i APPEAL I: I PART C Decision under Appeal The decision under appeal is the reconsideration decision of the Ministry of Social Development and Social Innovation (the ministry) dated 03 October 2013 denying the appellant designation as a person with disabilities (PWD). The ministry determined that the appellant did not meet all of the required criteria for PWD designation set out in the Employment and Assistance for Persons with Disabilities Act, section 2. Specifically, the ministry determined that, while the ministry was satisfied that the appellant has a severe mental and physical impairment, the information provided did not establish that his severe impairment, (i) in the opinion of a prescribed professional, directly and significantly restricts his ability to perform daily living activities (DLA) either continuously or periodically for extended periods; and, (ii) as a result of those restrictions, he requires help to perform those activities. The ministry also determined that the appellant satisfied the other 2 criteria: he has reached 18 years of age and his impairment in the opinion of a medical practitioner is likely to continue for at least 2 years. PART D Relevant Legislation Employment and Assistance for Persons with Disabilities Act (EAPWDA) section 2 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) section 2 EAAT 003( 10/06/01)
I APPEAL# PART E -Summar of Facts The ministry did not appear at the hearing. After confirming that the ministry was notified of the hearing, the hearing proceeded in accordance with section 86(b) of the Employment and Assistance Regulation. The evidence before the ministry at reconsideration consisted of the following: 1. The appellant's PWD Designation Application dated 21 May 2013. The Application contained: • A Physician Report (PR) dated 21 May 2013, completed by a general practitioner (GP) who has known the appellant for about 2 years and seen him 11or more times in the past 12 months • An Assessor Report (AR) of the same date completed by the same GP. • A Self Report (SR) completed by the appellant. 2. The appellant's Request for Reconsideration dated 01 October 2013, setting out his reasons for the request (see below). Attached to the Request for Reconsideration are the PR and AR, with revisions made by the GP based on "worst case" scenarios. As the revised PR and AR were before the ministry at reconsideration and formed the basis for the I ministry's decision, the panel will summarize only the revised versions, not the original ones. I In the PR, the GP diagnoses the appellant's impairment as depression (onset 1990), asthma/ allergies (onset since 12 years old), substance abuse (onset 1985) and arthritis (chronic pain) (onset increasing for >30 years). In the PR, the GP reports that the appellant can walk less than 1 block unaided (GP: foot-awaiting surgery on nerves), climb no stairs (GP: uses elevator), lift under 5 lbs., and remain seated for less than an hour (GP: aggravates back, has to get up and move about periodically). The GP also reports that the appellant has difficulties with communication, causes being cognitive and other (emotional). The GP assesses the appellant with significant deficits with cognitive and emotional function in the areas of executive, memory, emotional disturbance, motivation, impulse control, attention or sustained concentration, and psychotic symptoms (GP: has been when under the influence of drugs). The panel will summarize the evidence from the PR and AR relating to the appellant's impairments as it relates to the PWD criteria at issue. Ability to perform DLA PR: The GP indicates ("worst case scenario") that the appellant is restricted in performing following DLA on a periodic basis: personal self care, meal preparation, management of medications and daily shopping, commenting "when depression is bad." The GP indicates that the appellant is restricted in , performing the following DLA on a continuous basis: basic housework, use of transportation management of finances and social functioning, commenting regarding the latter "tends to isolate himself." The GP indicates that the appellant is not restricted with respect to mobility inside the home ("no stairs in home") and provides no assessment with respect to mobility outside the home. EAA T003( 10 /06101 )
I APPEAL 0 i The GP indicates that the appellant has not been prescribed any medications that interfere with his ability to perform DLA. AR: Regarding communications, the GP assesses the appellant's level of ability with respect to speaking and hearing as satisfactory. The GP assesses the appellant's ability with respect to reading and writing as poor, commenting: "Has difficulty with communications difficulty expressing self," and with a further comment: "Tends to isolate self, has difficulty dealing with other people." With respect to mobility and physical ability, the GP assesses the appellant as independent with walking indoors, walking outdoors, climbing stairs, standing, lifting and carrying and holding, with the comment: "But can only do short distances. Prior club foot. Has had orthopedic surgery. Still painful to walk or stand for any prolonged time." The GP provides assessments for the appellant's ability to perform DLA as follows (The GP's comments in parenthesis): • Personal care independent for all listed aspects: dressing, grooming, bathing, toileting, feeding self, regulating diet, transfers in/out of bed and transfers on and off chair (but needs encouragement to groom self, keep self clean; mom helps to regulate and prepare diet/food). • Basic housekeeping periodic assistance required from another person for laundry (mother does this); no assessment provided for basic housekeeping. • Shopping independent for all listed aspects: going to and from stores, reading prices and labels, making appropriate choices, paying for purchases, and carrying purchases home (mother helps with shopping and managing associated finances). • Meals periodic assistance from another person required for meal planning (mother helps him), food preparation and cooking; independent for safe storage of food. • Pay rent and bills independent for all listed aspects: banking and budgeting; periodic assistance from another person for paying rent and bills (mother helps). • Medications independent for all listed aspects: filling/refilling prescriptions, taking as directed and safe handling and storage. • Transportation independent for all listed aspects: getting in and out of vehicle, using public transit and using transit schedules and arranging transportation. The GP further comments: "See [impact on daily functioning of mental impairment]. Depression severe at times to point of suicidal thinking. 'No purpose' in life. Finds it hard to get out of bed most days despite being treated with medication." He also writes: "Struggles with depression daily, often severe at times with suicidal thinking; hard to get out of bed most days." As to how the appellant's mental impairment impacts his daily functioning, the GP assesses a moderate impact in the following areas: emotion (depression), impulse control, insight and judgment, attention/concentration, executive, memory, and motivation. The GP assesses no impact in the areas of bodily function, consciousness, motor activity, language, psychotic symptoms, other neuropsychological problems, and other emotional or mental problems. The GP comments: "Has suffered with depression all his life, exacerbated by many personal losses and then by drug and alcohol addiction. Has been seeing a counselor and has done some mental health programs. Still struggles on a daily basis, can be severely depressed at times with suicidal thinking." With respect to social functioning, the GP assesses the appellant requiring periodic sup art/supervision in the followin areas: makin a ro riate social decisions, abilit to develop EAAT 003( 10/06/01)
I APPEAL~ 7 and maintain relationships, interacting appropriately with others and ability to deal appropriately with unexpected demands (for these areas, the GP comments: "Has counselors and daily meetings." The GP assesses the appellant independent regarding the ability to secure assistance from others. The GP reports that the appellant's mental impairment impacts his relationships with both his immediate and his extended social networks as resulting in marginal functioning. Assistance required PR: The GP reports that the appellant's mother helps him with cooking, cleaning, shopping and finances. AR: With respect to social functioning, the GP describes the support/supervision required by the appellant to help maintain him in the community as counselors and addiction group meetings. The GP indicates that the appellant receives assistance provided by family, health authority professionals, community service agencies and volunteers (e.g. [addiction recovery support group]) The GP does not identify any assistive devices as being routinely used or required by the appellant. The GP comments: "Substance abuse --"does attend support group, would probably relapse if did not attend." In the SR the appellant describes a troubled early life and goes on to write: "My daily life now is a daily battle with depression and anxiety. These episodes can last for a day or two weeks. When in these episodes I am unable to cope with daily life. I isolate, don't care for myself properly and can't deal with people. I am presently in recovery but it is a struggle and creates high anxiety and then depression. During these times I do require some assistance with daily living chores and to steer me in the right direction." In his Request for Reconsideration the appellant writes that in the initial application he was not responding to his GP under worse case scenarios, as his pride would not allow him to think he was disabled. Since making his original application he has tried to return to his profession of baking, but has realized his depression and anxiety and chronic pain from arthritis make it impossible for him to work. He refers to seeing his GP and the revisions the GP has made to the PR and AR (see above). He also refers to the support provided by his mother. He writes that she would help on occasion, but now no longer assist him due to her own situation. He refers to an attached letter from his mother dated 30 September 2013. In that letter, his mother writes that she has supported the appellant financially in the past but due to a change in her financial situation she is no longer able to do this. She adds that the appellant will need assistance, as due to his mental and physical health he is no longer able to work to support himself; this will cause problems for him and could very well lead to a severe crisis. After reconsideration, but before the hearing, the appellant submitted revisions to the AR made and initialed by his GP and a letter from the GP. The revisions to the AR are set out below: • Mobility and physical ability in addition to assessing the appellant independent for walking indoors, walking outdoors, climbing stairs, standing, lifting, and carrying and holding, the GP indicates that all these activities take significantly longer than typical. • DLA: EAA T003( 10 /06/01)
I APPEAL~ 7 Personal care transfers in/out of bed and transfers on/off of chair: independent, adding that these take significantly longer than typical (due to arthritis, especially on rainy days). Shopping going to and from stores and carrying purchases home: independent, adding that these take significantly longer than typical. Transportation getting in and out of vehicle: independent, adding that this takes significantly longer than typical. • Mental impairment impact on daily functioning the GP revised the assessments from moderate impact to major impact for emotion, impulse control, insight and judgment, attention/concentration, and motivation; no impact assessments for other neuropsychological problems and other emotional or mental problems are revised to an assessment of major impact. In the letter dated 18 October 2013 submitted with the revisions to the AR, the GP writes: 'This letter will confirm that [the appellant] suffers with a significant depression and anxiety disorder. Despite medication he still struggles daily with his mood, making it difficult for him to function, as previously documented in his disability application. In addition the medications [2 antidepressants] do cause a fair bit of drowsiness during the day which makes functioning even more difficult. [The appellant] also suffers with chronic pain due to spinal degeneration and osteoarthritis of many of his other joints. This, added to his affective disorder, makes many physical tasks difficult & painful to perform. He does use some low-dose anti-inflammatory medications for this but his gastro-esophageal reflux disease prevents using adequate doses of these medications so that he could function better." At the hearing, the appellant submitted a "To whom it may concern" letter from a health authority mental health and addictions counselor who had a counseling relationship with the appellant from July 2012 until May 2013. The counselor notes that the appellant continues to foster healthy long-term relationship with the recovery community; this is fortunate as the appellant has struggled throughout his life with a depressive disorder arising from caustic parental family environment. She states: "As is true for many individuals in his circumstances, he requires more support from society than individuals do not receive adequate support from family at the start of life." The appellant explained the background to the most recent revisions to the AR. He stated that his GP is not familiar with the legislation and ministry requirements associated with PWD status. In addition, he noted that an assessor may be uncertain of how to complete the assessor report because the range of examples provided in the form can cause confusion regarding the assessment of the impact on daily functioning. The confusion arises from the fact that some of the examples are relevant to the appellant but others are not. For example, he cited the categories listed under Cognitive and Emotional Functioning (on page 16 of the AR). He clarified his symptoms as follows: • Under Emotion, his depression has a major impact on daily functioning but he does not suffer from excessive or inappropriate anxiety; • Under Impulse Control, his failure to resist doing something has a major impact on daily functioning but he does not suffer from an inability to stop doing something; • Under Attention/concentration, his poor short term memory has a major impact on daily functioning but he does not suffer from the other examples listed; • Under Motivation, his Joss of interest has a major impact on daily functioning; • Under Other Neuropsychofoqical Problems, he suffers from Jeaminq disabilities which have a EAAT 003(10/06/01)
I APPEAL# major impact on daily functioning but not from the other examples listed; • Under Other Emotional or Mental Problems, the GP provided a comment to explain the nature of these problems and how they had a major impact on the appellant's daily functioning. But the appellant is not hostile. The appellant explained that the most recent AR revisions resulted from the appellant clarifying with the GP how his particular symptoms impacted his daily functioning. In addition, the appellant explained that initially he had been embarrassed to admit to his GP how severely was his mobility and physical activity restricted. Accordingly, the most recent AR report is a more accurate reflection of his limitations and their impact on his daily functioning. In response to a question, the appellant outlined what a typical day was like for him: • most days he has nothing to do; • he has a small dog which he lets out after he gets up in the morning; • he often goes back to bed and sleeps until about 11 a.m. and usually goes to bed by 9 p.m.; • if he does have any errands such as medical appointments these will have been on his mind for much of the previous day. • he spends much of the day sitting and watching TV; • if he has a good day he may do some housework; • he goes out to his addiction recovery support group meetings 3 to 4 times a week. He sometimes convenes these meetings and this gives him a sense of accomplishment. This organization is a big part of his life; • he sometimes struggles to find the motivation to walk his dog; • he lives alone but his mother usually prepares meals for him about 3 times a week. He does know how to prepare meals as he was a single parent and had previously worked as a baker. But he lacks the motivation to make meals and will often just make himself a sandwich. If his mother is away he often relies on fast food such as burgers and pizza. In response to a question, the appellant indicated that he finds it difficult to prepare meals because he finds it very depressing to eat alone and will sometimes be in tears when he tries cook alone. He indicated that his mobility is especially limited outdoors since he has had 5 surgeries on his feet and has a painful bunion which was poorly treated and that is now constantly swollen. It is painful to walk but he does not use a cane. When asked how he manages to walk his dog he indicated that he finds this very difficult but he "mans-up" to do so and can walk about 3 blocks; he usually finds that he loses feeling in his foot during the walk and needs to rest afterwards. Walking indoors is less of a problem since he lives in a small 750 sq. ft. apartment. But he has trouble getting out of bed, and getting up from a chair, due to arthritis that is throughout his body. The appellant explained that he can do vacuuming on a good day and he can't afford a cleaning lady. His mother does his laundry since he does not have his own washer/dryer and the machines in his building are not hygienic. It would take him a long time to fold his clothes. He can change the sheets on the bed himself. In response to a question, the appellant stated that he needs assistance with meal planning and preparation so that he will eat the right things and not just a bowl of cereal. He knows that he tends to isolate himself too much and he needs hel to not rela se and to kee attend in his su art rou . EAAT 003( 10/05/01 )
I APPEAL# He has a mentor in his support group with whom he talks on a daily basis, and meets weekly. At his support group meetings they talk about events in their week including daily stresses they face. The group is close-knit and he is able to give and receive feedback. This is his main source of support. He has had a counselor for the past year but that program has been competed and his file has been closed. Until recently, the appellant's mother had been providing him with financial assistance but she is no longer able to do so. Otherwise, he is able to manage his own finances although he struggles with budgeting. The appellant is able to drive a car although he has difficulty getting in and out of a vehicle. He relies on his mother for support in a number of areas such as meal preparation, housekeeping and shopping but his relationship with her can be difficult and he finds that she can be overbearing. The appellant feels that he has made many mistakes in life and he feels that he is not very , competent. He reported that he second guesses himself a lot and worries about how he comes across to others. He sometimes uses sarcasm or humor which might be misunderstood by others. His experience in his support group has been very helpful but he has no friends and hasn't been in a relationship for a long time. This adds to his depression. In response to a question, the appellant explained that he is taking an anti-depressant and an anti-psychotic medication that also helps him sleep. The anti-depressant keeps him level so that he doesn't get overexcited especially when he experiences verbal abuse from his mother. He expects that without the medication that helps him to sleep he would be up all night. Unfortunately, the medication makes him drowsy during the day and he wants to nap all day even though he is on the lowest dosage. He regularly sleeps 12 to 15 hours each day. Even when he is able to make it through the day, he is tired by 7 p.m. He spends much of the time sitting on the couch. With the exception noted below, the panel finds that the information provided by the GP in the revised pages of the AR and in his letter, by the addictions counselor in her letter and by appellant in his testimony at the hearing is in support of the information before the ministry at the time of the reconsideration. This information clarifies the nature of the impacts of the appellant's impairments on his ability to manage DLA and the nature of help required. The panel therefore admits the appellant's submissions pursuant to Section 22(4)(b) of the Employment and Assistance Act. The panel does not admit as evidence the GP's reference in his letter to the appellant's prescribed medications and their drowsiness impact, and the appellant's testimony to the same effect, as this contradicts the evidence in the PR before the ministry at reconsideration that the appellant has not been prescribed any medications that interfere with his ability to perform DLA EAAT003(10l06i01)
I APPEAL# PART F Reasons for Panel Decision The issue in this appeal is whether the ministry reasonably determined that the appellant is ineligible for PWD designation because he did not meet all the requirements in section 2 of the EAPWDA. Specifically the ministry determined that the information provided did not establish that the appellant's severe mental and physical impairments (i) in the opinion of a prescribed professional, directly and significantly restricts his ability to perform daily living activities either continuously or periodically for extended periods; and, (ii) as a result of those restrictions he requires help to perform those activities. The ministry determined that he met the 3 other criteria in EAPWDA section 2(2) set out below. The following section of the EAPWDA applies to this appeal: 2 (1) In this section: "assistive device" means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "prescribed professional" has the prescribed meaning. (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 following section of the EAPWDR applies to this appeal: 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) manaae Personal medication, and EAA T003( 1 0/06101)
I APPEAL# (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. Significant restrictions in the ability to perform DLA. In the reconsideration decision, the ministry notes that it would be reasonable to assume that due to the appellant's physical/mental impairments, his ability to manage his DLA would be significantly affected and that the ministry must rely on the expertise of his physician in this matter. The position of the ministry is that based on the information provided by the GP there is not enough evidence to establish that the appellant's impairments directly and significantly restrict his DLA continuously or periodically for extended periods. The position of the appellant is that his GP has provided new information which, along with the assessments earlier provided in the PR and AR, demonstrates that this criterion has been met. Panel findings The panel notes that, according to the legislation, the direct and significant restriction in the ability to perform DLA must be a result of a severe impairment, a criterion established in this appeal. This DLA criterion must also be considered in the broader context of the legislation, which provides that the minister may designate a person as a person with disabilities "if the minister is satisfied that" the criteria are met, including this one. In exercising the discretion conferred by the legislation, it is reasonable that the minister would expect that the opinion of a prescribed professional be substantiated by information that would satisfy the minister that there are direct and significant restrictions in the ability to perform DLA, either continuously or periodically for an extended period. The panel notes that in the PR the GP assesses under "worst case scenario," the appellant is restricted in all listed DLA except mobility inside the home. The issue is whether, from an overall perspective, these restrictions are significant and continuous or periodic for extended periods. In his 18 October letter, the GP writes: "Despite medication he still struggles daily with his mood, making it difficult for him to function ... " and "[The appellant] also suffers with chronic pain due to spinal degeneration and osteoarthritis of many of his other joints. This, added to his affective disorder, makes many physical tasks difficult & painful to perform." The panel takes these sentences to mean that the impact of the appellant's severe impairments on his ability to perform DLA is ongoing or continuous. The panel also notes that in his revisions to the AR submitted after reconsideration, the assessments for mobility and physical ability walking, carrying and holding, etc. the GP has noted that, in addition to his comments that the appellant can only do short distances and it is painful to walk or stand for any prolonged time, these activities take significantly longer than typical. The GP has also revised his assessments on the impact of the appellant's mental impairment on daily functioning to "major impact" in a number of areas, including emotion (depression), motivation and attention/concentration. The panel sees this evidence, as well as his earlier assessments in the PR and AR, as confirmin eneral terms the descri tion rovided b the EAA T003( 10106101)
I APPEAL# appellant at the hearing of his restrictions in managing the 8 DLA set out in para (a) of section 2(1) of the EAPWDR, where varying combinations of his severe mental and physical impairments restrict his ability to perform DLA The overall picture, as the panel understands it, is that the appellant is, for the most part, physically capable of performing most DLA, albeit taking significantly longer than typical, but this is compounded by his depression, with the associated impacts on motivation and attention/concentration, form a mental barrier that impairs his ability to perform these DLA effectively or independently. For example: • Mobility the GP has reported that, "worst case scenario," the appellant is restricted to walking less than 1 block. The appellant testified at the hearing that he could walk up to 3 blocks, after which he would need a rest and that his feet would lose all feeling. He stated that he could "man-up" to walk this distance occasionally, but that most of the time he lacked the motivation to do so. a Personal self care the GP has reported that the appellant is independent for dressing and grooming, etc. but that he needs encouragement to groom himself and keep himself clean. This indicates to the panel another area where lack of motivation and attention/concentration has an impact. • Meals the GP has indicated that the appellant requires periodic assistance from another person, commenting "mother helps him." At the hearing, the appellant testified that when he tries to cook for himself, he is overcome by depression, bringing on tears and preventing him from carrying on; instead he relies on meals prepared by his mother or on fast food or cereal. • Basic housekeeping the GP assesses the appellant as taking significantly longer than typical for basic housekeeping and periodic assistance from another person for laundry ("mother does this"). The latter may be a situational restriction, as the appellant testified that the machines in his building were not hygienic. The appellant testified that he is physically capable of vacuuming his apartment, albeit taking longer than typical, but that again he lacks the motivation to do so. This impact on motivation is confirmed by the GP's comment: "hard to get out of bed most days." • Shopping the GP assesses the appellant independent in all aspects, taking significantly longer than typical for going to and from stores and carrying purchase home, commenting that his mother helps with shopping and managing associated finances. Though the financial assistance is not relevant, the difficulties with the mobility aspects of shopping are consistent with the GP's other assessments in that regard. In terms of social functioning, the GP has revised its impact assessment to "major impact" in the areas of impulse control, insight and judgment, executive, memory and other neuropsychological problems, the latter explained by the appellant's advocate at the hearing as relating to learning disability. The panel understands that the main concern here relates to how his depression increases the risk of relapse back into substance abuse, even after over a year of abstinence. Thus the need for help through an addiction recovery support group (see below under Help with DLA). The GP assesses the appellant requiring periodic support/supervision in the areas of making appropriate social decisions, ability to develop and maintain relationships, interacting appropriately with others and ability to deal appropriately with unexpected demands, noting that help provided through several times a week meetings of his addiction recovery support group. The panel considers this as evidence that the appellant's severe mental impairment depression significantly restricts his ability to perform the DLA under para (b) of section 2(1) of the EAPWDR to make decisions about personal activities, care or finances, particularly in the area of potential substance abuse. EAAT 003( 10/06/01)
I APPEAL# 7 Regarding the other DLA applicable to a person with a severe mental impairment under para (b) of section 2(1) of the EAPWDR relate to, communicate or interact with others effectively the appellant testified that this too is an issue for him, as he tends to isolate, has no real friends, has not been in a relationship for years and feels that he has been over-reliant on his mother. While the GP has assessed the appellant with marginal functioning with his immediate and extended social networks, the GP has not provided sufficient evidence to substantiate a significant restriction in this DLA. Overall, and taking into account the new information provided by the GP, the panel finds it difficult not to conclude that the GP has provided sufficient evidence to substantiate a finding that the appellant's severe mental and physical impairments directly and significantly restrict his ability to perform DLA, and, as these impairments are ongoing, that these restrictions are continuous. While the ministry did not have the benefit of the new information provided by the GP, the panel finds that the ministry was not reasonable in determining that this criterion had not been met. Help with DLA The ministry's position is that as it has not been established that DLA are significantly restricted, it cannot be determined that significant help is required from other persons. The position of the appellant is that, he requires the support of his addiction recovery group and his mentor in that group to maintain his abstinence and recovery. A relapse would compromise his ability to manage his DLA. Panel findings The panel has found that the appellant's severe mental and physical impairments directly and significantly restrict his ability to perform DLA. The GP's evidence is that the appellant's depression has major impacts on his daily functioning. These impacts continue despite over a year of substance abuse recovery and abstinence. Of particular note are the major impacts relating to insight and judgment, impulse control and motivation. As the appellant's advocate pointed out at the hearing, deficits in these areas could put his recovery at risk. The GP noted in the AR: "does attend support group, would probably relapse if did not attend." Given the importance the GP attaches to this help, and as the appellant attends the support group meetings several times a week, as well as talking with his mentor frequently during the week, the panel considers this help provided to be significant in preventing relapse and therefore to continuing his ability to manage all his DLA. Conclusion Having reviewed and considered all of the evidence and the relevant legislation, the panel finds that the ministry's decision that the appellant was not eligible for PWD designation was not reasonably supported by the evidence. The panel therefore rescinds the ministry's decision in favour of the apoellant. EAAT 003( 10/06/01 )
You are being directed to the most recent version of the statute which may not be the version considered at the time of the judgment.