(Written by family member)

To whom it may concern:

I am responding to the letters of denial that you issued regarding the LifeStand Compact seated to standing power wheelchair we purchased for my wife. While we are going through this appeal process, we are already seeing improvements in both her disability status as well as our quality of life as a result of this durable item. Enjoying baking a cake with our eight year-old son is just one example of an activity that was previously out of reach. You see, she can stand up to look into a pot on the stove, and sit down to check whatís in the oven, or to rest a bit, or to interact face to face with our child, all without reducing herself to utter exhaustion. They had a good time on this occasion. We are all enjoying seeing her as a standing person again; our son had forgotten that she ever stood up.

The program of regular standing she is now on with the help from her physical therapist has already led to some noticeable improvements in her disability. When she first started, muscles in her buttocks, torso, and legs that hadnít been used in two years ached terribly, but now that is going away, and we are starting to see improvement in her ability to sit up straight, reduction of leg spasms, and with muscle control of her bladder. All this simply from being able to stand up and extend her trunk and legs for several hours a day. As she regains strength in these muscles, we are looking forward for the first time in a long time, to some actual improvements in her condition.

Is there any other device or technology that would allow these physical improvements in someone with progressive MS? I donít think so. We think that compared to the in-hospital rehab program that has shown reduction in disability, this is the prudent alternative. Those programs show gradually declining efficacy as the time the patient had left the program increases. Our alternative, with the standing wheelchair, keeps the program going indefinitely.

Thank you for your reconsideration of this request.

Sincerely,