P A RT C -Decision und er App eal The dec ision under appeal is t he Mini st ry of Social Development Re conside ra t ion Decision dated April 11, 2014, which held th Pe rson with Disabili t i e s (PWD) . The Ministry found that the Appellant di o ut in Section 2 (2) of t he Employme n t and Assi stance for Persons with Disabilities Ac the Appellant met the age requirem ent and th at her impairment is lik however the Mini stry found that the info rmation p r ovi de d mental or physical impairment, that her impa irment significantly restricts her act i vities cont i nuo us ly or periodically for e xtended p e riods the signif icant help or supervision of an other p erson to p P A R T D -Relevant L e g i s lation Employmen t an d Assista n ce for Pe r sons w ith Dis ab ilities E m p loyment an d Ass i sta n ce for Per s o ns with Di s a bil ities EAAT 003( 10/06/0 I) � APPEAL# and Soc i al Inn o v at i o n (Ministry) a t t h e App e llant is n o t eligible for des i g nation as a d not meet thre e of t he f iv e cr iteria set t. The Mini st ry f ound th at ely to cont i nu e for at leas t two years; does not establish that the Appellant has a severe abili ty to perform da i ly l iving or t hat as a r es u l t o f th ose restrictions she requires er form d a ily liv ing activities . Act ( E APW DA) Sect ion 2 R e gulat i on ( EAPWDR ) Se ctio n 2
P ART E -Summ ar of Fact s I n formatio n bef ore th e Ministry at R econsi deration incl uded: T h e Appellant's Persons wi th .Disabilities Designation Applica October 29, 2013: • Self Report dated September 30, 2013: The Appel muscular/spinal p a in, spasms and fibromy p ain for fi ve y ears, whi c h affe cts her sitt ing, sh e has balance problems with chronic di than one hour. She state d t h at she does no bal an ce problems , she suffers from envi ronmental has had six abdomin, al su r g e ries. • Phys ician's Report dated Sep tember 13, 2013: dia gnosed with chr o n ic anxiety/depres sive illness, sp ine, chroni c fatigue syndr om e, fibro myalgia his to ry of en d ome triosis, osteoporosis and artr motor vehicle a ccident s, degene r a t ive d isc diso balance p roblems a nd d i zz i n e ss . The p h likel y to continu e fo r t wo ye ars or mo re , with the chronic + not ame nabl e to rem ed i al treatments" • Funct ional S kil ls: The p h ysic ian r eported clim b 5+ st eps, cannot li ft , can r emai n se at c o m munication. Wi t h respect to cogni tive t here are si gni ficant defi cits with memor y, c oncentr a t io n , with n o co m ments. • Assessor R eport dat ed Septem ber 2 0, 201 ph y sician and c o n tained the foll owi n g info • Me ntal or P hysical Impairment: The p h y sician's "generalized s ymp t om s of weak ness, diz zin reporte d th a t all a spe ct s o f the a bil ity to com and physi cal abi l i t y ar e as fo llows: Wal ki ng i cli mb ing stairs , period ic a ssist a nce fr o m ano problem s" ; s t and in g, i ndep enden t ; lifti ng, with the comment "una b le to lift d u e to muscle w ass istance from another p erson. With r espect t physician reported no impact with executive, motor activity, language, psycho othe r neuropsychological or e moti onal or memory and motivation; moderate impact with insight and judgment and attent and ma jor imp a ct s with bodily f un c tions , e • Daily Living Activities (DLA's):The physician reported dressing, grooming, bathing and toileting, take significan comment "x2 normal length of time due to aspects of personal care: feeding sel f / regulate diet, transfers in/out of bed and transfer of chair, are independent. With respect to basic housekeeping, the physician reported that both aspec ts, laundry and basic houseke eping, comment"x2 normal time due to above reasons". With respect to shopping, the physician reported that two aspects, going to and from stores and reading prices and labels, take significantly longer than typical; two aspects, makin urchases are inde endent and one as eel, car EMT 003(10/06/01) ' . APPEAL # t ion, stamped as received b y th e ministry lant stated that she has been suffe r ing from algia for 13 years, and extrem e muscular spa sms and standing an d every day a c tiviti es. She s t a t ed that zziness and nausea, and that she cannot sit fo r more t h a v e a clear d i ag n osis fo r he r di zziness and dis e a se, she i s a c a n cer survivor and she The ph y s i cian re p orted that the Appellant is degenerati ve disc disease cer vical thoracic and envir o nme ntal sensit iv it ie s , with a health isis [ sic], breast c a n cer, envir onmental disease, 3 r d er, f ib ro myal g ia , sp ina l steno si s and chronic y sic ian c on firme d that the Ap pe llan t' s imp air m ent i s c omm ent "th i s pat i ent's co n d i t i on appea r s to b e . t h at the Ap pel lant c an walk 1 to 2 block s u naided, ed less than o ne ho ur a nd has no diffi cu lties with and e moti onal fun c ti on, the physici an r eported t hat em ot ional distu r bance and att e n tion or sus tain e d 3 : Thi s s ection w as co m plet e d by t he same rmati o n: bri ef summary i n se c tion 1 ind i c ated ess, b ack and a b d om i na l p a ins". T he physici an muni c ate ar e g o od o r satisfactory; a nd tha t mobi lity nd oors, i ndependen t ; Wa l king o u tdoo r s and ther person, wit h the comm ent" dizziness /ba l a nce continuou s assist a nce from another pers on o r unable, eakness"; car rying and ho l d i ng, periodic o co gn it ive and emotional function ing, the t ic sym ptoms and m ental p r oblems; minimal impact with consciousness, i o n /concentration motion and impulse co n tro l . t hat four aspects of pe r so na l care: t ly longer than typical, with the malaise, LOE [loss o f energ y ], dizziness"; Fou r s on/off take significantly lo n ger t h a t t y pical, with the g app ropriate choice s an d pay ing fo r in urchases home, re uires eriodic
a s s i s t a n c e , w i t h t h e c o m m e n t " u n a b l e t o a s p e c t s a r e r e p o r t e d a s i n d e p e n d e n t , m e f o o d p r e p a r a t i o n a n d c o o k i n g , a r e d e s c r i b c o m m e n t " t a k e s e x c e s s i v e l e n g t h o f t i m e m e d i c a t i o n s a r e r e p o r t e d a s i n d e p e n d e n t p u b l i c t r a n s i t a n d u s i n g t r a n s i t s c h e d u l e s i n d e p e n d e n t , a n d o n e a s p e c t , g e t t i n g i n a a s s i s t a n c e , w i t h t h e c o m m e n t " w h e n f a s t c o m m e n t s t h e p h y s i c i a n w r o t e : ' W i t h m o e s p e c i a l l y i n t h e k i t c h e n a n d p u b l i c p l a c e r e p o r t e d a s r e q u i r i n g p e r i o d i c s u p p o r t / s u d u e t o c h r o n i c p a i n , L O E , d i z z i n e s s , m a l a i m p a c t s t h e a p p l i c a n t ' s r e l a t i o n s h i p w i t h i r e p o 'r t e d m a r g i n a l f u n c t i o n i n g . • A s s i s t a n c e P r o v i d e d f o r A p p l i c a n t : T h e p f r i e n d s w i t h t h e c o m m e n t " N e e d s a s s i s t a a s s i s t a n c e p r o v i d e d t h r o u g h t h e u s e o f a " n o " b o x b e s i d e t h e q u e s t i o n " D o e s t h e a • A d d i t i o n a l i n f o r m a t i o n : T h e p h y s i c i a n a d d p a t i e n t i s t h e n e c k c o n d i t i o n d u e t o t h e b u p e r f o r m i n g m o s t o f t h e d a i l y a c t i v i t i e s . T h a r e r e s t r i c t e d d u e t o t h e l o w t o l e r a n c e , t a P r i o r t o t h e h e a r i n g t h e A p p e l l a n t s u b m i t t e d t h e f o l l o w i n g 1 . A r e p o r t t i t l e d ' ' T o w h o m i t m a y c o n c e r n " d a t e p h y s i c a l c o n d i t i o n . 2 . A n o t e d a t e d A p r i l 2 3 , 2 0 1 4 , c o n t a i n i n g a d d i t a p p l i c a t i o n f o r m , p a g e s 1 0 a n d 1 6 , i n d i c a t i n g r e p o r t s f i l e d w i t h t h e P W D a p p l i c a t i o n a n d a h c l i e n t . " W i t h r e s p e c t t o p a g e 1 0 , f u n c t i o n a l s k l i m i t a t i o n s a r e r e s t r i c t e d a n d a r e m o r e t h a n m l i g h t o b j e c t s a n d a l w a y s n e e d s t h e h e l p o f o t h a n d o r g a n i z i n g b e f o r e a n d a f t e r m e a l s . S h e c g a r b a g e , v a c u u m i n g , c l e a n i n g s t a i r s o r w i n d o p r o b l e m s c a u s e m o v e m e n t a n d b a l a n c e p r o b a r e v e r y s t r e s s f u l a n d e x h a u s t i n g . W i t h r e s p i m p a i r m e n t , t h e p h y s i c i a n s t a t e d t h a t w i t h r e f " d e f i n i t e p r o b l e m s w i t h p l a n n i n g a n d o r g a n i z i p o s t p o n e d . " W i t h r e s p e c t t o m o t o r a c t i v i t y , t h t e n s i o n a r e n o t i c e d w h e n t h e r e i s p a i n , w h i c h r e s p e c t t o p s y c h o t i c s y m p t o m s a n d o t h e r n e u t h e A p p e l l a n t " i s i n a n g e r w h e n i n p a i n , " a n d t i r e d n e s s a n d l o w e n e r g y , w i t h i n a b i l i t y t o c o n 3 . A n o t e f r o m t h e a p p e l l a n t ' s p h y s i c i a n o n a p r e t h e A p p e l l a n t " c o n t i n u e s t o e x p e r i e n c e s e v e r e 4 . A c o p y o f a m e d i c a l l e g a l o p i n i o n f r o m t h e A p t h a t t h e m o s t c o n s i s t e n t a n d s t r i k i n g f i n d i n g t h A p p e l l a n t w a s h e r s e v e r e a n x i e t y a n d d i s t r e s h e r s m t o m s a n d a n u n w a v e r i n b e l i e f t h a t E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )'. A P P E A L # c a r r y h e a v i e r w e i g h t s " . W i t h r e s p e c t t o m e a l s , t w o a l p l a n n i n g a n d s a f e s t o r a g e o f f o o d , a n d t w o a s p e c t s , e d a s t a k i n g s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l w i t h t h e ( 2 x ) " . A l l a s p e c t s o f p a y i n g r e n t a n d b i l l s a n d . W i t h r e s p e c t t o t r a n s p o r t a t i o n , t w o a s p e c t s , u s i n g a n d a r r a n g i n g t r a n s p o r t a t i o n a r e r e p o r t e d a s n d o u t o f a v e h i c l e , i s r e p o r t e d a s r e q u i r i n g p e r i o d i c d i z z i n e s s , l o s t o f b a l a n c e , n a u s e a " . U n d e r a d d i t i o n a l s t o f t h e s e a c t i v i t i e s h a s t o b e v e r y c a r e f u l , s l o w s . " W i t h r e s p e c t t o s o c i a l f u n c t i o n i n g , a l l a s p e c t s a r e p e r v i s i o n , w i t h t h e c o m m e n t " A l l o f t h e s e a r e i m p a c t e d i s e . " W i t h r e s p e c t t o h o w t h e m e n t a l i m p a i r m e n t 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 n e t w o r k s , t h e p h y s i c i a n h y s i c i a n r e p o r t e d t h a t h e l p i s p r o v i d e d b y f a m i l y a n d n c e w i t h m o s t A O L ' s . " T h e s e c t i o n r e f e r r i n g t o s s i s t i v e d e v i c e s i s b l a n k . T h e r e i s a c h e c k m a r k i n t h e p p l i c a n t h a v e a n a s s i s t a n c e a n i m a l ? " e d t h e c o m m e n t " T h e m o s t s e v e r e p r o b l e m o f t h e l g e d i s c a n d f i b r o m y a l g i a w h i c h p r e v e n t s h e r b e f o r e e c o n d i t i o n i s n o t a s u b j e c t o f s u r g e r y , m e d i c a t i o n s k e n p e r i o d i c a l l y . " d o c u m e n t s : d M a y 2 0 , 2 0 1 4 , s t a t i n g t h e A p p e l l a n t ' s r e p o r t o f h e r i o n a l c o m m e n t s r e l a t e d t o t h e A p p e l l a n t ' s P W D t h e a d d r e s s o f t h e 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 n d w r i t t e n n o t e : " H a v e r e v i e w e d s y m p t o m o l o g y w i t h i l l s , t h e p h y s i c i a n r e p o r t e d t h a t f u n c t i o n a l s k i l l o d e r a t e d u e t o t h e f a c t t h a t t h e a p p e l l a n t c a n o n l y l i f t e r p e o p l e w i t h c l e a n i n g , s h o p p i n g , p a c k i n g , t r a v e l l i n g , a n n o t c a r r y o r w a s h " h e a v y p o t s , p l a t e s , h e a v y w s . " T h e p h y s i c i a n s t a t e d t h a t t h e A p p e l l a n t ' s s p i n a l l e m s , a n d t h a t p a c k i n g h e r b e l o n g i n g s a n d t r a v e l l i n g e c t t o p a g e 1 6 , w h i c h r e f e r s t o m e n t a l o r p h y s i c a l e r e n c e t o e x e c u t i v e f u n c t i o n , t h e A p p e l l a n t h a s n g h e r l i f e , p r o b l e m s o l v i n g i s d i f f i c u l t a n d s i m p l y e p h y s i c i a n r e p o r t e d t h a t e x t r e m e a g i t a t i o n a n d i s s o m e t i m e s e x p r e s s e d b y b i z a r r e b e h a v i o r s . W i t h r o p s y c h o l o g i c a l f u n c t i o n , t h e p h y s i c i a n r e p o r t e d t h a t t h a t w h i l e u n d e r m e d i c a t i o n , s h e e x p e r i e n c e s c e n t r a t e a n d l i m i t e d i n t e l l e c t u a l s k i l l s . s c r i p t i o n f o r m d a t e d M a r c h 1 9 , 2 0 1 4 , c o n f i r m i n g t h a t b a c k p a i n a n d i s c o n s i d e r e d t o b e t o t a l l y d i s a b l e d . " p e l l a n t ' s p h y s i c i a n d a t e d A u g u s t 2 2 , 2 0 1 2 , s t a t i n g r o u g h o u t t h e e i g h t e e n m o n t h s h e h a d k n o w n t h e s , t h e t e n d e n c y t o f o c u s a n d d w e l l o n m i n u t e d e t a i l s o f h e r s m t o m s r e r e s e n t e d e x t r e m e ! s e r i o u s a n d l i f e
threatening ailments. Pain tolera nce was very low. believes she has a mild but p ermanent partial well as emotion al distress. 5. A checklist dated April 5, 201 3, where t he Appel 6. A stateme n t of the App e lla nt's wor k and heal 7. A copy of submissio ns previously pro vided w 8 . S ta t ement by the Appellant date d September 16, 20 . 9. Copies o f l e t ters from the Appellant to the Ministry dated March additional details of her medical conditions. 10. A documen t t i tl ed "Appendix" dated Mar ch 11, 2014, l working ability between February 2013 and February, 20 1 1. Eight letter s f o r m a medical specia li s t t o th e ap and M ay 27, 2003 detailing th e a ppellan t 's p revious m 12. Six letters/reports from various medical specialists dated betwe 201 4 detailing the a ppel lant's various med ical conditions 2014 in dicat e th a t c ertain med ical tests are not n surgery i s cou nte r-in dicated f or the app e l lan t' sho wed n o rma l results, mil d c o ndi tio ns, or condit e xercise , an d medic ati ons fo r muscle sp asm s. 1 3 . A report from a R e g is tered M assage Thera p i the App e l lan t wil l be able t o ma k e a nearly full wi th t re atment . 14. A co py of a l e tter f ro m a fri en d d a t e d July 14 , and bac k pain whi le w orking, c annot lift, a nd wa ex erc i s ing desp ite s uff ering a lot . 15. A co py of a lett er f ro m a friend, undat ed, st ating t 201 O a n d 20 11, and that t he las t time h e r saw 16. A co p y of a let ter f ro m a f orm er emp loyer , und 20 11 , but was unable to carry o n due to ba ck 17. A copy o f a l et ter date d May 17, 20 1 2 from an in 2 011 and 2012, h owev er s he could r a r e ly wo b a ck pain. 18. A medical spe cia list's rep ort dated June 6 , 2 01 changes of h er knees t hat i s consistent wit h he threshold. 19. A c h i r o practor's r eport dated March 20, 2014, sta he r chr o n ic back p a in to help decrease and manage her pain to a comfortable level. 20. Ten notes on a prescription pad or medical certificate form, from the appell between January 4, 201 O and April 8, 2013 indicating the appellant medical conditions and pain and is referred to various physical rehabilitation therapies including chiropractor and massage treatments. 21. A copy of an undat ed letter from the Appel l a nt health. 22 . Two submissions from the a p pellant d a ted Ma ill nesses history years 1985 -2006", "The his work and illness e s September 2009-September 2012" ,and 23. Description of the events of her life from May 17 to J At the hearing the Ministry stated that they did not object to the admission of these documents. found that the documents relate to the appellant's medical history and her assessment of her ability to function. The oanel th erefore admitt ed all of the abo v e -listed docum EAA T003(10/06/01) '. APPE AL# The physician sta t ed in hi s conclus ion that he d i sa bil ity in terms of pain and i mp aired function as lant stated her di f fi c ul t i e s w ith daily activitie s . th history from 1979 to 2010. ith the Appellant's a p plica tion for PWD designation. 1 3 'To Whom I t May Con cern.' (App 111, p. 24) 7, 20 1 4 , and April 11, 2014 listing i st ing the A ppellant's healt h condition a nd 14. pellant's physicia n date d be tween June 21, 2 000 e dical conditions. en Februa ry 20, 2004 an d April 9, and test results. The recent reports from ec es s ar y for p a t ie n ts with c hron i c p ai n ; th at s c ondi tio n s, an d the tests th a t w ere perform ed ions a men ab l e t o elbo w padding, vitam in s , s t d a t ed Decem b e r 6, 2 009 , stating t ha t s h e bel i eves re covery from h er whip lash i njury if s h e co n tin ue s 20 11 s ta t ing t ha t the a ppellan t suff ere d s evere neck s alw ays try ing to st ay a ctive b y wa lki ng a n d hat the A ppella nt had v ery b a d bac k an d neck pain h e r in 20 1 1 she was t r emendously improve d . a ted, s ta ti ng that t he Ap pell ant worked wit h h im in a nd ne ck problems. archi t e ct s t ati ng that th e Appellant worked w ith h im rk more t han two h o urs at a time due t o ne ck and 2 statin g that th e Ap pella nt ha s ear ly deg enerative r age, an d that her major problem is a very low pain ting that the Appe llant should rec eive t re atmen t for ant's physici an dated is unable to work due to her to a friend explaining that she moved to BC for her y 29, 2014 and Ju ne 3, 2014describing "My work and t ory of Hea lth and W ork y ears 2006-2009", "History o f une 1, 2014. The Panel ents under section 22/4)/b) of the Employment and
I APPEAL# Assistance Act as written testimony in support of the information and records that were before the minister when the decision being appealed was made. At the hearing the Appellant submitted 14 photographs which she stated were to "show what makes life more difficult". The photographs depict the following: 1. The Appellant opening a window. 2. The Appellant holding the hood of a car. 3. A staircase at her former residence in 2011. 4. A staircase in the Appellant's current residence showing 8 stairs. 5. A bathtub with high sides. 6. Tables and chairs. 7. A laptop on a tabletop. 8. A drafting table. 9. A table and chair. 10. An ergonomic chair. 11. A stool and chair. 12. , 13 and 14: various mattresses. The Ministry did not object to the introduction of the photographs, but commented that they do not reflect the Appellant's physician's recommendations regarding the type of furniture the appellant can or cannot use due to her medical conditions and symptoms. The Panel admitted all of the above-listed photographs under section 22(4)(b) of the Employment and Assistance Act as documents in support of the information and records that were before the minister when the decision being appealed was made. At the hearing the Appellant stated that her condition affects her daily life. In the morning, she has to slow down. It can take two hours to leave the house, she feels very insecure in the bathtub or shower because there are no grab bars. The height of the bathtub, demonstrated by a photograph she provided, is making her feel dizzy. In the house, she can handle the ground floor, but not stairs. She stated that she can sometimes walk up stairs, but not down, and sometimes walking upstairs helps her lower back. She stated that her lower back (bulging disc) does not affect her legs as yet, but it does cause weakness. She stated that she needs a specific mattress to sleep and she has furniture in storage, but she needs a better place to live. She stated that she needs a cart for shopping, but it causes her to pull muscles. She stated that her doctors do not know how to describe her muscular weakness; it might be arthritis. She stated that her condition is not only about her spine; she had a lumpectomy and now has scar tissue inside her chest. Also, she has had six abdominal surgeries which have left her with adhesions causing pain in her lower back. The Appellant stated that she moved back to B.C in 2013. She wanted to go back to work, but failed. Her income was from computer work, but she can no longer do this type of work because she cannot sit for long periods. She stated that she cannot find work in her field. In response to questions from the Panel, the Appellant stated that she is scheduled for an MRI in December, and she is on a list for cancellations since her doctor has said no decision will be made about surgery until the MRI is done. She was told several times that her condition "is not classified for surgery." She also asked for a cortisone injection but it was not recommended. She recently had an MRI, but it was for her neck and spine, not her lower back. She stated that the results showed mild scoliosis and a narrowing of the space between discs but no pressure on the nerve. It appears that there has been some improvement in her neck and thoracic spine, probably because she has not been working. In response to a question about the physician's comment on the PWD application form "needs assistance", the Appellant stated that she needs help with DLA's, such as vacuuming, lifting heavy objects and heavy household cleaning. She knows when she needs to stop housework and she will rest for 1 or 2 hours. For shopping, she stated that she needs help when she buvs larae amounts and needs a ride to bring ourchases home because she no lonaer has a car. She EAAT003(10/06/01)
s u b m i t t e d t h a t s h e a l s o r e q u i r e s a s s i s t a n c e f o r a c t i v i t i e s p e o p l e a t t h e h o u s e w h e r e s h e l i v e s . S h e s t a t e d t h a t s h k i l o g r a m s , s u c h a s 2 l i t e r m i l k c o n t a i n e r s . T h e A p p e l l a n p r o b l e m s , p r o b a b l y r e l a t e d t o h e r i n n e r e a r , c a u s i n g v e r t T h e M i n i s t r y d i d n o t s u b m i t a n y e v i d e n c e i n a d d i t i o n t o t E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # t h a t n e e d m u s c l e s t r e n g t h a n d s h e r e c e i v e s h e l p f r o m e h a s d i f f i c u l t y l i f t i n g w e i g h t s g r e a t e r t h a n 2 o r 3 t s t a t e d t h a t s h e h a s c h r o n i c d i z z i n e s s a n d b a l a n c e i g o w h i c h s e v e r e l y l i m i t s h e r a b i l i t y t o p e r f o r m D L A ' s . h e R e c o n s i d e r a t i o n D e c i s i o n .
'. AP PEAL# PAR T F -Reas ons f or Pa nel Decision The i s sue in t his appeal is the reasonableness of the Mini s t ry's Reconsideration Decision dated April 11, 2014, wh ich held that th e A ppell ant is not eligible for designation as a Person wit h Di s a bilities (PWD ). The Min is try found that the Appellant did not meet three of the five criteria set out in Section 2(2) of the Em plo yme nt an d Assis tanc e fo r Pe r sons with Disabilities Act. The M inistry found that the Appellant me t t he age requirement an d that her impair m ent i s l ikely to continue for at least tw o year s; however the Mini st ry found that the information pr o vid ed doe s not est ablish t hat the Appellant has a severe mental or physical i mp airment, tha t h e r impairme n t significant l y restr icts her abi lity to perform daily living activ i ties continuously periodi ca l ly for extended p e r iods or that as a result of those restrictions she requires the significant help or supervision of a n other p erson to perform dail y living activities. Legis lation EAP WDA Persons wit h disa bilities 2 (1) I n this sec tion : "assisti v e dev ice " m eans a devi ce d esigned to enab l e a person t o perform a daily liv in g act i vit y that, b ecause o f a seve re m ent al or ph y s i cal im p a irm e n t, the p erson is u nable to perform ; "daily livi n g acti v i ty" has th e p rescribed mean ing; "presc ri b ed pr ofessio nal" h a s t he p resc ribed meaning . (2) The minis t e r m ay de sign ate a pers o n wh o has reach e d 18 years of a ge a s a person with disab i l i t i e s for t he pur p o se s of this A c t if t he mini s ter i s s a tisfi e d t h at the pe rson has a seve r e ment al o r physic al im pairment tha t (a) in t he o p i ni on of a m edi ca l pr ac tit ion e r i s likel y t o conti nue f or at l e ast 2 ye ars, and ( b ) in t h e o p i nion of a pr e scri b ed prof e ssiona l (i) directly and s i gn i fican t l y res tricts the pers on's abi li ty to perform daily liv ing ac ti viti es ei ther (A ) continuous l y, or (B) period icall y fo r exten d ed peri ods, and (ii) as a result of those restrictions, the person req ui res help to perform those a c tivities. (3) For the purposes of subsection (2), ( a) a per son who has a severe mental impairm ent 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 assistiv e device, (ii) the significa nt help or supervision of another person, or (iii) th e ser vices of an assistance animal. (4) The minister may rescind a design a ti on under subsection (2). EAPWDR 2 (1) For the purposes of the Act and this regu lat ion, "daily living activ ities", EAAT003(10/06/01)
I APPEAL# (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 Schoo/Act, or (ii) a board or a francophone education authority, as those terms are defined in section 1 (1) of the School Act, if qualifications in psychology are a condition of such employment. The Appellant's position is that she meets the requirements for designation as a PWD, but the application form does not ask for information that reflects her condition. The Appellant holds that although her condition is not covered in the application process, she meets the requirements to be designated as a PWD because she is in a lot of pain and has movement difficulties that restrict her daily function. The Appellant argued that the application form for PWD designation does not cover certain types of conditions, such as hers. She stated that she suffers mostly from scoliosis and fibromyalgia, which affect her cervical spine and lower back and that has become the more critical condition, whereas it used to be the problem with her neck. She stated that she goes to the hospital almost every second week, and that she is currently awaiting an MRI, then surgery. She stated that surgery has been denied for some time. The Appellant stated that she has the most difficulty with sitting and standing, which she finds exhausting. She is having more difficulty with walking, but that "walking 3, 4, 5 blocks helps to relieve pain" and has been recommended, thouqh some davs she can only walk 1-2 blocks EMT003(10/06/01)
� APPEAL# due to pain in her lower back and weakness in her legs. She stated that she has difficulty climbing stairs, especially in the past two months, and she had to move to a ground floor apartment because she could not climb stairs several times per day. She stated that her living conditions are critical, she has no permanent address, and when she moved to live on the ground floor she improved somewhat. The Appellant argued that although the answers given by her physician on the application form are correct, there are no details of her spinal condition, fibromyalgia, scoliosis and a "weird" muscular condition which is now under investigation. She stated that a few tests she had a few months apart do not show muscle atrophy; the most recent test was in April. She stated that she has weakness in her arms, legs and spine, which is muscular but her "limpness" is not detected by (medical) devices or neurological tests .. She stated that doctors do standard neurological tests, but they do not show a problem, and she has had chronic weakness after her surgery which was made worse by whiplash. These conditions contribute to her chronic balance problems and dizziness, which conditions have been described as "severe" because they affect her everyday life. The Ministry's position is that they make a determination based on the information provided, and there is insufficient information in the Appellant's application to confirm that she has a severe mental or physical condition that restricts her ability to perform DLA's to the extent that she requires significant assistance to perform them. The Ministry argued that their decision is based on the information provided at the time of application, and that the information provided by the Appellant was not sufficient to confirm that she has a severe mental or physical condition that impacts her ability to perform DLA's to the point where she requires significant assistance to perform them. In response to questions from the Appellant, the Ministry responded that there is no definition of severity, but it depends on how the doctor completes the application, which is then reviewed by the Health Assistance Branch. The condition has to impact DLA's and the appellant's doctor did not confirm with any detailed explanation how the appellant's DLA's are restricted. Severe physical impairment With respect to a severe physical impairment, the Panel notes that the Appellant's physician, in the original application, refers to the Appellant's condition as chronic and not amenable to treatment under "Degree and course of impairment". Also, in the note of March 19, 2014, the physician reports that the appellant is totally disabled due to severe back pain. Nevertheless, the physician notes that the appellant can walk 1 to 2 blocks, climb 5+ steps, cannot lift and can remain seated less than one hour. Two of the five aspects of mobility and physical ability are reported as independent, three are reported to require periodic assistance and one, lifting, is reported as requiring continuous assistance. At the hearing, the appellant stated that "walking 3, 4, 5 blocks helps to relieve pain" but some days she can only walk 1-2 blocks due to pain in her lower back and weakness in her legs, and she can lift up to 2 or 3 kg. In the letter from the Appellant to the Ministry dated March 7, 2014, the appellant stated that she can climb 10 to 15 stairs and that she walks more than 2 blocks for exercise. In the section dealing with daily living activities, the physician did not report any requirement for an assistive device, reported that periodic assistance is required with two tasks of physical DLA's and that the Appellant takes significantly longer that typical with dressing, grooming, bathing, toileting, laundry, basic housekeeping, going to and from stores, reading prices and labels, food preparation and cooking, with a notation "x2 normal". The ministry found that the functional skill limitations "are not significantly restricted and are more in keeping with a moderate degree of physical limitation" The ministry also noted that "the narrative also does not demonstrate a severe functional limitation." Given that the nhvsician indicated indenendence, periodic assistance onlv, and takinq no more than twice as EAA T003(10/06/0 I)
l o n g t o p e rf o r m t h e m a j o r i t y o f t h e l i s t e d a c t i v i t i e s , t h e p a c o n c l u d i n g t h a t t h e r e i s i n s u f f i c i e n t e v i d e n c e o f a s e v e r e W i t h r e s p e c t t o t h e A p p e l l a n t ' s s e l f r e p o r t i n g , t h e P a n e l a n d n o t e s s u b m i t t e d b y t h e A p p e l l a n t a r e c o n t r a d i c t o r y a a l o t o f t h e i n f o r m a t i o n i s d a t e d a n d d o e s n o t a d d r e s s t h e v i d e n c e o f v a r i o u s m e d i c a l s p e c i a l i s t s b e t w e e n F e b r u a a n d s u r g e r i e s t h a t a r e n o t i n d i c a t e d , n o r m a l t e s t r e s u l t s t h a t a r e a m e n a b l e t o a n e x e r c i s e p r o g r a m a n d o t h e r t r e a l e s s e r s e v e r i t y t h a n w h a t t h e a p p e l l a n t s e l f r e p o r t s . T h e c o n c l u d e d t h a t t h e t o t a l i t y o f t h e i n f o r m a t i o n p r o v i d e d i s S e v e r e m e n t a l i m p a i r m e n t W i t h r e s p e c t t o a s e v e r e m e n t a l i m p a i r m e n t , t h e P a n e l n t h e A p p e l l a n t ' s a p p l i c a t i o n i s c h r o n i c a n x i e t y a n d d e p r e s e m o t i o n a l t r a u m a , a n x i e t y a n d d e p r e s s i o n a s a r e s u l t o f t h e M i n i s t r y , a s t o h o w m a j o r i m p a c t s o n p h y s i c a l f u n c t i o t h e a n x i e t y a n d d e p r e s s i o n . I n t h e s e c t i o n d e a l i n g w i t h c r e p o r t e d i n t h e a r e a s o f b o d i l y f u n c t i o n s , e m o t i o n a n d i m j u d g e m e n t a n d a t t e n t i o n / c o n c e n t r a t i o n a n d m i n i m a l i m p a c o m m e n t s p r o v i d e d . 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 t h a 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 ( d e c i s i o n m a k e f f 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 h e e v i d e n c e i n d i c a t e s t r e s p e c t t o d e c i s i o n m a k i n g i n t h a t s h e i n d e p e n d e n t l y m a m e d i c a t i o n s , a n d a l s o 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 ( m a k i n g a p p r o p r i a t e c h o i c e s ) , m e a l p r e p a r a t i o n ( m e a l p l s u p p o r t / s u p e r v i s i o n w i t h m a k i n g a p p r o p r i a t e s o c i a l d e c i s c o n d i t i o n . I n t h e s e c t i o n d e a l i n g w i t h D L A ' s r e l a t e d t o s o c i a l f u n c t i o i s r e q u i r e d i n a l l a s p e c t s , w i t h a n o t e t h a t a l l o f t h e s e a r e m a l a i s e . M a r g i n a l f u n c t i o n i n g i s r e p o r t e d w i t h r e l a t i o n s h T h e a p p e l l a n t i s a s s e s s e d a s h a v i n g a g o o d o r s a t i s f a c t o t h a t t h e M i n i s t r y r e a s o n a b l y c o n c l u d e d t h a t t h e i n f o r m a t i m e n t a l i m p a i r m e n t . I n t h e n e w i n f o r m a t i o n p r o v i d e d f o r t h i s a p p e a l , t h e p h y s i n d i c a t e d t h a t t h e m o s t c o n s i s t e n t a n d s t r i k i n g f i n d i n g i n a n d d i s t r e s s " , t e n d e n c y t o f o c u s a n d d w e l l o n m i n u t e d e h e r s y m p t o m s r e p r e s e n t e d e x t r e m e l y s e r i o u s a n d l i f e t h r d i s c u s s t h e a p p e l l a n t ' s a n x i e t y i n t e r m s o f h e r f u n c t i o n a l s u f f i c i e n t t o 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 i r m e n t . R e s t r i c t i o n s i n a b i l i t y t o p e r f o r m D L A ' s T h e m i n i s t r y f o u n d t h a t " t h e m a j o r i t y o f d a i l y a c t i v i t i e s a r e t w i c e a s l o n g " a n d t h a t a l t h o u g h p e r i o d i c h e l p i s n e e d e d t h e r e i s n o i n d i c a t i o n o f t h e f r e q u e n c y o r d u r a t i o n o f t h e a e r i o d i c s u o r t i s r e u i r e d i n a l l a s e e l s o f s o c i a l f u n c t i o E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )' . A P P E A L # n e l f i n d s t h a t t h e m i n i s t r y w a s r e a s o n a b l e i n p h y s i c a l i m p a i r m e n t . n o t e s t h a t i t i s l a r g e l y s u b j e c t i v e . T h e m e d i c a l r e p o r t s n d c o v e r d a t e s f r o m 2 0 0 0 t o t h e p r e s e n t . T h e r e f o r e , e a p p e l l a n t ' s c u r r e n t m e d i c a l s t a t u s . F u r t h e r , t h e r y 2 0 , 2 0 0 4 a n d A p r i l 9 , 2 0 1 4 r e f e r s t o m e d i c a l t e s t s o r r e s u l t s t h a t s h o w m i l d c o n d i t i o n s , a n d c o n d i t i o n s t m e n t s . S u c h i n f o r m a t i o n s u g g e s t s i m p a i r m e n t s o f a P a n e l t h e r e f o r e f i n d s t h a t t h e M i n i s t r y r e a s o n a b l y n o t e v i d e n c e o f 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 . o t e s t h a t t h e d i a g n o s i s o f a m e n t a l h e a l t h c o n d i t i o n i n s i v e i l l n e s s d e s c r i b e d i n t h e h e a l t h h i s t o r y a s p r i o r b r e a s t c a n c e r w i t h n o e x p l a n a t i o n , a s n o t e d b y n s a s c h e c k m a r k e d b y t h e p h y s i c i a n a r e c r e a t e d b y 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 g , m a j o r i m p a c t s a r e p u l s e c o n t r o l , w i t h m o d e r a t e i m p a c t s i n i n s i g h t a n d c t i n m e m o r y a n d m o t i v a t i o n . T h e r e a r e n o 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 s 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 i n t e r a c t w i t h o t h e r s h a t t h e a p p e l l a n t i s n o 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 n a g e s h e r f i n a n c e s ( p a y r e n t a n d b i l l s ) a n d h e r i o n m a k i n g c o m p 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 a n n i n g a n d f o o d s t o r a g e ) , a n d r e q u i r e s p e r i o d i c i o n s d u e t o c h r o n i c p a i n r a t h e r t h a n t o a m e n t a l h e a l t h n i n g , t h e p h y s i c i a n r e p o r t e d t h a t p e r i o d i c s u p e r v i s i o n i m p a c t e d d u e t o c h r o n i c p a i n , L O E , d i z z i n e s s a n d i p s w i t h 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 n e t w o r k s . r y a b i l i t y t o c o m m u n i c a t e i n a l l a r e a s . T h e P a n e l f i n d s o n p r o v i d e d i s n o t s u f f i c i e n t e v i d e n c e o f a s e v e r e i c i a n ' s m e d i c a l l e g a l o p i n i o n d a t e d A u g u s t 2 2 , 2 0 1 2 , t h e a p p e l l a n t ' s m e d i c a l h i s t o r y w a s h e r " s e v e r e a n x i e t y t a i l s o f h e r s y m p t o m s a n d a n u n w a v e r i n g b e l i e f t h a t e a t e n i n g a i l m e n t s . H o w e v e r , t h e p h y s i c i a n d i d n o t a b i l i t i e s a n d t h e n e w e v i d e n c e i s t h e r e f o r e n o t p e r f o r m e d i n d e p e n d e n t l y a l b e i t s o m e t a s k s t a k e t o c a r r y p u r c h a s e s a n d g e t i n a n d o u t o f a v e h i c l e , s s i s t a n c e . F u r t h e r , t h e m i n i s t r y n o t e d t h a t a l t h o u g h n i n , t h e h s i c i a n ' s n a r r a t i v e d e s c r i b e s t h e
: APPEAi # appellant's physical factors and not her mental health issues. The physician reported that although the appellant has been prescribed a number of medications, these do not interfere with her ability to perform DLA. As the physician's information indicated that the majority of DLA's are performed independently or require little help from others, the panel finds that the ministry reasonably determined that "the information from your prescribed professional does not establish that impairment significantly restricts daily living activities either continuously or periodically for extended periods as required under clause 2(2)(b)(i) of the EAPWDR. With regard to the appellant's new information provided for this appeal, the note dated April 23, 2014 indicated that functional skill limitations are restricted and are more than moderate due to the fact that the appellant can only lift light objects and always needs the help of other people with cleaning, shopping, packing, travelling, and organizing before and after meals. She cannot carry or wash "heavy pots, plates, heavy garbage, vacuuming, cleaning stairs or windows. The physician stated that the Appellant's spinal problems cause movement and balance problems, and that packing her belongings and travelling are very stressful and exhausting. With regard to executive function, the physician stated that the Appellant has "definite problems with planning and organizing her life, problem solving is difficult and simply postponed". The Panel notes that these tasks of DLA are performed within the functional skill limitations, previously described, which are more in keeping with a moderate degree of physical limitation. Help to perform DLA's With respect to a requirement for significant help to perform DLA's, the Panel notes that the majority of DLA's, 15 out of 27, are reported as being performed independently, with one requiring periodic assistance, 10 taking significantly longer than typical and none requiring continuous assistance. Social functioning DLA's are all reported as requiring periodic support. In the section dealing with assistance, the Appellant's physician reported that she needs assistance with most DLA's with no comment about what assistance would be necessary. There is no assistive device reported as being required. In her self-reports the appellant argued that she needs help with heavier physical activities but can perform many activities independently with adaptations such as taking rests, buying groceries in smaller, lighter quantities, and using a cart to carry items on transit. The Panel finds that the Ministry reasonably concluded that the information provided does not establish that to perform directly and significantly restricted DLA's, the Appellant requires the significant help of another person, an assistive device or an assistance animal. Panel's decision In conclusion, the Panel confirms the Ministry's reconsideration decision, which found that the appellant is not eligible for designation as a person with disabilities, as being reasonably supported by the evidence. EAAT003(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.