Terry Moakley of United Spinal Association testified on behalf of the Consortium for Citizens with Disabilities at a January 16, 2008 hearing on “Social Security Benefits for Economically Vulnerable Beneficiaries” before the Social Security Subcommittee of the House Ways & Means Committee.

In his testimony, Terry emphasized:

• Serious concerns that Social Security’s proposed regulations will deny claimants the ability to submit additional evidence of their disability at the time of their hearing. Essentially, if a claimant’s disability worsened between the time that they initially filed a claim and the time of their hearing, then they would be forced to begin the claims process from the beginning in order to submit additional evidence of the worsened disability.
• Changes to Social Security programs so that disability beneficiaries who are able to work are encouraged to do so without fear of serious repercussions.
• The need to eliminate the 24-month waiting period to receive Medicare. This critical period of time after a disabling injury or diagnosis can make or break a person - it is simply the worst time to be without continuity of medical care and can have serious medical, financial and psychosocial repercussions.

I find this incredibly troubling - not that Medicare is paying more than internet retail, but that the HHS IG believes that service levels of Medicare suppliers are equivalent to black-hole websites that will drop ship any piece of equipment to anyone without a proper fitting. Does the HHS IG understand how complicated a power wheelchair can be? Do they understand how essential the right wheelchair is to its user? There are many services that cannot be found over the internet which make this comparison ludicrous:

1. Wheelchairs are customized pieces of medical equipment that can be detrimental to the user if improperly fitted. Pressure sores anyone??
2. Medicare suppliers provide a range of services and supports that are unavailable from the comparison’s websites:
   1. Assistance with selection
   2. Customization for the patient’s individual needs
   3. Functional evaluation in the patient’s home
   4. Trial wheelchairs
   5. Wheelchair assembly, training and service
3. Medicare codes are not a reliable indicator of equivalence. Different manufacturers assign the same Medicare code (HCPCS) to a wide range of wheelchairs with varying reliability, quality and performance.

If you would like to see the HHS IG’s full report: click here.

Finally, the folks at Independence Care Systems in New York City have taken issue with the IG’s report. Click here to see their letter to the IG, and click here to see the IG’s response.

Thank you to ICS’ Rick Surpin for taking issue with this report and its conclusions and for bringing it to the Council’s attention through Henry Claypool, ICS Director of Policy.

• Christopher and Dana Reeve Foundation
• Kennedy Krieger Institute
• National Spinal Cord Injury Association
• Paralyzed Veterans of America
• Sam Schmidt Paralysis Foundation
• Miami Project to Cure Paralysis
• Craig Hospital
• Commission on the Accreditation of Rehabilitation Facilities
• National Rehabilitation Hospital
• Shepherd Center
• United Spinal Association
• University of Utah-Rehabilitation Services
• Rehabilitation Institute of Indianapolis
• Keck Center for Collaborative Neuroscience
• Craig H. Neilsen Foundation
• ITEM Coalition
• New Mobility magazine
• American Association of SCI Nurses
• American Association of SCI Psychologists and Social Workers
• American Paraplegia Society and the American Spinal Injury Association.