RERC on AMI logoImportance of Accessible Weight Scales


Updated 11.22.04

June Isaacson Kailes MSW, Associate Director
Christie Mac Donald MPP, Senior Policy Analyst
Center for Disabilities Issues and the Health Professions
Western University of Health Sciences
309 E. Second Street, Pomona, CA 91766
Voice-909.469.5213/TTY-909.469.5520, Fax 909.469.5503, ahcs@westernu.edu

Contents of this briefing

Other briefs

Introduction

Health care providers should have accessible weight scales for these reasons:

  1. Improve quality of care for people with disabilities and activity limitations;
  2. Comply with legal obligations under Title III of the Americans with Disabilities Act.
  3. Serve Individuals with disabilities who represent a sizable portion of the population;
  4. Reducing health care professionals' workplace injuries (See CDIHP Brief: Importance of Accessible Examination Tables); and
  5. Take advantage of the federal tax incentives for improving accessibility.

Several types of accessible weight scales are available from a number of manufacturers. Two wheelchair accessible scales are shown here. These examples are not intended to be exhaustive. No endorsement of any product is intended or implied.

Portable Wheelchair Scale
Portable wheelchair scale with wheels

Wall Mounted Folding Wheelchair Scale
Wall mounted folding wheelchair scale that folds down to floor level when not use

Note-For a listing of weight scales with additional access features. (e.g., wheelchair, platform, bed, standing, and bariatric) see www.cdihp.org/products.html coming soon.

Accessible scales allow you to comply with the requirements of the Americans with Disabilities Act (ADA), by accurately obtaining the weight of all patients' during the medical visit.

Accessible scales are usable by all people including: wheelchair users, people with activity limitations, and larger people who may exceed a standard weight scale limit. This includes people with conditions that interfere with mobility, walking, climbing, using steps (joint pain, short stature, pregnancy, fatigue, respiratory and cardiac conditions, post surgical conditions, orthopedic injuries.); and/or who use mobility devices (e.g. canes, crutches, walkers.)

1. Improved Quality of Care for People with Disabilities and Activity Limitations

When patients cannot be weighed, they receive a lesser quality of health care. Without an accurate and current weight measurement, chances of missed diagnosis or incorrectly prescribed medication increase. It is well documented that weight gain and obesity can be linked to:

In addition, cancer-related weight loss can negatively affect response to therapy, quality of life and survival. Weight loss of just 5 percent is associated with a decreased rate of survival. 2

Unintended weight loss can put older people and people with disabilities at higher risk for infection, depression and death. The leading causes of involuntary weight loss are depression (especially in residents of long-term care facilities), cancer (lung and gastrointestinal malignancies), cardiac disorders and benign gastrointestinal diseases.3

For 18 years, John Lonberg, a man in his early 60's with quadriplegia from a spinal cord injury, urged his health care clinic to install accessible equipment...."It took a while," he said, "but I gradually realized that I wasn't getting the same level of care I had received when I could walk, and get on the scale, and climb up on the examination table. Doctors were prescribing dosages based on what they guessed I weighed, so I began thinking maybe I should be weighed."4

By providing accessible weight scales you can improve the quality of care provided to people with disabilities and activity limitations.

2. Comply with Legal Obligations under the ADA 5

Title II of the Americans with Disabilities Act (ADA) covers health care activities of state and local government. Title III covers privately operated medical and health care facilities. Title III coverage includes physician offices located in private homes. Standard examinations typically include the taking of temperature, blood pressure, and a weight measurement. If the patient cannot get onto a weight scale because of the scale design, the ADA requires that the physician's office provide an accommodation that will enable the physician to perform the appropriate weight measurement.

If a physician's office does not provide a weight scale that can be accessed, the office must provide assistance to help patients onto the scale, including lifting them if necessary. However, unlike non-accessible examination tables, this is not possible for most wheelchair users who may have: paralysis, balance and mobility limitation, or other chronic conditions.

A growing number of private and public disability discrimination cases have been successfully filed over the past ten years. Individuals with disabilities and the disability community have become increasingly public and diligent in asserting their civil rights to equal access, specifically, requiring the courts to enforce ADA requirements in the health care field.

To-date one of the most significant health disability discrimination cases includes:

Metzler v. Kaiser Permanente of California, 2001. 6 The agreement settled a class-action lawsuit filed against the health maintenance organization, Kaiser Permanente, on behalf of all its California members with disabilities. The lawsuit argued that Kaiser discriminated against patients with disability by giving them inferior medical care.

In part, the suit alleged that Kaiser does not offer accessible examination tables, toilets, scales and other medical devices in its California hospitals and clinics. The settlement includes Kaiser's agreement to install accessible medical equipment, including wheelchair accessible scales.

3. Serving a Sizable Portion of the Population Including Individuals with Disabilities

According to the US Census of 2000 people with disabilities represent 19.3 percent of the 257.2 million people who were aged 5 and older in the civilian non-institutionalized population or nearly one person in five.

Fifty percent of people over age 65 have some form of disability. With the average age of patients on the rise, more people will require easier access to equipment. The average life span today is 75 years, and is projected to rise to 85 years by 2050.7

In addition to improved access for people with physical disabilities, accessible medical equipment makes life easier for everyone.

Bar chart of population with a disability by age and sex for year 2000 - approximately 4-7% of people age 5-15, 17-19% of those age 16-64, and 40-43% of those 65 or older have a disability. Men had slightly more disabilities up to age 65; women that were 65 and older tended to have more disabilities. Bar chart of population with a disability by age and sex, and by type of disability for year 2000 overall ranked physical disabilities most frequent, followed by difficulty going outside, sensory, mental, and self-care disabilities. All percentages increased significantly and consistently from the age ranges of 16-61 and 65 and over.

4. Reduction of Workplace Injuries

When an accessible weight scale is not available, wheelchair users may go years without being weighed, and people with other activity limitations may be unsafely lifted onto a standard scale. This type of lifting is not only dangerous to the patient, but can cause back or other musculoskeletal injuries to the medical facility staff.

"The Occupational Safety and Health Administration (OSHA) estimated that 1.8 million US workers develop work-related musculoskeletal disorders. According to the US Department of Labor's Bureau of Labor Statistics, healthcare-related services reported over 59,000 musculoskeletal injuries in 1999. The majority of the injuries reported were strains and sprains to the back and shoulder caused by overexertion in lifting and resulted in the employee being off of work for several days." 8

1998 injury data show that nearly 12 out of 100 nurses in hospitals and 17.3 out of 100 nurses working in nursing homes report work-related musculoskeletal injuries, including back injuries, which is about double the rate for all other industries combined. 9

5. Tax Credits Under Section 44 of Title 26 in the IRS Code 10

The "Disabled Access Tax Credit" (Internal Revenue Code, Title 26, Section 44), is allowed for expenditures that are incurred in order to comply with the Americans with Disabilities Act (ADA). This enables an eligible small business to elect to take a nonrefundable tax credit equal to half of the expenditures it makes on eligible accommodations that exceed $250. The maximum credit a business can elect to take in any tax year is $5,000 for eligible expenditures of $10,250 or more. (For more information see: CDIHP Brief: Disability Access Tax Incentives)

Choosing an Accessible Weight Scale

Desirable features of an accessible weight scale include:

Resources

Manufacturers of Accessible Examination Tables and Weight Scales

To download a 250KB Excel file containing a listing of increased access weight scales (e.g., wheelchair, platform, bed, standing, and bariatric), along with manufacturers and contact information, click here.

Endnotes

  1. Weight Control and Diet, December 2001, Reuters Health (RH) www.reutershealth.com/wellconnected/doc53.html
  2. Frequently Asked Questions. Cancer Care. www.cancercare.org
  3. B. Huffman., M.D., Evaluating and Treating Unintentional Weight Loss in the Elderly. Am Fam Physician 2002;65: 640-50. Feb.15, 02. www.aafp.org/afp/20020215/640.html
  4. J. M. Glionna, California and the West; Suit Faults Kaiser's Care for Disabled; Courts: Advocates Say Provider Fails to Give Equal and Adequate Treatment to the handicapped. Chain Says it Complies with Disabilities Act, Los Angeles Times (Record edition), 27 July 2000, p. 3
  5. U.S. Department of Justice. Americans with Disabilities Act www.usdoj.gov/crt/ada/reg3a.html
  6. Metzler v. Kaiser Foundation Health Plan, Inc., No. 829265-2 (Calif. Super. Ct., Ala. Cnty) (Dismissal Based on Settlement Agreement March 2001) [full settlement available at www.dralegal.org/downloads/cases/metzler/settlement.pdf].
  7. U.S. Bureau of Labor Statistics. (16 Sept. 2002).
  8. Wells, J., Achieving the Highest Level of Efficiency and Comfort in the Examination Room for both Physician and Patient. Midmark Corporation (August 2002).
  9. Hedge, A. Spine Universe: Back Care for Nurses www.spineuniverse.com/displayarticle.php/article1509.html
  10. The Internal Revenue Service, Know the Rules Regarding Tax Incentives for Improving Accessibility for the Disabled, (Headliner Volume 56 September 24, 2003)
    And http://www.usdoj.gov/crt/ada/taxpack.htm

Disclaimer: The Center for Disabilities Issues and the Health Professions does not endorse nor profit in whole nor in part, from any manufacturer or vendor whose equipment appears in this publication. Illustrations of specific equipment are provided for information and educational purposes only.

Distribution is encouraged, and permission is granted provided that:

(1) This copyright notice and citation is attached to each copy;

Kailes, J., and Mac Donald, C., Importance of Accessible Weight Scales, 2004. Published and distributed by the Center for Disability Issues and the Health Profession, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766 1854, (available at www.cdihp.org/products.html) Email: ahcs@westernu.edu Voice-909.469.5213/TTY-909.469.5520, Fax 909.469.5503,

(2) No alterations are made to the contents of the document;

(3) The document is not sold for profit; and

(4) The Center for Disability Issues and the Health Professions is notified of such use. Please contact the Center by way of fax (909) 469-5503 or e-mail: ahcs@westernu.edu

The Rehabilitation Engineering Research Center (RERC) on Accessible Medical Instrumentation is a five-year project that evaluates methods and technologies to increase the accessibility and usability of diagnostic, therapeutic, and procedural healthcare equipment, and associated assistive technologies, for people with disabilities. This brief was funded, in-part, by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education, under grant #H133E020729