I APPEAL# PART C Decision under Appeal The decision under appeal is the Ministry of Social Development (ministry) reconsideration decision of October 24 th , 2012 wherein the ministry determined that the appellant was not eligible for a crisis supplement under section 57 Employment and Assistance for Persons with Disabilities Regulation EAPWDR because the appellant had requested reimbursement for funds spent on a variety of items and had not identified a specific item which related to an unexpected expense or an item that was needed unexpectedly. Therefore the ministry was not able to establish that: • the appellant had an unexpected expense, or that the appellant needed to obtain an item that was unexpectedly needed, and -• the appellant was.unableJo_meeUheexpense or obtainthe_item that was unexpectedly needed ___ j__ _ because there were no resources available to the family unit as set out in section 57(1)(a) EAPWDR. Further, that the ministry determined that failure to meet the expense or obtain the item will not result in imminent danger to the physical health or any person in the family unit, or removal of a child under the Child, Family and Community Service Act as set out in section 57(1 )(b) EAPWDR. PART D Relevant Legislation Employment and Assistance for Persons with Disabilities Act (EAPWDA) section 5 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR), section 57 EAAT003(10/06/01)
I APPEAL# PART E -Summa of Facts The evidence before the ministry at the time of reconsideration: • Request for reconsideration dated September 27'h, 2012 • Receipt from Wal-Mart dated September 15 th , 2012 • Receipts from Shopper's Drug Mart dated August 31 st ; September 25 th , 2012; September 14 th ; July 3•d; • Receipt from Zellers dated September 3•ct, 2012 On September 11 th , 2012 the appellant contacted the ministry to request a crisis supplement to reimburse her for funds spent on various items, i.e. thermometer, tweezers and two massage machines. The ministry denied the appellant's request for a crisis supplement because the appellant had not identified an item(s) that was an unexpected expense or an item(sffnat was needed unexpectedly. The iiifnistry also stated that 1nformafiort had not been provided to establish that the appellant did not have resources available to purchase the item(s) or meet the expense. In the Request for Reconsideration the appellant stated that she has a number of medical issues that have impacted on her health and that in addition to her disability cheque she had to borrow money to make different purchases, i.e. a back massage machine, massage therapy treatments, etc, to assist her with her health. The appellant stated she has vision problems as well and needs help with her vision and paying for an eye examination. At the hearing the ministry relied on the facts in the reconsideration decision. The ministry did not call any witnesses. At the hearing the appellant called one witness. In response to questions from the advocate the witness testified that it was his dad that usually took his mother (the appellant) shopping and he recalled that one day after his mother was released from hospital (a few months ago) that his mother and dad came home from shopping with a back massager and muscle stimulator. The witness recalled that when his mother was released from hospital she appeared to have back problems and was unable to walk. In response to a question from the panel, the witness testified that he is of adult age. The panel finds the testimony from the witness contains information or evidence that is in support of the information and record that was before the ministry at the time the reconsideration decision was made and therefore is admissible as evidence under section 22(4) Employment and Assistance Act (EAA). The appellant testified that she was admitted to hospital in mid-August and was released from hospital after being there for 1 to 2 months. The appellant testified she was still in a lot of pain and not ready to leave but th was released and then re-admitted 4 days later. The appellant testified that on September 11 , 2012 she called the ministry office requesting a crisis supplement to reimburse her for some past expenses medical prescriptions not covered by Pharmacare, special tweezers, back massage machine and a thermometer and requested money to purchase some other items that she felt she needed so she could deal with her back pain. The appellant testified that she also needed an eye examination and wanted it covered as she has had vision problems for several years and now she is having trouble seeing again. The appellant testified that when she spoke to the ministry she requested money for everything that she was going to need for the rest of the year as she has to pay for many items that are not covered by the ministry. The appellant testified that at the time of her request the ministry advised her about the medical equipment process and requested that she have the necessary forms completed by her medical practitioner (MP) and an occupational therapist (OT). The appellant testified that she started doing her own therapy and that her spouse bought the back massage machine on September 16 th based on a recommendation from her chiropractor as her MP and the OT declined to complete and sign the forms because the MP and OT felt the equipment was not necessary. The appellant testified she purchased the thermometer on August 31 st because she had been having high temperatures and she wanted th to monitor them; the prescri lion from Sho er's Dru Mart purchased on September 15 is taken on a re ular EAAT003(10/06/01)
I APPEAL#~ basis; the tweezers purchased on July 3' were for a skin condition she has had for several years; the massage machine purchased from Zeller's on September 3 rd helps relieve her back pain and her husband had to borrow the money to make the purchase. The appellant testified she considered the items were needed to deal with a life threatening condition because she was in pain. The panel finds the testimony from the appellant contains information or evidence that is in support of the information and record that was before the ministry at the time the reconsideration decision was made and therefore is admissible as evidence under section 22(4) Employment and Assistance Act (EAA). Findings of Fact • The appellant resides with her spouse and adult son. EAA T003(10106101)
PART F Reasons for Panel Decision The issue under appeal is the reasonableness of the ministry's reconsideration wherein the ministry determined that the appellant was not eligible for a crisis supplement under section 57 EAPWDR because the appellant had requested reimbursement for funds spent on a variety of items and had not identified a specific item which related to an unexpected expense or an item that was needed unexpectedly. Therefore the ministry was not able to establish that: • the appellant had an unexpected expense, or that the appellant needed to obtain an item that was unexpectedly needed, and • the appellant was unable to meet the expense or obtain the item that was unexpectedly needed becausEl there were no resources available to the fa_m~ily,__un_i_t ________ as set out in section 57(1)(a) EAPWDR. Further, that the ministry determined that failure to meet the expense or obtain the item will not result in imminent danger to the physical health or any person in the family unit, or removal of a child under the Child, Family and Community Service Act as set out in section 57(1 )(b) EAPWDR. The relevant legislation: EAPWDR Crisis supplement Section 57 (1) The minister may provide a crisis supplement to or for a family unit that is eligible for disability assistance or hardship assistance if (a) the family unit or a person in the family unit requires the supplement to meet an unexpected expense or obtain an item unexpectedly needed and is unable to meet the expense or obtain the item because there are no resources available to the family unit, and (b) the minister considers that failure to meet the expense or obtain the item will result in (i) imminent danger to the physical health of any person in the family unit, or (ii) removal of a child under the Child, Family and Community Service Act. (2) A crisis supplement may be provided only for the calendar month in which the application or request for the supplement is made. (3) A crisis supplement may not be provided for the purpose of obtaining (a) a supplement described in Schedule C, or (b) any other health care goods or services. (4) A crisis supplement provided for food, shelter or clothing is subject to the following limitations: (a) if for food, the maximum amount that may be provided in a calendar month is $20 for each person in the family unit, (b) if for shelter, the maximum amount that may be provided in a calendar month is the smaller of (i) the family unit's actual shelter cost, and (ii) the maximum set out in section 4 of Schedule A or Table 2 of Schedule D, as applicable, for a family unit that matches the family unit, and (c) if for clothing, the amount that may be provided must not exceed the smaller of (i) $100 for each person in the family unit in the 12 calendar month period preceding the date of application for the crisis supplement, and (ii) $400 for the family unit in the 12 calendar month period preceding the date of application for the crisis supplement. At the hearing the appellant argued that she understood she was entitled to one or two crisis supplements a year and that she needed the supplements to meet past expenses that the ministry would not cover, i.e. prescri lions, and that she needed some other items, i.e., massa e machines to help relieve her back pain. EAAT 003( 10/06/01)
I APPEAL# The appellant argued that she is designated a Person with Disabilities (PWD) and that she has to pay for many items that are not covered by the ministry and needs money to cover future expenses. The ministry argued that the appellant's request does not meet the legislated criteria, that the appellant must meet all three criteria stated in the legislation to be eligible for a crisis supplement. The ministry noted that the appellant wanted to be reimbursed for purchases she had made and wanted funds for other items that she needed. The ministry argued that in the appellant's request she indicated she needed clothing, a hospital bed and a walker and that these requests are being addressed separately and in accordance with section 57(3) and (4), EAPWDR. The ministry argued that the appellant has not identified a specific item that meets the legislated criteria, Further, the appellant did not show that the supplements requested were needed to meet an unexpected expense or needed to obtain an item that was unexpected needed; and she did not show that she did not have the resources to obfamlhe item. The~ministry argueath~atitcanrro~authorize a supplemenHo~· cover expenses that are not covered in the legislation, section 57(1) EAPWDR. The panel finds the ministry's position is that the appellant did not provide information that established that she met the legislated criteria within section 57 EAPWDR and the appellant's position is that she has a number of debilitating health issues and needed the supplement to recoup her expenses for equipment, i.e. massage machines, prescriptions, tweezers, thermometer, etc. and to purchase future items that she will need to assist her with her health issues. The appellant's evidence is that the tweezers were purchased in July for a skin condition that she has had for several years; that the thermometer was purchased in August to monitor her body temperature; and the ointment was purchased in September without prescription. The panel finds the appellant did not provide any evidence that any one item purchased was an unexpected expense or that she needed to obtain an item that was unexpectedly needed. The panel finds the ministry's decision reasonable that the appellant did not provide sufficient information to establish that she needed the supplement to meet an unexpected expense or obtain an item unexpectedly needed. The panel finds that the appellant chose to purchase the various items in an attempt to relieve some of her health symptoms but there is no medical evidence before the panel that the item(s) were of an emergent nature whereby the purchase could be considered needed and unexpected or that these item(s) were prescribed by a medical practitioner to provide the appellant with some relief from her medical symptoms. The panel finds the appellant had suffered from medical conditions for years and purchasing tweezers to assist with that condition does not make the purchase unexpected or an item that is unexpectedly needed. The panel makes the same finding in relation to the purchase of the thermometer, the ointment and the prescriptions. In reference to the issue that the appellant does not have resources available to meet the expense or obtain the item; the ministry argued that the appellant did not provide information to establish that she did not have resources available to purchase a specific item as no specific item or expected expense had been identified. The appellant argued that she had informed the ministry that she wanted to be reimbursed for purchases that she made and provided the ministry with her receipts of purchase. The appellant also argued that she needed other items but did not have any funds to make these purchases so her spouse had to borrow the money. The panel finds the ministry's decision reasonable that the appellant did not provide sufficient information to establish that she did not have the resources to meet an unexpected expense or obtain an item unexpectedly needed. The panel finds that the evidence supports the ministry's decision that the appellant did not provide sufficient information to establish that she required a crisis supplement to meet an unexpected expense or obtain an item that was unexpectedly needed and the panel finds that the ministry reasonably determined that the appellant did not meet the criteria set out in section 59(1)(a) EAPWDR. In reference to section 59(1) b)(i) and (1)(b (ii EAPWDR the le islation states: EMT003(10/06/01)
I APPEAL# Section 59(1 )(b) the minister considers that failure to meet the expense or obtain the item will result in (i) imminent danger to the physical health of any person in the family unit, or (ii) removal of a child under the Child, Family and Community Service Act. The ministry argued that no item of need had been identified so it cannot be established that failure by the ministry to provide the item or meet the appellant's need will result in imminent danger to the physical health of any person in the family unit. The ministry argued the appellant's son is an adult and therefore the removal of a child under the Child, Family and Community Service Act does not apply. The appellant argued that she needed to purchase the items because she was in pain and that this was life threatening. The panel finds there is no evidence before the panel that if the ministry failed to provide the appellant a crisis supplement that it would result in imminent danger to the physical health of any person in the family unit. The appellant's son, who testified before the panel, stated that he is of adult age which was not contested by the appellant and therefore the removal of a child from the appellant's home under the Child, Family and Community Service Act is not applicable in this matter. The panel finds that the ministry's decision to determine that failure to meet the expense or obtain the item unexpectedly needed would not result in the imminent danger to the physical health of any person in the family unit or the removal of a child under Child, Family and Community Service Act was reasonable and that the criteria set out in section 59(1 )(b) EAPWDR was not established. In reference to the appellant's request for clothing, a hospital bed and a walker, in the reconsideration decision the ministry stated that these requests are being addressed under separate processes to which the appellant concurred. Section 57(3) states that a crisis supplement may not be provided for the purposes of obtaining a supplement described in Schedule C, or any other health care goods or services. The appellant did not raise an objection to the ministry's position. Therefore the panel finds that the ministry's decision to determine that the appellant's request for clothing, hospital bed and a walker will be determined by another process was reasonable. The panel finds that the ministry's reconsideration decision is supported by the evidence and confirms the decision pursuant to section 24(1)(a) and 24(2)(a) of the EAA. EAAT003(10/06I01)
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