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The decision whether to get a wheelchair for the first time is generally accompanied by emotional overlays such as the feeling that sitting in a wheel chair is giving in. However, the decision whether to use a chair is simply about the decision whether to use technology to increase your mobility and freedom.

In addition to considering the type of chair you will need, give some consideration to the options and choices that are available and which may be important to you. It can help to use a team of people to assist in making the decision.

To get an idea how a chair you are considering will work for you, look for a dealer who will lend or rent you a demo. If you can't find such a dealer in your area, perhaps a local disease specific nonprofit organization has or knows of a chair that isn't being used that you could borrow.

Health insurance generally pays for wheelchairs. Proof of necessity to accomplish activities of daily living is generally required for an insurer to pay for an electric wheelchair.

If money is a problem, free or low cost chairs are available.

NOTE: If the doorways where you live are too small for a wheelchair, consider installing offset door hinges. They can add an extra few inches to the doorway.

For additional information, see:

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Deciding To Use A Wheelchair

Deciding that the time has arrived to start using a wheelchair can bring all sorts of emotional reactions to the surface. It may come as a recommendation from your doctor or physical therapist, or it may be something you consider as you find walking and moving about becoming more difficult and limiting.

Avoid internalizing some of the messages you may associate with wheelchair usage:

  • You are NOT giving up or surrendering. A wheel chair can be an expansion of your capabilities, not a restriction. You will be able to do more and go further with the assistance of a chair. Most people find that a chair gives them more freedom, not less.
  • You are NOT deciding you will never walk again. You may initially use the chair intermittently or only under certain conditions where or when walking is particularly difficult or tiring.
  • Your muscles do NOT have to atrophy and become worse from lack of use. Exercise can still help you maintain what strength and muscle tone you have.

If you find yourself emotionally torn during this decision, ask your doctor or physical therapist to refer you to a mental health specialist to help deal with those issues.

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More Information

Mental Health Professionals

Power Chair Or Manual

Deciding whether to use a manual or power chair is often the easiest of the decisions that need to be made.

Generally, unless absolutely necessary for your immediate needs, it is advisable to start with a manual chair. If your mobility is expected to deteriorate over time, such as generally happens with ALS, it may be advisable to start with a power chair even though you do not currently need one.

Power chairs:

  • Are expensive. Power chairs can run as high as $10,000 or more depending on the features.
  • Have to be shown to be "medically necessary" to be covered by insurance (Including Medicare). Given their high cost, your needs will be examined carefully before coverage is authorized.
  • Are more difficult to transport than non-power chairs. To accommodate the power source and movement mechanism, power driven wheel chairs are heavier and bulkier than manual chairs. They may require you to modify your vehicle or purchase a special one for transporting.
  • Require maintenance. The power must be regularly recharged and, as with most transportation devices, there are moving parts to wear out and break.
  • Can be liberating. For the person who needs one, power chairs can be very liberating, allowing you to resume activities that you thought you were too disabled for.

If you decide to purchase a power chair, the seller can help with an insurer's required paperwork, including gathering necessary information, completing forms, submitting the forms on your behalf and following up as needed.

To assist with the purchase of a power chair there are many sites that provide in-depth information and assistance. If you type "power wheelchairs" into most major search engines, you will find hundreds of sites, many of which are operated by manufacturers. A few sites to note are:

Assess Your Needs

Before thinking about a specific chair (see below), give some thought to your specific needs in a chair.


Consider the following subjects in your home, your workplace, homes of friends or relatives and other places in which you spend a lot of time.

  • How wide are the doors and halls?
  • Are there narrow sharp turns that may make it difficult to get around?
  • The bathrooms:
    • How large is the largest one that will be accessible to you?
    • Is there space to turn around?
    • How easy is it to reach the toilet? The tub?
    • How high is the sink?
    • Will the door close with you and the chair in it?
  • How high is the underside of each table you use? Each desk you use?
  • How high are shelves and cabinets that you want to access?
  • What surfaces will you move over? Are they all wood? Some carpet? Any deep shag?
  • Is the outside terrain paved? Grass? Are there gravel paths?


  • If you drive:
    • Is the vehicle a car? Van? Two-door? Four-door?
    • How large and convenient to use is the trunk or other storage area?
  • Do you use public transportation?
    • If so, what type?
    • How accessible is vehicle to a person in a wheelchair?

Other factors to consider

  • What hobbies, type of work, exercise or other activities should be considered when choosing a chair?
  • What is your level of physical activity? How does that impact the kind of chair you should consider?
  • What is the importance of appearance of your chair?
  • What particular features do you need (see below) or what accessories are important to you?

What will your insurance pay for?

  • If you have Medicare or private health insurance, a prescription from a physician will be required before there will be coverage. To get payment for a chair that is more than a standard chair with standard features, your medical team will have to show the "medical necessity" of the more costly items.
  • If your insurance won't pay for what you need, can you qualify for other health coverage?

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Types Of Wheelchairs

There are many types of models of wheelchairs that are made to meet many different needs. The three primary styles are:

Standard Wheelchair

This is the most common and least expensive of chairs. It weighs between 40 and 60 pounds, has a folding seat (sling seat) with a folding backrest. (Typical cost: $500 - $1,000*)

Lightweight Wheelchair

This chair is similar in size to the Standard chair. However, since it's built of lighter weight metals, it usually weighs no more than 30 pounds. These chairs tend to roll easier than Standard chairs on carpeting or gravel. They can take longer to open and fold as they are designed to be more rigid due to their light weight. (Typical cost is $1,000 or more*)

Ultralight Wheelchair

These chairs are made from the same metals used to build aircraft. They are very strong, but extremely light, often weighing half that of the standard chair or less. Their light weight makes them the easiest of the group to pick up and stow in vehicles. Because of their light weight, these chairs may take some practice to maneuver. They move faster because they move with such less effort. Also, there is a tendency for the front wheels to lift when going up a ramp or incline if you are not familiar with their lightness. These chairs tend to cost about twice what a Standard chair costs. (Typical cost is $1,500 - $2,000*)

*Typical costs shown are general. Prices can vary substantially depending on your geographical location, who is paying for the chair, and other factors.

Specialized Chairs

These chairs are made for a wide variety of special needs. There are racing chairs, sports chairs, beach chairs, and almost any other chair that someone may have a need for. (Typical cost is expensive to very expensive)

Wheelchair Options

Wheel chair options include:

Cushions: Padding in the seat of the chair. Cushions not only provide comfort, they also enhance circulation and help prevent problems with pressure and posture. Choices include:

  • Air Cushions: Filled with air, they are lightweight, relatively low cost and may help prevent pressure sores.
  • Foam Cushions: Lightweight and low cost, they are not as effective in preventing pressure sores.
  • Gel Cushions: Heavy, can be expensive. They are excellent at preventing pressure sores. Cloth covers make them more comfortable.
  • Fleece Cushions: Lightweight, comfortable. Not much help in preventing pressure sores or in posture support.

Arm Rests: Both styles listed below may be fixed, meaning they are permanently attached, or flexible, meaning that they may be removed or swing away. Arms that swing away facilitate moving closer to a table or desk. Removable arms facilitate side transfers.


  • Full length arms provide good support for arms, but may encumber ability to wheel close to a table or desk unless they swing away or are removable.
  • Desk arms are shorter so you can pull closer to tables and desks.

Foot Rests

  • Swing Away: Foot rests swing out of the way for easily getting in and out of the chair.
  • Elevated Leg Rests: Either or both leg rests may be elevated if medical condition requires it.


  • Molded Mag: Solid wheels are easier to clean and require much less maintenance.
  • Spoked Wheels: Much lighter, but must be tightened and aligned periodically.


  • Polymer: Solid tires. Provide excellent mobility, long wearing and low maintenance.
  • Air-Filled (Pneumatic): Cushioned ride with good traction. Better for outdoor use. Requires some maintenance. "No-Flat" tires are available.
  • Hand Rims: These are mounted outside the large wheels and used to propel the chair.
  • Smooth Surface: Easy on hands, but more difficult if grip is weak.
  • Fluted Edges: Provides added grip but not as comfortable as a smooth surface unless hand fits indentations perfectly.
  • Hand Rim Knobs: Knobs or projections can be placed on the outside of the Hand Rim to give adding gripping power.

Other Options: There are other options and accessories you may need or want to consider:

  • Anti-Tip Bars: Bars mounted on the lower portion of the chair, in front or back or both, to prevent tipping over.
  • Grade Lock: Mechanism that prevents you from rolling backwards when going up a ramp or other grade.
  • Special Features : Chairs can generally be modified for your specific needs, such as linking wheels so the chair can be guided and propelled with one hand, or shifting the center of gravity to compensate to balance the chair for someone who has lost one or both legs.
  • Bags, Pockets, or Pouches: In all sizes and shapes to carry your belongings.
  • Transfer Boards: Plastic or wooden boards to help you slide from the chair to another surface or into the tub.
  • Trays and Lapboards: Clip or snap-on flat surfaces to function as table or desk.
  • Safety or Lap Belts: To help keep you in the chair and prevent sliding or slumping.
  • Cane or Crutch Holder: Clamps to hold walking aids while in the chair.
  • Clothing Guards: Protects clothing and hands from rear wheels.

Working With Your Team

Now that you have an idea of what is available and have given some thought to your own needs, it’s time to meet with your team and get their input. Set up a meeting with your physiotherapist or physiatrist and the Durable Medical Equipment salesperson.

Your therapist will contribute medical expertise and knowledge of your specific limitations and need. The sales representative will know what’s available, what it will cost, and how it can be paid for. You need to bring your personal thoughts and preferences to the picture. Among the three of you, you should develop a good idea of just what chair will be optimal for you.

Although the other members of your team are experts, remember you are the one who will be using the chair. If they recommend something that you don’t understand, don’t accept their recommendation until they have explained their reasoning to you so that you understand what they’re recommending and why. You have the final say. You are the expert on your own wishes and opinions.

Build A Team To Assist You In Choosing A Wheelchair

After you've assessed your needs, and considered the various features which are available, make use of a team when choosing a chair.


A doctor will write the prescription for your chair, although research must be done long before that occurs.

Occupational or Physical Therapist

If your doctor is not a rehabilitation specialist (physiatrist), ask him or her to refer you to an occupational or physical therapist who is knowledgeable about mobility devices. Some therapists even specialize in consulting on wheelchair selection. Your therapist will likely know local dealers to work with as well.

A Durable Medical Equipment salesperson

Look for a durable medical equipment salesperson who:

  • Specializes in, or is at least knowledgeable about, the available brands, models and features of wheelchairs.
  • Has experience in helping match people with a variety of needs with the right equipment.
  • Is acquainted with preauthorization procedures and payment policies of insurance companies as well as Medicare or Medicaid if you expect one of those plans to pay for the chair.

How To Fit A Chair

A properly fitted chair is extremely important, not just for comfort reasons but also to prevent bruising, pressure sores, and poor posture. While the members of your team are very knowledgeable in knowing how to fit your chair to your body (if they aren't they shouldn't be on your team), general guidelines to consider are:






Seat Width

Distance across thighs or hips plus 2 inches

Allow room for body to sit comfortable

Palm of hand should fit between hips and sides with some room to spare

Seat Depth

Distance from back of buttocks to back of knees plus 2 inches

Allow room for knee to bend without pinching against seat edge

Four fingers should fit between front edge of seat and back of knees

Seat Height

Distance from knees to heels plus 2 inches

Allow feet to rest comfortably on foot rests without knees bent more than 90 degrees

Two fingers or more should fit under the thigh to at least the second knuckle

Back Height

Distance from seat to under the armpit with arms extended from your sides

May vary depending on the level of support required for the upper body

At minimum, four fingers should fit between the top of the seat back to under the armpits

Arm Height

Distance from seat to under elbow bent at right angle plus 1 or 2 inches

Arm should rest on armrest comfortably when sitting erect

Create a triangle with your arm, the armrest and back as the three sides

Getting The Chair

Once you and your team have decided upon a chair and made the proper measurements for it, your physician will write it up as a prescription. Read the prescription to make sure it is accurate and describes what you intend to order.

If there is a payer, such as Medicare, Medicaid, or private insurance, your physician will probably have to send the prescription for review and “preauthorization” of coverage for the chair and the price.

Once the payer approves the order, the chair is ordered.

It may take one to three months from your first consultation to arrival of the chair.

Once the chair arrives, make sure your therapist accompanies you to pick it up. Do not accept delivery until you and he or she have a chance to thoroughly check it to see that it is exactly what you ordered and that the fit is appropriate. Make an appointment with your physiatrist as soon as possible after delivery so that he or she can double check to be sure it is the chair that was ordered (including critical measurements) and the fit is correct. If possible, have your physiatrist with you when you accept delivery.

If there are problems, contact the manufacturer immediately.

Travel With A Wheelchair

Step 1. Choose a destination. When you decide where you want to go, do not initially worry about whether the destination is wheelchair friendly. Start with a place you want to go to.

Step 2. Research the means of getting to your destination and accommodations when you get there.

  • If you will be flying, check with the airlines to find out their procedures for people in wheelchairs. The goal is to find an airline that will all you to travel in comfort.
  • While learning how the plane, train or bus can accomodate a wheelchair, also find out about their regulations. For instance:
    • Do you have to book a minimum of a certain number of days in advance. 
    • Do you need a certificate from your doctor certifying your physical (and possibly mental) ability to travel?
  • When booking an accommodation:
    • Be sure there is either a ground floor entrance to your living space or there is an elevator that can easily accommodate a wheel chair.
    • Are the doors in the public and private spaces wide enough for a wheelchair?  
    • Are there inside steps?
    • Are there handicapped shower facilities available?
    • Can you get to the toilet?

IF you find the above steps difficult, consider contacting a travel agency that specializes in dealing with people who have specific needs. One way to locate such an agency is to look for for an agent that is a member of Society For Accessible Travel and Hospitality (SATH), offsite link Tel.: 212.447.7284

FOR ADDITIONAL INFORMATION ABOUT TRAVEL, including what you need to know about medications, click here. For additional information about traveling with a wheelchair, see:  Click on Community Living.

Wheelchair Etiquette

Many people simply are not aware of how to act when communicating with a friend or loved one who uses a wheelchair. Therefore, these pointers may be helpful.

  • Always ask the person using the wheelchair if he or she would like assistance BEFORE you help. It may not be needed or wanted.
  • Don't hang or lean on a person's wheelchair because it is part of that person's personal body space.
  • If conversation lasts more than a few minutes, use wheelchair etiquette and consider sitting down or kneeling to get yourself on the same level.
  • Don't patronize the person by patting them on the head.
  • Give clear directions, including distance, weather conditions and physical obstacles that may hinder the person's travel.
  • Don't classify persons who use wheelchairs as sick. Wheelchairs are used for a variety of non-contagious disabilities.
  • Speak directly to the person in the wheelchair, not to someone nearby as if the person in the wheelchair did not exist.
  • When a person using a wheelchair "transfers" out of the wheelchair to a chair, toilet, car or bed , do not move the wheelchair out of reaching distance.
  • Be aware of the person's capabilities. Some users can walk with aid and use wheelchairs to save energy and move quickly.
  • It is ok to use terms like "running along" when speaking to a person who uses a wheelchair. The person is likely to express things the same way.
  • Don't discourage children from asking questions about the wheelchair.
  • Don't assume that using a wheelchair is in itself a tragedy. It is a means of freedom that allows the person to move about independently.
  • We add: in an elevator: always turn the wheelchair so the person is facing the doors. Studies indicate that people are not comfortable facing a wall.

This article on wheel chair etiquette was written by Robin Kettle, an access auditor and disability awareness trainer currently assisting businesses across the UK. She can be contacted at Blue Badge Disability Equality and Awar offsite linkeness Training offsite link.

What If I Can't Afford A Chair?

If you have health insurance:

  • Wheelchairs are usually paid for by health insurance. This includes both Medicare and Medicaid, both of which cover wheelchairs.

If you do not have health insurance and are not eligible for either Medicare or Medicaid:

Below are listed some possible sources for obtaining a wheel chair at little or no cost. The sources don't even have to be local. A national organization not present in your area may be able tol ship you a chair.

When contacting potential sources, ask about all possible alternatives including obtaining a chair as a donation or as a loan (for free or for a minimal amount of money). At worst, ask about reductions and discounts. You may be able to obtain a used or rebuilt chair at a dramatic discount.

Places to contact are:

  • Wheel chair manufacturers:
    • Many manufacturers have programs that make available used, rebuilt and demonstration models.
    • Some companies work through a non-profit organization. They can direct you to the organization if necessary.
    • To find a manufacturer, type in "wheelchair manufacturer" in your favorite search engine.
  • Medical equipment supply houses:
    • Frequently carry used chairs and have lease or rental programs available. Look in your local Yellow Pages.
  • Non-profit organizations:
    • Wheelchair Project matches donated wheelchairs with people in need. (To learn more, see: offsite linkor call Tel: 317.536.5219).
    • Your local disease specific non-profit organization and other groups which work with patients who may need chairs may have programs to make chairs available at little or no cost, or can connect you with groups that do.
  • Large medical facilities:
    • Hospitals, nursing homes, large medical clinics, museums and airlines often maintain "fleets" of chairs. Find out what they do with their older chairs when they're replaced.
  • Medical Providers:
    • Ask your doctor or his/her office manager/nurse and other medical providers about other sources of low cost or free chairs.