Prostheses for amputees

Interim (rehabilitation) prosthesis

Following an amputation you will generally be referred to a participating WA public hospital amputee clinic for assessment and referral to a rehabilitation program. As part of your treatment you may require an interim prosthesis soon after your surgery to assist healing and management of your residual limb. Prescription of interim limbs will depend on your individual condition and readiness for a fibreglass socket.

WALSA provides funding assistance for interim prostheses (including associated essential supplies) across all age groups for eligible WALSA clients. To assess your eligibility for funding you will be required to register with WALSA.

Except for agreed non-standard cases, interim products include a:

• standard Solid Ankle Cushion Heel (SACH) foot
• standard knee, or
• safety knee.

Definitive (permanent) prostheses

To determine the level of prosthetic componentry you will be provided with by WALSA, your mobility needs and abilities first need to be assessed by your PSP.

Please note the total funding limits detailed below under 'Funding of prostheses' are correct as at 1 October 2020.

Mobility class 1 – home walkers (standard SACH foot, standard knee or safety knee)

You would have the ability or potential to use a prosthesis to move around the home or walk on a flat surface at low speed. The walking time and the walking distance are both short due to your condition.

Treatment objective: To restore your ability to stand and enable you to walk around at home.

Mobility class 2 – restricted outside walkers

You would have the ability or potential to use a prosthesis to walk at low speed and to overcome minor obstacles such as kerbs, single steps or uneven ground. The walking time and the walking distance are both short due to your condition. Componentry rated at this level, not to exceed the maximum funding limit of $884.49 per foot. Standard knee to be determined by the PSP (not to exceed maximum funding of a Mobility Class 3).

Treatment objective: To restore your ability to stand and enable you to walk around at home and the immediate vicinity.

Mobility class 3 – unrestricted outside walkers

You would have the ability or potential to use a prosthesis to walk at moderate to high and variable speeds and to overcome most obstacles. You would be able to move around on open ground and carry out occupational, therapeutic and other activities that do not exert undue mechanical stresses on the prosthesis. The time and distance you walk are both marginally limited compared with limbed individuals. Componentry rated at this level not to exceed the maximum funding limit of $884.49 per foot and up to a maximum funding limit of $3,017.66 per knee.

Treatment objective: To restore your ability to stand and enable you to walk unhindered at home and, with minor restrictions only, outside.

Mobility class 4 – unrestricted outside walkers with very high demands

You would have the ability or potential to use a prosthesis to walk as per the unrestricted outside walker. In addition, high impact stresses and strains may occur because of high functional demands. The time and distance you walk are unlimited. Componentry rated at this level not to exceed the maximum funding limit of $1,352.75 per foot and up to a maximum funding limit of $3,329.85 per knee.

WALSA funds a variety of essential prosthetic services for eligible amputee clients:

• of all age groups requiring an interim prosthesis for the completion of a rehabilitation program
• 65 years of age and above for definitive (permanent) prosthesis for essential day-to-day activities.

Interim prosthesis

Any permanent WA resident who holds a current green Medicare card is eligible for interim prosthetic services funded by the WALSA program, irrespective of their age.

Residents of other states who are eligible for prosthetic services in their state of origin may be eligible for urgent services in WA.

Definitive prosthesis if you are 65 years of age or older

Your definitive prosthesis will be funded by WALSA if you are:

• a permanent WA resident who holds a:
• current green Medicare card, or
• protected special category visa (SCV)
• have completed a ‘rehabilitation program’ using an interim prosthesis, been assessed by the rehabilitation consultant and deemed competent and suitable to use a prosthetic limb
• are not obtaining prosthetic funding support or services through another government agency or state service.

Residents of other states who are eligible for prosthetic services in their state of origin may be eligible for urgent services in WA.

*If you are 64 years of age or younger and in need of a definitive (permanent) prosthesis you are ineligible for WALSA funding.

For definitive prosthetic funding support you first need to register with the National Disability Insurance Scheme (NDIS). To find out more:

• browse the NDIS for eligibility criteria (external site)
• find information on NDIS Participant Plans and your NDIS pathway (external site)
• view NDIS fact sheets (external site).

Other eligibility criteria

The following eligibility criteria apply to both interim and definitive prostheses.

Department of Veteran Affairs card holders

If you hold a Department of Veteran Affairs (DVA) Gold treatment card you will have your limbs paid for in full for all conditions.

If you hold a DVA White treatment card, your prosthetic treatment will only be paid for in full if your amputations are related to the DVA’s accepted war-caused disabilities.

All other veterans, including holders of a DVA concession card – rather than Gold or White treatment cards (not relating to your amputation) – are considered as eligible clients for WALSA services.

Foreign nationals

If you are a resident of another country (foreign national), we may provide services and incur costs if your home country has a reciprocal health care arrangement with Australia. Each case shall be assessed individually.

Read more about reciprocal health care arrangements (external site).

Upon request at the amputee clinic and your private prosthetic service provider (PSP), you will need to provide:

• your Medicare and/or DVA card
• proof of residential address.

Annual essential supplies and limits

Annual funding limits apply to all services provided through WALSA.

Essential supplies such as stump socks, shrinkers, liners and cosmetic gloves are available to WALSA registered clients with an interim (rehabilitation) or definitive (permanent) prosthesis on an annual (as needed) basis, within set funding limits as follows:

WALSA recognises that special cases exist and these will be considered on a case by case basis.

Gap funding

WALSA will contribute up to the maximum funding levels for registered WALSA clients by the relevant mobility class for the purchase of non-standard componentry. Some clients may wish to provide additional funding themselves (gap funding) to purchase an alternative prosthesis. Talk to your PSP for more information.

New amputee clients seeking funding assistance from WALSA for prosthetic services must complete the WALSA admission form to test their eligibility.

Please email the WALSA Office or call 1300 884 903 for a copy of the form.

If you have received compensation for your injury and/or limb loss, please contact WALSA to establish your eligibility for prosthetic funding assistance.

If you are seeking compensation for your limb loss, funding is available through:

• WorkCover (external site)
• NDIS (external site)
• your travel insurance provider
• your private funding body.

If you are in the process of seeking compensation you may be provided standard prosthetic services funded by WALSA until your legal matters are finalised. You are expected to inform WALSA once any compensation funds are received and reimburse WALSA for the cost of services provided. WALSA perform an annual review of all clients in the process of seeking compensation. A letter will be sent to you requesting an update on the progress of your compensation claim.

If you are pursuing or have received compensation funds, you will need to complete a Declaration of compensation form. Please email WALSA or call 1300 884 903 to receive this form.

Work-related accidents

If you have suffered a workplace injury resulting in an amputation you may be eligible for funding under the workers compensation scheme for treatment and prosthetic services. If you are a permanent WA resident visit WorkCover (external site) for more information.

Motor vehicle accidents

If you have sustained an injury in a motor accident, you may be eligible for funding support. If you are a permanent WA resident visit the Insurance Commission of Western Australia (external site) for more information.

WALSA clients are responsible for maintaining in a clean condition their prosthesis and associated essential supplies, such as prosthetic liners. Neglected or misused prosthetic limbs will not be repaired or replaced under WALSA funding

The minimum expected life of most prosthetic limbs, knee and feet components to children and adults under the WALSA program is 3 years, starting from the time you sign for and receive your prosthesis. Prosthetic limbs and sockets will only be replaced when medically or mechanically justified, not solely upon the age of the prosthesis.

Replacement of a prosthesis during this 3-year period may require clinical justification and/or clarification by the private prosthetic service providers (PSP) maintaining the prosthetic limb and components.

Prosthetic limbs should be checked and serviced annually (or as needed) by your private PSP:

• Orthopaedic Appliances Pty Ltd (OAPL) (external site)
• TLCU (external site)

Second or spare prostheses

WALSA clients are not routinely provided with a spare or second prostheses funded by WALSA – the standard level of service provision is 1 standard (essential) prosthetic limb for each amputated limb.

Upon application from your private PSP, WALSA may approve the issue of a second limb if you:

• work in an occupation which could place extra stress on the prosthesis
• would suffer economic loss by not being able to work while the prescribed limb is being repaired.
• live alone in an isolated location and could be stranded if a second limb was not available.

Supply of prosthetic limb components

Prosthetic components are expected to last for the period or use and/or warranty period associated with daily use as identified by the supplier of the component.

Under the Artificial Limb Scheme (ALS), WALSA monitors the use of Therapeutic Goods Administration (TGA) certified standard components available for the provision of funding. These components are for all types of prosthetic limbs, based on different mobility levels for a variety of activity needs.

WALSA clients may co-contribute or self-fund non-standard components beyond what the State Government is able to fund.

Before any additional non-standard components can be incorporated into a WALSA funded prosthesis, you must first discuss this with your PSP and obtain their agreement.

• Limbs4Life (external site) offers a range of programs and services that assist amputees, their families, their care givers and health care professionals.
• Advocacy WA (external site) provides information, advocacy and support to people living in the south west of WA who live with disabilities or mental health issues and find themselves in vulnerable or marginalised situations.
• The Advocacy and Peer Support for Western Australian Amputees Facebook Group (external site) is coordinated by and for amputees and people with limb difference.
• The Australian Rehabilitation and Assistive Technology Association (external site) is a forum for rehabilitation and assistive technology issues. Membership is open to anyone with an interest in the use of assistive technology for people with disabilities.
• If you are about to have your first limb made, visit artlimb (external site) for information on the process of designing and making a prosthetic limb.

Returning to driving

Find information on modifying a vehicle for drivers or passengers with disabilities at the Department of Transport (external site).

Sports

Find information on sports for people with a disability.

• WA Disabled Sports Association (WADSA) (external site)
• Australian Institute of Sport (external site)