P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t r y o f S o c i a l r e c o n s i d e r a t i o n d e c i s i o n d a t e d A p r i l 1 6 , 2 0 1 4 w h i c h f i v e s t a t u t o r y r e q u i r e m e n t s o f S e c t i o n 2 o f t h e E m p D i s a b i l i t i e s A c t f o r d e s i g n a t i o n a s a p e r s o n w i t h d i s a p p e l l a n t m e t t h e a g e r e q u i r e m e n t a n d t h a t h i s i m p H o w e v e r , t h e m i n i s t r y w a s n o t s a t i s f i e d t h a t t h e e v i d • t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l o r m e n t a • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( D L A ) a r e d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t e d e i t h e r c o n • a s a r e s u l t o f t h e s e r e s t r i c t i o n s , t h e a p p e l l a n a n o t h e r p e r s o n , t h e u s e o f a n a s s i s t i v e d e v i c p e r f o r m D L A . P A R T D R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b A P P E A L # I D e v e l o p m e n t a n d S o c i a l I n n o v a t i o n ( t h e m i n i s t r y ) f o u n d t h a t t h e a p p e l l a n t d i d n o t m e e t t h r e e o f t h e l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h a b i l i t i e s ( P W D ) . T h e m i n i s t r y f o u n d t h a t t h e a i r m e n t i s l i k e l y t o c o n t i n u e f o r a t l e a s t t w o y e a r s . e n c e e s t a b l i s h e s t h a t : l i m p a i r m e n t ; , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s ; a n d , t r e q u i r e s t h e s i g n i f i c a n t h e l p o r s u p e r v i s i o n o f e , o r t h e s e r v i c e s o f a n a s s i s t a n c e a n i m a l t o i l i t i e s A c t ( E A P W D A ) , S e c t i o n 2 i l i t i e s R e g u l a t i o n ( E A P W D R ) , S e c t i o n 2
PAR T E -Surnrnarv of Fact s The evidence b e for e the mini stry at the tim e of the rec Disabil i ties (PWD) Application comprised of th e ap plica 20, 2 013, a physician r ep or t ( PR) dat ed November 6, 2013 and an assess November 27, 2013 and completed by the appellant's fam for approximate l y 5 m onths. The e v idence al s o included 1) Letter d a ted April 1, 2014 w ith st atemen t s to 2) Request for Reconsid eration d ated April 1, 2014. Diagnoses In the PR, the appellant wa s di agnosed by hi s physician with right ul function of right hand, with onset in April 2013, ost eoarthr di sease] of lumbar spine, with onset in 2 0 13, and ch April 2013. There was no dia gno s is ind icated for a mental health con Phy s i c al Impai rme n t I n th e PR, th e app e llant 's physician r e p orte d that: • In terms of h e alth hi story, the ap pe llant h ad a rig ht si de of h i s body was struck by a heavy m la ter revealed no evi dence of fr ac ture or d islocation, but he has bee of f unction s i nce t h a t time. He h as s ympt o ms wh i ch r e duce s hi s a b il ity to u s e hi s ri g ht hand. hi s mobi li t y. He h as pai n at the base of his neck and r ota ti o n ." • T h e appe ll ant does not re quire an y prosth esis n ote d " n o tr e a tment at pr es ent ." • Fo r the d egr ee and cou r se of i mpairment, t he f uncti o n a l prior t o hi s in jury" . .. but in vi ew o f h fit for ma nua l l a bour aga i n." • In t erms of fun c ti o n al s kills , th e appellant can walk 4 un a i ded an d is a ble t o l ift 7 to 1 6 k g. (15 to 35 "nee ds t o move aro u nd"). • In the addi tional c o mm e n ts, the p hy sician wro Requires the help of friends for heavier tasks, otherwise he is able to function independently." In the AR, the appellant's physician indicated that: • The �ppellant is assess ed as independ ent with all mobi outdoor s , climbing stairs, and s tanding, while requ carrying and holding. The physician noted: "needs assistance with heavy objects." • The section of the AR relating to assistance provided through the use of assistive devices is not completed by the physician. In the appellant 's self-report, he wrote tha t: • He was not able to see a doctor until 3 ½ months after his accident. nerve injury with reduced function of his right hand, osteoarthritis, DDD of his lumbar spine, c urve in his spine and chronic pain synd r om e and loss of function. I APPEAL# o ns ideration decisi on included the Pers o n With nt information and self-re por t dated Novem ber or report (AR) date d il y physic ian who has known the app el lant the following: whi ch the appell a nt's physic ian responded; an d, na nerve injury with reduced i tis ("OA") and O DD [ de generat ive disc ronic pain syndrome-neck and ribs, with onset in dition. work-relate d inju ry in A p ril 20 1 3 " ... whe r e the eta l ob ject. M edical asses sm en t done 3 mont h s n disabled by pa i n and loss of ulna ne rve im p i ngemen t at the r ight elbow H e h a s right lower lateral rib pa in w hich li mits r educed neck mo vement i n lef t si de or aid fo r hi s impairm e n t, and the p hys icia n phys i cia n noted that t h e appe l lant wa s f ully i s sp i nal OA an d DDD, he is unl i kel y to b e co m e o r more blocks and c limb 5 or more step s lbs.) and remain seate d less tha n 1 hour (n o te: te: " no hospital ization r equired. Live s alone. lit y, including walking indoors an d i ring periodic assistance wi t h lifting and He now suffer s from (neck and ribs). He is n ow d isa b l ed due to p ain '
I APPEAL# • He is only able to walk up to ½ of a block before he has to stop and take a break. He can only climb up to 3 stairs before he needs to hold onto something to climb any more stairs. He is only able to lift up to 10 lbs. at a time. He is only able to sit for less than 1 hour. • Without surgery to his elbow, he cannot grip anything and nerve damage makes arm normal functions impossible. • He needs rib-cage and hip on right hand side dealt with in order to just sit down and a brace for his spinal column to help possibly correct the curve in his spine caused by the accident at his work. In the letter dated April 1, 2014, the physician indicated with a check mark that he agreed that the appellant states: • He is only able to walk up to ½ block at a time and he has to use a handrail at all times when he climbs stairs. • He is only able to lift up to 10 lbs. at a time and if he bends to lift any weight, he will black out. • He is only able to stand for a maximum of 20 minutes at a time and he is only able to sit for up to 20 minutes at a time. • He has to lie down at least 4 times a day for about 1 hour at a time. Mental Impairment In the PR, the appellant's physician reported that: • The appellant has no difficulties with communication and no significant deficits with cognitive and emotional function. In the AR, the physician indicated that: • The appellant has a good ability to communicate in speaking and hearing, and satisfactory reading and writing. The physician noted that the appellant is "grade 9 educated." • The sections of the report describing impacts to cognitive and emotional functioning and social functioning are not applicable to the appellant. In the appellant's self-report, he did not describe a mental health condition. In the April 1, 2014 letter, there were no statements describing impacts from a mental health condition. Daily Living Activities (DLA) In the PR, the physician indicated that: • The appellant has not been prescribed any medication and/or treatment that interfere with his daily living activities. • He is restricted on a continuous basis with daily shopping, mobility inside the home and mobility outside the home. • The appellant is not restricted with personal self care, meal preparation, management of medications, basic housework, use of transportation, management of finances, and social functioning. • Regarding the degree of restriction, the appellant's "mobility is reduced by pain in neck, back and ribs." • With respect to the assistance needed with DLA, the appellant is "able to perform the activities of daily living, but may take longer to perform some of them." • For additional comments, the physician noted that the appellant lives alone and "requires the help of friends for heavier tasks, otherwise he is able to function independently,"
I APPEAL# In the AR, the physician reported that: 0 The appellant is independent with moving about indoors and outdoors. • The appellant is independent in all 8 tasks of the DLA personal care: dressing, grooming, bathing, toileting, feeding self, regulating diet, transfers in/out of bed and transfers on/off chair. • The appellant is independent with basic housekeeping and laundry. • For shopping, the appellant is independent with 4 of 5 tasks, namely going to and from stores, reading prices and labels, making appropriate choices and paying for purchases. The appellant requires periodic assistance with carrying purchases home, with a note added: "needs help for heavy objects." • The appellant is independent in performing 2 of 4 tasks of the DLA meals, including meal planning and safe storage of food. The appellant requires periodic assistance from another person with food preparation and cooking, described as "uses easy, prepackaged foods." • The appellant is independent with all 3 tasks of the DLA paying rent and bills: banking, budgeting, and paying rent and bills. • The appellant is independent in performing all 3 tasks of managing his medications: filling/ refilling prescriptions, taking as directed and safe handling and storage. • The appellant is independent with all 3 tasks of managing transportation: getting in and out of a vehicle, using public transit and using transit schedules and arranging transportation. In the appellant's self-report, he wrote that: • He has great difficulty with regulating his diet. He lost 40 lbs. this last summer. • He only does his shopping once every 3 to 5 months. He is very isolated where he lives and, due to snow fall, he is unable to get to the nearest community to get his groceries. He has to use a shopping cart when shopping and he is unable to read small print without glasses. He is unable to lift over 10 lbs. at a time. • For meals, he is unable to do meal planning and he relies on easy prepackaged foods. • He is unable to do daily chores around his home and any chores requiring him to bend at the waist. • Without surgery to his elbow, he cannot grip anything and nerve damage makes arm normal functions impossible. In the letter dated April 1, 2014, the physician indicated with a check mark that: • He agrees that the appellant states he is in need of continuous assistance or he is unable to do the following DLA due to his medical conditions and limitations they present him: carry purchases home ("unable over 10 lbs. at a time"), basic housekeeping ("unable to sweep, unable to bend over to ciean out bathtub or shower"), and banking ("unable to stand in line at bank, all banking done by debit card, auto deposit"). The physician wrote that the appellant " ... says that his condition is getting worse, but still able to live alone." • He disagrees that the appellant states he is in need of continuous assistance or he is unable to do the following DLA due to his medical conditions and limitations they present him: regulate diet, meal preparation, and cooking. The physician wrote that the appellant "states that he is not a cook ... and has therefore always relied on pre-prepared food." Need for Help The physician reported in the AR that the help required for DLA is provided by the appellant's friends. The section of the report indicating assistance provided through the use of assistive devices is not completed.
I n h i s N o t i c e o f A p p e a l , t h e a p p e l l a n t e x p r e s s e d h i s d e c i s i o n a n d w r o t e t h a t w i t h h i s p h y s i c a l c o n d i t i o n , A t t h e h e a r i n g , t h e a p p e l l a n t a n d h i s a d v o c a t e s t a t e • T h e d o c t o r w h o p r e p a r e d t h e r e p o r t s f o r t h e t e s t i n g t h a t h e n e e d s t o h a v e t o d e t e c t n e rv e a s s e s s m e n t ' d o n e 3 m o n t h s a f t e r t h e a c c i d e d a m a g e . T h e d o c t o r s e e m e d t o b e o f t h e o p p r o b l e m . • T h e a p p e l l a n t h a s f o u n d a n e w d o c t o r i n a n o E M G s c a n o f h i s r i g h t e l b o w . H e h a s n o t g o s i n c e h e c u r r e n t l y h a s v e r y l i t t l e u s e o f h i s r i g s c a n o f h i s s p i n a l c o l u m n . H e i s r e l i e v e d b e • T h e a p p e l l a n t c a n n o t c o o k f o r h i m s e l f . H e r e a p r e t t y g o o d d i e t i n t h e p a s t b y p a y i n g o t h e r • I t h a s b e e n c o s t l y t o g e t i n t o s e e t h e d o c t o r a n d h e h a d t o u s e h i s f o o d a l l o w a n c e m o n e y • H e w o u l d l i k e t o l o o k i n t o p o s s i b l e s u r g e r i e s n e r v e d a m a g e . T h e r e w a s d a m a g e d o n e t o b u l g e s i n h i s s p i n e c a n b e s e e n a n d h e c a n f • H e h a s t o s i t o r l i e d o w n 3 t o 4 t i m e s p e r d a y • H e i s n o t a b l e t o d o m a n u a l l a b o u r a n y m o r e e v e n k n o w h o w t o t u r n o n a c o m p u t e r . • L o o k i n g a t t h e A R , h e s a y s i t d e p e n d s o n w h c o o k f o r h i m s e l f b u t h e c a n p u t a s p o o n t o h i • F o r t r a n s f e r s ( i n / o u t o f b e d a n d o n / o f f o f c h a f u t u r e . • I t i s i m p o s s i b l e f o r h i m t o l i f t o v e r 1 0 l b s . , o r a • H e h a s " b a d h a b i t s " a n d h e h a s n e v e r p l a n n e b e e n u n a b l e t o g a i n m o r e t h a n a b o u t 2 l b s . • H e i s a l l e r g i c t o a b o u t 6 5 t o 7 0 % o f t h e m e d i r e s o l v e t h e p r o b l e m a n y w a y , t h e y j u s t n u m b • A f t e r h e w a s i n j u r e d , h e a p p l i e d f o r a w o r k s a d i s a b i l i t y a t t h e s a m e t i m e . A t f i r s t , h e t h o u g g e t t i n g v e r t i g o w h e n h e b e n t o v e r a n d w o u l d • H i s c o n d i t i o n i s " n o t g e t t i n g b e t t e r . " H e h a s d • H e c a n n o t m o w t h e l a w n . H e c a n s w e e p h i s w a t e r a n d n o r e f r i g e r a t i o n . T h e m i n i s t r y r e l i e d o n i t s r e c o n s i d e r a t i o n d e c i s i o n . t h e a p p e l l a n t i s c l a s s e d a s a n e m p l o y a b l e p e r s o n , h d o e s n o t c u r r e n t l y h a v e t h e s t a t u s o f a P e r s o n w i t h ( P P M B ) .I A P P E A L # d i s a g r e e m e n t w i t h t h e m i n i s t r y ' s r e c o n s i d e r a t i o n h e n e e d s a p r o p e r d o c t o r a n d s u r g e r y . d t h a t : P W D a p p l i c a t i o n d i d n o t r e f e r t h e a p p e l l a n t f o r t h e d a m a g e a n d o n l y d i d X R a y s . T h e ' m e d i c a l n t w a s X R a y s , b u t t h e s e w i l l n o t d e t e c t n e r v e i n i o n t h a t t h e a p p e l l a n t o n l y t h i n k s h e h a s a t h e r c o m m u n i t y w h o h a s a l r e a d y r e q u i s i t i o n e d a n n e f o r t h e s c a n y e t b u t h o p e s t o h a v e i t d o n e s o o n h t a r m . H e i s a l s o g e t t i n g n e w X R a y s a n d a C T c a u s e h e d o e s n o t w a n t t o e n d u p i n a w h e e l c h a i r . l i e s o n o t h e r s t o c o o k f o r h i m . H e h a s m a i n t a i n e d s t o c o o k f o r h i m . e v e r y 2 w e e k s , t o k e e p h i s w o r k s a f e c l a i m a c t i v e , f o r t r a n s p o r t a t i o n c o s t s . t o c o r r e c t h i s s p i n a l c o l u m n a n d t r e a t m e n t f o r t h e h i s s p i n e f r o m t h e i m p a c t a t t h e j o b s i t e . T h e e e l f r i c t i o n i n s p o t s . t o r e a l i g n h i s s p i n e . a n d t h a t i s a l l h e h a s e v e r k n o w n . H e d o e s n o t a t i s m e a n t b y " f e e d i n g s e l f " b e c a u s e h e c a n n o t s m o u t h . i r ) , h e c a n d o t h a t n o w , b u t p r o b a b l y n o t i n t h e n y w e i g h t f r o m t h e g r o u n d . d f o r h i s m e a l s s o h e l o s t 4 0 l b s . a n d h e h a s c a t i o n s f o r p a i n r e l i e f , b u t t h e m e d i c a t i o n s d o n o t t h e p a i n . f e c l a i m a n d n o o n e t o l d h i m t o a l s o a p p l y f o r h t h e c o u l d d o t h i n g s b u t t h e n h e w o u l d e n d u p b l a c k o u t . e t e r i o r a t i n g d i s c d i s e a s e w h i c h i s g e t t i n g w o r s e . t r a v e l t r a i l e r t h a t h e i s l i v i n g i n , b u t i t h a s n o h o t T h e m i n i s t r y s t a t e d a t t h e h e a r i n g t h a t a l t h o u g h e h a s b e e n e x c u s e d f r o m l o o k i n g f o r w o r k . H e P e r s i s t e n t M u l t i p l e B a r r i e r s t o e m p l o y m e n t
I APPEAL# I PART F -Reasons for Panel Decision The issue on the appeal is whether the ministry's reconsideration decision, which found that the appellant is not eligible for designation as a person with disabilities (PWD), was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. The ministry found that the appellant does not have a severe mental or physical impairment and that his daily living activities (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, it could not be determined that the appellant requires the significant help or supervision of another person, the use of an assistive device, or the services of an assistance animal to perform DLA. The criteria for being designated as a person with disabilities (PWD) are set out in Section 2 of the EAPWDA as follows: Persons with disabilities 2 (1) In this section: "assistive device" means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "prescribed professional" has the prescribed meaning. (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i) directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B) periodically for extended periods, and (ii) as a result of those restrictions, the person requires help to perform those activities. (3) For the purposes of subsection (2), (a) a person who has a severe mental impairment includes a person with a mental disorder, and (b) a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, (ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. (4) The minister may rescind a designation under subsection (2). Section 2(1)(a) of the EAPWDR defines DLA for a person who has a severe physical or mental impairment as follows: Definitions for Act 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;
APPEAL# I (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. Severe Physical Impairment The appellant's position is that a severe physical impairment is established by the evidence of the reduced function of his right hand and arm due to the right ulna nerve injury, back pain due to OA and DDD of his lumbar spine, and chronic pain syndrome in his neck and ribs. The appellant argued that the doctor who provided the evidence for his PWD application was not prepared to conduct the appropriate investigations and seemed to be of the opinion that he only thinks he has a problem. His new doctor, however, has taken the appellant's concerns seriously and has already requisitioned an EMG scan of his right elbow, new X-Rays to compare with the previous X-Rays, as well as a CT scan of his spinal column. The ministry's position is that the ministry does not have enough information from the general practitioner to confirm that the appellant has a severe physical impairment. The ministry argued that, in terms of physical functioning, the general practitioner indicated in the PR that unaided the appellant can walk 4 or more blocks and climb 5 or more steps and he can lift 15 to 35 lbs. and remaining seated for up to 1 hour, with the comment by the general practitioner that the appellant needs to move around. The ministry argued that the general practitioner indicated that the appellant is independently able to walk indoors and outdoors, climb stairs and stand, with periodic assistance required with lifting and carrying and holding "heavy objects." The ministry argued that the general practitioner reported that no assistive devices are routinely used to help compensate for impairment. The ministry argued that the new assessment by the· general practitioner provided in the April 1, 2014 letter does not demonstrate a severe impairment or significant restrictions in the appellant's ability to perform DLA. Panel Decision A diagnosis of a serious medical condition does not in itself determine PWD eligibility or establish a severe impairment. An "impairment" is a medical condition that results in restrictions to a person's ability to function independently or effectively. To assess the severity of an impairment one must consider the nature of the impairment and the extent of its impact on daily functioning as evidenced by functional skill limitations and the degree to which performing DLA is restricted. In making its determination the ministry must consider all the relevant evidence, including that of the appellant. However, the legislation is clear that the fundamental basis for the analysis is the evidence from a prescribed professional -in this case, the appellant's physician.
T h e a p p e l l a n t ' s f a m i l y p h y s i c i a n o f a p p r o x i m a t e l y 5 i n j u r y w i t h r e d u c e d f u n c t i o n o f h i s r i g h t h a n d , O A a n s y n d r o m e i n h i s n e c k a n d r i b s . T h e p h y s i c i a n n o t e d c o n d u c t e d 3 m o n t h s a f t e r t h e a p p e l l a n t ' s w o r k p l a c e d i s l o c a t i o n , b u t t h a t t h e a p p e l l a n t h a s b e e n d i s a b l e d t h e h e a r i n g , t h e a p p e l l a n t s t a t e d t h a t t h e ' m e d i c a l a t h a t t h e s e w i l l n o t d e t e c t n e r v e d a m a g e . T h e p h y s i u l n a n e r v e i m p i n g e m e n t a t t h e r i g h t e l b o w w h i c h r e r i g h t l o w e r l a t e r a l r i b p a i n w h i c h l i m i t s h i s m o b i l i t y . n e c k m o v e m e n t i n t h e l e f t s i d e r o t a t i o n . T h e p h y s i c a n y p r o s t h e s i s o r a i d f o r h i s i m p a i r m e n t w r o t e : " n o t I n t e r m s o f f u n c t i o n a l s k i l l s , t h e p h y s i c i a n i n d i c a t e d b l o c k s a n d c l i m b 5 o r m o r e s t e p s u n a i d e d a n d i s a b 1 h o u r . I n t h e a d d i t i o n a l c o m m e n t s , t h e p h y s i c i a n w f o r h e a v i e r t a s k s , o t h e i w i s e h e i s a b l e t o f u n c t i o n i n w r o t e t h a t h e i s o n l y a b l e t o w a l k u p t o ½ o f a b l o c k c a n o n l y c l i m b u p t o 3 s t a i r s b e f o r e h e n e e d s t o h o l d a p p e l l a n t w r o t e t h a t h e i s o n l y a b l e t o l i f t u p t o 1 O l b d a m a g e m a k e s n o r m a l a r m f u n c t i o n s i m p o s s i b l e . I n i n d i c a t e d w i t h a c h e c k m a r k t h a t h e a g r e e d t h a t t h e b l o c k a t a t i m e , h e h a s t o u s e a h a n d r a i l a t a l l t i m e s 1 O l b s . a t a t i m e a n d i f h e b e n d s t o l i f t a n y w e i g h t , h a p p e l l a n t s t a t e s h e h a s t o l i e d o w n a t l e a s t 4 t i m e s I n t h e A R , t h e p h y s i c i a n a s s e s s e d t h e a p p e l l a n t a s i n d o o r s a n d o u t d o o r s , c l i m b i n g s t a i r s , a n d s t a n d i n g , o r f r o m a n a s s i s t i v e d e v i c e . T h e p h y s i c i a n r e p o r t e d w i t h l i f t i n g a n d c a r r y i n g a n d h o l d i n g , b u t l i m i t e d t h e a p p e l l a n t i n d i c a t e d i n h i s s e l f r e p o r t t h a t h e n e e d s a c o r r e c t t h e c u r v e i n h i s s p i n e c a u s e d b y t h e a c c i d e n s e c t i o n o f t h e A R r e l a t i n g t o a s s i s t a n c e p r o v i d e d t h r i n d i c a t e d e q u i p m e n t o r d e v i c e r e q u i r e d b u t n o t c u r r e 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 i o i n t h e a b i l i t y t o p e r f o r m D L A ' , a n y p h y s i c a l l i m i t a t i o n 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 s i g n i f i c a n t r e s t r i c t i n d e p e n d e n t l y . I n v i e w o f t h e r e p o r t s o f l e v e l o f i n d e t h e a p p e l l a n t d o e s h a v e s o m e p h y s i c a l h e a l t h i s s u e e v i d e n c e f a l l s s h o r t o f e s t a b l i s h i n g t h a t h e h a s a s e v E A P W D 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 a p p e l l a n t d i d n o t m a i n t a i n a p o s i t i o n t h a t h e h a A P P E A L # I m o n t h s , d i a g n o s e d t h e a p p e l l a n t w i t h u l n a n e r v e d O D D o f h i s l u m b a r s p i n e a n d c h r o n i c p a i n i n t h e h e a l t h h i s t o r y t h a t a m e d i c a l a s s e s s m e n t a c c i d e n t r e v e a l e d n o e v i d e n c e o f f r a c t u r e o r b y p a i n a n d l o s s o f f u n c t i o n s i n c e t h a t t i m e . A t s s e s s m e n t ' w a s X R a y s a n d t h e a p p e l l a n t a r g u e d c i a n w r o t e t h a t t h e a p p e l l a n t h a s s y m p t o m s o f d u c e s h i s a b i l i t y t o u s e h i s r i g h t h a n d . H e h a s H e h a s p a i n a t t h e b a s e o f h i s n e c k a n d r e d u c e d i a n i n d i c a t e d t h a t t h e a p p e l l a n t d o e s n o t r e q u i r e r e a t m e n t a t p r e s e n t . " i n t h e P R t h a t t h e a p p e l l a n t c a n w a l k 4 o r m o r e l e t o l i f t 1 5 t o 3 5 l b s . a n d r e m a i n s e a t e d l e s s t h a n r o t e : " . . . l i v e s a l o n e . R e q u i r e s t h e h e l p o f f r i e n d s d e p e n d e n t l y . " I n h i s s e l f r e p o r t , t h e a p p e l l a n t b e f o r e h e h a s t o s t o p a n d t a k e a b r e a k , a n d h e o n t o s o m e t h i n g t o c l i m b a n y m o r e s t a i r s . T h e s . a t a t i m e , h e c a n n o t g r i p a n y t h i n g a n d n e r v e t h e l e t t e r d a t e d A p r i l 1 , 2 0 1 4 , t h e p h y s i c i a n a p p e l l a n t s t a t e s h e i s o n l y a b l e t o w a l k u p t o ½ w h e n h e c l i m b s s t a i r s , h e i s o n l y a b l e t o l i f t u p t o e w i l l b l a c k o u t . T h e p h y s i c i a n a g r e e d t h a t t h e a d a y f o r a b o u t 1 h o u r a t a t i m e . i n d e p e n d e n t w i t h a l l m o b i l i t y , i n c l u d i n g w a l k i n g w i t h n o n e e d f o r a s s i s t a n c e f r o m a n o t h e r p e r s o n t h a t t h e a p p e l l a n t r e q u i r e s p e r i o d i c a s s i s t a n c e a s s i s t a n c e n e e d e d f o r " h e a v y o b j e c t s . " W h i l e t h e b r a c e f o r h i s s p i n a l c o l u m n t o h e l p p o s s i b l y t a t h i s w o r k , t h e p h y s i c i a n h a s n o t c o m p l e t e d t h e o u g h t h e u s e o f a s s i s t i v e d e v i c e a n d h a s n o t n t l y b e i n g u s e d . 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 ' R e s t r i c t i o n s s r e s u l t i n g f r o m t h e a p p e l l a n t ' s i m p a i r m e n t s d o 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 L A p e n d e n c e , t h e p a n e l h a s c o n c l u d e d t h a t w h i l e s , 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 t h e e r e p h y s i c a l i m p a i r m e n t u n d e r s e c t i o n 2 ( 2 ) o f t h e s a s e v e r e m e n t a l i m p a i r m e n t .
m ent al he a lth disorder . The minist ry arg ued that the appellant h as any signi ficant defici ts wit h his cogni tive ha ve an im pact o n his cogn itiv e and e m o tion a l functioni Panel D e c isio n The p h ys i c i an did not diagnose a menta l disor d e r in the defi cits we re rep orted with cogn iti v e a n d emotional functi on i ng w ere mark ed by t he phy sic ian as n ot app re ported that the ap pel lant does not ha ve difficulties with a p pella nt h as a good or satisfactory ability t o comm r epor t d e s cribin g impa cts to soci al fun ctioning w as the absence of a mental d isor der diagnos is and no the pane l f in ds that the m inistry r eason ably dete rm i est abli s hed under sect ion 2(2} o f the E A P WDA . Re s tr ic t ions i n the abili ty to pe rform DLA T he appel lant' s pos i t ion is that his phy s ic a l imp a i rment per form DLA o n an ong oing b asis to th e poin t t h at he pers on a nd the us e of a brac e as an assisti ve d e vi ce deteri orating and the d octor who p r ep ar ed the initial r inv es ti g ations to d ocument the extent of the in jury and d The m inistry's position i s t ha t as the ma j orit y of the a r equ ire l ittle h elp fro m o ther s a n d the inform ati on fr om t h a t imp a i rment signi ficantly rest r ict s DLA either c on The mi nis try a r g u ed t h a t the g en eral practi tioner repor pe rfo rm t he m a jo rity of t he tasks of his D L A, o r 25 o t h e g en eral practition er n ote d t h at th e appellant is able to p take lo nger to per form so me o f them; how ever, ho w Panel Decision Section 2(2)(b) of the EAPWDA requires t h a t a prescribed professio applicant's severe impairment directly and significantly restricts his DLA, continuously or periodically for extend ed periods. In this case, the app ellant's previous physician is the prescribed DLA are defined in section 2(1) of the EAPWDR and are also listed in the PR details, in the AR. Therefore, a prescribed professional completing these to indicate which , if any, DLA are sign ificantly restricted or periodically for ex tended peri o d s . In the app ellant 's circumstances, his physician initially r tasks of several DLA, including personal care, basic housekeeping, paying rent and bills, managing his medications and transportation, and with social functioning. indicated in the PR that the appellant is continuously restricted and, in the AR, that the appellant requires periodic assistance with 1 of 5 tasks, namely carrying purchases home, and that it is for "heavy objects." In his self-report, the appellant explained that he only does his shopping once every 3 to 5 months as he is very isolated where he lives. and he is unable to lift over 1O lbs. at a time. For mobilit AP PEAL# I g en eral pract iti o ne r d id n ot i n d icate that the an d em otional fu ncti on no r do hi s im pairm ents ng. PR or the April 1, 20 1 4 l ett e r. No s ign ific a nt func tion ing and im pact s t o areas of daily l ic ab le t o the a p pellant. In th e P R, the p hysi cian com muni cation and, in the AR, t ha t t he uni cate in al l are as . In the AR, the s ection o f the not ed as not app l i cable to th e appell ant. Given impacts r epor ted to mental or s o c ia l func tioning, ned t ha t a s eve re m e ntal imp airment was not dir ectly and s ignif ican tly restricts his abilit y to requires the si gnifi can t a ssis tance of ano ther . The appellan t a rgu ed t hat h i s co ndi tion i s eports di d not con d uct the neces sary e teriorat ion. p pe llant 's DLA are perf ormed i ndepend ent ly o r t he presc ribed pr ofessional d oes not establis h t inu ously or p eriodic a ll y for ex tended peri o ds . ted t hat the app e llant can indepen d e ntly ut of a tot al 2 8 tas k s . The ministr y a r g u ed th at e r form th e activiti e s of d aily liv ing bu t may mu c h l on g e r i s n ot des crib ed. nal provide an opinion that an p rofes si o nal. and, w ith ad ditional forms has the opportunity by the ap pellan t ' s imp airmen ts continuousl y e ported t h a t th e appellant is independent in all For the DL A shopping , t h e physicia n He has to use a shopping cart when shopping inside and outside the home, the h _sician
rep orted in the PR that the app e l lant is contin u ous ly r estr ic tion , noted t ha t th e ap pella n t ' s " m o bil ity is re d fu n ction al ski ll limit a ti on as s et out in the l et ter d ated and the a ppellant wrot e in his s elf report th a t he has to stop re s pec t to the meal D LA, t h e physi c ia n repor ted i n the A assi s t ance fr o m an other p er s on with 2 o f 4 t ask s, namely food prep "use s e a sy, pre-packaged food s. " In the A pril 1, 20 a p pella n t s tates he i s in nee d o f c o ntin u ous a s sis ta coo ki n g. T h e physici an wro te that the a ppellant "states th a l way s rel i e d on pre-prepared food . " In hi s self-report, m ea l plannin g and he r elie s on ea s y prepacka ged f never le a r ned ho w to pl an m eals or do much coo king m eals for him. T he p a n el fi nds th a t t h e evidence d escribes m a nage the meal DLA whic h pre -da te his i n jur y and co n diti on . I n t he Apri l 1, 2014 l e tt er, th e ph ysic ian agreed th a t the a ass i s tan ce o r he i s u n able to carry p urchases ho m e (" ho usekee ping ( " u n able t o sweep, unab l e.to bend o ver ("unabl e to stan d in line at b ank, al l banking do n e b y app ell ant state d th a t h e ca n sweep h is re s i dence because it been causing him to bla ck out and thi s i s one of the de te rmine t he e xtent o f his injur y and t h e d e t e ri o r at i p hys i c ian wr ote that t he ap pell ant " ... s a ys th a t his co alone." In the a d ditional com ments to the PR , the physician " re q uires the he l p of frien ds for heavier t a sks, ot herwi T he panel fin d s t hat the minis try re asonabl y determined that t DLA in d epe n d ently and th e a ssist anc e required i s for cleaning req uiring b ending, and he r equir es res ts d u f inds that th e ministry reas onably c oncluded that the professi ona l to establish that the appellant's impairment si DLA either continuously or periodically for extended per c r iterion of section 2(2)(b )(i) of the EAPWDA. Help to perform DLA The appell an t's position is th at he requires th e significant ass device to perform DLA. The ministry's position is t hat be cause it has not been established that DLA are significa r es tric ted, it ca nnot be determined t hat s ignifi cant help general practitioner indicated that the appellant does not requi Panel Decision Section 2(2)(b)(ii) of the EAPWDA requires that, as a result of direct and significant restrictions in the ability to perform DLA, a person requires help to perform those activities. Help is defined in subsection (3) as the requirement for an assistive device, the sionificant help or supervision of I AP PEAL # rest ricted a n d, regardi ng the degree of uc ed b y pain in neck, b a ck a n d r i bs." T he Apri l 1, 201 3 is walking unaided up to ½ b lock, a n d take a bre a k before contin u in g . Wi th R that t he app e l lant requi res periodic arati on and coo ki n g, an d that h e 14 le tter, t h e physician di sagree d th a t the n c e w ith re gulating his d iet, mea l preparatio n, and a t he is not a cook . . . and has ther efore t he app ellant w rote that he is u na b l e to do ood s and , a t the hearing , expl ai n ed th at he h a s b ecause he has always p aid o thers to p repare impacts to the appella n t's a b ili ty to d o not relat e to the ap pella nt's physi c al h eal th p pe lla nt state s he i s in need of co ntinu ous unabl e ov er 10 lbs. at a tim e "), basic to cl e an out ba thtu b or shower ") , and ba nking debit card , a uto de p os i t "). A t th e heari n g, the is a sma ll spac e but bending o ver h a s reasons he belie ves mor e t ests are n e cessar y to o n in h is co ndition. I n t h e Apr il 1 , 2014 lett e r, the ndition is g e tti n g worse, but s t ill a ble t o l i v e n o ted that t h e app ellant lives alone and se h e i s a ble to fu nc t ion i ndep ende ntly." he appell ant p erfor m s t he m ajor ity o f h is lift ing heavier we i g hts or p e r for mi ng h ea v ier e t o r estr ict io n s t o his mobility. O ver a ll, th e pa nel re is not enough evide n ce from the pres cribed gn ificantly restricts his abi lity t o manage his i ods, thereby not satisfying the l e g islativ e i s t ance o f another p e rson or an assistive ntly is requi red. The mini s try arg ued th at th e re any assistive devices.
APPEAL# I another person, or the services of an assistance animal in order to perform a DLA. The evidence of the physician, as a prescribed professional, is that the help required with DLA is provided by the appellant's friends and that no assistive devices are required. The panel finds that the ministry reasonably determined that as direct and significant restrictions in the appellant's ability to perform DLA have not been established, it ca'nnot be determined that the appellant requires help to perform DLA as a result of those restrictions, as defined by section 2(3)(b) of the EAPWDA. Conclusion Having reviewed and considered all of the evidence and relevant legislation, the panel finds that the minis try's reconsideration decision which determined that the appellant was not eligible for PWD designation was reasonably supported by the evidence, and therefore confirms the decision.
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