PA RT C -D ecis ion un d er Ap peal T h e de ci sion under app eal is the Mi nis try of So c i a l reconsiderat i on d ecisio n dat ed Fe br uary 24, 2 014 w the fi ve statutory r equ i r eme nts of Se ctio n 2 of th e Employmen D i s abiliti es Act for designation as a person with disabilitie appell a nt m et the a ge req ui rem e n t a nd that h e has a medi ca l prac titione r , i s lik e ly to con tinue f o r at least t sa tisfied t h a t th e evid en c e establi shes that: • the appel lant has a severe phy s ical i m pa irmen • t h e appell a nt's dail y l iving a ct ivi t ies (DLA) are, i dir e ctly and sign if ican tly re stri cte d ei ther con • as a res ult of t h es e r estrictions, the ap pellant anoth er person, the use of an a ssisti ve device, o pelio rm D LA. PART D -Rel evan t L eg i s l a tio n Employment a n d As sistance for Per s ons wit h D is a b Employment and A ssi stanc e for Per s ons wit h Dis abili I APPEAL# Devel opment a nd So c i a l I n novat i on (th e mi nistr y) h ich fo u nd that the a pp e lla n t d i d no t mee t two of t and Assist a nc e fo r P ersons wit h s (P W D). The m inis try f o und t h a t t h e a s e ver e ment al im p a ir m ent that , i n t he opinio n of w o ye ar s. H owev er, the mini stry was not t; n the opinio n of a pr escribe d pr of e ss ional, tinuousl y or per iodically for exte n ded per i ods ; a nd , requi res th e signific ant h e l p or su pervi sion of r the ser vices of an as sis tance animal t o ilities Ac t ( EAPWDA), Sec tion 2 ties Reg u lation (EAPW D R ), Section 2
P A R T E S u m m a r v o f F a c t s T h e a p p e l l a n t s t a t e d t h a t t h e a d v o c a t e w h o p r e p a r e n o t a t t e n d t h e h e a r i n g w i t h h i m a n d h e i s n o t a t a l l f p a n e l e x p l a i n e d t h e p r o c e s s f o r t h e h e a r i n g a n d f o r p r o c e e d w i t h t h e h e a r i n g a n d t o r e p r e s e n t h i m s e l f . 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 1 ) 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 ) A p p l i c a t i o n c r e p o r t d a t e d S e p t e m b e r 6 , 2 0 1 3 , a p h y s i c i a n d a t e d S e p t e m b e r 6 , 2 0 1 3 a n d c o m p l e t e d b y t h e a p p e l l a n t f o r a p p r o x i m a t e l y 5 y e a r s ; 2 ) L e t t e r d a t e d F e b r u a r y 6 , 2 0 1 4 p r e p a r e d b y a p h y s i c i a n ; a n d , 3 ) 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 J a n u a r y 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 h i s g e n e w i t h o n s e t i n 2 0 0 8 , d i a b e t e s w i t h o n s e t i n 2 0 1 2 a n d 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 ' s " d i a m a n a g e d . " " B a c k p a i n s t a r t e d m o r e t h a n 5 y i n j e c t i o n s , m a n u a l t h e r a p i e s a n d a l t e r i n g w o r k e e p a j o b a s h e c a n ' t d r i v e o r s i t f o r l o n g . C c o m f o r t a b l y a t a d e s k . " • T h e a p p e l l a n t r e q u i r e s a " w a l k i n g s t i c k " a s a n u s e s . • 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 " . . . c h r o n i c b a c k p a i n , n o t s u i t a b l e f o r s u r g e ry a n d m e d i c a t i o n . " • 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 h y s i c i a n a s s u n a i d e d o n a f l a t s u r f a c e , c l i m b 2 t o 5 s t e p s u s e a t e d l e s s t h a n 1 h o u r . • 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 h o s p i t a l b u t h e t a k e s r e g u l a r a n d h i g h d o s e s f r u s t r a t e d b y h i s p a i n . " 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 t a k i n g s i g n i f i c a n o u t d o o r s a n d u s e s a n a s s i s t i v e d e v i c e f o r w a " o c c a s i o n a l l y u s e s s t i c k " ) . • 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 h o l d i n g . T h e p h y s i c i a n w r o t e t h a t " . . . h e h a s p b a c k p a i n a n d c a u s e s s c i a t i c a . " I n t h e a o o e l l a n t ' s s e l f r e p o r t h e w r o t e : I A P P E A L # d t h e F e b r u a r y 6 , 2 0 1 4 l e t t e r f o r h i s d o c t o r w o u l d a m i l i a r w i t h t h e p r o c e s s f o r t h e h e a r i n g . A f t e r t h e t h e a p p e a l , t h e a p p e l l a n t s t a t e d t h a t h e w i s h e d t o r 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 : o m p r i s e d o f t h e a p p l i c a n t i n f o r m a t i o n a n d s e l f 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 o t h 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 w h o h a s k n o w n n a d v o c a t e a n d s i g n e d b y t h e a p p e l l a n t ' s 2 8 , 2 0 1 3 . r a l p r a c t i t i o n e r w i t h d e g e n e r a t i v e d i s c d i s e a s e , d e p r e s s i o n w i t h o n s e t i n 2 0 0 8 . b e t e s d i a g n o s e d i n 2 0 1 2 a n d h a s b e e n w e l l e a r s a g o a f t e r i n j u r y a t w o r k . D e s p i t e s t e r o i d k , b a c k p a i n h a s s e v e r e l y i m p a c t e d h i s a b i l i t y t o h r o n i c s c i a t i c a p r e v e n t s h i m f r o m s i t t i n g a i d f o r h i s i m p a i r m e n t , w h i c h h e o c c a s i o n a l l y e n t , 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 b u t h a s b e e n c o n s t a n t d e s p i t e p h y s i c a l t h e r a p i e s e s s e d t h e a p p e l l a n t a s a b l e t o w a l k 2 t o 4 b l o c k s 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 . ) , a n d r e m a i n t e t h a t t h e a p p e l l a n t : " . . . h a s r e s i s t e d g o i n g t o o f o p i a t e s " a n d " . . . i s o f t e n i n t e a r s a n d v e ry t l y l o n g e r t h a n t y p i c a l w i t h w a l k i n g i n d o o r s a n d l k i n g o u t d o o r s a n d c l i m b i n g s t a i r s ( n o t e : y p i c a l w i t h s t a n d i n g , l i f t i n g , a n d c a r r y i n g a n d o o r m u s c l e t o n e a n d s o a n y l i f t i n g a g g r a v a t e s I
• He has severe pain fr o m h is nec k to his f eet. • T he pai n in h i s back preve nts him from an y lift than an ho ur. Dai ly L iving Act i v i t i e s (DLA ) In the P R , the g e neral prac t itione r i n dicated th at: • T he a p pellant ha s no t bee n pr escrib ed medic h i s dai l y liv in g act i vities. • In terms of his h e alt h hi st ory, " H is men t a l hea wor k. He ha s lost his so cia l ne twork, lost his i limi t e d his c apacity to care for himse lf o r hold dow • T he a p pellant ha s signi f i can t d eficits with cogniti memory, em o tional di s turb an ce, m ot ivati on ph ysic ia n wr ote "chronic pai n causes a tten tion h a ve pr even ted h i m from sett li n g into a ny one In the AR, the g e neral pr act itio ne r reported tha t : • The ap pellan t tak es s i g n ifica ntly lon g e r t han a nd us e s an as si s tiv e dev ice f o r walk i ng out d app ellant us e s an assisti v e dev ice for cli mbing wi th lifting and ca rrying a nd hol d ing, and th e a nd c ar ryin g and ho ld ing as much as he can • The app ellant is as sessed as ind ep end ent in 4 of 8 groom i ng, toiletin g and feeding sel f and re g ula typica l with dr e ss i n g (not e : "diff icult to ben d to get us e s g r ab b ars") , tra ns fe rs in/ out of b ed (n o te: • Fo r ba sic house k e epin g, the ap pell ant is ind epe typica l with d o i ng lau ndry (note: "b end ing for dryer t • The ap pe l lan t i s assessed as in de pen den t with 4 s i gn i fic a ntly l on ger w ith carryi ng purch ases hom • The ap pe l la nt i s asses sed as inde pende nt with al and m e dications w ith no further comm ents pr • For transportation, t h e appellant is independent with using tran transporta tion and he takes significantly longer than typical with getting in and out of a vehicle (note: "has to rota te slowly bein g aware of back") and public transit (note" "Doesn't use bus but would need help"). • For social functioning, the appellant is assessed as independ requires periodic s u pport/supervision with d ealing a (note: "knows that he gets angry with change and keep himself away"). The appellant has good functioning in both his i mmediate and exten that the appellant "gets angry and can walk away." In his self-report, the appellant wrote that: • From the moment he wakes up he is in pain and he cannot get a comfortable sleep due to pain. Average sleep time is maybe 2 to 4 ho urs • He left his job because he could not properly do his work duties which included lots of lifting, bendinq, sittina for lonq periods of time. A P PEAL # I F rom the mo ment h e wakes up, h e i s in pain. i ng or any kind of s itti n g or standing for more at ion an d/or treatm ent that wou ld i n terfe re wit h lt h has deteriorated due to pain an d being ou t of n depen den ce and havi ng de p ressi on h as n wor k ." ve and emoti on al f unctio n in the areas o f an d attenti on or s ust ai ned con ce ntra tion and the lack a nd mem o ry loss. Dep ressi on and an xi e ty p l a ce." typic al w ith walk i n g indoors an d walkin g ou tdoors oo r s as h e "occ asionally us e s stic k. " The st a irs and t a kes si gnifi c antly longer than typica l physic ian n oted that th e ap pe l lan t avoids lifting . t a sks of the p ersonal care DLA, including t i ng di et , wh ile ta king significan tl y longer t han d ressed"), bathi ng (note: "d if ficul t t o tran sfer " uses s t ick" ) , a nd t r ans f e rs on/o ff of chair. nd ent whil e t aking significan tl y l onger than a kes a lon g time" ). of 5 tasks of the s hoppin g DLA and as t a king e (note: "Ha s to ke ep lo ads lig ht"). l task s of the DLA mea l s , pay ing rent and bills o vid ed by the physician. sit schedules and arran g in g he uses an assistive device for using ent in 4 of 5 aspects and he ppro p riately with u n expected de mands ded social networks and the physician wrote a night. i-
• D i a b e t e s h a s r e a l l y a f f e c t e d h i s f e e t . I n t h e l e t t e r d a t e d F e b r u a r y 6 , 2 0 1 4 p r e p a r e d b y a n s t a t e m e n t s t h a t : • T h e a p p e l l a n t s t a t e s t h a t h e h a s o n l y b e e n a h a s t o u s e a h a n d r a i l a t a l l t i m e s w h e n c l i m b • T h e a p p e l l a n t s t a t e s t h a t w h e n c o m m u n i c a t i w o r d s o r g e t t i n g t h o u g h t s c l e a r l y o u t t o o t h e r • T h e a p p e l l a n t s t a t e s t h a t s e v e r a l a r e a s o f c o i m p a c t o n h i s d a i l y f u n c t i o n i n g , i n c l u d i n g b o d ( c o n f u s i o n ) , e m o t i o n ( d e p r e s s i o n ) , a t t e n t i o n / m e m o r y ) , e x e c u t i v e ( p l a n n i n g / o r g a n i z i n g ) , l a t e n s i o n ) , a n d w r o t e " a c o m b i n a t i o n o f d e p r e s • T h e a p p e l l a n t s t a t e s t h a t h e r e q u i r e s c o n t i n u s t o r e s ( h e t a k e s s o m e o n e w i t h h i m d u e t o d i s o c i a l f u n c t i o n i n g ( i s o l a t e s s e l f , f e e l s o t h e r s [ d o ] w e l l w i t h t h i n g s o u t o f r o u t i n e a n d g e t s a • 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 " s t r u g I n t h e l e t t e r d a t e d F e b r u a r y 6 , 2 0 1 4 , t h e p h y s i c i a n d • T h e a p p e l l a n t s t a t e s t h a t h e u s e s h i s w a l k i n g w r o t e t h a t t h e a p p e l l a n t " . . . s e l f m o b i l i z e s i n t 3 0 % t i m e . " • T h e a p p e l l a n t s t a t e s t h a t h e r e q u i r e s c o n t i n u h o u s e k e e p i n g , m a k i n g a p p r o p r i a t e c h o i c e s , b • T h e p h y s i c i a n a d d e d a n o t e t h a t t h e a p p e l l a n N e e d f o r H e l p I n t h e A R , i n t e r m s o f t h e h e l p r e q u i r e d f o r D L A , t h e r e p o r t i n d i c a t i n g a s s i s t a n c e p r o v i d e d t h r o u g h t h e u s a r e i d e n t i f i e d 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 m a l l s w i l l u s e a v a i l a b l e s c o o t e r . " I n h i s N o t i c e o f A p p e a l d a t e d M a r c h 1 0 , 2 0 1 4 , t h e a m i n i s t r y ' s r e c o n s i d e r a t i o n d e c i s i o n a n d w r o t e t o r e f e A t t h e h e a r i n g , t h e a p p e l l a n t p r o v i d e d t h e f o l l o w i n g 1 ) X R a y R e p o r t d a t e d M a y 3 , 2 0 0 6 i n d i c a t i n g t h • T h e r e i s s o f t t i s s u e c a l c i f i c a t i o n s a n d m a p p e l l a n t ' s s h o u l d e r s . • T h e r e i s l o s s o f n o r m a l l o r d o t i c c u r v e a C 2 -3 , C 5 -6 a n d C 6 -7 l e v e l s o f t h e a p p o f n o r m a l c a l i b e r ; 2 ) T o m o g r a p h y R e p o r t d a t e d N o v e m b e r 5 , 2 0 0 8 • L 2 / 3 a n d L 3 / 4 a r e n o r m a l . A t L 4 / 5 t h e e f f e c t . • A t L 5 / S 1 , a s m a l l b r o a d b a s e d r i ri h t p o I A P P E A L # a d v o c a t e , t h e a p p e l l a n t ' s p h y s i c i a n a g r e e d t o b l e t o w a l k u p t o 2 b l o c k s a t a t i m e a n d t h a t h e i n g s t a i r s . n g ( s p e a k i n g ) h e h a s d i f f i c u l t y p u t t i n g t h o u g h t s i n t o s a n d t h a t h e h a s d i f f i c u l t y c o n c e n t r a t i n g t o r e a d . 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 h a v e a m a j o r i l y f u n c t i o n s ( s l e e p d i s t u r b a n c e ) , c o n s c i o u s n e s s c o n c e n t r a t i o n ( d i s t r a c t e d , p o o r s h o r t t e r m c k o f m o t i v a t i o n , m o t o r a c t i v i t y ( a g i t a t i o n , e x t r e m e s i o n a n d m e d i c a t i o n . " o u s a s s i s t a n c e o r h e i s u n a b l e t o g o t o a n d f r o m z z y s p e l l s ) , t o c a r ry h i s p u r c h a s e s h o m e , a n d w i t h d o n ' t u n d e r s t a n d h i m i n s o c i a l s e t t i n g s , d o e s n ' t g i t a t e d e a s i l y ) . g l e s w i t h A O L ' s . " i s a g r e e d w i t h t h e s t a t e m e n t t h a t : s t i c k t o m o b i l i z e a t l e a s t 5 0 % o f t h e t i m e a n d h e c l i n i c b u t d o e s h a v e a s t i c k m a y b e u s e s 2 5 -o u s a s s i s t a n c e w i t h d r e s s i n g , b a s i c u d g e t i n g a n d p a y i n g r e n t a n d b i l l s . t " f i n d s d r e s s i n g d i f f i c u l t d u e t o p a i n . " p h y s i c i a n m a r k e d " n i l . " I n t h e s e c t i o n o f t h e e o f a s s i s t i v e d e v i c e s , b o t h a c a n e a n d a s c o o t e r l a n t " h a s h i s o w n c a n e " a n d " w h e n i n s h o p p i n g p p e l l a n t e x p r e s s e d h i s d i s a g r e e m e n t w i t h t h e r t o t h e X R a y s a n d M R l ' s . a d d i t i o n a l d o c u m e n t s : a t : i n o r d e g e n e r a t i v e a rt h r i t i s p r e s e n t i n t h e n d e v i d e n c e o f d e g e n e r a t i v e d i s c d i s e a s e a t t h e e l l a n t ' s c e r v i c a l s p i n e . T h e n e u r a l f o r a m i n a a r e f o r t h e a p p e l l a n t ' s L S p i n e i n d i c a t i n g t h a t : r e i s a d i f f u s e d i s c b u l g e w i t h o u t s i g n i f i c a n t m a s s s t e r o l a t e r a l d i s c o r o t r u s i o n i s o r e s e n t , s l i ri h t l v
d i s p l a c i n g t h e r i g h t S 1 n e r v e r o o t s l e • M i l d b i l a t e r a l f a c e t O A [ o s t e o a r t h r i t i s ] 3 ) T o m o g r a p h y R e p o r t d a t e d M a r c h 1 8 , 2 0 1 3 f • T h e l u m b a r s p i n e d e m o n s t r a t e s n o r m w e l l m a i n t a i n e d . • T h e L 2 / 3 d i s c d e m o n s t r a t e s a r i g h t l a n e r v e r o o t ; h o w e v e r , t h e r e i s n o e v i d e • T h e L 3 / 4 d i s c d e m o n s t r a t e s n o e v i d e s t e n o s i s . • T h e L 4 / 5 d i s c d e m o n s t r a t e s n o s i g n i f i c e n t r a l / f o r a m i n a l s t e n o s i s . • T h e L 5 / S 1 d i s c d e m o n s t r a t e s a m i l d r d i s p l a c e t h e t r a v e r s i n g r i g h t S 1 n e r v e c e n t r a l / f o r a m i n a l s t e n o s i s . • T h e r e i s n o e v i d e n c e o f s p o n d y l o l y s i s a b n o r m a l i t y i s s e e n . A t t h e h e a r i n g , t h e a p p e l l a n t s t a t e d t h a t : • E v e r y m o r n i n g , b e f o r e h e g e t s u p , h e • I f h e h a d t o , h e c o u l d n o t g o t o w o r k . h o u r s j u s t t o g e t m o v i n g i n t h e m o r n i n o f b e d . S o m e t i m e s h e j u s t g i v e s u p a • H e u s e d t o b e a n e x c e l l e n t s w i m m e r b h u r t t h e s m a l l o f h i s b a c k a n d h e w a s • H e i s c u r r e n t l y i n a l o t o f p a i n j u s t s i t t i n a f f e c t h i s a r m s , w h i c h w o r r i e s h i m . • H e c a n n o t s i t o r s t a n d f o r v e r y l o n g . H • W h e n h e d r i v e s , i t h u rt s s o m e t i m e s t o • H e w o u l d l i k e t o h a v e a p e r s o n a l t r a i n c o n d i t i o n , b u t h e c a n n o t a f f o r d t h i s . • H e h a s d i f f i c u l t y b e n d i n g s o h e u s e s s l o n g e r t o g e t o u t o f b e d o r o u t o f a c h a • T h e m e d i c a t i o n s h e t a k e s f o r t h e p a i n " h e a v y d u t y ' ' m e d i c a t i o n s b u t h e f o u n d h e s t o p p e d t a k i n g t h e m . H e i s s t i l l t a k h i m f e e l a s d r a i n e d . • H i s e m o t i o n s a r e a f f e c t e d a n d , w h e n h i s a l s o i m p a c t e d . • B e i n g b y h i m s e l f h a s a l s o c a u s e d h i m h a p p e n e d i n h i s r e l a t i o n s h i p w i t h h i s c r a i s i n g t h e m f r o m a y o u n g a g e . • H e h a s n o t b e e n m o t i v a t e d a t a l l a n d h • H e u s e d t o b e a g o o d s p e a k e r b u t n o w • H e m a n a g e s t o d o h i s o w n h o u s e w o r k s o m e t i m e s h e h a s t o k i c k t h e l a u n d r y b • I t w o u l d b e n i c e t o h a v e s o m e h e l p p r e c a n n o t a f f o r d t h i s s e r v i c e .A P P E A L # I e v e p o s t e r i o r l y . i s p r e s e n t . o r t h e a p p e l l a n t ' s L S p i n e i n d i c a t i n g t h a t : a l a l i g n m e n t a n d t h e v e r t e b r a l b o d y h e i g h t s a r e t e r a l p r o t r u s i o n w h i c h c o n t a c t s t h e e x i t i n g r i g h t L 2 n c e o f a h e r n i a t i o n o r c e n t r a l / f o r a m i n a l s t e n o s i s . n c e o f a b u l g e / h e r n i a t i o n o r c e n t r a l / f o r a m i n a l c a n t b u l g e a n d n o e v i d e n c e o f a h e r n i a t i o n o r i g h t p o s t e r o l a t e r a l b u l g e t h a t c o n t a c t s b u t d o e s n o t r o o t . T h e r e i s n o e v i d e n c e o f a h e r n i a t i o n o r . T h e r e i s m i l d f a c e t o s t e o a r t h r i t i s . N o o t h e r h a s t o t a k e m e d i c a t i o n j u s t t o b e a b l e t o g e t u p . H e w i s h e s h e c o u l d w o r k b u t i t t a k e s h i m a b o u t 2 g . I t t a k e s h i m a l o t l o n g e r t h a n n o r m a l t o g e t o u t n d s t a y s i n b e d . u t w h e n h e t r i e d t o g o s w i m m i n g f o r e x e r c i s e , i t u n a b l e t o c o n t i n u e . g i n t h e h e a r i n g . T h e p a i n i s a l s o s t a rt i n g t o e h u r t s e v e r y w h e r e . h o l d h i s a r m s u p o n t h e s t e e r i n g w h e e l . e r t o a s s i s t w i t h p h y s i o t h e r a p y t o h e l p h i s l i p o n s h o e s . D u e t o b a c k p a i n , i t t a k e s h i m m u c h i r . m a k e h i m d r o w s y . H e h a d b e e n p r e s c r i b e d s o m e t h e y m a d e h i m " l o o p y " a n d m o r e d e p r e s s e d a n d i n g s o m e p a i n m e d i c a t i o n s , b u t t h e y d o n o t m a k e i s b a c k p a i n i s e s p e c i a l l y b a d , h i s i m p u l s e c o n t r o l t o g o " d o w n h i l l . " H e d o e s n o t k n o w w h a t h i l d r e n a s h e f e e l s d i s t a n c e d f r o m t h e m a f t e r e f e e l s t h a t h e h a s b e e n " k i c k e d t o t h e c u r b . " h e j u s t f r e e z e s w h e n h e t r i e s t o s p e a k i n p u b l i c . a n d l a u n d r y , a l t h o u g h i t t a k e s h i m l o n g e r a n d a s k e t d o w n t h e h a l l . p a r i n g m e a l s a n d d o i n g h o u s e w o r k , b u t h e
• H e m e t w i t h a n a d v o c a t e w h o p r e p a r e d i s c u s s e d h i s s i t u a t i o n . T h e a d v o c a t e m e t w i t h h i s d o c t o r t o h a v e i t f i l l e d o u t m u c h t i m e , a b o u t 1 0 t o 1 5 m i n u t e s , a a n d h a n d e d h i m t h e c o m p l e t e d l e t t e r . • S i n c e S e p t e m b e r 2 0 1 3 w h e n t h e r e p o w o r s e . A b o u t a y e a r a g o , h e s t a r t e d g t h e h e a v y p a i n m e d i c a t i o n , a n d t h e y s • B o t h h i s p h y s i c a l a n d m e n t a l i m p a i r m c o n d i t i o n i s a b o u t 7 0 % o f t h e p r o b l e m • T h e p a i n a f f e c t s h i s t h i n k i n g a n d h e c • T h e a p p e l l a n t c o n f i r m e d t h a t t h e X R a a r e t h e a d d i t i o n a l d o c u m e n t s h e p r o v i T h e m i n i s t r y d i d n o t o b j e c t t o t h e a d m i s s i b i l i t y o f t h e R e p o r t s a s f u r t h e r d e s c r i p t i o n s o f t h e e x t e n t o f h i s p t h e r e f o r e , b e i n g i n s u p p o rt o f t h e i n f o r m a t i o n a n d r e p u r s u a n t t o s e c t i o n 2 2 ( 4 ) ( b ) o f t h e E m p l o y m e n t a n d T h e m i n i s t r y r e l i e d o 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 .I A P P E A L # d t h e l e t t e r d a t e d F e b r u a r y 6 , 2 0 1 4 w h i l e t h e y g a v e h i m a c o p y o f t h e p r e p a r e d l e t t e r a n d h e a n d s i g n e d . H i s d o c t o r d i d n o t w a n t t o s p e n d n d s i m p l y a s k e d a f e w q u e s t i o n s , l o o k e d a t h i s f i l e , rt s w e r e c o m p l e t e d , h i s c o n d i t i o n h a s g o t t e n e t t i n g s p a s m s i n h i s b a c k , f o r w h i c h h e w a s g i v e n t a r t e d a g a i n a b o u t 3 m o n t h s a g o . e n t i m p a c t h i s d a i l y a c t i v i t i e s , b u t h i s p h y s i c a l a n d t h e m e n t a l i m p a i r m e n t i s a b o u t 3 0 % . a n n o t f u n c t i o n p r o p e r l y . y s a n d M R l ' s r e f e r r e d t o i n h i s N o t i c e o f A p p e a l d e d a t t h e h e a r i n g . a d d i t i o n a l d o c u m e n t s . T h e p a n e l a d m i t t e d t h e r e v i o u s l y d i a g n o s e d m e d i c a l c o n d i t i o n s a n d , c o r d s b e f o r e t h e m i n i s t r y o n r e c o n s i d e r a t i o n , A s s i s t a n c e A c t .
PART F -Reaso ns for Panel Decisi on The issue on the app eal i s whet her the m in is t r y's decis el igib le f or d es ig nation as a p e rson wit h disabili t ies (PWD S ection 2 of t he E APWDA, w as reasonably s upp orted app l ication of the applicabl e enactment i n t he c ir c umstanc th e appella n t has a sever e ment al impa irme nt bu t n livi n g ac tivit ies (DLA) are not , in th e opi nio n o f a pr e r estricted either cont inuou s l y or per iodicall y for extended per r estri c ti ons, it co u ld not be deter mined th at the appellant another person, the use of a n ass istive device, or th DLA . Th e criteria for being d e sign a ted as a person w ith d EAPWDA as f ol lows: P ersons with disabili tie s 2 (1) In t his se cti on : "as sis t ive de vi ce" m e a n s a d e vice desi gned to en abl e a se vere me nta l or phy si ca l impa irment , the per son is unable to "d ai ly living a ctivity" h as t he presc ribed m eani ng; "pre scribed pr ofessi onal" has the p rescribed mea ning. (2) The mini ste r may des ig na te a p erson who h a s reached 1 o f t h is Act if the minister is satisfi e d t h a t the pe rson has a severe menta (a) in the opin i o n of a m edi cal pra ct i tion er is l ikely t o continue f (b) in the opinio n of a prescribed profes siona l (i) directly a nd significantly restricts the p erso n's abili ty (A) co ntin u o u sly, or (B) p eri odi c ally for e xtend ed periods, an d ( ii) as a resu lt of t hose r estric t i ons, the pe rson requires hel (3) For the purposes of subsection (2), (a) a pe rson w ho has a severe mental impairment includes a person with a mental disorder, and ( b ) a person re quires he lp in relation to a daily living activity if, in order to perform it, the (i) an assistive device, ( ii) t he sign i f i c a n t hel p or supervision o f a nother perso (iii) the services of an assistance animal. ( 4) T he minister ma y resc i n d a designation under subsectio n Section 2(1)(a) of the EAPWDR defines DLA for a person who has a severe physical or mental impairment as foll o ws: 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 APPEAL# ion, wh ic h fou nd that the appell ant is n ot ) as he d o es n ot meet all t he cri t e ria in b y th e ev idence or wa s a reaso n able es of t he appel lant. The mini stry found t hat o t a s evere physic al im pair ment and that h i s daily sc rib ed p r ofessional, directly and si g nif ica nt ly i o ds and t hat, as a re s ult of thos e re quires th e signif icant h e lp or supervisi on o f e s ervi c es of an assist a n ce animal to perform i sab ilitie s (PWD) a re set out i n Section 2 of t he person to p erfo rm a daily livin g activity th at , bec au se o f a per form; 8 years of ag e as a per son with disab ilities fo r the purp os e s l o r phy si ca l imp air ment that or at l east 2 years , and to perfor m daily li v ing ac t i vit ies either p to per f o rm those a ctivities. person requires n, o r (2). I
I APPEAL# (i) prepare own meals; (ii) manage personal finances; (iii) shop for personal needs; (iv) use public or personal transportation facilities; (v) perform housework to maintain the person's place of residence in acceptable sanitary condition; (vi) move about indoors and outdoors; (vii) perform personal hygiene and self care; (viii) manage personal medication, and (b) in relation to a person who has a severe mental impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. (2) For the purposes of the Act, "prescribed professional" means a person who is authorized under an enactment to practice the profession of (a) medical practitioner, (b) registered psychologist, (c) registered nurse or registered psychiatric nurse, (d ) occupational therapist, (e) physical therapist, (f) social worker, (g) chiropractor, or (h) nurse practitioner. At reconsideration, the ministry was satisfied that the information provided is evidence of a severe mental impairment, but was not satisfied that the information provided is evidence of a severe physical impairment. Severe Physical Impairment The appellant's position is that a severe physical impairment is established by the evidence of his back pain due to degenerative disc disease. The appellant argued that both his physical and mental impairment impact his daily activities, but his physical condition is about 70% of the problem. The ministry's position is that the impacts described by the general practitioner are more in keeping with a moderate degree of impairment and there is not sufficient information to confirm that the appellant has a severe physical impairment. The ministry argued that, in assessing the appellant's physical ability, the general practitioner indicated that the appellant is able to walk 2 to 4 blocks and climb 2 to 5 stairs unaided, lift under 5 lbs. and remain seated less than 1 hour. The ministry argued that the general practitioner indicated that the appellant takes significantly longer with walking indoors and outdoors, standing, lifting and carrying and holding, but provided no information on how much longer it takes the appellant. The ministry argued that the general practitioner wrote in the letter dated February 6, 2014 that she disagrees that the appellant needs his walking stick at least 50% of the time and wrote that he might need it 25 to 30% of the time. In the reconsideration decision, the ministry argued that although the general practitioner reported that the appellant's back pain has severely impacted his ability to keep a iob, the PWD application is not intended to assess
em p l oyability since employability is not an eli gible cri Panel Decisi on The d iagnosis of a medi c a l condi tion is not it sel f deter the severity of a n i mpairment one m u st consider the natur appellant's ab ilit y to mana g e h i s DLA as evidenced by fun DLA, and the degre e of ind e p endence in pe rf o rming DL when it defi ne s the word "impai rme n t" in the ph ysi cian p sychol ogi cal, anatomical or ph ysi o logic al struct ure f u nctio n ind ependen t l y, ef fectiv el y, a ppropriately or for a reasonable duration." s et o ut in leg i sla t ion and i s not bindi ng on the pan el, describes the legisla tive in t en t . T h e legislati o n c le a rly provide s that the determ i nation th e mi nister, t a ki n g into account all of the ev i dence inclu le gislati o n i s also clea r that the fundam ental basis for th p rofessi onal resp e ctin g the nature of t he impa i r me n The me d i cal practitioner, a p hy sici a n w ho ha s know the app el lant wi t h de g e nerative disc d isease a nd diab that the appell ant's diabet es is w e ll m a n a ged. With r physicia n wro t e, in the ad dition al comments to the PR, tha hospit al but he takes r eg u l ar and high d oses o f o piate h i s pai n." The most recent Tomog raphy Re po rt d at ed M ind icated th a t ther e a re d isc pr ot r usions or b ulges but no eviden stenosi s, no e v i dence o f sp o n dylolysis, an d that t here a ppellan t state d at the heari n g th a t s i nc e Sep te mber 2013 w h i s c on dit ion has go tten worse. A t th e hearing, the appellant sta aff ect h is arms, w hich w orr ies h i m; ho w eve r , there was i n dicate th e caus e or t h e serio u sness of t h i s s ym ptom. The a a go, he started gettin g s p asms i n his b ack, for which he qu i t taking these medications becau s e they made him feel "loo spasms started aga in ab out 3 months ago, and he did not ind how l on g they last. The appellant indic ated that he is continuing with only the les m e di ca ti o n a t t his time, wh ich the panel considered a side effects of the medicatio n currently outweigh the impact from the muscle spasms. In terms of functional skills, the physician assesse d unaided o n a fl at surface, c l imb 2 t o 5 steps unai ded, l hour. In the letter dated February 6, 2014, the appellant's physician appellant states that he has only been able to walk up to 2 blocks at a time and that he has to use a handrai l at all tim es when climbing sta irs. In the AR, the taking significan t ly longer than typical with walking indoors and outdoors and using a stick as an assistive device for walking outdoors a nd an assistive device for climbing sta identified by the phys i cian . In the PR, the physician ind stick" as an aid for his impairment, which he "occasionally'' uses. 2014, the physician disagreed with the statement that the appellant states that he uses his walking stick to mobilize at least 50% of the time and wrote that the annellant " ... self mobilizes in the clinic but APPEAL# I t eri on for de sig nation a s a PWD. minative of a severe impairment. To assess e of the impair ment and its i mpact on t he ctional skill limitati o n s, the re s trictions to A . The ministry des cri be s th is approach rep ort as being "a loss or abnormality of or fun ction causing a restri ction in t h e ability to Thi s definition is not but in the panel's view it qu i te ap propriately of severity of i mpairmen t is a t t h e discretion of ding that of the appellant. However, the e a nalysis is t he e v i dence from a p r escribed t an d its impact o n da i ly f unct i oning . n t he appel lant for a peri od of 5 years, diagnosed etes. The phys i c i an noted i n the health hist or y espect t o t he d eg ener at ive disc disease, the t t he appe l la nt : " . .. has resis ted goi ng t o s " and " ...i s often in tea rs and very fr u str a ted b y arch 18, 20 13 f o r the ap pellan t 's L-S pin e ce of a hernia t i on o r ce n tral/forami n a l is eviden ce of m i l d fa cet o s te oarthri ti s. T he hen the P WD a pplicati o n was completed, t ed that the pain is a lso starting to n o f u rt he r med ical inform at ion pr ovi ded to ppellant also st a t e d that about a year he was prescrib ed heavy p ain medicat i on an d py. " T he appellant state d tha t the icate the frequency of the spasms or s potent pain s an assessment by him that the de tr i mental the appellant as able to walk 2 to 4 blocks ift u nder 5 lb s., and remain seat ed less than 1 agreed to the statement that the app ell ant is assesse d by the physician as irs t hat h as not b een icated that the appellant requires a "walking In the letter dated February 6,
d o e s h a v e a s t i c k m a y b e u s e s 2 5 -3 0 % t i m e . " T h e l o n g e r t h a n t y p i c a l w i t h s t a n d i n g , l i f t i n g , a n d c a r r y i n h a s p o o r m u s c l e t o n e a n d s o a n y l i f t i n g a g g r a v a t e s T h e p h y s i c i a n a l s o n o t e d i n t h e h e a l t h h i s t o r y i n t h e d e g e n e r a t i v e d i s c d i s e a s e , " . . . d e s p i t e s t e r o i d i n j e c t p a i n h a s s e v e r e l y i m p a c t e d h i s a b i l i t y t o k e e p a j o b p r e v e n t s h i m f r o m s i t t i n g c o m f o r t a b l y a t a d e s k . " I n t h e a p p e l l a n t w r o t e t h a t h e l e f t h i s j o b b e c a u s e h e c i n c l u d e d l o t s o f l i f t i n g , b e n d i n g , a n d s i t t i n g f o r l o n g h e a r i n g t h a t e v e n i f h e h a d t o , h e c o u l d n o t g o t o w a b o u t 2 h o u r s j u s t t o g e t m o v i n g i n t h e m o r n i n g . F o s e c t i o n 2 o f t h e E A P W D A r e q u i r e 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 t o a s p e c i f i e d d e g r e e i n c e r t a i n s p e c i f i e d t h a t f o r P W D d e s i g n a t i o n , t h e m i n i s t e r m u s t b e s a t i p h y s i c a l i m p a i r m e n t t h a 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 [ p r e s c r i b e d ] d a i l y l i v i n g a c t i v i t i e s a n d a s a r e s u l t o f t a s s i s t i v e d e 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 rv i s i o n a s s i s t a n c e a n i m a l t o p e r f o r m t h o s e a c t i v i t i e s . " ] A s e m p l o y m e n t i s n o t l i s t e d a s o n e o f p r e s c r i b e d D L A , t h a t e m p l o y a b i l i t y i s n o t a f a c t o r i n a s s e s s i n g e l i g i b i 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 c o n f i r m t h a t t h e a p p e l l a n t h a s m o r e t h a n a m o d e r a t t h a t t h e m i n i s t r y a c k n o w l e d g e d t h a t t h e a p p e l l a n t h a d e t e r m i n e d t h a t , w h i l e 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 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 i e s , o n l y o c c a s i o n a l l y r e q d e v i c e . 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 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 s e v e r e p h y s i c a R e s t r i c t i o n s i n t h e a b i l i t y t o p e r f 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 i s s e v e r e m e n t a l a n 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 L A a n d h e r e q u i r e s t u s e o f a c a n e a s a n a s s i s t i v e d e v i c e t o p e r f o r m m a n 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 e v i d e n c e o f t h e p r 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 D L A e i t p e r i o d s o f t i m e . T h e m i n i s t r y a r g u e d t h a t w h i l e t h e p t a k e s s i g n i f i c a n t l y l o n g e r w i t h d r e s s i n g , b a t h i n g , t r a n c a r r y i n g p u r c h a s e s h o m e a n d g e t t i n g i n / o u t o f a v e h 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 h e m i n i s t r y a r g F e b r u a r y 6 , 2 0 1 4 t h a t t h e a p p e l l a n t s t r u g g l e s w i t h A c o n t i n u o u s a s s i s t a n c e w i t h v a r i o u s t a s k s . T h e m i n i s t h a t t h e a p p e l l a n t r e q u i r e s c o n t i n u o u s a s s i s t a n c e w i c a r ry i n g p u r c h a s e s h o m e , t h e m a j o r i t y o f t h e a p p e l l a A P P E A L # I a p p e l l a n t i s a s s e s s e d a s t a k i n g s i g n i f i c a n t l y g a n d h o l d i n g a n d t h e p h y s i c i a n w r o t e t h a t " . . . h e b a c k p a i n a n d c a u s e s s c i a t i c a . " P R t h a t , w i t h r e s p e c t t o t h e a p p e l l a n t ' s i o n s , m a n u a l t h e r a p i e s a n d a l t e r i n g w o r k , b a c k a s h e c a n ' t d r i v e o r s i t f o r l o n g . C h r o n i c s c i a t i c a h i s s e l f r e p o r t i n c l u d e d w i t h t h e P W D a p p l i c a t i o n , o u l d n o t p r o p e r l y d o h i s w o r k d u t i e s w h i c h p e r i o d s o f t i m e . T h e a p p e l l a n t s t a t e d a t t h e o r k , t h a t h e w i s h e s h e c o u l d w o r k b u t i t t a k e s h i m r a n i m p a i r m e n t t o b e a " s e v e r e i m p a i r m e n t , " m u s t b e s a t i s f i e d t h a t t h e e v i d e n c e d e m o n s t r a t e s a r e a s o f d a i l y f u n c t i o n i n g . T h e l e g i s l a t i o n r e a d s 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 m e n t a l o r 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 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 q u i r e s h e l p [ a n o f 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 b i l i t y t o s e a r c h f o r , a c c e p t o r c o n t i n u e i n 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 h e l d l i t y f o r P W D d e s i g n a t i o n . e d t h a t t h e r e i s n o t s u f f i c i e n t i n f o r m a t i o n t o e d e g r e e o f p h y s i c a l i m p a i r m e n t . T h e p a n e l f i n d s s a p h y s i c a l i m p a i r m e n t a n d r e a s o n a b l y t l y l o n g e r , h e i s l a r g e l y i n d e p e n d e n t w i t h h i s u i r i n g t h e u s e o f a w a l k i n g s t i c k a s a n a s s i s t i v e d e t e r m i n e d t h a t t h 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 l i m p a i r m e n t u n d e r s e c t i o n 2 ( 2 ) o f t h e E A P W D A . d p h y s i c a l i m p a i r m e n 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 h e s i g n i f 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 t h e y D L A . e s c r i b e d p r o f e s s i o n a l s d o e s n o t e s t a b l i s h t h a t t h e 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 h y s i c i a n i n d i c a t e d i n t h e A R t h a t t h e a p p e l l a n t s f e r r i n g i n / o u t o f b e d a n d o n / o f f c h a i r s , l a u n d r y , i c l e , t h e r e i s n o i n f o r m a t i o n p r o v i d e d o n h o w u e d t h a t w h i l e t h e p h y s i c i a n w r o t e i n t h e l e t t e r o f O L ' s , s h e d i s a g r e e s t h a t t h e a p p e l l a n t r e q u i r e s t ry a r g u e d t h a t a l t h o u g h t h e p h y s i c i a n a g r e e s t h s o c i a l f u n c t i o n i n g , g o i n g t o / f r o m s t o r e s a n d n t ' s D L A a r e c o n s i d e r e d i n d e p e n d e n t .
P a n e l D e c i s i o n S e c t i o n 2 ( 2 ) ( b ) o f t h e E A P W D A r e q u i r e s t h a t a p r e a p p l i c a n t ' s s e v e r e i m p a i r m e n t d i r e c t l y a n d s i g n i f i c a 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 f D L A a r e 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 e t a i l s , i n 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 p p o r t u n i t y t o d i r e c t l y i n d i c a t e w h i c h , i f a n y , D L A a r i m p a i r m e n t s , 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 T h e e v i d e n c e o f t h e a p p e l l a n t ' s p h y s i c i a n i s s e t o u t d a t e d F e b r u a r y 6 , 2 0 1 4 , a t w h i c h t i m e t h e p h y s i c i a n p r e p a r e d b y a n a d v o c a t e o n b e h a l f o f t h e a p p e l l a n t P 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 t h e a p p e l l a n t h a s n o t h a t i n t e r f e r e w i t h h i s D L A . I n t h e A R , t h e p h y s i c i a n l o n g e r t h a n t y p i c a l w i t h w a l k i n g i n d o o r s a n d w a l k i n g a s s i s t i v e d e v i c e f o r w a l k i n g o u t d o o r s . T h e a p p e l l a n t h e p e r s o n a l c a r e D L A , i n c l u d i n g g r o o m i n g , t o i l e t i n g 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 w i t h d r e s s i n g , b a t h i n c h a i r d u e t o h i s b a c k p a i n a n d r e s u l t i n g d i f f i c u l t y b e u s e s s l i p o n s h o e s t o m i n i m i z e t h e a m o u n t o f b e n d i g e t o u t o f b e d o r a c h a i r . F o r b a s i c h o u s e k e e p i n g , t 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 w i t h d o i n g l a u n d r y a a p p e l l a n t s t a t e d t h a t h e c a n g e t h i s l a u n d r y d o n e b u " k i c k t h e l a u n d ry b a s k e t d o w n t h e h a l l . " I n t h e A R , t h e p h y s i c i a n a s s e s s e d t h e a p p e l l a n t a s D L A a n d a s t a k i n g s i g n i f i c a n t l y l o n g e r w i t h c a r r y i n g 2 0 1 4 , t h e p h y s i c i a n a g r e e d t o t h e s t a t e m e n t t h a t t h e a s s i s t a n c e o r h e i s u n a b l e t o g o t o a n d f r o m s t o r e s a n d t o c a r r y h i s p u r c h a s e s h o m e . F o r t r a n s p o r t a t i o s c h e d u l e s a n d a r r a n g i n g t r a n s p o r t a t i o n a n d h e t a k e a n d o u t o f a v e h i c l e ( n o t e : " h a s t o r o t a t e s l o w l y b e i n d e v i c e f o r u s i n g p u b l i c t r a n s i t ( n o t e : " d o e s n ' t u s e b u a s s e s s e d t h e a p p e l l a n t a s i n d e p e n d e n t w i t h a l l t a s k m e d i c a t i o n s w i t h n o f u r t h e r c o m m e n t s p r o v i d e d . I n d i s a g r e e d w i t h t h e s t a t e m e n t t h a t t h e a p p e l l a n t s t a t e d r e s s i n g , b a s i c h o u s e k e e p i n g , m a k i n g a p p r o p r i a t e c a d d e d a n o t e t h a t t h e a p p e l l a n t " f i n d s d r e s s i n g d i f f i c F o r t h e D L A w h i c h r e l a t e s t o a s e v e r e m e n t a l i m p a i r a s s e s s e d i n t h e A R a s i n d e p e n d e n t w i t h m a k i n g a p p p h y s i c i a n d e m o n s t r a t e s t h a t t h e a p p e l l a n t i s i n d e p e n f i n a n c e s ( b a n k i n g , b u d g e t i n g a n d p a y i n g r e n t a n d b m e d i c a t i o n s a s d i r e c t e d , w i t h s a f e h a n d l i n g a n d s t o r a n d l a b e l s a n d m a k i n g a p p r o p r i a t e c h o i c e s w h e n s h p l a n n i n g . I n t h e l e t t e r d a t e d F e b r u a r y 6 , 2 0 1 4 , t h e p s t a t e s t h a t s e v e r a l a r e a s o f c 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 q , i n c l u d i n q c o n s c i o u s n e s s / c o n f u s i o n ) , a t t I A P P E A L # s c r i b e d p r o f e s s i o n a l p r o v i d e a n o p i n i o n t h a t a n n t l y r e s t r i c t s h i s D L A , 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 a m i l y p 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 a r e a l s o 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 o n a l c o m p l e t i n g a n y o f t h e s e f o r m s h a s t h e 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 a p p e l l a n t ' s e d p e r i o d s . i n t h e P R a n d A R a s w e l l a s t h e a d d i t i o n a l l e t t e r e i t h e r a g r e e d o r d i s a g r e e d w i t h s t a t e m e n t s a n d a l s o p r o v i d e d h a n d w r i t t e n c o m m e n t s . I n t h e t b e e n p r e s c r i b e d m e d i c a t i o n a n d / o r t r e a t m e n t r e p o r 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 c a n t l y o u t d o o r s a n d " o c c a s i o n a l l y u s e s s t i c k " a s 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 i n 4 o f 8 t a s k s o f a n d 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 , w h i l e t a k i n g g , t r a n s f e 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 n d i n g . A t t h e h e a r i n g , t h e a p p e l l a n t s t a t e d t h a t h e n g r e q u i r e d a n d t h a t i t t a k e s h i m m u c h l o n g e r t o h e a p p e l l a n t i s i n d e p e n d e n t w h i l e t a k i n g s a r e s u l t o f h i s d i f f i c u l t i e s b e n d i n g , a n d t h e t i t t a k e s h i m l o n g e r s i n c e h e s o m e t i m e s h a s t o i n d e p e n d e n t w i t h 4 o f 5 t a s k s o f t h e s h o p p i n g p u r c h a s e s h o m e . I n t h e l e t t e r d a t e d F e b r u a ry 6 , a p p e l l a n t s t a t e s t h a t h e r e q u i r e s c o n t i n u o u s ( h e t a k e s s o m e o n e w i t h h i m d u e t o d i z z y s p e l l s ) n , 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 w i t h u s i n g t r a n s i t 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 w i t h g e t t i n g i n g a w a r e o f b a c k " ) a n d h e u s e s a n a s s i s t i v e s b u t w o u l d n e e d h e l p " ) . I n t h e A R , t h e p h y s i c i a n s o f t h e D L A m e a l s , p a y i n g r e n t a n d b i l l s a n d t h e l e t t e r d a t e d F e b r u a ry 6 , 2 0 1 4 , t h e p h y s i c i a n s t h a t h e r e q u i r e s c o n t i n u o u s a s s i s t a n c e w i t h h o i c e s , b u d g e t i n g a n d p a y i n g r e n t a n d b i l l s , a n d u l t d u e t o p a i n . " m e n t b e i n g f o u n d b y t h e m i n i s t r y , t h e a p p e l l a n t i s r o p r i a t e s o c i a l d e c i s i o n s . T h e e v i d e n c e o f t h e d e n t w i t h t h e " m e n t a l " t a s k s o f m a n a g i n g h i s i l l s ) , f i l l i n g / r e f i l l i n g p r e s c r i p t i o n s , t a k i n g a g e o f m e d i c a t i o n s a s w e l l a s w i t h r e a d i n g p r i c e s o p p i n g a n d w i t h s a f e s t o r a g e o f f o o d a n d m e a l h y s i c i a n a g r e e d t o s t a t e m e n t s t h a t t h e a p p e l l a n t f u n c t i o n i n g h a v e a m a j o r i m p a c t o n h i s d a i l y e n t i o n / c o n c e n t r a t i o n / d i s t r a c t e d , o o o r s h o r t t e r m
m e m o r y ) , a n d e x e c u t i v e ( p l a n n i n g / o r g a n i z i n g ) ; h o w c o n c l u d e d t h a t t h e s e i m p a c t s a r e n o t e x h i b i t e d i n t h 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 n a n c e s . F o r t h e o t h e r D L A w h i c h r e l a t e s t o a s e v e r e m e n t a a p p e l l a n t i s a s s e s s e d i n t h e A R a s i n d e p e n d e n t w i t w i t h o t h e r s e f f e c t i v e l y . I n t h e A R , t h e a p p e l l a n t i s a o f 5 a s p e c t s a n d h e r e q u i r e s p e r i o d i c s u p p o r t / s u p e d e m a n d s ( n o t e : " k n o w s t h a t h e g e t s a n g ry w i t h c h a r e p o r t e d t h a t t h e a p p e l l a n t h a s n o d i f f i c u l t i e s w i t h c i s g o o d 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 , w r 2 0 1 4 , h o w e v e r , t h e p h y s i c i a n a g r e e d t o s t a t e m e n t s c o m m u n i c a t i n g ( s p e a k i n g ) h e h a s d i f f i c u l t y p u t t i n g t t o o t h e r s a n d t h a t h e h a s d i f f i c u l t y c o n c e n t r a t i n g t o s t a t e s t h a t h e r e q u i r e s c o n t i n u o u s a s s i s t a n c e w i t h s u n d e r s t a n d h i m i n s o c i a l s e t t i n g s , d o e s n ' t [ d o ] w e l l I n t h e A R , t h e p h y s i c i a n a s s e s s e d t h e a p p e l l a n t a s e x t e n d e d s o c i a l n e t w o r k s a n d t h e p h y s i c i a n w r o t e t T h e p h y s i c i a n w r o t e i n t h e l e t t e r d a t e d F e b r u a r y 6 , t h e e v i d e n c e d e m o n s t r a t e s t h a t t h e a p p e l l a n t t a k e s o f D L A a n d r e q u i r e s c o n t i n u o u s a s s i s t a n c e w i t h 2 o i m p a i r m e n t . 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 o r n a r r a 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 w i t h t h e t a s k s o f D L A t h o r e v i d e n c e o f r e s t r i c t i o n s t o t h e a p p e l l a n t ' s D L A f r o 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 a t t h e r e i s 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 n t ' s i m p a i r m 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 o r e x t e n d e d 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 D A . H e l p t o p e r f 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 w a l k i n g s t i c k o r g r a b b a r s a s a s s i s t i v e d e v i c e s , t o p 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 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 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 r 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 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 p h y s i c i a n i n d i c a t e d i n t h e A R t h a t h e l p r e q u i r e d u s e s g r a b b a r s w h e n b a t h i n g a n d h i s o w n c a n e a n d t h e l e t t e r d a t e d F e b r u a r y 6 , 2 0 1 4 , t h e p h y s i c i a n c o n w a l k i n q a n n r o x i m a t e l v 2 5 -3 0 % t i m e . W h i l e t h e p a n e A P P E A L # I e v e r , 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 e a p p e l l a n t ' s a b i l i t y t o m a k e d e c i s i o n s a b o u t h i s l i m p a i r m e n t b e i n g f o u n d b y t h e m i n i s t ry , t h e h h i s a b i l i t y t o 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 s s e s s e d f o r s o c i a l f u n c t i o n i n g a s i n d e p e n d e n t i n 4 r v i s i o n w i t h d e a l i n g a p p r o p r i a t e l y w i t h u n e x p e c t e d n g e a n d k e e p h i m s e l f a w a y " ) . T h e p h y s i c i a n a l s o o m m u n i c a t i o n , a n d t h a t h i s a b i l i t y t o c o m m u n i c a t e i t i n g a n d h e a r i n g . I n t h e l e t t e r d a t e d F e b r u a r y 6 , t h a t t h e a p p e l l a n t s t a t e s t h a t w h e n h o u g h t s i n t o w o r d s o r g e t t i n g t h o u g h t s c l e a r l y o u t r e a d . T h e p h y s i c i a n a g r e e d t h a t t h e a p p e l l a n t o c i a l f u n c t i o n i n g ( i s o l a t e s s e l f , f e e l s o t h e r s d o n ' t w i t h t h i n g s o u t o f r o u t i n e a n d g e t s a g i t a t e d e a s i l y ) . h a v i n g g o o d f u n c t i o n i n g i n b o t h h i s i m m e d i a t e a n d h a t t h e a p p e l l a n t " g e t s a n g r y a n d c a n w a l k a w a y . " 2 0 1 4 t h a t t h e a p p e l l a n t " s t r u g g l e s w i t h A O L ' s " a n d 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 w i t h s e v e r a l t a s k s f 5 t a s k s o f t h e s h o p p i n g D L A d u e t o h i s p h y s i c a l t i v e f r o m t h e p h y s i c i a n t o d e s c r i b e h o w m u c h a t t a k e h i m l o n g e r d u e t o h i s p h y s i c a l i m p a i r m e n t m h i s 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 p a n e l f i n d 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 p r e s c r i b e d 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 m a n a g e h i s 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 l e g i s l a t i v e f 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 t h e u s e o f a e r f o r m D L A . 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 f r o m o t h e r p e r s o n s . a 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 f 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 e v i c e o r 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 . f o r D L A i s p r o v i d e d b y " n i l " a n d t h e a p p e l l a n t a s c o o t e r , w h e n a v a i l a b l e , a t s h o p p i n g m a l l s . I n f i r m e d t h a t t h e a p p e l l a n t u s e s a s t i c k t o h e l p w i t h l f i n d s t h a t t h e e v i d e n c e o f t h e p r e s c r i b e d
APPEAL# I professional establishes that the appellant requires some assistance with use of grab bars when bathing and a cane for moving about outdoors, the panel also finds that the ministry reasonably determined that, as direct and significant restrictions in the appellant's ability to perform DLA have not been established, it cannot be determined that the appellant requires help to perform DLA as a result of those restrictions. 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.