By Kevin Wallace ATP, CRTS, Rehab Technology Specialist, ATF Medical
Obesity rates are on the rise. Researchers project that by 2030 – just 7 years away – a full 50% of the US adult population will be obese.
This public health issue directly impacts workers’ comp payers. Claims involving obese workers cost three times more than comparable claims for workers of recommended weight, according to a 2010 NCCI Research Brief (PDF). Medical costs continued to mount as these claims aged with costs being four times more expensive at 36 months post-injury and five times greater at five years.
Perhaps even more troubling, NCCI researchers said there is a greater risk that injuries will result in permanent disability when the worker is obese. These injured employees will need bariatric wheelchairs, beds, and other complex rehab technology for the rest of their lives.
While bariatric equipment isn’t a top claim cost driver, it is more expensive than non-bariatric equipment. A 2017 article in Politico priced a mechanical lift that holds up to 600 pounds at $6,000 and its bariatric counterpart was $13,000.
In the early days, bariatric just meant bigger and heavier. It wasn’t even always safer; big doesn’t necessarily mean strong support. It had an institutional look and could be difficult to set up in a home. The original bariatric beds for homes were cumbersome and required using a drill in the person’s home to install an additional brace. Also, these beds came in brown, blue and grey giving them the appeal and appearance of a battleship.
During the past few years, the healthcare industry has adopted an inclusivity initiative. The concept is to remove barriers to access and to promote health and well-being for all people, including patients of all sizes and with all disabilities. Hard-to-maneuver wheelchairs and the old hospital beds were just some of the equipment barriers.
Wheelchairs and other equipment should be considered an extension of the person as opposed to something they’re using or sitting in. The more functional and more aesthetically pleasing the equipment is, the more likely the injured person will use it and overcome access barriers.
Fortunately, bariatric equipment has undergone a major makeover during the past 20 years.
New engineering techniques, materials and manufacturing methods transformed bariatric beds, wheelchairs, bathroom aids, and other equipment. Now we can install a high-low bed with head and foot elevation that looks like a normal bed. Low-air-loss mattresses with a weight capacity of 1,000 pounds come in various widths and styles. Foam borders accommodate sliding board transfers and keep people from rolling out of bed. And to help heal skin conditions and prevent pressure injuries, lateral rotation mattresses remove pressure from affected areas.
Bariatric shower chairs and commodes have wide seats and accommodate heavier weights. Their predecessors looked like something found in a hospital and now some are built on ergonomic principles that work better with the human body and are easier for a disabled person to use.
Lighter bariatric wheelchairs maneuver more easily and are much more aesthetically pleasing. The Series 7 aluminum wheelchair lost 20 to 30 pounds over the years and now weighs in at about 50 pounds, making it easier to take workers’ comp patients outside their home. And there are some chairs that can support 600 pounds in a tilted position so the injured worker can perform or participate in much-needed medically related aids to daily living.
These changes are much more than window dressing. The newer vehicle lifts and wheelchairs make it easier to go out into society, enjoy a play or concert, shop, visit family, attend church, and in some cases, return to work. Engaging in the world like this positively affects a person’s mood and mental health.
With hundreds of products and features, selecting the most appropriate bariatric wheelchair and other products takes careful planning from experts in equipment for people who have disabilities. Ideally, Assistive Technology Professionals, occupational therapists or similar specialists visit the injured worker in the hospital or rehab center to assess their condition and prognosis.
ATPs can look at someone using a wheelchair and tell by the position of their shoulders, hips and overall symmetry of the body if a chair works well for them. In addition, the facility’s clinicians can provide valuable input on the person’s physical and emotional status.
Most important is really listening to the injured worker. What concerns them? Are there pre-injury activities they’d like to resume one day? Are they outdoorsy or did they play sports competitively before the injury?
Clinicians also need to see if it’s realistic to expect the injured worker to regain more functionality as they recover. Have we accounted for the likely changes in the person’s body? Some people’s weight can fluctuate 70 pounds in a month.
If return-to-work is in the cards, the specialists should visit the work site and determine specific needs for that environment. For example, some workers require power chairs at work because of the distances they cover there, while a manual chair suffices for the home.
This investigation leads to informed decisions about the most appropriate type of complex, bariatric rehab technology for a specific injured employee. Also, before recommending a mobility and accessibility solution, the team should collaborate with home modification experts to get things right the first time.
Payers don’t want to buy a power chair and find out it can’t be used in the home. Nor should they pay for construction changes when the right equipment can replace the need for them.
In addition to addressing users’ medical and safety needs, equipment needs to be comfortable and easy enough for them to use. Educating injured workers on its use and maintenance and ensuring a right fit are vital. Nothing wastes money faster than equipment abandonment.
It should also be as aesthetically appealing as possible and easy to use so they aren’t embarrassed to take it out into the world or have visitors to their home. Bariatric or not, wheelchairs and other equipment need to be the right fit and have the right fit. As they are extensions of the user, they need to look and feel good.
About Kevin Wallace
As a Rehab Technology Specialist for ATF Medical, Kevin Wallace sees workers’ comp patients in clinics and through telehealth visits to evaluate their conditions and needs and determine the most appropriate equipment for their unique conditions. He also delivers, sets up, and fits the equipment, educating injured workers and families on its use so they can derive the maximum benefit of the complex rehab technology. Wallace’s role also involves educating other ATF Medical staff on seating and positioning, complex rehab technology, and emerging technologies.
A graduate of East Stroudsburg University in Pennsylvania, Wallace has worked in the rehabilitation field for 33 years. He started with a day program for people with special needs, then worked for Web Medical, where he fit patients for mobility equipment, before joining ATF Medical in 2018.
About ATF Medical
ATF Medical provides all the medical equipment and adaptive housing projects required for a complex workers’ compensation claim.
Specialists assess injured workers and their homes and recommend and implement solutions to foster mobility, independence, and safety. Clinically driven, outcomes-oriented solutions include DME, such as complex rehab chairs, home access equipment, and hospital beds. ATF Medical stays involved for the life of the claim, fitting equipment to injured workers and educating them on its use and care and maintaining and servicing DME for the life of the claim. In addition, the company provides a pressure injury prevention program and efficient, cost-effective home modifications.
Known for its stellar service, ATF Medical takes work off the desks of claims representatives by handling the myriad details of ordering and scheduling and ensuring that work is done on time and within budget. Clients include workers’ compensation ancillary service providers, carriers, employers, and other payers.
Formerly known as After the Fall, ATF Medical was founded in 2001. For more information, visit www.atfmedical.com or call 877-880-4283.