Leaving Money on the Table, Part 9 – NEMT Service and Lap Belts

Most paratransit vehicles in any form of paratransit – complement paratransit service, special needs schoolbus service, NEMT service, service for medical trips to VA clients, shuttles to day-care centers – deploy vehicles weighing less than 10,000 lbs. So even apart from the Americans with Disabilities Act (ADA) requirements, regulations of the National Highway Traffic Safety Administration (NHTSA) require that every seat in every and any vehicle weighing less than 10,000 lbs. GVWR (gross vehicle weight rating) contain a lap-belt. Over at least the last decade. NHTSA officials have commented that this requirement was upgraded to include three-point occupant restraint systems – i.e., a lapbelt and a shoulderbelt.?Oddly, it is difficult to find documentation of this “upgrade” for all vehicles – even while it is obvious that this requirement applied to personal vehicles for decades. (Historically, this requirement first applied only to the driver’s seat – as it does on transit buses, and until November, 2014, to motorcoaches. Then, in personal vehicles, it was added to the shot-gun seat. Then to the rear seats.)

This requirement is an important footnote to wheelchair tipover cases where operable lapbelts are not on board. This is because while the ADA requires a three-point occupant restraint system at every wheelchair securement position (and obviously has since 1991). Thus, the absence of a lapbelt on a vehicle of this size at any seating position – including and apart from a wheelchair – also comprises a violation of a critical NHTSA regulation. This reality is just another tool to increase the settlement value of a case with this omission, since it “piles on” another regulatory violation.

Varieties and Formats

Particularly in the past 20 years, a plethora of new lap-and-shoulderbelt combinations have hit the market. Thankfully, most service providers ignore them, and continue to install the more-intuitive, traditional format whereby the lapbelts are separate from the shoulder harness – and the lapbelts are affixed to the wheelchair occupant first, and then the shoulder harness affixed to this person, often attached to the lapbelt. In short, there are two basic formats, yet dozens of varieties.

With the most-typical, traditional lapbelt format, the male and female belt buckles connect to one another either at the passenger’s navel or at his or her hip – opposite the side of the vehicle from which the shoulder harness will come. The other ends attaches either to hex-hole or slot in the rear wheelchair track (which have plenty of multiple holes) or disc, or to a nub on the wheelchair retractor housings of both rear retractor/tie-down units. In older models, these rear retractors contained loops roughly midpoint between their attachment to the floor tracks (or plates) and their attachment to the wheelchair’s securement positions. The “other end” of the lapbelt contained a closed-loop hook that clamped around that loop on each rear tie-down belt.

Confused yet? Well maybe this post – among eight before it and possibly another 20 or so – will convince you, Mr. attorney, why any old slob or some local yokel should not be your expert in a wheelchair tipover case. But just dealing with lapbelts, and dealing with the intuitive configuration, the complexity continues.

Returning to the buckles, the configuration that places the buckle at the wheelchair occupant’s navel contains a nub. With this configuration, the end of the shoulder harness that attaches to this buckle contains an fitting with an oval shaped hole that fits over this nub. (Note that in some shoulderbelt configurations, long shoulderbelts contain this same fitting – but they are designed to extend beyond the wheelchair occupant, and attach to the nub on the rear retractor housing. Confused more now?

The other buckle position, at the hip, usually contains two slots: This buckle is known as the “female buckle.” Into one slot, the end-fitting of the “male buckle” is inserted. The other slot – for those buckles with dual slots – is for the insertion of the shoulder harness. Its end-fitting is contains a rectangular fitting with rounded corners, with a similarly-shaped hole in it. But, as noted, some shoulder harnesses – even of this simple format – attach to other things (loops, nubs on the rear tie-down retractor housing, etc.)

For the curious, this is one way a genuine expert can tell when securement hardware was tossed into the vehicle to try to fool the expert conducting a wheelchair inspection -- compared to hardware that is compatible (i.e., fits together) and, presumably, intended to be used. ?Keep in mind that at some point in the inspection of an accessible vehicle, the expert assembles all these pieces (or tries to). Often, they don’t match and, obviously, they cannot be assembled.

Finally, the other format – some form of integrated lap-and-shoulderbelt – includes a dizzying variety of pieces which even a well-trained driver might have trouble connecting if he or she did not do this regularly. In one video deposition of a driver I recall, where the vehicle contained a configuration that took me nearly an hour to figure out, she not only could not identify the parts, but when some parts were shown to her and deliberately mis-identified, she agreed to almost every mid-classification. When your tipover occurred in a vehicle with this type of lapbelt-and-shoulderbelt format, the deposition of the driver can be a masterpiece – if your expert understands it and guides you through the questioning.

One of the most curious things about wheelchair securement is that drivers who can connect even the simplest of formats in their sleep have great difficulty describing them in words (particularly when the pieces are not in sight). So deposing the driver in a wheelchair tipover case is a “must.” Where the driver is no longer employed, and the defendant claims he or she cannot find him, make sure you track him or her down, at all costs. Frankly, if the defendant kept any records, this tasks is something a computer-literate middle school student can do.

Because of the counter-intuitiveness of the lap-and-shoulderbelt combinations of this format, I would actually argue that purchasing them was negligent. Once in a blue moon I suppose one could defend this opinion if he or she could produce a work force full of drivers who could put them together, much less describe how to do so. Just the same, they exist because the near-monopoly who sells them – the genuinely-reputable Q-Straint/SureLOK acquisition that makes excellent products, sells them in complete sets, and provides literature about usage that reflects the industry standards – makes more money selling the more exotic combinations. Keep in mind that a skilled salesman can put together almost anything he or she sells, and can usually explain (or con) the customer into understanding how this contraption can save the driver time – a meaningful reality if most drivers actually performed passenger securement (much less the more-time-consuming wheelchair securement that preceded it). But when I find such contraptions on a vehicle, I do not draw the conclusion that the purchaser selected them to save the driver time and encourage the driver to deploy this device on every wheelchair occupant. I conclude that this configuration was purchased to dissuade drivers from using it. In stating this, one must keep in mind that most fleets grow, and vehicles are added, piecemeal, from year to year. So finding an entire fleet with every vehicle containing an exotic securement configuration of this format – much less the same configuration on every vehicle – is a moon shot. Most drivers are used to the conventional, separate lap-and-shoulderbelt format described above. When they are suddenly given a vehicle with an integrated lap-and-shoulderbelt, they are either terrified, or they are at peace because they know that it is there boss’ intention that they never use it. To be fair to the manufacturer, increased profit or otherwise, it’s intention is that the customer’s drivers use this equipment. That the contrary usually happens is beyond the manufacturer’s control. ?