I APPEAL# PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (the "ministry") reconsideration decision of December 20, 2013, which found that the appellant did not meet four of five statutory requirements of section 2 of the Employment and Assistance for Persons With Disabilities Act ("EAPWDA") for designation as a person with disabilities ("PWD"). The ministry found that the appellant met the age requirement. However, the ministry was not satisfied that: • in the opinion of a medical practitioner, the appellant's impairment is likely to continue for at least 2 years; • the evidence establishes that the appellant has a severe physical or mental impairment; • the appellant's daily living activities ("DLA") are, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods; and that • as a result of those restrictions, the appellant requires the significant help or supervision of another person, an _assistive device, or the services of an assistance animal. PART D -Refovant Legislation Employment and Assistance for Persons with Disabilities Act ("EAPWDA"), section 2 Employment and Assistance for Persons with Disabilities Regulation ("EAPWDR"), section 2 EAAT 003( 10/06/01)
PART E Summary of Facts The inf o rm ation before the ministry at t he t ime of reco • The appel lant's PWD application form consisting o 2013], a physician's report (" PR") s ig n e d by the of 13 years {dated Ju l y 15, 20 13}, and an assessor's report ("AR") therapist ("OT") w ho h a d known the appe llant was completed {dated July 4, 20 13}. • A progre ss note from th e OT dated Ju ly 17, 2013. • A letter fr om the appella nt's clinical neuropsy • An assessment of the appel lant by the CN P d • A l e tter from the OT dated Novembe r 26, 2013 Admissi bilit y o f N ew Inf ormat ion At t he app eal hear i ng t he appe ll ant , t h roug h his a dvoca con s iderati o n by the panel : 1. A print out of an e -mail from t he appe l lan t ' s GP, dated 2. A lett e r f rom the C N P dated January 2 3, 201 3 . A rep o rt fr om t he OT see king to update the informa Th e minis t ry w a s invited to ma k e s u bm issi o ns of the took th e posit ion that the abo ve noted doc ume nt s prov ministry at th e tim e of recon s iderati o n . . Th e pa n el ac cept ed d o cument 1 as pr ovidi n g clarification of ex pected duration of the appe ll ant's impairment. Document 2 pr statement made by the CNP which had been before a ssessment of the appellant's current limitations. The panel admitted all 3 documents as inf i n support of information and r ec ords th at were before the ministry at th acco r d an c e with section 22(4) of the Employm ent and Assista In oral testimony the appellant provided new information provides addit ional detail with respect to issues addre Accordingly, the panel has admitted this ne w information as bein record s that were before the ministry at the time of reconsideration, in accordanc Employment and Assistance Act. The min istry relied on its recons ideration decision and submitt · . EAAT003(10/06/01 I I APPEAi .,, nside r a ti on i n cluded the foll owing: f t he a pp ell ant's self-repor t [dated May 30, appellant's general medical practitioner (" GP ") signed by a n o ccupational for app r oximatel y 1 month at the t im e t he AR chologist ("CNP " ) dated Ju ly 23, 2013. ated No vember 21, 2013. . t e, submitte d the f o ll o wi ng d o cuments for Janu a ry 27, 20 14. 4. t ion s he h a d p rovided in t he AR. adm issi bility of these d oc uments. Th e minis tr y i de n ew i nformation tha t was not b e f ore the the GP' s opinion with r espe ct to the ovides c l arification of a previous the ministry , and document 3 updates the OT's o rmation e time of reconsideration in n c e Act. regarding his impairment. This inf o rm at ion ssed in t he o rigina l P WD ap plication. g in supp ort of i n f o rmati o n a nd e with s. 22(4) of the ed no n ew i nf o rmat i o n .
APPEAL# I Duration of Impairment • In the PR the GP responded "No" to the question "Is the impairment likely to continue for two years or more from today?" He then commented "unknown". • In his e-mail of January 27, 2014 the GP wrote "Regarding [the appellant's] aneurysm of March 2013, it is disappointing that he has not recovered as expected ... it is clear that he is currently unemployable and is unlikely to make many further gains. " Physical Impairment • In the PR the GP diagnosed the appellant with "subarachnoid bleed from ruptured cerebral aneurysm." He commented "successful surgery and BP control". • In terms of functional skills, the GP indicated the appellant can walk 4+ blocks unaided on a flat surface, climb 5+ stairs unaided, and has no limitations with respect to lifting or remaining seated. • In the AR the OT noted the appellant independently manages walking indoors and outdoors, climbing stairs, and standing. She noted he needs periodic assistance lifting/carrying/holding noting "weights he can carry are limited before he experiences symptoms" of blurred vision, headaches, and a tingling/numbness in his scalp, and that "his questionable insight has caused him to overdo it several times to date." • In his SR, the appellant wrote that if he over exerts he experiences headaches, blurry vision, tingling in the skull, pressure in his eyes and skull, and light headedness. He noted that because of his brain injury he was not able to work or to drive. • In the July 17, 2013 progress note the OT described the appellant as experiencing increased blood pressure and feeling generally unwell after minimal exertion. • In his e�mail of January 27, 2014 the GP wrote "Physically, [the appellant] is doing well." • In her letter of November 26, 2013 the OT noted that the appellant is currently using weights of up to 30 pounds for upper body exercises, but stated that his physical performance in rehab " . . .i s in no way comparable to the level of exertion required to resume work." • In his oral testimony, the appellant said that he used to walk for up to an hour a day, but that lately he is not active at all. Mental Impairment • In the PR the GP made no diagnosis of a mental impairment, but noted that the appellant repeatedly reported "forgetfulness, poor concentration". The GP also noted "ongoing subtle cognitive impairment". • The GP indicated the appellant has no difficulties with communication, but reported significant deficits with cognitive and emotional function in the areas of consciousness, executive, memory, and attention/sustained concentration. • In the AR the OT noted the appellant has impaired short term memory, that he experiences overstimulation and has difficulty planning and problem solving. She noted that his ability to communicate is good or satisfactory in all respects. • The OT reported the appellant as experiencing moderate impacts in 7 of 14 categories of cognitive and emotional functioning and minimal or no impacts in the remaining categories. She commented that the appellant reports significant sleep disturbance. She observed him to have anxiety related to his injury, and "slowed speed of processing, moderately to severely impaired verbal learning and perseveration." • The OT noted "fThe appellant] is experiencinq coqnitive chanqes ... that impact his day to day E AAT 003( 10/06/01)
APPEAL# I function .. . he would not currently be in a position to return to work given the nature of his work and the need to manage his small business. Anxiety and overstimulation are significant, particularly when [the appellant]faces a more complex task." • In his SR the appellant noted symptoms of forgetfulness, confusion, and difficulty sleeping. He noted that he'd missed his medication "a few times", and that he'd forgotten about a small claims conference date. • In her letter of November 26, 2013 the OT wrote that "It would be foolhardy for [the appellant] to attempt to manage the details of his previous work/business at this time given the nature and significance of his deficits. " • In his e-mail of January 27, 2014 the GP wrote that "[The appellant] gets easily overwhelmed with even slightly stressful situations, and often becomes quite non functional. .. at these points he requires periodic assistance to redirect negative thoughts, to help him focus, etc. . . . These events occur at least once or twice a week, but are somewhat unpredictable. This is likely to persist into the future." • In his assessment of November 21, 2013 the CNP noted the appellant appeared "well motivated . . . alert and oriented to person, place and time. Simple attention was normal.. .V isual learning and memory were severely impaired . . . Basic problem solving and reasoning were within normal limits. More complex problem solving/reasoning was moderately impaired .. . " • In her report of January 23, 2014, the OT indicated that the impacts the appellant experiences in virtually every area of cognitive and emotional function had worsened since July 2013 when she completed the AR. She reported he experiences major or moderate to major impacts in 8 categories of cognitive and emotional function. • In response to questions from the panel, the appellant said that a) He believes the OT's January 23, 2014 report is a more accurate reflection of his condition. He said that his ability to manage his medications is "a little bit better now" since his medications come in a blister pack and it is easier for him to keep track. Otherwise, he said he would "have no idea. " b) He does his own cooking and doesn't get any help with meal planning. He said that he was getting weekly assistance from a dietician regarding his diabetes but that he hasn't seen her in about a month. c) He does his own shopping. He used to walk to the stores but now he's driving his own vehicle again. d) He pays his rent and manages his bank account. About 3 months ago he made a mistake and bounced a cheque. DLA • In the PR the GP indicated the appellant is not restricted in his ability to perform the DLA of personal self-care, meal preparation, basic housework, daily shopping, moving about indoors or outdoors, and use of transporlation. He indicated the appellant requires periodic assistance with management of medications, and continuous assistance with management of finances. He explained "periodic" as meaning "periodic forgetfulness", and commented "lifelong difficulty management of$". With respect to social functioning, the GP wrote "worse social function since brain surgery." • In the AR the OT reported the appellant independently manages all aspects of the DLA of personal self-care, basic housekeeping, meal preparation, and management of medications (commenting "has missed occasionally"). • With respect to daily shopping the OT noted the appellant requires periodic assistance going to and from the stores because he wasn't currently driving, but that otherwise he managed independently though taking longer than typical with some aspects. • With_respect to use of tran§pgrlation tile OT noted the_a ellant is inde endent but there is no EAAT 003(10/06/01)
public tr ansportation availa b le in hi s co mmun • T he O T indicated t he appellant requires periodic a (pay rent and bills), noting tha t "t akes longe r of s mall b usiness are mo re than he c a n hand • Regardi ng social functioning, th e OT noted the app for needing period s upport to d e al appropriat as bein g good fu nctionin g with hi s imme d iate soci ex te nded social networ k s. • In her lett er of Novem ber 26, 2013 the O T wrote that and able t o c omplete his self-care task s, he team of clinicians involve d in his rehab i litation in order to make mo and manage his aff ai rs. " • In his let ter o f Jul y 23, 20 13 t he CNP not e d "it was recomm in his home to assist.. . w ith day -to-day management. . pa tie n t have a s sistance , gu i dance , and s upervis fina nces, more complex de cisi ons, et c. " • In h i s a ssessment of November 21 , 201 3 the CN i n dep enden tly and d o e s n ot ha ve a ny s upports • I n his letter of Janua ry 2 3, 2014 t he CN P e x plai appellan t's indepe n d ence cam e fr o m th e clinica neur o p s ycho log ical e v alu a tio n, it b e came s t rik neuro p s ycho log ical dys func t ion a rgues fo r the pat th at w i ll be cha l lenging due to c ogniti ve and em injury ... W hile h e liv e s on his ow n , he is defi nite undou bt ed ly fac ilita te his abi l ity t o have a higher qualit de terioration. " • I n he r r e port of Ja nuary 23, 2014 the OT indi DLA is wo rse than h ad p r ev i o usly been report f i nan ces, ma na gemen t of m edica tions , a n d social functi p r e paration, t he OT i n d ica ted th at the appellant diabetic diet since he does not have the motivation to do so. p er s onal fin ances, t he OT wro t e th at the appe out , and t h a t he has made mistakes with rent and bill paym mana ge financial concern s is a daily issue and team and "other professionals". Regarding manageme ap pellant req uires perio dic to continuous ass reported the appellant requires periodic to continuous support in all aspects. Help • In response to a questio n in th e PR regarding the assist comment ed "needs help with for m completion" and "needs help with follow up with [illegible] work. " He noted the appellant requires no pros • In the AR the OT commented that "Guidance is required fo ensure proper completion and to [decrease] anxiety." She reported by friends, health authority professionals, and volunteers (driving). uses no assist i ve devices and does not have an assistance animal. EAA T003( 10/06/01) [ ��PEAL# ity and tha t h e has dif ficulty usin g the schedule. ssi st ance wi t h manage pers onal finances tha n previous ly . . . g uid ance i s needed ... financ es l e. " e llant is independe nt in all res p e cts except ely with unexpected demands. She reporte d h im al n etw ork and margin a l func t i oning with " Th ough [the ap pellant] i s ambulatory requires r e gular assistance and g uidance fr o m the r e complex decisio n (s i c) ended [the app ellant] have supp ort . I t was clearly recomm ended tha t the i o n, if he was to pa r ti cipa te in t ask s inv olving P ind ica te d '' The a ppe lla n t i s now a b le to live in the h ome. " ne d that the abov e-no ted st atement abou t the l inter view , but th at ". . . a fter t h e ing ly e vi de nt th at t h e nature and seve r ity of ient t o have s uppor t s .. . with m a naging [DL A] ot ional issues stemm ing from his br ain ly c o mpromised, and incr eased support wi l l y of life, and as well, r educ e t he r isk of ca t ed t hat the ap pell ant's abilit y to manage four ed -meal preparati on, ma nag ement of persona l o n ing. W ith respe c t to mea l n ow nee d s p eriodic a ssista nce to pla n for a Regarding manag eme nt of ll a n t has significant financial issues to be sorted e nts. She noted his abi lity to that he ne eds co nt i nuous help from his rehab nt of me dica tions , she indicated the istance . Regardin g social func tioning, the O T ance n eeded by the appellant, the GP t heses o r ai ds fo r h is impair ment. r mo re comp l ex [DLA] in order to t hat assistan ce is pro vided She indicated the appellant
APPEAL# I PART F -Reasons for Panel Decision The issue on this appeal is whether the ministry's decision to deny the appellant designation as a PWD was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. In particular, was the ministry reasonable in determining that • in the opinion of a medical practitioner, the appellant's impairment is not likely to continue for at least 2 years; • the evidence does not establish that the appellant has a severe physical or mental impairment; • the appellant's DLA are not, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods; and that • as a result of those restrictions, the appellant does not require the significant help or supervision of another person, an assistive device, or the services of an assistance animal? The relevant legislation is as follows: EAPWDA: 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 reaulres help in relation to a dailv livina activitv if, in order to ·, · · -. --. EAA T003( 10/06/01)
I APPEAL# I 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. EAPWDR section 2(1): 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 impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (Ii) relate to, communicate or interact with others effectively. (2) For the purposes of the Act, "prescribed professional" means a person who is (a) authorized under an enactment to practise the profession of (i) medical practitioner, (ii) registered psychologist, (iii) registered nurse or registered psychiatric nurse, (iv) occupational therapist, (v) physical therapist, (vi) social worker, (vii) chiropractor, or (viii) nurse practitioner, or (b) acting in the course of the person's employment as a school psychologist by (i) an authority, as that term is defined in section 1 (1) of the Independent School Act, or (ii) a board or a francophone education authority, as those terms are defined in section 1 / 1) of the School Act, EAAT 003(10/06/01)
i f q u a l i f i c a t i o n s i n p s y c h o l o g y a r e a c o n d D u r a t i o n o f I m p a i r m e n t T h e a p p e l l a n t ' s p o s i t i o n i s t h a t s i n c e t h e G P c o m m P R , h i s " N o " r e s p o n s e s h o u l d b e i n t e r p r e t e d a s a " m a k e s i t c l e a r t h e i m p a i r m e n t i s l i k e l y p e r m a n e n t . 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 i n t h e i n f o r m a t i o n b e G P c l e a r l y i n d i c a t e d t h a t i n h i s o p i n i o n t h e a p p e l l a n r e q u i s i t e 2 y e a r s . P a n e l D e c i s i o n I n t h e p a n e l ' s v i e w , w i t h h i s c o m m e n t " u n k n o w n " , t i m p a i r m e n t w a s n ' t l i k e l y t o c o n t i n u e f o r 2 y e a r s , i t w l o n g e r . H i s e m a i l o f J a n u a r y 2 7 , 2 0 1 4 m a k e s i t c l e r e c o v e r y a n d t h a t i n h i s o p i n i o n t h e i m p a i r m e n t i s l i a p p e l l a n t i s n o t l i k e l y t o m a k e m a n y f u r t h e r g a i n s . t h e o p i n i o n t h a t t h e 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 t h e m i n i s t r y d i d n o t h a v e t h e b e n e f i t o f t h i s i n f o r m a c o n s i d e r e d a s a w h o l e , t h e e v i d e n c e d o e s n o t r e a s c r i t e r i o n . S e v e r e P h y s i c a l I m p a i r m e n t T h e a p p e l l a n t ' s p o s i t i o n i s t h a t t h e o v e r s t i m u l a t i o n h a c t i v i t y d e m o n s t r a t e s a s e v e r e p h y s i c a l i m p a i r m e n t t o h i s l i g h t h e a d e d n e s s a n d t h e n e e d t o l i e d o w n a f t T h e m i n i s t r y ' s p o s i t i o n , a s s e t o u t i n i t s r e c o n s i d e r a s k i l l s d o n o t d e m o n s t r a t e a s e v e r e p h y s i c a l i m p a i r m 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 n a b i l i t y t o f u n c t i o n i n d e p e n d e n t l y o r e f f e c t i v e l y . T o a s s e s s t h e s e v e r i t y o f a n i m p a i r m e n t o n e m u s t c e x t e n t o f i t s i m p a c t o n d a i l y f u n c t i o n i n g a s e v i d e n c e w h i c h p e r f o r m i n g D L A i s r e s t r i c t e d . T h e l e g i s l a t i o n a t t h e d i s c r e t i o n o f t h e m i n i s t e r . I n m a k i n g i t s d e t e r c o n s i d e r a l l t h e r e l e v a n t e v i d e n c e , i n c l u d i n g t h a t o f c l e a r t h a t t h e f u n d a m e n t a l b a s i s f o r t h e a n a l y s i s i s t E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # . i t i o n o f s u c h e m p l o y m e n t . * * * * * * * e n t e d " u n k n o w n " w i t h r e s p e c t t o d u r a t i o n i n t h e m a y b e " . H e a r g u e d t h a t t h e n e w i n f o r m a t i o n 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 c o n s i d e r a t i o n t h e t ' s i m p a i r m e n t w a s n o t l i k e l y t o c o n t i n u e t h e h e G P w a s i n d i c a t i n g t h a t w h i l e i n h i s o p i n i o n t h e a s n o t i m p r o b a b l e t h a t i t c o u l d c o n t i n u e f o r a r t h a t t h e G P i s d i s a p p o i n t e d w i t h t h e a p p e l l a n t ' s k e l y t o p e r s i s t i n t o t h e f u t u r e , a n d t h a t t h e T h i s i n d i c a t e s t o t h e p a n e l t h a t t h e G P i s n o w o f f o r a t l e a s t 2 y e a r s . T h e p a n e l a c k n o w l e d g e s t h a t t i o n a t t h e t i m e o f r e c o n s i d e r a t i o n . H o w e v e r , w h e n o n a b l y s u p p o r t t h e m i n i s t r y ' s f i n d i n g o n t h i s e e x p e r i e n c e s w h e n h e e n g a g e s i n p h y s i c a l . H e e m p h a s i z e d t h e O T ' s e v i d e n c e w i t h r e s p e c t e r m i n i m a l e x e r t i o n . t i o n d e c i s i o n , i s t h a t t h e a p p e l l a n t ' s f u n c t i o n a l e n 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 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 m a k e s i t c l e a r t h a t t h e 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 m i n a t i o n t h e m i n i s t r y m u s t a c t r e a s o n a b l y a n d t h e a p p e l l a n t . 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 h e e v i d e n c e f r o m a o r e s c r i b e d o r o f e s s i o n a l .
I n t h e p a n e l ' s v i e w , t h e e v i d e n c e r e g a r d i n g t h e a p p a p p e l l a n t i s a t t h e h i g h e r e n d o f f u n c t i o n a l a b i l i t y , w l i f t i n g c a p a c i t y i n t h e r a n g e o f 3 0 p o u n d s . D e s p i t e a n d h i g h b l o o d p r e s s u r e i n h e r p r o g r e s s n o t e o f J u a p p e l l a n t ' s b l o o d p r e s s u r e i s c o n t r o l l e d . T h e p a n e e m a i l t h a t " P h y s i c a l l y , [ t h e a p p e l l a n t ] i s d o i n g w e l l p r o f e s s i o n a l c o m m e n t a r y r e g a r d i n g t h e a p p e l l a n t ' s t o h i s p r e v i o u s e m p l o y m e n t . A s r e f e r e n c e d a b o v e , P W D d e s i g n a t i o n t h e f o c u s o f t h e l e g i s l a t i o n i s o A s d i s c u s s e d i n m o r e d e t a i l i n t h e s u b s e q u e n t s e c t R e s t r i c t i o n s t o D L A , t h e a p p e l l a n t ' s p h y s i c a l c o n d i s i g n i f i c a n t r e s t r i c t i o n s i n h i s a b i l i t y t o m a n a g e h i s D A c c o r d i n g l y , t h e p a n e l h a s c o n c l u d e d t h a t t h e m i n i s h o r t o f e s t a b l i s h i n g t h a t t h e a p p e l l a n t h a s a s e v e r e S e v e r e M e n t a l I m p a i r m e n t T h e a p p e l l a n t ' s p o s i t i o n i s t h a t e v e n w i t h o u t t h e n e b e f o r e i t a t t h e t i m e o f r e c o n s i d e r a t i o n t o d e t e r m i n e i m p a i r m e n t . T h e m i n i s t r y ' s p o s i t i o n , a s s e t o u t i n i t s r e c o n s i d e r a s u b m i t t e d d o e s n o t e s t a b l i s h a s e v e r e m e n t a l i m p a P a n e l D e c i s i o n I n t e r m s o f m e n t a l f u n c t i o n a l s k i l l s , t h e e v i d e n c e o f t h a t t h e a p p e l l a n t ' s c o m m u n i c a t i o n s s k i l l s a r e g o o d 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 , b u t h e a l s o d e s c r " s u b t l e " . I n t h e A R t h e O T d e s c r i b e d t h e s e a s b e i n J a n u a r y 2 3 , 2 0 1 4 t h e O T n o w s a y s t h a t t h e s e a s s e a p p e l l a n t ' s r e c o v e r y , a n d t h a t i t h a s b e c o m e a p p a r e A c c o r d i n g l y , s h e h a s a d j u s t e d v i r t u a l l y a l l o f t h e i m p a d j u s t m e n t d o e s n o t a p p e a r t o b e s u p p o r t e d b y t h e S e c t i o n 2 ( 1 ) ( b ) o f t h e E A P W D R p r e s c r i b e s t w o D L A d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e o r f i n a n c e s i n t e r a c t w i t h o t h e r s e ff e c t i v e l y ( s o c i a l f u n c t i o n i n g ) . T s i g n i f i c a n t l y r e s t r i c t e d w i t h r e s p e c t t o d e c i s i o n m a k i m e d i c a t i o n s ( a l b e i t w i t h t h e u s e o f b u b b l e p a c k t e c h i n d e p e n d e n t l y m a n a g e s t h e d e c i s i o n m a k i n g c o m p o a p p r o p r i a t e c h o i c e s ) , a n d m e a l p r e p a r a t i o n ( m e a l p t h e a p p e l l a n t i s n o t m a n a g i n g h i s d i a b e t i c d i e t a s w e t h a t t h i s s h o r t c o m i n a i s o f s u f f i c i e n t s i a n i f i c a n c e t o a E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )[ A P P E A L # e l l a n t ' s p h y s i c a l f u n c t i o n a l s k i l l s i n d i c a t e s t h a t t h e i t h v i r t u a l l y n o l i m i t a t i o n s t o h i s m o b i l i t y , a n d a t h e O T ' s o b s e r v a t i o n s r e g a r d i n g o v e r s t i m u l a t i o n l y 1 7 , 2 0 1 3 , t h e G P n o t e d i n t h e P R t h a t t h e l n o t e s t h e G P ' s s t a t e m e n t i n h i s J a n u a r y 2 7 , 2 0 1 4 . " T h e p a n e l a l s o n o t e s t h a t m u c h o f t h e p h y s i c a l c o n d i t i o n r e l a t e s t o h i s i n a b i l i t y t o r e t u r n e m p l o y a b i l i t y i s n o t a s t a t u t o r y c r i t e r i o n r e g a r d i n g n t h e a b i l i t y t o p e r f o r m D L A . i o n o f t h i s d e c i s i o n u n d e r t h e h e a d i n g S i g n i f i c a n t t i o n d o e s n o t a p p e a r t o h a v e t r a n s l a t e d i n t o L A i n d e p e n d e n t l y . s t r y r e a s o n a b l y d e t e r m i n e d t h a t t h e e v i d e n c e f a l l s p h y s i c a l i m p a i r m e n t . w i n f o r m a t i o n , t h e m i n i s t r y h a d e n o u g h i n f o r m a t i o n t h a t t h e a p p e l l a n t h a s a s e v e r e m e n t a l t i o n d e c i s i o n , i s s i m p l y t h a t t h e i n f o r m a t i o n i r m e n t . t h e G P i n t h e P R a n d t h e O T i n t h e A R i n d i c a t e s . T h e G P n o t e d s i g n i f i c a n t d e f i c i t s i n 4 a r e a s o f i b e d t h e d e g r e e o f c o g n i t i v e i m p a i r m e n t a s b e i n g g a t m o s t m o d e r a t e i m p a c t s . I n h e r r e p o r t o f s s m e n t s w e r e p r e v i o u s l y d o n e t o o e a r l y i n t h e n t t h a t t h e r a t i n g s r e q u i r e a d j u s t m e n t . a c t s u p w a r d s i n t e r m s o f s e v e r i t y . T h i s u p w a r d s m o s t r e c e n t e v i d e n c e o f t h e G P o r t h e C N P . t h a t a r e s p e c i f i c t o m e n t a l i m p a i r m e n t m a k e ( d e c i s i o n m a k i n g ) , a n d r e l a t e t o , c o m m u n i c a t e o r h e e v i d e n c e i n d i c a t e s t h a t t h e a p p e l l a n t i s n o t n g i n t h a t h e i n d e p e n d e n t l y m a n a g e s h i s n o l o g y t o h e l p h i m k e e p t r a c k ) . H e a l s o n e n t s o f t h e D L A o f d a i l y s h o p p i n g ( m a k i n g l a n n i n g a n d f o o d s t o r a g e ) . T h e O T p o i n t s o u t t h a t l l a s h e s h o u l d . T h e r e i s n o e v i d e n c e , h o w e v e r , f f e c t t h e a n n e l l a n t ' s h e a l t h . T h e G P , t h e O T , a n d
t h e C N P a l l i n d i c a t e t h a t t h e a p p e l l a n t h a s d i f f i c u l t i e b u t t h e G P i n d i c a t e d i n t h e P R t h a t t h e a p p e l l a n t h T h e O T a n d t h e C N P a l s o r e f e r r e d t o t h e a p p e l l a n t b u s i n e s s f i n a n c e s a n d l e g a l i s s u e s a r i s i n g f r o m h i s a p p e a l w a s t h a t h e m a n a g e s h i s o w n b a n k a c c o u n v i e w , t h e e v i d e n c e i n d i c a t e s t h a t w h i l e t h e a p p e l l a n b u d g e t , a n d g e t s a d v i c e w i t h r e s p e c t t o t h e m o r e c s u b s t a n t i a l l y m a n a g e s h i s o w n p e r s o n a l f i n a n c e s . i n d i c a t e s t h a t w h i l e t h e a p p e l l a n t h a s s o m e r e s t r i c t r e s t r i c t i o n s a r e n o t s i g n i f i c a n t . R e g a r d i n g t h e a p p e l l a n t ' s s o c i a l f u n c t i o n i n g , t h e G f u n c t i o n i n g w a s w o r s e t h a n i t w a s b e f o r e s u r g e r y . f u n c t i o n i n g w e l l w i t h h i s i m m e d i a t e s o c i a l n e t w o r k a S h e n o w n o t e s i n h e r r e p o r t o f J a n u a r y 2 3 , 2 0 1 4 t h t h a t h e n o w n e e d s e i t h e r c o n t i n u o u s o r p e r i o d i c s u p I n t h e p a n e l ' s v i e w , t h e G P ' s e m a i l o n J a n u a ry 2 7 , d e t e r i o r a t i o n i n h i s c o n d i t i o n o v e r a l l , t h e a p p e l l a n t h p r o g r e s s e d a s f a r a s t h e G P h a d a n t i c i p a t e d . G i v e r e s p e c t t o t h e a p p e l l a n t ' s s o c i a l f u n c t i o n i n g , a n d t h e t h i s i s s u e , t h e p a n e l h a s g i v e n l i t t l e w e i g h t t o t h e O C o n s i d e r i n g t h e e v i d e n c e a s a w h o l e , t h e p a n e l c o n e x p e r i e n c e i m p a c t s w i t h r e s p e c t t o h i s m e n t a l h e a l t n o t d e m o n s t r a t e a s e v e r e m e n t a l i m p a i r m e n t . S i g n i f i c a n t R e s t r i c t i o n s t o D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h i s i m p a i r m e n t s c a u h i s D L A . H e a r g u e d t h a t h e i s s i g n i f i c a n t l y r e s t r i c t e p e r s o n a l fi n a n c e s , a n d s o c i a l f u n c t i o n i n g . T h e m i n i s t r y ' s p o s i t i o n ( a s s e t o u t i n i t s r e c o n s i d e r a a p p e l l a n t m a n a g e s t h e m a j o r i t y o f h i s D L A i n d e p e n e s t a b l i s h t h a t h i s i m p a i r m e n t d i r e c t l y a n d s i g n i f i c a n 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 o d s . P a n e l D e c i s i o n T h e l e g i s l a t i o n r e q u i r e s t h a t a s e v e r e i m p a i r m e n t d i a b i l i t y t o p e r f o r m D L A e i t h e r c o n t i n u o u s l y o r p e r i o d i c m e a n s t h a t t h e r e m u s t b e a c a u s a l l i n k b e t w e e n t h e r e s t r i c t i o n m u s t a l s o b e s i g n i f i c a n t . T h e e v i d e n c e i s c o n s i s t e n t t h a t t h e a p p e l l a n t ' s p h y s p e r f o r m D L A . I n t h e A R t h e O T i n d i c a t e d t h a t t h e a h e c a n c a r r v . H o w e v e r , n o w t h a t t h e a o o e l l a n t i s d r E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # s w i t h r e s p e c t t o m a n a g i n g h i s p e r s o n a l f i n a n c e s , a s h a d " l i f e l o n g " d i f f i c u l t y m a n a g i n g h i s f i n a n c e s . ' s " c o m p l e x " i s s u e s r e l a t e d t o h i s f o r m e r s m a l l p r e v i o u s b u s i n e s s . T h e a p p e l l a n t ' s e v i d e n c e o n t a n d p a y s h i s o w n r e n t a n d b i l l s . I n t h e p a n e l ' s t d o e s e x p e r i e n c e d i f f i c u l t i e s i n m a n a g i n g h i s o m p l e x a s p e c t s o f h i s f i n a n c e s f r o m o t h e r s , h e I n t h e p a n e l ' s v i e w , t h e e v i d e n c e o n b a l a n c e i o n s w i t h r e s p e c t t o d e c i s i o n m a k i n g , t h e s e P n o t e d i n t h e P R t h a t t h e a p p e l l a n t ' s s o c i a l T h e O T i n d i c a t e d i n t h e A R t h a t t h e a p p e l l a n t w a s n d m a r g i n a l l y w i t h h i s e x t e n d e d s o c i a l n e t w o r k s . a t t h e a p p e l l a n t h a s b e e n w i t h d r a w i n g s o c i a l l y a n d p o r t w i t h a l l a s p e c t s o f s o c i a l f u n c t i o n i n g . 2 0 1 4 i n d i c a t e s t h a t r a t h e r t h a n s u f f e r i n g a s r e a c h e d a p l a t e a u i n h i s r e c o v e r y a n d h a s n o t n t h e l a c k o f c o r r o b o r a t i n g m e d i c a l e v i d e n c e w i t h v e r y s i g n i f i c a n t c h a n g e i n t h e O T ' s o p i n i o n o n T ' s J a n u a r y 2 3 , 2 0 1 4 o p i n i o n o n s o c i a l f u n c t i o n i n g . c l u d e s t h a t w h i l e t h e a p p e l l a n t c l e a r l y d o e s h , t h e m i n i s t r y r e a s o n a b l y d e t e r m i n e d t h a t i t d o e s s e s i g n i f i c a n t r e s t r i c t i o n s t o h i s a b i l i t y t o m a n a g e d i n t e r m s o f m a n a g i n g m e d i c a t i o n s , m a n a g i n g t i o n d e c i s i o n ) i s t h a t t h e e v i d e n c e s h o w s t h a t t h e d e n t l y , a n d t h a t t h e r e i s n o t e n o u g h e v i d e n c e t o 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 e i t h e r 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 s t h e a p p e l l a n t ' s a l l y f o r e x t e n d e d p e r i o d s . T h e t e r m " d i r e c t l y " s e v e r e i m p a i r m e n t a n d t h e r e s t r i c t i o n . T h e d i r e c t i c a l c o n d i t i o n d o e s n o t r e s t r i c t h i s a b i l i t y t o p p e l l a n t ' s d a i l y s h o p p i n g i s l i m i t e d b y t h e a m o u n t i v i n a h i s o w n v e h i c l e t h a t s h o u l d n o t b e a
[::_EAL# significant restriction. The DLA of decision making and social functioning were discussed above and found notto be significantly restricted. The DLA of managing medications also does not appear to be significantly restricted, since the appellant is managing on his own with the help of bubble pack technology to keep him on track. Regarding the remaining DLA of managing personal finances, the evidence indicates that while the appellant relies on counselling from professionals with respect to legal issues and the "significant financial issues" referenced by the OT, the appellant manages his own bank account and pays his own bills. It is not necessarily a sign of a significant restriction for a person to have to rely on outside assistance in dealing with "significant financial issues". .Accordingly, the panel concludes that he is not significantly restricted in this DLA. In the panel's view, the evidence does not present a compelling picture of an individual whose ability to manage his DLA is significantly restricted as contemplated by the legislative scheme. Accordingly, the panel concludes that the ministry reasonably determined that the appellant's ability to manage his DLA independently is not significantly restricted either continuously or periodically for extended periods. Help with DLA The appellant's position is that he relies on help from friends, volunteers, and his rehab team and other professionals to perform various DLA. The ministry's position is that since ii has not been established that the appellant's DLA are significantly restricted, it cannot be determined that significant help is required from other persons. Panel Decision The panel notes that there may be situations in which a person may "require" help but not be receiving it. In the panel's view the word "require" indicates a degree of necessity so that it is something that a person cannot reasonably do without. If the person does not get the help he requires, the DLA goes undone either continuously or periodically for extended periods, or the DLA takes an unreasonably long time to complete. In the panel's view there is simply insufficient evidence to show that the appellant's DLA go undone for lack of assistance, that it takes him an inordinate amount of time to perform DLA, or that he relies upon "the significant help or supervision of another person" as required by EAPWDA section 2 ( 3)( b )( ii) . The panel finds that there is no evidence to indicate that the appellant uses assistive devices or that he has an assistance animal. Accordingly, the panel finds that the ministry reasonably concluded that as it has not been established that DLA are significantly restricted, it could not be determined that the appellant requires help with DLA as defined bys. 2(3)/b) of the EAPWDA. EM T003(1 0/06/01)
Conclu s ion The pan el ac k nowled ges tha t the appe llant's m e dical once did. However, having reviewed and considered all the panel fin ds that the mi nis t ry's d ecision finding the reaso nable appli cation of the legislati on in the circumstance confirms the min istr y's decisi o n . EAAT003(10/06/01) [APPEAL# c on dition af f e cts his abi lity to functio n a s he of t he ev id ence and the relevant legislation, a p pell an t in elig ible for PWD designa tion is a s of the appellan t . The pa nel the refor e
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.