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Sample Medical Justification – Dynamic Footrests

Sample Medical Justification – Dynamic Footrests

The following are sample medical justification wording for the Seating Dynamics Dynamic Footrests for wheelchairs which may be used in funding documentation, such as a Letter of Medical Necessity. Justifications are listed by features and clinical indicator and a client may benefit from a Dynamic Seating component for more than one reason. In that case, you may combine sample wording to address each application. Justifications should also be customized for a specific client’s needs. These examples do not replace competent evaluation. If you require further assistance with documentation, please contact us for help.

Dynamic Footrests are available in 3 configurations: telescoping, telescoping and knee extension, and telescoping, knee extension, and plantar / dorsi flexion. Justifications are provided for each configuration by clinical indicator.

When ordering Dynamic Footrests for wheelchairs, we recommend you also order shoe holders with straps to secure the client’s feet to the footplates to activate the dynamic movement (available from other manufacturers). You may also consider pads on the medial surface to prevent contact with the hardware, as appropriate. These lateral knee pads are available from Seating Dynamics and the justification for this item is listed below. These items will be justified separately in your funding documentation.

Please Note:

  • Dynamic footrests are not standard footrests (which are considered to be included and paid for with the wheelchair purchase)
  • Dynamic footrests are not a replacement footrest. Replacement parts are considered to be “like kind”, as the original.
  • Dynamic footrests provide function not offered by any “standard” wheelchair footrests by moving in response to client forces (involuntary or intentional). These do not move the leg as a power elevating legrest does.
  • DO NOT ABBREVIATE “DYNAMIC” IN ANY OF YOUR DOCUMENTATION. The reviewer may not know what the abbreviation refers to.

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