PART C -D e ci s ion u n d er A p peal The deci sio n un der appeal is the Mi nis tr y of Social Deve "Min istry" ) r econsider ation deci sion dat e d Marc h 5 , eli g i ble for a scoote r as he d i d not mee t t he legisla tive an d Assi stan ce f o r Person with Dis abi lit y Regulat ion and 3 .4(3 )(a) an d ( c). T h e Mi nist ry held t hat t he Ap pel lan t's ass e ss ment pro not est ablish t h a t there was a medical need for t he s to achie ve or m aint ain b asic m obility. PART D -Rele v an t Legislat ion EAPWD R sec tion 62 and S c hed ule C, sect i on s 3( 2)(b} a EAAT 003(10/06/01) APPE A L I lop men t an d S ocial Innov ation (t he 2014 whic h h eld tha t the Ap pell ant was not req uire ments as s et ou t in the Employm ent (the "E APWDR") S chedule C, sect ions 3( 2) ( b} vided by the occupational t h e rapi st ("O T"} does cooter or that the s cooter is m e d icall y essential nd 3.4( 3 }(a) and (c)
P A R T E S u m m a r v o f F a c t s T h e M i n i s t r y w a s n o t i n a t t e n d a n c e a t t h e h e a r i n g . A h e a r i n g p r o c e e d e d u n d e r s e c t i o n 8 ( b ) o f t h e E m p l o y T h e e v i d e n c e b e f o r e t h e M i n i s t r y a t r e c o n s i d e r a t i o n i . M e d i c a l E q u i p m e n t R e q u e s t a n d J u s t i f i c a t i o n 2 4 , 2 0 i 3 . T h e t y p e o f m e d i c a l e q u i p m e n t t h a t i s r e c o m m a " s c o o t e r ( f o u r w h e e l ) . " 2 . A f u n c t i o n a l a s s e s s m e n t f r o m t h e O T t o t h e A T h e A p p e l l a n t w a s d i a g n o s e d w i t h a r t h r i t i s , I D A p p e l l a n t n o t e d t h a t h e h a s a l o n g h i s t o r y o f T h e O T s t a t e d t h a t t h e c l i e n t h a s d i f f i c u l t y s t a f a l l i n g " a n d t h a t t h e A p p e l l a n t i s a b l e t o n e g o t O T s u g g e s t e d t h a t t h e A p p e l l a n t u s e a 4 w h e T h e O T s t a t e d t h a t t h e s c o o t e r r e q u e s t i s " c l i e i s t o u s e a 4 w h e e l w a l k e r b u t t h e A p p e l l a n t c O T s t a t e d t h a t t h e A p p e l l a n t c a n w a l k a p p r o x i n t e n d s o n u s i n g t h e s c o o t e r t o a t t e n d m e d i c a s c o o t e r t o d e a l w i t h t h e o n g o i n g p r o b l e m s i d e 3 . E m p l o y m e n t a n d A s s i s t a n c e R e q u e s t f o r R e c S e c t i o n t h r e e o f t h e R e q u e s t c o m p l e t e d b y t h t h e M i n i s t ry ' s d e c i s i o n t o d e n y h i m t h e s c o o t e h e h a d " s e v e r e b a c k a n d l e g p r o b l e m s f o r o v e h a r d e r t o w o r k e a c h y e a r . T h e A p p e l l a n t e x p l a i n e d s t a t e d t h a t t h e b o t t o w h i l e h e h a s m e d i c .a t i o n t w o p e o p l e i n h i s b u i o n e h a s l o s t h i s l i f e . I n t h e N o t i c e o f A p p e a l d a t e d M a r c h i 2 , 2 0 i 4 , u n d e . t h e " M i n i s t r y d e c i s i o n i s n o t p r o p e r l y b a s e d . " A t t h e h e a r i n g , t h e A p p e l l a n t p r o v i d e d t h e f o l l o w i n g a i . t h e A p p e l l a n t o n l y s a w t h e O T f o r 7 m i n u t e s a n d 2 . t h e A p p e l l a n t ' s d o c t o r c o n f i r m s t h a t h e d o e s n e e d p r e s c r i p t i o n ; 3 . t h e A o o e l l a n t d o e s n o t k n o w w h e r e t h e p r e s c r i p t i E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L I f t e r c o n f i r m i n g t h e M i n i s t r y w a s n o t i f i e d , t h e m e n t a n d A s s i s t a n c e R e g u l a t i o n . w a s a s f o l l o w s : f o r m c o m p l e t e d b y a m e d i c a l p r a c t i t i o n e r o n J u l y e n d e d b y t h e m e d i c a l p r a c t i t i o n e r w a s l i s t e d a s p p e l l a n t d a t e d N o v e m b e r 5 , 2 0 i 4 . D M , D D D , p r o s t a t e C A . T h e O T s t a t e s t h a t t h e l e g a n d b a c k p a i n a s a r e s u l t o f a b a c k i n j u r y . n d i n g f o r m o r e t h a n a f e w m i n u t e s d u e t o " f e a r o f i a t e s h o r t d i s t a n c e s i n s i d e h i s a p a r t m e n t . T h e e l e d w a l k e r b u t t h e c l i e n t p r e f e r s t o u s e h i s c a n e . n t d r i v e n " a n d t h a t " t y p i c a l l y t h e n o r m a l p r o c e s s h o o s e s n o t t o b e c a u s e h e f e e l s i t i s u n s a f e . T h e i m a t e l y o v e r a b l o c k b e f o r e r e s t i n g a n d t h a t h e l a p p o i n t m e n t s . T h e O T r e c o m m e n d e d a p u r s u i t n t i f i e d a b o v e . o n s i d e r a t i o n f o r m ( t h e " R e q u e s t " ) . e A p p e l l a n t d a t e d F e b r u a r y 2 0 , 2 0 i 4 s t a t e d t h a t r f a i l s t o a d d r e s s t h e r e a l p r o b l e m a n d s t a t e d t h a t r 2 0 y e a r s . . . " a n d i t i s g r o w i n g p r o g r e s s i v e l y m o f h i s f e e t " b r e a k o p e n " w h e n h e w a l k s a n d l d i n g h a v e l o s t f e e t f r o m t h e s a m e c o n d i t i o n a n d r ' R e a s o n s f o r A p p e a l ' t h e A p p e l l a n t s t a t e d t h a t d d i t i o n a l o r a l e v i d e n c e : t h a t t h e a s s e s s m e n t i s n o t a c c u r a t e ; a s c o o t e r a n d t h e d o c t o r w r o t e t h i s o n a o n o r r e c o m m e n d a t i o n i s b u t h e c o u l d g e t
a n o t h e r o n e ; 4 . t h e A p p e l l a n t u s e s h i s c a n e t o g e t a r o u n d t o k e e p r o b l e m s ; 5 . t h e A p p e l l a n t d o e s n o t u s e t h e h a n d y d a r t a s h e 6 . t h e A p p e l l a n t d o e s n o t t a k e p u b l i c t r a n s i t a s h e i b a c k p r o b l e m a n d h i s l e g s h a v e b e e n f r e q u e n t l y 7 . t h e A p p e l l a n t f r e q u e n t l y c o l l a p s e s a s a r e s u l t o f e x a m p l e , t h e A p p e l l a n t ' s b a c k g o e s o u t w i t h o u t n 8 . t h e A p p e l l a n t h a s o p e n s o r e s o n h i s f e e t t h a t b r e a n d t h i s i s w h y h i s d o c t o r p u t i n a r e q u e s t f o r a s 9 . t h e A p p e l l a n t w a n t s t o s t a y o f f h i s f e e t o r t h e s o r 1 0 . t h e A p p e l l a n t i s a b l e t o w a l k b u t t h e m o r e h e w a s t a y o f f h i s f e e t t o p r e v e n t t h i s f r o m h a p p e n i n g ; a 1 1 . t h e A p p e l l a n t i s g o i n g f o r n e r v e t e s t i n g t o d e t e r m r e s u l t o f h i s d i a b e t e s . T h e p a n e l f i n d s t h a t t h e a d d i t i o n a l e v i d e n c e p r o v i d e i s n o t i n s u p p o r t o f t h e r e c o r d s b e f o r e t h e M i n i s t r y a s e c t i o n 2 2 ( 4 ) o 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 h e a d d i t i o n a l o r a l e v i d e n c e c l a r i f i e d h i s s i t u a t i o n a n 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 a s i t w a s i n s u p p o r r e c o n s i d e r a t i o n . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L I p t h e p r e s s u r e o f f h i s f e e t , a s w e l l a s f o r h i s b a c k b e l i e v e s i t w o u l d b e t h e s a m e a s p u b l i c t r a n s i t ; s f o r c e d t o s i t w i t h h i s l e g s i n t h e a i s l e d u e t o h i s b u m p e d / k i c k e d b y o t h e r t r a n s i t u s e r s ; h i s b a c k i n j u r y . S t a n d i n g d o i n g d i s h e s , f o r o t i c e a n d h e c o n s e q u e n t l y d r o p s t o t h e g r o u n d . a k o p e n w i t h w a l k i n g o n t h e m d u e t o d i a b e t e s c o o t e r ; e s w i l l g e t w o r s e ; l k s t h e m o r e t h e " h o l e s " o p e n u p a n d h e h a s t o n d i n e w h e t h e r t h e h o l e s / s o r e s o n h i s f e e t a r e a d b y t h e A p p e l l a n t r e l a t i n g t o t h e s o r e s o n h i s f e e t t r e c o n s i d e r a t i o n a n d w a s n o t a d m i s s i b l e u n d e r t . d w a s a d m i s s i b l e u n d e r s e c t i o n 2 2 ( 4 ) o f t h e t o f t h e r e c o r d s b e f o r e t h e M i n i s t r y a t
P A R T F R e a s o n s f o r P a n e l D e c i s i o n T h e i s s u e w h e t h e r t h e M i n i s t r y ' s d e c i s i o n t o d e n y t h l e g i s l a t i v e r e q u i r e m e n t s a s s e t o u t i n t h e E A P W D R i s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e o r a r e a s o n t h e c i r c u m s t a n c e s o f t h e A p p e l l a n t . S e c t i o n 6 2 o f t h e E A P W D R a d d r e s s e s g e n e r a l h e a l a n y h e a l t h s u p p l e m e n t s e t o u t i n s e c t i o n s 2 ( g e n e r a a n d d e v i c e s ) o f S c h e d u l e C p r o v i d i n g t h e r e c i p i e n t m a n d S c h e d u l e C o f t h e E A P W D R . S c h e d u l e C s e c t i o n 3 o f t h e E A P W D R a d d r e s s e s h e a n d d e v i c e s . S p e c i f i c a l l y s e c t i o n 3 ( 2 ) ( b ) p r o v i d e s t h a n a s s e s s m e n t b y a n O T a n d / o r a p h y s i c a l t h e r a p i s e q u i p m e n t o r d e v i c e . S e c t i o n 3 . 4 ( 2 ) ( a ) i n c l u d e s a s c o o t e r f o r t h e p u r p o s e r e q u i r e m e n t s o f s e c t i o n ( 3 ) a r e m e t . S e c t i o n 3 . 4 ( 3 ) ( t h e r a p i s t c o n f i r m i n g t h a t i t i s u n l i k e l y t h a t t h e r e c i p i e d u r i n g t h e 5 y e a r s f o l l o w i n g t h e a s s e s s m e n t . S e c t i o n 3 . 4 ( 3 ) ( c ) r e q u i r e s t h a t t h e M i n i s t r y i s s a t i s f i e o r m a i n t a i n b a s i c m o b i l i t y . T h e M i n i s t r y a r g u e s t h a t t h e c r i t e r i a a s s e t o u t i n t h e 3 . 4 ( 3 ) ( a ) a n d ( c ) h a v e n o t b e e n m e t . I n d e t e r m i n i n g r e q u i r e m e n t s , t h e M i n i s t r y r e l i e d o n t h e O T a s s e s s m m e d i c a l n e e d f o r a s c o o t e r a n d t h a t t h e s c o o t e r w a s m o b i l i t y . T h e M i n i s t r y s t a t e d t h e f o l l o w i n g : Y o u r O T r e p o r t s t h a t i t i s y o u r g o a l t o u s e a s c o o t e r t o i n f o r m a t i o n p r o v i d e d d e m o n s t r a t e s t h a t y o u r O T r e c o m n o t t o u s e i t . T h e M i n i s t r y d i d a c k n o w l e d g e t h a t t h e A p p e l l a n t e x p b u t t h a t t h a t t h e s e c o n d i t i o n s d i d n o t c r e a t e a m e d i c t h a t t h e n e e d f o r t h e s c o o t e r w a s f o r t r a n s p o r t a t i o n p n e c e s s i t y . T h e a p p e l l a n t a r g u e d t h a t t h e O T e x a m i n e d h i m f o r w a s n o t a c c u r a t e . T h e A p p e l l a n t s u b m i t t e d t h a t h e h i s g e t t i n g p r o g r e s s i v e l y w o r s e e a c h y e a r . T h e A p p e o f c o l l a p s i n g a s a r e s u l t o f h i s b a c k i s s u e s w a r r a n t s T h e l e g i s l a t i o n c l e a r l y s t i p u l a t e s t h a t i n o r d e r f o r t h e a s s e s s m e n t m u s t c o n f i r m t h e m e d i c a l n e e d f o r a s c o a m e d i c a l n e e d f o r a w h e e l c h a i r f i v e y e a r s f o l l o w i n g t h a t t h e M i n i s t r v i s s a t i s f i e d t h a t t h e s c o o t e r i s m e d i c E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E , A e A p p e l l a n t a s c o o t e r f o r f a i l i n g t o m e e t t h e S c h e d u l e C , s e c t i o n s 3 ( 2 ) ( b ) a n d 3 . 4 ( 3 ) ( a ) a n d ( c ) a b l e a p p l i c a t i o n o f t h e a p p l i c a b l e l e g i s l a t i o n i n t h s u p p l e m e n t s a n d a l l o w s t h e M i n i s t r y t o p r o v i d e l h e a l t h s u p p l e m e n t s ) o r 3 ( m e d i c a l e q u i p m e n t e e t s e l i g i b i l i t y r e q u i r e m e n t s i n b o t h s e c t i o n 6 2 a l t h s u p p l e m e n t s r e l a t i n g t o m e d i c a l e q u i p m e n t a t a r e c i p i e n t m u s t p r o v i d e t o t h e M i n i s t r y e i t h e r t c o n f i r m i n g t h e m e d i c a l n e e d f o r t h e m e d i c a l o f s e c t i o n 3 o f t h e S c h e d u l e i f a l l t h e a ) r e q u i r e s a n a s s e s s m e n t b y a n o c c u p a t i o n a l n t w i l l h a v e a m e d i c a l n e e d f o r a w h e e l c h a i r d t h a t t h e i t e m i s m e d i c a l l y e s s e n t i a l t o a c h i e v e E A P W D R S c h e d u l e C , s e c t i o n s 3 ( 2 ) ( b ) a n d t h a t t h e A p p e l l a n t d i d n o t m e e t t h e l e g i s l a t i v e e n t w h i c h t h e M i n i s t r y h e l d d i d n o t e s t a b l i s h a m e d i c a l l y e s s e n t i a l t o a c h i e v e o r m a i n t a i n b a s i c a t t e n d m e d i c a l a p p o i n t m e n t s , e t c . T h e m i n i s t r y f i n d s t h e m e n d e d t h e u s e o f a 4 w h e e l w a l k e r h o w e v e r y o u c h o o s e e r i e n c e s l i m i t a t i o n s a s a r e s u l t o f h i s " c o n d i t i o n s " a l n e e d f o r t h e s c o o t e r . T h e M i n i s t r y d e t e r m i n e d u r p o s e s r a t h e r t h a n a r e s u l t o f m e d i c a l n e e d o r a t o t a l o f s e v e n m i n u t e s a n d t h a t t h e a s s e s s m e n t a s h a d s e v e r e b a c k p r o b l e m s s i n c e 1 9 8 9 a n d i t l l a n t a r g u e d t h a t h i s b a c k p a i n a n d t h e p o s s i b i l i t y a s c o o t e r . A p p e l l a n t t o b e e l i g i b l e f o r a s c o o t e r t h e O T o t e r a n d t h a t i t i s u n l i k e l y t h a t A p p e l l a n t w i l l h a v e t h e a s s e s s m e n t . T h e r e i s a l s o a r e q u i r e m e n t a l l v e s s e n t i a l t o a c h i e v e o r m a i n t a i n b a s i c -�
APPEAL I mobility. The Ministry argued that the OT assessment did not establish a medical need for a scooter or that the scooter is medically essential to achieve or maintain basic mobility. On review of the OT assessment there is very little support to confirm the Appellant has an injury that warrants a medical need for the scooter or that the use of a scooter is medically essential to achieve or maintain basic mobility. The OT made two recommendations in her assessment regarding the Appellant's physical condition. She first suggested that the Appellant use a 4 wheeled walker for long distances so he can periodically rest, but noted that the client. preferred to use his cane to get around. The OT ultimately recommended the pursuit scooter as a means to address the Appellant conditions but made it clear in her report that the "[s]cooter request is client driven" and that "typically the normal process is using a 4WW" but the OT notes that the client chooses not to use the four wheeled walker as the Appellant believes it to be "unsafe." The Appellant gave oral evidence that he uses his cane to get around and to keep the pressure off his back and legs. The Appellant acknowledged that he could still walk but he needed to stay off his feet due to an unrelated condition. The Appellant noted that while he uses his cane to assist him walking he has an aversion to the public transit system as he is forced to sit with his legs in the aisle and this often leads to other transit users bumping into his legs. The Appellant similarly believed the local handy dart would be similar to the public transit and opts not to use this service. The Appellant did give evidence that his back can give out at any minute which would cause him to collapse without any notice but beyond the OT reporting that the Appellant had a fear falling there is no actual report of similar occurrences or the frequency of these incidents. There is no doubt the Appellant suffers with chronic pain resulting from a variety of conditions all of which make it difficult for him to get around on a daily basis. The information that was provided by the OT in her assessment, however, does not support that the Appellant has condition that would make a scooter medically essential to achieve basic mobility, particularly when the Appellant acknowledged he is able to get around on his own with the aid of his cane. The Panel therefore finds the Ministry's determination that the Appellant was not eligible for a scooter having found the Appellant's assessment provided by the OT did not establish that there was a medical need for the scooter or that the scooter was medically essential to achieve or maintain basic mobility pursuant to Schedule C, section 3(2)(b) and 3.4(3)(a)(b) of EAPWDR was a reasonable application of the applicable legislation in the circumstances of the Appellant and confirms the decision. EMT 003(10106/01)
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.