PART C Decision under Appeal The decision under appeal is the Ministry of Social Development (the "Ministry") March 8, 2013 reconsideration decision in which the Ministry determined that the Appellant was not eligible for Persons with Disabilities ("PWD") designation because she did not meet all the requirements in section 2(2) of the Employment and Assistance for Persons with Disabilities Act. The Ministry was not satisfied that the Appellant has a severe mental or physical impairment that in the opinion of a prescribed professional (i) directly and significantly restricts her ability to perform daily living activities either continuously or periodically for extended periods; and, (ii) as a result of those restrictions she requires help to perform those activities. The Ministry was satisfied that the Appellant has reached 18 years of age and in the opinion of a medical practitioner her impairment is likely to continue for at least 2 years. : PART D Relevant Legislation Employment and Assistance for Persons with Disabilities Act ("EAPWDA") Section 2(2) and 2(3). Employment and Assistance for Persons with Disabilities Regulation ("EAPWDR") Section 2. EAAT 003(10106101)
LPPEAL# -------~ PART E Summary of Facts For its reconsideration decision, the Ministry had the following evidence: 1. The Appellant's PWD application consisting of the Appellant's self-report dated November 20, 2012, and a physician's report ("PR") and an assessor's report ("AR") both completed by the same doctor on November 15, 2012 who indicated that the Appellant has been his patient for 6 months and he had seen her between 2-10 times during that time. 2. Appellant's request for reconsideration dated February 25, 2013 together with a letter from an advocate addressed to the doctor who completed the PR and AR dated February 25, 2013, an October 15, 2012 x-ray, an MRI appointment confirmation for February 22, 2013, a breast imaging requisition, a receipt for an MRI dated June 15, 2012, receipts for massage/chiropractic visits from May 2012 to February 13, 2013, receipts for physiotherapist treatments dated August 2012 through January 2013, a letter dated October 3, 2012 to the Appellant's doctor from a neurosurgeon, and a November 13, 2012 neurodiagnostic requisition. Diagnoses In the PR, the doctor described the Appellant's diagnosis as severe degenerative disc disease onset 2011. He added, "the patient may suffer from thoracic outlet syndrome, but this has not yet been confirmed by imaging or specialist consult." The doctor described the Appellant's health history as "suffers from cervical degenerative disease, with possible nerve impingement." Physical Impairment The Appellant described her disability as: • Suffering from severe degenerative disc disease of her cervical spine and recent x-rays detected a cervical rib on her right side producing symptoms of thoracic outlet syndrome which will likely require surgery; MRI of thoracic area will follow, as well as nerve conduction tests. • When she is vertically upright, the weight of her head puts pressure (compresses) on the discs in her neck, impinging the nerves in her arms. • All activities require the use of her neck and arms, therefore increasing her pain with every motion, affecting all of her everyday activities. • Her left shoulder has limited range of motion and strength; certain positions cause excruciating pain that radiates down her arm for about thirty seconds. • Putting shirts, bras and jackets on and off cause extreme pain for a short duration; any use of her right arm, brushing hair and teeth, lifting, pouring coffee, stirring or chopping food, etc., wiping counters causes her neck, shoulder, arm, shoulder blades constant aching and burning. • Pain medication does not reduce her pain enough to continue any tasks. • She often lies down and uses ice packs and/or heat compresses to reduce pain; she also suffers severe headaches and pain in the right eye. • Due to the severity of erratic, unbearable pain, it is impossible for her to be upright throughout the day; dressing is very limited as well as her ability to write and use the computer to help her son with homework. • She is still waiting for nerve blocking injections for her neck, which may aid in reducing the intensity of her pain; MRI and nerve conducting tests will follow for thoracic area; her cervical rib may need removal. The doctor wrote, in the PR, that the Appellant's cervical degenerative disease "causes severe neck and right shoulder, severe pain with minor use. She is unable to push, pull, lift, carry or stand up for orolonc:ied periods. Functionally, she now must have a relative (her father or son) perform all cook~ · EAAT003(10/06/01)
I APPEAL# housework, and shopping for her all the time." In the PR, the doctor also wrote that the degenerative disc disease is permanent and a neurosurgeon, who saw the patient, indicated that there is no surgical treatment available. However, the neurosurgeon indicated that the Appellant's symptoms may be improved with injections into her neck. She is now on a wait list to see another specialist about injections. The doctor also reported: • the Appellant's functional skills as follows -can walk unaided on a flat surface 2-4 blocks, climb 5+ stairs unaided, no lifting and can remain seated 1-2 hours. • No significant deficits with cognitive and emotional function. • The Appellant "is anxious to return to her previous level of function and is disappointed that there is no surgical treatment offered." In the October 2012 letter, the neurosurgeon describes the history of the Appellant's neck and shoulder conditions and her physical examination. The neurosurgeon wrote that: • The Appellant has normal range of motion of the cervical spine, with palpation over the upper cervical spines processes she jerks her left arm out. • Reflexes are normal and symmetrical; has normal strength in all muscle groups in both arms; sensation is normal to touch and pin prick in all dermatomes in both arms; complains of pain with internal and external rotation of the left shoulder; left shoulder abduction is limited. • The June 2012 MRI of the cervical spine was reviewed; showed some spondlytic change in her neck with some loss of disc space height and osteophyte formation of C506 and C6-7, casing some narrowing of the spinal canal; no signal change in the spinal cord in the cervical area; some narrowing of the spinal canal shown in axial views; bit of narrowing of invertebral foramina at C5-6 and C6-7. The neurosurgeon provided the following assessment: · • Wearing a cervical collar for an extended period is not necessarily a good idea. • Appellant does not have any instability of her cervical spine; good portion of the symptoms she describes are not related to cervical spine disease. • May benefit from some physic for her left shoulder. • Doesn't see the Appellant benefiting from any surgery on her spine; may benefit from some injections but the Appellant clearly shows some signs of functional overlay on examination. • Surgery definitely not indicated at that point. The October 15, 2012 x-ray report indicated that x-rays : • Of the chest showed the lungs and pleural spaces are clear; cardiomediastinal contour appears normal. • Of thoracic spine indicates it is in normal alignment; vertebral body and disc heights are maintained. • Of right shoulder indicates no significant bony or joint space abnormality is identified. • Of left shoulder indicates no significant bony or joint space abnormality; left rib appears hypoplastic and mid portion is absent; no evidence of a mass at this site; recommend correlation with any history of prior surgical or traumatic history. In the advocate's February 25, 2013 letter, the doctor was asked to check "agree" or "disagree" by statements about the Appellant's physical functioning abilities and restrictions to her daily living activities. The advocate prefaced the checklist with the statement that the Aopellant "has provided us ! EAAT 003(10/06/01)
!A PPEAL~ with additional information regarding her condition. We would ask that you indicate your agreement or disagreement and add any comments that you think would be helpful." The doctor signed the bottom of the letter on February 25, 2013 and added his office stamp. Each part requiring a check is prefaced with the statement the Appellant "states that she". The doctor checked that he agreed that the Appellant is only able to walk up to 2-4 blocks at one time, has to use a handrail at all times when going down stairs, and is unable to lift or carry any weight at all. Mental Impairment There is no diagnosis of any mental health condition and no information about any mental impairments, or impacts to cognitive and emotional functioning in any of the reports. Restrictions to Daily Living Activities In the AR, the doctor wrote that the Appellant lives with her father and her son. The impairments impacting her ability to manage daily living activities are described as "cannot lift, carry, push, pull or stand for prolonged periods." The doctor reported that: • The Appellant's ability with speaking, writing, and hearing is good, and with writing is satisfactory, adding that writing causes her neck pain to flare. • Walking indoors and outdoors, climbing stairs and standing are all independent, for lifting, carrying and holding the Appellant needs continuous assistance -"cannot lift, carry or hold". • For the following tasks of personal care dressing, grooming, bathing, toileting and transfers in/out of bed takes significantly longer, "takes approx. 45 minutes, [occasionally] sleeps with clothing on because it takes so long to do the next morning." For the tasks of feeding herself, regulating diet and transfers in/out of a chair, the Appellant is independent. • For all aspects of basic housekeeping the Appellant needs continuous assistance -"all laundry and housekeeping are done by her father or son because she cannot." • For all aspects of shopping, except carrying purchases home, the Appellant is independent; she needs continuous assistance carrying purchases home -"all carrying is done by son". • For meal planning, the Appellant is independent; for food preparation, cooking and safe storage of food the Appellant needs continuous assistance -"all cooking etc. is done by her father". • For all aspects of paying rent and bills, medications and getting in and out of a vehicle the Appellant is independent. Using transit and transit schedules is not applicable. The physician did not complete the section for cognitive and emotional functioning or the section for social functioning. In the February 25, 2013 letter, the doctor checked that he agreed with statements that the Appellant: • Needs continuous assistance (has to rely on father and son) or is unable to do the following daily living activities due to the combination of her conditions laundry, basic housekeeping, food preparation and cooking. • Takes significantly longer than typical (2-3 times longer) with dressing, grooming, bathing, toileting, transfers (in/out of bed) and getting in and out of a vehicle. The doctor disagreed that the Appellant needs continuous assistance going to and from stores adding, "patient can physically go to the store". Help with Daily Living Activities The Appellant wrote that her elderly father is burdened with her limitations and does the majority of all household chores. ' EAAT003(10/06/C1)
I lsPPEAL # In the AR, the doctor wrote that the Appellant's "father and son do all household chores and shopping", "all laundry and housekeeping are done by her father and son because she cannot", "all carrying is done by son", and "all cooking etc. are done by her father". The doctor did not indicate that any assistive devices are needed or being used, and did indicate that no assistance is provided by an assistance animal. In her notice of appeal dated March 21, 2013, the Appellant wrote that her condition has not been fully diagnosed; all tests and treatments have not been done. The neurosurgeon could not attribute impingement at that time as tests showing the mid section of her first rib as missing was not available. She wrote that her doctor believes that she has impingement and if treatments aren't successful, surgery will be the next plan. The Appellant stated that she is still waiting for nerve blocking injections and a nerve conduction test on November 2, 2013. She has a colon x-ray scheduled for March 13, 2013, a mammogram scheduled for March 27, 2013 and surgery for possible breast cancer on April 2, 2013. She also wrote that her MSP (medical services plan) visits are almost exhausted. Physiotherapy and her inversion table are necessary or she spends days at a time in agony. The Appellant stated that she does not walk everyday or shower. She often sleeps in her clothes. Her dad is not fully capable and they need help. She also described impacts to her son. At the hearing, the Appellant submitted copies of the following documents: • MRI report dated February 2013 indicating that the Appellant has degenerative disc disease and narrowing of the spinal canal. • Consultation report dated October 1, 2012 by a doctor reviewing the Appellant's medical history, history of her neck and bilateral radicular arm pain, right worse than left, reviewing the details in the June 15, 2012 MRI described above and stating that Appellant has moderate disc space narrowing, prominent osteophyte complex, and severe degenerative changes in the facet joints. • Referral form dated April 8, 2013 for additional physiotherapy treatments extension for acute neck pain. • Pathology report dated April 8, 2013 diagnosing the Appellant with focal low-grade ductal carcinoma, columnar cell hyperplasia, and lobular carcinoma in situ. The Ministry did not object to the admissibility of these documents. At the hearing, the Appellant provided the same information as in her notice of appeal. In addition, she stated that she just had surgery for breast cancer. The Appellant said she is waiting to have nerve injections and nerve induction tests scheduled for November 2012. She described her current impairments as being unable to sit comfortably for 2 hours, unable to walk comfortably and spending lots of time lying down. She wears a neck collar when she is driving and walking. The Appellant also stated that she takes large amounts of pain killers and she feels that her body is shutting down from . the medications and severe pain. Someone, usually her father or son, helps with shopping and now she only makes breakfast for her son. Sometimes she spends days in bed after shopping. Pursuant to section 22(4) of the Employment and Assistance Act, the Panel admitted the documents submitted by the Appellant as well as the information in her notice of appeal and her testimony at the hearing as providing further detail relating to the Appellant's medical conditions and as being in support of information that was before the Ministry on reconsideration. At the hearing, the Ministry relied on its reconsideration decision. EAAT003(10/06/01)
I APPEAL# PART F Reasons for Panel Decision The issue in this appeal is whether the Ministry reasonably determined that that the Appellant was not eligible for PWD designation because she did not meet all of the requirements in section 2(2) of the EAPWDA, and specifically, that the Appellant does not have a severe mental or physical impairment . that in the opinion of a prescribed professional (i) directly and significantly restricts her ability to perform daily living activities either continuously or periodically for extended periods; and, (ii) as a result of those restrictions she requires help to perform those activities. The eligibility criteria for PWD designation are set out in the following sections of the EAPWDA: 2 (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i) directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B) periodically for extended periods, and (ii) as a result of those restrictions, the person requires help to perform those activities. (3) For the purposes of subsection (2), (a) a person who has a severe mental impairment includes a person with a mental disorder, and (b) a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, (ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. The "daily living activities" referred to in EAPWDA section 2(2)(b) are defined in the EAPWDR as: 2 (1) For the purposes of the Act and this regulation, "daily living activities", (a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities: (i) prepare own meals; (ii) manage personal finances; (iii) shop for personal needs; (iv) use public or personal transportation facilities; (v) perform housework to maintain the person's place of residence in acceptable sanitary condition; (vi) move about indoors and outdoors; (vii) perform personal hygiene and self-care; (viii) manage personal medication, and (b) in relation to a person who has a severe mental impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. The Panel will consider each party's position regarding the reasonableness of the Ministry's decision under the applicable PWD criteria at issue in this appeal. In this appeal, the Panel Chair and the Panel Member agreed on the findings with respect to the issue of the reasonableness of the Ministry's decision regarding the severity of the Appellant's impairment. However, they did not agree on the reasonableness of the Ministry's decision as to whether or not the Appellant met the requirements in section 2(2)(b) of the EAPWDA. Therefore, under restrictions to daily living activities and help for daily living activities discussed below, there are two sets of findings and conclusions, one by the Panel Chair and one by the Dissenting Panel Member. Severe Phvsical /mnairment EMT 003( 10/06/01)
I APPEAL# The Appellant's position is that her medical conditions severely impair her ability to function every day. She has severe degenerative disc disease and because of the severity of the pain she experiences daily she has difficulty dressing, is unable to cook, do housework or shop, and it is impossible for her to be upright throughout the day. The Ministry's position is that the Appellant's functional skill limitations are not significantly restricted except for lifting, and are more in keeping with a moderate degree of impairment. The Ministry is not satisfied that the information provided is evidence of a severe physical impairment. The Full Panel's Findings The EAPWDA provides that the determination of the severity of impairment is based on whether the Minister is satisfied that the information provided establishes a severe impairment, taking into account all of the evidence including that of the Appellant. That legislation is also clear that the fundamental basis for that assessment is the evidence from a prescribed professional regarding the type of impairment and its impact on daily functioning as evidenced by functional skill limitations and restrictions to daily living activities. With her reconsideration request and at the hearing, the Appellant provided evidence that she was recently treated for breast cancer. She submitted that this medical condition contributes to her overall health problems. The Panel finds that there is no evidence as to how this medical condition restricts her functional skills or her ability to manage daily living activities. The diagnosis of and treatment for a medical condition are not in themselves determinative of a severe impairment . The Appellant described experiencing severe, erratic, unbearable pain even with medication because . of severe degenerative disc disease of her cervical spine. She stated that all activities requiring the · use of her neck and arms increases her pain and affects her ability to dress, lift, carry items, cook and · even wipe counters. The pain can be so excruciating that she finds it impossible to remain upright. The Appellant also stated that she does not walk or shower every day, and often sleeps in her clothes because of the pain. She wears a neck collar when walking and driving. The Appellant also described how lifting her arms causes severe pain and she is unable to stand for any length of time. She submitted that she often has to lie down with ice packs or heat compression to reduce the pain. The Appellant stated that she relies on her father and son to do the cooking and housework. She does drive herself to go shopping. The Appellant's doctor, who completed the PR and AR, diagnosed the Appellant with cervical degenerative disease, causing severe neck and right shoulder pain with minor use. He described her restrictions from this condition as being unable to push, pull, lift, carry or stand for prolonged periods, and he wrote that writing causes her neck pain to flare. The doctor also noted that the Appellant is restricted to walking 2-4 blocks at a time, to using a hand rail when climbing down stairs and limited in seating for 1-2 hours. In his reports, the doctor indicated that the Appellant is continuously restricted in lifting, carrying and holding, in all aspects of housekeeping and with carrying purchases home. The doctor also described the Appellant's impairments in dressing, grooming, bathing, toileting and transfers in/out of bed as taking significantly longer; adding that it takes her about 45 minutes longer and she occasionally sleeps with her clothing on because it takes so long in the morning. The full Panel finds that the doctor's description of the Appellant's impairments and how they restrict her daily functioning is substantially the same as the Appellant's. The full Panel further finds that when the A ellant's evidence is considered to ether with the doctor's it was not reasonable for the Minis! to !=AA T003(10/06/01)
~APPEAL# determine that the Appellant does not have a severe physical impairment. Severe Mental Impairment The full Panel finds that there was no diagnosis of a mental health condition, no information about any mental impairment and no evidence of impacts to cognitive and emotional function. Therefore, the full Panel finds that the Ministry reasonably determined that the Appellant does not have a severe mental impairment. Restrictions to Daily Living Activities The Appellant's position is that she relies on her elderly father and her son to do the laundry, housekeeping, cooking and carrying shopping. She also takes significantly longer to dress, sometimes sleeping with her clothes on and often has to lie down because of the severity of the pain. The Ministry's position is that because the majority of daily living activities are performed independently or require help mostly with tasks that involve lifting, the information from the Appellant's prescribed professional does not establish that the impairment significantly restricts daily living activities either continuously or periodically for extended periods. The Panel Chair's Findings Section 2(2)(b) of the EAPWDA requires the opinion of a prescribed professional to confirm that the Appellant's severe impairment directly and significantly restricts her daily living activities. In other words, the restrictions to those activities must be directly caused by the severe impairment. The prescribed professional, the Appellant's doctor, described the impairments that impact her ability to manage daily living activities as "cannot lift, carry, push, pull or stand for prolonged periods". The doctor reported that the Appellant is continuously restricted in lifting, carrying and holding. She is also continuously restricted in basic housekeeping tasks, carrying purchases home and with food preparation, cooking and safe storage of food. However, the Appellant testified that she prepares breakfast for her son. The Appellant's father and son help with these tasks. Also, although the doctor indicated that the Appellant takes significantly longer with some aspects of personal care (dressing, grooming, bathing, and transfers in/out of bed), there is no evidence that she requires help with these tasks. In his initial report, the doctor indicated that the Appellant was independent getting in and out of a vehicle, but in February 2013 agreed that this activity takes significantly longer. However, the Panel notes that the Appellant testified that she drives herself. The doctor further reported that the Appellant is independent feeding herself, regulating her diet and transferring in/out of a chair. She is also independent in all aspects of shopping, except for carrying purchases home. In fact, the doctor specifically wrote that the Appellant "can physically go to the store". The doctor also reported that the Appellant is independent walking indoors and outdoors, climbing stairs and standing. Therefore, the Panel Chair finds that even though the doctor reported that the Appellant is continuously restricted in some tasks of daily living activities requiring physical functioning abilities, he also reported that she is independent in many other activities requiring physical abilities. The continuous restrictions reported are only for tasks generally involving carrying and lifting. She is also independent paying rent and bills, in all aspects of medications and transportation. The social functioning aspects of daily living activities in the AR were not completed by the doctor. Therefore, based on the doctor's evidence, the Panel Chair finds that although the Appellant experiences continuous restrictions in tasks involving liftin and car in , it also finds that the Minis! reasonabl determined that the evidence does not EAAT 003(10/06/01)
I APPEAL# establish that the Appellant's impairment significantly restricts daily living activities either continuously or periodically for extended periods. The Dissenting Member's Findings Section 2(2)(b) of the EAPWDA requires the opinion of a prescribed professional to confirm that the Appellant's severe impairment directly and significantly restricts her daily living activities. The prescribed professional, the Appellant's doctor, described the impairments that impact her ability to manage daily living activities as "unable to push, pull, lift, carry, or stand for prolonged periods". The doctor writes that the Appellant "must have a relative (her elderly father or young son) perform all cooking, housework, shopping all of the time." In the AR the doctor indicates that the Appellant requires continuous assistance from another person to perform basic housekeeping, laundry, carrying purchases home from shopping, food preparation, cooking, and the safe storage of food. The doctor indicates that the Appellant takes significantly longer that typical in dressing, grooming, bathing, toileting, and to transfer in/out of bed. The Dissenting Member finds that although the Appellant is independent in most of her daily living activities the doctor indicates in the AR that she requires continuous assistance from another person for three daily living activities out of a possible eight. The doctor writes that the Appellant is continuously restricted for six different activities within 3 daily living activity categories. The Dissenting Member acknowledges the Ministry's argument that "the majority of the daily living activities are performed independently" however the Dissenting Member notes that the legislation does not require the majority of daily living activities to be affected but rather the legislation states the restriction must "in the opinion of a prescribed professional directly and significantly restricts the person's ability to · perform daily living activities either continuously or periodically for extended periods." The legislation uses the plural when referring to "activity" so the Dissenting Member finds that more than one daily living activity can be affected by the Appellant's condition. The Dissenting Member is satisfied that the PR notes three separate daily living activities are affected continuously or periodically for extended periods. The Dissenting Member acknowledges that the Appellant's restrictions are related to lifting or carrying but notes that the legislation does not require that the cause of the Appellant's restrictions be from multiple motions. The fact that all of the Appellant's daily living activity restrictions are relating to lifting or carrying doesn't change the fact that the doctor confirms that she is directly and significantly restricted. Further, the Dissenting Member notes that the doctor added comments to the AR to further clarify his assessment. He writes that the housekeeping and laundry are "always done by her father or son because she cannot," carrying purchases from shopping is "always done by son," and regarding food prep, cooking, and food storage, "All cooking etc. is done by her father." The Dissenting Member is satisfied after considering the doctor's written comments as well as how he responded on the AR and PR form that in his opinion the Appellant meets the legislative requirements in EAPWDA section 2. The Dissenting Member finds that the Ministry was not reasonable to find that the Appellant's physician did not establish that her impairment directly and significantly restricts her daily living activities. Help with Daily Living Activities The Appellant submits that her father and son have to do the cooking, food preparation, laundry, housekeeping and carrying shopping. She also uses a neck collar when walking and driving. The Ministrv's position is that because the evidence does not establish that dailv livina activities are EAAT003(10/06/01)
I APPEAL# significantly restricted, it cannot determine that significant help is required from other persons. Also, no assistive devices are used. The Panel Chair's Findings Section 2(2)(b)(ii) of the EAPWDA also requires the opinion of a prescribed professional to confirm that as a result of her restrictions the Appellant requires help with her daily living activities. The Panel Chair finds that there is evidence that the Appellant has continuous help with certain tasks involving lifting and carrying, such as cooking, food preparation, laundry and carrying shopping. However, the Panel Chair finds based on this evidence that the Ministry reasonably determined that the Appellant does not need significant help with her daily living activities and that because direct and significant restrictions in the Appellant's ability to perform daily living activities have not been established, it cannot be determined that the Appellant needs help to perform those activities. The Dissenting Member's Findings Section 2(2)(b)(ii) of the EAPWDA requires the opinion of a prescribed professional to confirm that as a result of her restrictions the Appellant requires help with her daily living activities. The Dissenting Member is satisfied that the doctor has been unambiguous in his assessment of her abilities and the assistance she requires to perform her daily living activities. In both the AR and the PR the doctor indicates by checking the boxes on the form and in his notations that the Appellant requires the assistance of others. The Dissenting Member finds that the Ministry was unreasonable to find that the appellant does not require the significant assistance of another person. Conclusion As noted above, the Panel Chair and the Panel Member did not agree as to whether the Ministry reasonably determined that the Appellant met the criteria in section 2(2)(b) of the EAPWDA. Section 24(5) of the Employment and Assistance Act provides that the decision of a majority of the members of a Panel is the decision of the tribunal, but the decision of the Chair of the Panel governs in the case of a tie. Therefore, in this case, having reviewed and considered all of the evidence and relevant legislation, the Panel Chair finds that the Ministry's reconsideration decision, which determined that the Appellant was not eligible for PWD designation, was reasonably supported by the evidence and therefore it confirms that decision. EAAT003(10/06/01)
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