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D's Wheelchair Locks

D's Wheelchair Locks

Mounted to your wheelchair and wheel set, D's Wheelchair Locks are a positive wheelchair wheel lock. With D's Wheelchair Locks, all it takes is a simply lever flip to set your wheels in a fully locked position, and they will not turn for anything. Make it easy on yourself and order D's Wheelchair Locks from Sportaid, where you can select your wheelchairs make/model and the make/model of your wheels, and know you will get a great deal.

Note: D's Locks will not fit Quickie DT, or Quickie Revolution.

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Stock# DS-LOCKS
 
Retail: $399.00
Cost: $359.00
 
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Client: John Doe

D.O.B.: 10/26/1965

 

Diagnosis: Spinal Cord Injury

 

Sample Letter of Medical Necessity

 

Dear Medical Reviewer,

 

John Doe is a 47 y/o male with Spinal Cord Injury. His condition is characterized by __________________________________________.

 

John Doe is unable to ambulate to accomplish his mobility related Activities of Daily Living (ADL's).  He requires the use of a manual wheelchair to accomplish these types of tasks while in a seated position. 

 

I am writing this letter to provide documentation to show medical necessity for the following item:

 

D's Locks

It is widely accepted that a large number of wheelchair related injuries occur when  individuals in wheelchairs attempt to transfer to or from their wheelchair. Typically, these falls happen when the wheelchair user fails to, or is physically unable to engage the standard wheel locks.

 

With D’s Locks, the danger of wheelchair movement and slippage during transfer is almost entirely removed.  They are a basic safety item for the wheelchair and are medically necessary to prevent falls from the wheelchair and prevent injury.  D’s Locks are durable and secure.  Simple operation allows for total control in wheelchair stability, significantly minimizing the inconvenience and threat of injury during transfer associated with the use of standard wheelchair brakes.  These safety benefits translate into increased freedom and peace of mind, decreasing the dependence on others.

 

Since John Doe has fair to poor static trunk control, he requires D's Locks.  D's Locks can be activated with a single hand and one lever locks both wheels simultaneously.  Unlike standard push-pull or scissors style brakes, D's Locks can be conveniently located on the wheelchair frame to maximize accessibility.  D's Locks can be activated with minimal bending of the trunk.   D's Locks are necessary to allow John Doe to safely lock his wheels for transfers and other essential daily living requirements.

 

Since John Doe has fair to poor dynamic trunk support he requires D's Locks.  D's Locks can be activated with a single hand and one lever locks both wheels simultaneously.  Unlike standard push-pull or scissors style brakes, D's Locks can be conveniently located on the wheelchair frame to maximize accessibility.  D's Locks can be activated with minimal bending of the trunk.  D's Locks are necessary to allow John Doe to safely lock his wheels for transfers and other essential daily living requirements.

 

Since John Doe has tricep weakness, he requires locks that are easily engaged.  D's Locks can be activated with a single hand and one lever activates both wheels simultaneously.  The locking mechanism is easier to engage compare to push-pull or scissors style brakes.  D's Locks are necessary to allow John Doe to safely lock his wheels for transfers and other essential daily living requirements.

 

Since John Doe has weakness in his wrists and limited hand control, he requires locks that are easily engaged.  D's Locks can be activated with a single hand and one lever activates both wheels simultaneously.  The placement of the locking lever will also facilitate additional benefit as he will be able to activate the lever using his "special spot" on his arm/wrist.  The locking mechanism is easier to engage compare to push-pull or scissors style brakes.  D's Locks are necessary to allow John Doe to safely lock his wheels for transfers and other essential daily living requirements.

 

Since John Doe has a weakness in his left (right) arm, he requires locks that are easily engaged with his right (left) hand.  The D's Locks locking lever can be mounted on the right (left) side to accommodate his needs. D's Locks can be activated with a single hand and one lever activates both wheels simultaneously.  The locking mechanism is easier to engage compare to push-pull or scissors style brakes.  D's Locks are necessary to allow John Doe to safely lock his wheels for transfers and other essential daily living requirements.

 

Since John Doe is a left (right) arm amputee, he requires locks that are easily engaged with his right (left) hand.  The D's Locks locking lever can be mounted on the right (left) side to accommodate his needs. D's Locks can be activated with a single hand and one lever activates both wheels simultaneously.  The locking mechanism is easier to engage compare to push-pull or scissors style brakes.  D's Locks are necessary to allow John Doe to safely lock his wheels for transfers and other essential daily living requirements.

 

D’s Locks are hub locks for manual wheelchairs. They take the place of either push-pull or scissors style brakes currently offered.  D’s Locks work independently of the tire by locking the wheel at the hub.  Tire types and air pressure no longer matter. Wheels can be locked securely in place, regardless of tire condition.  They mount completely out of the way, so thumbs stay intact.  Additionally, the brakes are no longer the widest part of the chair.  D’s locks typically add no width to the chair, and wheels can be taken on and off with the locks engaged.

 

D's Locks was assigned the Medicare HCPCS code (E2228 - Manual Wheelchair Accessory, Wheel Braking System and Lock, Complete, Each) to use to bill the four Durable Medical Equipment Medicare Administrative Contractors for this product.

 

The above item has been determined to be medically necessary for John Doe and are in no way for his convenience.  Thank you in advance for your anticipated approval of this much needed item for John Doe.  Please feel free to call me if you have any questions.

 

Sincerely,

 

 

______________________________________

Jane Doe, PT/OT

 

 

 

I have read and agree with the justification of medical necessity for the above described durable medical equipment.

 

 

______________________________________

Physician Name (print)

 

 

______________________________________

Physician Signature

 

 

_____________________

Date