PART C -Decisi on under Appeal The decision un der a pp e al is the Ministry of Social Development and reconsi deration decision of February 18, 201 4, w hich fou s ta tutory requiremen t s of section 2 of the Employment and Assistance for Persons With Disab ("EAPWDA") for designation as a pers o n with disab ilities the age requir ement and that i n the opinion of med i cal pra continue for at l ea st two years. However, the minist ry was not satisfi • the evidence e s t ab lishes that the appell ant has a se • th e appella nt's dai ly living a ctivities ( "DLA") are, in s ignificantly restricted eith er contin uous l y or periodically for extended periods; and that • as a result of thos e res trictions, t he appellant req person, an ass i s tiv e device, or the services of an ass PA RT D -Rel ev an t Legi slation E mployment a n d Ass istance f or Pers on s with Disabilities Ac Emplo yme nt a nd Ass istance f or Pe r so n s wit h Disabilit ies EAAT 003(10/06/01) � APPEAL# Social Inn ovation ( the "ministry") nd th at th e app e llant d i d not meet three o f fiv e ilities Act ("PWD"). The mi nistry found that the appella nt met c t itioner the appella nt's imp airment is li kely to e d that: vere physical o r mental impa ir me nt ; th e opinio n of a prescribed professional, direc tly and u ires the significant help or supervision of another i s tance animal. t ( " EA P WD A" ) , sect i on 2 Re g ulation (" E APWDR"), section 2
I APPEAL# PART E -Summary of Facts The appellant and the ministry were not in attendance at the hearing. After confirming that both parties were notified, the hearing proceeded under section 86(b) of the Employment and Assistance Regulation. The information before the ministry at the time of reconsideration included the following: • The appellant's application for designation as a PWD which was submitted to the ministry on September 24, 2013 and included the appellant's handwritten self-report (SR) dated June 26, 2013. • A physician's report (PR) and an assessor's report (AR) dated August 16, 2013, completed by the appellant's physician who has indicated that she has attended the clinic for years and that he has reviewed her records. • The appellant's request for reconsideration, dated February 7, 2014. Diagnosis In the PR the physician, who has seen the appellant 2-1 0 times in the last 3 months, diagnosed the appellant with cervical myofascial strain (post high speed MVA) -onset of June 2012, longstanding depression, nasal septa! perforation and recent persistent MRSA. The physician reports the appellant has severe neck pain/headaches that were aggravated while performing CPR at a cardiac arrest. She has not been able to return to her regular work because of use of analgesics, antidepressants and Citalopram. The appellant is noted to have traumatic nasal septa! post cocaine abuse and persistent infections. She has been referred to ENT for ongoing management. In response to the question; Has the applicant been prescribed any medication and/or treatments that interfere with her ability to perform DLA? The physician indicated no. In the AR, the physician noted that the appellant's impairments are longstanding depression, dysphoria/anxiety, social withdrawal and chronic neck pain and fatigue. Physical Impairment • In terms of Functional Skills, the physician reported that the appellant can walk 4+ blocks unaided on a flat surface, can climb 5+ steps unaided, can lift 15 to 35 pounds, and has no limitation to remain seated. • In the PR, it was indicated the appellant does not require aids or prostheses for her impairment, and in the AR it was indicated that the appellant does not have an assistance animal. • In the AR, under Mobility and Physical Ability, it was noted that the appellant is independent in all areas however, takes significantly longer than typical for standing, lifting and carrying/holding due to fatigue and neck pain. Mental Impairment • In the PR, the physician indicated that the appellant has a significant deficit with cognitive and emotional function in the area of emotional disturbance noting chronic longstanding depression and chronic pain disorder. • The two sections in the AR that are to be completed only for applicants with an identified mental impairment or brain injury contained the following: Under Cognitive and Emotional Functioning, the physician reported a major impact for 3 of 14 items emotion, motivation and other emotional or mental problems, 3 moderate impacts -bodily functions (sleep disturbance), attention/concentration (distractible, unable to maintain concentration, ooor short EAAT 003(10/06/0I)
t e r m m e m o r y ) , m o t o r a c t i v i t y ( d e c r e a s e d g o a l o r i ( r a c i n g s p e e c h ) , w i t h n o i m p a c t o n t h e r e m a i n i n g T h e p h y s i c i a n c o m m e n t e d t h a t d u e t o a n x i e t y , t h t h a t f a t i g u e a f f e c t s h e r a b i l i t y t o c o n c e n t r a t e a n d d i s r u p t i o n e m o t i o n a l l y a n d s t r u g g l e s w i t h m o t i v a t a n h e d o n i a p r o d u c e s l a c k o f i n i t i a t i v e a n d d i m i n i s h U n d e r S o c i a l F u n c t i o n i n g ; t h e a p p e l l a n t w a s d e s d e v e l o p a n d m a i n t a i n r e l a t i o n s h i p s a s s h e s o c i a l r e p o r t e d a s h a v i n g m a r g i n a l f u n c t i o n i n g w i t h b o t h n e t w o r k s . I n t h e P R , u n d e r 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 a n d c o n s i d e r a l t e r n a t e e m p l o y m e n t r e a l i z i n g h e r a n d i n d e p e n d e n t . T h e p h y s i c i a n f u r t h e r s t a t e d t h a c o u l d o c c u r a n y t i m e i n t h e f u t u r e i n c l u d i n g w i t h i n I n t h e A R , u n d e r a b i l i t y t o c o m m u n i c a t e , t h e p h y s D a i l y L i v i n g A c t i v i t i e s • 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 t h e a p p e l l a p e r f o r m 9 o f t h e 1 0 l i s t e d D L A : P e r s o n a l s e l f c a r e B a s i c h o u s e w o r k , D a i l y s h o p p i n g , M o b i l i t y i n s i d e t r a n s p o r t a t i o n , a n d M a n a g e m e n t o f f i n a n c e s . T h w i t h r e s p e c t t o 1 D L A , S o c i a l f u n c t i o n i n g . T h e p h u n d e r " P e r i o d i c " d y s p h o r i a / a n x i e t y o c c a s i o n u n d e r S o c i a l F u n c t i o n i n g i s i m p a c t e d " c o n s i s w i t h d r a w a l a n d l o w m o t i v a t i o n , a n x i e t y e s p e c o f n a s a l t i s s u e s , a n d u n d e r " 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 " w r e l a x e d a n d o r a t e a s e n o s i g n i f i c a n t r e s t r i c • 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 P e r s o n a l C a r e , B a s i c H o u s e k e e p i n g , S h o p p i n g , M T r a n s p o r t a t i o n . I t w a s e x p l a i n e d t h a t d r e s s i n g , g r p e r s o n d u e t o p a i n , a s d o e s b a s i c h o u s e k e e p i n g a s s i s t a n c e f r o m h e r d a u g h t e r w h e n c a r r y i n g p u r c • I n t h e S R , t h e a p p e l l a n t n o t e d t h a t s h e h a s d i f f i c u b a s i c h y g i e n e , t o e a t r e g u l a r m e a l s a n d h e a l t h y f o h o m e c l e a n . S h e a l s o i n d i c a t e d d i f f i c u l t y w i t h m a k a n x i o u s o r s c a r e d , s t o p p i n g h e r s e l f f r o m b u y i n g t h r a t i o n a l c h o i c e s , r e m e m b e r i n g a p p o i n t m e n t s a n d s c a r e d , i n t e r a c t i n g w i t h f r i e n d s , f a m i l y , h e r p a r t n e m a i n t a i n i n g r e l a t i o n s h i p s , a s k i n g f o r h e l p , d e a l i n g o t h e r s s a y a n d h e a r i n g i n p e r s o n o r o n t h e p h o n e s o u n d s a n d m o t i o n . H e l p R e q u i r e d w i t h D L A E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )� A P P E A L # e n t e d a c t i v i t y ) a n d 1 m i n i m a l i m p a c t l a n g u a g e 7 c a t e g o r i e s . e a p p e l l a n t s o m e t i m e s h a s p r e s s u r e d r a c i n g s p e e c h h e r s h o r t t e r m m e m o r y , t h a t s h e h a s v e r y s i g n i f i c a n t i o n / c o n c e n t r a t i o n a n d o n g o i n g d i s t r a c t i o n a n d e d i n t e r e s t i n n o r m a l a c t i v i t y . c r i b e d a s r e q u i r i n g p e r i o d i c s u p p o r t t o b e a b l e t o l y i s o l a t e s h e r s e l f , d u e t o d e p r e s s i o n . S h e w a s a l s o h e r i m m e d i a t e s o c i a l n e t w o r k a n d e x t e n d e d s o c i a l i a n s t a t e d t h a t t h e a p p e l l a n t i s m o t i v a t e d t o r e t r a i n m e n t a l h e a l t h w o u l d b e e n h a n c e d b y b e i n g p r o d u c t i v e t h e i s s u p p o r t i v e o f s u c h r e t r a i n i n g a n d t h a t t h i s t h e n e x t 6 m o n t h s . i c i a n n o t e s t h a t t h e a p p e l l a n t h a s s o m e h e a r i n g l o s s . n t ' s i m p a i r m e n t s d o n o t d i r e c t l y r e s t r i c t h e r a b i l i t y t o , M e a l p r e p a r a t i o n , M a n a g e m e n t o f m e d i c a t i o n s , t h e h o m e , M o b i l i t y o u t s i d e t h e h o m e , U s e o f e P R i n d i c a t e d t h e a p p e l l a n t i s p e r i o d i c a l l y r e s t r i c t e d y s i c i a n p r o v i d e d t h e f o l l o w i n g e x p l a n a t i o n s ; a l w i t h d r a w a l a n d s o c i a l i m p a i r m e n t , t e n t a n d d e p r e s s i v e d i s o r d e r s o m e a n h e d o n i a i a l l y r e g a r d i n g l e g a l i s s u e s a n d h e r o n g o i n g i n f e c t i o n h e n o v e r w h e l m e d m a r k e d r e s t r i c t i o n s a n d w h e n t i o n s . n t i n d e p e n d e n t l y m a n a g e s a l l a s p e c t s o f D L A ; e a l s , P a y R e n t a n d B i l l s , M e d i c a t i o n s a n d o o m i n g a n d b a t h i n g t a k e t w i c e a s l o n g a s a n o r m a l a n d t h a t t h e a p p e l l a n t a l s o s o m e t i m e s n e e d s h a s e s h o m e . l t y r e m e m b e r i n g o r h a v i n g t h e m o t i v a t i o n f o r d a i l y o d , t o v a c u u m , d u s t , c l e a n w i n d o w s a n d t o k e e p h e r i n g d e c i s i o n s , p l a n n i n g , g o i n g o u t w i t h o u t b e i n g i n g s s h e d o e s n ' t n e e d , p r i o r i t i z i n g , m a k i n g g o o d , i n f o r m a t i o n , s o c i a l i z i n g w i t h o u t b e c o m i n g a n x i o u s a n d r a n d s t r a n g e r s i n p u b l i c , e s t a b l i s h i n g a n d w i t h u n e x p e c t e d s i t u a t i o n s , u n d e r s t a n d i n g w h a t . T h e a p p e l l a n t a l s o e x p e r i e n c e s s e n s i t i v i t y t o l i g h t
I APPEAL# • In the PR, it is noted that the appellant requires ongoing support/counselling and some personal assistance when overwhelmed/stressed to assure she does things required for daily living ( e.g. shopping/social interaction). • In the AR, it is noted that the appellant requires continued assistance from family, friends and community resources. • In the PR the prescribed professional indicated the appellant does not require aids or prostheses for her impairment, and in the AR, the prescribed professional indicated that appellant does not have an assistance animal. EAA T003(10/06/01)
I A P P E A L # P A R T F R e a s o n s f o r P a n e l D e c i s i o n T h e i s s u e u n d e r a p p e a l i s w h e t h e r t h e m i n i s t r y ' s d e c i s i o n t o d e n y t h e a p p e l l a n t d e s i g n a t i o n a s a P W D w a s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e o r w a s a r e a s o n a b l e a p p l i c a t i o n o f t h e a p p l i c a b l e e n a c t m e n t i n t h e c i r c u m s t a n c e s o f t h e a p p e l l a n t . I n p a r t i c u l a r , w a s t h e m i n i s t r y r e a s o n a b l e i n d e t e r m i n i n g t h a t t h e a p p e l l a n t d o e s n o t h a v e a s e v e r e p h y s i c a l o r m e n t a l i m p a i r m e n t , a n d 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 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 n o 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 h e r f r o m p e r f o r m i n g 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 e x t e n d e d p e r i o d s , a n d t h a t 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 . 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 h e l p t o p e r f o r m D L A ? T h e r e l e v a n t l e g i s l a t i o n i s a s f o l l o w s : E A P W D A : 2 ( 1 ) I n t h i s s e c t i o n : " a s s i s t i v e d e v i c e " m e a n s a d e v i c e d e s i g n e d t o e n a b l e a p e r s o n t o p e r f o r m a d a i l y l i v i n g a c t i v i t y t h a t , b e c a u s e o f 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 n t , t h e p e r s o n i s u n a b l e t o p e rf o r m ; " d a i l y l i v i n g a c 1 i v i t y " h a s t h e p r e s c r i b e d m e a n i n g ; " p r e s c r i b e d p r o f e s s i o n a l " h a s t h e p r e s c r i b e d m e a n i n g . ( 2 ) T h e m i n i s t e r m a y d e s i g n a t e a p e r s o n w h o h a s r e a c h e d 1 8 y e a r s o f a g e a s a p e r s o n w i t h d i s a b i l i t i e s f o r t h e p u r p o s e s o f t h i s A c t i f t h e m i n i s t e r i s s a t i s f i e d t h a t t h e p e r s o n 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 n t t h a t ( a ) i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r i s l i k e l y t o c o n t i n u e f o r a t l e a s t 2 y e a r s , a n d { b ) 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 ( 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 t h e p e r s o n ' s a b i l i t y t o p e r f 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 { A ) c o n t i n u o u s l y , o r ( B ) 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 , t h e p e r s o n r e q u i r e s h e l p t o p e rf o r m t h o s e a c t i v i t i e s . ( 3 ) F o r t h e p u r p o s e s o f s u b s e c t i o n ( 2 ) , ( a ) a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a i r m e n t i n c l u d e s a p e r s o n w i t h a m e n t a l d i s o r d e r , a n d ( b ) a p e r s o n r e q u i r e s h e l p i n r e l a t i o n t o a d a i l y l i v i n g a c 1 i v i t y i f , i n o r d e r t o p e rf o r m i t , t h e p e r s o n r e q u i r e s ( i ) a n a s s i s t i v e d e v i c e , ( i i ) t h e s i g n i f i c a n t h e l p o r s u p e rv i s i o n o f a n o t h e r p e r s o n , o r ( i i i ) t h e s e r v i c e s o f a n a s s i s t a n c e a n i m a l . E A P W D R s e c 1 i o n 2 ( 1 ) : 2 ( 1 ) F o r t h e p u r p o s e s o f t h e A c t a n d t h i s r e g u l a t i o n , " d a i l y l i v i n g a c t i v i t i e s " , ( a ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e p h y s i c a l i m p a i r m e n t o r a s e v e r e m e n t a l i m p a i r m e n t , m e a n s t h e f o l l o w i n g a c t i v i t i e s : ( i ) p r e p a r e o w n m e a l s ; ( i i ) m a n a g e p e r s o n a l f i n a n c e s ; ( i i i ) s h o p f o r p e r s o n a l n e e d s ; ( i v ) u s e 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 t i o n f a c i l i t i e s ; ( v ) p e r f o r m h o u s e w o r k t o m a i n t a i n t h e p e r s o n ' s p l a c e o f r e s i d e n c e i n a c c e p t a b l e s a n i t a ry c o n d i 1 i o n ; ( v i ) m o v e a b o u t i n d o o r s a n d o u t d o o r s ; ( v i i ) p e r f o r m p e r s o n a l h y g i e n e a n d s e l f c a r e ; ( v i i i ) m a n a g e p e r s o n a l m e d i c a t i o n , a n d { b ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a i r m e n t , i n c l u d e s t h e f o l l o w i n g a c t i v i t i e s : ( i ) m a k e d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e o r f i n a n c e s ; ( i i ) r e l a t e t o , c o m m u n i c a t e o r i n t e r a c t w i t h o t h e r s e f f e c t i v e l y . ( 2 ) F o r t h e p u r p o s e s o f t h e A c t , " p r e s c r i b e d p r o f e s s i o n a l " m e a n s a p e r s o n w h o i s a u t h o r i z e d u n d e r a n e n a c t m e n t t o p r a c t i c e t h e p r o f e s s i o n o f ( a ) m e d i c a l p r a c t i t i o n e r , ( b ) r e g i s t e r e d p s y c h o l o g i s t , ( c ) r e g i s t e r e d n u r s e o r r e g i s t e r e d p s y c h i a t r i c n u r s e , ( d ) o c c u p a t i o n a l t h e r a p i s t , ( e ) p h y s i c a l t h e r a p i s t , ( f ) s o c i a l w o r k e r , E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )
( g ) c h i r o p r a c t o r , o r ( h ) n u r s e p r a c t i t i o n e r . S e v e r e P h y s i c a l I m p a i r m e n t 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 s h e h a s n e c k p a i n d u e t o o s t e o a r t h r i t i s , n u m b n e s s a n d t i n g l i n g i n r i g h t a r m , c e l l u l i t h a t t h e a p p e l l a n t h a s s o m e h e a r i n g l o s s . T h e m i n i s t r y ' s p o s i t i o n , a s s e t o u t i n i t s r e c o n s i d e r a t i o n d r e p o r t e d b y t h e p h y s i c i a n a r e t h a t t h e a p p e l l a n t c a n w a l k s t e p s u n a i d e d a n d c a n l i f t 1 5 t o 3 5 p o u n d s a n d h a s n o l i a p p e l l a n t i s i n d e p e n d e n t i n a l l a s p e c t s o f m o b i l i t y a n d p h l o n g e r w i t h s t a n d i n g , l i f t i n g a n d c a r r y i n g a n d h o l d i n g d u e p r o v i d e d o n h o w m u c h l o n g e r i s r e q u i r e d b y t h e a p p e l l a n e v i 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 s e v e r e p h P a n e l D e c i s i o n T h e d i a g n o s i s o f a m e d i c a l c o n d i t i o n i s n o t i t s e l f d e t e r m i t h e s e v e r i t y o f a n i m p a i r m e n t o n e m u s t c o n s i d e r t h e n a t u a b i l i t y t o m a n a g e h e r D L A a s e v i d e n c e d b y f u n c t i o n a l s k i n d e p e n d e n c e i n p e rf o r m i n g D L A . T h e d e t e r m i n a t i o n o f s e v e r i t y o f i m p a i r m e n t i s a t t h e d i s c t h a t t h e s t a t u t o r y c r i t e r i a f o r g r a n t i n g P W D d e s i g n a t i o n a m u s t a c t r e a s o n a b l y a n d c o n s i d e r a l l t h e r e l e v a n t e v i d e n l e g i s l a t i o n i s c l e a r t h a t t h e f u n d a m e n t a l b a s i s f o r t h e a n a t h e p r o f e s s i o n a l e v i d e n c e h a s t o b e w e i g h e d a n d a s s e s s I n t h e a p p e l l a n t ' s c a s e , t h e p h y s i c i a n h a s c o n f i r m e d t h e p e r f o r a t i o n , a n d p e r s i s t e n t M R S A . U n d e r F u n c t i o n a l S k i l h a s a n y d i f f i c u l t i e s w i t h w a l k i n g u n a i d e d o n a f l a t s u r f a c e l i m i t a t i o n o f 1 5 -3 5 l b s f o r l i l t i n g i n d i c a t e s a r e a s o n a b l e l e 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 a l l D L A e x c e p t f o r S o c i a l F t h a t d r e s s i n g , g r o o m i n g a n d b a t h i n g f o r t h e a p p e l l a n t t a k d o e s b a s i c h o u s e k e e p i n g a n d t h a t t h e a p p e l l a n t a l s o s o m 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 a n e l f i n d s t h a t w h i l e t h e a p p e l l a n t ' s d i a g n o s i s o f c e l i m i t h e r a b i l i t y t o f u n c t i o n ; t h e e v i d e n c e d o e s n o t e s t a b l i s f u n c t i o n i n d e p e n d e n t l y , e f f e c t i v e l y , a p p r o p r i a t e l y o r f o r a p h y s i c i a n r e s p e c t i n g p h y s i c a l F u n c t i o n a l S k i l l s a n d t h e a d e s c r i p t i o n o f t h e a p p e l l a n t ' s M o b i l i t y a n d P h y s i c a l A b i l i t y f u n c t i o n i n g . B a s e d o n t h e e v i d e n c e , 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 d i d n o t e s t a b l i s h a s e v e r e p h y s i c a l i m p a i r m e n t . S e v e r e M e n t a l I m p a i r m e n t E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # a c a r a c c i d e n t a y e a r a g o , a n d s u f f e r s f r o m t i s a n d s t i f f n e s s i n h e r s h o u l d e r s . H e r p h y s i c i a n n o t e s e c i s i o n , i s t h a t t h e a p p e l l a n t ' s f u n c t i o n a l s k i l l s a s 4 + b l o c k s u n a i d e d o n a f l a t s u r f a c e , c a n c l i m b 5 + m i t a t i o n t o r e m a i n s e a t e d . T h e A R n o t e d t h a t t h e y s i c a l a b i l i t y h o w e v e r , t h e a p p e l l a n t t a k e s s i g n i f i c a n t l y t o f a t i g u e a n d n e c k p a i n w i t h o u t f u r t h e r i n f o r m a t i o n t . T h e m i n i s t r y c o n c l u d e s t h a t t h e r e i s n o t e n o u g h y s i c a l i m p a i r m e n t . n a t i v e o f a s e v e r e i m p a i r m e n t . A c c o r d i n g l y , t o a s s e s s r e o f t h e i m p a i r m e n t a n d i t s i m p a c t o n t h e a p p e l l a n t ' s i l l l i m i t a t i o n s , t h e r e s t r i c t i o n s t o D L A , a n d t h e d e g r e e o f r e t i o n o f t h e m i n i s t e r t h e m i n i s t r y m u s t b e " s a t i s f i e d " r e f u l f i l l e d . I n m a k i n g i t s d e t e r m i n a t i o n t h e m i n i s t r y c e , i n c l u d i n g t h a t o f t h e a p p e l l a n t . W h i l e t h e l y s i s i s t h e e v i d e n c e f r o m p r e s c r i b e d p r o f e s s i o n a l s , e d l i k e a n y o t h e r e v i d e n c e . d i a g n o s e s a s c e r v i c a l m y o f a s c i a l s t r a i n , n a s a l s e p t a l l s , t h e p h y s i c i a n h a s n o t 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 , c l i m b i n g s t a i r s o r r e m a i n i n g s e a t e d a n d t h e r e p o r t e d v e l o f i n d e p e n d e n t f u n c t i o n i n g . T h e P R i n d i c a t e d t h e u n c t i o n i n g . I n t h e A R , t h e p h y s i c i a n f u r t h e r e x p l a i n e d e t w i c e a s l o n g a s a n o r m a l p e r s o n d u e t o p a i n , a s e t i m e s n e e d s a s s i s t a n c e f r o m h e r d a u g h t e r w h e n r v i c a l m y o f a s c i a l s t r a i n a n d c h r o n i c n e c k p a i n m a y h t h a t t h e s y m p t o m s r e s t r i c t t h e a p p e l l a n t ' s a b i l i t y t o r e a s o n a b l e d u r a t i o n . T h e i n f o r m a t i o n p r o v i d e d b y t h e p p e l l a n t ' s a b i l i t y t o m a n a g e D L A a s w e l l a s t h e a r e n o t r e f l e c t i v e o f a s e v e r e i m p a i r m e n t o f d a i l y r e a s o n a b l y d e t e r m i n e d t h a t t h e i n f o r m a t i o n p r o v i d e d
The ap pel lan t's pos ition is th at s he s u f fe rs from depr e ss fatig ue . In the S R , she al so in dicate d h aving di fficulty w ith ma a nxi o u s or scared, stop ping he rself f r o m buying th i ng s she ch oi c es, remem beri ng ap pointment s a n d informat i o n , soc intera c ting with fri e n d s , fami ly, h er p artner a n d s trangers aski ng for help, and de aling wi th u nexpected situati o ns . Th e mi n istry's p os i tion , as set out in its re consid era tio n decis that s he has a def i c i t with cog nit ive an d emotiona l f unctions has major impac t s to e mot i o n, m o t ivation and other e m otio by the appellant's phy s ician are m ore in keeping with a mod the inf ormatio n provid ed by th e ph y s ician t he mi nis try find menta l impairment. Panel D e cisio n In th e appellant' s ca se, t h e p hysici a n h as confirmed the d r e p o r ted that the ap pel l ant h as been pr e s cribed an y m ed to pe rfo rm DLA. T he appellant has been re p o rt e d to have a area o f em otional distur ban ce s and s he has m a jor impac ment a l prob le ms . U nder Soci al Fu nctionin g, the appellant was described a ble to deve l o p a n d mainta i n relat i onsh ips d ue to s oc ially iso marginal func tioning w ith b o th her immediate s o cial netwo n o t ed expl an ations pro v ided in t he PR u nder "Perio d ic", impairmen t, u nder " I mpac t on Social F unc tionin g ", consiste withdrawa l an d low motivati on, anxiety esp e cia l ly rega r d tiss ues, and u n der "Degree of Re s t riction ", wh en ove rwhelme a t ea s e n o sig nifi cant rest ric tion s at all. Se c tion 2 ( 1 )( b} of the E A PWD R prescri b e s two D L A that are ab o u t personal acti vitie s , c a re or finances (de cisi on making) effe ctively (s ocial functioning). In the AR, it was indicated that the appellant is independe her financ es , managing her medications, making appropriate social decisions, interacting appropriately with others, abl e to deal appropr iat e ly with unexpected demands and being able to secure assistance from others. Considering the evidence as a whol e, the panel finds the evidence establishes that identified for some aspects of cognitive and emotional functioning and the a t h e physician's evidence is that, except for requiring periodic assistance with 1 of 5 aspects of social functioning (deve lop and m ai ntain relatio nships ), the a p pella tasks, includin g decision-makin g. Further, the physician's narrative indicates that the appel occasionally w ithd rawn and socially impaired. For these reasons, the pane determined that the evidence does not demonstrate a severe mental impairment. S ignifican t Restrictions to DLA The appellant's position is that she has difficulty remembering or having the motivation to eat regular meals and healthy food, to vacuum, dust, clean windows and to keep her home clean. She also indicated difficulty with making decisions, planning, going out without being anxious or scared, stopping herself from bu in thin s she doesn't need, rioritizin , makin EAAT003(10/06/01) '. APPEA L# ion, anxi ety, p a ni c at tacks due t o st ress, ins o mn ia a nd ki n g dec i sions , p lan ni n g, going out with out b ei n g do es n' t need, pri o r itizin g, ma kin g good, rat ional ializin g withou t be coming anxious and scared, i n p u b lic, estab lishing and maintaining r e lationship s, ion, is that w hile the appellant' s p hys i c i an repo rt s in t he a rea o f emotion al d isturb a n c es and that she nal or mental pr ob l e ms, the se im pacts as des cri bed erate de gree of impai rment. There fo re, ba s e d on s there is not enoug h e videnc e to e stab lish a seve r e i a gnosi s o f depr essio n. The p hy sic ian h as n o t i cat io n and /or t reatmen ts that in terfere with he r abil i t y defic it with c ogn itive and emotional fu nc t ions i n the t s t o emotion, motivation a nd other emo ti o nal or as req u iri n g periodic support to be l a t i ng h er self w hen de p ress ed a n d a s having rk and extended soci al network s . The pa nel has also d ysphoria / anxie t y -occ asi onal w it hdrawa l a nd social nt and d e p re s sive di sorde r -some anhed onia i ng l egal issues and her o n going infect i on o f na s al d m arked restr i ctio ns and w hen relaxed and or s pe cific to me n tal impair ment -mak e d ec isions , and relate to , communica t e or interact wi t h o t hers nt with respect to making decisio n s ab o u t mana g ing despite the major impact ppellant's s elf-reported d if ficulties, nt indepe nd ently mana ges all other c ogn itive DLA l ant is only l finds that the ministry reasonably for daily basic hygiene, ood, rational choices, rememberin a ointments
and infor m ation , so cializ ing without beco ming anxious and s a nd s tra ng ers in public, e stab l ishi ng a nd m aintai ning rel s i tuatio ns, un de rstandi ng wha t o t hers s ay, and hearin g exp erie nce s sensit ivity t o l ight sounds a n d motion. The mini s try's position is that it r elies on th e medi cal opin de ter min e that the a p pe l l ant's impa irme nt s sign ifican tly restric con t i nu ously or period ically for e x te nd ed p er i ods. The min b ases on phy sic al , men t al and daily livi ng ass e ssm e nts p provided by the a p pe l l a n t's p h ysic ian, the min ist r y d oe s not appel lant's i mp airme nt s i g n ific antly r estricts h e r abi lity to perform per io d ical ly for extend ed per iods . Therefore, the ministry sev ere mental or physica l i m p a ir m e nt t hat , i n the op in ion r estricts the appellant's abil ity to perf o rm d aily l ivi ng activi Pan el D e c ision The legisl ation -Sec tion 2 { 2 )(b )(i) o f th e E A PW D A -req signif i cant r estric tio ns o f D L A in cons ide r a t ion of th e opi nion t hat ot h e r evid ence -suc h as that f r om the a ppellant -shouldn't ci ar ific at io n of th e p rofes sional ev i dence, b ut th e legisla t pr o fessional' s op ini on is fu nd ame n tal t o t he m inis try's de appel l ant's c ase , the pres c ri bed pro f essio na l has sup pli ed de g re e o f re str iction t o DL A. The legisl a ti on requi res that a s e ve re impai r ment d i re ctl y per for m DLA e ither c onti nuously or periodicall y for ex tende m u st be a c ausal link between the s e ver e i m p airmen t a nd t i me or du ration . Th e dire c t a nd s ign i ficant restri c tion may must be for an e xt end ed time. Inhe ren tly, a ny ana lysi s o fr equ en cy. In ci r c u mstances w here the e vide nce i ndica te appropria te for t h e ministry to re quire ev i d en c e of the du "satisfied" that this legislat iv e crit erion is met. The onus is on the appellant to prove on the balance of probabilitie with respect to direct and severe restrictions to her ability to manage her The evidence pro vide d in the PR indicated that the appellant's impairm perform 9 of the 10 listed DLA [the panel notes that the PR lists mobility inside the home and mob the home as 2 s epar ate D LA though t h ey are defined in t is periodically restricted with respect to 1 DLA, Social functioning. Additionally, h tha t she h a s been prescribe d any medication and/or treat In the AR , the physician indicated that the appellant independen Care, Basic Housekeeping , Shopping, Meals, Pay Rent and Bills, Medications and Transportation. It was explained that dressing, grooming and bathing take twice as long as a normal person due to pain, as does basic housekeeping and that the appellant also sometimes needs assistance from her daughter when carrying purchases home. EMT 003(10/06/01) A PPEAL# : c a r ed , int e r acting with fr i en ds, fa mil y, her pa r tner ationshi ps, ask ing for help, deal ing wi t h unexpe ct e d in pe rson or on the phone . T he ap pe l l a n t al so ion and expe rtize from the appe llant's phy sician to t her abil ity to p erf orm d aily living activiti es ei ther ist r y make s its d ec ision reg ard ing PW D el igi bil ity r ovid ed b y the physicia n . Based on the in f orma ti on h ave eno ugh evidenc e to c o n f ir m that t he d ail y l i ving activi t i es continuo us ly or is not sa t is fied that the i nformat io n d emonst rates a of a p re s cr ibed professi onal, d ire c tly a nd signi ficantly t i es contin uously or perio dically for extend ed per iods. uire s the min ist er to substan tially ass ess dir ect a nd of a prescribe d p rofessional. Thi s doesn't mean b e f a ctored in as req uired to p ro vide ive language makes it clea r that th e pre scribed termi nation as t o wh e th e r it is "satisfied". In the li ttle in the way of narra t ive t o est abl ish t h e requis ite and signi f i cantly restri c ts the ap pellant's abili ty to d pe riods . The t erm "dir ec t l y '' m e a ns that t here th e r estriction . T h ere is also a c ompo n ent rel a t ed to be eit her continuous or periodi c . If i t i s per io d ic i t f period ic ity must als o incl u de conside ration o f t h e s that a re stri c t ion arises peri odical l y, i t is en tirely r at ion a nd fre qu en c y of t h e r estriction in ord er to be s that she satisfies the legislative criteria DLA i n dependently. e nts do not directly restrict her ability to ility outside he legislation as comprising 1 D LA] a nd the appellant er physi c i a n h a s not rep o rt ed m en ts that interfere with her ability to perform DLA . tly m anages all aspe cts of the DLA; Personal
W h i l e , t h e a p p e l l a n t n o t e d t h a t s h e h a s d i f f i c u l t y r e m e m b h e r p h y s i c i a n h a s r e p o r t e d t h a t a n h e d o n i a p r o d u c e s l a c k t h e d e g r e e o f i n d e p e n d e n c e w i t h a l m o s t a l l t a s k s o f a l l D t h e e x t e n t o f s u c h r e s t r i c t i o n s a s d e s c r i b e d b y t h e a p p e l l a f o r s o m e a s p e c t s o f p e r s o n a l c a r e a n d h o u s e k e e p i n g , r e 1 5 -3 5 l b s . , a n d i s o c c a s i o n a l l y s o c i a l l y w i t h d r a w n , w a s r e s i g n i f i c a n t r e s t r i c t i o n i n t h e a b i l i t y t o p e r f o r m D L A . I n t h e p a n e l ' s v i e w , w h i l e t h e e v i d e n c e i n d i c a t e s t h a t t h e e s t a b l i s h 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 a b i l i t y t o m a n a g e h e r 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 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 f o u n d t h a t t h i s l e g i s l a t i v H e l p w i t h 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 s h e r e q u i r e s h e l p w i t h D L 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 s i n c e i t h a s n o t b e e n e s t a b r e s t r i c t e d , i t c a n n o t b e d e t e r m i n e d t h a t s i g n i f i c a n t h e l p i s P a n e l D e c i s i o n F i n d i n g s t h a t a s e v e r e i m p a i r m 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 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 a n e x t e n d e d p e r i o d a r e a b y s e c t i o n 2 ( 3 ) ( b ) o f t h e E A P W D A . I n t h e P R , i t i s n o t e d t h a t t h e a p p e l l a n t r e q u i r e s o n g o i n g w h e n o v e r w h e l m e d / s t r e s s e d t o a s s u r e s h e d o e s t h i n g s r a p p e l l a n t r e q u i r e s c o n t i n u e d a s s i s t a n c e f r o m f a m i l y , f r i e n p r e s c r i b e d p r o f e s s i o n a l i n d i c a t e d t h e a p p e l l a n t d o e s n o t t h e A R , t h e p r e s c r i b e d p r o f e s s i o n a l i n d i c a t e d t h a t a p p e l l a 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 c o n c l u d e d t h a t s i n c e i t s i g n i f i c a n t l y r e s t r i c t e d , i t c o u l d n o t b e d e t e r m i n e d t h a t t h e l e g i s l a t i o n . C o n c l u s i o n T h e p a n e l a c k n o w l e d g e 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 r e v i e w e d a n d c o n s i d e r e d a l l o f t h e e v i d e n c e a n d t h e r e l e v d e c i s i o n f i n d i n g t h e a p p e l l a n t i n e l i g i b l e f o r P W D d e s i g n a t p a n e l t h e r e f o r e c o n f i r m s t h e m i n i s t r y ' s d e c i s i o n . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )� A P P E A L # e r i n g o r h a v i n g t h e m o t i v a t i o n f o r a v a r i e t y o f D L A a n d o f i n i t i a t i v e a n d d i m i n i s h e d i n t e r e s t i n n o r m a l a c t i v i t y , L A r e p o r t e d b y t h e p h y s i c i a n d o e s n o t s u b s t a n t i a t e n t . A d d i t i o n a l l y , t h a t t h e a p p e l l a n t t a k e s t w i c e a s l o n g q u i r e s s o m e a s s i s t a n c e w i t h l i f t i n g t h o u g h s h e c a n l i f t a s o n a b l y v i e w e d b y t h e m i n i s t r y a s n o t e s t a b l i s h i n g a a p p e l l a n t h a s s o m e d i f f i c u l t y w i t h h e r D L A , i t d o e s n o t h e r i m p a i r m e n t s 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 h e r a l l y f o r e x t e n d e d p e r i o d s . A c c o r d i n g l y , t h e p a n e l e c r i t e r i o n i s n o t s a t i s f i e d . A . l i s h e d t h a t t h e a p p e l l a n t ' s D L A a r e s i g n i f i c a n t l y r e q u i r e d f r o m o t h e r p e r s o n s . l y r e s t r i c t s a p e r s o n ' s a b i l i t y t o m a n a g e h i s D L A e i t h e r p r e c o n d i t i o n t o a p e r s o n r e q u i r i n g " h e l p " a s d e f i n e d s u p p o r t / c o u n s e l l i n g a n d s o m e p e r s o n a l a s s i s t a n c e e q u i r e d f o r d a i l y l i v i n g . I n t h e A R , i t i s n o t e d t h a t t h e d s a n d c o m m u n i t y r e s o u r c e s . A l s o i n t h e P R , t h e r e q u i r e a i d s o r p r o s t h e s e s f o r h e r i m p a i r m e n t , a n d i n n t d o e s n o t h a v e a n a s s i s t a n c e a n i m a l . T h e p a n e l h a s n o t b e e n e s t a b l i s h e d t h a t t h e a p p e l l a n t ' s D L A a r e a p p e l l a n t r e q u i r e s h e l p w i t h D L A a s d e f i n e d b y t h e d i t i o n s a f f e c t h e r a b i l i t y t o f u n c t i o n . H o w e v e r , h a v i n g a n t l e g i s l a t i o 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 ' s i o n i s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e . T h e
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.