in the room that the OT works in, at Patrica Neal? I used their seating clinic about 10 years ago. To try different cushions I had to transfer to their exercise mat and then back to my chair. The mat was at the least 7 or 8 inches lower than my chair seat height. That didn't make sense me. I got my chair and cushion through Carr, also.

                Comment


                  #9
                  Yes, same one, it's sort-of exam table/place to transfer to. They checked my butt for all the scars to see if I was eligible for a roho I guess. They USED to do a pressure map, didn't see it or a computer in the room. Doesn't seem as in depth as it was before and SHOULD be. They have a new(additional) seating specialist, I was assigned to her. Michelle, the one I had before, was booked up and not there that day anyhow. All in all, not what I expected. As I stated before, I fear it is going to be a mess, four months in the future<rolls eyes back in head>. I wonder whatever happened to SCI_OTR that used to be here? Scanned a few threads and seemed his is no longer here... I think me and you talked at one point many years ago, on here. I lived in Morristown then, you were in Greeneville I believe. It may have been on the wheelchairjunkie.com site.
                  Drove up to Clingman's Dome in the rain today. Sure wish I had a way to the lookout. Took my Bounderplus in a trailer about 12 years ago and spent the day up there. I head for the mountains to get my head cleared, if I were rich I would be living on a mountaintop away from all the hustle and bustle of these one horse towns lol.

                  https://www.facebook.com/john.baxter.1213986

                  Comment


                    #10
                    Yep, I live in Greene County. I think Michele may have been the therapist that evaluated me. Is she blonde headed? I liked her. She was determined to find the right chair and cushion for me. The guy from Carr didn't impress me very much.

                    I haven't been to Clingman's Dome in years or Cade's Cove. I live fairly close to parts of the Appalachian Trail. Before becoming a sitter, I used to spend a lot of weekends hiking around it. It was a good get away. Do you have any trouble finding "shine" there in Newport? That used to be my go to place for it.

                    Comment


                      #11
                      felt it needed smarrrtdriiiive!! in there somewh00rZ...

                      You can find it very easily, I don't drink anymore though. I've got a power chair that I can trust to get me up to the tower now. You up for a trip there? I don't have a trailer but I have a truck. It's hard for me to get the chair in presently, gonna have to work on a way to make it fast, safe and easy.

                      I got a letter from Medicare today, a copy of the one they sent to CARR Rehab about my chair order. says
                      Subject : ADVANCE DETERMINATION of MEDICARE COVERAGE
                      says I met the medical necessity requirements for the K0005 Manual Wheelchair...
                      does not provide assurance that medicare eligibility requirements...secondary payer, etc have been met...
                      Only upon submission of a COMPLETE CLAIM ...make a full and complete determination.
                      Also this decision doesn't extend to the price that medicare will allow for the item...
                      Payment amounts are determined upon receipt of the claim...

                      In addition to approval for the wheelchair base, we have determined that the medical records support the medical necessity for all of the accessories in this request.(smarrrtdriiiive!!)

                      I left out most of the blah, blah, blahs, listing what I determined to be the pertinent statements for someone familiar with the process
                      to tell me, does this mean I get what I THINK I have asked for OR did the DME submit a PORTION of the whole thing to find out if I had medicare like I said...why would they submit a less-than all I asked for claim? Just afraid to get excited at this point. It LOOKS like I have what I THINK they ordered lol. Whether that FITS or not is an entirely different matter.
                      Who can answer these paper-pusher conundrums or who has ever SAW such a thaaang as this?

                      Twisted, inquiring minds(or part of ONE bumfuddled mind) wants to know...

                      https://www.facebook.com/john.baxter.1213986

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                        #12
                        Got my chair on 8 Dec 2016...that's 'I went to the DME and got it'. Not, they set a time to deliver and set it up for me. Started this process in the summer, weeks before my seating appointment at Pat Neal Rehab in Knoxville, TN, the appointment being 11 Aug 2016.
                        Nothing about this went like it should have except for I have the chair, it fits, and Medicaire/Medicaid did a STELLAR job with no hassles, mailing me updates along the way without me asking!!
                        I was worried that it would not fit, it does, making minor adjustments myself as is always needed with a new chair. I have a {states on the frame TRA] [paperwork calls it Titanium upgrade] Aero T with a Ride Java Back Support (regular or short height) version. It is a heavy son of a gun! Much heavier that any chair I have ever had. Twice the amount of tubing that is necessary for a chair. I think the back being so heavy in comparison to standard cloth backs makes it a lot more difficult for me to load/unload it because it throws the balance WAY off. The back wants to go straight to the ground in spite of my trying to wrestle it so it doesn't. I FINALLY found a way to get it to prop up on my door(seatback) and footplate to the ground so it doesn't get muddy and make getting the wheels on, difficult(more). Going to take some getting used to, finding the best way to break it down and set it up. I do a lot of getting in and out so believe me, I am trying different ways lol.
                        Bad weather here so I've only had a few of those days out and about with it. The Smart Drive is like a UniK0rn to me...a maJiKal Beast I took it to Aldis grocery shopping the other day. Made pushing the cart a breeze, no more twisting the spine back pain, wearing out the shoulder connective tissue pain, run-away buggy aggravation, etc. I got to get all I needed(full buggy) and the only grioe was I couldn't get it all in the back seat area of my truck(removed the back seats). Going to have to take containers to organize it next time. I just piled it in and tried to drive like the normal slow-pokes so it wouldn't scatter everywhere...got home and opened the back door and a bunch-0-goodies fell out, one of the glass jars of sauerkraut broke in the mud. I managed to pick it up without bleeding and put it in my Smart Drive box that I had yet to throw away <check> It should be noted here that I was THEN in my new-to-me, powerchair I bought off ebay back in the summer for 250 federal reserve notes. You can't do ANYTHING in a manual chair, especially in 2 inches of mud. No way I am dumb enough to attempt using the SmartDrive in mud. I will only use it in the dry. Gotta make these items last until Jesus returns(soon).
                        The skinny tubes on the frame make it more likely to slip when transferring as I have big hands. All the other chairs I have owned are large diameter tubes. At least it's TI so not as much worries dropping it on pavement/gravel exiting vehicles. About to wear holes in the other Al frames. Neither of which have all 4 wheels touching the ground at the same time. I have straightened them so much that I fear they will break if I do it again. Haven't rode the SpazzG since summer and was REALLY worried about the ZRA I was left solely with. It is paper thin at the front bends on both sides and rocked with one wheel about a 1/4 inch high at anytime. That's really interesting transferring on hills from the truck.
                        The back at some point, I am going to have to make attachment parts a lot lighter for. If it were not so necessary, I would go back to a sling back. It is so nice having correct posture, breathe easier, way less pain from sitting for long periods and not feeling like I am going to fall out of the chair at any given moment(not hanging on for dear life). Didn't realize how bad my posture was until this year, when I saw a picture of me sitting in the chair. The Roho Quad Select and a 3/4 inch foam block for added height under the right read side gets my hips level. Going to take a while to get used to this all, as it still feels like sitting on the side of a hill, the change is so drastic. I got the standard eleventy seven spoked Shadow wheels, with scrawny 1 inch tires that I quickly changed with my Spox so I can have room for fingers between the spokes...REALLY, why would ANYONE make a wheel with 4 zillion spokes so that even LIGHT can't get trough them?? I just changed axles to a pair I had on hand and made a minor adjustment to the bolts for correct fit. I have been using >2 inch wide tires since about 2005 when I made my first trip to the beach since I lived on Galveston and had to be pushed on the sand at the beach (Thanks to many of care cures' finest chair fit instructors).
                        Nothing I can think of at the moment, after rambling on so long. I will measure the tube thickness of this and the ZR I have on the wall to answer a question that arose on another thread, soon.
                        BTW The list of UPGRADE charges that I paid out of pocket for this is as follows
                        Titanium Frame 500 federal reserve notes <--fear of holes in frame acquired@highcost
                        Composite wheel locks 75 federal reserve notes <~~who0oda thUnk brakes were an EXTRA!?
                        Lite speed casters 50 federal reserve notes <--1.5x5 inch I don't live in a castle anymore lol
                        Aluminum side guards 100 federal reserve notes <~~for a hunErT' smackers, I w00da went with wood

                        pictures when the weather changes to good

                        https://www.facebook.com/john.baxter.1213986

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