I APPEA PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (the ministry)'s Reconsideration Decision, dated April 9, 2014 in which the ministry denied the appellant's request for a medical transportation subsidy for her vehicle repairs, as the request does not meet the criteria set out in Schedule C, section 2(1 )(f) of the Employment and Assistance for Persons with Disabilities Regulation (EAPWDR). PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Regulation (EAPWDR), Schedule C, section 2(1 )(f). Employment and Assistance for Persons with Disabilities Act (EAPWDA), section 31( 1) EMT 003(10/06/01)
I APPEA" PART E-Summary of Facts The appellant is designated as a person with disabilities, and is a sole recipient of disability assistance with no dependants. On February 26, 2014 the appellant was advised by the ministry that her request for a medical transportation supplement had been denied because the request did not meet the eligibility criteria for this supplement. The appellant requested reconsideration of that decision on March 26, 2014. The evidence before the ministry at the time of the reconsideration decision consisted of: • A letter from the appellant's Naturopathic Physician, dated July 31, 2012, stating that the appellant had an appointment in his office on August 2, 2012. • A Service Request from a transmission/vehicle repair shop, dated October, 2002 addressed to the ministry, providing a detailed list of the repairs and maintenance needed for the appellant's vehicle, totaling $1062.88. • A Service Request from the same transmission/vehicle repair shop, dated June 14, 2012, addressed to the ministry, and indicating "As won under Tribunal Decision 1 ' providing a detailed list of the repairs and maintenance needed for the appellant's vehicle, totaling $1467.96. • An Employment and Assistance Appeal Tribunal Decision dated October 11, 2002, which rescinded the ministry's decision to deny the appellant's request to pay for vehicle repairs. • A letter from the appellant's physician, dated October 26' , 1994, which describes the appellant's diagnosis of Multiple Chemical Sensitivities and supports her application for GAIN status. • A letter from the appellant's Physician(1 ), dated January 7, 1995, which outlines the reasons what public transportation is hazardous to the appellant's health. The physician adds that the appellant's condition is long-standing and he believes it will be permanent. • A letter from the appellant's Physician(1 ), dated June 5, 1995, which describes her medical diagnosis and supports the appellant's requirement for a vehicle of her own. • A letter from the appellant's Physician(2), dated July 19, 2000, describes the appellant's condition and her need for access to 'clean' transportation. • A letter from the appellant's Physician(2), dated March 5, 2014, stating that the appellant is unable to use public transport due to her widespread hypersensitivity to environmental chemicals. • A letter from the appellant's Physician(1), dated March 6, 2014, stating that her condition is chronic and no treatments are available, adding that keeping her personal vehicle operational is a 'critical issue'. • The appellant's Request for Reconsideration (RFR) dated March 25, 2014 and signed by the appellant. To Section 3 of the RFR the appellant attaches copies of the previous Tribunal decision, physician letters (noted above) and an 11 page, handwritten letter, stating why she feels that her decision should be reconsidered and payment made for the repairs and maintenance to her vehicle, which she requires for transportation to medical appointments. As set out in the reconsideration decision, dated April 9, 2014, the ministry states that the previous appeal decision (2002) no longer applies to the appellant's current situation. The ministry finds that the aooellant has not provided specific evidence reqardinq her need to attend an aooointment with a EAAT 003(10/06/01)
APPEA I medical practitioner, which would include a specific office location or frequency of medical care required. Without having the specific requirements for medical transportation, the ministry is unable to establish if repairs to the appellant's vehicle is the least expensive, appropriate mode of transportation. The ministry adds that the repairs required appear to include regular maintenance items which should be incorporated into normal expenses, as well, when using discretion in determining if a supplement can be issued, ministry policy states that "under no circumstances is the medical transportation to be issued to purchase, maintain repair or insure a vehicle." The appellant submitted a signed Notice of Appeal on April 29, 2014, in which she states that she disagrees with the ministry decision because the decision ignores her testimony and physician letters which support the need for medical transportation as it pertains to her specific disability and the impact that her lack of transportation has on her ability to access medical care. She adds that the ministry falsely asserts that she is not receiving assistance with vehicle insurance. She concludes that "No effort has been made to understand the client's complex and challenging medical issues and disability, and the downward spiral of her health and functioning initiated by the arbitrary and discriminating decisions, inflexibility applied to which she has been subjected for the past years since 2010." The appellant's evidence at the hearing included the following information: • The appellant stated that her medical condition, Multiple Chemical Sensitivity, is the most severe case that she is aware of. It negatively impacts all facets of her daily life and has left her feeling desperately isolated and impoverished. She identified some of the numerous costs associated with her condition, including: organic foods, air filters, water filters, natural supplements and remedies. • The appellant stated that her vehicle had been specially modified to seal it from the outside air, in order to prevent her from coming into contact with toxicities and pollutants when she travels. The vehicle does not provide heat as this many allow outside air to enter the vehicle. She added that because of her rural location and the severity of her condition to toxicity exposure, there are no alternative options for medical transportation that could even be considered. • The appellant stated that as a result of the previous Tribunal decision in 2002, which awarded her the costs of repairs and maintenance to her modified vehicle, that she felt that she was entitled to receive continued support for this purpose, as it was more cost effective to the ministry than arranging any other type of medical transportation, of which there are none that are appropriate. • The appellant described her condition in great detail and the difficulties she experiences on a daily basis because she cannot even go out to pick up her mail or drop off her rent without encountering people or environmental toxins that she is unable to tolerate in her sensitive and volatile condition. • The appellant indicated that she is frustrated with how, over the years that she has been receiving assistance, her supports keep being taken away and things have gotten so bad for her that her health is in even further decline and she fears she will become a "statistic of the ministry". • The appellant stated that she is unable to comply with the ministrv requests to pre-aoorove EM T003(10/06101)
a r r a n g e d m e d i c a l a p p o i n t m e n t s b e c a u s e s h t o s e e k m e d i c a l a t t e n t i o n d u e t o t h e s e v e r i t y t h a t b e c a u s e t h e r e a r e n o f a m i l y p h y s i c i a n s m u s t a t t e n d a W a l k I n c l i n i c w h e r e a p p o i n t m t o s p e c u l a t e o n t h e f r e q u e n c y o f m e d i c a l a p t i m e p e r i o d . • T h e a p p e l l a n t e x p l a i n e d t h a t i n o r d e r t o k e e p p a s t s h e w o u l d t r y t o c o m b i n e m u l t i p l e a p p o s i n g l e t r i p , a n d b e c a u s e o f t h i s , s h e f e l t t h a t r e q u i r e m e d i c a l t r a n s p o r t a t i o n a s o f t e n a s s h t a k i n g a w a y s u p p o r t s . • T h e a p p e l l a n t s t a t e d t h a t s h e i s c u r r e n t l y i n l a b o r a t o r y t e s t i n g b u t h a s b e e n u n a b l e t o h a l a c k o f t r a n s p o r t a t i o n , s p e c i f i c a l l y t h e r e p a i r s T h e m i n i s t r y r e l i e d p r i m a r i l y o n i t s r e c o n s i d e r a t i o n d n o w 6 5 y e a r s o r o l d e r , s h e i s r e c e i v i n g C P P b e n e f i m i n i s t r y s t a t e d t h a t t h e a p p e l l a n t ' s s i t u a t i o n h a d c h w a s m a d e w h e n t h e a p p e l l a n t a n d h e r s o n r e q u i r e d a p p o i n t m e n t s . T h e m i n i s t r y e x p l a i n e d t h a t t h e f u n d i s s u e d u n d e r a T r i b u n a l d e c i s i o n w h i c h w a s t h e n " s E A P W D A c t s e c t i o n 3 1 ( 1 ) , " w h i c h s t a t e s t h a t a n a d d e c r e a s e o f d i s c o n t i n u a t i o n ) m a y b e a p p l i c a b l e i f t h c o n t i n u i n g c o n d i t i o n s o f e l i g i b i l i t y a r e n o l o n g e r s a t i E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L I e o f t e n d o e s n o t k n o w i n a d v a n c e w h e n s h e n e e d s a n d u n p r e d i c t a b i l i t y o f h e r c o n d i t i o n . S h e a d d e d a c c e p t i n g p a t i e n t s i n t h e n e a r e s t c o m m u n i t y , s h e e n t s a r e n o t a v a i l a b l e . T h e a p p e l l a n t w a s u n a b l e p o i n t m e n t s t h a t s h e m a y h a v e o v e r a n u p c o m i n g t h e c o s t s o f h e r m e d i c a l t r a n s p o r t a t i o n l o w , i n t h e i n t m e n t s ( p h y s i c i a n , l a b o r a t o r y , n a t u r o p a t h ) i n t o a t h e m i n i s t r y o n l y r e c o g n i z e d t h a t s h e d i d n o t e h a d i n t h e p a s t , a n d p e n a l i z e d h e r e f f o r t s b y g r e a t n e e d o f m e d i c a l c a r e , d e n t a l c a r e a n d v e a n y o f h e r h e a l t h i s s u e s a d d r e s s e d d u e t o a t o h e r m o d i f i e d v e h i c l e . e c i s i o n a n d c o n f i r m e d t h a t a s t h e a p p e l l a n t i s t s a n d s u p p o r t f o r M e d i c a l S e r v i c e s O n l y . T h e a n g e d s i n c e t h e 2 0 0 2 T r i b u n a l D e c i s i o n , w h i c h m e d i c a l t r a n s p o r t a t i o n t o a t t e n d w e e k l y s t o r e p a i r t h e a p p e l l a n t ' s v e h i c l e i n 2 0 1 2 w e r e e t f o r r e v i e w b y p o l i c y a n a l y s t , a s d i c t a t e d b y j u s t m e n t o r a l t e r a t i o n i n b e n e f i t s ( i n c r e a s e , e r e i s a c h a n g e i n a s s i s t a n c e o r i f t h e i n i t i a l a n d s f i e d .
APPEAL I PART F -Reasons f or Pan e l Decis ion T he issue on appeal is wh et her the min i stry 's d e ci s ion to deny the appel lant's req uest for a medical t ranspor tat ion supp l e ment for her vehicle repairs, as the request does not m e et the c r iteria set out in Sched u le C, secti o n 2(1 ) ( f) of the E APWD R, w as re as onably supported by t h e evidence or w as a reasonable application of t he applicable le g is lation in the circumstances o f the appell ant. The rele vant legislation is: Sect ion 2(1)(f) of Schedule C of the EAPWDR: General health supplements 2 (1) The following are the health supplem ents that may be paid for by the minister if provided to a f am ily unit tha t is eligible und e r section 62 [gener al healt h suppleme n t s] o f t h is regulation: (f) th e l east exp e n siv e ap propriate m ode of transportati o n to or fro m (i) a n office, in th e local ar ea, o f a m edical p ra ctitioner or nurse p r actiti o ne r , (ii ) t he o ffice of the nearest a vailab l e spec ialis t in a fie ld of medic ine o r s urger y if the pe r s on has been r e f e rred t o a spec ialist in that fi eld by a l oc al me d i c al pr actit ion er o r nurse practit ion er, (i ii) th e nearest suitab le general hospita l or rehabili tation h o spita l, as tho se facil iti e s are def ined in section 1.1 of t h e Hospital Insurance Ac t Regulat ion s , or (iv ) th e ne arest suita b le hospital a s defined in pa r a g ra p h (e) of t he definiti on of "hospi ta l " in sectio n 1 of t he Ho s pi t al Insuran ce Act , provided that (v) t he tra nsporta tion is to e n able the pe rso n to r e cei ve a bene fit unde r t he Medica re Prot e ct ion Act or a g ener al hospi tal se rvic e u n de r th e Ho s pital In s uran c e Act, and (v i) there are no res ources ava ilable t o the pe rson's f amily uni t to cover t he cost. S ection 31 of EAPW D Act R e cipients u nder fo rmer A c t deemed recipients u n d er th i s Ac t 31. (1 ) On t he date this sectio n c omes i nto f or c e, a perso n with disabilit i es who is r e ceiv ing income a ssista nce , a disabili t y allowanc e o r a be nefit und e r a fo rm er Act ( a) is d e emed to ha v e appl ied fo r and be in receipt of d i s abili ty assistan ce or suppl ements under this Ac t, and (b) i n ord e r to con ti n u e receiv ing disability assistance or the supplement, must satisfy the initial and continuing cond i t ions of e ligibility estab l ished un der this Act t hat apply i n respect of the disability a ssistance or sup plement. (2) On t h e dat e this sec t ion c o m es i nto f orce, a perso n with disabilities who is receiving hardship a ssistance under the BC Benefit s (Income Assistance) Act (a) i s deemed to h av e applied for and received hardship assi stance under this Act, and (b) in order to receive further hardship assis tanc e , must satisfy the conditions of eligibility established under this Act for hardship assist anc e. (3) Despite a final decision of a tribunal, or the BC Benefits Appeal Board, under the BC Benefits (Appeals ) Act, the minis ter may (a) adjust an amount of disability allowance, income assistance, hardship assistance or a benefit, (b) alt er a category of disability allow anc e, income a s si stance, hardship as sistance or a ben efit p r ovided to or for a r ecipient r e ferr e d t o i n subsections ( 1) and ( 2) and his o r her de pendants, and (c) al t er the ca t egory o f perso n of the recipient or hi s or h er dep endan t s to equal the amounts or categories of disability assistance, hardship assistance or supplements the recipient and his or her dependants are e ligible for un der this Act. (4) An adjustment or alteration referred to in subsection (3) (a) or (b) may be, as applicable, (a) an increase, a decrease or a discontinuance of an amount, or (b) a change in, or a discontinuance or an addition of, a category of disability assistance, hardship assistance or supplements. EMT003 (1 0 /06l01)
W h e t h e r a p r e v i o u s t r i b u n a l d e c i s i o n e n t i t l e s a p e r s T h e a p p e l l a n t a r g u e s t h a t s h e w a s a w a r d e d t h e c o s 2 0 0 2 , a n d b e c a u s e o f t h i s , s h e s h o u l d b e e n t i t l e d t o s a m e v e h i c l e . 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T h e p a n e l s a c c e p t s t h a t t h e a p p e l l a n t ' s m e d i c a l c o n h i s l e t t e r t h a t i t i s i m p e r a t i v e t h a t s h e h a v e a c c e s s t n o t b e e n p r o v i d e d t h a t e s t a b l i s h e s t h e f r e q u e n c y o r a p p e l l a n t , a s s e t o u t i n S c h e d u l e C , s e c t i o n 2 ( 1 ) ( f ) t h a t t h e m i n i s t r y ' s d e c i s i o n w a s r e a s o n a b l e . W h e t h e r t h e s u p p l e m e n t r e q u e s t e d w a s f o r t r a n s p o u n d e r t h e M e d i c a r e P r o t e c t i o n A c t o r g e n e r a l h o s p i t T h e a p p e l l a n t a r g u e s t h a t h e r h e a l t h i s i n d e c l i n e a n s h e h a d a c c e s s t o h e r v e h i c l e s h e w o u l d m a k e a p p l a b o r a t o r y a n d h e r n a t u r o p a t h f o r u r g e n t a t t e n t i o n f o T h e m i n i s ! ' s o s i t i o n , a s s e t o u t i n t h e r e c o n s i d e r a E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A i o n t o r e c e i v e c o n t i n u e d a n d s i m i l a r b e n e f i t s . t o f h e r v e h i c l e r e p a i r s i n a T r i b u n a l d e c i s i o n i n r e c e i v e o n g o i n g s i m i l a r b e n e f i t s f o r r e p a i r s t o t h e 0 0 2 T r i b u n a l d e c i s i o n , b o t h t h e l e g i s l a t i o n a n d d b y E A P W D A c t s e c t i o n 3 1 ( 1 ) , a n a d j u s t m e n t o r i n u a t i o n ) m a y b e a p p l i c a b l e i f t h e r e i s a c h a n g e i n o f e l i g i b i l i t y a r e n o l o n g e r s a t i s f i e d . o u s T r i b u n a l d e c i s i o n s a n d t h e p a n e l i s n o t b o u n d d i n E A P W D A c t s e c t i o n 3 1 ( 1 ) , t h e a p p e l l a n t m u s t S c h e d u l e C , s e c t i o n 2 ( 1 ) ( f ) o f t h e E A P W D R . e l e a s t e x p e n s i v e , a p p r o p r i a t e m o d e o f i t h a m e d i c a l p r a c t i t i o n e r . e o n l y f o r m o f t r a n s p o r t a t i o n t h a t c a n b e u s e d , d i c a l c o n d i t i o n . S h e a d d s t h a t t h e u n p r e d i c t a b i l i t y b e c a u s e o f a l a c k o f l o c a l f a m i l y p h y s i c i a n s d o e s t s . t i o n d e c i s i o n , i s t h a t t h e r e i s n o e v i d e n c e o f t h e g s p e c i f i c i n f o r m a t i o n r e g a r d i n g t h e l o c a t i o n o r i n i s t e r i s u n a b l e t o e s t a b l i s h t h a t r e p a i r o f t h e r a n s p o r t a t i o n , a s s e t o u t i n S c h e d u l e C , s e c t i o n 2 d i t i o n i s s e v e r e a n d t h a t h e r p h y s i c i a n s t a t e d i n o ' c l e a n ' t r a n s p o r t a t i o n , h o w e v e r , e v i d e n c e h a s l o c a t i o n o f m e d i c a l a p p o i n t m e n t s r e q u i r e d b y t h e o f t h e E A P W D R a n d t h e r e f o r e , t h e p a n e l s f i n d s r t a t i o n t o e n a b l e t h e p e r s o n t o r e c e i v e b e n e f i t a l s e r v i c e . d s h e u r g e n t l y n e e d s t h e r e p a i r s t o h e r v e h i c l e . I f o i n t m e n t s t o s e e h e r m e d i c a l d o c t o r , a d e n t i s t , t h e r n e w a n d o n g o i n g i s s u e s . t i o n d e c i s i o n , i s t h a t t h e r e i s n o e v i d e n c e o f t h e
APPEAi I appellant's need for medical transportation to attend a medical or nurse practitioner's office or hospital to obtain benefit under Medicare Protection Act or general hospital service, as required by Schedule C, section 2 (1) (f) of the EAPWDR. The panels acknowledges the appellant's desire to attend appointments with her medical doctor, a dentist, the laboratory and her naturopath in order to improve her health, however, evidence has not been provided which establishes her requirement to do so, as required by Schedule C, section 2 (1)(f) of the EAPWDR, therefore, the panels finds that the ministry's decision was reasonable. Whether there are resources available to the person to cover the least expensive, appropriate mode of transportation available. The appellant argues that she has no money to cover the cost of repairs to her vehicle and all her available funds go toward the other items (organic food, air filters, water filters, natural supplements) in order to try to manage her severe medical condition. The ministry did not dispute whether information has been provided to establish that the appellant has no resources available to her to cover the cost of the vehicle repairs. The panel finds that because the ministry did not deny the appellant's request based on this criteria, the panel will not make any findings on whether or not the appellant had resources available to her. Conclusion In conclusion, the panel finds that the ministry's decision to deny the appellant's request for a medical transportation supplement in order to have repairs made to her vehicle was reasonably supported by the evidence and a reasonable application of the legislation in the circumstances of the appellant. The panel thus confirms the ministry's decision. EMT 003(10/06101)
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