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 r y o f S o c i a l " m i n i s t r y " ) r e c o n s i d e r a t i o n d e c i s i o n o f J a n u a r y 2 9 , 2 t h r e e o f 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 D i s a b i l i t i e s A c t ( " E A P W D A " ) f o r d e s i g n a t i o n a s a p e t h a t t h e 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 a p p e l l a n t ' s i m p a i r m e n t i s l i k e l y t o c o n t i n u e f o r a t l e a s a t i s f i e d t h a t : • t h e e v i d e n c e e s t a b l i s h e s t h a t t h e a p p e l l a n t h • 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 LA " ) a 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 h a t • a s a r e s u l t o f t h o s e r e s t r i c t i o n s , t h e a p p e l l a n t a n o t h e r p e r s o n , a n a s s i s t i v e d e v i c e , o r t h e s . 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 E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )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 0 1 4 w h i 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 e E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s W i t h r s o n w i t h d i s a b i l i t i e s ( " P W D " ) . T h e m i n i s t r y f o u n d i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r t h e s t t w o y e a r s . H o w e v e r , t h e m i n i s t r y w a s n o t a s a s e v e 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 ; r e , 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 , 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 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 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 . i li 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 T h e i n f o r m a t i o n 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 r e • T h e a p p e l l a n t ' s P W D a p p l i c a t i o n f o r m c o n s i s 1 1 , 2 0 1 3 ] , a n d a p h y s i c i a n ' s r e p o r t ( " P R " ) a n d a p p e l l a n t ' s p h y s i c i a n o f 2 m o n t h s [ d a t e d O c t • T h e a p p e l l a n t ' s t y p e w r i t t e n r e c o n s i d e r a t i o n s • A l e t t e r f r o m t h e a p p e l l a n t ' s p h y s i c i a n d a t e d • A S e r v i c e C a n a d a M e d i c a l R e p o r t f o r m , c o m y e a r s , d a t e d F e b r u a r y 1 9 , 2 0 1 3 . • A n u n d a t e d t y p e w r i t t e n d o c u m e n t p r e p a r e d b A t t h e a p p e a l h e a r i n g t h e a p p e l l a n t s a i d s h e J a n u a r y , a n d t h o u g h i t w a s n ' t r e f e r e n c e d e x p a p p e l l a n t s t a t e d t h a t i t w a s b e f o r e t h e m i n i s t r A d m i s s i b i l i t y o f N e w I n f o r m a t i o n F o r t h e p u r p o s e s o f t h e a p p e a l h e a r i n g t h e a p p e l l a n 1 . A t w o p a g e l e t t e r f r o m t h e a p p e l l a n t ' s d a u g h t 2 . A o n e p a g e l e t t e r f r o m t h e a p p e l l a n t ' s p h y s i c 3 . A t w o p a g e o u t l i n e o f a r g u m e n t . T h e p a n e l a c c e p t e d d o c u m e n t 3 a s a r g u m e n t . D o c t h e a p p e l l a n t a n d h e r d a u g h t e r , p r o v i d e d s u p p o r t i n g t h e r e s t r i c t i o n s t h e y i m p o s e , a n d t h e a s s i s t a n c e t h e a d m i t t e d t h i s n e w i n f o r m a t i o n a s b e i n g w r i t t e n a n d o r e c o r d s t h a t w e r e b e f o r e t h e m i n i s t ry a t t h e t i m e o f r 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 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 a n * T h e p a n e l r e v i e w e d t h e e v i d e n c e a s f o l l o w s : 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 p h y s i c i a n d i a g n o s e d t h e a p p e l l a i s c h e m i c h e a r t d i s e a s e , a n d d i a b e t e s . H e d 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 h y s i c i a n i n d i b l o c k u n a i d e d o n a f l a t s u r f a c e , c a n c l i m b 2 t o r e m a i n s e a t e d f o r 1 t o 2 h o u r s . H e c o m m e n t e i m p a i r e d b y h e r m e d i c a l p r o b l e m s . • I n t h e A R , i n r e s p o n s e t o a a u e s t i o n a s k i n a w E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )c o n s i d e r a t i o n i n c l u d e d t h e f o l l o w i n g : t i n g o f t h e a p p e l l a n t ' s s e l f r e p o r t [ d a t e d O c t o b e r a s s e s s o r ' s r e p o r t ( " A R " ) b o t h s i g n e d b y t h e o b e r 9 , 2 0 1 3 ] . u b m i s s i o n . N o v e m b e r 2 6 , 2 0 1 3 . p l e t e d b y t h e a p p e l l a n t ' s p r e v i o u s p h y s i c i a n o f 1 0 y t h e a p p e l l a n t t i t l e d " C P P s u m m a r y P A R T B " . b e l i e v e d t h e d o c u m e n t w a s p r e p a r e d i n e a r l y r e s s l y i n t h e r e c o n s i d e r a t i o n d e c i s i o n t h e y . t s u b m i t t e d 3 n e w d o c u m e n t s : e r , d a t e d F e b r u a r y 2 1 , 2 0 1 4 . i a n , d a t e d F e b r u a r y 2 6 , 2 0 1 4 . u m e n t s 1 a n d 2 , a s w e l l a s t h e o r a l t e s t i m o n y o f i n f o r m a t i o n a b o u t t h e a p p e l l a n t ' s i m p a i r m e n t s , a p p e l l a n t r e c e i v e s . A c c o r d i n g l y , t h e p a n e l h a s r a l t e s t i m o n y i n s u p p o r t o f i n f o r m a t i o n a n d e c o n s i d e r a t i o n , i n a c c o r d a n c e w i t h s . 2 2 ( 4 ) o f t h e d p r o v i d e d n o n e w i n f o r m a t i o n . * * n t w i t h b r e a s t c a n c e r , t h y r o i d c a n c e r , m e l a n o m a , s c r i b e d t h e s e c o n d i t i o n s a s b e i n g c h r o n i c . c a t e d t h a t t h e a p p e l l a n t c a n w a l k l e s s t h a n 1 5 s t e p s u n a i d e d , c a n l i f t 5 -1 5 p o u n d s , a n d c a n d t h a t h e r f u n c t i o n a l a b i l i t i e s a r e s e v e r e l y h a t i m p a i r m e n t s i m p a c t t h e a n n e l l a n t ' s a b i l i t v t o
p e r f o r m D L A , t h e p h y s i c i a n r e s p o n d e d " S h e c a u s i n g p a i n i n h e r s h o u l d e r a n d l i m i t e d r a n g f a t i g u e . " • 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 w i t h r e s p e c t t o m " i m p a i r e d 1 0 0 % o f t h e t i m e " a n d t a k e s s i g n i f i i n d o o r s a n d o u t d o o r s , c l i m b i n g s t a i r s , s t a n d i n • I n h i s l e t t e r o f N o v e m b e r 2 6 , 2 0 1 3 t h e p h y s i c s u r g e r y o n h e r f o o t a n d i t r e q u i r e s o n g o i n g fo • I n t h e S e r v i c e C a n a d a M e d i c a l R e p o r t , t h e a d i a g n o s e s : 1 ) b r e a s t c a n c e r 2 0 0 5 r t . M a s t e a s t h m a ; 4 ) t y p e 2 d i a b e t e s ; 5 ) m i g r a i n e s ; 6 t a k e n o f f r t . s h o u l d e r n o m e t a s t a s e s s o f a r ; s u r g e r y ; 9 ) h y p e rt e n s i o n ; 1 0 ) n e u r o p a t h y s e " s m o u l d e r i n g " r h e u m a t o i d a r t h r i t i s ; 1 2 ) s m o k c o m m e n t i n g " o n g o i n g a n d d a i l y d i s c o m f o r t " . p r o c e d u r e . • I n h e r s e l f r e p o r t , t h e a p p e l l a n t i d e n t i f i e d m o s M e d i c a l R e p o r t , a n d a d d e d s l e e p d i s t u r b a n c e M a y 2 0 1 3 ) , t h y r o i d c a n c e r ( r e m o v e d A p r i l 2 0 " i n v e s t i g a t i n g T I A ' s " . • I n h e r o r a l t e s t i m o n y t h e a p p e l l a n t s a i d t h a t s h o u r t o g e t o u t o f b e d , a n d t h a t s h e c a n ' t s i t f a n d t h a t d u r i n g " b a d t i m e s " s h e n e e d s h e l p g r e p o r t e d t h a t s h e l o s e s h e r b a l a n c e a n d c a n s h o w e r i n g d i f f i c u l t . • I n h e r l e t t e r o f F e b r u a r y 2 1 , 2 0 1 4 a n d i n h e r o s i n c e 2 0 1 1 t h e a p p e l l a n t h a s b e e n e x p e r i e n c c a u s e d h e r t o b e c o m e w e a k a n d u n s t a b l e a n h e a d . S h e w r o t e t h a t i n D e c e m b e r 2 0 1 1 a T I l e a v i n g t h e d a u g h t e r t o b e t h e m a i n c a r e g i v e r p l a c e u n t i l M a y 2 3 , 2 0 1 3 . 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 p h y s i c i a n d i a g n o s e d n o m e n t a l d i ff i c u l t i e s w i t h c o m m u n i c a t i o n , a n d i n d i c a t e d e m o t i o n a l f u n 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 e a p p e l l a n r e s p e c t s . I n s e c t i o n 8 4 o f t h e A R , w h i c h i s t o i m p a i r m e n t o r b r a i n i n j u r y , t h e p h y s i c i a n r e s p • I n h i s l e t t e r o f N o v e m b e r 2 6 , 2 0 1 3 t h e p h y s i c i s i g n i f i c a n t a m o u n t o f s u p e r v i s i o n m e d i c a l l y , a 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 f a t i g u e . H e c o m m e n t e d t h a t t h e a p p e l l a n t i s u • 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 D L A o f s o c i a l f u n c t i o n i n a , m a n a a e p e r s o n a l f i E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )h a s s u r g i c a l s c a r s f r o m h e r s u r g i c a l i n t e r v e n t i o n s e o f m o t i o n . S h e h a s h a d t h y r o i d e c t o m y c a u s i n g o b i l i t y a n d p h y s i c a l a b i l i t y t h e a p p e l l a n t i s c a n t l y l o n g e r t h a n t y p i c a l r e g a r d i n g w a l k i n g g , a n d l i f t i n g / c a r r y i n g / h o l d i n g . 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 s o m e p e n d i n g l l o w u p . p p e l l a n t ' s f o r m e r p h y s i c i a n p r o v i d e d t h e f o l l o w i n g c t o m y ; 2 ) 2 0 0 1 g a s t r o p l a s t y f o r o b e s i t y ; 3 ) ) s c i a t i c a w i t h p a i n i n b o t h l e g s ; 7 ) m e l a n o m a 8 ) f r a c t u r e o f r t . b a s e o f 5 t h m e t a t a r s a l a w a i t i n g c o n d a r y t o s c i a t i c a a n d d i a b e t e s ; 1 1 ) e r . H e i d e n t i f i e d s c i a t i c a a s t h e m a i n p r o b l e m , T h e m e l a n o m a e x c i s i o n w a s d e s c r i b e d a s a d a y t o f t h e d i a g n o s e s f r o m t h e S e r v i c e C a n a d a , l e ft a n d r i g h t f o o t p a i n ( r i g h t h a s h a d s u r g e r y 1 3 ) , e c z e m a , g l a u c o m a , f r o z e n s h o u l d e r s , a n d h e i s i n p a i n a l l t h e t i m e , t h a t i t t a k e s h e r u p t o ½ o r l o n g . S h e s t a t e d t h a t h e r f e e t f e e l l i k e g l a s s , e t t i n g o n a n d o f f t h e c o u c h . T h e a p p e l l a n t o n l y s t a n d f o r 5 t o 1 0 m i n u t e s , w h i c h m a k e s r a l t e s t i m o n y , t h e a p p e l l a n t ' s d a u g h t e r s a i d t h a t i n g t r a n s i e n t i s c h e m i c a t t a c k s ( T I A ' s ) t h a t h a v e d u n a b l e t o l i f t h e r h e a d o r p u t h e r a r m s o v e r h e r A c a u s e d t h e a p p e l l a n t t o f r a c t u r e h e r f o o t , f o r t h e f a m i l y . S u r g e r y f o r t h e f o o t d i d n o t t a k e i m p a i r m e n t , r e p o r t e d t h e a p p e l l a n t a s h a v i n g n o n o 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 t ' s a b i l i t y t o c o m m u n i c a t e a s b e i n g g o o d i n a l l b e c o m p l e t e d f o r a n a p p l i c a n t w i t h m e n t a l o n d e d b y d r a w i n g a l i n e t h r o u g h t h e s e c t i o n . a n w r o t e t h a t t h e a p p e l l a n t r e q u i r e s " . . . a s w e l l a s s o c i a l l y . " e l l a n t ' s d i a b e t e s a n d c a r d i a c m e d i c a t i o n s c a u s e n a b l e t o w o r k a n d p e r f o r m D L A n o r m a l l y . 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 a l l a s p e c t s o f t h e n a n c e s / n a v r e n t a n d b i l l s ) a n d m a n a g e n e r s o n a l
medi cations. • The physician indicated the ap pellant indepen of daily shopping (readi ng pr ices and labels, maki preparation (meal plannin g, safe storage of food). • Wit h r espect to t he rema inin g aspects of da il of th e D LA of personal self-care, bas ic housekeeping, and u indicat ed that th e app ellant is impai r ed by pain and fatig takes s ignificantl y l onge r than typ i cal to co mple • In his letter of Nove m b er 26, 2013 the physi c [DLA] are significantly impacted. She takes significantly longer mobilizi out doors. Cl im bing st a i rs, lift ing, st a nd ing and carrying is toileting takes significantly longer to pe rform." • In her s elf-report the a p pella nt identified some o diagnos e s . • In t he "CPP summary P A RT B" docume n t the appellant wrote that her sciatica, swolle a n d frozen s h oulders impact her ability to perform preven t h er from l ifting hi gher th an her shou lde to do her h ai r an d makeup. She w rot e that it frequ e nt med ic a l appointme nts, and th at s he ye a r lab work. • In her oral te sti m ony th e ap pellan t s t a t ed that p er da y. In r esponse to a question from the panel t th e day r eading o r w atching television. • In res po nse to qu e s ti o ns from the panel, the app ► For a while h er sho u lder was f roz e n a nd limited r an ge of motion . ► She does d o s ome vacu umi n g. ► She can pa r tly mak e h er be d -th r o win ► She can d o a l oad or so of laund ry o nce in a ► She dress es h e rself. ► She usuall y just has c offee or a m u ffi n p repares hers el f. Sh e c a n put some t hing long enough to do something like stuffing a turkey. the appellant c an't do i t. ► S he only d rives if sh e has to. She feels the pain impairs he the chauffeur 95% of the t i m e. ► She retired from her career as a foster parent in July 2013, at which time she moved to her p r es ent community to live with her daughter. • In her letter of February 21, 2014 the appellant's daughter wrote tha attempted to clean the bathro om and 4 days later had not managed to complete the task s i t causes too mu c h p a i n to stan d, bend, or reach. • In he r oral testimony, i n r esp onse to a question from the advocate, the appellant's daughter said that while the appellant does dress herself, she struggles with it. often stays in h er pajamas all d a y and t hat it can tak • The daughter stated that: ► The appell ant doesn't cook meals. ► The dau ahter does most of the s h onnina. EAAT 003(10/06/01) dently manages the mental a s pects of the DLA ng a ppr o pr iate ch o ice s) and meal y sho ppi ng and meal preparat i on, and all aspe ct s se of transportation, the p hysician ue 100% of the time and that she t e t he m. i a n wrote that "My o p inion is t h at her mobility and n g ind o ors as wel l as pa r ticularly dif fic ult f o r her. Even her f th e impacts being cau s ed by each of her n knees, DL A. She w rote that her froz e n sho ulder s rs o r mo r e than 5-10 pou nd s, m aking it dif ficul t is difficu lt to stand in t he showe r, t hat she a t tend s is on m any medic ations w h ich requ ire 4 ti mes p e r she can on ly do on e "event ", s u c h as sh owe ring, he a p pellant said that she spen ds most of ellant sai d th a t: too k 2 y e ars to come b a c k . I t now has a g it tog et h e r n ot l ike she used to. while, bu t fold ing is di ffic u l t. for bre akfast, a n d a sa lad fo r lunch which s h e li ke fa st food i n to the oven but she c an 't stand Her daughter usually makes dinn er as r driving, s o h er d a ugh ter is t h er mother recently ince She said the appellant e her up to 25 minutes to put on an outfit. The annellant onlv aoes shoooina once or
t w i c e a m o n t h , a n d o n l y t o s t o r e s w h e r e t h e a p p e l l a n t e i t h e r s i t s a n d w a i t s fo r o n e a n d w a i t s f o r t h e d a u g h t e r , o r s h e w i l l w a c a r . T h e d a u g h t e r d o e s t h e m a j o r i t y o f e ► T h e a p p e l l a n t t r i e s t o w a s h d i s h e s b u t a g a i n s t t h e c o u n t e r . ► T h e d a u g h t e r o f t e n h a s t o s t r a i g h t e n o ► T h e a p p e l l a n t d o e s n ' t y e t n e e d h e l p s H e l p • I n r e s p o n s e t o t h e q u e s t i o n i n t h e P R a s t o w a i d s f o r h e r i m p a i r m e n t , t h e p h y s i c i a n r e s p o n • 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 c o m p e n s a t e f o r h e r i m p a i r m e n t , a n d t h a t s h e i n d i c a t e d t h a t a s s i s t a n c e f o r D L A i s p r o v i d e d p r o f e s s i o n a l s . • I n h i s l e t t e r o f F e b r u a r y 2 6 , 2 0 1 4 t h e p h y s i c i a a l l d a i l y t a s k s i n c l u d e d b u t n o t l i m i t e d t o c o o k S h e c u r r e n t l y r e s i d e s w i t h h e r d a u g h t e r t o e n • I n t h e " C P P s u m m a r y P A R T B " d o c u m e n t t h e l e f t l e g a n d a k n e e t e n s o r o n h e r r i g h t l e g . • I n r e s p o n s e t o a q u e s t i o n f r o m t h e p a n e l t o c t h a t d e s p i t e h e r p h y s i c i a n ' s e v i d e n c e s h e d o e o f 2 m o n t h s d o e s n ' t k n o w h e r w e l l e n o u g h t o a n o t h e r p h y s i c i a n . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )t h e r e i s a s c o o t e r a v a i l a b l e . I f t h e r e i s n o s c o o t e r t o b e a v a i l a b l e , o r s h e g o e s o u t t o s i t i n t h e c a r l k a m a x i m u m o f 2 a i s l e s a n d t h e n g o s i t i n t h e r r a n d s . c a n o n l y s t a n d f o r 1 0 m i n u t e s , t h e l a s t 5 l e a n i n g u t t h e a p p e l l a n t ' s c l o t h e s . h o w e r i n g b u t l i k e l y w i l l i n t h e f u t u r e . h e t h e r t h e a p p e l l a n t r e q u i r e s a n y p r o s t h e s e s o r d e d " Y e s p r o s t h e t i c b r a " . p e l l a n t d o e s n o t r o u t i n e l y u s e a n y d e v i c e s t o d o e s n o t h a v e a n a s s i s t a n c e a n i m a l . H e t o h e r b y f a m i l y , f r i e n d s , a n d h e a l t h a u t h o r i t y n w r o t e " [ T h e a p p e l l a n t ] n e e d s h e l p t o c o m p l e t e i n g , c l e a n i n g , s h o p p i n g , d r i v i n g , a n d e r r a n d s . s u r e a s s i s t a n c e i s a v a i l a b l e a t a l l t i m e s . " a p p e l l a n t w r o t e t h a t s h e u s e s a l e g b r a c e o n t h e l a r i f y h e r u s e o f p r o s t h e s e s , t h e a p p e l l a n t s a i d s n ' t w e a r a p r o s t h e t i c b r a , a n d t h a t h e r p h y s i c i a n k n o w t h a t s h e w e a r s a l e g b r a c e p r e s c r i b e d b y
PART F Reasons for P anel D eci sion T h e i ssu e o n th is app eal is whethe r the mi n i st ry's dec PW D was reasonably support ed by the e v id enc e or was a en ac t ment in t he cir cumst ances o f th e appellan t. I n determ ining tha t th e a ppellant does n ot h ave a severe phys op i ni on of a p resc ribed pr o fession al the app e lla nt's restric t her fr o m performin g DL A eit her contin uo usly a result of t h ose r e st rict i ons the a ppellant does not The relevant legi sl a t i on i s.as f oll o ws: E APWDA : 2 (1) I n this se ct i o n: "a ssist ive device" means a de vice designed to enable a pe activity t h at, becau s e of a se vere mental or p erform; "daily l i v in g ac tivity" has the prescribed "pre s crib ed p rofe ssi o nal" ha s the prescribe (2) The minis te r m ay desi g nat e a person di sabilit ies for t h e purposes of th i s Ac t if men t a l or ph y sica l imp a i rment that (a) in the opinion o f a med ical year s, a nd (b) in t h e opinion of a p r e scrib (i) di rectly and signific l ivin g a c tivi tie s either (A) continuo usly (B) periodically for ( i i) as a result of those r those activities. ( 3) For the pu rposes of subs e cti o n (2), (a) a per son wh o ha s a severe menta 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 su (iii) the services of an assistance animal. EAAT 003( 10/06/01) ision to de n y th e appel lant d esigna t i on a s a reasonab l e app licatio n o f the app licable p artic ular , was th e mi ni st ry reaso n a ble i n i c al or men t a l impair m ent, and t h at i n th e impairments do not d i rectly an d sig nificant ly or periodically f o r exte nded peri od s, an d th at a s require help to per f or m DLA? rson to p erform a da il y li ving physi c al i mpai rment, the pe rson i s unable to meanin g; d mea ning. who h as reach e d 1 8 years of a ge as a pers on w ith th e ministe r i s satisfied that the p erson has a severe p ract i t i oner i s li kel y to contin ue for at least 2 e d pro f essional a nt ly re strict s the pers o n's abil ity to pe r fo r m dai l y , o r ex tended pe riods , and e strictions, the person r e qui re s help to perform l impair m ent in cludes a pe rson with a pervision of another person, or
EAPWDR section 2(1): 2 ( 1) For th e purposes of the Act and this regulation, "da (a) in r e lat i o n to a person who has a seve mental impairment, means the following activiti (i) prepare own mea (ii) manage personal financ (iii) shop for personal needs; (iv) u se publi c or personal tra ( v ) perfo rm housewor .acceptab le sanitary condition; (vi) m ove a bout indoo (vii) perfo rm personal hygiene and se (viii) m an age personal (b) i n relatio n to a person wh fo l lowing acti vit ies: (i ) m a ke decisi ons (ii ) relate to, commu (2) For t he purposes of t he Act, "prescribed (a ) au thor iz ed under a n enac (i) medi c al prac tit (ii) r e gis tered ps ychologi (iii ) regi ste r e d nur (i v) occupa t i onal t ( v ) p hysi ca l t herapi ( v i ) s oci al worker, (vii) chiropractor, or (viii) nu rs e practition ( b) acting i n the c ourse of the person's employment as a school psychologist b y (i) an authority, as that term is defined in section 1 (1) of the Independent School Act, or (ii) a board or a f rancop defined in section 1 (1) of the School Act, if qualifications in psychology are a condition of such employment. ***** Severe Physical Impairment The appellant's position is that her many medical conditions constitute a severe appellant emphasi zed the physician's use of the terms "severe" and "significant" and said that he couldn't have been clearer in his choice of language. in n ot takinQ t h e phv sician's ooin ion at face v alue to dete EAA T003(10/06/01) ily liv i ng activ itie s" , r e physical impairment or a severe es: ls; es; n sportation facilities; k to main t ain th e person's pl a c e of res idence in rs and o ut do ors; lf care; me dic at ion, and o has a sev ere m e n t al impairme nt, inc ludes t he abo ut pers ona l activities, ca re or finances; nica t e or int e ract with othe r s e ffecti ve l y . profe s sio n a l " mean s a p e rson w h o is t m e nt to pra cti se t h e profe ssion of ion e r , st, s e or reg iste r e d psy c hi atric n urse , he r api s t, s t , e r, or hone ed uca tion authority, as those t erm s are ** impairment. The She argued that the ministry was unreasonable rmi ne that this leaislative criterion had b een PAGE 8 of 13
s a t i s f i e d . 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 , w h i l e i t a c k n o w l e d g e s s o m e l i m i t a t i o n s , t h e p h y s i c i a n ' s e v i d e n c e d o e s n ' t p t h e a p p e l l a n t ' s p h y s i c a l i m p a i r m e n t i s s e v e r e . 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 t 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 o 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 rf 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 i 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 . d e t e r m i n a t i o n o f s e v e r i t y i s a t t h e d i s c r e t i o n o f t h e m H o w e v e r , t h 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 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 t h i s c a s e , t h e a p p e l l a I n e x e r c i s i n g i t s 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 p r o f e s s i o n a l s w i t h 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 c a n n o t s i m p l y t a k e t h e a p p r o a c h t h a t " T h e p h y s i c i a n t h i s c r i t e r i o n i s s a t i s f i e d . " T h a t a p p r o a c h w o u l d c o n m i n i s t r y m u s t a s s e s s t h e p r o f e s s i o n a l e v i d e n c e i n c l e g i s l a t i v e c r i t e r i a a r e m e t . I n t h i s c a s e , t h e r e a r e a n u m b e r o f g a p s a n d i n c o n s c o h e r e n t , c o n v i n c i n g p i c t u r e o f a n i n d i v i d u a l w i t h a s t e s t i f i e d t h a t h e r c u r r e n t p h y s i c i a n o f 2 m o n t h s d o e s s h e w e a r s a k n e e b r a c e , w h i c h c a l l s i n t o q u e s t i o n t h o f i m p a i r m e n t . T h e p h y s i c i a n c o m m e n t e d i n t h e A R s h o u l d e r p a i n a n d f a t i g u e f r o m m e d i c a t i o n s . I n h e r f o o t p a i n , a n d d i d n o t r e f e r t o f a t i g u e i n h e r s e l f r e p o s u m m a r y P A R T B d o c u m e n t . H e r p r e v i o u s p h y s i c i a i d e n t i f i e d s c i a t i c a a s t h e p r i m a r y p r o b l e m . T h e a p p e u n s t e a d i n e s s d u e t o T I A s , a d i a g n o s i s w h i c h s h e s a m e d i c a l e v i d e n c e w a s p r o v i d e d . ( T h i s i s n o t t o s a y e v i d e n c e o n t h i s p o i n t , b u t s e c t i o n 2 o f t h e E A P W D A m u s t b e c o n f i r m e d b y a m e d i c a l p r a c t i t i o n e r . ) T h e a p a p p e l l a n t ' s c o n d i t i o n h a d w o r s e n e d o v e r t h e p a s t 2 y h o w i t w a s t h a t t h e a p p e l l a n t m a n a g e d t o p e r f o r m D c a r e u n t i l h e r r e t i r e m e n t i n J u l y 2 0 1 3 , b u t b y t h e t i m e c o u l d n o l o n g e r p e r f o r m D L A f o r h e r s e l f . T h e p a n e l a c k n o w l e d g e s t h a t i t w o u l d b e u n r e a s o n a t o a l i n e r f e c t l , b u t t h e n u m b e r o f i n c o n s i s t e n c i e s E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )t h a t 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 c a u s e r o v i d e s u f f i c i e n t i n f o r m a t i o n t o d e m o n s t r a t e t h a 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 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 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 T h e l e g i s l a t i o n m a k e s i t c l e a r t h a t t h e 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 . 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 c e f r o m n t ' s p h y s i c i a n . c a n n o t m e r e l y d e f e r t o t h e o p i n i o n o f t h e e q u i r e m e n t s a r e m e t . I n o t h e r w o r d s , t h e m i n i s t r y u s e d t h e w o r d ' s e v e r e ' s o w e m u s t a c c e p t t h a t s t i t u t e a n i m p r o p e r f e t t e r i n g o f d i s c r e t i o n . T h e o n t e x t i n o r d e r t o b e s a t i s f i e d a s t o w h e t h e r t h e i s t e n c i e s s o t h a t t h e e v i d e n c e d o e s n o t p r e s e n t a 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 n ' t k n o w h e r v e r y w e l l a n d t h a t h e d i d n ' t r e a l i z e e r e l i a b i l i t y o f h i s e v i d e n c e r e g a r d i n g h e r d e g r e e t h a t t h e a p p e l l a n t ' s p r i m a r y p r o b l e m s a r e h e r o r a l t e s t i m o n y t h e a p p e l l a n t e m p h a s i z e d l e g a n d r t , h e r r e c o n s i d e r a t i o n s u b m i s s i o n , o r t h e C P P n , i n t h e S e r v i c e C a n a d a M e d i c a l R e p o rt , l l a n t ' s d a u g h t e r ' s e v i d e n c e s t r e s s e d i d w a s r e c e n t l y c o n f i r m e d , b u t n o s u p p o rt i n g t h a t t h e p a n e l d o e s n ' t b e l i e v e t h e d a u g h t e r ' s r e q u i r e s t h a t t h e d i a g n o s i s o f a n i m p a i r m e n t p e l l a n t a n d h e r d a u g h t e r h a d s a i d t h a t t h e e a r s , b u t t h e r e i s n o m e d i c a l e x p l a n a t i o n a s t o L A f o r b o t h h e r s e l f a n d f o s t e r c h i l d r e n u n d e r h e r o f h e r P W D a p p l i c a t i o n i n O c t o b e r 2 0 1 3 s h e b l e t o e x p e c t e v e r y m i n u t e d e t a i l o f t h e e v i d e n c e h e r e s i n i f i c a n t l l e s s e n s i t s i m a c t . T h e a n e l
also ac knowle dges t ha t there may be some ad di t i o nal t he ongoing ass e s sment of the T IA iss ue m entio ne d surgery iss ue menti oned b y the ph ysician. Ho wever, t ha t it curr e ntly ha s befor e it. Acc o rd ingly , t he pa n el d etermine d th at the eviden ce f a lls short of estab l ishing a ppella nt has a sever e p hysica l i m pai rm ent. Severe M e nt a l I mpairment The a ppella nt advanc ed no argument wi th re s pec t to menta The ministry's po s it io n, a s set out in its rec onsi de ra tion d a di agn osi s o f me nta l impa irme n t a nd did n ot id e nt ify e m o t io nal function . Ac cord ingly, t h e mi n i stry st ated tha severe m e ntal impairment. Pa n el Decision Th e p h ysic ian ha s provide d no d iag nosis of a ment al a p pel lant's abili ty to co m municate is goo d in all res pec S e cti o n 2(1) ( b ) of t h e E A PWD R p r e scribes t wo DLA that ar decisions a bo ut pers onal ac tiv ities , c are o r f i na nc es i n teract wi th others eff e ctivel y (soc ial f un c tio nin g) . The appellant is not sign i f i cantly restrict ed with resp ect to man a ges the d e cis ion making aspects of da il y sho ppin p erson al med i c a ti on (fillin g/refill i n g/tak i n g as directed), man budgetin g, pay rent an d bills), s o ci al f unctioning ( a p (meal pla n ning). Th e r e i s no evid enc e of any restr iction s to her s o c i al functioning, AR t ha t the app ellan t has good f unc tioning in res pect C onsi dering the evidence as a wh ole, the panel concludes th that it does not demonstrate a severe mental impairment. Significant Restrict ions to DLA The appellant's position is that her ability to perform DLA is significantly restricted. the evidence of the ph ysic ia n from the AR in d i c ati ng physical aspec t s of all DLA "100 % of the t i m e", and argued that t physician's opinion with respect to the significance of the impairment. PR an d AR t h e physi c ian did not provide evidence regardin to perform DLA and the amount of help she requires, but said that the ministry should have drawn logical conclusions with respect to this, and also pointed to the additional evidence from the physician and the appellant's daughter as providing the missing information. EMT 0D 3 ( 1 0/ 06/ 01) I medical info rmation ye t to c om e as a result of by the ap pel lant and her daughter, and the f o o t th e p anel is li m i ted to c o n s idering the evid en ce ha s conc l ude d th at t h e mi n i str y reasonably o n the ba lanc e of p r ob ab ilit ies tha t the l impair me n t. e cision , i s tha t the phys ician did n ot p rovide any significant r e str ic t ions to cognit ive and t the ev idence is insuf fi c i e nt to demon strate a i m pairment, a nd h as indicat e d t ha t t he ts. e speci f ic to me n t a l impairme nt-m a ke (d eci sion m akin g) , and r ela te to, commun i cate or ph ysici an' s e v i dence ind ica t es tha t the dec ision m aking in that s h e independently g (making ap propriate choic es), ma nage age persona l fi nance s (ba nking, pr opriate s oc i al d e cis ion s ) and m e a l prep ara tion and the physician conf i r med in the o f h er i m mediate and exte nded social n e two rks. at th e m i n i stry reasonably deter m ined She emphasized that she is "significantly" r e stric t ed in the he m inistry must acce pt the She acknowl edged that in the g the amount of tim e it takes the appellant
T he min i str y's position, as se t out in its reconsi dera an y information as to ho w l ong it take s th e ap pe ll a nt req uir es assist an ce from . an o ther person or f rom an m a jority of DLA are p erf ormed ind ep end en tly and re insufficient t o e sta blish that impairme nt significa ntly f o r ex ten de d pe ri o ds. Pa nel Decision The leg i s l a t ion re qui res t h at a se ve re i mpairment direc ab i lit y t o p erfo rm DLA either c on tinu ou sly or pe r iodic mean s tha t the r e m u st b e a ca us al lin k be twee n t h e severe imp restr icti o n must also be sign ifi cant. Fi nall y, the re i s d ir e c t an d sign ificant rest rict io n m ay b e e i ther contin ex ten de d t ime. With resp ect to th e app ellant's degr ee of ind ependen EAPWD A i n dicates that a per son must " re quire" help as define "requ ire" ind i c ates a degr ee o f necessit y so that it is so wi tho ut. If the per son do es not ge t the he lp s he requires, th or p eriodic ally fo r exten ded -pe r io ds, or the D L A takes an The physician's evidence f rom the AR i s that t he app of the ti me . He provided no evidence a s to h ow m u a ny assistance to per form DLA. As explai ned above i Impairment, the mini st ry ca nno t fet ter its discreti on by mer w o rds "si g n if i c antl y impac t e d" and "signifi c antl y longer" The mi nistry d id not h ave the b enefit of t he appe l lant's da physici an's le tter of Februar y 26, 2 01 4. Both of t h ese l a pp ellan t r equ i res help w ith DLA and that it i s th e appell Essentiall y, th e ev i d ence of the p hysic ian i n t h e AR m e ntal as pe ct of all DLA but that she is "significantly im t h e November 26 , 2013 letter he wrote that she takes "signific about indoo rs and outdoors an d with the toileting aspect of the DLA of personal self-care. daughter's letter a ttempts t o fi l l the gap wi th respect to The assessment of the appellant's restrictions to DLA must be considered in the cont being no medical explanation as to why the appellan children until her retirement in July, 2013, but by October, 2013 she could no longer perform DLA for herself. Viewing the evidence as a whole, it in dicates aspects of the 5 DLA of persona l self-car e, manage personal finances, manage personal medications, decision-making, and social functioning. With respect to the use of transportation, the appellant can drive when she has to. re aration, she can re are breakfast and lunch, and can EAA T003(10/06/01) tion d eci sion , i s that t he phys ici an d i d n o t p r o v id e to perform DLA, an d he di d no t in dic ate th at she as sis tive device. The m in ist ry argu ed that a s t h e qu ire l it tl e h elp from othe rs, the ev i d en ce is r estr icts D L A ei ther co ntin uo usl y or pe r iod i c all y tly an d si gnif icant ly restricts the ap pe llant's all y fo r exte nde d periods . The term "d i re c tly " airmen t an d the restr ict io n. The d i rect a co m p onent rela t e d t o time or d uration . Th e uous or perio dic. If it is pe riod ic it mus t be f o r an ce, t he pa ne l not es t hat s ection 2(3) o f the d. In th e p an el's v i ew the w or d mething that a person ca nn ot reas onably d o e DLA g oes un do ne eit h er c ontinu ous ly unreaso nably long tim e to compl e t e. ell an t' s ab i li ty to perform DLA is res t ricte d 100% ch longer the a ppell ant t ak es o r that she r equi r ed n the disc us sion of S evere Phys i c al ely acc e ptin g th e ph ys i c i a n's u s e of the a s fulfilling th e st atut or y cr iter ia. ugh ter's le tter of Febr uary 21, 20 14 or t he e tt e rs are consi stent in saying t h at the ant's da ug hte r who p rovide s the help. is th at the appellant independently manages the pa ct e d" with t h e physical as pects o f DLA. In a ntly longe r" with the DLA of moving The the significance of the restrictions. ext of ther e t was able to perform DLA for herself and foster th at t he appellant indep endently per forms all Regarding meal Ian meals and use the oven for heatin
meal s b u t generally l e av es di nne r u p to her da ug h ter. appellant can make her bed, do a l oad o f lau nd ry , and clean ing ha v e to be broken d ow n in f o sm a ller c o m po amount of time. R egar di ng the 2 remaining DL A, the appellant is res ou t d o ors , bu t t h ere i s n o evid en c e that sh e receives a w ea rs a kn ee br ace an d uses a scoo ter or w heel c ha to d aily s h opp ing, the app el lan t is usu a lly accompan ge t to and fr om the store and make de cisio n s about O n b alance, w hil e ackn o wle dgi ng a degree of impai r easona bly determined t h at the evidence is i ns u fficie the app ell ant ' s ab ility to m a nag e h er DLA is signi fica f o r extended peri o d s. Help wi th DLA Th e appe lla nt's position i s t hat she requ i res her d aught simply w o uld n ot be a bl e to g et b y o n h er own . The mi nistry's position is that since i t has not be en e signif icantly r estri cted, i t cann ot be det erm ine d t h a t Panel De cisi o n Findings that a se v e re i mpairment d i re ct ly and s ignificantl DLA eith er co n tinuousl y or p e rio dically f o r an ex tended " h elp" as d efined by secti on 2( 3 )(b ) of th e E APWDA. prec o ndit ion has n ot bee n s a tisf ied on the ba lance of prob A ccordingly, the pa ne l finds that the m ini s t ry r easo na th e a ppe llant requires help with DLA a s defined by section 2(3 Conclusion The panel acknow ledg es t h at the ap pell an t's me d i cal Howe ver, having rev i e wed and considered all of the evidence and th finds that the ministry's decision finding th e appellant application of the legislation in the circumstances of the appellant. ministry's deci sion. EAAT 003(1 0106101) Wit h res pect t o basic hou sek eep in g, t he some vacuumin g. Large j obs or he av y nents b ut a ppea r to require an in o rdi nate tric ted with res pect to mo v i ng abo ut i ndoo rs and ny assista nce wit h this o th er th an that she ir wh e n one i s a vail able at a store. W ith r esp ect ie d by her dau g h ter but s h e can ind epe nd ent ly w hat t o purchase . r ment , the p anel concludes t h a t the min is t ry nt t o show on t he balance of pr o b a bi li tie s tha t ntly restri c t ed either c o n tinuously or periodically er's help t o man age her D L A , and th at she s t ab l ish e d t hat the a p pell a nt ' s DL A are s ignif ic a nt help is required fr o m other p ersons. y res tric t s a per son 's ab i l i ty to manag e h e r pe riod i s a p recond i tion to a p erson re q uir in g For the re as ons pr ovide d a bove, th a t abil ities in t his c ase. b ly conclud e d it could not b e deter mined that ) (b) of the EAP WD A . co n d i tio n s affect h er ability t o f un ction. e re l e vant legislation, the panel i neligible for P WD d e sig n ation is a reasonable The panel therefore confirms the
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.