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 M i n i s t ry o f S o c i a l 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 J a n u a r y 8 , 2 0 1 4 w h i t h e f i v e s t a t u t o r y r e q u i r e m e n t s o f S e c t i o n 2 o f t h e E D i s a b i l i t i e s A c t f o r d e s i g n a t i o n a s a p e r s o n w i t h d i s a a p p e l l a n t m e t t h e a g e r e q u i r e m e n t a n d t h a t h i s i m p a H o w e v e r , t h e m i n i s t r y w a s n o t s a t i s f i e d t h a t t h e e v i d • t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l o r m e n t a • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( D L A ) a r e 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 e d e i t h e r c o n t • a s a r e s u l t o f t h e s 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 h e u s e o f a n a s s i s t i v e d e v i c p e r f o r m D L A . 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 f o r P e r s o n s w i t h D i s a b 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 b D e v e l o p m e n t a 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 ) c h f o u n 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 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 b i l i t i e s ( P W D ) . T h e m i n i s t r y f o u n d t h a t t h e 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 a t l e a s t t w o y e a r s . e n c e e s t a b l i s h e s t h a t : l i m p a i r m e n t ; , 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 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 p e r i o d s ; a n 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 e , o r 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 o i l i t i e s A c t ( E A P W D A ) , S e c t i o n 2 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 W i t h t h e c o n s e n t o f b o t h p a r t i e s , t h e h e a r i n g w a s c o 2 2 ( 3 ) ( b ) o f 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 A c t . 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 t h e t i m e o f t h e r D i s a b i l i t i e s ( P W D ) A p p l i c a t i o n c o m p r i s e d o f t h e a p p p h y s i c i a n r e p o r t ( P R ) a n d a n a s s e s s o r r e p o r t ( A R ) b p h y s i c i a n w h o n o t e d t h a t h e h a s k n o w n t h e a p p e l l a i n t h e a b s e n c e o f t 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 . s o u r c e s u s e d t o c o m p l e t e t h e A R , t h e p h y s i c i a n i n d a n d n o r e v i e w o f h i s f i l e o r c h a r t i n f o r m a t i o n o r a n y i n c l u d e d t h e f o l l o w i n g : 1 ) R e v i s e d p a g e f r o m t h e A R ( p a g e 1 6 o f 2 3 ) r e f u n c t i o n i n g ; a n d , 2 ) 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 d a t e d D e c e m b e D i a g n o s e s I n t h e P R , t h e a p p e l l a n t w a s d i a g n o s e d b y t h e m e d a b o u t 8 y e a r s a g o , d i a b e t i c n e u r o p a t h y w i t h o n s e t 1 w i t h o n s e t o f 6 m o n t h s . I n t h e R e q u e s t f o r R e c o n s i d a p p e l l a n t h a s a s e v e r e i n c o n t i n e n c e p r o b l e m . T h e r 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 r a m e n t a l d i s o r d e r . P h y s i c a l I m p a i r m e n t I n t h e P R , t h e a p p e l l a n t ' s p h y s i c i a n r e p o r t e d t h a t : • I n t e r m s o f h e a l t h h i s t o r y , t h e a p p e l l a n t h a s " d i a b e t i c n e u r o p a t h y , w i t h w e a k n e s s a n d d i s a • T h e a p p e l l a n t d o e s n o t r e q u i r e a n y p r o s t h e s i • W i t h r e s p e c t t o d e g r e e a n d c o u r s e o f i m p a i r m i s u s u a l l y p r o g r e s s i v e a n d t h e a p p e l l a n t " i s l i k o n g o i n g . " • I n t e r m s o f f u n c t i o n a l s k i l l s , t h e r e i s n o a s s e s b u t t h e p h y s i c i a n n o t e d " m a y w a l k b u t v e r y s l u n a i d e d , l i f t u n d e r 2 k g . ( u n d e r 5 l b s . ) , w i t h n r e m a i n s e a t e d b u t t h e p h y s i c i a n w r o t e " n e e d s • I n t h e a d d i t i o n a l c o m m e n t s , t h e p h y s i c i a n w r o d o a n y t h i n g . W e a k , o f t e n s h o r t o f b r e a t h . " I n t h e A R , 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 : • T h e a p p e l l a n t i s a s s e s s e d a s i n d e p e n d e n t w i a s s e s s m e n t f o r c l i m b i n g s t a i r s b u t t h e n o t e : " a s s i s t a n c e f r o m a n o t h e r p e r s o n w i t h s t a n d i n g c o m m e n t s w e r e a d d e d b y t h e p h y s i c i a n . • T h e s e c t i o n o f t h e A R r e l a t i n g t o a s s i s t a n c e p n o t c o m p l e t e d . • I n t h e a d d i t i o n a l c o m m e n t s , t h e o h y s i c i a n w r o n d u c t e d a s a w r i t t e n h e a r i n g , p u r s u a n t t o s e c t i o n e c o n s i d e r a t i o n d e c i s i o n i n c l u d e d t h e P e r s o n W i t h l i c a n t i n f o r m a t i o n d a t e d A u g u s t 9 , 2 0 1 3 , a o t h d a t e d A u g u s t 2 , 2 0 1 3 a n d c o m p l e t e d b y a n t f o r a p p r o x i m a t e l y 6 m o n t h s a s h e h a s s e e n h i m I n d e s c r i b i n g t h e a p p r o a c h a n d i n f o r m a t i o n i c a t e d o n l y a n o f f i c e i n t e r v i e w w i t h t h e a p p e l l a n t o t h e r s e c o n d a r y s o u r c e . T h e e v i d e n c e a l s o g a r d i n g i m p a c t s t o c o g n i t i v e a n d e m o t i o n a l r 2 0 , 2 0 1 3 . i c a l p r a c t i t i o n e r w i t h D i a b e t e s w i t h d a t e o f o n s e t 8 -2 4 m o n t h s , a n d C O P D , s h o r t n e s s o f b r e a t h e r a t i o n , t h e m e d i c a l p r a c t i t i o n e r r e p o r t e d t h a t t h e e w a s n o d i a g n o s i s i n d i c a t e d i n t h e P R o r t h e m o d e r a t e t o s e v e r e d i a b e t e s m e l l i t u s ; h e a l s o h a s b i l i t y . " s o r a i d fo r h i s i m p a i r m e n t . e n t , t h e p h y s i c i a n w r o t e t h a t d i a b e t i c n e u r o p a t h y e l y t o g e t w o r s e " a n d t h a t " C O P D i s a l s o s m e n t r e g a r d i n g h o w f a r t h e a p p e l l a n t c a n w a l k o w l y , s h o r t o f b r e a t h " , h e c a n c l i m b 2 t o 5 s t e p s o a s s e s s m e n t o f h o w l o n g t h e a p p e l l a n t c a n t o l i e d o w n o f t e n ; t i r e d a n d s h o r t o f b r e a t h . " t e : " h e m o v e s v e r y s l o w l y . T a k e s a l o n g t i m e t o t h w a l k i n g i n d o o r s a n d o u t d o o r s , w i t h n o r a r e l y , i s d i f f i c u l t " , a n d t h e n e e d f o r p e r i o d i c , l i f t i n g , a n d c a r r y i n g a n d h o l d i n g . N o f u r t h e r r o v i d e d t h r o u g h t h e u s e o f a s s i s t i v e d e v i c e s i s t e t h a t t h e a n n e l l a n t " i s v e r v w e a k a n d s l o w . "
I n t h e 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 , t h e p h y s i c i a n w • H e s a w t h e a p p e l l a n t o n D e c e m b e r 2 0 , 2 0 1 3 t o i l e t i n g . H e h a s a s e v e r e i n c o n t i n e n c e p r o b d o a n y t h i n g a t h o m e b e c a u s e o f t h i s p r o b l e m • H e s a i d t h a t h e f e l t e m b a r r a s s e d b y t h e p r o b p a g e 1 6 o f 2 3 o f t h e P W D a p p l i c a t i o n , t h e r e f r o m n o i m p a c t t o m a j o r i m p a c t . M e n t a l I m p a i r m e n t I n t h e P R , t h e a p p e l l a n t ' s p h y s i c i a n r e p o r t e d t h a t : • I t i s u n k n o w n w h e t h e r t h e a p p e l l a n t h a s a n y f u n c t i o n i n g . • T h e a p p e l l a n t i s r e s t r i c t e d w i t h s o c i a l f u n c t i o n o r p e r i o d i c , i t i s n o t e d : " r a r e l y a b l e t o s o c i a l i z 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 a p p e l l a n t h a s a p o o r a b i l i t y t o c o m m u n i c w r i t i n g a n d h e a r i n g . • T h e s e c t i o n o f t h e A R d e s c r i b i n g i m p a c t s t o c f u n c t i o n i n g w a s n o t c o m p l e t e d . • T h e a p p e l l a n t i s i n d e p e n d e n t i n 4 o f 5 a s p e c a p p r o p r i a t e s o c i a l d e c i s i o n s , d e v e l o p i n g a n d a p p r o p r i a t e l y w i t h o t h e r s , a n d d e a l i n g a p p r o p e r i o d i c s u p p o r t / s u p e r v i s i o n w i t h s e c u r i n g a • T h e a p p e l l a n t h a s g o o d f u n c t i o n i n g i n h i s i m m t h e p h y s i c i a n " f e w f r i e n d s " , a n d v e r y d i s r u p t e I n t h e R e v i s e d p a g e f r o m t h e A R , t h e p h y s i c i a n r e p o • T h e r e i s a m a j o r i m p a c t t o t h e a p p e l l a n t ' s c o g b o d i l y f u n c t i o n s ( e . g . t o i l e t i n g p r o b l e m s ) , a m p r o b l e m s , m i n i m a l i m p a c t s t o e m o t i o n , i m p u l m o t i v a t i o n , m o t o r a c t i v i t y , l a n g u a g e , p s y c h o t i p r o b l e m s , a n d n o i m p a c t i n t h e r e m a i n i n g 3 a D a i l y L i v i n g A c t i v i t i e s ( D L A ) I n t h e P 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 h a s n o t b e e n p r e s c r i b e d a n y m d a i l y l i v i n g a c t i v i t i e s . • T h e a p p e l l a n t i s c o n t i n u o u s l y r e s t r i c t e d i n p e r c a r e , m e a l p r e p a r a t i o n , b a s i c h o u s e w o r k , d a i a n d u s e o f t r a n s p o r t a t i o n . • T h e a p p e l l a n t h a s u n d e f i n e d r e s t r i c t i o n s w i t h m a n a g e m e n t o f m e d i c a t i o n s a n d m a n a g e m e n • T h e r e a r e n o c o m m e n t s r e g a r d i n g t h e r e s t r i c t r e s t r i c t i o n t o t h e o t h e r D L A .r o t e : a n d t h e a p p e l l a n t r e v e a l e d a m a j o r p r o b l e m w i t h l e m , s o m u c h s o t h a t h e c a n h a r d l y g o o u t o r e v e n . l e m a n d h e d i d n o t t e l l t h e p h y s i c i a n a b o u t i t . O n s p o n s e h a s b e e n c h a n g e d f o r b o d i l y f u n c t i o n 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 e m o t i o n a l i n g , a l t h o u g h n o t d e f i n e d i n t e r m s o f c o n t i n u o u s e . " a t e i n a l l a r e a s , i n c l u d i n g s p e a k i n g , r e a d i n g , o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g a n d s o c i a l t s o f s o c i a l f u n c t i o n i n g , i n c l u d i n g m a k i n g m a i n t a i n i n g r e l a t i o n s h i p s , i n t e r a c t i n g p r i a t e l y w i t h u n e x p e c t e d d e m a n d s , w h i l e r e q u i r i n g s s i s t a n c e f r o m o t h e r s . e d i a t e s o c i a l n e t w o r k s , w i t h t h e n o t e a d d e d b y d f u n c t i o n i n g i n h i s e x t e n d e d s o c i a l n e tw o r k s . r t e d t h a t : n i t i v e a n d e m o t i o n a l f u n c t i o n i n g i n t h e a r e a o f o d e r a t e i m p a c t t o o t h e r e m o t i o n a l o r m e n t a l s e c o n t r o l , a t t e n t i o n / c o n c e n t r a t i o n , m e m o r y , c s y m p t o m s , a n d o t h e r n e u r o p s y c h o l o g i c a l r e a s o f f u n c t i o n i n g . e d i c a t i o n a n d / o r t r e a t m e n t t h a t i n t e r f e r e w i t h h i s f o r m i n g s e v e r a l D L A , i n c l u d i n g p e r s o n a l s e l f l y s h o p p i n g , m o b i l i t y i n s i d e a n d o u t s i d e t h e h o m e , s o c i a l f u n c t i o n i n g a n d i s n o t r e s t r i c t e d i n t h e D L A t o f f i n a n c e s . i o n s t o s o c i a l f u n c t i o n i n g o r t h e d e g r e e o f
In the AR, the ph ysician reported that: • The appellant is independent with moving about indoors • The ap pellant i s independent in 6 of 8 ta sks gr oomi n g, toileting, fe ed ing sel f, transfers in/out of on/o f f chair. There is no assessmen t for regulating diet and the appe assistance with bathing. • The appellant require s periodic assi stance from n o a ssessmen t for laundry but the comment a • Th e appellant is independent in performing all tasks of the and fr om stor e s, rea ding prices and labels, making app and carrying purchases home. • The app el lant is independent with all 4 tasks of the DLA meals, including meal preparation, cook i ng and safe storag e of f oo • The app el lant is independent with all 3 task s ba nking, budgeting, a n d p ay i n g ren t and bill s. • The a pp e llant is indep endent i n per forming all fill ing/r e f i l ling pr e scriptions, ta king a s dir e cted and safe ha • The a pp e llant is i nd e pendent w ith al l 3 t asks and out of a vehi c l e, usi ng p ubl i c t rans it and trans po rtati o n. • Additi o n a l comm ents are that th e a ppellant "is v ho me work and sociali zing." Nee d for Help T he physician repor ted in t h e AR that t he help requi The se c tion o f t he rep o rt indi catin g assi st a n ce prov id comp l eted. I n hi s No t ic e of A ppeal dated Ja nuary 1 7, 201 4, the appell is e x acer ba te d a n d he i s in d ire str a its. He has inc ont wh en h e wa lks o r slee ps. H e nee d s to use a w hee lch The m inistry r elied o n its re c onsider ation d ecis ion . The minis try did not raise an objection to the admissibility of the information in the of Appeal. The panel reviewed the Notice and admitted the information regarding inco nt inence, a s relating to t he appel lant's previously diagnosed me support of information before the ministry on reconsideration, pursuant to Section 22(4) of the Employment and Assistan c e Act. The panel did not admit the reference to s information is not in support of inf o rmation that was before the ministry on reconsideration. and o u tdo ors. o f the D LA p ersonal ca r e, including d res sing, bed (note: " w i th support") a n d t r a n sfers lla nt requires periodi c another person with basic housekeeping, with dded: "barely possible . " DLA s h opping, in cluding going to r op ri a t e choices , paying for purchases , plannin g, f o od d . of the DLA paying rent and bills, including 3 t asks of managing h is me dicati ons, inclu ding ndling a n d stora g e . of m ana g i ng tr a n s port a tion, inclu ding getting in using transit s ch e dul e s a nd arr a n ging ery we ak and slo w ; o ften n eeds help w it h red f or DL A is pr o vided by t h e a p pel lant' s fri en ds . ed t hrou gh the use o f a ssi stiv e d ev ices is n ot a nt wrot e th at h e su ffers from diabet es th a t inenc e and sp i n a l s cia t i ca. H e has cr a mps a ir or a cane. appellant's Notice diabetes and d ical conditions and being in pinal s c i atica as this
L PART F -Reasons for Panel Decision The issue on the appeal is whether the ministry's reconsideration decision, which found that the appellant is not eligible for designation as a person with disabilities (PWD), was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. The ministry found that the appellant does not have a severe mental or physical impairment and that his daily living activities (DLA) are not, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods and that, as a result of those restrictions, it could not be determined that the appellant requires the significant help or supervision of another person, the use of an assistive device, or the services of an assistance animal to perform DLA. The criteria for being designated as a person with disabilities (PWD) are set out in Section 2 of the EAPWDA as follows: Persons with disabilities 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. (4) The minister may rescind a designation under subsection (2). Section 2(1 )(a) of the EAPWDR defines DLA for a person who has a severe physical or mental impairment as follows: Definitions for Act 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;
( 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 r t 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 l a c e ( 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 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 ( 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 o r f ( 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 e f f e S e v e r e 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 p o s i t i o n i s t h a t a s e v e r e p h y s i c a l i m w e a k n e s s a n d s h o r t n e s s o f b r e a t h d u e t o d i a b e t e s , w r o t e t h a t h e s u f f e r s f r o m d i a b e t e s t h a t i s e x a c e r b a i n c o n t i n e n c e a n d h e n e e d s t o u s e a w h e e l c h a i r o r a T h e m i n i s t r y ' s p o s i t i o n i s t h a t t h e r e i s n o t e n o u g h i n t h a t t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l i m p a i r m e n t g e n e r a l p r a c t i t i o n e r 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 h o m e b u t h e i s " s l o w , n e e d s s u p p o r t " a n d a l s o t h a t m i n i s t r y s t a t e d t h a t i t i s d i f f i c u l t t o d e t e r m i n e w h i c h a b i l i t y t o m o v e a t a n o r m a l p a c e a s t h e g e n e r a l p r a c a s c h e s t x r a y s o r t e s t r e s u l t s , n o r d o e s h e i n d i c a t e e n d o c r i n o l o g i s t , p u l m o n o l o g i s t , e t c . ) . T h e m i n i s t r y s a n d e l a b o r a t i o n i n r e g a r d s t o t h e s e v e r i t y o f t h e a p p P a n e l D e c i s i o n 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 t s e l f d e t t h e s e v e r i t y o f a n i m p a i r m e n t o n e m u s t c o n s i d e 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 h i s D L A a s e v i d e n c e d D L A , a n d t h e d e g r e e o f i n d e p e n d e n c e i n p e r f o r m i n g w h e n i t d e f i n e s t h e w o r d " i m p a i r m e n t " i n t h e p h y s i c i 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 t o u t i n l e g i s l a t i o n a n d i s n o t b i n d i n g o n t h e p a n e l d e s c r i b e s t h e l e g i s l a t i v e i n t e n t . T h e l e g i s l a t i o n c l e a r l y p r o v i d e s t h a t t h e d e t e r m i n a t i o t h e m i n i s t e r , t a k i n 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 l e g i s l a t i o n i s a l s o c l e a r t h a t t h e f u n d a m e n t a l b a s i s f o p r o f e s s i o n a l r e s p e c t 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 h e m e d i c a l p r a c t i t i o n e r , a p h y s i c i a n w h o h a s k n o w d i a g n o s e d t h e a p p e l l a n t w i t h d i a b e t e s , d i a b e t i c n e u r n o t e d i n t h e P R t h a t t h e a e l l a n t h a s " m o d e r a t e t o 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 c o n d i t i o n ; a i r m e n t , i n c l u d e s t h e f o l l o w i n g a c t i v i t i e s : i n a n c e s ; c t i v e l y . p a i r m e n t i s e s t a b l i s h e d b y t h e e v i d e n c e o f h i s d i a b e t i c n e u r o p a t h y , a n d C O P D . T h e a p p e l l a n t t e d a n d h e i s i n d i r e s t r a i t s , t h a t h e h a s c a n e . f o r m a t i o n f r o m t h e g e n e r a l p r a c t i t i o n e r t o c o n f i r m . T h e m i n i s t r y s t a t e d t h a t , i n t e r m s m o b i l i t y , t h e d e p e n d e n t i n m o b i l i z i n g i n s i d e a n d o u t s i d e o f h i s h e d o e s n o t u s e a n y a s s i s t i v e d e v i c e s . T h e o f t h e a p p e l l a n t ' s m e d i c a l c o n d i t i o n s a f f e c t h i s t i t i o n e r d i d n o t i n c l u d e a n y m e d i c a l r e p o r t s , s u c h a n y r e f e r r a l s t o a p p r o p r i a t e s p e c i a l i s t s t a t e d t h a t t h e r e i s a l a c k o f w r i t t e n e x p l a n a t i o n e l l a n t ' s c o n d i t i o n s t h r o u g h o u t t h e a p p l i c a t i o n . e r m i n a t i v e o f a s e v e r e i m p a i r m e n t . T o a s s e s s 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 t h e b y f u n c t i o n a l s k i l l l i m i t a t i o n s , t h e r e s t r i c t i o n s t o D L A . T h e m i n i s t r y d e s c r i b e s t h i s a p p r o a c h a n r e p o r t a s b e i n g " 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 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 h i s d e f i n i t i o n i s n o t , b u t i n t h e p a n e l ' s v i e w i t q u i t e a p p r o p r i a t e l y n o f s e v e r i t y o f 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 i n c l u d i n g t h a t o f t h e a p p e l l a n t . H o w e v e r , t h e r t h e a n a l y s i s i s t h e e v i d e n c e f r o m a p r e s c r i b e d t a n d i t s i m p a c t o n d a i l y f u n c t i o n i n g . n t h e a p p e l l a n t f o r a p e r i o d o f 6 m o n t h s , o p a t h y , C O P D , a n d i n c o n t i n e n c e . T h e p h y s i c i a n s e v e r e d i a b e t e s m e l l i t u s ; h e a l s o h a s d i a b e t i c
n e u r o p a t h y w i t h w e a k n e s s a n d d i s a b i l i t y . " T h e a p p 1 7 , 2 0 1 4 , t h a t h e s u f f e r s f r o m d i a b e t e s t h a t i s e x a c e p r o v i d e d f u r t h e r i n f o r m a t i o n i n t h e R e q u e s t f o r R e c o d i a b e t e s h a d w o r s e n e d s i n c e t h e t i m e o f t h e P W D a I n t h e a d d i t i o n a l c o m m e n t s t o t h e P R , t h e p h y s i c i a n T a k e s a l o n g t i m e t o d o a n y t h i n g . W e a k , o f t e n s h o rt P R 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 " m a y w a l k b u t v e r y s u n a i d e d , l i f t u n d e r 5 l b s . a n d h e " n e e d s t o l i e d o w n i n d i c a t e d i n t h e P R t h a t t h e a p p e l l a n t i s c o n t i n u o u s l h o m e , b u t n o c o m m e n t s a r e i n c l u d e d r e g a r d i n g t h e h a n d , t h e a p p e l l a n t i s a s s e s s e d a s i n d e p e n d e n t w i t s t a i r s a s i t i s " d i f f i c u l t " , a n d h e n e e d s p e r i o d i c a s s i s t a n d c a r r y i n g a n d h o l d i n g , a l t h o u g h h o w o f t e n a n d f o n o t b e e n f u r t h e r d e f i n e d . I n h i s N o t i c e o f A p p e a l , t h e a p p e l l a n t w r o t e t h a t h e a c o n f i r m e d i n t h e 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 t h a t h t h e a p p e l l a n t r e v e a l e d a m a j o r p r o b l e m w i t h t o i l e t i n g s e v e r e i n c o n t i n e n c e p r o b l e m , s o m u c h s o t h a t h e c a b e c a u s e o f t h i s p r o b l e m . I n t e r m s o f t h e i m p a c t t o t r e p o r t e d a m a j o r i m p a c t t o c o g n i t i v e a n d e m o t i o n a l n o t d e s c r i b e s p e c i f i c i m p a c t s t o t h e a p p e l l a n t ' s p h y s b e i n g u s e d . T h e a p p e l l a n t i n d i c a t e d a n e e d f o r a w h t h e p h y s i c i a n r e p o r t e d i n t h e P R t h a t t h e a p p e l l a n t d s e c t i o n o f t h e A R r e l a t i n g t o a s s i s t a n c e p r o v i d e d t h r c o m p l e t e d . 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 r e a s o n a b l y c o n c l u d o f t h e a p p e l l a n t ' s p r e s e n t p h y s i c a l l i m i t a t i o n s d u e t o e v i d e n c e . W h i l e t h e p h y s i c i a n w r o t e t h a t d i a b e t i c n e " i s l i k e l y t o g e t w o r s e , " h e a l s o d e s c r i b e d t h e a p p e l l a r e f e r t o a n e x a c e r b a t i o n i n t h e a p p e l l a n t ' s c o n d i t i o n p h y s i c i a n d e s c r i b e d t h e a p p e l l a n t ' s C O P D a s " o n g o s h o r t n e s s o f b r e a t h , t h e r e i s n o i n d i c a t i o n o f t h e d e g r e m e d i a l m e a s u r e s t a k e n t o a m e l i o r a t e t h e s y m p t o m f i n d s t h a t t h e m i n i s t r y r e a s o n a b l y d e t e r m i n e d t h a t t h a p p e l l a n t h a s a s e v e r e p h y s i c a l i m p a i r m e n t u n d e r s e S e v e r e M e n t a l I m p a i r m e n t T h e a p p e l l a n t d i d n o t m a i n t a i n a p o s i t i o n t h a t h e h a s T h e m i n i s t r y ' s p o s i t i o n i s t h a t t h e r e i s i n s u f f i c i e n t e v i s e v e r e m e n t a l i m p a i r m e n t , p a rt i c u l a r l y s i n c e t h e a p p h e a l t h c o n d i t i o n . T h e m i n i s t r y s t a t e d t h a t t h e p h y s i c h a s a n y s i g n i f i c a n t d e f i c i t s w i t h h i s c o g n i t i v e a n d e m t h e p h y s i c i a n w r o t e i n t h e R e a u e s t f o r R e c o n s i d e r a t e l l a n t w r o t e i n h i s N o t i c e o f A p p e a l d a t e d J a n u a ry r b a t e d a n d h e i s i n " d i r e s t r a i t s . " T h e p h y s i c i a n n s i d e r a t i o n a n d d i d n o t r e p o r t t h a t t h e a p p e l l a n t ' s p p l i c a t i o n . w r o t e t h a t t h e a p p e l l a n t " . . . m o v e s v e r y s l o w l y . o f b r e a t h . " T h e f u n c t i o n a l s k i l l s r e p o r t e d i n t h e l o w l y , s h o rt o f b r e a t h " , h e c a n c l i m b 2 t o 5 s t e p s o f t e n ; t i r e d a n d s h o r t o f b r e a t h . " T h e p h y s i c i a n y r e s t r i c t e d w i t h h i s m o b i l i t y i n s i d e a n d o u t s i d e t h e d e g r e e o f r e s t r i c t i o n . I n t h e A R , o n t h e o t h e r h w a l k i n g i n d o o r s a n d o u t d o o r s , h e " r a r e l y " c l i m b s a n c e f r o m a n o t h e r p e r s o n w i t h s t a n d i n g , l i f t i n g , r h o w l o n g t h e p e r i o d i c a s s i s t a n c e i s r e q u i r e d h a s l s o h a s i n c o n t i n e n c e a n d t h e p h y s i c i a n e s a w t h e a p p e l l a n t o n D e c e m b e r 2 0 , 2 0 1 3 a n d . 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 h a s a n h a r d l y g o o u t o r e v e n d o a n y t h i n g a t h o m e h e a p p e l l a n t ' s f u n c t i o n i n g , h o w e v e r , t h e p h y s i c i a n f u n c t i o n i n g i n t h e a r e a o f b o d i l y f u n c t i o n s , b u t d i d i c a l f u n c t i o n i n g o r w h e t h e r a n y t o i l e t i n g a i d s a r e e e l c h a i r o r a c a n e i n h i s N o t i c e o f A p p e a l , b u t o e s n o t r e q u i r e a n a i d f o r h i s i m p a i r m e n t a n d t h e o u g h t h e u s e o f a s s i s t i v e d e v i c e s h a s n o t b e e n e d t h a t i t i s d i f f i c u l t t o o b t a i n a n a c c u r a t e p i c t u r e t h e i n c o n s i s t e n c i e s a n d l a c k o f d e t a i l i n t h e u r o p a t h y i s u s u a l l y p r o g r e s s i v e a n d t h e a p p e l l a n t n t ' s d i a b e t e s a s " m o d e r a t e t o s e v e r e " a n d d i d n o t i n t h e 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 . T h e i n g " a n d a l t h o u g h r e f e r e n c e s a r e m a d e t o r e e o f p r o g r e s s i o n o f t h i s d i s e a s e a n d a n y s . I n t h e a b s e n c e o f f u r t h e r d e t a i l , t h e p a n e l e r e i s n o t s u f f i c i e n t e v i d e n c e t o e s t a b l i s h t h a t t h e c t i o n 2 ( 2 ) o f t h e E A P W D A . a s e v e r e m e n t a l i m p a i r m e n t . d e n c e t o 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 h a s a e l l a n t ' s p h y s i c i a n d i d n o t d i a g n o s e a m e n t a l i a n i n d i c a t e d t h a t h e d i d n o t k n o w i f t h e a p p e l l a n t o t i o n a l f u n c t i o n i n g . T h e m i n i s t r y s t a t e d t h a t w h i l e i o n t h a t a t o i l e t i n g i s s u e h a s a m a i o r i m p a c t o n
t he appel lant's m ental he alt h, th e la r ge maj o rity o f the rest f unctioni n g are reporte d to h a ve a mini mal impact on d p hy s ic ian made so m e comm ents i n the PW D a p plic app e llan t' s men tal hea lth b ut he di d not di agno se the a he pr ovid e el a b orat e de ta il to the d isrup t ion o f t he app re f errals to me ntal he a l th s p e cialist s. P an el Decision The gen eral p ractition er d id not diagno se a me ntal dis Reconsid eration. The physician reported i n the PR that sign if ican t d efi ci ts t o the a p pel lan t 's cog nitive and emotional func desc r i bing imp acts to cogn i tive and em o t i ona l function fro m the A R, the physician r epo rted tha t there is a majo em o tional functi on i n g in the area of b odily functions (e. o t he r em o tional or mental p r oble ms wh ich are no t further de no imp ac t to in the remaining 12 areas o f fun ctionin g. phy sici an wr ote th a t t h e ap pell a n t did not t ell hi m about appellant sai d he felt em barras se d b y the p r oblem and he h ome because o f this pro b lem . The ph y s ician indi c a t e d in the P R that the appe llant is "rar e ly a b le to soc ialize;" ho weve r , the a ppellant is asses so cial f uncti oning, in cluding maki ng appro pr iate social deci relations hip s , inte rac t i n g a pp ropria te ly with othe rs, and dealing de mands, whi l e req uir in g period ic s up port/supervision A R, t he physicia n in d ic ated t hat the a ppellant h as a poor a sp eakin g, r eading, wri ting and h e aring , b ut there are thes e difficult ie s . The phy sici an repor ted that the a ppe i ndepen d e ntly, incl uding mak ing a ppro p r ia t e c hoices rent a nd bills a s we ll a s taki ng m edicat ion s a s directe diag nosis and a la ck o f detail r egard i n g impact s t o me the ministry reasonably determine d that a severe mental impai section 2 (2) of the EAP WDA. Restrictions in the a bi l i t y to pe rform DLA The appellant's position is that his physical impairment directly and signif perform DLA on an ongoing basis to the point that he requires the significant assistance of another person, as well as assistive devices such as a wheelchair or a cane The ministry's position is that the appellant can independen independentl y and, for th ose tasks wh ere periodic assis explained the exten t of the periodic assistance requi time. of the appel lan t's cog niti v e an d emotiona l a ily f u nc tioning. The minist ry state d that th e ation regarding iss u es whic h m ay af f ec t th e ppella nt w ith a me ntal h ealth iss ue, no r does ellant's emot i ona l func t i on i ng or i n dica te any o rde r in t he PR o r in the Request for it i s "unknown" wheth er there ar e any ti o ni ng and the sectio n of t he AR i n g was not comple ted . I n the Revised page r imp a ct to t he appellant's c o gnitive and g. toi leting proble ms ), a m o d erate impact to scr ibe d by th e physician, and m inimal or In the Re que s t for Reconsideration, the s e vere inc o ntinence earlier be caus e the can h a r dly go out or ev en do anything at rest ricted with soci al fu nctionin g, described as sed as in d e pendent in 4 o f 5 a s pects of s i ons, de v e loping and mai nt a ining a pp ropr i a te ly with unex p e c te d with secur ing a s si s ta n ce f r om oth e r s. In th e bility to communica te in all ar e as , including no comme nts provided explai ning t h e c au se of llant performs a ll "m ental " t a s ks o f D LA when shopp ing, ba nk, b ud ge t i ng and p ayi n g d . Gi ven t he a b sence of a m ental disorder ntal and soc i a l fun c tion ing , t he pa nel f ind s th a t r ment was not established under icantly restricts his ability to . tly manage the majority of his DLA tance is required, the physician has not red to indicate restrictions for e xtended periods of
f o r e x t e n d e d p e r i o d s . I n t h i s c a s e , t h e a p p e l l a n t ' s p d e f i n e d i n s e c t i o n 2 ( 1 ) o f t h e E A P W D R a n d a r e a l s o t h e A R . T h e r e f o r e , a p r e s c r i b e d p r o f e s s i o n a l c o m p w h i c h , i f a n y , D L A a r e s i g n i f i c a n t l y r e s t r i c t e d b y t h e 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 . I n t h e a p p e l l a n t ' s c i r c u m s t a n c e s , h i s p h y s i c i a n r e p o r e s t r i c t e d i n p e r f o r m i n g s e v e r a l D L A , i n c l u d i n g p e r s h o u s e w o r k , d a i l y s h o p p i n g , m o b i l i t y i n s i d e a n d o u t s f u r t h e r c o m m e n t s p r o v i d e d r e g a r d i n g t h e d e g r e e o f t h e a p p e l l a n t i s c o m p l e t e l y i n d e p e n d e n t w i t h p e r f o r m a b o u t i n d o o r s a n d o u t d o o r s , s h o p p i n g , m e a l s , p a y i n a n d t r a n s p o r t a t i o n . T h e a p p e l l a n t i s a l s o a s s e s s e d p e r s o n a l c a r e , w h i l e r e q u i r i n g p e r i o d i c a s s i s t a n c e w a p p e l l a n t a s r e q u i r i n g p e r i o d i c a s s i s t a n c e f r o m a n o t a s s e s s m e n t f o r l a u n d r y b u t t h e c o m m e n t a d d e d : " b a A R , 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 f t e n n e e h o w e v e r , t h e r e i s n o f u r t h e r d e t a i l p r o v i d e d . I n t h e a b s e n c e o f n a r r a t i v e o r n o t e s t o f u r t h e r e x p l a i a s s i s t a n c e w i t h t h e s e t a s k s o f D L A , o r t o e x p l a i n t h e r e p o r t e d i n t h e P R a n d t h e A R , t h e p a n e l f i n d s t h a t t b e 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 r e s t r i c t e d p e r i o d 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 r e a s o n a b l y c o n c l u d e d t h p r e s c r i b e d p r o f e s s i o n a l t o e s t a b l i s h t h a t t h e a p p e l l a m a n a g e h i s D L A 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 l e g i s l a t i v e c r i t e r i o n o f s e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W H e l p t o p e rf o r m D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h e r e q u i r e s t h e s i g n i f d e v i c e t o p e r f o r m D L A . T h e m i n i s t r y ' s p o s i t i o n i s t h a t b e c a u s e i t h a s n o t b e e r e s t r i c t e d , i t c a n n o t b e d e t e r m i n e d t h a t s i g n i f i c a n t h e a p p e l l a n t d o e s n o t r e q u i r e a n a s s i s t i v e d e v i c e . P a n e l D e c i s i o n S e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A r e q u i r e s t h a t , a s a a b i l i t y t o p e r f o r m D L A , a p e r s o n r e q u i r e s h e l p t o p e rf s u b s e c t i o n ( 3 ) a s t h e r e q u i r e m e n t f o r a n a s s i s t i v e d e a n o t h e r p e r s o n , o r 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 T h e e v i d e n c e o f t h e p h y s i c i a n , a s a p r e s c r i b e d p r o f e p r o v i d e d b y t h e a p p e l l a n t ' s f r i e n d s . A l t h o u g h t h e a p r e q u i r e s t h e u s e o f a w h e e l c h a i r o r a c a n e , t h i s h a s n r e p o r 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 n o a i d s f o r h i s i m r e a s o n a b l v d e t e r m i n e d t h a t a s d i r e c t a n d s i a n i f i c a n t h y s i c i a n i s t h e p r e s c r i b e d p r o f e s s i o n a l . D L A a r e l i s t e d i n t h e P R a n d , w i t h a d d i t i o n a l d e t a i l s , i n l e t i n g t h e s e f o r m s h a s t h e o p p o r t u n i t y t o i n d i c a t e a p p e l l a n t ' s i m p a i r m e n t s e i t h e r c o n t i n u o u s l y o r r t e d i n t h e P R t h a t t h e a p p e l l a n t i s c o n t i n u o u s l y o n a l s e l f c a r e , m e a l p r e p a r a t i o n , b a s i c i d e t h e h o m e , a n d u s e o f t r a n s p o r t a t i o n , w i t h n o r e s t r i c t i o n . I n t h e A R , t h e p h y s i c i a n r e p o r t e d t h a t i n g m a n y o f t h e s e s a m e D L A , i n c l u d i n g m o v i n g g r e n t a n d b i l l s , a n d m a n a g i n g h i s m e d i c a t i o n s a s i n d e p e n d e n t i n 6 o f 8 t a s k s o f t h e D L A i t h b a t h i n g . T h e p h y s i c i a n a l s o a s s e s s e d t h e h e r p e r s o n w i t h b a s i c h o u s e k e e p i n g , w i t h n o r e l y p o s s i b l e . " I n t h e a d d i t i o n a l c o m m e n t s t o t h e d s h e l p w i t h h o m e w o r k a n d s o c i a l i z i n g ; " n h o w o f t e n o r f o r h o w l o n g t h e a p p e l l a n t r e q u i r e s i n c o n s i s t e n c i e s b e t w e e n t h e r e s t r i c t i o n s t o D L A h e m i n i s t r y r e a s o n a b l y c o n c l u d e d t h a t i t c a n n o t i c a l l y fo r e x t e n d e d p e r i o d s o f t i m e . O v e r a l l , t h e a t t h e r e i s n o t e n o u g h e v i d e n c e f r o m t h e 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 a b i l i t y t o o r e x t e n d e d p e r i o d s , t h e r e b y n o t s a t i s f y i n g t h e D A . i c a n t a s s i s t a n c e o f a n o t h e r p e r s o n o r a n a s s i s t i v e n e s t a b l i s h e d t h a t D L A a r e s i g n i f i c a n t l y l p i s r e q u i r e d . T h e m i n i s t r y s t a t e d t h a t t h e r e s u l t o f d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n s i n t h e o r m t h o s e a c t i v i t i e s . H e l p i s d e f i n e d i n v i c e , 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 l i n o r d e r t o p e r f o r m a D L A . s s i o n a l , i s t h a t t h e h e l p r e q u i r e d w i t h D L A i s p e l l a n t s t a t e d i n h i s N o t i c e o f A p p e a l t h a t h e o t b e e n c o n f i r m e d b y t h e p h y s i c i a n w h o p a i r m e n t . 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 r e s t r i c t i o n s i n t h e a o o e l l a n t ' s a b i l i t v t o o e r f o r m
DLA have not been established, it cannot be determined that the appellant requires help to perform DLA as a result of those restrictions, as defined by section 2(3)(b) of the EAPWDA. Conclusion Having reviewed and considered all of the evidence and relevant legislation, the panel 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 confirms the decision.
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.