Ministry of Social Development and Poverty Reduction

Decision Information

Decision Content

PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (Ministry)'s reconsideration decision dated January 9, 2014, finding the Appellant is not eligible to receive a medical transportation supplement as the request does not meet the criteria set out in section 2(1 )(f)(iii) of the Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) that the supplement cover the costs associated with travel to and from the nearest available specialist. PART D -Relevant Legislation The relevant legislation is section 2(1) of Schedule C of the EAPWDR. EAAT 003( 10106101) 0-l..-, --. •. , . --
PART E -Summary of Facts The Appellant is in re c ei p t of disab ility assistance a relate d health issues which requir e relatively freq uent a o phthal mo l o gist. T he a ppe l lant provide d a li st of se ophthalmologist t o occur b etween Nov e m ber 26 , 2013 and June 11, 2014. The appellant has be pa t ient of t he s ame ophthalmologist for approximately 20 denie d the a pp e llant's request for a medical tra n sport ophthal m ol og ist on December 2. The distance between ophth almologist's o ffice wa s app rox i m ately 300 km ea to his Decemb er 2 appointment and reported that he h a p pel lant reque sted reconsideration of the ministry' transportati o n sup plement on December 23, 201 3 . The appell a nt sub mit te d in supp ort o f his appeal a letter 2014 . In t his let ter the app e lla n t's ophthal m o logist and st a tes t hat " Th e com p lexi ty of his ocul ar di s e a ne ed to b e do ne on a relatively ur gent basis a n d o n say , "My wor kin g rel atio nship with [t h e app ellan t ] trust built bet ween us is imp ortant f o r the timely The impo r t an ce of the doctor-pat ie n t relati o nship is paramoun app ell ant] ." Finall y, the op h thal molo g ist declines the minis try's o phthalmologi st working closer t o the app el la nt's residence c su ppo r t for the ap pellant's cond itions. The panel consid er e d the a dmissibili ty of this new evid new facts a nd ar gume nts but ra t h e r is in su pp ort of the ap reconsideration decisi on and so admitted the latter .. . -_--.-,. _ ..• -· -.-.\ -,_,-�, . ,.,-•· --:-. -EAAT 003( 10/06/01) s a c ouple. He h a s a number of s e rio u s visi o n ­ ttention and consultatio n with an v e n app ointme n t s scheduled with his en a years. O n November 28, 20 13 th e minist ry ation supplement in order to see h is the appellant' s resi d e nce and the ch wa y an d the appell ant had a friend drive him a d to bo r ro w the mo ney to pay for gas. The s decisi o n not to provide the medical f rom his ophthalmo l o g ist dated January 15 , briefl y d is c u ss e s the app e lla n t's ocular c o n d i tion s se st a t u s means that i mpo rt a n t i nte rvent ions m ay a relat ively regula r ba sis." He the n goes on t o h as b ee n forged over the se past 2 0 y e ars and the man agement of h i s di fficult o cul ar condi ti on s . t f o r so m eone lik e [ t h e i nvit ati o n to commen t o n whether ano t h e r ould or coul d not pro v ide adequ a te ence an d fou n d that it d id not i ntroduce any pellant's p osition at the time of th e in accordance wi th section 22(4)(b) . , .. _. . . ,_,,., -., '
P A R T F R e a s o n s f o r P a n e l D e c i s i o n T h e i s s u e u n d e r a p p e a l i s t h e r e a s o n a b l e n e s s o f t J a n u a r y 9 , 2 0 1 4 , f i n d i n g t h e A p p e l l a n t i s n o t e l i g i b l a s t h e r e q u e s t d o e s n o t m e e t t h e c r i t e r i a s e t o u t i n s u p p l e m e n t c o v e r t h e c o s t s a s s o c i a t e d w i t h t r a v e l T h e r e l e v a n t l e g i s l a t i o n i s s e c t i o n 2 ( 1 ) o f S c h e d u l e G e n e r a l h e a l t h s u p p l e m e n t s 2 ( 1 ) T h e f o l l o w i n g a r e t h e h e a l t h s u p p l e m e n t s t h a t m a y b e e l i g i b l e u n d e r s e c t i o n 6 2 { g e n e r a l h e a l t h s u p p l e m e n t s ] o f t h i s ( f ) t h e l e a s t e x p e n s i v e a p p r o p r i a t e m o d e o f t r a n s p o r t a t i o n t o ( i ) a n o f f i c e , i n t h e l o c a l a r e a , o f a m e d i c a l p r a c t i t i o ( i i ) t h e o f f i c e o f t h e n e a r e s t a v a i l a b l e s p e c i a l i s t i n a t o a s p e c i a l i s t i n t h a t f i e l d b y a l o c a l m e d i c a l p r a c t i t ( i i i ) t h e n e a r e s t s u i t a b l e g e n e r a l h o s p i t a l o r r e h a b i l t h e H o s p i t a l I n s u r a n c e A c t R e g u l a t i o n s , o r ( i v ) t h e n e a r e s t s u i t a b l e h o s p i t a l a s d e f i n e d i n p a r a H o s p i t a l I n s u r a n c e A c t , p r o v i d e d t h a t ( v ) t h e t r a n s p o r t a t i o n i s t o e n a b l e t h e p e r s o n t o r e c g e n e r a l h o s p i t a l s e r v i c e u n d e r t h e H o s p i t a l I n s u r a n ( v i ) t h e r e a r e n o r e s o u r c e s a v a i l a b l e t o t h e p e r s o n ' T h e M i n i s t r y f o u n d t h e a p p e l l a n t d i d n o t q u a l i f y f o r a c c o r d a n c e w i t h s u b c l a u s e 2 ( 1 ) ( f ) ( i i ) , t h e r e q u e s t w s u p p o r t o f t h i s p o s i t i o n t h e m i n i s t r y i d e n t i f i e d a n u m a p p r o p r i a t e t o m a n a g e t h e t h e a p p e l l a n t ' s o c u l a r c o r e s i d e n c e . T h e a p p e l l a n t ' s p o s i t i o n i n h i s w r i t t e n a p p e a l s d o c u o p h t h a l m o l o g i s t , i s t h a t h i s 2 0 y e a r r e l a t i o n s h i p w i t h d o c t o r p a t i e n t r e l a t i o n s h i p s u c h t h a t , " T h e b e s t c a r e T h e p a n e l c o n s i d e r s t h a t t h e w o r d i n g o f s e c t i o n 2 ( 1 a m e d i c a l t r a n s p o r t a t i o n s u p p l e m e n t t o t h e " n e a r e s t h a t t h e a p p e l l a n t ' s o p h t h a l m o l o g i s t i s n o t t h e n e a r e o p h t h a l m o l o g y . T h e r e f o r e , t h e m i n i s t r y c a n n o t p r o v s u p p l e m e n t t o t r a v e l t o a n d f r o m t h i s o p h t h a l m o l o g i A c c o r d i n g l y , t h e p a n e l f i n d s t h a t t h e M i n i s t r y ' s d e c i s m e d i c a l t r a n s p o r t a t i o n s u p p l e m e n t t o t r a v e l t o a n d f a p p l i c a t i o n o f t h e r e l e v a n t l e g i s l a t i o n a n d c o n f i r m s t E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )h e M i n i s t r y ' s r e c o n s i d e r a t i o n d e c i s i o n d a t e d e t o r e c e i v e a m e d i c a l t r a n s p o r t a t i o n s u p p l e m e n t s e c t i o n 2 ( 1 ) ( f ) o f t h e E A P W D R t h a t t h e t o a n d f r o m t h e n e a r e s t a v a i l a b l e s p e c i a l i s t . C o f t h e E A P W D R : p a i d f o r b y t h e m i n i s t e r i f p r o v i d e d t o a f a m i l y u n i t t h a t i s r e g u l a t i o n : o r f r o m n e r o r n u r s e p r a c t i t i o n e r , f i e l d o f m e d i c i n e o r s u r g e r y i f t h e p e r s o n h a s b e e n r e f e r r e d i o n e r o r n u r s e p r a c t i t i o n e r , i t a t i o n h o s p i t a l , a s t h o s e f a c i l i t i e s a r e d e f i n e d i n s e c t i o n 1 . 1 o f g r a p h ( e ) o f t h e d e f i n i t i o n o f " h o s p i t a l " i n s e c t i o n 1 o f t h e e i v e a b e n e f i t u n d e r t h e M e d i c a r e P r o t e c t i o n A c t o r a c e A c t , a n d s f a m i l y u n i t t o c o v e r t h e c o s t . a m e d i c a l t r a n s p o r t a t i o n s u p p l e m e n t b e c a u s e , i n a s n o t f o r " t h e n e a r e s t a v a i l a b l e s p e c i a l i s t " . I n b e r o f o p h t h a l m o l o g i s t s , w i t h t h e e x p e r t i s e n d t i o n , w i t h o f f i c e s m u c h c l o s e r t o t h e a p p e l l a n t ' s m e n t s , s u p p o r t e d b y a l e t t e r f r o m h i s h i s o p h t h a l m o l o g i s t h a s e s t a b l i s h e d a g o o d I c a n r e c e i v e i s f r o m h i m . " ) ( f ) ( i i ) c l e a r l y l i m i t s t h e m i n i s t r y ' s a b i l i t y t o p r o v i d e t a v a i l a b l e s p e c i a l i s t " . I t i s c l e a r f r o m t h e f a c t s , s t a v a i l a b l e s p e c i a l i s t i n t h e f i e l d o f i d e t h e a p p e l l a n t w i t h a m e d i c a l t r a n s p o r t a t i o n s t . i o n t o f i n d t h e A p p e l l a n t i n e l i g i b l e t o r e c e i v e a r o m h i s o p h t h a l m o l o g i s t w a s a r e a s o n a b l e h e M i n i s t r y ' s r e c o n s i d e r a t i o n d e c i s i o n .
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