PAAT CASES

Our PAAT (Protection and Advocacy for Assistive Technology) program helps people understand their rights to use medical devices or technology that can aid them in managing their disability. Collectively this is called Assistive Technology (AT). We help people navigate legal issues such as insurance denials of coverage for AT or related services, access to medical care that requires use of AT, housing accommodations, workplace accommodations, and accommodations in schools. The PAAT program was created in 1994.

Below, we highlight a few of our PAAT cases and outcomes.

Our client had a documented medical need for a cubby bed.

The Cubby Bed® (Sensory Medical Inc) is an enclosed, low height safety bed that features a sensory canopy, padded walls, and sensory equipment such as a camera, microphone and sensory light. Cubby Bed is a class 1 medical device: patient bed with canopy.

The West Virginia Bureau for Medical Services (BMS) would not approve the cubby bed and DRWV was advised by the vendor that BMS' below market pay rate was unacceptable. The Medicaid Act requires coverage of all medically necessary services that are included within the categories of mandatory and optional services listed in section 1905(a), regardless of whether such services are covered under the State Plan. If there are insufficient vendors to provide the service or product or the Medicaid payment is too low to attract sufficient vendors Centers for Medicare and Medicaid Services (CMS) states that "the state would need to develop a payment methodology for the service, supply or equipment, including the possibility that payment may need to be made using a single-service agreement with an in-state provider or an out-of-state provider who will accept Medicaid payment."

DRWV was successful in representing the client to ensure BMS fulfilled its obligations under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program and the vendor promptly provided the medically necessary cubby bed to our client.

The client was in need of a vehicle lift for her motorized wheelchair.

DRWV provided advocacy on client's behalf with the WV Division of Rehabilitation Services (DRS) for her to be provided with a vehicle wheelchair lift to allow her improved access to her place of employment and retain her job.

The client requested assistance with getting his scooter replaced with one that better meets his needs.

DRWV appealed the Workers' Compensation Claim Administrator's decision denying authorization for a heavy duty, zero turn wheelchair then represented the client before the WV Workers' Compensation Board of Review.

The Claim Administrator's decision was overturned and the client now has the heavy duty, zero turn wheelchair.

The mother requested assistance with getting the school to implement the AT device and speech therapy per the client's IEP and provide the client with access necessary AT.

DRWV filed a due process complaint and negotiated a settlement agreement.

A favorable settlement agreement was completed with provisions for updated training and usage of clients AT Communication Device.

The client needed assistance with getting her dentures.

DRWV advocated for client to be taken to obtain her dentures after she had experienced numerous delays in being transported for dental services.

Client was transported to her dental appointments and received her dentures.

The grandmother requested assistance with getting the school to allow the client access to AT devices at home.

DRWV reviewed information on the hearing technology listed in his IEP then attended an IEP meeting.

DRWV reviewed information on the hearing technology listed in his IEP then attended an IEP meeting. During the meeting, we learned that the school was not having the client wear the AT due to it making a loud buzzing noises. DRWV requested that the AT be sent home in order to do homework.

Due to advocacy provided by DRWV, arrangements were made for the AT to be repaired. DRWV successfully advocated for the equipment to be sent home. The grandmother will be trained in how to use the hearing device.

The client requested assistance with getting his hearing aids repaired while in federal prison.

DRWV communicated with the client and the Health Services Administrator at the federal prison regarding the hearing aids.

The client received his hearing aids. He said he had tears in his eyes because he could hear birds singing, which he had not heard in 18 months. He expressed gratitude for DRWV assistance.