PART C -Decision under Appeal The decision under appeal is the reconsideration decision of the Ministry of Social Development and Social Innovation (the ministry) dated January 15, 2014 denying the appellant designation as a person with disabilities (PWD). The ministry determined that the appellant did not meet three of the five criteria required for PWD designation as set out in the Employment and Assistance for Persons with Disabilities Act (EAPWDA) section 2. The ministry found that the appellant meets the criteria of age and duration of impairment in that he is 18 years of age or older and in the opinion of a medical practitioner, his impairment is likely to continue for two or more years. However, the ministry determined that, based on the information provided, the following criteria as set out in section 2(2)(b) of the EAPWDA were not met: • The minister is satisfied that the appellant has a severe mental or physical impairment. • In the opinion of a prescribed professional, the appellant's impairment significantly restricts his ability to perform daily living activities (DLA) either continuously or periodically for extended periods; and • As a result of the restrictions, the appellant requires the significant help or supervision of another person to perform the DLA restricted by his impairment. PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Act (EAPWDA) -section 2 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) -section 2 EMT 003(10/06/01)
PART E -S u mmar v of Fac t s The ev i d en ce bef or e the ministry a t r e conside r a tion 1. Th e app e l lant's PWD De signatio n A ppl ic a t i o • Th e ap pella n t's Self Report (S R ) com p lete d • Th e Physi cian Repor t (PR ) d ated A ugu st 8, 20 has known the ap pel lant s i nc e M a r ch 2 9 2012 a t imes i n the p revi ous year; and • Th e Asse ssor Re port (AR ) dated Au g u s t 8, 201 2 . The appe l lant ' s req u e s t f or r e considerati on dated following t w o documents: • A two-page s ub miss ion dated J anuary 9 , 201 • A one-page s ubm iss ion su mmarizing the dec Appeal Tribunal, 20 09 BCSC 1461, pre pa r ed The a pp ella nt compl eted hi s notic e of a p pe a l on January 27, 2014, a disagr e es wi th the m in i st ry's rec onsiderat i on deci s io my o riginal a pplica ti on." P r ior to t he hear ing, th e app ellant subm itted t o the pan a pp ellant 's advocat e a nd signed a nd dat e d by the appell ("Docume nt #1 "). Document #1 co ntains a ser ies of que co mments pr ovided by the physici a n re g ar d i n g the a a bi lity t o perform his DLA (sp ecific a nswers are ad dressed At the he ar i ng, th e appella nt submi t ted to the pan el a dv o ca te and signed by a wo ma n identified as a fr iend and February 17, 2 014 ("Docum e nt #2") . Doc ument #2 cont provided by th e appe ll a nt's friend re g ar d i n g the im pact D L A . The frien d wrote that the a ppella nt, "needs daily assistance with most everything. He is unable t o or g anize t h e s i mp lest task s due t o m ent al health & phy com ment, "Since quitting drug and alcoho l abuse I have seen a steady decl health. He is always in pain, he cannot fo c us or r ememb T h e app ellant's friend identified her title as In his submissions at the hearing, the appellant said that he star designation 8-9 months ago and he wanted the panel to consider the additional docu they s upport his submissions that his hea lth is dete r doctor completed the PWD application and he is no longer impairments. The appellant stated that in Document #1, his physician has confirmed that his impairments are severe and that they restrict 8 of his DLA and that his physician has confirmed he requires help to perform his DLA. The appellant told the panel that the friend who completed Document #2 used to be his la ndlord and he l pe d h im abuse and she continues to offer him support. He told the panel his friend confirms that his health is deterioratina and that he cannot perform DLAs and needs assistance. EAAT 003(10/06/01) con sis ted of the following: n, co n taining the f o ll o wing thr ee parts: Ju ne 1 4, 2 013; 1 3. com p le ted b y the app ellant's physic ian wh o n d in d i cated he had see n him 1 1 or more 3 al s o com p let ed by the app e l lant's phy s i cian. Janua ry 9, 2014, a t ta ched to whic h w ere the 4 p re pared b y a n advocate fo r the ap pella n t; an d i sion of H udson v. Em p l o yment and A ssi stance b y the appellan t's ad vocate. nd on it he wrote tha t he n "b ecau se my con diti o n has g row n [w orse ] since el a 2-page quest ionn aire pre pa r ed by the ant 's famil y p hys i cia n on Febr ua r y 11 , 20 14 sti o ns wi th c ircled ans we rs and some wri tt e n ppella nt's imp airmen t s and that the y a ffect h is in t he d i scussion b elo w). a se cond 2-pag e q uestionn ai re pr epar ed by his the appella nt 's for m e r lan dlord a nd da ted ains a ser ies of questions w ith co mme n ts of his impairm ent s on his abil ity t o pe rform h is s ica l iss ues." Th e friend adde d the ine in [ th e ap pellant's] e r what he is doing to the end of a task." ted the applicatio n for PWD men ts because io r a ting, his health is worse than when he and his able to perfo rm his DLA because of his get into treatment for his drug and alcohol
T h e m i n i s t r y r e p r e s e n t a t i v e h a d n o o b j e c t i o n t o t h e p h y s i c i a n i n D o c u m e n t # 1 , a l t h o u g h t h e m i n i s t r y s a n a r r a t i v e t o e x p l a i n t h e c h a n g e f r o m t h e i n f o r m a t i o n c o u l d i n d e p e n d e n t l y p e rf o r m s e v e r a l o f h i s D L A , t o a p p e l l a n t ' s p e r f o r m a n c e o f 8 o f h i s D L A a r e c o n t i n u o b j e c t e d t o t h e a d m i s s i o n o f t h e i n f o r m a t i o n i n D o c u h a d a n o p p o r t u n i t y t o c o n f i r m t h e i n f o r m a t i o n p r o v i d T h e p a n e l f i n d s t h a t t h e i n f o r m a t i o n i n b o t h D o c u m 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 t h e d e c i s a d d i t i o n a l i n f o r m a t i o n p u r s u a n t t o s e c t i o n 2 2 ( 4 ) ( b ) o p h y s i c i a n w h o c o m p l e t e d t h e a p p e l l a n t ' s P W D a p p l a d d i n g c l a r i f i c a t i o n o f i n f o r m a t i o n i n t h e P W D a p p l i c a p p e l l a n t ' s p h y s i c i a n d i d n o t p r o v i d e a n e x p l a n a t i o n P R a n d A R t o D o c u m e n t # 1 a n d a l s o n o t e s t h a t t h e D o c u m e n t # 2 c a n n o t b e c o n f i r m e d ( s h e d i d n o t a t t 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 t o l d t h e p a n e l t h a t h i s h P W D a p p l i c a t i o n 8 -9 m o n t h s a g o . H e s a y s t h a t h e s h o u l d e r a n d n e c k . H e t o l d t h e p a n e l t h a t f o r s e v e r b y u s i n g d r u g s a n d a l c o h o l , b u t t h a t h e i s n o w c l e a n t r e a t m e n t . T h e a p p e l l a n t s a i d t h a t h e h a s m e n t a l h e b e c a u s e o f h i s d r u g a b u s e , h e c a n n o l o n g e r f o c u s , o f a n x i e t y . T h e a p p e l l a n t t o l d t h e p a n e l h e i s o n m e d b e c a u s e h e c a n n o t t a k e o p i a t e d e r i v a t i v e s f o r p a i n m T h e f o l l o w i n g i s a s u m m a r y o f t h e e v i d e n c e f r o m t h e a s t h e y r e l a t e t o t h e P W D c r i t e r i a a t i s s u e . T h e p a n S R i n t h e P W D a p p l i c a t i o n , a s w e l l a s h i s s u b m i s s i o S e v e r i t y o f i m p a i r m e n t s ( c r i t e r i a s e t o u t i n s u b s . 2 ( 2 T h e a p p e l l a n t ' s p h y s i c i a n d i a g n o s e d h i m i n t h e P R a 2 0 1 1 , a l c o h o l i s m a n d d r u g a d d i c t i o n , b o t h o n s e t 1 9 9 o n s e t 2 0 1 1 . T h e p h y s i c i a n w r o t e t h a t a l l f o u r o f t h e c o m m e n t s : " p a i n ➔ i n a b i l i t y t o d o p h y s i c a l w o r k , d u e i n s o m n i a . S u b s t a n c e a b u s e ➔ i n a b i l i t y t o s e e k o r m m u l t i p l e s y m p t o m s , r e s u l t i n i n a b i l i t y t o l e a v e h o m e a T h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t h a s b e e n a b i l i t y t o p e r f o r m D L A , w r i t i n g t h a t t h e m e d i c a t i o n s " I n t h e f u n c t i o n a l s k i l l s a s s e s s m e n t i n t h e P R , t h e a p c o u l d w a l k 2 -4 b l o c k s u n a i d e d o n a f l a t s u r f a c e , t h a t l i f t 2 -7 k g ( 5 -1 5 p o u n d s ) , a n d h a s n o l i m i t a t i o n s r e m a 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 w a s i n d e p e n d e ( w a l k i n g i n d o o r s a n d w a l k i n a o u t d o o r s ) . T h e o h v s i c E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )a d m i s s i o n o f t h e i n f o r m a t i o n f r o m t h e a p p e l l a n t ' s i d t h a t t h e p h y s i c i a n h a d n o t p r o v i d e d a n y i n t h e P W D a p p l i c a t i o n s h o w i n g t h e a p p e l l a n t t h e i n f o r m a t i o n i n D o c u m e n t # 1 t h a t t h e o u s l y r e s t r i c t e d . T h e m i n i s t r y r e p r e s e n t a t i v e m e n t # 2 o n t h e b a s i s t h a t t h e m i n i s t r y h a d n o t e d b y t h e a p p e l l a n t ' s f r i e n d . n t # 1 a n d # 2 i s w r i t t e n t e s t i m o n y i n s u p p o r t o f i o n u n d e r a p p e a l w a s m a d e a n d a d m i t s t h e f t h e E m p l o y m e n t a n d A s s i s t a n c e A c t . T h e i c a t i o n ( t h e P R a n d A R ) c o m p l e t e d D o c u m e n t # 1 , a t i o n . H o w e v e r , t h e p a n e l a g r e e s t h a t t h e o f t h e c h a n g e s i n t h e i n f o r m a t i o n s e t o u t i n t h e i n f o r m a t i o n f r o m t h e a p p e l l a n t ' s f r i e n d i n n d t h e h e a r i n g a s a w i t n e s s ) . e a l t h h a s d e t e r i o r a t e d s i n c e h e c o m p l e t e d t h e l i v e s w i t h c h r o n i c p a i n f r o m a n e a r l i e r i n j u r y i n h i s a l y e a r s , h e s e l f m e d i c a t e d t o d e a l w i t h h i s p a i n a n d h a s g o n e t h r o u g h d r u g a n d a l c o h o l a l t h i s s u e s t h a t h e i s v e r y d e p r e s s e d a n d o r c o n c e n t r a t e , a n d h e s u f f e r s f r o m a g r e a t d e a l i c a t i o n t o t r e a t h i s p a i n a n d h i s a n x i e t y , b u t e d i c a t i o n , h e i s s t i l l i n p a i n . P R a n d t h e A R , a s w e l l a s D o c u m e n t s # 1 a n d 2 , e l h a s a l s o i n c l u d e d r e f e r e n c e t o t h e a p p e l l a n t ' s n s o n r e c o n s i d e r a t i o n a n d a t t h e h e a r i n g . ) E A P W D A ) s h a v i n g c h r o n i c p a i n s y n d r o m e w i t h a n o n s e t o f 5 , a n d m a j o r d e p r e s s i v e d i s o r d e r w i t h a n x i e t y a p p e l l a n t ' s c o n d i t i o n s a r e s e v e r e , w i t h t h e t o c o n t i n u o u s n e c k p a i n ➔ s h o u l d e r s . C a u s e s a i n t a i n e m p l o y m e n t . D e p r e s s i o n / a n x i e t y t t i m e s . A l s o p a i n c h r o n i c b a c k a n d k n e e s . " p r e s c r i b e d m e d i c a t i o n t h a t i n t e r f e r e s w i t h h i s c a u s e d r o w s i n e s s . " 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 h e c o u l d c l i m b 5 + s t e p s u n a i d e d , t h a t h e c o u l d i n i n g s e a t e d . I n t h e A R , t h e a p p e l l a n t ' s n t i n 2 a s p e c t s o f m o b i l i t y a n d p h y s i c a l a b i l i t y i a n i n d i c a t e d t h a t t h e a o o e l l a n t t a k e s s i a n i f i c a n t l v
l o n g e r t h a n t y p i c a l w i t h c l i m b i n g s t a i r s a n d s t a n d i n g a n d k n e e d i f f i c u l t i e s , d u e t o p a i n s . " T h e p h y s i c i a n i a s s i s t a n c e w i t h t h e t a s k s o f l i f t i n g a n d c a r r y i n g a n d l i f t i n g + c a r r y i n g o f h e a v y o b j e c t s . " I n t h e P R , t h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n s e n s o r y c a u s e s , w r i t i n g t h e c o m m e n t , " a n x i e t y + s t r c h e c k e d t h a t t h e a p p e l l a n t h a s s i g n i f i c a n t d e f i c i t s w c o n s c i o u s n e s s , e x e c u t i v e , m e m o r y , e m o t i o n a l d i s t u a n d a t t e n t i o n o r s u s t a i n e d c o n c e n t r a t i o n . T h e p h y s d i f f i c u l t y p l a n n i n g , p o o r m e m o r y , d e p r e s s e d m o o d + c o n t r o l , g e t s f i d g e t y a n d " t w i t c h y " , p o o r c o n c e n t r a t i o a p p e l l a n t h a d g o o d a b i l i t y t o s p e a k , b u t p o o r a b i l i t y " i m p a i r e d d u e t o p o o r c o n c e n t r a t i o n d u e t o n o i s e e x I n t h e A R , i n t h e a s s e s s m e n t o f t h e a p p e l l a n t ' s m e n f u n c t i o n i n g , t h e p h y s i c i a n i n d i c a t e d t h a t h i s m e n t a l e m o t i o n , m e m o ry , m o t i v a t i o n a n d m o t o r a c t i v i t y , t h a f u n c t i o n s , c o n s c i o u s n e s s , i m p u l s e c o n t r o l , a t t e n t i o n m i n i m a l i m p a c t i n t h e a r e a s o f i n s i g h t a n d j u d g m e n t i m p a i r e d , a s a b o v e , d u e t o d e p r e s s i o n , c h r o n i c p a i n I n D o c u m e n t # 1 c o m p l e t e d b y t h e a p p e l l a n t ' s p h y s i i n d i c a t e d b y c i r c l i n g " y e s " t h a t t h e a p p e l l a n t h a s a s a n d s i g n i f i c a n t l y r e s t r i c t s h i s a b i l i t y t o p e r f o r m D L A s A D L s a r e r e s t r i c t e d c o n t i n u o u s l y , d u e t o c h r o n i c p a i T h e a p p e l l a n t t o l d t h e p a n e l t h a t h e i s i n c o n s t a n t p a a p p e l l a n t s a i d t h a t h i s c h r o n i c p a i n i s s o b a d t h a t i t i a n d i t w i l l t a k e h i m a c o u p l e o f h o u r s t o g e t u p . T h e h e c a n n o t t a k e o p i a t e d r u g s t o t r e a t h i s p a i n a n d a l t i n a g r e a t d e a l o f p a i n o n a d a i l y b a s i s . T h e a p p e l l a n l i f t a n y t h i n g b e c a u s e o f t h e p a i n i n h i s s h o u l d e r a n d c h o r e s ( s u c h a s s w e e p i n g a n d m o p p i n g ) , i t i s v e r y d s u f f e r s f r o m a n x i e t y a n d d e p r e s s i o n , f o r w h i c h h e t a h i m s l e e p . T h e a p p e l l a n t s a i d t h a t h e c a n ' t c o n c e n t t h a t h e i s v e r y d e p r e s s e d . T h e a p p e l l a n t i s l i v i n g i n w o r k e r s t h e r e a r e e n c o u r a g i n g h i m t o d o 1 o r 2 t h i n g a n d a s s i s t w i t h c h o r e s a t t h e t r a n s i t i o n h o u s i n g , b u t a p p e l l a n t ' s f r i e n d s a i d t h a t t h e a p p e l l a n t i s a l w a y s i n i s d o i n g t o t h e e n d o f a t a s k . A b i l i t y t o p e rf o r m D L A ( c r i t e r i a s e t o u t i n s u b s . 2 ( 2 ) ( b I n t h e A R , t h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t D L A s o f 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 m e d i c a t i o n i n d e p e n d e n t i n p e r f o r m i n g 4 o f t h e 5 l i s t e d t a s k s o f t E M T 0 0 3 ( 1 0 / 0 6 / 0 1 ), w r i t i n g t h e c o m m e n t , " b e c a u s e o f n e c k , b a c k n d i c a t e d t h a t t h e a p p e l l a n t r e q u i r e d c o n t i n u o u s h o l d i n g , w r i t i n g t h e c o m m e n t , " g r e a t d i f f i c u l t y w i t h t h a d d i f f 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 s a r e s u l t o f e s s ➔ d i f f i c u l t y c o m m u n i c a t i n g . " T h e p h y s i c i a n i t h 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 t h e a r e a s o f r b a n c e , m o t i v a t i o n , i m p u l s e c o n t r o l , m o t o r a c t i v i t y i c i a n w r o t e , " p o o r c o n c e n t r a t i o n , e a s i l y c o n f u s e d , a s s o c i a t e d p o o r m o t i v a t i o n , p o o r i m p u l s e n . " 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 f o r r e a d i n g , w r i t i n g a n d h e a r i n g , c o m m e n t i n g , p o s u r e . " t a l i m p a i r m e n t o n h i s c o g n i t i v e a n d e m o t i o n a l i m p a i r m e n t h a d a m a j o r i m p a c t i n t h e a r e a s o f t i t h a d a m o d e r a t e i m p a c t i n t h e a r e a s o f b o d i l y / c o n c e n t r a t i o n a n d e x e c u t i v e , a n d t h a t i t h a d a a n d l a n g u a g e . T h e p h y s i c i a n w r o t e , " s i g n i f i c a n t l y + s u b s t a n c e a b u s e . " c i a n o n F e b r u a r y 1 1 , 2 0 1 4 , t h e p h y s i c i a n e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t t h a t d i r e c t l y . T h e p h y s i c i a n a l s o w r o t e , " p h y s i c a l a s p e c t s o f n . M e n t a l h e a l t h i s s u e s r e s t r i c t t h e o t h e r A D L s . " i n a n d h e t a k e s 3 t y p e s o f p a i n m e d i c a t i o n s . T h e s v e r y d i f f i c u l t f o r h i m t o g e t u p i n t h e m o r n i n g a p p e l l a n t s a i d t h a t b e c a u s e o f h i s p r i o r d r u g u s e , h o u g h h e i s o n m e d i c a t i o n f o r h i s p a i n , h e i s s t i l l t s a i d t h a t h e c a n n o t w a l k v e r y f a r , t h a t h e c a n n o t n e c k , a n d t h a t a l t h o u g h h e t r i e s t o h e l p w i t h i f f i c u l t f o r h i m . T h e a p p e l l a n t s a i d t h a t h e a l s o k e s m e d i c a t i o n , a n d h e t a k e s m e d i c a t i o n t o h e l p r a t e f o r v e r y l o n g , t h a t h e h a s n o m e m o r y , a n d t r a n s i t i o n h o u s i n g w h e r e h e h a s s u p p o r t a n d t h e s p e r d a y , s u c h a s a t t e n d h i s t r e a t m e n t s e s s i o n s h e f i n d s t h i s d i f f i c u l t . I n D o c u m e n t # 2 , t h e p a i n a n d h e c a n n o t f o c u s o r r e m e m b e r w h a t h e ) E A P W D A ) i s i n d e p e n d e n t i n p e r f o r m i n g a l l a s p e c t s o f t h e s . T h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t i s h e D L A o f s h o p p i n !-1 , i n d i c a t i n a t h a t t h e a o o e l l a n t
requir es peri odic a ssi stance carry i n g pur ch a s e s h om a pp e ll a nt's phy sici an indi ca ted th e a p pe l lan t req uire basic h ousekeeping, co m men t in g "he lped by a fri end." si gnif i cant l y longer tha n ty pical i n p erforming 6 of t he gro oming, bathi n g , toil e ti n g , transfer s i n /o ut of bed, back + kn ee pa in als o d ue to -!-motivatio n difficul ty th e appell a nt wa s ind epend en t in t he 2 tasks of f ee p ersonal care. I n the AR sectio n re gardin g t he appellant's social funct he r equired peri odic sup port /su per vis ion f or a p prop [il le g ibl e ]", ab le to deve lop and m ai n tain relationships (" ap propriately wit h u n ex p e cted demands (" nee d s help ap pella n t w as ind e p e n dent i n interac ting a ppropriately from other s. The ph ysici an indicate d that t he a p pe social networ k commentin g, "intermit t e n t discord w ith f f un ctionin g w i t h his exte nded social net w or ks. In Document #1 co m pl et ed Fe bru ary 1 1, 2 014 , the app im pairm e n t s conti nuou s ly restri ct h i s abilit y to pe rform medicat i ons, ba sic house work, mob i l i ty ins ide the h t rans porta tion , m anag eme nt of finance s, an d social by the ph ys ician regard ing th e re s t riction s is t ha t th e restric ted b y ch r o n ic p a in, and th e app ellan t 's mental health In Do c ument # 2 , t h e appe l lan t's friend indicate d t ha o f meal prep arati o n, mana ge ment of medic at io ns, bas th e ho me , mo bilit y o utside the h ome, use of t ran sp o functi o ning. S he wro te that the app el lan t is unable to he alt h and physi cal is sue s . At the hearing, the appellan t told the panel he is living in tr he ca n not p repare his o w n mea ls as i t hu rt s too mu forget that he is cooking, so the staff at the transition housing prepare his meals appellant said that he does not often eat breakfa s t (his chronic pain is too bad in the morning for him to get up a nd come down for bre a kfast), he will eat bring hi s dinner up to hi s r oom. The ap pellan t s ai d the st can clean himself. He s a i d that the staff or a friend drive him to stores if he has to do personal sho pping. The appellant said that he tries to help with chores at the t ransition ho us ing, su c h as s w eeping, but mopping hurts said that he is not very sociable because of his anxiety and depression -he told the panel that he w a s v e r y stressed attending the hearing, but had not wanted to be lucid at the hearing. Ass i st an c e required/provided ( cri teria se t out in subs. 2(2)(b){ii) EA In the section of the AR describ i n g the ass istance provided for the appellant, the phvsician indicated EAAT 003( 1 0/ 06/01)e, com mentin g "us ual ly ge ts a r ide." T h e d perio dic assist an ce for both tasks of the DLA of The phy sician indi ca ted the a pp e l la nt tak e s 8 ta s ks of t he DLA of personal ca re (dressi ng, and tra nsfer s on/off o f chair) commenting, "due to reac h ing h is fee t." The physici an indicate d t hat d i n g se l f and reg ulating diet under th e DL A of io ning, the a p pe llan t's ph ysic ian ind icated th a t ri ate so cial decis ions ("u ses d ru gs/alcohol d if ficulty wit h this " ) a n d able to deal from fri e nds") . T h e p hysi cian i ndicated the wi th o thers a n d was abl e to sec ure a ssi stance l lan t ha d marg i na l funct io ning wit h his im med iat e amily related to d rug use" and had mar gin a l ell a n t 's ph ys ician in dica ted that th e appe l lant's the D L As of m eal prepa ration , m anag eme nt of ome, mobilit y outs ide the h ome, use of fu nc tioning . The explanation /c o mments p r ovided physical aspects o f t he ap pellant's D L As are i s sues "res tri ct the ot he r " D L As. t the appellan t had difficulty perform ing the DLA s ic ho u sework, dai ly sh opp ing, mob i l ity insid e r tatio n, management of f inance s an d so c i al or ga nize the simplest t ask s due to h is me n tal ansi tion h ousing. T h e appellant said tha t c h to stand fo r any pe r iod of time and he wi ll for him. T he lunch, and will often e at dinner o r someone wi l l a ff w i ll he lp h im get to the bathroom, but he hi s m e dical a p po i n tments a nd to his shoulder and c au s e s too much pa in. He taken hi s full dose of m e dication because h e PWDA)
t h a t t h e a p p e l l a n t r e c e i v e d h e l p f r o m f a m i l y a n d f r i e a s s i s t a n c e a n i m a l a n d d i d n o t p r o v i d e a n y c o m m e n I n D o c u m e n t # 1 , t h e a p p e l l a n t ' s p h y s i c i a n c i r c l e d " y o p i n i o n , t h e a p p e l l a n t r e q u i r e s h e l p t o p e r f o r m t h o s D o c u m e n t # 2 , t h e a p p e l l a n t ' s f r i e n d w r o t e t h a t t h e e v e r y t h i n g . " T h e a p p e l l a n t t o l d t h e p a n e l a t t h e h e a g e t t i n g t o t h e b a t h r o o m , a l t h o u g h h e c a n c l e a n h i m a p p o i n t m e n t s a n d s h o p p i n g . T h e a p p e l l a n t s a i d t h a h o u s i n g , i t h u r t s t o o m u c h t o s t a n d f o r l o n g , s o t h e T h e p a n e l f i n d s t h a t t h e t e s t i m o n y p r o v i d e d b y t h e a 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 t h e r e c r e i t e r a t e s t h e i n f o r m a t i o n i n h i s S R a n d d e s c r i b e s t h D L A s . T h e p a n e l t h e r e f o r e a d m i t s t h e a p p e l l a n t ' s t 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 . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )n d s , b u t d i d n o t n e e d a s s i s t i v e d e v i c e s o r a n t a r y . e s " i n a n s w e r t o t h e q u e s t i o n w h e t h e r i n h i s e a c t i v i t i e s a s a r e s u l t o f h i s r e s t r i c t i o n s . I n a p p e l l a n t " n e e d s d a i l y a s s i s t a n c e w i t h m o s t r i n g t h a t t h e t r a n s i t i o n h o u s i n g s t a f f a s s i s t h i m s e l f , a n d t h a t t h e y ( o r a f r i e n d ) d r i v e h i m t o h i s t a l t h o u g h h e c a n c o o k m e a l s a t t h e t r a n s i t i o n s t a f f p r e p a r e m e a l s f o r h i m . p p e l l a n t a t t h e h e a r i n g i s i n s u p p o r t o f t h e o n s i d e r a t i o n . T h e t e s t i m o n y o f t h e a p p e l l a n t e e x t e n t o f t h e h e l p p r o v i d e d i n m a n a g i n g h i s e s t i m o n y 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
PART F -Reasons for Panel Decision The issue in this appeal is whether the ministry reasonably determined that the appellant is ineligible for PWD designation because he did not meet all the requirements in section 2 of the EAPWDA. Specifically, the ministry determined that the information provided did not establish that the appellant has a severe mental and/or physical impairment or demonstrate that his impairments in the opinion of a prescribed professional directly and significantly restricts his ability to perform daily living activities either continuously or periodically for extended periods, and, as a result of those restrictions he requires help to perform those activities. The following section of the EAPWDA applies to this appeal: 2 (1) In this section: "assistive device" means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "prescribed professional" has the prescribed meaning. (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i) directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B) periodically for extended periods, and (ii) as a result of those restrictions, the person requires help to perform those activities. (3) For the purposes of subsection (2), (a) a person who has a severe mental impairment includes a person with a mental disorder, and (b) a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, (ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. The following section of the EAPWDR applies to this appeal: 2 (1 )For the purposes of the Act and this regulation, "daily living activities", (a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities: (i) prepare own meals; (ii) manage personal finances; (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 imoairment, includes the followina activities: EAA T003( 10/06/01)
( i) make deci s i ons about p ersonal a ctivities, car e or fin (ii ) r e late t o, communi cate or inte ract with others eff Severity of physic a l an d me n t al impa irment Th e a p pella nt tol d the panel t hat he is in cons tant pain an Docu ment #2. He said that he has c h r o nic p a in for He said hi s pain is so sever e that he has t r o u b le g etting aft er noon. He also t ol d the pa n el that he s uffers from d take s medica tions . He said that his conditi o n i s d e teri th an when he was ta k ing dru gs ( wh ich he says he t the inform a ti o n p ro vid ed by his ph ysi ci an in t h e AR e m o ti o nal func tioning, his physici an ind icated that his the area s, that it h ad a mo de rate impact on 5 of t h e areas, an illu s tr at i n g t hat the majorit y of the areas of c ogniti ve ment al i m pairment. The appell ant al so pointed to t he p h ysicia n s t ated t hat h is impairme n ts are s evere and as w it h sev eral of h is DL As , as circ led o n t he que s tion naire In the reconsidera tion d eci sion , t he m inistry b ased it an d sh oul der pain was not a se vere ph y sica l impairment a ppel lan t's phys i c i an in the P R and AR . Th e min istry i n t he functi o n al s k i ll s sect ion of the P R: that the a ppel st airs unaide d, l ift 5 to 15 lb s and has n o limitations the AR, t h e a ppe l lan t's phy s ician in d i c a ted he ta ke s to neck and b ac k p a in, a nd re quire s c o nt inuo us a ssista ha s difficul t y li f ti ng a nd carr yin g h e avy o bjec t s . Th e m appe l lant 's abi lity to man age h is DLA i ndependentl y physica l i mpairment is not ev i d en ce d." The minist r y pr o v ide d eno u gh evidence to co nfirm th at the a p pell hearin g th e ministr y re pre senta tive said that alth oug indic ates that the appellant's im pairm ent i s s e vere, h for the change in the appel lant 's c o n dition or na rr a tive In the reconsidera tion decision, the ministry noted that a result of mental impairm ents, the appellant has significant deficits i and emotional functioning (emotional disturbance, mo at tention, memo ry, executive and consciousness). T indicated in the AR that the appella n t's mental impairment had a major impact in the areas of emotional disturbance, motivation, motor activity, and memory. "indicat e s that [the appellant's] im pairments hav e no impact, majority of [the appe l lan t's] cognitive an d em o tional fun was difficult to determine whether the appellant's mental impairments are severe as his physician had indicated he was independent or required periodic assistance with managing his social functioni The ministry also found that the limitations resulti ng ap pear to have translated int o s i gnificant restricti ons" i det ermin ed t h a t there was not e nou h ev id ence r o EMT 003(10/06/01) a nces ; ective ly. d t h at this is co n firmed b y his friend in whi ch he m us t ta k e 3 t ypes of medicati o n d a ily. out of b ed in the m or ning and na p s ev ery isabling anxiety and d epr ess i on, f or wh ich h e o ra ting an d h e feel s that h e is in worse sha pe oo k t o ea se h is pain). T h e a p pell ant pointed to t h at of the 14 li st ed areas of c ognitive and me ntal impairme n t had a m ajor imp act on 4 of d a m inima l imp a c t on 2 o f t he areas, and emo t i on a l fu nc tioni ng w e r e aff ect ed b y hi s informati on i n Doc u ment #1 in w h ich hi s a result he req u ir es cont inuo us assista nce by his phy sician . s determ in ation tha t the appell an t's chronic n eck on the i nf o rma ti o n provi ded b y t he no ted t he f ollowi ng r es p on ses of the physicia n lant i s a b l e to wa lk 2-4 blo c k s a nd c l i mb 5 + remain ing se ated . T he ministry al s o no ted that in significantly lo n g er to climb st airs and s tand du e nce with lifti ng, ca rrying an d holding, and he inis try determi ned t hat it appears from the or w ith per i odic assi stance "that a sev ere found th at th e appel lant 's ph ysicia n had no t ant has a sev ere physic al impairme n t. At the h t he appell an t's physic ian i n Docum ent # 1 e d o es n o t provide a n ex plan ation of the reason a bou t the s everity of the i m pai rm ent s. the appellant's physician had indi cated that as n sev eral areas o f hi s cogn itive t ivation, im pulse control, motor acti vity, he ministry also noted that the physician also The ministry stated that the physician minimal or moderate impact on the ctioning." Howev er, the ministry found that it ng. from the appellant's mental impa irments "do not n his a bility to manage his DLA. The ministry vided b t h e a el lant's h s i c ian to c onfirm a
se vere me ntal impai r m e nt . As stated above, at t h e although the appell an t ' s physician indicated a severe me the ph ys ician d id not provide any narrat ive about the severity or the e appell an t 's ab i l i ty to perform DLA. Analysi s and dec ision The legisl ation provides that the minist er may de signate th a t th e person h as a severe menta l or physi c a l imp pra c ti tioner is likely to c o ntinue f or at least 2 years (s physician confirmed in th e PR t ha t the appell an t has chronic addiction and major depressive d isorder w i th anxi e ty and wrote in the PR, "al severe ." In the PW D applicat io n form, t h e ministry h as pr ov i d is not set o ut in th e app l icable legislati o n, o ffers gu i an ap plicant's i mp a irment. T h e mi n i stry stat es, "impa ps y ch olo gical, anato m ical or phy s i ological st r u cture f unct i o n indep e ndent l y , effectively, appro priately or for a re se v e r ity o f an impa irm ent, the re i s bo th a cause t he t o wh ic h it rest ricts t h e abil ity to fu n c tion indepen d e ntly, d uration. The pan el notes t hat the l eg i s l ation provides t imp ai rment is a t the d iscretion o f the minis ter, ta king th e ap pe ll an t . Howe ver, t he start in g poin t mus t be the th e PW D ap plication completed i n July 2 0 13, togethe sign ed by th e app ell a nt's ph ysicia n on F e b ruary 11 , With res pect to t he seve r i t y of t h e appellant's physical conf ir m ed he ha s chronic pa i n syndr ome specificall y indicates it is al so in his knee in so me of his comments). r esults i n in ab i l i t y to do p h ysical wo r k due to co ntinuo app el la n t's phy sician indicated the appellan t coul d walk steps, lift 5-15 pounds, and has no limitations remaining seated. In the AR, the appellant's physician indicated that the appell ant could independently walk indoors a as sistance l iftin g an d car ryi n g a nd ho lding, writ ing "great difficu objects , " and indicated t hat he took significantly longer than typical climbing stairs and standing with the comment, "because of neck, back and knee pains, difficult due to pain." In D ocu ment #1 , t h e appellant's physician circled "yes" that the appellant has a severe physical impairment, an d wr o te the com ment, "p hysical aspects of ADLs are restricted continuously due to chronic pain." However, the panel notes that the physician did not provide any additional commentary indicating tha t the appellant's condition ha explanation for inconsistencies between the PWD application and Document #1. unclear why the DLA of personal care, which in th e longer with many tasks, which would reasonably be viewed as a continuous or ongoing restriction ( though not necess arily significant) is now identified Additionallv, it is unclear whv the aooellant, who was reoorted in the PWD aoolication as EMT 003( 10106101) hear i ng, the mini st ry representa tive sai d that ntal impa irm ent i s se vere i n Document #1, f fe ct of the i mpairment on the a person a s a PWD if the mini s ter is satis f i ed airment that in the o pi nion o f a med ic a l ubs. 2 (2)(a) of the EAPWDA). The appellant's pai n s yndro m e, alcohol is m, d rug l 4 condit ions are ed a definitio n of " impairment" wh ich, a lthoug h it dance in con s iderin g t he e xist e nce and severity o f irment " i s a "loss or abno rm ality of or funct i o ning c a u sing a res trictio n i n the ability to aso n able d u r ation. " To dete rmine t he impairme nt itself -and an effect t he degree e f fe c tively, a ppr opriately or f o r a re as onable ha t the dete rm in atio n of th e s everit y of th e in t o a ccount all of the eviden ce , i ncluding t hat of med i cal evide nce the informa t i on s et o ut in r w i t h th e ad di t ional in formation in Docu ment #1 2014. impai r ment, the a ppel lant's phy sici an ha s in h is neck and should er (alth ou gh th e p hys ician The physici an wrot e in the PR that the pain us neck pai n to his sho uld e r s. In the PR , t h e 2-4 bl o ck s unaided on a flat su rface, clim b 5+ nd outdoors, r e q u i red continuous l t y with lifting and carrying of heavy d de terio rated or offering any other Specifically, it is PWD applic ation is noted as taking signi fica ntly as n ot be i ng continuously restricted.
independently managing the DLA of meals without any noted restriction, is no longer able to do so. Furthermore, while the physician's information respecting DLA in the AR provides details respecting listed aspects or tasks within each DLA in the form of both check marks and accompanying narrative for each aspect within a DLA noted to have some restriction, the information provided in Document #1 does not explain how the physical aspects of the appellant's DLA are restricted by his chronic pain. The panel also notes that the physician did not alter the answers to the functional skills assessment. Accord ingly, the panel has placed greater reliance on the detailed information respecting the appellant's physical functional skills and physical ability together with the assessment respecting the impact of the appellant's physical impairment on DLA provided by the appellant's physician in the PR and AR. The panel finds that the ministry's determination that the information provided that the appellant independently mobilizes, though climbing stairs takes longer and assistance is required for heavier lifting, and manages DLA with periodic assistance for some tasks, does not establish a severe physical impairment from chronic pain is reasonable. With respect to the severity of the appellant's mental impairment, the physician confirmed in the PR that the appellant has alcoholism, drug addiction and major depressive disorder with anxiety, writing that the conditions are severe. The physician commented that the appellant's substance abuse results in inability to seek or maintain employment and that his depression/anxiety cause multiple symptoms that result in inability to leave home at times. The appellant's physician indicated in the PR that the appellant had difficulty communicating because of anxiety and stress. He also indicated that there are significant deficits with cognitive and emotional functioning in several areas (consciousness, executive, memory, emotional disturbance, motivation, impulse control, motor activity and attention or sustained concentration). In the PR, the physician wrote, "poor concentration, easily confused, difficulty planning, poor memory, depressed mood and associated poor motivation, poor impulse control, gets fidgety and "twitchy"." In the AR, the physician indicated the appellant's ability to communicate through reading and writing was poor, writing, "impaired due to poor concentration" and his hearing was poor, "due to noise exposure." The physician indicated that the appellant's mental impairment had a major impact in 4 areas of cognitive and emotional functioning, a moderate impact in 5 areas, and a minimal impact in 2 areas. The physician wrote, "significantly impaired, as above, due to depression, chronic pain and substance abuse." However, in the section of the AR describing the restrictions on DLA, the appellant's physician indicated he was independent in all of the tasks of the DLA of paying rent and bills and medications -areas where one would expect to see a restriction as a result of a mental impairment. Additionally, in the AR the appellant's ability to manage the listed aspects of social functioning are reported as either independent or requiring periodic -not continuous -support. In Document #1, the appellant's physician has circled "yes" the appellant has a severe mental impa irment and has written, "mental health issues restrict the other DLAs." However, the physician has not provided any narrative about how the appellant's mental health issues restrict his ability to perform DLA and how this has changed since the original PWD application. Accord ingly, given the information provided by the appellant's physician in the PR and AR as well as a lack of additional detail in Document #1, the panel finds that the ministry's determination that the information provided does not establish a severe mental impairment is reasonable EAAT003(10/06/01)
Direct and significant restrictions in the ability to perform DLA. The appellant told the panel that because of his impairments, he is incapable of performing any of his DLA and he also points to the information provided by his physician in Document #1 and his friend in Document #2 (both of whom write that the appellant requires assistance described as daily in Document #2 with several of his DLA -his physician circled all of the listed DLA except daily shopping and personal self care, the friend circled all of the listed DLA except personal self care). The appellant described how he receives assistance from the staff of the transition housing with preparing meals, getting to the bathroom, going to and from stores and appointments. He told the panel that he cannot concentrate and his memory is poor and that he suffers from anxiety and depression to the point where he does not like to socialize, spends a lot of time in his room, and found it very difficult to attend the hearing. In the reconsideration decision, the ministry determined that based on the inf o rmation provided by the appellant and his physician, there was not enough evidence to establish that the appellant's impairment directly and significantly restricts his DLA either continuously or periodically for extended periods. The ministry referred to the fact that the physician in the AR indicated that the appellant could independently or with periodic assistance manage 28 out of the 28 assessed areas of his DLA. The ministry wrote that the appellant's physician indicated that he takes significantly longer to complete some of the tasks of personal care (dressing, grooming, bathing, toileting, transfers in/out of bed and on/off a chair) due to back and knee pain and low motivation, but that the physician did not report how much longer it took the appellant to complete these tasks. The ministry noted that although the physician had written that he is "significantly disabled by the disabilities mentioned above" the physician's assessment of the appellant's ability to manage his DLA "does not establish that [his] impairments significantly restrict [DLA] continuously or periodically for extended periods. Analysis and decision Subse ction 2(2)(b) of the EAPWDA requires that a prescribed professional confirm that the appellant's impairments directly and significantly restrict his ability to perform his DLA continuously or periodically for extended periods. The panel notes that although a prescribed professional may indicate that, because of a restriction, an individual requires assistance either continuously or periodically for extended periods, this does not necessarily meet the legislative test that requires the ability to perform DLA to be directly and significantly restricted by the impairments. The DLA to be considered for a person with a mental impairment are, as set out in subs. 2(1) of the EAPWDR, as follows: • Prepare own meals; • Manage personal finances; • Shop for personal needs; • Use public or personal transportation facilities; • Perform housework; • Move about indoors and outdoors; • Perform personal hygiene and self care; • Manage personal medication; • Make decisions about personal activities, care or finances; and • Relate to, communicate or interact with others effective! EMT 003(10/06/01)
T h e a p p e l l a n t a t t h e h e a r i n g s e t o u t a p i c t u r e o f a t y h e a l t h i s s u e s a n d c h r o n i c p a i n i m p a c t s h i s a b i l i t y t o r e q u i r e s t h a t 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 o t h e r w o o p i n i o n t h a 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 d i r e c t l y a n d 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 p e r i m u s t s i m p l y a c c e p t a p r e s c r i b e d p r o f e s s i o n a l ' s s t a t r e s t r i c t e d , a s t o d o s o w o u l d f e t t e r t h e m i n i s t r y ' s d i s i n c l u d i n g t h a t 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 , s h o u l d b 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 a u t h o r i t y . T h e p a n e l n o t e s t h a t , i n t h e A R , t h e a p p e l l a n t ' s p h y e a c h D L A w h e r e h e 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 c o u l i s t e d t a s k s , t h e a p p e l l a n t ' s p h y s i c i a n i n t h e A R i n d i i n d e p e n d e n t l y ( a l l o f t h e t a s k s l i s t e d f o r t h e D L A s o f o f t h e 8 t a s k s l i s t e d u n d e r t h e D L A o f p e r s o n a l c a r e 2 o f t h e 3 l i s t e d t a s k s u n d e r t h e D L A o f t r a n s p o r t a t i o a p p e l l a n t t o o k s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l t o p e r s p e c i f i c a l l y , d r e s s i n g , g r o o m i n g , b a t h i n g a n d t o i l e t i n d u e t o ( l o w ] m o t i v a t i o n d i f f i c u l t y r e a c h i n g h i s f e e t " ) a c h a i r ( c o m m e n t i n g " d u e t o b a c k a n d k n e e p a i n " ) . T p e r i o d i c a s s i s t a n c e w i t h t h e t a s k o f c a r r y i n g p u r c h a s " u s u a l l y g e t s a r i d e . " F o r t h e t a s k o f g e t t i n g i n a n d o 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 k n e e p a i n s . " T h e p a n e l n o t e s t h a t t h e i n f o r m a t i o n p r e i t h e r r e f e r e n c e s t h e a p p e l l a n t ' s k n e e a n d b a c k p a i F o r t h e D L A s p e c i f i c a l l y r e l a t e d t o p e r s o n s w i t h a m b y t h e p h y s i c i a n i n t h e A R t o i n d i c a t e t h a t t h e a p p e l s i g n i f i c a n t i m p a c t o n h i s p e r f o r m a n c e o f t h e D L A o f o r f i n a n c e s ( t h e p h y s i c i a n i n d i c a t e d h e w a s i n d e p e n f i n a n c e s p a y i n g r e n t a n d b i l l s a n d m e d i c a t i o n s ) . p e r s o n a l c a r e , t h e p h y s i c i a n ' s c o m m e n t s r e l a t e p r i m t h e o n e c o m m e n t " d u e t o l o w m o t i v a t i o n " . F o r t h e D w i t h o t h e r s e f f e c t i v e l y , 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 o r s u p e r v i s i o n i n t h e a r e a s o f a p p r o p r i a t e s o c i a l d e c a n d m a i n t a i n r e l a t i o n s h i p s ( " d i f f i c u l t y w i t h t h i s " ) a n d d e m a n d s ( " n e e d s h e l p f r o m f r i e n d s ) . T h e p h y s i c i a n a s p e c t s o f i n t e r a c t i n g a p p r o p r i a t e l y w i t h o t h e r s a n d p h y s i c i a n i n d i c a t e d t h e a p p e l l a n t h a d m a r g i n a l f u n c t n e t w o r k s , w r i t i n g t h e c o m m e n t , " i n t e r m i t t e n t d i s c o r d d i d n o t p r o v i d e a n y f u r t h e r c o m m e n t a r y i n t h e A R . I n D o c u m e n t # 1 , t h e a p p e l l a n t ' s p h y s i c i a n ' s m o s t r e t h e p h y s i c i a n d o e s n o t p r o v i d e a n y a d d i t i o n a l n a r r a t i m p a i r m e n t s c o n t i n u o u s l y r e s t r i c t h i s a b i l i t y t o p e r f o r t h e p a n e l h i s t v o i c a l d a y i n t h e t r a n s i t i o n h o u s i n q w h E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )p i c a l d a y a n d t h e d e g r e e t o w h i c h h i s m e n t a l p e r f o r m h i s D L A . H o w e v e r , t h e l e g i s l a t i o n r d s , t h e a p p e l l a n t ' s p h y s i c i a n p r o v i d e a n 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 p e r f o r m D L A o d s . T h a t i s n o t t o s a y , h o w e v e r , t h a t t h e m i n i s t r y e m e n t t h a t D L A a r e d i r e c t l y a n d s i g n i f i c a n t l y c r e t i o n a s a d e c i s i o n m a k e r . A l l e v i d e n c e , e w e i g h e d a n d a s s e s s e d b y t h e m i n i s t r y w h e n s i c i a n p r o v i d e d c o m m e n t s b e s i d e e a c h t a s k o f l d n o t p e r f o r m t h e t a s k i n d e p e n d e n t l y o f t h e 2 8 c a t e d t h a t t h e a p p e l l a n t c o u l d p e r f o r m 1 8 o f t h e m 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 m e d i c a t i o n s , 2 , 4 o f t h e 5 t a s k s u n d e r t h e D L A o f s h o p p i n g , a n d n ) . I n t h e A R , t h e p h y s i c i a n w r o t e t h a t t h e f o r m 6 o f t h e 8 t a s k s o f p e r s o n a l c a r e g ( c o m m e n t i n g " d u e t o b a c k a n d k n e e p a i n a l s o n d 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 h e p h y s i c i a n i n d i c a t e d t h e a p p e l l a n t r e q u i r e d e s h o m e u n d e r t h e D L A o f s h o p p i n g , w r i t i n g , u t o f a v e h i c l e u n d e r t h e D LA o f t r a n s p o r t a t i o n , t t a k e s s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l " d u e t o o v i d e d b y t h e a p p e l l a n t ' s p h y s i c i a n i n t h e A R n , o r i n d i c a t e s h e r e c e i v e s a r i d e . e n t a l i m p a i r m e n t , 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 l a n t ' s m e n t a l i m p a i r m e n t h a s a d i r e c t a n d m a k i n g d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e d e n t i n a l l t a s k s o f m a n a g i n g h i s p e r s o n a l I n a d d i t i o n , f o r t h e t a s k s r e l a t e d t o t h e D L A o f a r i l y t o t h e a p p e l l a n t ' s b a c k a n d k n e e p a i n , w i t h LA o f r e l a t i n g t o , c o m m u n i c a t i n g o r i n t e r a c t i n g c a t e d i n t h e A R t h a t h e r e q u i r e d p e r i o d i c s u p p o r t i s i o n s ( " u s e s d r u g s / a l c o h o l r e p e a t e d l y " ) , d e v e l o p a b i l i t y t o d e a l 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 i n d i c a t e d t h e a p p e l l a n t w a s i n d e p e n d e n t i n t h e a b l e t o s e c u r e a s s i s t a n c e f r o m o t h e r s . T h e i o n i n g w i t h h i s i m m e d i a t e a n d e x t e n d e d s o c i a l w i t h f a m i l y r e l a t e d t o d r u g u s e . " T h e p h y s i c i a n c e n t a s s e s s m e n t p r e p a r e d o n F e b r u a r y 1 1 , 2 0 1 4 , i v e o r c o m m e n t a r y t o s u p p o r t t h a t t h e a p p e l l a n t ' s m t h e c i r c l e d D L A s . T h e a p p e l l a n t d e s c r i b e d t o e r e h e r e c e i v e s a s s i s t a n c e , b u t t h i s i s n o t
reflected in the information provided by the appellant's prescribed professional, that is, the physician does not describe the appellant's restrictions in the course of a typical day. The panel finds reasonable the ministry's assessment that the information provided by the appellant's physician -the prescribed professional -does not demonstrate that the appellant's impairments directly and significantly restrict his ability to perform DLA. Without such information, and based on the evidence provided by the appellant's physician in the PR and AR and the lack of detail provided by the physician in Document #1, the panel finds that the ministry's determination that the information provided does not establish that his impairment significantly restricts his DLA continuously or periodically for extended periods is reasonable. Help with DLA The appellant told the panel that he receives help from the staff of the transition housing to perform some of the tasks of the DLAs of personal care (for example, getting to the bathroom), meal preparation, and transportation (for example, the staff or a friend drive him to stores). The appellant's physician and friend in Documents #1 and #2 also state that the appellant requires assistance to perform his DLA. In its reconsideration, the ministry noted that as it "had not been established that [DLA] are significantly restricted ... it cannot be determined that significant help is required from other persons. No other assistive devices are required." The EAPWDA requires in subs. 2(b)(iii) that in the opinion of a prescribed professional, as a result of the appellant's restrictions, the appellant requires help to perform DLA. The panel notes the evidence before the ministry at the reconsideration as set out by the appellant's physician in the AR was that the appellant needs continuous assistance with lifting, carrying and holding, but in the more specific section of the AR, he indicated the appellant required periodic assistance carrying purchases home ("usually gets a ride") and laundry and basic housekeeping ("helped by a friend"). The physician has also check marked in the AR that the appellant received help for DLA from his family and friends, but does not provide any commentary. Although the appellant's physician has circled that the appellant's ability to perform the DLAs of meal preparation, management of medications, basic housework, mobility inside the home, mobility outside the home, use of transportation, management of finances and social functioning is continuously restricted by his impairment, the narrative provided does not elaborate on the assistance, only commenting that, "physical aspects of AOL's are restricted continuously, due to chronic pain. Mental health issues restrict the other AOL's." No assistive devices are used. The panel finds that the ministry's determination that because it has not been established that DLA are directly and significantly restricted, it cannot be determined that help is required as provided under section 2(2)(b)(ii) of the EAPWDA, is reasonable. Conclusion Having reviewed and considered all of the evidence and the relevant legislation, the panel finds that the ministry's decision that the appellant was not eligible for PWD designation is reasonably suooorted by the evidence. The panel therefore confirms the ministry's decision. EAAT 003( 10/06/01)
You are being directed to the most recent version of the statute which may not be the version considered at the time of the judgment.