Sample Medical Justification – Static Head Support Hardware

The following are sample medical justification wording for the Seating Dynamics Static Head Support Hardware which may be used in funding documentation, such as a Letter of Medical Necessity. Justifications should also be customized for a specific client’s needs. These examples do not replace competent evaluation. If you require further assistance with funding documentation, please contact us for help.

Static Head Support Hardware

Seating Dynamics Static Head Support Hardware is being recommended to match the specific head positioning requirements of the client. Other hardware has not retained its position or has broken multiple times (choose one or both, as applicable), leading to a loss of head support and/or alignment or the ability to use the wheelchair. Breakage may result in injury to the client from contact with damaged or broken wheelchair components and or the client being unable to use their wheelchair and/or seating system until repairs are completed. This hardware is designed to be more robust and to maintain position once adjusted.

(Include a full list of past equipment damage).

Sub-occipital Pad Adaptor

The Sub-Occipital Pad Adaptor is used when both a posterior head pad and a sub-occipital pad are recommended. The adaptor does not include head pads.

This wording may be used in conjunction with appropriate wording for the Dynamic Head Support Hardware or Static Head Support Hardware.

To support a sub-occipital pad for postural alignment

A sub-occipital pad provides support at the posterior base of the skull at the sub-occipital shelf. This level of support is used to provide some actual weightbearing of the skull for postural support, to limit neck hyperextension, and to promote a midline position. This hardware is required to support a sub-occipital pad on the Dynamic (or Static) Head Support Hardware.

Spreader Bar Mount

Head Supports are typically mounted using a bracket attached to the back of the seating system. This is not always possible, dependent on the type of back being used. By attaching to the back canes, the head support can be mounted in a precise location to match the client’s needs. The Spreader Bar Mount can be used with both Seating Dynamics Dynamic and Static Head Support Hardware.

Seating Dynamics Spreader Bar Mount is being recommended to mount a head support on the mobility base as (the client has a sling back and standard mounting hardware cannot be used) (the client is using a back that cannot support standard mounting hardware without risk of breakage) (the client needs to transfer the seating system between mobility bases). (Please choose the applicable application).

Lateral Component Hardware

The Lateral Component Hardware is used when a lateral pad or a switch mount by the side of the head is recommended. A separate lateral head pad or switch is required.

This wording may be used in conjunction with appropriate wording for the Dynamic Head Support Hardware or Static Head Support Hardware.

For postural alignment:

The Lateral Component Hardware attaches to the Dynamic (or Static) Head Support Hardware and provides lateral support to the head to limit neck rotation and lateral flexion, encouraging a midline position for improved visual regard, breathing, and swallowing.

For switch mounting:

The Lateral Component Hardware attaches to the Dynamic (or Static) Head Support Hardware and provides mounting for a switch by the side of the head for access to an assistive technology device

(Specify device, such as a speech generating device).

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