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 b e i n g a p p e a l e d i s t h e M i n i s t r y o f S o c i a " M i n i s t r y " ) M a y 2 i , 2 0 i 4 r e c o n s i d e r a t i o n d e c i s i o n i n w a s n o t e l i g i b l e f o r P e r s o n s w i t h D i s a b i l i t i e s ( " P W D " r e q u i r e m e n t s f o r P W D d e s i g n a t i o n i n s e c t i o n 2 ( 2 ) o w i t h D i s a b i l i t i e s A c t . B a s e d o n t h e i n f o r m a t i o n p r o v A p p e l l a n t h a s a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e ( i ) 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 e r a b i l i t y t o p 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 , ( i i ) a s a r e s u l t o f t h o s e r e s t r i c t i o n s s h e r e q u i r e s h e T h e M i n i s t r y w a s s a t i s f i e d t h a t t h e A p p e l l a n t h a s r e a m e d i c a l p r a c t i t i o n e r h e r i m p a i r m e n t i s l i k e l y t o c o n t i n 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 E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )� A P P E A L # l 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 w h i c h t h e M i n i s t r y d e t e r m i n e d t h a t t h e A p p e l l a n t ) d e s i g n a t i o n b e c a u s e s h e d i d n o t m e e t a l l t h e f t h e E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s i d e d , 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 n t t h a 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 e rf o r m d a i l y l i v i n g a c t i v i t i e s e i t h e r c o n t i n u o u s l y o r l p t o p e r f o r m t h o s e a c t i v i t i e s . c h e d i 8 y e a r s o f a g e a n d i n t h e o p i n i o n o f a u e f o r a t l e a s t 2 y e a r s . i l i t i e s A c t ( " E A P W D A " ) S e c t i o n 2 ( 2 ) a n d 2 ( 3 ) . 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 .
APPEAL# '. PART E -Summary of Facts With the oral consent of the Appellant, a representative from the Appellant's advocate office appeared at but did not participate in the hearing. For its reconsideration decision, the Ministry had the following evidence: 1. Appellant's PWD application consisting of: • Her self-report dated November 3, 2013. • A Physician's Report ("PR") and an Assessor's Report ("AR") both completed on December 3, 2013 by the same doctor who indicated that he has known the Appellant for 7 years and had seen the Appellant 11 or more times in the past year. 2. Appellant's April 30, 2014 request for reconsideration with: • Written argument from her advocate. • A letter from her daughter about help provided to the Appellant. • A revised PWD application with changes to the PR and the AR by the same doctor. The Panel has summarized the relevant evidence from the reconsideration record as follows. Diagnoses In the PR, the doctor diagnosed the Appellant with depression, bursitis, sleep apnea and osteoarthritis. Physical Impairment In her self-report, the Appellant wrote that: • She cannot stand for long periods and she cannot sit because her hips hurt. • Usually she uses a cane when outside and a walker at home. • Her hips sometimes hurt so bad that she cannot get around at all. • She cannot shop for any longer than 10-15 minutes. • She has trouble going up stairs. In the PR, the doctor reported that the Appellant's impairment was likely to last 18 months and she had been referred to an orthopedic surgeon. The doctor also report that the Appellant: • Has degenerative disease of the hips as shown in x-ray and clinical evidence. • Requires a walking cane for her impairment. • Has been referred to an orthopedic surgeon. • Can walk unaided for less than 1 block, cannot climb stairs unaided, can lift 5-15 lbs., the length time she can remain seated is unknown. • Has poor mobility; is unable to work In the first AR, the doctor reported that the Appellant: • Has hip pain impacting her ability to manage daily living activities. • Has good ability to communicate in all areas; that is, speaking, reading, writing and hearing. • Uses assistive devices for walking indoors and outdoors, and climbing stairs; also takes significantly longer with these activities -she "uses a cane to move around and stand". • Needs periodic assistance with lifting, and with carrying and holding. • Has hip pain and "[The Appellant] suffers from several medical problems. Her hip pain is her biggest problem right now". In the revised PR, the doctor chanqed the deqree and course of impairment to indicate it would last 2 EAAT 003( 10/06/01)
I APPEAL ii years or more and deleted the reference to 18 months. In the revised AR, the doctor added that the Appellant: • When walking indoors and outdoors, and climbing stairs, standing, lifting, carrying and holding "she takes up to five times longer to perform these tasks" and "she uses pain medication to get around". Mental Impairment In the PR, the doctor reported that the Appellant has no difficulties with communication. He did not complete the section for significant deficits with cognitive and emotional function in this report, but did so in the AR. In the first AR, the doctor reported the following impacts to the Appellant's cognitive and emotional functioning: • No impact to bodily function, consciousness, impulse control, insight and judgement, attention/concentration, executive, memory, motivation, motor activity, language, psychotic symptoms, other neuropsychological problems and other emotional or mental problems. • Moderate impact to emotion (e.g., excessive or inappropriate anxiety, depression, etc.). In the revised AR, the doctor wrote, regarding impacts to cognitive and emotional functioning: "Her hip pain has a significant impact on her ability to move around. This makes her sad and frustrated." Daily Living Activities In the PR, the doctor reported that the Appellant: • Has not been prescribed any medication and/or treatments that interfere with her ability to perform daily living activities. In the AR, the doctor reported that the Appellant: • In areas of personal care, is independent and takes significantly longer with dressing and grooming; is independent feeding herself and regulating her diet; takes significantly longer bathing and toileting, and with transfers in/out of bed and on/off chairs -"[The Appellant] has joint pain 100% of the time. This interferes with her mobility." • Uses assistive devices and takes significantly longer with laundry and basic housekeeping -"[The Appellant] has pain 100% of the time. This interferes with mobility". • Takes significantly longer and uses assistive devices going to and from stores; takes significantly longer reading prices and labels, making appropriate choices, paying for purchases and carrying purchases home -"[The Appellant] has difficulty performing these tasks due to pain". • Independently manages meal planning and safe storage of food; takes significantly longer with food preparation and cooking -"[The Appellant] has joint pain that interferes with her ADLs". • Independently manages all areas of paying rent and bills, and medications. • Takes significantly longer with all areas of transportation (getting in/out of a vehicle, using public transit, using transit schedules and arranging for transportation) -"[The Appellant] has joint pain interfering with her mobility". • Independently manages all areas of social functioning, and has good functioning with her immediate and extended social networks; and "NA" [not applicable] regarding help the Appellant needs to maintain her in the community. In the revised AR, the doctor wrote that: • "[The Appellant] uses strong pain medication to remain mobile. She requires help with daily activities. Her daurihter helps her clean the house". EAAT003(10l06/01)
APPEAL# : • Regarding food preparation and cooking -"She takes 5 times longer to perform these tasks." • "[The Appellant] requires pain medication to remain mobile. She requires help from her daughter''. Help with Oal1y Living Activities In the first AR, the doctor reported that the Appellant: • Uses a walking cane for her impairment and uses assistive devices for walking indoors and outdoors, and for climbing stairs -"she uses a cane to move around". • Uses assistive devices for laundry and basic housekeeping; and for going to and from stores. • Uses the following assistive devices -cane, crutches, walker, adding "she uses a cane"; but does not use an assistive animal. • Is provided assistance by family and friends. In the revised AR, the doctor reported that the Appellant: • "[The Appellant] uses strong pain medication to remain mobile. She requires help with daily activities. Her daughter helps her clean the house" and "She requires help from her daughter''. In her letter, the Appellant's daughter wrote that: • She does all her mother's vacuuming since she cannot stand for very long. • She does her mother's laundry because she has lots of problems with stairs and the laundry room is downstairs (at least i 5 stairs). • She helps her mother with shopping, either shopping for her or helping her in the store. • Her mother needs her to be with her when she showers; she has trouble getting in and out of the bathtub and is afraid of falling. The Appellant's advocate submitted oral and written arguments at the hearing, which are summarized in section F of this decision. The advocate also explained that the doctor completed the revised AR on about April 30, 20i4 so that it could be submitted with the request for reconsideration. At the hearing, the Appellant's daughter described the help she gives to her mother, including doing her mother's housework, sweeping and mopping the floors, and vacuuming. She also does the laundry because the laundry facilities are down stairs. The daughter stated that she supervises while her mother has a shower because of fear of falls. She also helps with grocery shopping because her mother can't walk through stores; she does whatever her mother needs. The daughter said that it can take her mother a long time to walk the length of a room and up to 45 minutes to walk up to her house, which is on a bit of an incline. At the hearing, the Appellant confirmed the information given by her daughter about the help she receives and added that her daughter now has to help with nail care because she can't get her legs up. The Appellant said that she now uses a device to help put her socks on. She stated that she does not have grab bars or a seat in her shower, but she often takes her cane into the shower. The Appellant also said she once spent about 2 weeks at home because she couldn't get out. She couldn't get down the stairs from her home. The Appellant said that recently she couldn't walk for 4-5 days, even with 2 canes or a walker. She tried to push the walker ahead, lifting one foot at a time. At home she uses a cane or walker all the time and when she goes out she uses 2 canes. The Appellant said that she cannot go anywhere without using the canes. She clarified that she has never used crutches, as the doctor had reported. When she climbs the steps to her home, she uses EAAT 003(10/06/01)
APPEAL# '. the stair rail on one side and her cane on the other side, but ii is a very slow climb. When preparing meals, the Appellant said she can stand for only a certain length of time and then she has to sit. She also stated that when she sits for awhile, she gets cramps. So, she can't sit or stand for long. The Appellant said that when she shops she can choose her items as long as she doesn't have to bend for them. Also, she can't unload the lower rack of her dishwasher, because she has to bend. The Appellant said that she once went 3 weeks without laundry because her daughter was unable to come and help. She said that her daughter usually stops in more than twice a week for laundry, to help her shower and help with housework, and her daughter telephones every day to make sure she is OK. The Appellant described her pain as feeling like a knife being stabbed into her hip bone. The Appellant said she takes prescription medications for her hip pain and a prescription rub. However, it takes a long time, up to 45 minutes, for the medications to provide relief and the medications only work for about 1 hour. She also said that because of the pain, she waits until the very end before getting up to go to the bathroom. The Appellant said that she had a cortisone shot about a month ago and has had other strong pain killers administered by injection. The Appellant said that her doctor has referred her to an orthopedic surgeon to have both hips replaced, but the doctor told her there is a 3-4 year waiting list for the surgery. The Appellant is also worried about having the surgery because of her other health conditions, such as her sleep apnea. The Appellant said that the doctor told her one hip is affected by bursitis and the other by arthritis. Pursuant to section 22(4) of the Employment and Assistance Act, the Panel admits the testimony from the Appellant and her daughter as being in support of the evidence the Ministry had at reconsideration because their testimony was consistent with the information about the Appellant's impairment that the Ministry had at reconsideration. At the hearing, the Ministry relied on and reaffirmed its reconsideration decision. EAAT 003(10/06/01)
PAR T F Reason s fo r Panel Decision The issue in this appeal is w hether the Ministry reas eligible fo r PW D de s ignation because s he did n ot meet EAPW DA, and sp ecif ical ly, th at th e App el lan t d oes tha t in t he opinion o f a pr esc r i b ed pr ofessional ( i ) dir perfo rm dai ly li ving act ivi ti es either continuousl y or per resul t of th ose re stri ction s s he req uires h el p to perform th The eligibilit y crite ria f or PW D des ign ation are se t out in the 2 (2 ) T he mini ster may designate a pe r so n who h as d i sabili t i es for the pu r p os es of this Act if t he mini ste or ph ysical im pai r m ent that (a) in the opi nion of a me dic al pra cti tio ner i s lik ely to ( b ) in the o pi n i o n of a pr escri b ed professional (i) dir ectly and sign if i cantly restricts the pers o n' s abilit (A) con ti n uo usly , or (B) p eri o di call y for exten ded p eriods, and (ii) as a r esul t of those restri ctions, th e p erson requi (3) Fo r th e p urpose s of s ub s ection (2), ( a ) a person w ho has a severe m ent al impairment inc (b) a pers o n r e quire s hel p in rel ation t o a d aily liv ing requ i re s (i ) a n a ss istiv e device, (i i) t h e sign ific ant he (iii ) th e servic es of an a ss istan c e a nima l. The "da i ly livin g a c tiviti es" ref err e d t o in EAPWDA section 2 (1) Fo r the p urpo ses of the Act and thi s r egulation, " (a) in relat ion to a p erson who h a s a seve r e phys i c a me an s t h e follo win g activ iti e s : (i ) pr e par e o wn meals; (ii) ma nage pers on al fina nc e persona l tra nsporta tion facil ities ; (v) p erfo rm h ouse work acceptab l e sani t a ry co ndit ion; (vi) move abo ut ind oors and self-care; (viii) ma na ge personal medication, a nd (b) in r e l a ti on to a p erson who h a s a severe mental i (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or in with other s effectively. The Pan el will co nsider each party's po sition r egarding the reasonableness of the Ministry's under the applicable PWD cr i ter i a at i s sue i n thi s appeal. Seve re Physical Impairment The Ap pellant's position is that the evidence establishes that she has a severe phy Her advocate referred to the doctor's description of the Appellant's limitations with all aspects physical mobility and her need to use a cane and walker whenever she walks and stands. For example, the advocate cited the doctor's report that the Appellant is able to walk less than a block using a cane and takes up to five times longer to perform physical tasks. that a cane is an assistive device within the meaning of the EAPWDA. is a basic requirement for beina able to do almost all daily livina activities. EAAT003(10/06/01) AP PFA I # : ona bly determine d th at the A ppellant was not all of t he req uirem en ts in section 2 ( 2 ) o f t he n ot have a s e v e re mental o r physi cal impairm ent ectl y an d significan tly rest ricts h er a bili ty to iodically for e xten ded p erio ds; and, (ii ) as a ose ac tiv itie s. follow ing se ctio ns o f the EAPW DA: reached 1 8 y e ars o f a ge as a pers on with r i s s atisfied t hat the pers on has a s evere m ent al co nti nue for at l eas t 2 year s, and y t o perform d aily li ving act iv it ies eit her r es h e lp to perform t hose activi t ies. lude s a person w ith a m ent al disorder, and a ctivit y i f , in order to per form it, t h e perso n l p or sup er v ision of a no t he r pe r so n, or 2(2)( b) are de f in ed in th e E APW DR as: d aily liv in g activiti es" , l imp airm ent or a s e vere me nta l impairm e nt, s ; (iii) s h op f or p erso nal ne eds; (iv) use public o r to ma i nta i n the perso n's place of resid en ce i n an d outdo ors; (v ii ) perf orm personal hygiene m pair m ent, includes the follo win g activi t i es: t e ract decision sical impai rment. of The advocate submit ted She also argued that mobility The advo cate referred to
t he A pp ell a n t's descriptions of her impairment, i ncludin that she canno t get aro u nd at a ll wi t ho u t an ass istive go out. In it s reconsideratio n decisi on , t he Minis try wrote that it con inclu ding the reports of the A ppe l lant's p hysical f unc limitation is caused by chr oni c pai n in the join ts for which t he pain medicatio n the App ell a n t uses to allow her the Minis try wa s not satisfied that there is e vidence The P anel 's Findings T he diagnosis of a medical condition is not in and of itsel satis f y the re qu i rements i n se ction 2(2) of t he EAPW me d ica l condition re stricts daily f unc t i oning must be c App ella nt a nd fr om a prescribed pro fes sional re gar ding on t he Ap pel lant 's abi li ty to manage the dail y li v i ng a As for f inding work and/or wor king , the Pa nel notes that emplo designatio n in sec t ion 2(2) of the EA P WDA n or i s it listed a i n section 2 of the EAP WDR. T he Appellan t's d octor co m p l eted both the PR and the recon sideration . Be c a u s e t h e s eco nd AR, from ab out in form ation about th e Appellant and beca use it is c onsistent repo rted, the P a nel gives that se cond AR more we i g A ppell a nt with bursitis, sle ep apn ea a nd ost eoar t hrit hip i s af fe c te d by b ursitis and o ne by osteoarthritis. He has r hav e b oth hi p s r ep laced . S he also said th a t she takes medica take tim e t o w ork a nd t hen onl y re l ieve her pain fo r a short time. bec ause of the pai n . T he A ppell a nt only m en t i oned sl rep laceme nt surgery . The d o c tor pro vided n o o t he r informatio In the PR a n d t he ame n de d AR, the doctor focused on the effects of the Appellant daily functioning. The d o ctor repo rted the following limitations to the App and m o bility: she c an walk less than 1 block unaided a un ai ded; a nd, sh e tak es significa ntly long er w alkin g indoo also uses an assistive device to stand and needs periodic assistance with lifting, ca holding. The doctor wrote that the Appellant takes up to five times longer to perform these tasks. As for the impact of the Appell a nt's hip pai n on her abi lity to physical ability, t he doctor no ted t h at the Ap pe l lant t ak bath i n g, toileting, transfers in/out of bed, transfers on/off a chair, laundry, basic housekeeping, all as pe cts of shopping, food p reparation, cooking, and all aspects of tr doctor provided nu me rou s comments, su ch as the Appellant h interferes with her mobility, she has difficulty performing shopping tasks due to pain, she has joint pa i n that interferes wit h her ADLs (activities of daily living), she takes 5 times longer to perform tasks associated wi th meals. The doctor also noted that th uses assistive devices. EAA T003(10/06/01) APPEAL# � g her statements that her hip hurts so much dev i ce a n d sometimes i t i s so b ad s he c ann o t sidered the i n for mation p rov ided, t i oning. It determined that the Appellant's remedial measures are available, such as to m obilize. B a sed on the i n for mation pr ovided, of a sever e physic al imp a irment. f evidence of the seve rity of impairm ent. To DA , e v idence of how and the extent to which a onsidered. Thi s inc lud e s the evi d e nce from the the n ature of the impairment and its impact c ti vitie s lis te d i n s e ctio n 2 ( 1) o f the EA PW D R. yability i s n ot a c ri t erion f or PWD mong t he pre scribed d a ily living ac tivities AR, and t hen pr ovided an amended AR for the Apri l 30, 2014, pr ovides the mo r e re cent wit h the physic al lim itat ions origina lly ht. The Appellant 's doc to r diag n o se d the is. The A ppell a nt said that the d oc t o r tol d her one efe rr ed he r to an ortho pedic surge on to t io n s f o r the p ain , b ut the medicatio n s S he cann ot stand o r sit for lo n g eep apnea w ith re spec t t o he r worries abo u t hip n about this latt er con d it ion. 's hip pain on her e llant's physical functioning nd uses a cane; she cannot climb stairs rs and o utdoors, a nd c l imb i n g stair s . She rrying and manag e other daily activities requiring es signif icantly long er with dress i ng, g roo ming , ansportation. I n addition, the as joint pain 100% of the time that e Appellant requires help from her daug hte r and
The evidence from the Appellant and her daughter i doctor provided. The Appellant described how her hip pain i c lim b st a irs and shower. She sai d t h er e ha ve b een because of the pain. The Appellant also said that she c a can e and when she go es outside she us es two canes. Insid Both the A ppel lant a n d h er da ught e r confirmed the same mobi by the docto r with respect t o i mp a irments in the Appellant's ability T hese incl ud e the Appellant taking significantly longer with areas of personal care, basic housekee pi ng, shopping, meal pr eparation and transp confirmed and furt h e r e xplai ne d t he h e l p the A ppell a houseke eping, bathing and shopping. Therefore , when Appellant and her daughter is consider ed, the Panel to determine that the A ppella nt does not have a severe physical impairment. S e ve r e Men tal Impa i rment In her PWD a ppli cation the A p pellant stated t hat th e mobility, ca u si ng h e r t o feel de pre ssed. Th e Minis t r y evidence of a sever e me n tal imp air me n t. Th e Pan el 's Findings Although the doc tor dia g n o sed th e Appellant with d epressio doc t or a bout a ny trea tme n t for that condi tion or effects the do ctor r eporte d only one moder ate i mpact to emotion, pain having a s ignific a nt impact o n he r ability lo mo ve The doctor repo r t e d no imp act to the othe r 13 aspects of cognitiv th e AR and that the Appella nt indep endently man age the Appella nt refer red on ly to f ee l in g depre s sed ab o no t expl a i n how fee ling dep ress e d affe cted h e r da ily M ini s try r ea s on ably de ter mined th a t t he e viden ce di d not establish Res t rict ion s to Daily Li v i n g Activities The Appellant's a d vocate submitted that the majority of the daily living activities Appell ant either receives assistance f rom her daughter or must use an assistive definition of daily living activities in the EAPWDR. The advocate submitted that, in the revised AR, the doctor reported on ly a few daily living activ ities as being referred to the narrati v e sta tements from the doctor, including notes that the App perfo rming t a sks due to pain, that she require s help with daily living activi times longer to perform these tasks. The advocate submitted that the Appellant's need for help is supported by the evidence from the Appellant and her daughter, including the tasks the da does and the assistive devices the Appellant uses. The Ministry determined that becaus e the m a j o rity of independently or require little help from others, the information from the prescribed professional does not esta blish that the Appellant's impairment sign ificantly continuously or periodically for extended periods. EMT 003(10/06/01) � APPE AL # s c onsistent w ith all o f t he info r mat ion that t he mpacts her abi l ity to sit, stand, w a lk , tim es that she was unable to l e av e h e r ho m e an not stand, walk or climb stairs without using e, she also sometim es uses a walker. lity and ph ysical restrictions reported t o m anage daily living activities. ortati o n. The Appellant and her daughter also nt ne eds and receives for laundr y, b asic all of this evidence from t h e d octor, the finds that it was not reason a ble for the Mi n i s try pain f r o m her hip h a s a signific ant impact on her wa s not s at isfied that the i n form ation provided is n, th er e was n o information from the from ii o n the Appella nt' s fu n ct i o n ing. A ls o, whic h h e a ttri b uted to the A p pellant ' s hi p around, thus making her s ad and fru s t rat ed. e and emo ti o nal f unctioning lis te d in s all asp ects of soc ial functioning. In a dd iti on , ut her h i p pain an d con s train ed mob i lity , b ut did fun c tioning. Theref o re , t he Pa n e l f ind s that the a se vere men tal i m p a i rme nt. for which the device are in the i n dependently m anaged. She al s o el lant has difficulty ties and that she lakes fi ve ught er daily living activities are performed restricts da il y livi ng a ctiviti e s e ither
APPEAL# '. The Panel's Findings Section 2(2)(b) of the EAPWDA requires that a prescribed professional provide an opinion that the Appellant's severe impairment directly and significantly restricts her daily living activities, continuously or periodically for extended periods. Daily living activities are defined in section 2(1) of the EAPWDR, and are also listed in the PR and in the AR. In this case the Appellant's doctor is the prescribed professional, therefore the Panel will consider the evidence he provided about the Appellant's restrictions, especially in the revised AR At the hearing, the Appellant said that her doctor prescribed pain medications. In the PR, the doctor reported that medications and/or treatments do not interfere with the Appellant's ability to perform daily living activities. In the original AR and in the revised AR, the Panel notes that the doctor specifically checked the box "independent" for the following listed daily living activities: dressing, grooming, feeding self, regulating diet, meal planning, safe storage of food, all aspects of paying rent and bills, medications and social functioning. For several activities, the doctor noted that the Appellant takes significantly longer, but he did not report whether or not the Appellant independently manages these or that she needs periodic or continuous assistance. These latter activities are bathing, toileting, transfers in/out of bed, transfers in/out of chair, reading prices/labels, making appropriate choices, paying for purchase, carrying purchases home, food preparation, cooking, and all aspects of transportation. The doctor did add comments such as the Appellant's joint pain interferes with her ability and she takes 5 times longer with the meal tasks. With respect to areas of mobility and physical ability, the doctor reported that the Appellant needs periodic assistance with lifting and with carrying and holding. However, for walking indoors and outdoors, climbing stairs and standing, again he did not indicate whether the Appellant is independent, or needs either periodic or continuous assistance. He did report that the Appellant uses an assistive device and that she takes up to five times longer to perform these tasks. The Panel notes that both the Appellant and her daughter provided details of the help the Appellant requires and obtains as well as how often the Appellant uses cane or a walker. However, the Panel also notes that the legislation requires that the prescribed professional, the Appellant's doctor, must provide his opinion that the Appellant's severe impairment directly and significantly restricts her daily living activities, continuously or periodically for extended periods. Based on the reports from the doctor, the Panel finds that the Ministry reasonably determined that the information from the prescribed professional does not establish that the Appellant's impairment significantly restricts daily living activities either continuously or periodically for extended periods. Help with Daily Living Activities The Appellant's advocate submitted that the Appellant requires help from her daughter with many of her daily living activities as well as the use of assistive devices, especially canes and a walker. The advocate specifically referred to the definition of assistive devices in the EAPWDA. The advocate also cited the doctor's reports of all of the activities for which the Appellant requires help as well as the information from the daughter and the Appellant confirming the help the Appellant needs. The Ministry's position is that because the evidence does not establish that daily living activities are significantly restricted, it cannot determine that significant help is required from other persons. EAAT 003(10/06/01)
APPEAL ii � The Panel's Findings Section 2(2)(b)(ii) of the EAPWDA also requires the opinion of a prescribed professional confirming that because of direct and significant restrictions in her ability to manage daily living activities, the Appellant requires help with those activities. Section 3 of the EAPWDA states that for the purposes of section 2(2) of the EAPWDA, a person requires help in relation to a daily living activity if, in order to perform it, the person requires an assistive device, the significant help or supervision of another person or the services of an assistance animal. In this case, the doctor reported that the Appellant does not use an assistance animal. He did report that the Appellant uses assistive devices for walking indoors and outdoors, and for climbing stairs and for basic housekeeping. He noted that she uses a cane to move around and stand. The doctor also wrote that the Appellant requires help from her daughter, but he did not specify how often or with which tasks except for cleaning. The information from the Appellant and her daughter provided further details of the help the Appellant needs and gets, but as the Panel noted above, it is the opinion of the doctor that is required to satisfy this part of the legislation. Because the doctor specified the use of assistive devices for only basic housekeeping and mobility, because he provided few details about the help the Appellant's daughter provides and because the Ministry reasonably determined that the evidence does not establish that daily living activities are significantly restricted either continuously or periodically for extended periods, the Panel finds that the Ministry reasonably found that section 2(2)(b)(ii) was not satisfied. Conclusion Having reviewed and considered all of the evidence and the 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. Therefore the Panel confirms that decision EM T003(10l06/01)
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