P ART C Decision un der A pp eal T he decisi on unde r ap pea l is the Minis try o f Social D " m i nist ry") r e con side r ation dec ision of Jan uary 2 2, thr ee of fiv e sta tu tory r equi rement s of s ect ion 2 of th Disa bilities Act ("EAPW DA") f o r des i g na t ion a s a person with di t hat th e app ellan t me t the age requirem ent an d that in a ppellant' s i m p airme nt is li k ely to c ont inu e for at lea satis fied t hat: • th e evi d en c e es t a blishe s that t h e a pp ellan t has a s • th e a ppe l la nt' s d aily livi ng act iv iti es ("DLA " ) are, in di rect ly a nd s ign ifica ntl y restr ict e d eithe r c o nti that • as a res ult of those rest riction s, t he ap pella nt ano t h er pe rson , an ass istive device, or the servi PA RT D -Re lev an t Leg i s l ation E mployme nt an d Ass i s tance fo r Perso ns with Disabilities Employment and A s sistan ce for Persons with Di sabil EAAT 003(1 0/06/01) evelopm ent a nd So cia l In no vat ion (t he 2014 whic h fo und th at the app el lant did no t m e et e Empl oy ment a nd A s sista nc e for Pers ons With sa bi lit ies ( "P WD"). The ministry f ound the opi ni on of a medical prac t ition er th e st t w o y ears. H o w e ver , the minist r y was not e v e re phy sic al or men tal imp air m en t ; t h e op i n ion of a prescri be d profess io nal, n uo usly or peri odical ly fo r extend ed p eriod s ; a nd requ i r es t he si gnifican t he lp or su pervision o f ces of an assistance a nima l. Act ("EAPW DA"), section 2 ities R e gulation ("EAPWDR"), sec t ion 2
PART E -Summary of Facts The inf o rmation before the ministry at the time of reconsideration included the following: • The appellant's PWD application form consisting of the appellant's self-report [dated Jilly 23, 2013], a physician's report ("PR") signed by the appellant's physician of 6 years [dated July 23, 2013], and assessor's report ("AR") signed by the appellant's anesthesiologist [dated June 27, 2013]. • An updated section E of the PR completed by the appellant's physician on December 23, 2013 (the "New Section E"). • An advocate-prepared questionnaire completed by the appellant's physician on December 23, 2013 (the "Questionnaire"). • Supporting medical documents including medical imaging reports and consultation reports from the anesthesiologist (c ollectively referred to as "the Medical Reports"). The panel reviewed the evidence as follows: Physical Impairment • In the PR the physician diagnosed the appellant with lower back pain/degenerative disc disease L5 nerve root compression. He commented that the appellant has been deriving benefit from nerve root blocks. • In terms of physical functional skills, the physician reported that the appellant can walk unaided 1 to 2 blocks on a flat surface, climb 5+ stairs unaided, lift 5 to 15 pounds, and can remain seated for 1 to 2 hours. • In the AR the anesthesiologist (who administers the appellant's nerve root blocks) indicated the appellant suffers from chronic pain secondary to lumbar degeneration and L5 nerve root compression. • The anesthesiologist reported that the appellant is independent with respect to walking indoors and outdoors, climbing stairs, and standing. She indicated that the appellant takes significantly longer than typical with lifting/carrying/holding, and commented that the appellant should not lift anything over 5 pounds. She commented that when the appellant is working she is in pain most of the time and is unable to concentrate at school or do any social activities. • The anesthesiologist recommended chronic pain treatments with lumbar injections, referral to psychologist for depression management, and a gentle exercise program. • In her self-report the appellant wrote that she suffers from chronic low back pain caused by her L4/5 and L5/S1 discs which are making contact with her nerve endings. She indicated that her sleep is disturbed by pain every couple of hours. • Regarding the Medical Reports: ► a medical imaging report from 2010 indicated the disc protrusion at L4-5 results in moderate bilateral lateral recess compromise and mild-to-moderate central canal stenosis [narrowing]. Mild bilateral neural foraminal stenoses were noted due to disc bulge and osteophyte complex. ► an outpatient clinic note prepared by the anesthesiologist on March 4, 2013 assessed the appellant as being " ... within normal limits. Full flexion, full extension, side flexina, rotation are all normal. Reflexes are normal. Mvotomes are normal. She has EAAT 003(10/06/01)
some gross sensory changes in the lateral aspect of her L5 distribution as well as 81 distribution on the right. The left remains normal." ► an MRI report dated April 14, 2013 indicated that the findings are "advanced for this patient's age." It reported that the bulging disc at L4/5 makes mild L5 nerve root contact bilaterally and that there is bilateral neural foraminal canal narrowing at the L5/S1 level which could affect either the right or left L5 nerve root. • In the Questionnaire, the physician indicated that the appellant has a severe impairment, referring to the appellant's use of analgesics. • In her oral testimony the appellant testified that she is in horrible pain every day. She said the pain severely impacts her ability to walk and to get out of bed. • In response to a question from the panel the appellant said that when walking outdoors, she can walk 1 to 2 blocks before back pain requires her to sit down for 15 to 20 minutes. After resting she can continue walking, but the pain never really goes away until she has a chance to lie down for a while. She stated that she can manage stairs on her own as her bedroom at home is upstairs. Mental Impairment • In the PR the physician diagnosed the appellant as having depression. He noted the appellant has no difficulties with communication, but noted one significant deficit in cognitive and emotional function related to depression. • In the AR the anesthesiologist indicated a moderate impact with respect to 1 of 14 aspects of cognitive and emotional functioning -emotion (depression). She indicated minimal or no impacts to the other 13 aspects of cognitive and emotional functioning. • In her self-report the appellant wrote that she has anxiety and depression, and that she can be very moody. She stated that the anxiety causes her to become easily stressed and sometimes causes left leg pain to flare. • In the Questionnaire, the physician indicated that the appellant has a severe impairment, referring to PTSD and general anxiety disorder. • In her oral testimony the appellant was adamant that she is not claiming to have a mental impairment. DLA • In the PR the physician indicated that the appellant has not been prescribed any medication or , treatments that interfere with her ability to perform DLA. • In the PR the physician reported the appellant's impairment does not directly restrict her ability to perform the 6 prescribed DLA of personal self-care, meal preparation, management of medications, use of transporlation, management of finances and social functioning. He reported direct restrictions of 3 DLA where the appellant required periodic assistance: mobility inside and outside the home (periodic assistance required with mobility outside the home), basic housework, and daily shopping. The physician described "periodic" as "requires assistance with heavier housework, carrying heavy purchases and occasionally requires a driver." • In the AR the anesthesiologist described the appellant as independently managing all aspects of the 6 DLA of personal self-care, meal preparation, management of finances (pay rent and bills), management of medications, use of transporlation, and socialfunctioning. She indicated that the appellant requires periodic assistance with basic housekeeping and with 1 of 5 aspects of daily shoooinq (c arrvinq purchases home). . . EAA T003(10/06/01)
• In her self-report the appellant wrote that she lives with her mother and that her mother does about 90% of the housecleaning with the appellant "pitch[ing] in when possible." She wrote that she tends to go a few days longer than she probably should with respect to doing laundry. • The appellant wrote that though she bathes and grooms herself it sometimes seems like an impossible task. She stated she can't any longer make plans with friends because she never knows if she is going to be able to get out of bed on any given day. • In the New Section Ethe physician indicated that the appellant was continuously restricted with the DLA of personal self-care, meal preparation, basic housework, daily shopping, mobility inside and outside the home (specifically outside the home), use of transportation, and social functioning. He described the restrictions as being "ongoing and significant". Regarding social functioning, the physician commented that the appellant was very withdrawn and isolated. Describing the assistance required by the appellant for DLA the physician indicated bathroom grab bars, extra pillow, heating pad, meal preparation, housework, transport and counselling for anxiety. • In the Questionnaire the physician noted that the appellant's DLA are significantly restricted by pain. • In her oral testimony the appellant testified that pain often makes taking a shower "impossible". She said that she often can't get out of bed for 5 or 6 days at a time. • The appellant stated that her medications do not interfere with her ability to perform DLA. She said that she has been fortunate in that she has not had to be upgraded to stronger opioids such as OxyContin. • In response to a question from the panel regarding the use of assistive devices, the appellant said that when shopping, if the store has a wheelchair or power scooter the appellant will always use it. She said she seldom goes shopping to places that don't have a wheelchair or scooter. • In response to a question from the panel as to why the physician's responses in the New Section E are so different from his responses in the PR, the appellant said that though she'd been with the physician when the PR was completed, she'd had little input into the physician's responses because the physician didn't ask her many questions. She said that she had significantly more input into the physician's responses to the New Section E and the Questionnaire. Help • In the PR the physician noted the appellant does not require any prostheses or aids for her impairment. • In the AR the anesthesiologist indicated that the appellant receives assistance with DLA from her family. She indicated no assistive devices required, and that the appellant does not have an assistance animal. Admissibility of New Information In oral testimony the appellant provided additional information regarding her impairment. This information provides detail with respect to issues addressed in the original PWD application. Accordingly, the panel has admitted this new information as being in support of information and records that were before the ministry at the time of reconsideration, in accordance withs. 22(4) of the Employment and Assistance Act. The ministry relied on its reconsideration decision and provided no • new information. . .. EAAT003(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 o 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 ' s d P W D w a s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e o r e n a c t m e n t i n t h e c i r c u m s t a n c e s o f t h e a p p e l l a n t . I n d e t e r m i n i n g t h a t t h e a p p e l l a n t d o e s n o t h a v e a s e v 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 t h e a p p e l l a n t ' s r e s t r i c t h e r f r o m p e r f o r m i n g D L A e i t h e r c o n t i n u o u s l y 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 a p p e l l a n t d o e s n o t T h e r e l e v a n t l e g i s l a t i o n i s a s f o l l o w s : E A P W D A : 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 a c t i v i t y t h a t , b e c a u s e o f a s e v e r e m e n t a 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 y " h a s t h e p r e " 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 ( 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 d i s a b i l i t i e s fo r t h e p u r p o s e s o f t h i s A c t i f 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 ( a ) i n t h e o p i n i o n o f a m e d i c y e a r s , a n d ( b ) i n t h e o p i n i o n o f a p r e s c r ( i ) d i r e c t l y a n d s i g n i f i l i v i n g a c t i v i t i e s e i t h e r ( A ) c o n t i n u o u s ( B ) p e r i o d i c a l l ( i i ) a s a r e s u l t o f t h o s t h o s e a c t i v i t i e s . ( 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 m e n t a l d i s o r d e r , 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 p e r f o r m i t , t h e p e r s o n r e q u i r ( 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 ( i i i ) t h e s e r v i c e s o f a n . ---' -, E AA T 0 0 3 ( 1 0 1 0 6 1 0 1 )e c i s i o n t o d e n y 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 w a s a r e a s o n a b l e a p p l i c a t i o n o f t h e a p p l i c a b l e p a r t i c u l a r , w a s t h e m i n i s t r y r e a s o n a b l e i n r e p h y s i c a l o r m e n t a l i m p a i r m e n t , a n d t h a t i n t h e i m p a i r m e n t s d o n o t d i r e c t l y a n d s i g n i f i c a n t 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 t h a t a s r e q u i r e h e l p t o p e r f o r m D L A ? e d t o e n a b l e 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 l o r p h y s i c a l i m p a i r m e n t , t h e p e r s o n i s u n a b l e t o s c r i b e d m e a n i n g ; e p r e s c r i b e d m e a n i n g . w h o h a s r e a 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 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 e r s o n h a s a s e v e r e a l 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 i b e d p r o f e s s i o n a l 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 b i l i t y t o p e r f o r m d a i l y l y , o r y f o r e x t e n d e d p e r i o d s , a n d e r e s t r i c t i o n s , t h e p e r s o n r e q u i r e s h e l p t o p e r f o r m r e m e n t a l i m p a i r m e n t i n c l u d e s a p e r s o n w i t h a r e l a t i o n t o a d a i l y l i v i n g a c t i v i t y i f , i n o r d e r t o e s , p o r s u p e r v i s i o n o f a n o t h e r p e r s o n , o r a s s i s t a n c e a n i m a l . . . . · ' . , ; ' .
EAPWDR sec t ion 2( 1): 2 (1) For the purpos e s of the Act and t hi s r (a) In rela tion to a person w mental Impai r ment, me ans (i) prep are own me ( ii) manage personal f ( iii) shop for pers o ( iv) use pub l i c or pers (v ) per form housework ac cep t a ble sa ni ta r ( vi) mov e about indoors and outdoors; (vi i) p er fo rm p ers onal (v i ii ) man age per s (b) in relation to a person who foll owi n g activitie s : (i ) mak e decis i o ns (ii) r e late to , c o m munic ( 2 ) For the purposes of the Act, "pr e s cribed p (a) a uthori z ed unde r an e (i) medical practi t (ii) registered psyc (ii i) re g istere d nurse (iv) occ upational ( v ) physica l t h erap (v i ) soci al work er, (vii ) c hirop ractor, or (viii) nurse practitioner, or (b) acting in the course of the person's employment as a scho by (i) an authority, as that term is defined in section 1 (1) of the Independent School Act, or (ii) a board or a francophone education authority, as those terms are defined in section 1 (1) of the School Act, if qualifications in p s y ch ology are a condition of suc ******* Severe Physica l Impairm en t The appellant's position is that her back pain constitutes a severe physical impairment. the MRI results show huge amounts of damage to her spine, and that she is in "horrible" pain daily. EAA T003(10/06/01) egu lat io n , "daily livi n g activitie s " , ho h as a s e vere physi cal im p air men t or a severe the fo l low ing a ct ivities: al s; i n ances; nal needs; o nal transpor tation facilit ies; to m a in tain t h e person's p l a ce of reside n ce in y c ondit ion; h yg ien e and self car e ; ona l medi ca t ion, an d ha s a se vere mental impai rment, includes the about pers o n al a c ti v it ies, car e or f i n ances; ate or interact wit h o thers effe c ti v e ly. rofession a l" me ans a p e rson w ho i s nact ment to pr a ctise t he pr o fess i on of i o ner, hologist, or registered ps ych i atric nur s e, therap ist , ist, ol psychologi st h employment. She said that
p r o v i d e d i s n o t 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 i m p a m e a s u r e s a r e i n p l a c e w h i c h p r o v i d e s o m e b e n e f i t , h e l p c o m p e n s a t e f o r t h e a p p e l l a n t ' s i m p a i r m e n t . P a n e l D e c i s i o n A d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n d o e s n o s e v e r e i m p a i r m e n t . A n " i m p a i r m e n t " i s a m e d i c a l c 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 y o r e f f e c t i v e l y . T o a s s e s s 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 e x t e n t o f 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 a s e v i d e n c e w h i c h p e r f o r m i n g D L A i s r e s t r i c t e d . A m e d i c a l b a r r e m p l o y m e n t i s n o t a l e g i s l a t e d c r i t e r i o n f o r s e v e r i t y c o n s i d e r a l l t h e r e l e v a n t 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 f u n d a m e n t a l b a s i s f o r t h e a n a l y s i s i s t h e e v i d e n d e c i s i o n m a k i n g p o w e r t h e m i n i s t r y c a n n o t m e r e l y d r e s p e c t t o w h e t h e r t h e s t a t u t o r y r e q u i r e m e n t s a r e m f e t t e r i n g o f d i s c r e t i o n . T h e p r o f e s s i o n a l e v i d e n c e h e v i d e n c e . T h e o n u s o f p r o v i n g t h a t s h e s a t i s f i e s t h e s t a t u t o r y t h e r e i s a s i g n i f i c a n t c o n f l i c t i n t h e e v i d e n c e o f o n e p h y s i c i a n . T h e p h y s i c i a n ' s e v i d e n c e i n t h e N e w S e a p p e l l a n t ' s i m p a i r m e n t c a u s e s c o n t i n u o u s r e s t r i c t i o p e r i o d i c r e s t r i c t i o n s t o 3 D L A . T h e p h y s i c i a n h a s p r a p p e l l a n t h a s s a i d t h a t s h e h a d m o r e i n p u t i n t o t h e t h e p a n e l n o t e s t h a t t h e p h y s i c i a n h a s k n o w n t h e a p a l e v e l o f f a m i l i a r i t y w i t h t h e a p p e l l a n t ' s f u n c t i o n a l a r e a s o n a b l y c o n s i s t e n t w i t h r e s p e c t t o t h e i r e v i d e n c e l e v e l o f i m p a i r m e n t p a i n t e d b y t h e N e w S e c t i o n E a n t h e o t h e r , a n d b e c a u s e t h e P R a n d t h e A R a r e r e m a c o m p l e t e d b y t w o d i f f e r e n t p r o f e s s i o n a l s , t h e p a n e l N e w S e c t i o n E a n d t h e Q u e s t i o n n a i r e . 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 P R a n d t h e A R i n d i c 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 u p t o 2 b l o c k s , a n d c l i r e m a i n i n g s e a t e d , a n d s t a n d s i n d e p e n d e n t l y . H e r a p o u n d s . T h e a p p e l l a n t s t a t e d t h a t h e r p a i n c a n k e e p h e r b e d v i e w , i f t h e a p p e l l a n t w a s b e i n g i m p a c t e d t o t h i s e x t e m o r e l i k e l y t h a n n o t h a v e c o n f i r m e d t h i s i n t h e P R , A T h e r e i s n o s u c h c o n f i r m a t i o n . T h e a p p e l l a n t e m p h a s i z e d t h e e v i d e n c e i n t h e M e d i c i m a i r m e n t ; h o w e v e r t h e a n e l n o t e s t h e h e a v r e E AA T 0 0 3 ( 1 0 1 0 6 1 0 1 )i r m e n t . T h e m i n i s t r y a r g u e d t h a t r e m e d i a l a n d t h a t n o a s s i s t i v e d e v i c e s a r e r o u t i n e l y u s e d t o t i n i t s e l f d e t e r m i n e P W D e l i g i b i l i t y o r e s t a b l i s h a o n d i t i o n t h a t r e s u l t s i n r e s t r i c t i o n s t o a p e r s o n ' s o n s i d e r 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 t h e d 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 a n d t h e d e g r e e t o i e r t o t h e a p p e l l a n t ' s a b i l i t y t o e n g a g e i n p a i d . I n m a k i n g i t s d e t e r m i n a t i o n t h e m i n i s t r y m u s t t h e a p p e l l a n t . W h i l e t h e l e g i s l a t i o n i s c l e a r t h a t c e f r o m p r e s c r i b e d p r o f e s s i o n a l s , i n e x e r c i s i n g i t s e f e r t o t h e o p i n i o n o f t h e p r o f e s s i o n a l s w i t h e t a s t h a t a p p r o a c h w o u l d a m o u n t t o a n i m p r o p e r a s t o b e w e i g h e d a n d a s s e s s e d l i k e a n y o t h e r c r i t e r i a r e s t s w i t h t h e a p p e l l a n t . U n f o r t u n a t e l y , o f 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 s t h e a p p e l l a n t ' s c t i o n E a n d t h e Q u e s t i o n n a i r e i n d i c a t e t h a t t h e n s t o 7 D L A a s o p p o s e d t o t h e P R w h i c h i n d i c a t e s o v i d e d n o e x p l a n a t i o n f o r t h e d i f f e r e n c e . T h e N e w S e c t i o n E a n d t h e Q u e s t i o n n a i r e . H o w e v e r , p e l l a n t f o r 6 y e a r s a n d c o u l d b e e x p e c t e d t o h a v e b i l i t i e s . F u r t h e r m o r e , t h e P R a n d t h e A R a r e b o t h . B e c a u s e o f t h e v a s t l y d i f f e r e n t p i c t u r e o f t h e d Q u e s t i o n n a i r e o n t h e o n e h a n d a n d t h e P R o n r k a b l y c o n s i s t e n t w i t h e a c h o t h e r d e s p i t e b e i n g h a s d e c i d e d t h a t l i t t l e w e i g h t c a n b e g i v e n t o t h e a t e t h a t t h e a p p e l l a n t i n d e p e n d e n t l y m a n a g e s m b i n g s t a i r s . S h e h a s a r e a s o n a b l e t o l e r a n c e f o r b i l i t y t o l i f t / c a r ry / h o l d i s l i m i t e d t o o b j e c t s u n d e r 5 r i d d e n f o r 5 o r 6 d a y s a t a t i m e . I n t h e p a n e l ' s n t t h e p h y s i c i a n a n d t h e a n e s t h e s i o l o g i s t w o u l d R , t h e N e w S e c t i o n E , o r t h e Q u e s t i o n n a i r e . a l R e p o r t s a s s u p p o r t i n g t h e s e v e r i t y o f h e r o n d e r a n c e o f a d · e c t i v e s s u c h a s " m i l d " ,
"mo dera t e " an d "nor m al" t o d es cribe t he ap pellan t 's A s disc uss ed in mor e detail i n t he su bse qu ent se ction R estrictions t o DLA , t he fun ctiona l skil ls li mitati o ns appear t o h ave t ranslated into signi ficant r estri ctions Fo r the for e goi ng r e as ons , th e p ane l has c o ncl u de d hea lth i ssues, t he mini str y rea sonably de t e rmi n ed that app ellant ha� a sever e physi cal impai rment as co nt Seve r e M en t a l Im pair m ent The app ellan t 's pos itio n is tha t she does not ha ve a c laimed t o have a sev ere mental imp air m ent. She m a nag ed. The m in is try's p osition is that given t h e a ppellant's go evide nce of imp acts to cog nitive an d emotio nal fun ctionin su pp ort or supervision f o r social function i n g, the i n formation i mpair ment. Panel Dec i s ion The eviden ce i n di ca t es t hat the a pp ellan t has so me a r e well-ma nag ed an d ha ve little imp act o n t he appellant's ability to fu physician and t h e an es the siolo gist are cons i stent tha in a ll respec t s. Th e ph ys i c ian in the PR and t he anesthes cog nitive and e motion al fu nct i on. Section 2 ( 1 )( b ) of th e EAPWDR pres c rib es two D L A tha dec ision s abo ut personal a ctiv it ie s, care o r fin anc es inte r a ct w i th o t hers e ff e ctive ly (so cial func t io ning). T h e evidence indi c at e s tha t the appellant is not si g ni in that she independ ently manages the decision making aspects of manag (filli ng/refilling/taki ng as directed), man age person al shopping (making appropriate choices), meal preparation (meal planning), (appr opriate soci a l decis io ns). On bala nce th e panel concludes t appellant manages her own decision making. Wi t h re s p ect to s ocial functioning, t h e evi dence in the appellant's self-report, indicates that wh i le the appell a nt's pa i n c a uses her to self-isolate to some degree, she good f unctioning with respect to her immediate and ext that the appellant receives or requires any support or supervision with respect to her social functioning. For the reaso ns discussed above under the heading Severe Physical Impairment, the panel has given little weight to the conflicting evidence in the New Section E and the Questionnaire. Considerin the evidence as a whol e, the anel concludes that the minist EAAT 003( 10/06/01) con diti o n in t he Med ic a l Repor ts. of thi s d eci sion und er t he he ad ing Si gn i f i ca nt resul ting f rom the appel lant' s impair m ent s d o not i n h er ability to m ana ge h er D LA ind epe nde ntl y . that w hile the ap pellant do es h av e physical t h e evi d en ce fa lls s hor t of es tablish ing th at t he em plated by th e l eg i slation. sever e menta l im pairmen t and t hat sh e has not stated tha t her depression an d anxiety ar e w ell od commun ic a tion sk ills a nd t he l imited g, and give n t h at the appe l lant re qu i re s no d oe s not es t a bli s h a s e vere me ntal de gre e o f d epre s sion a nd a nxiety, bu t that t h es e nctio n. The e vide nc e o f th e t the a pp ellan t's comm unicat ion skill s are goo d iologist in the A R noted limit e d impacts t o t are s p ecif i c to men tal im p airment -make (de cision making), and r e l ate to, commun i c ate o r ficantl y re str icted wit h res pect to d e cision ma king e personal medication finances (banking and budgeting), daily and social functioning hat th e evid ence indicates the the P R a nd the AR ess e ntiall y has ended social n etworks. There is no evid ence reasonabl determined
that it does not demonstrate a severe mental impairment. Significant Restrictiohs to DLA The appellant's position is that her ability to perform DLA is significantly restricted. She emphasized the physician's evidence from the New Section E and said that it "speaks for itself" in demonstrating continuous significant restrictions. The ministry's position is that as the majority of DLA are performed independently or require little help from others, the information from the prescribed professionals does not establish that impairment significantly restricts DLA either continuously or periodically f o r extended periods. Panel Decision The legislation requires that a severe impairment directly and significantly restricts the appellant's ability to perform DLA either continuously or periodically f o r extended periods. The term "directly" means that there must be a causal link between the severe impairment and the restriction. The direct restriction must also be significant. Finally, there is a component related to time or duration. The direct and significant restriction may be either continuous or periodic. If it is periodic it must be for an extended time. Inherently, any analysis of periodicity must also include consideration of the frequency. All other things being equal, a restriction that only arises once a year is less likely to be significant than one which occurs several times a week. Accordingly, in circumstances where the evidence indicates that a restriction arises periodically, it is appropriate for the ministry to require evidence of the duration and frequency of the restriction in order to be "satisfied" that this legislative criterion is met. Section 2(1) of the EAPWDA prescribes 10 DLA. Of those 10, the professional evidence in the PR and the AR are consistent that the appellant is unrestricted with respect to 7: personal self care, meal preparation, management of medications, use of transporlation, management of finances, social functioning, and decision making. With respect to the DLA of moving about indoors and outdoors, the evidence is consistent that the appellant is independently mobile indoors. She is restricted to walking up to 2 blocks outdoors without having to stop and rest. Other than the appellant's evidence that she makes use of a wheelchair or scooter if one is available in a store, there is no other evidence that the appellant relies on the support of anyone else or an assistive device f o r moving about indoors and outdoors. With respect to basic housekeeping, the physician's evidence in the PR is that the appellant requires assistance with "heavier housework". This is consistent with the anesthesiologist who indicated the appellant requires periodic assistance with housekeeping hut that she independently manages her laundry. The anesthesiologist's observations with respect to laundry reflect the appellant's comment on her ability to do laundry in her self-report. With respect to daily shopping, the evidence indicates that the appellant requires assistance with carrying heavier items over 5 pounds. The appellant also said that she will use a scooter or wheelchair in stores where one is available. EAA T003(10/06/01 I
For reasons mentioned above, the panel has given little weight to the evidence in the New Section E and the Questionnaire. The panel prefers the professional evidence in the PR and the AR to the appellant's evidence regarding the significance of restrictions to her ability to perform DLA. Viewing the evidence as a whole, the panel concludes that it falls short of showing on the balance of probabilities that the appellant's ability to perform her DLA is directly and significantly restricted either continuously or periodically for extended periods. The panel finds that the ministry reasonably determined that this legislative criterion was not satisfied. Help with DLA The appellant's position is that she relies on continuous help from her mother to manage her DLA. The ministry's position is that since it has not been established that the appellant's DLA are significantly restricted, it cannot be determined that significant help is required from other persons. Panel Decision The panel finds that the ministry reasonably concluded that as it has not been established that DLA are significantly restricted, it could not be determined that the appellant requires help with DLA as defined bys. 2(3)(b) of the EAPWDA. Conclusion The panel acknowledges that the appellant's medical condition affects her ability to function. However, having reviewed and considered all of the evidence and the relevant legislation, the panel concludes that the ministry's decision finding the appellant ineligible for PWD designation is a reasonable application of the legislation in the circumstances of the appellant. The panel therefore confirms the ministry's decision. 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.