P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e r e c o n s i d e r a t i o n d S o c i a l I n n o v a t i o n ( t h e m i n i s t r y ) d a t e d J a n u a r y 1 3 , p e r s o n w i t h d i s a b i l i t i e s ( P W D ) . T h e m i n i s t r y d e t e r m f i v e c r i t e r i a r e q u i r e d f o r P W D d e s i g n a t i o n a s s e t o w i t h D i s a b il i t i e s A c t ( E A P W D A ) s e c t i o n 2 . T h e m i b e i n g 1 8 y e a r s o f a g e o r o l d e r ( c r i t e r i o n 1 ) a n d t h a i m p a i r m e n t i s l i k e l y t o c o n t i n u e f o r t w o o r m o r e y e a t h a t , b a s e d o n t h e i n f o r m a t i o n p r o v i d e d , t h e f o l l o w l= A P W D A w e r e n o t m e t : . • T h e m i n i s t e r i s s a t i s f i e d t h a t t h e a p p e l l a n t h • I n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , a b i l i t y t o p e r f o r m d a i l y l i v i n g a c t i v i t i e s ( D L A ) p e r i o d s ; a n d • A s a r e s u l t o f t h e r e s t r i c t i o n s , t h e a p p e l l a n t a n o t h e r p e r s o n t o p e r f o r m t h e D L A r e s t r i c t e P A R T D R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e fo r P e r s o n s w i t h D i s a E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )e c i s i o n o f t h e M i n i s t r y o f S o c i a l D e v e l o p m e n t a n d 2 0 1 4 d e n y i n g t h e a p p e l l a n t d e s i g n a t i o n a s a i n e d t h a t t h e a p p e l l a n t d i d n o t m e e t t h r e e o f t h e u t i n t h e E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s n i s t r y f o u n d t h a t t h e a p p e l l a n t m e e t s t h e c r i t e r i a o f t i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r , h i s r s ( c r i t e r i o n 2 ) . H o w e v e r , t h e m i n i s t r y d e t e r m i n e d i n g c r i t e r i a a s s e t o u t i n s e c t i o n 2 ( 2 ) ( b ) o f t h e a s a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t . t h e a p p e l l a n t ' s i m p a i r m e n t s i g n i f i c a n t l y r e s t r i c t s h i s e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d r e q u i r e s t h e s i g n i f i c a n t h e l p o r s u p e r v i s i o n o f d b y h i s i m p a i r m e n t . b i l i t i e s A c t ( E A P W D A ) s e c t i o n 2 b i l i t i e s R e g u l a t i o n ( E A P W D R ) s e c t i o n 2
P A R T E S u m m a r y o f F a c t s T h e e v i d e n c e b e f o r e t h e m i n i s t r y a t r e c o n s i d e r a t i o 1 . T h e a p p e l l a n t ' s P W D D e s i g n a t i o n A p p l i c a t i • T h e a p p e l l a n t ' s S e l f R e p o r t ( S R ) c o m p l e t e • T h e P h y s i c i a n R e p o r t ( P R ) c o m p l e t e d b y t h a s k n o w n t h e a p p e l l a n t f o r 2 y e a r s a n d h T h e P R i s n o t d a t e d b y t h e p h y s i c i a n b u t t t h e s a m e t i m e h e c o m p l e t e d t h e A R ; a n d • T h e A s s e s s o r R e p o r t ( A R ) d a t e d J u l y 2 3 , 2 p h y s i c i a n . 2 . T h e a p p e l l a n t ' s r e q u e s t f o r r e c o n s i d e r a t i o n f o l l o w i n g : " U n a b l e t o l i f t , u n a b l e t o w o r k @ a n y l a b o u r o f t i m e d u e t o o s t e o a r t h r i t i s . E l b o w 5 t i m e s t h e e l b o w s g e t i n f e c t e d . T h e n h a v e t o g o g e i n f e c t e d 3 -5 t i m e s a y e a r . C a n ' t k n e e l d o w n b o t h l e g s . L o t s o f d e p r e s s i o n a n d s t r e s s , v t h i n g s I h a v e a r e a l h a r d t i m e t o d o t h e m . " T h e a p p e l l a n t c o m p l e t e d h i s n o t i c e o f a p p e a l o n J a b e e n t i t l e d t o d i s a b i l i t y " w r i t i n g t h a t h e " c a n ' t w o r k i n f e c t e d h a v e 2 g o t o h o s p i t a l a n t i b i o t i c I V . I n t e n s e T h e p a n e l h a d c o n f i r m a t i o n t h a t t h e N o t i c e o f H e a d e l a y e d t h e h e a r i n g f o r 2 0 m i n u t e s t o a c c o u n t f o r l h e a r i n g . T h e p a n e l h e l d t h e h e a r i n g i n t h e a p p e l l a n E m p l o y m e n t a n d A s s i s t a n c e R e g u l a t i o n . T h e f o l l o w i n g i s a s u m m a r y o f t h e e v i d e n c e f r o m t h c r i t e r i a a t i s s u e . T h e p a n e l h a s a l s o i n c l u d e d r e f e a p p l i c a t i o n , a s w e l l a s h i s s u b m i s s i o n s o n r e c o n s i d S e v e r i t y o f i m p a i r m e n t s ( c r i t e r i a s e t o u t i n s u b s . 2 ( T h e a p p e l l a n t ' s p h y s i c i a n d i a g n o s e d h i m i n t h e P R o s t e o a r t h r i t i s o n s e t i n 2 0 0 8 a n d h y p o t h y r o i d o n s e t h a s " s e v e r e g o u t " w h i c h i s w i d e s p r e a d o v e r h i s e l b h i s m o b i l i t y / a b i l i t y t o e x e r c i s e a n d h e i s i n p a i n o n a a p p e l l a n t h a s b i l a t e r a l o s t e o a r t h r i t i s i n h i s k n e e s a n t h a t t h e a p p e l l a n t h a s n o t b e e n p r e s c r i b e d a n y m e d D L A , a n d d o e s n o t n e e d a n y p r o s t h e s e s o r a i d s f o r i d e n t i f i e d t h e a p p e l l a n t ' s i m p a i r m e n t s a s , " d u e t o j o d i f f i c u l t y b e n d i n g , p u s h i n g , l i f t i n g , c a r r y i n g , p u s h i n g . . , ' , . ' , -, . . , _ . ; . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )n c o n s i s t e d o f t h e f o l l o w i n g : o n , c o n t a i n i n g t h e f o l l o w i n g t h r e e p a r t s : d J u l y 1 5 , 2 0 1 3 ; h e a p p e l l a n t ' s f a m i l y p h y s i c i a n w h o i n d i c a t e s h e a d s e e n h i m 1 1 o r m o r e t i m e s i n t h e p r e v i o u s y e a r . h e p a n e l a s s u m e s h e s i g n e d i t o n J u l y 2 3 , 2 0 1 3 a t 0 1 3 a l s o c o m p l e t e d b y t h e a p p e l l a n t ' s f a m i l y d a t e d D e c e m b e r 1 6 , 2 0 1 3 o n w h i c h h e w r o t e t h e i n g j o b , c a n ' t s l e e p p r o p e r l y , c a n ' t s i t f o r a n y l e n g t h ( l e f t ) n o r m a l a n d s o m u c h i n f l a m m a t i o n e v e n t u a l l y t a n t i b i o t i c @ h o s p i t a l I V d r i p . T h e y a r e g e t t i n g h u g e b u m p o n r i g h t k n e e a n d o s t e o a r t h r i t i s i n e r y h a r d t o g o u p o r d o w n s t a i r s . L o t s o f l i f e ' s l i t t l e n u a r y 2 4 , 2 0 1 4 , a n d o n i t h e w r o t e t h a t h e " s h o u l d f o r e v e n ½ h r a n y j o b , c a n ' t k n e e l d o w n , e l b o w s g e t p a i n e l b o w s + k n e e s c a n ' t s l e e p . " r i n g h a d b e e n d e l i v e r e d t o t h e a p p e l l a n t . T h e p a n e l a t e a r r i v a l b u t t h e a p p e l l a n t d i d n o t a t t e n d t h e t ' s a b s e n c e u n d e r t h e a u t h o r i t y o f s . 8 6 ( b ) o f t h e e P R a n d t h e A R a s t h e y r e l a t e t o t h e P W D r e n c e t o t h e a p p e l l a n t ' s S R i n t h e P W D e r a t i o n a n d i n h i s N o t i c e o f A p p e a l . 2 ) E A P W D A ) a s h a v i n g g o u t w i t h a n o n s e t o f 2 0 0 2 , i n 1 9 9 8 . T h e p h y s i c i a n w r o t e t h a t t h e a p p e l l a n t o w s , k n e e s , a n k l e s a n d t o e s a n d t h a t t h i s " l i m i t s d a i l y b a s i s . " T h e p h y s i c i a n a l s o w r o t e t h a t t h e d h i s m o b i l i t y i s l i m i t e d . T h e p h y s i c i a n i n d i c a t e d i c a t i o n t h a t i n t e r f e r e s w i t h h i s a b i l i t y t o p e rf o r m h i s i m p a i r m e n t . I n t h e A R , t h e p h y s i c i a n i n t p a i n [ s e c o n d a r y ] t o a r t h r i t i s / g o u t h e h a s , p u l l i n g [ a n d ] s i t t i n g . "
I n t h e f u n c t i o n a l s k i l l s a s s e s s m e n t i n t h e P R , t h e a c o u l d w a l k 2 -4 b l o c k s u n a i d e d o n a f l a t s u r f a c e , t h l i f t 2 -7 k g ( 5 -1 5 p o u n d s ) , a n d c o u l d r e m a i n s e a t e d p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t t a k e s s i g n i f i a s p e c t s o f m o b i l i t y a n d p h y s i c a l a b i l i t y ( w a l k i n g i n c a r r y i n g a n d h o l d i n g ) w r i t i n g t h e c o m m e n t , " h a s d l o n g e r t o c o m p l e t e t a s k s . " T h e p h y s i c i a n i n d i c a t e c l i m b s t a i r s , w r i t i n g , " u s e s g r a b r a i l s t o c l i m b s t a i r s I n t h e P R , t h e p h y s i c i a n c h e c k e d t h a t t h e a p p e l l a n e m o t i o n a l f u n c t i o n i n t h e a r e a s o f e x e c u t i v e , e m o t s u s t a i n e d c o n c e n t r a t i o n b u t d i d n o t w r i t e a n y c o m a p p e l l a n t h a d g o o d a b i l i t y t o c o m m u n i c a t e i n a l l a r a p p e l l a n t ' s m e n t a l i m p a i r m e n t o n h i s c o g n i t i v e a n d h i s m e n t a l i m p a i r m e n t h a d a m o d e r a t e i m p a c t i n t h c o n c e n t r a t i o n , e x e c u t i v e , m e m o r y , a n d m o t i v a t i o n c o m m e n t , " [ t h e a p p e l l a n t ] h a s [ i l l e g i b l e ] a n x i e t y / d e d i f f i c u l t y c o p i n g i n t h e s e a r e a s . " I n h i s N o t i c e o f A p p e a l a n d s u b m i s s i o n s o n r e c o n s " e v e n ½ h o u r , " h e c a n ' t k n e e l d o w n a n d h e h a s i n t H e a l s o s a i d t h a t h i s e l b o w s w i l l g e t i n f e c t e d a n d h a n t i b i o t i c s w h e n t h i s h a p p e n s ( 3 -5 t i m e s p e r y e a r ) s t a i r s . I n h i s S R , t h e a p p e l l a n t s e t o u t t h a t h e c a n ' c a n ' t w a l k m o r e t h a n 2 -3 b l o c k s w i t h o u t r e s t i n g , c a i n d i c a t e d i n t h e S R t h a t h e h a s d i ff i c u l t y s l e e p i n g a d e p r e s s i o n , p a r t i c u l a r l y w h e n p e o p l e n o t i c e h i s s w A b i l i t y t o p e rf o r m D L A ( c r i t e ri a s e t o u t i n s u b s . 2 ( 2 / A s d i r e c t e d b y t h e P W D a p p l i c a t i o n , t h e p h y s i c i a n A R , t h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t i s i n d p a y i n g r e n t a n d b i l l s , a n d m e d i c a t i o n s . T h e p h y s i c c o n t i n u o u s a s s i s t a n c e i n p e r f o r m i n g a l l o f t h e 5 l i s t w i f e d o e s t h e s h o p p i n g a n d b r i n g s h i m g r o c e r i e s . " t a k e s s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l t o p e r f o r m b o n o t p r o v i d e a n y c o m m e n t a r y . T h e p h y s i c i a n i n d i c a t t a s k s o f t o i l e t i n g , f e e d i n g s e l f a n d r e g u l a t i n g d i e t u n t h e a p p e l l a n t t a k e s s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l p e r s o n a l c a r e ( d r e s s i n g , g r o o m i n g , b a t h i n g , t r a n s f e c o m m e n t i n g , " h i s [ D L A ] t a k e s i g n i f i c a n t l y l o n g e r t o I n t h e A R s e c t i o n r e g a r d i n g t h e a p p e l l a n t ' s s o c i a l f u t h e a p p e l l a n t w a s i n d e p e n d e n t i n 4 o f t h e 5 a s p e c t s b e s i d e t h e a r e a " a b l e t o d e v e l o p a n d m a i n t a i n r e l a t a p p e l l a n t h a d m a r g i n a l f u n c t i o n i n g w i t h h i s i m m e d i a p r o v i d e a n y c o m m e n t a r v . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )p p e l l a n t ' s p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t a t h e c o u l d c l i m b 5 + s t e p s u n a i d e d , t h a t h e c o u l d f o r l e s s t h a n 1 h o u r . I n t h e A R , t h e a p p e l l a n t ' s c a n t l y l o n g e r t h a n t y p i c a l t o p e r f o r m 5 o f t h e 6 l i s t e d d o o r s , w a l k i n g o u t d o o r s , s t a n d i n g , l i f t i n g , a n d i ff i c u l t y w i t h b a s i c a c t i v i t i e s , t a k e s s i g n i f i c a n t l y d t h a t t h e a p p e l l a n t u s e s a n a s s i s t i v e d e v i c e t o . " t h a s s i g n i f i c a n t d e f i c i t s w i t h c o g n i t i v e a n d i o n a l d i s t u r b a n c e , m o t i v a t i o n , a n d a t t e n t i o n o r m e n t a r y . I n t h e A R , t h e p h y s i c i a n i n d i c a t e d t h a t t h e e a s . F u r t h e r i n t h e A R i n t h e a s s e s s m e n t o f t h e e m o t i o n a l f u n c t i o n i n g , t h e p h y s i c i a n i n d i c a t e d t h a t e a r e a s o f b o d i l y f u n c t i o n s , e m o t i o n , a t t e n t i o n / a n d o t h e r e m o t i o n a l o r m e n t a l p r o b l e m s , w i t h t h e p r e s s i o n [ s e c o n d a r y ] t o g o u t / h e a l t h i s s u e s . H e h a s i d e r a t i o n , t h e a p p e l l a n t w r o t e t h a t h e c a n ' t w a l k f o r e n s e p a i n i n h i s e l b o w s a n d k n e e s a n d c a n ' t s l e e p . e h a s t o g o t o t h e h o s p i t a l f o r a n I V d r i p o f . H e w r o t e t h a t i t i s v e r y h a r d t o g o u p a n d d o w n t g o u p a n d d o w n s t a i r s w i t h o u t g r e a t d i f f i c u l t y , n ' t l i f t , b e n d , k n e e l , p u s h o r p u l l o r s i t . H e n d h e i s s u f f e r i n g f r o m m e n t a l s t r e s s a n d o l l e n e l b o w s . ( b ) E A P W D A ) d i d n o t c o m p l e t e t h e D L A s e c t i o n o f t h e P R . I n t h e e p e n d e n t i n p e r f o r m i n g a l l a s p e c t s o f t h e D L A s o f i a n i n d i c a t e d t h a t t h e a p p e l l a n t r e q u i r e s e d t a s k s o f t h e D L A o f s h o p p i n g , w r i t i n g , " h i s e x  T h e a p p e l l a n t ' s p h y s i c i a n i n d i c a t e d t h e a p p e l l a n t t h t a s k s o f t h e D L A o f b a s i c h o u s e k e e p i n g , b u t d i d e d t h e a p p e l l a n t c o u l d i n d e p e n d e n t l y p e r f o r m t h e d e r t h e D L A o f p e r s o n a l c a r e , b u t i n d i c a t e d t h a t i n p e r f o r m i n g 5 o f t h e 8 t a s k s o f t h e D L A o f r s i n / o u t o f b e d , a n d t r a n s f e r s o n / o f f o f c h a i r ) c o m p l e t e d u e t o h i s h e a l t h i s s u e s . " n c t i o n i n g , t h e a p p e l l a n t ' s p h y s i c i a n i n d i c a t e d t h a t , a n d w r o t e , " d o e s n o t h a v e m a n y s o c i a l c o n t a c t s " i o n s h i p s . " T h e p h y s i c i a n i n d i c a t e d t h a t t h e t e a n d e x t e n d e d s o c i a l n e t w o r k s , b u t d i d n o t
In his submissions on reconsideration and in the Notice of Appeal, the appellant wrote that he is unable to work at any labouring job, can't work for even ½ an hour. He said that because of the pain in his elbows, he can't carry his shopping and his ex-wife does his shopping for him. Assistance required/provided (criteria set out in subs. 2(2)(b)(ii) EAPWDA) In the section of the AR describing the assistance provided for the appellant, the physician indicated that the appellant received help from family, writing, "his ex-wife does help him w/ shopping, and prescriptions." The physician did not indicate that the appellant required any assistive devices, but wrote, "may require these in the future." EMT 003(10/06/01)
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 i n t h i s a p p e a l i s w h e t h e r t h e m i n i s t r y r e f o r P W D d e s i g n a t i o n b e c a u s e h e d i d n o t m e e t a l l S p e c i f i c a l l y , t h e m i n i s t r y d e t e r m i n e d t h a t t h e i n f o r m h a s a s e v e r e m e n t a l a n d / o r p h y s i c a l i m p a i r m e n t a d e m o n s t r a t e t h a t h i s i m p a i r m e n t s i n t h e o p i n i o n o r e s t r i c t s h i s a b i l i t y t o p e r f o r m d a i l y l i v i n g a c t i v i t i e s p e r i o d s , a n d , a s a r e s u l t o f t h o s e r e s t r i c t i o n s h e r e T h e f o l l o w i n g s e c t i o n o f t h e E A P W D A a p p l i e s t o t 2 ( 1 ) I n t h i s s e c t i o n : " a s s i s t i v e d e v i c e " m e a n s a d e v i c e d e s i g n e d t o e n a b l e s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t , " d a l l y l i v i n g a c t i v i t y " h a s t h e p r e s c r i b e d m e a n i n g ; " p r e s c r i b e d p r o f e s s i o n a l " h a s t h e p r e s c r i b e d m e a n i n ( 2 ) T h e m i n i s t e r m a y d e s i g n a t e a p e r s o n w h o h a s r e a p u r p o s e s o f t h i s A c t i f t h e m i n i s t e r i s s a t i s f i e d t h a t t h e p ( a ) i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r i s l i k e l y t ( b ) i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l ( i ) d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t s t h e p e r s o n ' s ( A ) c o n t i n u o J.l s l y , o r ( B ) p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s , a n d ( i i ) a s a r e s u l t o f t h o s e r e s t r i c t i o n s , t h e p e r s o n r e ( 3 ) F o r t h e p u r p o s e s o f s u b s e c t i o n ( 2 ) , ( a ) a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a i r m e n t i a n d ( b ) a p e r s o n r e q u i r e s h e l p i n r e l a t i o n t o a d a i l y l i v i n r e q u i r e s ( i ) a n a s s i s t i v e d e v i c e , ( i i ) t h e s i g n i f i c a n t h e l p o r s u p e r v i s i o n o f a n o t h e r ( i i i ) t h e s e r v i c e s o f a n a s s i s t a n c e a n i m a l . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D R a p p l i e s t o t h 2 ( 1 ) F o r t h e p u r p o s e s o f t h e A c t a n d t h i s r e g u l a t i o n , " d a ( a ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e p h y s i c a l m e a n s t h e f o l l o w i n g a c t i v i t i e s : ( i ) p r e p a r e o w n m e a l s ; ( i i ) m a n a g e p e r s o n a l f i n a n c e s ; ( i i i ) s h o p f o r p e r s o n a l n e e d s ; ( i v ) u s e p u b l i c o r p e r s o n a l t r a n s p o rt a t i o n f a c i l i t i e s ( v ) p e r f o r m h o u s e w o r k t o m a i n t a i n t h e p e r s o n ' s p c o n d i t i o n ; ( v i ) m o v e a b o u t i n d o o r s a n d o u t d o o r s ; ( v i i ) p e r f o r m p e r s o n a l h y g i e n e a n d s e l f c a r e ; ( v i i i ) m a n a g e p e r s o n a l m e d i c a t i o n , a n d b . i n . r e l a t i o n t o a e r s o n w h o h c1 s a s e v e r e m e n t a l . i E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )a s o n a b l y d e t e r m i n e d t h a t t h e a p p e l l a n t i s i n e l i g i b l e t h e r e q u i r e m e n t s i n s e c t i o n 2 o f t h e E A P W D A . a t i o n p r o v i d e d d i d n o t e s t a b l i s h t h a t t h e a p p e l l a n t n d t h a t t h e i n f o r m a t i o n p r o v i d e d d i d n o t f a p r e s c r i b e d p r o f e s s i o n a l d i r e c t l y a n d s i g n i f i c a n t l y e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d q u i r e s h e l p t o p e r f o r m t h o s e a c t i v i t i e s . h i s a p p e a l : a p e r s o n t o p e r f o r m a d a i l y l i v i n g a c t i v i t y t h a t , b e c a u s e o f a t h e p e r s o n i s u n a b l e t o p e r f o r m ; g . c h e d 1 8 y e a r s o f a g e a s a p e r s o n w i t h d i s a b i l i t i e s f o r t h e e r s o n h a s a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t t h a t o c o n t i n u e f o r a t l e a s t 2 y e a r s , a n d a b i l i t y t o p e r f o r m d a i l y l i v i n g a c t i v i t i e s e i t h e r q u i r e s h e l p t o p e r f o r m t h o s e a c t i v i t i e s . n c l u d e s a p e r s o n w i t h a m e n t a l d i s o r d e r , g a c t i v i t y i f , i n o r d e r t o p e r f o r m i t , t h e p e r s o n p e r s o n , o r i s a p p e a l : i l y l i v i n g a c t i v i t i e s " , i m p a i r m e n t o r a s e v e r e m e n t a l i m p a i r m e n t , ; l a c e o f r e s i d e n c e i n a c c e p t a b l e s a n i t a r y 11]J> a i r m e n t , i n c: l u d e s t h ,\) J Cl l ! Cl v; j 1 1 J; 1 a c t i v i t i e s : I 1
( i ) m a k e d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e ( i i ) r e l a t e t o , c o m m u n i c a t e o r i n t e r a c t w i t h o t h e r s S e v e r i t y o f p h y s i c a l i m p a i r m e n t T h e a p p e l l a n t s e t s o u t i n h i s s u b m i s s i o n s t h a t h e b s u f f e r s f r o m c o n s t a n t p a i n i n h i s e l b o w s a n d h i s k n i n f e c t e d s o t h a t h e r e q u i r e s a n I V a n t i b i o t i c . H e s a d e p r e s s i o n a n d a n x i e t y a n d f i n d s i t h a r d t o d o " l i f e I n i t s r e c o n s i d e r a t i o n d e c i s i o n , t h e m i n i s t r y d e t e r m l i m i t a t i o n s d u e t o h i s g o u t a n d o s t e o a r t h r i t i s a n d i t t a s k s , t h e m i n i s t e r w a s n o t s a t i s f i e d t h a t t h e i n f o r m i m p a i r m e n t . T h e r e c o n s i d e r a t i o n d e c i s i o n n o t e s t h h o w m u c h l o n g e r i t t a k e s t h e a p p e l l a n t t o p e r f o r m t y p i c a l , n o r d i d t h e a p p e l l a n t ' s p h y s i c i a n i n d i c a t e t h b a s i s . I n i t s r e c o n s i d e r a t i o n d e c i s i o n , t h e m i n i s t r y t o s p e c i a l i s t s i n c l u d e d i n t h e a p p e l l a n t ' s P W D a p p p h y s i c a l m e d i c a l c o n d i t i o n s . T h e m i n i s t r y r e p r e s e n o t p r o v i d e d a n y m e d i c a l i n f o r m a t i o n t o s u p p o r t t h r e c o n s i d e r a t i o n o r w i t h h i s n o t i c e o f a p p e a l . A n a l y s i s a n d d e c i s i o n T h e l e g i s l a t i o n p r o v i d e s t h a t t h e m i n i s t e r m a y d e s i t h a t t h e p e r s o n h a s a s e v e r e m e n t a l o r p h y s i c a l i m p r a c t i t i o n e r i s l i k e l y t o c o n t i n u e f o r a t l e a s t 2 y e a r s T h e d i a g n o s i s o f a m e d i c a l c o n d i t i o n i s n o t i n a n d o s a t i s f y t h e r e q u i r e m e n t s i n s e c t i o n 2 ( 2 ) o f t h e E A P m e d i c a l c o n d i t i o n r e s t r i c t s d a i l y f u n c t i o n i n g m u s t b a p p e l l a n t a n d f r o m a p r e s c r i b e d p r o f e s s i o n a l r e g a r t h e a p p e l l a n t ' s a b i l i t y t o m a n a g e t h e d a i l y l i v i n g a c t I n t h e P W D a p p l i c a t i o n f o r m , t h e m i n i s t r y h a s p r o v i i s n o t s e t o u t i n t h e a p p l i c a b l e l e g i s l a t i o n , o f f e r s g u a n a p p l i c a n t ' s i m p a i r m e n t . T h e m i n i s t r y s t a t e s , " i m p p s y c h o l o g i c a l , a n a t o m i c a l o r p h y s i o l o g i c a l s t r u c t u r e f u n c t i o n i n d e p e n d e n t l y , e f f e c t i v e l y , a p p r o p r i a t e l y o r s e v e r i t y o f i m p a i r m e n t , t h e r e i s b o t h a c a u s e t h e w h i c h i t r e s t r i c t s t h e a b i l i t y t o f u n c t i o n i n d e p e n d e n t l d u r a t i o n . T h e p a n e l n o t e s t h a t t h e l e g i s l a t i o n p r o v i i m p a i r m e n t i s a t t h e d i s c r e t i o n o f t h e m i n i s t e r , t a k i n t h e a p p e l l a n t . H o w e v e r , t h e s t a r t i n g p o i n t m u s t b e t h e a p p e l l a n t ' s p h y s i c i a n i n t h e P W D a p p l i c a t i o n . I n t h e P R , t h e a h s i c i a n i n d i c a t e s t h a t t h E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )o r f i n a n c e s ; e f f e c t i v e l y . e l i e v e s h i s i m p a i r m e n t s a r e s e v e r e b e c a u s e h e e e s , h i s e l b o w s a r e g r e a t l y s w o l l e n a n d g e t y s t h a t a s a r e s u l t o f h i s c o n d i t i o n , h e s u f f e r s f r o m ' s l i t t l e t h i n g s . " i n e d t h a t a l t h o u g h t h e a p p e l l a n t h a s s o m e a p p e a r s t o t a k e h i m l o n g e r t o d o m o s t b a s i c l i v i n g a t i o n p r o v i d e d i s e v i d e n c e o f a s e v e r e p h y s i c a l a t t h e a p p e l l a n t ' s p h y s i c i a n d i d n o t e l a b o r a t e o n t h e t a s k s w h i c h t a k e h i m s i g n i f i c a n t l y l o n g e r t h a n e l e v e l o f p a i n t h e a p p e l l a n t e x p e r i e n c e s o n a d a i l y n o t e d t h a t t h e r e a r e n o m e d i c a l r e p o r t s o r r e f e r r a l s l i c a t i o n t o h e l p i n d i c a t e t h e l e v e l o f s e v e r i t y o f h i s n t a t i v e a t t h e h e a r i n g n o t e d t h a t t h e a p p e l l a n t h a s a t h i s i m p a i r m e n t s a r e s e v e r e w i t h h i s r e q u e s t f o r g n a t e a p e r s o n a s a P W D i f t h e m i n i s t e r i s s a t i s f i e d p a i r m e n t t h a t i n t h e o p i n i o n o f a m e d i c a l ( s u b s . 2 ( 2 ) ( a ) o f t h e E A P W D A ) . f i t s e l f e v i d e n c e o f t h e s e v e r i t y o f i m p a i r m e n t . T o W D A , e v i d e n c e o f h o w a n d t h e e x t e n t t o w h i c h a e c o n s i d e r e d . T h i s i n c l u d e s t h e e v i d e n c e f r o m t h e d i n g t h e n a t u r e o f t h e i m p a i r m e n t a n d i t s i m p a c t o n i v i t i e s l i s t e d i n s e c t i o n 2 ( 1 ) o f t h e E A P W D R . d e d a d e f i n i t i o n o f " i m p a i r m e n t " w h i c h , a l t h o u g h i t i d a n c e i n c o n s i d e r i n g t h e e x i s t e n c e a n d s e v e r i t y o f a i r m e n t " i s a " l o s s o r a b n o r m a l i t y o f o r f u n c t i o n i n g c a u s i n g a r e s t r i c t i o n i n t h e a b i l i t y t o f o r a r e a s o n a b l e d u r a t i o n . " T o d e t e r m i n e t h e i m p a i r m e n t i t s e l f a n d a n e f f e c t t h e d e g r e e t o y , e f f e c t i v e l y , a p p r o p r i a t e l y o r f o r a r e a s o n a b l e d e s t h a t t h e d e t e r m i n a t i o n o f t h e s e v e r i t y o f g i n t o a c c o u n t a l l o f t h e e v i d e n c e , i n c l u d i n g t h a t o f t h e m e d i c a l e v i d e n c e t h e i n f o r m a t i o n p r o v i d e d b y e a e l l a n t i s a b l e t o w a l k 2 -4 b l o c k s , c l i m b 5 +
steps unaided, can remain seated for less than one hour, and can lift 2-7 kg. The physician described the severity of the appellant's medical conditions in the PR as follows: "Patient has severe gout, has widespread gout over the elbows, knees, ankles, toes, this limits his mobility/ability to exercise and he is in pain on a daily basis. He also had bilateral osteoarthritis in his knees. His mobility is limited." In the AR, the appellant's physician indicated that the appellant requires an assistive device to climb stairs, writing "uses grab rails to climb stairs" and takes significantly longer than typical to perform all other tasks of mobility (walking indoors and outdoors, standing, lifting and carrying and holding), writing, "has difficulty with basic activities, takes significantly longer to complete tasks." In describing the restrictions caused by the appellant's physical impairment on the ability to perform DLA, the appellant's physician indicated that the appellant takes significantly longer to perform 5 of the 7 listed task of the DLA of personal care, writing "his daily living activity take significantly longer to complete due to his health issues" but the physician does not provide detail about how much longer the appellant takes. The appellant's physician indicates that the appellant takes significantly longer than typical to perform all tasks of basic housekeeping, meals and transportation, but does not provide any commentary to explain and describe the restriction caused by the appellant's impairments. It is difficult to assess the severity of the appellant's physical impairment as set out in the information provided by the appellant's physician in the PWD without further description from the appellant's physician to describe the severity of the physical impairment. Accordingly, the panel finds the ministry's determination that the information provided is not evidence of a severe physical impairment is reasonable. In considering whether the appellant has a severe mental impairment, the ministry determined that it was not satisfied that the information provided is evidence of a severe mental impairment because the appellant had not been diagnosed with a mental impairment in the PWD application, there are no major impacts reported on his cognitive and emotional functioning, there was no indication that the appellant had been referred to a mental health specialist, and the appellant's social functioning was considered marginal (not "very disrupted"). The panel notes that in the information in the PWD application, the appellant's physician did not diagnose him with a mental impairment or brain injury. The physician indicated in the PR that the appellant's impairments had an impact on cognitive and emotional functioning in 4 areas (executive, emotional disturbance, motivation and attention or sustained concentration), but did not provide any commentary. In the AR, the physician indicated that the appellant's impairment had a moderate impact on 7 areas of cognitive and emotional functioning (bodily functions, emotion, attention/ concentration, executive, memory, motivation and "other") writing, "patient has [illegible] anxiety/ depression [secondary] to gout/health issues, he has difficulty coping in these areas." The panel finds that based on the information from the appellant's physician set out in the PWD application, the ministry's determination that the information did not establish a severe mental impairment is reasonable. Direct and significant restrictions in the ability to perform DLA. In the reconsideration decision, the ministry noted that the physician indicated in the PWD application that the appellant takes significantly longer to perform several tasks of the DLAs, but does not specify how much longer. The ministry also noted that, other than the DLA of shopping, the physician did not indicate that the aooellant requires siqnificant help either continuouslv or oeriodicallv for extended EAAT 003(10/06/01)
periods to perform the DLAs. In its reconsideration decision, the ministry noted that although the physician indicated that the appellant was continuously restricted in all tasks of the DLA of shopping, the physician did not explain why the appellant required continuous assistance with the specific tasks of reading prices and labels, making appropriate choices, or paying f o r purchases. The physician only wrote that the appellant's ex-wife does all his shopping and brings him his groceries as an explanation for all the listed tasks. The ministry noted that the only DLA that the appellant's physician indicated was continuously restricted was shopping and the ministry was not satisfied that, based on the other assessments the physician made ih the PWD application (such as the appellant's ability to lift 5-15 pounds unaided and walk 2-4 blocks unaided), the appellant requires help on a continuous basis. Analysis and decision Section 2(2)(b) of the EAPWDA requires that a prescribed professional provide an opinion that an applicant's severe impairment directly and significantly restricts his daily living activities, continuously or periodically for extended periods. In this case the appellant's doctor is the prescribed professionals. Daily living activities are defined in section 2(1) of the EAPWDR and are also listed in the PR and in the AR. The appellant's physician indicated that the appellant requires continuous assistance to perform all tasks of the DLA of shopping, but commented only that the appellant's ex-wife "does the shopping and brings him groceries." The panel finds the ministry's determination that this information does not satisfy it that the appellant's impairment directly and significantly restricts his DLA either continuously ... or periodically for extended periods reasonable based.on the information provided by the appellant's physician in the PWD application. While other tasks of DLA are reported as taking significantly longer to perform, and as no further detail is provided, the panel finds the information provided by the appellant's physician in the PWD application does not establish that the appellant's impairments directly and significantly restrict his ability to perform any of his other DLA either continuously or periodically for extended periods. Help with DLA In its reconsideration, the ministry noted that as it "had not been established that [DLA] are significantly restricted ... it cannot be determined that significant help is required from other persons. No assistive devices are required." The legislation requires in subs. 2(b)(iii) that in the opinion of a prescribed professional, as a result of the appellant's restrictions, the appellant requires help to perform DLA. The panel notes the evidence before the ministry at the reconsideration as set out by the appellant's physician in the AR was that the appellant needs continuous assistance with all of the tasks of shopping and that his ex-wife performs these tasks for him. However, the panel notes the ministry's concern that the information from the physician that the physician requires continuous assistance for all tasks of shopping contradicts the inf o rmation from the physician that the appellant has good communication skills (for the tasks of reading prices and labels, making appropriate choices and paying for purchases) and can lift lighter items. The panel finds that the ministry's determination that because it has not been established that DLA are directly and significantly restricted, it cannot be determined that help is required as provided under section 2(2)/b)lii) of the EAPWDA, is reasonable. EAA T003(10/06/01)
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 is reasonably supported by the evidence. The panel therefore confirms the ministry's decision. EAA T003(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.