PART C Decision under A ppeal The decision u n d er appea l is t h e M i nis t r y of Social Dev re consideration decisi on dated April 9, 20 14 which found fiv e st atutory req uir e ments of Section 2 of the Employm Disabi li ti es Act for de si gnation as a person with d i sabilities ( appella nt met the age requirement and tha t his impair Howeve r , the ministry was not satisfied that the evi de • the appella nt has a severe physic a l or mental • the appellant ' s daily liv ing activitie s (DLA) are, in the dir e ctly and significantly restricted either con • as a result of these restriction s , the appe l lant another perso n, the u s e o f an assistive d e v ice, p er form DLA. PA RT D -Rel ev ant Legislati on E mployment and Assis tanc e for Persons with Disabil Employ m en t and Assis tanc e for Persons with D isabilities I APPEAL# elopment and S ocial Inno v a tion ( the ministry) tha t the a p pel lant did not me et thre e of the en t and A s sistance for Persons wit h PWD). The ministry found that the ment is li ke ly to c on tinue f o r at least two years. nce establis h e s that: impairment; o pinion of a prescribed p rof e ssional, tinuous l y or periodi c ally f o r extended p eriods; and , r eq uir e s t he signi fic ant he lp or sup erv isio n o f or the se rvi ces of a n ass i s tance ani mal to iti es A ct ( EAP W DA) , Section 2 Re gulat ion (EAP W DR), Se c tion 2
P A R T E S u m m a r v o f F a c t s T h e a p p e l l a n t ' s a d u l t s o n a t t e n d e d t h e h e a r i n g a s b a p p e l l a n t ' s o r i g i n a l l a n g u a g e . 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 t h e t i m e o f t h e r D i s a b i l i t i e s ( P W D ) A p p l i c a t i o n c o m p r i s e d o f t h e a p p 1 2 , 2 0 1 3 , a p h y s i c i a n r e p o r t ( P R ) a n d a n a s s e s s o r r c o m p l e t e d b y 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 w h o h w e e k s . T h e a p p r o a c h e s a n d i n f o r m a t i o n s o u r c e s u s i n t e r v i e w w i t h t h e a p p e l l a n t . T h e e v i d e n c e a l s o i n c l u d e d t h e f o l l o w i n g : 1 ) L e t t e r d a t e d M a r c h 2 6 , 2 0 1 4 w i t h s t a t e m e n t s 2 ) S u b m i s s i o n d a t e d A p r i l 7 , 2 0 1 4 p r e p a r e d b y a 3 ) R e q u e s t f o r R e c o n s i d e r a t i o n d a t e d F e b r u a r y D i a g n o s e s I n t h e P R , t h e a p p e l l a n t w a s d i a g n o s e d b y h i s p h y s i h e a d a c h e s a n d g a s t r i t i s s e c o n d a r y t o a n a l g e s i c u s e h e a l t h c o n d i t i o n . P h y s i c a l I m p a i r m e n t I n t h e P R , t h e a p p e l l a n t ' s p h y s i c i a n r e p o r t e d t h a t : • I n t e r m s o f h e a l t h h i s t o ry , t h e a p p e l l a n t " . . . h a 2 y e a r s a g o . S t i l l h a s r e s i d u a l l o w b a c k p a i n a g g r a v a t e s . P a i n w o r s e w h e n u p a n d a b o u t . i n f l a m m a t o r y d r u g s ] h a s e x p e r i e n c e d u p p e r a a n d u l c e r a t i o n w h i c h h a s b e e n u n d e r t r e a t m e h e a d a c h e s f o r 5 y e a r s a n d h a s b e e n t a k i n g m h a n d s a n d h a d s u r g e r y f o r h i s r i g h t t h u m b b o • 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 a n y p r o s t h e s i s • 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 a p p e l l a n t c a n a n d i s a b l e t o l i f t 2 t o 7 k g . ( 5 t o 1 5 l b s . ) a n d 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 r o w h i c h n e e d l i f t i n g , c a r ry i n g i t e m s ( m o d e r a t e l y I n t h e A R , t h e a p p e l l a n t ' s p h y s i c i a n i n d i c a t e d t h a t : • T h e a p p e l l a n t i s a s s e s s e d a s i n d e p e n d e n t w i t 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 , w h i l e c a r r y i n g a n d h o l d i n g . T h e p h y s i c i a n n o t e d : " c l o w b a c k a n d l e g p a i n . " • T h e 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 n o t c o m p l e t e d b y t h e p h y s i c i a n . I n t h e a p p e l l a n t ' s s e l f r e p o r t , h e w r o t e t h a t : • T h i s b a c k p r o b l e m t h a t h e h a s i n t h e l a s t 4 o r n a i n . W h e n e v e r h e w a l k s m o r e t h a n 5 m i n u t e I A P P E A L # _ _ _ _ _ _ _ _ _J o t h a w i t n e s s a n d t o p r o v i d e t r a n s l a t i o n i n t o t h e e c o n s i d e r a t i o n d e c i s i o n i n c l u d e d t h e P e r s o n W i t h l i c a n t i n f o r m a t i o n a n d s e l f r e p o r t d a t e d O c t o b e r e p o r t ( A R ) b o t h d a t e d O c t o b e r 1 8 , 2 0 1 3 a n d a s k n o w n t h e a p p e l l a n t f o r a p p r o x i m a t e l y t w o e d t o c o m p l e t e t h e f o r m w e r e s o l e l y a n o f f i c e t o w h i c h t h e a p p e l l a n t ' s p h y s i c i a n r e s p o n d e d ; n a d v o c a t e o n b e h a l f o f t h e a p p e l l a n t ; a n d , 2 5 , 2 0 1 4 . c i a n w i t h d e g e n e r a t i v e d i s c d i s o r d e r , m i g r a i n e . T h e r e w a s n o d i a g n o s i s i n d i c a t e d f o r a m e n t a l s h a d s e v e r e l o w b a c k p a i n f o r w h i c h h a d s u r g e r y w i t h r a d i a t i o n t o h i s t h i g h s . P a i n a t t i m e F o l l o w i n g u s i n g N S A I D ' s [ n o n s t e r o i d a l a n t i b d o m i n a l p a i n w h i c h i s d u e t o i n c r e a s e d a c i d i t y n t . H e h a s a l s o b e e n b o t h e r e d w i t h m i g r a i n e e d i c a t i o n f o r p a i n . H a s a l s o h a d p a i n i n b o t h n e a b n o r m a l i t y 4 y e a r s a g o . " o r a i d f o r h i s i m p a i r m e n t . w a l k 1 t o 2 b l o c k s a n d c l i m b 2 t o 5 s t e p s u n a i d e d e m a i n s e a t e d 1 t o 2 h o u r s . t e : " a s d e s c r i b e d , i s u n a b l e t o a t t e n d t o t a s k s h e a v y i t e m s ) . " 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 i n d o o r s a n d r e q u i r i n g p e r i o d i c a s s i s t a n c e w i t h l i f t i n g a n d a n n o t l i f t o r c a r r y m o d e r a t e l y h e a v y i t e m s d u e t o r o v i d e d t h r 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 s i s 5 y e a r s h a s b e e n g i v i n g h i m a l o t o f u n b e l i e v a b l e s o r s t a n d s m o r e t h a n 5 m i n u t e s , t h e p a i n a e t s
wor se a n d makes him s it d o wn on th e g round i • It h as been a l mo st 2 years sin c e su r ger y and noth he c a nnot do any work. • The amount o f mone y he gets in assi stan c e i beca use of this, his s e c ond most p ainful h ealth has t o ta k e 6 t o 8 dif ferent type s of pil ls a l mos • Bec a u se of t hese d ifficul ti es, his othe r he a lt h in to a "black day . " He wis h es he wa s heal t hy en In t he letter da t ed Mar ch 26, 2 0 14, the phys ician responded of th e appella n t's med i cal condit io ns on his daily life ph y sica l or mental impai rm e nt by writing that: • T he ap pe l lant has low back pain which "he expresses to be most of t • He also h a s migraine he adach es whic h r espond • He al so compla i ns of poor sleep p attern a t nights res • " The effect o f these con ditio ns as listed will r e M ent a l I mp a irme nt In the PR, the a ppe l lan t's physician report ed that: • The ap pellan t has n o diffic u l ties wit h commun an d emo t iona l fun ct io n. In th e AR, the physic ian indicated th at: • Th e ap pell ant has a sat i sf act ory ability to c o mmu a nd h ea r ing . • T he secti o n of th e rep ort d esc r ibing im pact s to comp let e d. • T he ap pe l la nt is in de pe nde nt in all aspe c ts o d ecisions, de v e l o ping and maintai n i ng relati o de aling ap propri a t e ly with un expe c te d d ema In the app ell an t 's self-repo rt, he did n ot descri be a mental letter, there were no statements describing impacts from a mental health condition. Daily Living Activities (DLA) In the PR, the physician indicated that: • The ap pellant has not been prescribed any medicati daily living activities. • He i s restricted on a periodic b as is w it h basic • The appe llant is not restricted with person al self care, meal preparation, managem medicat i o ns, mobility inside the home, mob ili management of finances, and social functioning. • For further explanation of "per iodic" restrictions, the physician wrote that the appellant "fee back and leg pain after a few minutes." • Regarding the degree of restriction, the physician wrote "moderate." • With respect to the assistance needed with DLA, "his family members help with housekeeping and shonnina tasks." I A PP E AL# n public no ma tter whe re he is . ing changed. He still h a s t he same pain and s n o t enoug h for his family t o live on and, p r oblem is m igrain es, wh ich ge t worse a nd he t every day. problem i s stom ac h pain which turns his worl d o ugh to w o rk and make money f o r h i s famil y. t o the quest ion whether, w h en the i m p act is con sid ere d, t he app el lant has a sev ere he time an d s e vere." t o me dication s. ulting iri fatigu e d urin g th e da y ti m e. su lt in seve re imp act on his daily life. " i c at ion and no s ig nificant d eficits with c o gniti ve nic a te in all areas : s peak ing, read in g, writ in g cogni tive and emotional fu n ction ing w a s n ot f socia l f u nctionin g: makin g appropr iate socia l nshi ps, i n terac t ing appropriately wit h others, nd s , and s e c urin g assis ta nce from others. hea l th condition. In the March 26, 2014 on and/ or treat ment that interfere with his housework and daily shopping. ent of t y ou tside the home, use of transp ortation, l s
I n t he AR, the physicia n reported t hat: • The ap pellant is indepe ndent with mo ving about indoo • The appella nt is indep ende nt in 7 of 8 tasks of the DLA personal care: dressing, toileting, feedi ng sel f, regulating diet , transfer req u i res periodic assis tan c e from an other person with bath p rovided . • T he appellant r equires p eriod ic as sistance with basic housekeepin further explanatio n or descrip tion provided. • For s h opping , the a ppellant is inde pend ent with 4 of 5 tasks, namely going to and reading prices and labels, making appropriate appe llant requires periodic a ssi stance w ith ca the appellant " h as low b ack/l eg and, a t times, wrist shopping/ items." • Th e appellant i s i ndepende nt in p e rforming 1 of o f food. The appellant requi res per i odic assistan fo od preparati o n an d coo kin g, d es cribed a s "due to than a few m inutes ." • T he appellant is inde pen de nt wi t h all 3 tasks of b udge tin g, and p a ying rent and b ill s. • The appellant is indepe ndent i n perfo rmi ng a ref i l ling p re s cr iptions, taki n g as d irec ted and • The appellant i s inde pe nde nt wit h all 3 tasks of mana v ehic l e, using public trans it and us ing t ransi t In the letter dated M ar c h 2 6, 2014, the phy sician wr o • In resp o ns e to the question w h ether it tak es the appellant DLA , or does h e pu t tasks off, as a direct res c o m ment ed that the appe llant " says pai n in h more tha n 3 to 4 minut e s . • Asked whet h er t he appellant's l eve l of act ivi ty "he expres ses that i s unable to walk, carry items, e • In response to a question ab out how o ften the app DLA, th e physicia n wrote th a t "he expr esses • Asked whether the appel lant's i m pai rment significantly restricts his DLA continuously or periodically for extended periods "expresse s his symptoms of low back pain and migraine headaches and fati signi f i cant res triction in a number of act ivities shoppin g , meal preparation, and p ersonal care Need for Help In the AR, the physician reported that: • The help required for DLA is provi ded by the appellant's family. assistance that would be necessary if help was not available, the physician wrote: "help for lifting and carrying moderately heavy items; help for cooking and meal preparation." • The section of the report indicating assistance provide not completed. I APPEAL# rs and outdoor s. g rooming , s in/out of be d and transfers o n/off c h air. He ing, w i th no further descri ption g an d l a u ndry, with no from stores, choices a n d pa yi ng for purc ha s es. The r rying purchases h ome. The physician no t ed t hat p a in; fam il y m e mbers h e lp t o lift and carry 4 tasks of the D L A meal s, nam el y sa fe stor ag e ce f rom anot her p erson with meal planni ng, b a ck an d leg pain, ca n no t st a n d f or m o r e t he D LA pay ing rent and bill s : b a nk ing , ll 3 tasks of m a nagi ng h i s m ed i cati ons: fill i n g / safe h and ling an d st o rage. gi ng tr a n sport a tion : gettin g in an d ou t of a sc hedule s and a rranging t r a n s p o r ta tion. te that : lon g er than norma l to p er f or m many u lt of his h ealth-rela t ed limit a t ion s, the p h ysi ci an i s lowe r b a ck and leg s preven t hi m f rom walking is sig nifi c ant ly reduced, the physi cian wrote that t c. due to h i s leg an d low er b ack pa i n." ellant is s ignificantly res tricted in performing most of the time he is restricted in his daily tasks . " a b ility to perform a range o f , the physician wrote that the appellant gue result in of daily living, such as basic housework, , etc ." Asked to describe the d through the use of assistive devices is
I n t h e l e t t e r d a t e d M a r c h 2 6 , 2 0 1 4 , t h e p h y s i c i a n w r • I n r e s p o n s e t o t h e q u e s t i o n w h e t h e r h e c a n c w i t h D L A , t h e p h y s i c i a n w r o t e t h a t " h i s f a m i l y o u t d o o r s ; s a y s a t h o m e h a s d i f f i c u l t y i n b a t h r 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 i t w a s n o t r e a s o n a b l e t o d e n 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 p r o v i d e d a n a d d i t J a n u a r y 6 , 2 0 1 1 c o m p l e t e d b y a s p e c i a l i s t i n n e u r o s r e p o r t . T h e a d v o c a t e e x p l a i n e d t h a t t h e M e d i c a l R e a p p l i c a t i o n f o r d i s a b i l i t y a s s i s t a n c e i n a n o t h e r p r o v i n g r a n t e d d i s a b i l i t y d e s i g n a t i o n . T h e d i a g n o s i s i s m u l f o r a m i n a l n a r r o w i n g , w i t h a c o m m e n t t h a t t h e " c o n d i f r o m h e a v y l a b o u r w o r k . " I n t e r m s o f a t t i t u d e / e m o t i o n e u r o s u r g e o n w r o t e " n o c o n c e r n s " a n d c o m p r e h e n s T h e t r e a t m e n t i s c o n s e r v a t i v e w i t h m e d i c a t i o n s a n d b e f o r e . T h e p r o g n o s i s i s " g u a r d e d " , p r e s e n t r e s p o n t h e f u t u r e i s " s u r g e r y i s n o t i n d i c a t e d b u t h a s t o a v o i s t a n d i n g p e r m a n e n t l y " a n d h e " c a n b e a u t o n o m o u s A t t h e h e a r i n g , t h e a d v o c a t e p r o v i d e d a p a g e w i t h e E A A T , 2 0 0 9 B C S C 1 4 6 1 . A t t h e h e a r i n g , t h e a p p e l l a n t ' s a d u l t s o n s t a t e d t h a t : • N o o n e i n t h e f a m i l y i s h a p p y w i t h t h e s i t u a t i o s i b l i n g s a r e w i t h t h e a p p e l l a n t 2 4 / 7 b e c a u s e o • H e s p e n d s a l o t o f t i m e w i t h h i s f a t h e r a n d i s m i g r a i n e s b e c o m e v e r y b a d . A t o t h e r t i m e s , g o e s a w a y . H e w i l l s o m e t i m e s t a k e a h o t s h o d o e s n o t g o a w a y , h e w i l l d r i v e h i s f a t h e r t o t h f a t h e r a n I V a n d t h e p a i n w i l l g o a w a y . • H i s m o t h e r w i l l h e l p t h e a p p e l l a n t g e t t o t h e w • S o m e t i m e s i f t h e y g o s h o p p i n g a n d a r e w a l k i m i n u t e o r t w o a n d , i f t h e r e i s n o b e n c h a r o u n d • S o m e t i m e s h i s f a t h e r w i l l d r i v e t o t h e g r o c e r y f a t h e r c a n n o t c a r ry t h e g r o c e r y b a g s . H e c a n • F o r m e a l p r e p a r a t i o n , t h e r e s t o f t h e f a m i l y w c a n n o t s t a n d f o r l o n g . • H i s f a t h e r j u s t s i t s a n d e a t s a n d d r i n k s a n d c a d o t h e c l e a n i n g . • H e t a k e s h i s f a t h e r t o h i s a p p o i n t m e n t s . • I n r e s p o n s e t o a q u e s t i o n , h e s t a t e d t h a t h i s f m o v e d f r o m a n o t h e r p r o v i n c e , a n d h a s n o t c h r e p o r t s f o r t h e P W D a p p l i c a t i o n , b u t i t i s t h e s • B e f o r e h i s f a t h e r s t a r t e d h a v i n g p r o b l e m s , t h e • T h e d o c t o r w h o c o m p l e t e d t h e r e p o r t s w i t h h i A P P E A L # I o t e t h a t : o n f i r m t h a t t h e a p p e l l a n t r e q u i r e s s i g n i f i c a n t h e l p m e m b e r s p r o v i d e h e l p ; . h e u s e s a w a l k i n g c a n e o o m a n d a g r a b b a r w i l l b e h e l p f u 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 y P W D d e s i g n a t i o n . i o n a l d o c u m e n t , n a m e l y a M e d i c a l R e p o r t d a t e d u r g e r y a n d a t t a c h i n g p a r t o f a n M R I a n d C T s c a n p o r t d a t e d J a n u a r y 6 , 2 0 1 1 w a s s u b m i t t e d i n c e a n d t h e a p p e l l a n t w a s s u c c e s s f u l i n b e i n g t i l e v e l d e g e n e r a t i v e d i s c d i s e a s e a n d b i l a t e r a l t i o n i s d e g e n e r a t i v e a n d r e l a t e d t o l o n g s t a n d i n g n a l s t a b i l i t y / b e h a v i o r a l p a t t e r n s , t h e i o n / o r i e n t a t i o n / m e m o r y i s " N / A " o r n o t a p p l i c a b l e . a n o t e t h a t p h y s i o t h e r a p y w a s t r i e d a n d f a i l e d s e t o t r e a t m e n t i s " n o t w e l l " a n d t h e o p i n i o n f o r d h e a v y l i f t i n g , b e n d i n g , p r o l o n g e d s i t t i n g , w i t h t h e a b o v e l i m i t a t i o n s . " x c e r p t s f r o m t h e c o u r t d e c i s i o n i n H u d s o n v . n t h a t t h e i r f a t h e r i s i n . E i t h e r h i s m o t h e r o r h i s f h i s c o n d i t i o n s . u s u a l l y t h e o n e t h a t t a k e s h i m t o t h e h o s p i t a l i f h i s h i s f a t h e r w i l l g o i n t o a d a r k r o o m u n t i l t h e p a i n w e r a n d t h a t m i g h t r e l i e v e t h e m i g r a i n e . I f i t s t i l l e h o s p i t a l . A t t h e h o s p i t a l , t h e y w i l l g i v e h i s a s h r o o m m o s t o f t h e t i m e i n t h e m o r n i n g s . n g i n t h e s h o p p i n g m a l l , h i s f a t h e r w i l l w a l k f o r a , w i l l s i t o n t h e f l o o r . s t o r e , b u t h i s m o t h e r d o e s t h e s h o p p i n g . H i s n o t d o a n y b e n d i n g , l i f t i n g o r c a r r y i n g . i l l n o t l e t t h e a p p e l l a n t g e t f o o d b e c a u s e h e n n o t d o a n y c l e a n i n g . H e a n d h i s s i s t e r h a v e t o a t h e r ' s c o n d i t i o n h a s n o t d e t e r i o r a t e d s i n c e t h e y a n g e d s i n c e w h e n t h e d o c t o r c o m p l e t e d t h e a m e . f a m i l y u s e d t o d o t h e h o u s e h o l d c h o r e s e q u a l l y . s f a t h e r ' s P W D a p p l i c a t i o n s p e a k s h i s f a t h e r ' s
origi na l l ang uage and t h er e was n o prob l e m w bus y and do es not ta ke much tim e as he is alw ha ve bee n look in g for a n ew doctor . At the hea rin g, t he appe llant and hi s advoca te s tat ed • The doctor w h o prep a red th e repo r ts for t he PW 2 wee k s b eca u s e the appe llant moved recently from anot • The advocate prepared th e lett er and provid e W h en the a d ditional l e tte r was presented to the a p pellant pre sent. • T he d octor appears to adop t a cautious w r i t i n appell a nt f o r long, but t he doctor w ould n ot si appellant's a ss ertions a re true . • The appe llant wa kes up in the nig h t with a mig fat igu ed during the d ay . H e fi nds that h e gets migrai • He has mig rai nes abo ut 3 to 4 ti mes per week and wi • The probl em wit h t he medications pr esc r ibed h e doe s not want t o sl e ep all t he time and asks: what r elie ve t h e migr aine f or a peri o d of time and th • Bef o re he started hav in g prob lems, h e us ed to make more recent job involve d prolonged sitti n g a n the inj u ry to h i s bac k, h i s lif e has cha n g ed and als m akes h is head aches worse. • H e ca n dri ve but n ot f or that lon g, o nly 20 to 3 beca u se he experie nces pain wh e n he is dri v • With h is back pain, he h a s pro b l e ms get ting up f mi n u tes. H e started using a c an e t o he l p w ith now uses it bot h in do ors and outd o ors . Someti fee l s lik e s omeon e is s t ick ing nails in his bac k stret ch or s it up . • H e alwa ys h as pain. The med ications pro v ide a few back. He has gone f or phy siother apy when he li It helps if he lies do w n on the couch. • W it h his stom ach pain , he ca nn ot ea t cer tai n foods o The mi n i stry relied o n its rec o nsi deration decision. Admissibility of New Information The minis try did not object to the admissibility of the Medical Report dated January 6, 2011 but cautioned that disability designation is not t r an sferable betw an objection to the admissib ility of the appellant's oral testimony. testimony on behalf of the appellant, new information was provided regarding the appellant's impairment. This information pro vi d es ad ditional d e original PWD application. The panel admitted this new information as being in support of information and records that were before the ministry at the time of reconsideration, in accordance with Section 22(4) of the Emplo ymen t and Assistance Act. The advocate's written submission was considered as amument on behalf of the annellant. I A PPE AL# ith communication. The doc to r, howe ve r , is very ay s in a rush and they are not s atisfied an d that: D appl ic ation h ad only k n o wn th e appellan t for h e r prov i nce. d it to the a ppel lant who met wi th the doctor . doct or, he r ev i e wed it and compl e ted it with th e g style, per h ap s b e c ause he had not known th e gn the l etter if he did not agr ee that the ra i ne h eadache a n d cannot sl eep s o th at he is n e s when he thinks about t h e pas t. ll la st up t o 2 da ys. f or h is m igraines i s t h a t it mak es him ' slee py' and kind o f li fe is that? The medi cations e n i t wil l c ome back . ver y g ood mo ney in his occ upati on . Hi s d it mad e h i s l owe r b ac k pain mu ch worse. Si n c e o his fam ily 's life . When he thinks a b out i t, it 0 m inut e s. T h e fa mily p r e f e r s to d r ive him i ng and he might ca use a n acci dent and get hurt. r om s it ting and he can no t walk for more th an 2 h is walking aft er the su rg ery t o his b ac k and he mes when h e is s leeping, the pai n in his ba ck and it w akes him up. He has to get up and h ours o f r elief bu t t hen the pai n c o m es v ed in another pro v ince but i t has not helped. r it will m ake i t worse. een provinces. T he mi n i stry did not r a ise In the Medical Report and oral t a il with r e spect t o i ssu es addressed in the
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 co_ ntinue f_ or 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 pain and fatigue due to degenerative disc disorder, migraine headaches and gastritis. The advocate argued that the decision in Hudson is authority for the position that significant weight must be placed on the appellant's evidence unless there is a legitimate reason not to do so. The advocate argued that the appellant's physician acknowledged that the appellant suffers from severe lower back pain most of the time, as set out in both the application and the most recent letter. The advocate argued that the language used by the doctor in the letter is a matter of style and that he would not sign the letter if he did not agree that the appellant's assertions are true. The advocate argued that the physician also indicated that the appellant has recurring migraine headaches and, due to the anti inflammatory medications he takes, he has increased stomach acidity and ulceration. The advocate argued that other health limitations include poor sleep patterns which have resulted in daytime fatigue. The advocate pointed out that the physician reported that the effect of these conditions will result in severe impact on the appellant's daily life. The ministry's position is that the ministry does not have enough information from the general practitioner to establish 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 1 to 2 blocks and climb 2 to 5 steps unaided and he can lift 5 to 15 lbs. and remaining seated for up to 1 to 2 hours, which the ministry considers to show a moderate degree of impairment. The ministry argued that the general practitioner reported that the appellant's gastritis and migraines are treated with medications and while he does not explain the success treating gastritis, he indicated that the migraines respond to medication. The ministry argued that the general practitioner did not know the appellant for very long and the information in the original reports is based only on an office interview with the appellant and the additional letter is framed in terms of the appellant's own assessment of his impairments. The ministry argued that the general practitioner reported the degree of restriction to DLA is "moderate" and this evidence is not sufficient to support a conclusion of a severe physical impairment. 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.
I APPEAL# extent of its impact on daily functioning as evidenced by functional skill limitations and the degree to which the ability to perform 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. The appellant's family physician of approximately 2 weeks, diagnosed the appellant with degenerative disc disorder, migraine headaches and gastritis. The physician noted in the health history that the appellant ". ..h as had severe low back pain for which had surgery 2 years ago" and that he still has residual low back pain with radiation to his thighs. The physician wrote that the pain aggravates "at times" and is worse when the appellant is "up and about." The physician indicated that the appellant has experienced upper abdominal pain which has been under treatment and he has been taking medication for migraine headaches. In the letter dated March 26, 2014, the physician provided further comment couched throughout in terms of the appellant's perspective. For example, he wrote that: the appellant has low back pain which "he expresses" to be most of the time and severe, the appellant "says" pain in his lower back and legs prevent him from walking more than 3 to 4 minutes, and he "expresses" that he is unable to walk, carry items, etc. due to his leg and lower back pain. The advocate argued that this is a matter of style; however, the panel notes that the physician did not use this same language in the narrative of either the PR or the AR. The panel finds that the ministry reasonably determined that these statements are to be considered as assessments by the appellant rather than by the physician. In the letter, the physician confirms that the appellant has low back pain which the appellant "expresses to be most of the time and severe," he has migraine headaches which respond to medications, and he complains of poor sleep pattern at nights resulting in fatigue during the day time. The physician concluded that the effect of these conditions as listed will result in severe impact on the appellant's daily life. The impact to the appellant's functional skills is further assessed by the physician in the PR, and the physician reported that the appellant can walk 1 to 2 blocks and climb 2 to 5 steps unaided and is able to lift 5 to 15 lbs. and remain seated 1 to 2 hours. In the additional comments, the physician wrote: "as described, is unable to attend to tasks which need lifting, carrying items (moderately heavy items)." In the PR, the physician reported that the appellant does not require any prosthesis or aid for his impairment. While the physician indicated in the March 26, 2014 letter that the appellant "uses a walking cane outdoors," the panel notes that the physician's language is again guarded as he does not indicate that the appellant "requires" a cane. The section of the AR relating to assistance provided through the use of assistive devices is not completed by the physician. At the hearing, the appellant stated that he uses a cane both indoors and outdoors. In the AR, the physician assessed the appellant as independent with all mobility, including walking indoors and walking outdoors, climbing stairs, and standing, while requiring periodic assistance with lifting and carrying and holding and wrote: "cannot lift or carry moderately heavy items due to low back and leg pain." In the Medical Report dated January 6, 2011, the physician who is a specialist in neurosurgery wrote at that time that the prognosis was "guarded", that "surgery was not indicated but the appellant has to avoid heavy lifting, bending, prolonged sitting, standing permanently" and he "can be autonomous with the above limitations." While the physician indicated in the March 26, 2014 letter that the appellant says he has difficulty in the bathroom and that a grab bar "will be helpful", the physician has not completed the section of the AR to indicate equipment or a device 'required' but not currently being used.
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 w r o t e t h a t h i s b a c k p h i m a l o t o f u n b e l i e v a b l e p a i n . W h e n e v e r h e w a l k s m i n u t e s , t h e p a i n g e t s w o r s e a n d m a k e s h i m s i t d o w J a n u a r y 6 , 2 0 1 1 , t h e o p i n i o n b y t h e n e u r o s u r g e o n a t h e a p p e l l a n t h a s t o " a v o i d h e a v y l i f t i n g , b e n d i n g , p r " c a n b e a u t o n o m o u s w i t h t h e a b o v e l i m i t a t i o n s . " T h b e e n a l m o s t 2 y e a r s s i n c e s u r g e r y a n d n o i h i n g c h a n c a n n o t d o a n y w o r k . A s f o r f i n d i n g w o r k a n d / o r w o r c r i t e r i o n i n s e c t i o n 2 ( 2 ) o f t h e E A P W D A n o r i s i t l i s t e s e c t i o n 2 o f t h e E A P W D R . T h e n a t u r e o f w o r k i s d i c o n s t a n t a n d p r o l o n g e d p e r f o r m a n c e o f t a s k s , p a r t i c w o r k a s i n v o l v i n g b o t h h e a v y l a b o u r a n d p r o l o n g e d 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 p h y s i c i a n d e s c r i b e d t h e d e g r e e o f r e s t r i c t i o n a s " m o a s s e s s m e n t o f r e s t r i c t i o n s i n t h e m o d e r a t e r a n g e , t h d e t e r m i n e d t h a t t h e e v i d e n c e f a l l s s h o r t o f e s t a b l i s h 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 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 s T h e m i n i s t r y ' s p o s i t i o n i s t h a t t h e r e i s i n s u f f i c i e n t e v i s e v e r e m e n t a l i m p a i r m e n t , p a r t i c u l a r l y s i n c e t h e a p p m e n t a l h e a l t h c o n d i t i o n . T h e m i n i s t r y a r g u e d t h a t t h a p p e l l a n t h a s a n y s i g n i f i c a n t d e f i c i t s w i t h h i s c o g n i t i v t h a t t h e a p p e l l a n t ' s a p p l i c a t i o n s o l e l y r e l a t e s t o h i s p m e n t a l i m p a i r m e n t i n h i s s e l f r e p o r t . P a n e l D e c i s i o n T h e p h y s i c i a n d i d n o t d i a g n o s e a m e n t a l d i s o r d e r i n s i g n i f i c a n t d e f i c i t s w e r e r e p o r t e d w i t h c o g n i t i v e a n d e r e p o r t f o r a s s e s s i n g i m p a c t s t o a r e a s o f d a i l y f u n c t i o P R , 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 e a p p e l l a n t d o e s n t h e A R , t h a t t h e a p p e l l a n t h a s a s a t i s f a c t o r y a b i l i t y t o 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 e p e n d e n t i n a l l a s p e c t b o t h h i s i m m e d i a t e a n d e x t e n d e d s o c i a l n e t w o r k s . G a n d n o i m p a c t s r e p o r t e d t o c o g n i t i v e , e m o t i o n a l o r s r e a s o n a b l y d e t e r m i n e d t h a t a s e v e r e m e n t a l i m p a i r m E A P W D A . R e s t r i c t i o n s i n t h e a b i l i t y t o p e r f o r m D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h i s p h y s i c a l i m p a i r m e e rf o r m D L A o n a n o n o i n b a s i s t o t h e o i n t t h a t h A P P E A L # I r o b l e m i n t h e l a s t 4 o r 5 y e a r s h a s b e e n g i v i n g m o r e t h a n 5 m i n u t e s o r s t a n d s m o r e t h a n 5 n o n t h e g r o u n d . I n t h e M e d i c a l R e p o r t d a t e d t t h a t t i m e w a s t h a t s u r g e ry w a s n o t i n d i c a t e d b u t o l o n g e d s i t t i n g , s t a n d i n g p e r m a n e n t l y " a n d h e e a p p e l l a n t w r o t e i n h i s s e l f r e p o r t t h a t i t h a s g e d s i n c e h e s t i l l h a s t h e s a m e p a i n a n d h e k i n g , t h e p a n e l n o t e s t h a t e m p l o y a b i l i t y i s n o t a d a m o n g t h e p r e s c r i b e d d a i l y l i v i n g a c t i v i t i e s i n f f e r e n t f r o m m a n a g i n g D L A a s w o r k i n v o l v e s u l a r l y a s t h e a p p e l l a n t d e s c r i b e d h i s p r e v i o u s s i t t i n g . 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 s i n c e t h e d e r a t e " . G i v e n t h e p h y s i c i a n ' s o v e r a l l e p a n e l 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 i n g t h a t t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l a s e v e r e m e n t a l i m p a i r m e n t . d e n c e t o e s t a b l i s h t h a t t h e a p p e l l a n t h a s a e l l a n t ' s g e n e r a l p r a c t i t i o n e r d i d n o t d i a g n o s e a e g e n e r a l p r a c t i t i o n e r d i d n o t i n d i c a t e t h a t t h e e a n d e m o t i o n a l f u n c t i o n . T h e m i n i s t r y a r g u e d h y s i c a l i m p a i r m e n t a n d h e d o e s n o t m e n t i o n a n y t h e P R o r i n t h e M a r c h 2 6 , 2 0 1 4 l e t t e r . N o m o t i o n a l f u n c t i o n i n g a n d t h e s e c t i o n o f t h e n i n g w a s n o t c o m p l e t e d b y t h e p h y s i c i a n . I n t h e o t h a v e d i f f i c u l t i e s w i t h c o m m u n i c a t i o n a n d , i n 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 h y s i c i a n s o f s o c i a l f u n c t i o n i n g , w i t h g o o d f u n c t i o n i n g i n i v e n t h e a b s e n c e o f a m e n t a l h e a l t h d i a g n o s i s o c i a l f u n c t i o n i n g , t h e p a n e l f i n d s t h a t t h e m i n i s t r y e n t w a s n o t e s t a b l i s h e d u n d e r s e c t i o n 2 ( 2 ) o f t h e n t 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 s h i s a b i l i t y t o e r e u i r e s t h e s i n i f i c a n t a s s i s t a n c e o f a n o t h e r
person and the use of a cane a nd a grab bar as assistive devices. court d ecis ion in Hudson is aut h or ity f or t he position profe ssiona l i ndicating a direct a nd s ignificant restric requirement that more th an two D L A b e r estricted in o The advocate argued that the physician confirmed in appell ant is preve n te d from walking more than 3 or 4 minutes, he is rest housework, meal preparation a nd persona l care , and th in th e AR. The a d v oc at e a r gu e d that the physician acknowledged that the appellant's symptoms of lower back pain , migraine headaches an d fatigue result in signifi a nd that th ese restrictions occur m o st o f the time. The ministry' s position is that the info rmatio n pr ovide March 26, 2014 is from the appell a nt's own assessment of his impairment the gener a l practit i oner . The mini s try pointed out that the general practitioner had j appellant at t he tim e that he co mplet e d t he P R and bes ides an interv iew w i th the ap pellant and, the r efore, the i ra ther than the opini o n of t h e p r escr ibed pro fessiona P ane l Decisi on Section 2(2)(b) of the EAPWDA r e q uires that a pre sc applica nt's sev ere i mpai r m ent di r ectly an d significan for exten d e d p e riods. I n thi s c ase, the appell a n t 's ph defi n ed i n sectio n 2(1 ) of t h e E A P WDR an d are also t h e AR. Therefo r e , a pres cri bed pr ofess i ona l co mpleting wh i ch, if a ny , D LA a r e signifi can tl y r estr icted b y the pe ri odic ally for extended p eriods. T h e c o u rt held in Hu dson that that the r e m ust be evi dir e ct and signi ficant restri ct ion on at lea s t t wo DLA, a E A PWDA sti p ulate s t h at the m inist ry must be sat isfie professional establishes direct and si g ni fica nt restrictions to the person' DLA . In this cas e , the a p pe l lant 's phys i ci an indic a ted in t with personal self care, me a l p r eparat ion, management mobi lity o u tside th e hom e, use of transpor t ation, manageme the letter dated March 26, 2014, t he ph ysician commented, in response to the question whether it takes the appellant longer than normal to perfor m many DLA as a direct result of his health-related limitat ions, that the appellant "says pain in his lower back and legs prevent him from walking more than 3 to 4 minutes." As previously discussed, the language used by the physician in the letter differs from that in the original reports and is limited to the appellant's own assessment of his restrictions; however, with res pect to the DLA of moving about indoors and o functional skill limitation of walking 1 to 2 block s unai a signific ant restriction. In response to a question about how often the appellant is significantly restricte the physician wrote in the letter that the appellant "expresses most of the time he is restricted in his daily tasks." Asked whether the appellant's impairment significantly restricts his ability to perform a range of DLA c o nt in uously or pe r i o di c ally for extended peri "expresses his svmotoms of low back oain and miaraine headaches and fatiaue result in sianificant I APP EAL# The advocate argued that the that there mu s t be evidence from a prescr i b ed tion on at least two DLA, but there i s no st a t u t or y r d er to m eet the PW D el igibility requ irements. th e letter dated Ma rch 26, 201 4 t h at the ricted with shopping, i s is con s istent w ith th e information p r o v id e d c a nt restrictions in a number of DL_A d by the gen era l prac t itioner in the lette r dated s rather than th e opinion of us t met the A R an d did not use any other inform at i on sou rces n f orm ation p r ovided i s fr om the app ellant l . rib e d profe ss ional prov i de an o p i ni on th a t an tly r e s tricts his DLA, co n tinuously or perio dica lly y sic ia n i s t he prescrib ed p rofe s sion al. D LA are l i s t ed in th e PR an d, with addi t ion al d e tails, in t hese fo r ms has the opp ortunit y to in d i cate ap pell ant's im p a ir ment s continuo u sly o r de nce from a pr e sc ribed p ro fessional in dica tin g a nd the pane l f ind s tha t s ec tion 2 of the d in each ca s e that th e opinion of a presc rib ed s over all abili ty to perform h e PR that the ap pell ant is not r estricted o f me di cation s, mobility inside th e home and nt of finances, a n d so ci al functioning. In ut door s i s consistent with the ded and the p a n el f ind s t h at t h i s does not reflect d in performing DLA, ods , the physician wrote that the appellant
r e s t r i c t i o n i n a n u m b e r o f a c t i v i t i e s o f d a i l y l i v i n g , s u p r e p a r a t i o n , a n d p e r s o n a l c a r e , e t c . " I n t h e P R , t h e o n a p e r i o d i c b a s i s w i t h b a s i c h o u s e w o r k a n d d a i l y r e s t r i c t e d w i t h h i s p e r s o n a l c a r e o r m e a l p r e p a r a t i o n p h y s i c i a n w r o t e " m o d e r a t e . " I n t h e A R , 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 e a p p e l l a n t o u t d o o r s a n d w i t h a l l t a s k s o f t h e D L A m a n a g i n g h i s m e d i c a t i o n , a n d u s i n g p u b l i c o r p e r s o n a l t r a n s p o r t a i n 7 o f 8 t a s k s o f t h e D L A p e r s o n a l c a r e : d r e s s i n g , g t r a n s f e r s i n / o u t o f b e d a n d t r a n s f e r s o n / o f f c h a i r , a n p e r s o n w i t h b a t h i n g , w i t h n o f u r t h e r d e s c r i p t i o n p r o v p e r i o d i c a s s i s t a n c e w i t h b a s i c h o u s e k e e p i n g a n d l a p r o v i d e d . I n t h e a d d i t i o n a l c o m m e n t s t o t h e P R , t h e a t t e n d t o t a s k s w h i c h n e e d l i f t i n g , c a r r y i n g i t e m s ( m n e e d f o r a s s i s t a n c e w i t h l i f t i n g w i t h i n t h e f u n c t i o n a l a p p e l l a n t i s i n d e p e n d e n t w i t h 4 o f 5 t a s k s , n a m e l y g l a b e l 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 a n d p a y i n g f o r p c a r r y i n g p u r c h a s e s h o m e . T h e p h y s i c i a n n o t e d t h a w r i s t p a i n ; f a m i l y m e m b e r s h e l p t o l i f t a n d c a r r y s h o I n t h e A R , t h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t w i t h m e a l p l a n n i n g , 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 , d s t a n d f o r m o r e t h a n a f e w m i n u t e s . " T h e a p p e l l a n t ' s f a m i l y w i l l n o t l e t t h e a p p e l l a n t g e t f o o d b e c a u s e h e t h e a p p e l l a n t a s i n d e p e n d e n t w i t h s t a n d i n g a n d t h e s t a n d u p t o 5 m i n u t e s , a n d t h e p a n e l f i n d s t h a t t h e r e a s s i s t a n c e i s r e q u i r e d f o r e x t e n d e d p e r i o d s o f t i m e w h o w t h e p e r i o d i c r e s t r i c t i o n s t o s t a n d i n g h a v e a s i g n 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 p r o b l e m w i t h t h e m e d i c m a k e s h i m ' s l e e p y ' a n d h e d o e s n o t w a n t t o s l e e p a t h e a p p e l l a n t h a s n o t b e e n p r e s c r i b e d a n y m e d i c a t i o l i v i n g a c t i v i t i e s . G i v e n t h e a p p e l l a n t ' s l e v e l o f i n d e p e n d e n c e a n d t h e b y t h e p h y s i c i a n , t h e p a n e l f i n d s t h a t t h e m i n i s t r y r e a i n f o r m a t i o n p r o v i d e d i n t h e o p i n i o n o f t h e p r e s c r i b e d i m p a i r m e n t s i g n i f i c a n t l y r e s t r i c t s h i s a b i l i t y t o m a n a g e x t e n d e d p e r i o d s , t h e r e b y n o t s a t i s f y i n g t h e l e g i s l a t i H e l p t o p e r fo r m D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h e r e q u i r e s t h e s i g n i f d e v i c e t o p e rf o r m D L A . T h e a d v o c a t e a r g u e d t h a t t h o n h i s f a m i l y m e m b e r s t o p r o v i d e h e l p a n d u s e s a c b a r s i n t h e b a t h r o o m . T h e m i n i s ! ' s o s i t i o n i s t h a t b e c a u s e i t h a s n o t b e e I A P P E A L # c h a s b a s i c h o u s e w o r k , s h o p p i n g , m e a l p h y s i c i a n r e p o r t e d t h a t t h e a p p e l l a n t i s r e s t r i c t e d s h o p p i n g , b u t h e r e p o r t e d t h a t t h e a p p e l l a n t i s n o t , a n d , r e g a r d i n g t h e d e g r e e o f r e s t r i c t i o n , t h e i s i n d e p e n d e n t w i t h m o v i n g a b o u t i n d o o r s a n d p e r s o n a l f i n a n c e s , m a n a g i n g h i s p e r s o n a l t i o n f a c i l i t i e s . T h e a p p e l l a n t i s a l s o i n d e p e n d e n t r o o m i n g , t o i l e t i n g , f e e d i n g s e l f , r e g u l a t i n g d i e t , d h e 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 f r o m a n o t h e r i d e d b y t h e p h y s i c i a n . T h e a p p e l l a n t r e q u i r e s u n d r y , w i t h n o f u r t h e r e x p l a n a t i o n o r d e s c r i p t i o n p h y s i c i a n w r o t e t h e a p p e l l a n t " i s u n a b l e t o o d e r a t e l y h e a v y i t e m s ) , " w h i c h i s c o n s i s t e n t w i t h a s k i l l l i m i t a t i o n o f 5 t o 1 5 l b s . F o r s h o p p i n g , t h e o i n g t o a n d f r o m s t o r e s , r e a d i n g p r i c e s a n d u r c h a s e s , a n d 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 w i t h t t h e a p p e l l a n t " h a s l o w b a c k / l e g a n d , a t t i m e s , p p i n g / i t e m s . " 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 f r o m a n o t h e r p e r s o n e s c r i b e d a s " d u e t o b a c k a n d l e g p a i n , c a n n o t s o n s t a t e d a t t h e h e a r i n g t h a t t h e r e s t o f t h e c a n n o t s t a n d f o r l o n g . T h e p h y s i c i a n a s s e s s e d a p p e l l a n t w r o t e i n h i s s e l f r e p o r t t h a t h e c a n i s n o t s u f f i c i e n t i n f o r m a t i o n t o e s t a b l i s h t h a t i t h 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 , o r t o e x p l a i n i f i c a n t i m p a c t o n m e a l p l a n n i n g . A t t h e h e a r i n g , a t i o n s p r e s c r i b e d f o r h i s m i g r a i n e s i s t h a t i t l l t h e t i m e . I n t h e P R , t h e p h y s i c i a n r e p o r t e d t h a t n a n d / o r t r e a t m e n t t h a t i n t e r f e r e w i t h h i s d a i l y m o d e r a t e n a t u r e o f t h o s e r e s t r i c t i o n s i d e n t i f i e d s o n a b l y d e t e r m i n e d t h a t t h e r e i s i n s u f f i c i e n t p r o f e s s i o n a l t o e s t a b l i s h t h a t t h e a p p e l l a n t ' s e h i s D L A e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r v e c r i t e r i o n o f s e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A . i c a n t a s s i s t a n c e o f a n o t h e r p e r s o n o r a n a s s i s t i v e e p h y s i c i a n c o n f i r m e d t h a t t h e a p p e l l a n t r e l i e s a n e w h e n o u t d o o r s a n d w o u l d b e n e f i t f r o m g r a b n e s t a b l i s h e d t h a t D L A a r e s i
I APPEAL# restricted, it cannot be determined that significant help is required. The ministry argued that the gener al practitioner indicated that the appellant does not require any assistive devices. 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 significant help or supervision of 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 family and that no assistive devices are required. As discussed previously, while the physician indicated in the March 26, 2014 letter that the appellant uses a cane for walking outdoors and he says that a grab bar will be useful in the bathroom, the physician did not report that these assistive devices are required by the appellant. 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 cannot 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 ministry'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.
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.