Initiating The Referral

The insurance carrier and case manager begin the process by determining the future needs of a patient, including the best mode of transportation--van, truck or car. A referral is issued to a catastrophic care company to identify the best and most cost effective options available for the individual. Once the referral is received, the company assigns a dedicated rehabilitation specialist who is highly trained in streamlining and coordinating the often complex process of vehicle modification. The specialist familiarizes him or herself with the specific case and patient, facilitates all phases of the modification from start to finish and serves as the primary contact for all parties involved. He or she also takes care of contacting a certified driver rehabilitation specialist near or within the injured patient's own community to arrange a personal evaluation.

Evaluating Needs

Driver rehabilitation specialists, certified by the Association of Driver Educators for the Disabled/Association for Driver rehabilitation specialist (ADED), plan, develop, coordinate and implement services for individuals with driving disabilities. They are selected from the ADED national database based on their proximity to the patient's residence. Through the specialist, ADED provides the disabled or injured with the ability to drive safely while acquiring and maintaining independence. ADED members perform comprehensive driver evaluations, determine required modifications, advise about which vehicle would work best and ensure that drivers are appropriately trained.

Before choosing a vehicle, the specialist begins the critical process of assessing the patient's medical history, current condition and future prognosis. Equally important to take into account are the person's mental, emotional and physical abilities. A sampling of key areas reviewed in the evaluation include:

Lifestyle considerations must also be carefully weighed. Will the adaptive vehicle be used to transport passengers such as children, family members or caregivers? Will the recipient be driving the vehicle, be a passenger, or both? Throughout the evaluation process, the driver rehabilitation specialist works closely with the individual to gauge the most appropriate vehicle to fit his or her physical and emotional comfort level, as well as that which will best support increased mobility and optimum quality of life.

After the assessment process has been completed, the rehabilitation specialist provides a detailed and itemized price quote to the insurance carrier, including make, model and year of the vehicle recommended, as well as necessary adaptive equipment and modifications most suitable to meet the individual's specific needs. Once the insurance carrier provides a signed authorization, the process of securing a vehicle and arranging for the adaptive equipment gets underway. The rehabilitation specialist provides a document, much like a prescription, that a mobility supplier will follow to modify the vehicle.

Selecting the Right Vehicle

Driver rehabilitation specialists now have more automobile manufacturers to select from when determining the vehicle to best meet the individual's personal and adaptive equipment needs. Chrysler, Dodge, Ford, General Motors and Toyota are all qualified National Mobility Equipment Dealer's Association (NMEDA) members with more manufactures seeking approval to become approved vendors. As recently as two years ago, Chrysler and Dodge were the only manufacturers. While others have received certification, these two companies continue to lead the industry and are the only manufacturers with production lines dedicated to vans used for mobility conversion.

Since not all vehicles meet the design and construction standards for adaptive equipment, it's important that specialist use only certified dealers. Vans are primarily selected because they best accommodate wheelchairs and lifts that require lower floors and elevated roofs. Having larger access areas to enter and exit the vehicle and maneuver within makes it easier for drivers. Vans also allow for safety and stability due to the added weight of equipment.

Determining the Right Adaptive Equipment

The options for adaptive equipment and vehicle modifications are nearly as limitless as the spirits of the disabled individuals they are designed to serve. Some of the more frequently installed items include:

This assistive technology is available for all injury levels and is constantly evolving. Case managers may find it helpful to attend mobility conferences, speak with experienced equipment specialists or visit showrooms in order to ensure they understand and have access to the most advanced equipment available to keep pace with patient needs and emerging products.

Choosing A Qualified Mobility Supplier

The first rule of thumb when selecting a supplier is to choose one that is certified. The National Mobility Equipment Dealer's Association (NMEDA), a non-profit trade association, is the national organization that governs vehicle modification suppliers. The organization's goal is to increase independence for people with disabilities through the provision of safe, adaptive transportation.

NMEDA actively establishes and reviews guidelines enhancing the quality of adaptive equipment installed nationally; operating and maintaining an accredited Quality Assurance Program (QAP) for the mobility equipment industry. Members adhere to the safety standards of the National Highway Traffic Safety Administration, agreeing to follow all guidelines in meeting or exceeding standards of excellence set forth by NMEDA in order to become part of the list of approved vendors to supply mobility services and products. A supplier with a QAP designation is considered a leading expert in van and vehicle adaptation and assures an installation that follows the highest industry standards. The Rehabilitation Specialist works with NMEDA members within the injured parties' geographical area to supervise the vehicle modification process.

Completing the Process Through Delivery and Training

Delivery time varies based on extent of modifications. Many providers across the country stock a fleet of vans available for adaptations. If the supplier has immediate access to a van, delivery is made in as little as one week to one month. If the van is ordered directly from the manufacturer, delivery is anywhere from three to six months.

When the individual receives the van, the driver rehabilitation specialist works with the drivers and caregivers to help orient them to the vehicle and equipment. Instruction and training for various traffic conditions must be provided to both new and experienced drivers to assure that they know how to safely operate the new adaptive equipment. Off-road instruction offers drivers an opportunity to familiarize themselves with the vehicle, helping build comfort and confidence under the instruction of a qualified driving instructor.

Many catastrophic care companies take extra steps by measuring a person's satisfaction with the van through surveys mailed 30 days and one year after van delivery. The rehabilitation specialist share responses with the driver rehabilitation specialist and mobility supplier involved in the vehicle modification. This valuable feedback helps providers enhance products and services to better provide future modifications. If the patient is not satisfied, corrective action is taken to assure any problems are resolved quickly.

Measuring Results

Case managers quantify successful outcomes based on medical, financial and quality of life criteria. Van modification programs exist to help bring an enhanced quality of life to the disabled individual. A sense of emotional well being, positive self worth and independence are priceless factors that can't be measured in financial terms. As the disabled gain accessibility to mobility, they're able to live more productive and fulfilling lives.