Until December 2005, only three power wheelchair models had been crash-tested to ANSI/RESNA WC Vol. 1 Section 19 (WC-19) — one from Invacare Corp. Since then, a number of crash-tested options have been added to different power wheelchair designs. This has raised a good question: What took so long for us to have WC-19 crash-tested tie-down options on power wheelchairs?
Over the past two years, I have tried to learn as much about the topic of wheelchair transportation as possible. For me, it is a topic I need to understand because not only am I a product manager for Invacare — I also have a beautiful 5-year-old niece who uses a power wheelchair, and a family full of related questions.
So what took so long for us to have WC-19 crash-tested tie-down options on power wheelchairs?
Voluntary Standards: ANSI/RESNA WC Vol. 1 Section 19, commonly referred to as WC-19, is a voluntary standard. Manufacturers are not obligated legally to test any wheelchair base for crashworthiness.
Liability: As of this date, no governmental agency, including the Department of Transportation, has approved any tie-down systems for transportation of a user while in a wheelchair in a moving vehicle of any type. In 1993, the National Highway Traffic Safety Administration (NHTSA) issued a standard for school buses that requires four wheelchair securement anchorages (49 C.F.R. 571.222). However, NHTSA does not have authority to regulate wheelchairs, since they are not “motor vehicle equipment,” and so NHTSA did not issue any standards for wheelchair occupant seat-restraint systems.
As there are no government standards to follow for crashworthiness of wheelchairs, often manufacturers are unable to recommend that wheelchair users be transported in vehicles of any kind while in wheelchairs. In the interest of safety and in hopes that the government will adopt crashworthiness standards in the future, however, some manufacturers voluntarily crash-test many wheelchair models to ANSI/RESNA Vol. 1 Section 19.5.3 Frontal-Impact Test.
Just for Kids: WC-19 was predominantly thought of as a need only for pediatric users.
More Pediatric Manual Wheelchairs: Children are prescribed manual wheelchairs over power wheelchairs more frequently. This is due to a number of reasons/concerns, including:
- Ability of the child to safely operate a power wheelchair.
- The family’s acceptance of powered mobility.
- Power wheelchair accessibility in the home.
- Ability of the family to provide transportation for the power wheelchair.
- Difficulty in justifying power wheelchair use to a third-party payer source.
Funding: Lack of funding for WC-19 crash-tested options. There is no separately billable HCPCS code for any transport tie-down option, making it difficult for manufacturers to recoup product costs associated with this type of option.
Product & Testing Costs: The WC-19 frontal-impact test is a 30-mph/20g frontal-impact crash-test. Each chair can only be tested one time. The actual product cost increases approximately 10 to 15 percent when a WC-19 crash-tested tie-down option is added to the base cost of the power wheelchair.
Weight Rating: The way the current WC-19 specification is designed, manufacturers can only test to a specification using the 168-lb. test dummy secured into the chair using a lap and shoulder restraint during the crash-test. This corresponds to a 114-lb. to 209-lb. rating (a dummy sized similarly to ones used in automotive crash-tests). Many power wheelchairs have a 250-lb. to 400-lb. weight capacity, leaving manufacturers unsure about how to manage the two weight ratings.
Why are we seeing more power wheelchair designs now being crash-tested to WC-19?
The Tipping Point: Once one manufacturer starts, others will follow. Invacare now offers eight different models, including some of the most widely used power wheelchair designs in the industry.
Voice of Customer: Increasingly, we are receiving calls from providers, clinicians and consumers requesting information on our WC-19 crash-tested models. There are a number of securement bracket options available from manufacturers at no additional cost; however, these systems have not been crash-tested to WC-19 and have created a false sense of security.
NOT Just for Kids!: Some providers need to establish where to tie down the chairs in service and delivery vehicles for their own insurance needs. This adds a new twist to the need for tie-down options.
More Vehicle Options: With modified minivans becoming more cost effective for some families, tie-down options could be needed to secure an unoccupied wheelchair. Many vehicles come equipped with a four-point tie-down system as part of the base vehicle modification.
New Power Wheelchair Codes?: The Centers for Medicare & Medicaid Services (CMS) is proposing to one day make ANSI/RESNA WC Vol. 1 Section 19 part of the requirements for certain Medicare code sets. The idea that this might become a reality has prompted many manufacturers to act. If all power wheelchair designs are required to have passed WC-19 in the future, this could impact pricing, especially on lighter-duty products.
There are endless numbers of questions anytime the topic of WC-19 comes up, and nobody has all of the answers. Knowing that there are now going to be crash-tested options on many power wheelchair designs means that we are making progress. In the meantime, I encourage you to do the following things:
- Educate: Educate yourself about ANSI/RESNA WC Vol. 1 Section 19. You can find information on this specification, and identify which models have been crash-tested, at www.rercwts.pitt.edu.
- Advocate: Educate others about the differences between securement points and crash-tested designs.
- Validate: Support manufacturers who crash-test their power wheelchair designs to WC-19. Otherwise, manufacturers may question whether or not spending resources on crash-testing is the best business decision.
