Utilize Subsidies for Wheelchair Purchases! Explanation of Eligibility Criteria and the Process for the Assistive Devices Expense Payment System

Wheelchairs, prosthetic limbs, white canes, and other assistive devices are essential for individuals with physical disabilities in their daily lives.

Did you know that subsidies are available for purchasing these assistive devices?

This article explains the overview of the assistive device support system, eligibility criteria, and the application process.

If you are considering purchasing assistive devices, this is a must-see system.

1. What is the Assistive Device Subsidy System?

The Assistive Device Subsidy System is a program that provides partial financial assistance for the purchase of assistive devices to complement or rehabilitate the physical functions of individuals with disabilities.

This system is based on the Self-Support Benefits under the Comprehensive Support Law for Persons with Disabilities and is implemented primarily by municipalities.

Eligible assistive devices include not only manual wheelchairs but also electric wheelchairs.

For a detailed list of eligible items, please refer to the Ministry of Health, Labor and Welfare's "List of Assistive Devices."

Reference: List of Assistive Devices | Ministry of Health, Labor and Welfare

Assistive devices are defined in the Enforcement Regulations of the Comprehensive Support Law for Persons with Disabilities as follows:

(1) Items designed to complement or substitute the physical functions of persons with disabilities and ensure compatibility with their bodies.
(2) Items that are worn on the body of persons with disabilities and are intended for long-term continuous use in daily life, employment, or education.
(3) Items that require use based on opinions or diagnoses from professionals such as doctors.

Source: Article 6-20 of the Enforcement Regulations of the Comprehensive Support Law for Persons with Disabilities | e-Gov Law Search

The Assistive Device Subsidy System was unified under the Comprehensive Support Law for Persons with Disabilities in 2006, which integrated the Welfare Law for Persons with Physical Disabilities and the Child Welfare Law. The current system, based on the Comprehensive Support Law for Persons with Disabilities, was enacted in April 2013.

The Comprehensive Support Law for Persons with Disabilities is regularly revised, with new content being implemented in 2024.

If you want to know more about the revisions, please refer to the article

2. What are the Eligibility Criteria for the Assistive Device Subsidy System?

The Assistive Device Subsidy System is available to individuals with disabilities, children with disabilities, and patients with intractable diseases who require assistive devices.

For patients with intractable diseases, it is limited to those specified by the Ministry of Health, Labor and Welfare.

Reference: Target Diseases under the Comprehensive Support Law for Persons with Disabilities (Intractable Diseases, etc.) | Ministry of Health, Labor and Welfare

Additionally, the Assistive Device Subsidy System requires the acquisition of a Disability Certificate, and if not possessed in cases of intractable diseases, a doctor's opinion is needed at the time of application.

There are two methods of assessment for the system: "on-site assessment" and "document assessment."

On-site assessment involves the applicant visiting a rehabilitation consultation center or a consultation meeting venue to receive a direct assessment.

Eligible devices include prosthetic limbs, seating support devices, and electric wheelchairs.

On the other hand, document assessment is based on the opinion form submitted during the application.

Eligible devices include hearing aids, custom-made wheelchairs, and communication devices for individuals with severe disabilities.

These two assessments are conducted by municipalities based on the evaluation by the rehabilitation consultation center.

Additionally, devices determined solely by the municipality based on a doctor's opinion form include:

• Artificial eyes
• Glasses (corrective, light-filtering, contact lenses, low vision glasses)
• Ready-made wheelchairs
• Walkers
• White canes for the blind
• Walking aids

Source: Assessment of Assistive Device Subsidy (Current) | Ministry of Health, Labor and Welfare

The assessment methods and criteria vary depending on the type of assistive device, so caution is necessary.

The key points in the assessment criteria are whether there is a legitimate reason for needing the assistive device and whether it enables independent living.

For example, in the case of an electric wheelchair, it may be difficult to receive a subsidy if the reason is simply "a manual wheelchair can be used for commuting, but an electric one would be more convenient."

However, if there is a slope on the commuting route that makes it difficult to commute with a manual wheelchair, and commuting alone is not possible, the electric wheelchair is likely to be recognized as eligible for subsidy.

While the assessment criteria vary by municipality, the "Assistive Device Subsidy Assessment Manual" created by the National Rehabilitation Center for Persons with Disabilities includes basic examples, so please refer to it.

Reference: Assistive Device Subsidy Assessment Manual | National Rehabilitation Center for Persons with Disabilities

3. Self-Payment Amount and Income Limit for Assistive Device Subsidy

The self-payment amount for the assistive device subsidy is generally 10% of the purchase cost.

For households subject to municipal tax, the monthly cap is 37,200 yen.

For households exempt from municipal tax and recipients of public assistance, both the self-payment amount and the monthly cap are 0 yen.

However, if the individual with a disability or a household member has a certain level of income (if the highest municipal tax income tax payer's tax payment is 460,000 yen or more), they are not eligible for the assistive device subsidy system.

However, even if the income is high, there are families that need to frequently purchase expensive electric wheelchairs or renew assistive devices to match the growth of children with disabilities.

Therefore, the income limit for the assistive device subsidy system for children with disabilities was abolished on April 1, 2024. For more details, please check the websites of the Children's and Families Agency and the Ministry of Health, Labor and Welfare.

Reference: Abolition of Income Limit for Assistive Device Subsidy System for Children with Disabilities | Children's and Families Agency
Reference: Overview of the Assistive Device Subsidy System | Ministry of Health, Labor and Welfare

4. Application Process for Purchasing a Wheelchair Using the Assistive Device Subsidy System

The application process for the Assistive Device Subsidy System varies depending on the type of assistive device, but here we will explain the process for purchasing a wheelchair.

4-1. Consult the Municipal Office and Receive Application Forms

First, consult with the disability welfare office at your municipality to see if you are eligible for the system and receive the application forms.

Application forms may also be downloadable from the municipality's website, so you may not need to visit the office in person to obtain them.

4-2. Have a Doctor Prepare the "Assistive Device Subsidy Opinion Form"

The application forms for the Assistive Device Subsidy System require a "Assistive Device Subsidy Opinion Form" prepared by a doctor, so you will need to request this.

The doctor preparing the opinion form should have specialized knowledge and experience as follows:

a. Doctors preparing the opinion form for assessment by rehabilitation consultation centers should be designated doctors under Article 15, Paragraph 1 of the Disability Welfare Law, or specialists primarily responsible for the relevant medical care at institutions providing medical care based on Article 1, Paragraph 2 of the Enforcement Order of the Comprehensive Support Law for Persons with Disabilities (so-called "self-support medical institutions"), or doctors who have completed the assistive device-related suitability assessment physician training course conducted at the National Rehabilitation Center for Persons with Disabilities.
b. Doctors preparing the opinion form for assessment and decision by municipalities should be doctors recognized as equivalent to those in a.
c. For patients with intractable diseases, in addition to doctors in a, they should be specialists certified by their academic societies and primarily responsible for medical care at designated intractable disease medical centers or cooperating medical institutions designated by prefectures. For applications for assistive device subsidies for children with disabilities, the opinion form should, in principle, be prepared by doctors at designated self-support medical institutions or health centers.

Source: 4 About the Preparation of the Assistive Device Subsidy Opinion Form | Assistive Device Subsidy Administration Guidebook

When requesting the preparation of the opinion form, make sure the attending physician meets the above conditions.

Consulting with the municipal office about which doctor to have prepare the form can also be a good approach.

The cost of preparing the opinion form varies by hospital but is generally around 3,000 to 4,000 yen, and it is entirely the user's responsibility.

However, if the need for assistive devices can be confirmed with a Disability Certificate, the preparation of the opinion form may be omitted, so be sure to check with your doctor or municipal office in advance.

Reference: Assistive Device Subsidy Administration Guidebook p.17 | Ministry of Health, Labor and Welfare

4-3. Fill Out and Submit Application Forms at the Municipal Office

Once the doctor has prepared the Assistive Device Subsidy Opinion Form, fill out and submit the application forms at the municipal office.

The format of the application forms varies by municipality, but you may need to present identification such as a My Number card or driver's license, so don't forget to bring them.

Additionally, a Disability Certificate and a personal seal (stamp) are required for the application.

The requirements vary by municipality, so it is advisable to check in advance.

For example, here are the requirements for an application in Okazaki City, Aichi Prefecture:

• Disability Certificate
• Personal seal (stamp)
• My Number confirmation documents (individual number card or notification card, etc.)
• Estimate (detailed statement)
• Doctor's opinion form
• Prescription, etc.

Source: Assistive Device Subsidy for Persons with Disabilities | Okazaki City

4-4. Decision on Assistive Device Subsidy

The municipality will determine whether it is appropriate to provide the assistive device subsidy based on opinions from rehabilitation consultation centers, etc.

The assessment method varies depending on the type of assistive device applied for, but in the case of custom-made wheelchairs, it is subject to document assessment by the rehabilitation consultation center.

For electric wheelchairs, the assessment is conducted through direct evaluation, including on-site consultations, so the user must visit the rehabilitation consultation center at the specified date and time for assessment.

For ready-made (off-the-shelf) wheelchairs, the assessment is based solely on documents by the municipality.

The assessment method varies depending on the type of wheelchair, so be sure to check with the welfare office in advance.

4-5. Contract with Assistive Device Manufacturer

After receiving the subsidy decision, the user directly contracts with the assistive device manufacturer and requests the creation of the assistive device.

During the contract, carefully review important details and contract terms, and request a cost estimate.

Once the assistive device is completed, confirm its suitability, make any necessary adjustments, and then it can be handed over.

4-6. Manufacture and Payment of Assistive Devices

Once the manufacture and handover of the assistive device are complete, the user pays their portion (generally 10%) through either reimbursement or proxy receipt, and claims the remaining amount from the municipality.

Reimbursement means the user initially pays the full cost to the manufacturer and then claims and receives the amount minus their portion from the municipality.

Proxy receipt means the user only pays their portion, and the manufacturer directly claims the remaining amount from the municipality.

The payment method varies by municipality, so be sure to confirm during the application.

Reference: Chapter 1 Assistive Device Subsidy System.3-4 Flow of Assistive Device Subsidy Procedures | Assistive Device Subsidy Administration Guidebook

5. Number of Assistive Devices Eligible for Subsidy

The number of assistive devices eligible for subsidy is generally one per item and disability.

However, depending on the disability status and environment of the individual or child, if deemed necessary for vocational or educational purposes, it can be increased to two.

For example, in the case of wheelchairs, if there is a need to have different wheelchair widths to match the desk width at the workplace, owning two wheelchairs may be allowed if deemed necessary.

The idea is that owning the same item as a spare is not permitted, but using different functional items according to the environment is the purpose of owning two.

Reference: Chapter 2 Understanding and Operation of Assistive Device Subsidy Administration.1-4 Multiple Subsidies | Assistive Device Subsidy Administration Guidebook

6. Assistive Device Subsidy System for Those Under 18

For the assistive device subsidy system for individuals with disabilities under 18, usage years are set instead of durability years, considering the growth process.

For failures within the usage years, parts replacement or repair is generally used to address the issue.

Additionally, if the child's physical growth or progression of symptoms requires frequent replacement of assistive devices within a short period, rental and other borrowing options have been allowed since April 2018, so it can be considered as needed.

Reference: Chapter 2 Understanding and Operation of Assistive Device Subsidy Administration.1-6 Durability Years | Assistive Device Subsidy Administration Guidebook

7. Re-subsidy and Repair of Assistive Devices

Re-subsidy and repair of assistive devices are also covered by the system.

Assistive devices have durability years set for each item, model, and year, so re-subsidy is generally possible after the durability years have passed.

However, if continued use is possible through repair even after the durability years, re-subsidy is not applicable.

Additionally, assistive devices that are damaged before re-subsidy are generally subject to repair.

However, if repair is not possible before the durability years, re-subsidy is applicable.

In cases of loss or damage due to circumstances beyond the individual's control, such as disasters or accidents, the necessary assistive device subsidy is provided.

Damage or theft due to the individual's responsibility is generally considered self-responsibility, but municipalities may approve re-subsidy considering the circumstances.

Reference: Chapter 2 Understanding and Operation of Assistive Device Subsidy Administration.1-5 Re-subsidy | Assistive Device Subsidy Administration Guidebook

8. Conclusion

This article has explained the overview of the Assistive Device Subsidy System and the application process up to the point of subsidy.

Since the Assistive Device Subsidy System is implemented by municipalities, the content of the system may vary by region, so please contact your local welfare office for inquiries.

Assistive devices are indispensable for individuals with disabilities and serve as companions that support daily life.

By correctly understanding the Assistive Device Subsidy System and wisely utilizing subsidies, let's further enrich our daily lives.