Can I get this paid for? Part 2: the DRBi

Michelle L. Lange, OTR/L, ABDA, ATP/SMS

Our last blog provided suggested general wording to be used in documentation to obtain successful funding for Dynamic Seating components. In this blog, we will look at more specific wording for various applications of the Dynamic Rocker Back Interface. The justifications we provide in a Letter of Medical Necessity will vary with the specific dynamic component as well as the individual reasons the client would benefit from this technology.

These examples do not replace competent evaluation. Choose the wording that matches an individual’s specific needs and modify accordingly to reflect a specific client’s needs. I find it helpful to begin with a brief definition, as reviewers are often unfamiliar with this technology. For example:

“The Dynamic Rocker Back interface moves in response to client force and assists the client back to an upright starting position.”

1. For a client who requires a Dynamic Rocker Back to prevent equipment breakage:

  • For the client with a history of equipment breakage:

The Dynamic Rocker Back moves posteriorly in response to client force and assists the client back to an upright starting position. The Dynamic Rocker Back is recommended to absorb forces exerted by the client which have led to equipment breakage in the past and to prevent future breakage. The dynamic components absorb these excessive forces, protecting the wheelchair frame, seating system and hardware from breakage. Breakage may result in the client being unable to use their wheelchair and/or seating system until repairs are made.

Or

  • For the client who does not have a history of equipment breakage, but has the potential to break equipment:

The Dynamic Rocker Back moves posteriorly in response to client force and assists the client back to an upright starting position. The Dynamic Rocker Back is recommended to absorb forces exerted by the client to prevent equipment breakage. The dynamic components absorb these excessive forces, protecting the wheelchair frame, seating system and hardware from breakage. Breakage may result in the client being unable to use their wheelchair and/or seating system until repairs are made.

2. or a client who requires a Dynamic Rocker Back to absorb extensor forces:

The Dynamic Rocker Back moves posteriorly in response to client force and assists the client back to an upright starting position. The Dynamic Rocker Back is recommended to absorb forces resulting from active client extensor tone. By absorbing and diffusing these forces, extensor tone can be decreased. Reducing extensor tone can increase function, sitting tolerance and conserve energy. Active range of motion at the hips is also provided, reducing risk and progression of range of motion losses.

3. For a client who requires a Dynamic Rocker Back to provide movement:

The Dynamic Rocker Back moves posteriorly in response to client force and assists the client back to an upright starting position. The Dynamic Rocker Back is recommended to provide movement for the client to provide vestibular input, increase alertness, decrease agitation, increase sitting tolerance and increase function.

4. For a client who requires a Dynamic Rocker Back to increase trunk strength and postural control:

The Dynamic Rocker Back moves posteriorly in response to client force and assists the client back to an upright starting position. The Dynamic Rocker Back is recommended to provide movement for the client against resistance to increase trunk strength and improve postural control.

What justification wording have you used in your documentation? Share in our comments section below!

For a Downloadable version of all Dynamic Seating Sample Medical Justification Wording, click here.

One response on “Can I get this paid for? Part 2: the DRBi

Leave a Reply

Your email address will not be published. Required fields are marked *