A-29, r. 4 - Regulation respecting devices which compensate for a physical deficiency and are insured under the Health Insurance Act

Section 53 Disposition versions

2016-01-01

53. Notwithstanding section 38, a powered wheel chair or any of its components or supplements appearing on a list in the Tariff is insured only if it is furnished in the following cases:

(1)  to a quadriplegic insured person whose injury is located at levels C3-C4, C4-C5 or C5-C6; or

(2)  to an insured person with a permanent loss of function of both upper limbs and at least one lower limb;

(3)  to an insured person who has been suffering for more than 6 months from a severe cardiovascular or cardiorespiratory insufficiency associated with a physical deficiency within the meaning of this Title, who already has a device allocated under section 51, who is still able to use a powered wheel chair and who requires such wheel chair because, by reason of that insufficiency and that deficiency, and notwithstanding optimal medical treatment, he is now unable to use a manual wheel chair or a lightweight manual wheel chair independently.

For an insured person referred to in subparagraph 3 of the first paragraph, and notwithstanding section 38 and the first paragraph, only a powered wheel chair having been returned to an institution in accordance with the second paragraph of section 57 is insured.

Only fitting and repair services for a powered wheel chair and its components or supplements furnished in the same cases are insured.

Furthermore, where an insured person referred to in subparagraph 3 of the first paragraph agrees to have the Board assume responsibility for a powered wheel chair belonging to him on 12 November 1998 but for which the Board has not assumed the purchase or replacement cost, fitting and repair services for such wheel chair and its components or supplements are insured.

The Board shall assume responsibility only for a wheel chair that is similar to a wheel chair appearing on a list in Subdivision III of Division I of Part I of the Tariff, that complies with the requirements of section 41 and that meets the requirements of the first paragraph of section 45.

For the purposes of subparagraph 3 of the first paragraph, a severe cardiorespiratory insufficiency is that of Group B of the respiratory impairment classification used by Retraite Québec, as determined when the insured person is under optimal treatment and the insufficiency has been present for more than 6 months.

Furthermore, for the purposes of subparagraph 3 of the first paragraph, a severe cardiovascular insufficiency is that of Class III of the functional cardiovascular impairment classification used by the New York Heart Association, as determined when the insured person is under optimal treatment and the insufficiency has been present for more than 6 months.

O.C. 612-94, s. 53; O.C. 1334-98, s. 25; Decision 001-2009, s. 26.

2012-09-01

53. Notwithstanding section 38, a powered wheel chair or any of its components or supplements appearing on a list in the Tariff is insured only if it is furnished in the following cases:

(1)  to a quadriplegic insured person whose injury is located at levels C3-C4, C4-C5 or C5-C6; or

(2)  to an insured person with a permanent loss of function of both upper limbs and at least one lower limb;

(3)  to an insured person who has been suffering for more than 6 months from a severe cardiovascular or cardiorespiratory insufficiency associated with a physical deficiency within the meaning of this Title, who already has a device allocated under section 51, who is still able to use a powered wheel chair and who requires such wheel chair because, by reason of that insufficiency and that deficiency, and notwithstanding optimal medical treatment, he is now unable to use a manual wheel chair or a lightweight manual wheel chair independently.

For an insured person referred to in subparagraph 3 of the first paragraph, and notwithstanding section 38 and the first paragraph, only a powered wheel chair having been returned to an institution in accordance with the second paragraph of section 57 is insured.

Only fitting and repair services for a powered wheel chair and its components or supplements furnished in the same cases are insured.

Furthermore, where an insured person referred to in subparagraph 3 of the first paragraph agrees to have the Board assume responsibility for a powered wheel chair belonging to him on 12 November 1998 but for which the Board has not assumed the purchase or replacement cost, fitting and repair services for such wheel chair and its components or supplements are insured.

The Board shall assume responsibility only for a wheel chair that is similar to a wheel chair appearing on a list in Subdivision III of Division I of Part I of the Tariff, that complies with the requirements of section 41 and that meets the requirements of the first paragraph of section 45.

For the purposes of subparagraph 3 of the first paragraph, a severe cardiorespiratory insufficiency is that of Group B of the respiratory impairment classification used by the Régie des rentes du Québec, as determined when the insured person is under optimal treatment and the insufficiency has been present for more than 6 months.

Furthermore, for the purposes of subparagraph 3 of the first paragraph, a severe cardiovascular insufficiency is that of Class III of the functional cardiovascular impairment classification used by the New York Heart Association, as determined when the insured person is under optimal treatment and the insufficiency has been present for more than 6 months.

O.C. 612-94, s. 53; O.C. 1334-98, s. 25; Decision 001-2009, s. 26.