Things Every Assistive Technology User Should Know
The term "assistive technology" refers to any object or machine that helps a person with a disability in some activity of daily living. People who work with assistive technology often call it "AT" for short. It includes:
- Things that help people get from one place to another, like wheelchairs, walkers, and leg braces, and crutches. So are things like wheelchair ramps, wheelchair lifts, and grab bars. Grab bars are handles mounted to a wall that help a person get from a wheelchair to a toilet or shower, and back again. A wheelchair lift helps a person using a wheelchair to get in and out of a van or other vehicle.
- Things that help people use computers. Today there are all kinds of AT devices that make computers easier for people with disabilities to use. There are screens that magnify everything they show so a person with low vision can read them. There are computer programs that allow a person to speak commands instead of typing them on the computer keyboard. There are even "screens" that people who are blind can "read" with their fingers.
- Communication devices: There are devices for people who cannot speak. In most cases, the user pushes buttons or uses a computer mouse to make the device produce speech.
- Things that help with important bodily functions. This includes devices that help a person breathe, eat, use the bathroom, or care for themselves.
You Have Rights If Medicaid Won't Pay For What You Need
Most people with a disability who need AT devices get them paid for by one of these:
- Medicaid (also called "Title 19"),
- Medicare Part B, or private insurance.
- Most low-income Iowans get their AT through Medicaid, so that's what we'll talk about here. Medicaid pays for a lot of different AT devices, though Medicaid does not use the term "AT." In Medicaid law, AT is called "durable medical equipment" or DME. In Iowa, the Medicaid program is run by the Iowa Department of Human Services (DHS) although Iowans receive health coverage through managed care organizations. Initial requests for DME may need to go through managed care organizations. If the managed care organization decision is sent to DHS for review and DHS says you can't have the AT device you need, remember this:
- You have the right to appeal DHS's decision to an administrative law judge or ALJ. An ALJ is a person who works for another state agency, the Department of Inspections and Appeals. The ALJ will hear your case almost exactly the way a regular judge would. You may bring an attorney if you want one. You may present witnesses, documents, or other evidence. You may question DHS's witnesses, and see any documents they are going to show the judge. If the judge thinks DHS is wrong, he or she will order them to give you your AT.
- If the ALJ thinks DHS was right to deny you the device you are asking for, you may ask the director of DHS to review the case. The director may agree with you, or with the ALJ.
- If the director of DHS agrees with the ALJ, you may file a lawsuit against DHS in district court. This is a special kind of lawsuit called a "petition for judicial review." In most cases, neither the director nor the district court will hear new evidence. They will only review what is in the file, which includes a tape recording of the ALJ hearing. You may ask to present new evidence, but usually you have to show that there was a good reason why you couldn't present it to the ALJ.
You Have Rights If Your AT Device Does Not Work Properly
A manufacturer who sells an AT device in Iowa must give you a one-year warranty. If they don't, Iowa law says you have a oneyear warranty anyway. If you discover during the warranty period that there is something wrong with the device, the manufacturer generally must:
- Try to fix it.
- Give you a "loaner" (or money to pay for one) while your device is being fixed.
- If it cannot be fixed, refund your money or give you a new one.
Also, before an AT dealer can sell you a device that was previously returned by somebody else, they have to tell you. They have to tell you that the device was returned, and why it was returned.
Iowa Legal Aid provides help to low-income Iowans.
To apply for help from Iowa Legal Aid:
- Iowans age 60 and over, call 800-992-8161.
- Apply online at iowalegalaid.org