P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e r e c o n s i d e r a t i o n d e S o c i a l I n n o v a t i o n ( t h e m i n i s t r y ) d a t e d A p r i l 3 , 2 0 1 4 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 ( P W D ) . T h e m i n i s t r y d e t h e f i v e c r i t e r i a r e q u i r e d f o r P W D d e s i g n a t i o n a s s e P e r s o n s w i t h D i s a b i l i t i e s A c t , s e c t i o n 2 . T h e a p p e l l a a m e d i c a l p r a c t i t i o n e r h a s c o n f i r m e d h e r i m p a i r m e n m i n i s t r y i 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 a s e v e r e d e t e r m i n e d t h a 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 i d e d o t h e a p p e l l a n t ' s i m p a i r m e n t , i n t h e o p i n i o n o f a r e s t r i c t s h e r 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 e x t e n d e d p e r i o d s ( s u b s . 2 ( b ) ( i ) ) ; a n d • 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 r e s t r i c t e d b y h e r i m p a i r m e n t ( s u b s . 2 ( b ) ( i i ) ) . 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 fo 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 )I A P P E A i c i s i o n o f t h e M i n i s t r y o f S o c i a l D e v e l o p m e n t a n d d e n y i n g t h e a p p e l l a n t ' s a p p l i c a t i o n f o r d e s i g n a t i o n 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 i d n o t m e e t t w o o f t o u t i n 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 n t h a s m e t t h e c r i t e r i a o f b e i n g 1 8 y e a r s o r o l d e r , t i s l i k e l y t o c o n t i n u e f o r a t l e a s t 2 y e a r s a n d t h e m e n t a l i m p a i r m e n t . H o w e v e r , t h e m i n i s t r y , t h e a p p e l l a n t h a d n o t m e t t h e f o l l o w i n g c r i t e r i a : p r e s c r i b e d p r o f e s s i o n a l , d i r e c t l y a n d s i g n i f i c a n t l y i t i e 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 e a p p e l l a n t r e q u i r e s h e l p t o p e r f o r m t h e D L A i l i t i e s A c t ( E A P W D A ) s e c t i o n 2 il 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
P A R T E S u m m a r v o f F a c t s T h e m i n i s t r y d i d n o t a t t e n d t h e h e a r i n g . T h e p a n e l m i n i s t r y h a d b e e n n o t i f i e d o f t h e d a t e , t i m e a n d l o c a t h e E m p l o y m e n t A s s i s t a n c e R e g u l a t i o n , t h e p a n e l h 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 r e c o n s i d e r a t i o n 1 . T h e a p p e l l a n t ' s P W D D e s i g n a t i o n A p p l i c a t i o o T h e a p p e l l a n t ' s S e l f R e p o r t c o m p l e t e d A u g u o T h e P h y s i c i a n R e p o r t ( P R ) d a t e d N o v e m b e r w h o i n d i c a t e s h e h a s k n o w n t h e a p p e l l a n t s t h e p r e v i o u s 1 2 m o n t h s ( t h e m i n i s t r y e r r s i n p h y s i c i a n i n d i c a t e d " 2 -1 O t i m e s " i n t h e p r e v i p h y s i c i a n a r e a d i a g n o s t i c i m a g i n g r e p o r t f o a l e t t e r t o t h e a p p e l l a n t ' s p h y s i c i a n f r o m a c 2 0 1 3 r e g a r d i n g t h e d i a g n o s t i c i m a g i n g r e p o O c t o b e r 2 , 2 0 1 3 r e g a r d i n g t h e a p p e l l a n t ' s c • T h e A s s e s s o r R e p o r t ( A R ) d a t e d S e p t e m b e t h a t s h e p r e p a r e d t h e A R a f t e r o n e m e e t i n g 2 . T h e a p p e l l a n t ' s 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 s i x p a g e s u b m i s s i o n p r e p a r e d b y h e r a d v o c a a n d a o n e p a g e s u m m a r y o f t h e d e c i s i o n i n H T ri b u n a l p r e p a r e d b y t h e a d v o c a t e . 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 u b m i t t e d a 1 p a g e l e t t w e l l a s a c o p y o f t h e f i r s t p a g e o f h e r s i x p a g e s u b m i n c l u d e d i n t h e a p p e a l m a t e r i a l s , b u t i s i n c o m p l e t e a t h e o n e p a g e s u m m a ry o f t h e H u d s o n d e c i s i o n w h i c a p p e l l a n t ' s 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 , b u t w a s n o t T h e l e t t e r f r o m t h e a p p e l l a n t ' s m o t h e r r e f e r s t o t h e i n a p p l i c a t i o n , i n p a r t i c u l a r t h e a p p e l l a n t ' s s e l f r e p o r t , a p a g e o f t h e a p p e l l a n t ' s s u b m i s s i o n o n r e c o n s i d e r a t i o w a s t h e o n e p a g e s u m m a r y o f t h e H u d s o n d e c i s i o n t h e r e f o r e a d m i t s a s e v i d e n c e t h e d o c u m e n t s s u b m i t t e s t i m o n y i n s u p p o r t o f t h e i n f o r m a t i o n a n d r e c o r d s b e i n g a p p e a l e d w a s m a d e ( t h e l e t t e r f r o m t h e a p p e l t h e m i n i s t e r w h e n t h e d e c i s i o n b e i n g a p p e a l e d w a s a n d A s s i s t a n c e A c t . T h e f o l l o w i n g i s a s u m m a r y o f t h e e v i d e n c e f r o m t h e i m p a i r m e n t s a s t h e y r e l a t e t o t h e t w o P W D c r i t e r i a a t o t h e a p p e l l a n t ' s s e l f r e p o r t i n t h e P W D a p p l i c a t i o n , E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L I r e c e i v e d c o n f i r m a t i o n f r o m t h e T r i b u n a l t h a t t h e t i o n o f t h e h e a r i n g . A c c o r d i n g l y , u n d e r s . 8 6 ( b ) o f e a r d t h e a p p e a l i n t h e m i n i s t r y ' s a b s e n c e . c o n s i s t e d o f t h e f o l l o w i n g : n , c o n t a i n i n g t h e f o l l o w i n g t h r e e p a r t s : s t 2 0 , 2 0 1 3 ; 8 , 2 0 1 3 , c o m p l e t e d b y t h e a p p e l l a n t ' s p h y s i c i a n i n c e A p r i l 2 0 1 3 a n d s e e n h e r 1 1 o r m o r e t i m e s i n s t a t i n g i n t h e r e c o n s i d e r a t i o n d e c i s i o n t h a t t h e o u s 1 2 m o n t h s ) . A t t a c h e d t o t h e P R b y t h e r t h e a p p e l l a n t d a t e d O c t o b e r 2 2 , 2 0 1 3 ( 2 p a g e s ) , o n s u l t i n g g a s t r o e n t e r o l o g i s t d a t e d O c t o b e r 2 2 , r t ( 1 p a g e ) , a n d a r e p o rt f r o m a h o s p i t a l d a t e d o l o n o s c o p y ( 2 p a g e s ) ; a n d r 1 0 , 2 0 1 3 , c o m p l e t e d b y a n u r s e w h o i n d i c a t e s w i t h t h e a p p e l l a n t t o c o m p l e t e t h e A R . , d a t e d M a r c h 2 1 , 2 0 1 4 , t o w h i c h w a s a t t a c h e d a t e , t o g e t h e r w i t h a c o p y o f t h e I n t e r p r e t a t i o n A c t u d s o n v . E m p l o y m e n t a n d A s s i s t a n c e A p p e a l e r d a t e d M a y 3 , 2 0 1 4 w r i t t e n b y h e r m o t h e r , a s i s s i o n o n r e c o n s i d e r a t i o n ( a c o p y o f w h i c h i s s a r e s u l t o f p h o t o c o p y i n g ) , a s w e l l a s a c o p y o f h w a s s u b m i t t e d t o t h e m i n i s t r y w i t h t h e i n c l u d e d i n t h e a p p e a l m a t e r i a l s . f o r m a t i o n b e f o r e t h e m i n i s t r y s e t o u t i n t h e P W D n d t h e c o m m e n t a r y i n t h e P R a n d A R . T h e f i r s t n w a s b e f o r e t h e m i n i s t r y a t r e c o n s i d e r a t i o n , a s p r e p a r e d b y t h e a p p e l l a n t ' s a d v o c a t e . T h e p a n e l t e d b y t h e a p p e l l a n t a t t h e h e a r i n g a s w r i t t e n t h a t w e r e b e f o r e t h e m i n i s t e r w h e n t h e d e c i s i o n l a n t ' s m o t h e r ) a n d a s i n f o r m a t i o n t h a t w a s b e f o r e m a d e p u r s u a n t t o s u b s . 2 2 ( 4 ) o f t h e E m p l o y m e n t P R a n d A R r e g a r d i n g t h e a p p e l l a n t ' s t i s s u e . T h e p a n e l h a s a l s o i n c l u d e d r e f e r e n c e a s w e l l a s h e r s u b m i s s i o n s a t t h e h e a r i n g .
B a c k g r o u n d A g e , D u r a t i o n a n d S e v e r i t v o f i m p a i r m I n t h e r e c o n s i d e r a t i o n d e c i s i o n , t h e m i n i s t r y n o t e s t a t l e a s t 1 8 y e a r s o l d , a n d t h a t a m e d i c a l p r a c t i t i o n e c o n t i n u e f o r t w o y e a r s o r m o r e , a s s e t o u t b y h e r p h A t t h e h e a r i n g , t h e a p p e l l a n t c o n f i r m e d t h a t s h e d o e t h e r e i s n o t e n o u g h e v i d e n c e t o e s t a b l i s h t h a t s h e h 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 i d e n t i f i e d h e r i m P T S D ( p o s t t r a u m a t i c s t r e s s d i s o r d e r ) s y m p t o m s , d C r o h n ' s d i s e a s e . T h e m i n i s t r y n o t e s i n i t s r e c o n s i d e a p p e l l a n t ' s p h y s i c i a n i n t h e P R t h a t s h e h a s d e f i c i t s a r e a s o f e m o t i o n a l d i s t u r b a n c e s , m o t i v a t i o n , i m p u l s u n a b l e t o c o n t r o l i m p u l s i v e r e p e t i t i v e b e h a v i o u r d u e t r a i t s a n d s h e h a s s e v e r e p a n i c a t t a c k s w h e r e s h e b i n f o r m a t i o n f r o m t h e n u r s e i n t h e A R t h a t t h e a p p e l l a f u n c t i o n s , c o n s c i o u s n e s s , e m o t i o n a n d m o t i v a t i o n , a a n d j u d g m e n t , m o t o r a c t i v i t y a n d o t h e r n e u r o p s y c h o a c k n o w l e d g e s t h a t t h e m i n i s t r y i s s a t i s f i e d t h a t t h e i e s t a b l i s h e s 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 m e n t a l i d e s i g n a t i o n ) . A b i l i t v t o p e r f o r m D L A ( c ri t e ri a s e t o u t i n s u b s . 2 ( 2 )( 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 i n d i c a t e d t h a t t h a b i l i t y t o p e r f o r m t h e f o l l o w i n g l i s t e d D L A : p e r s o n a l m e d i c a t i o n s , u s e o f t r a n s p o r t a t i o n a n d s o c i a l f u n c t i o a p p e l l a n t w a s n o t r e s t r i c t e d i n h e r D L A o f b a s i c h o u o u t s i d e t h e h o m e , 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 a p p e l l a n t ' s i m p a i r m e n t c o n t i n u o u s l y r e s t r i c t e d t h e D t r a n s p o r t a t i o n , a n d p e r i o d i c a l l y r e s t r i c t e d t h e D L A o f a n d 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 ' s p h y s i c i a n w r a p p e l l a n t r e q u i r e s p e r i o d i c a s s i s t a n c e , " w h e n e x p e r i f r i e n d s / f a m i l y u p t o 3 -4 t i m e s p e r w e e k . " T h e a p p e l l i n t h e P R a b o u t t h e i m p a c t o f t h e a p p e l l a n t ' s i m p a i r m c o n t r o l i m p u l s i v e r e p e t i t i v e b e h a v i o u r / O C D t r a i t s . S ( b l a c k o u t s ) a n d c o m p u l s i v e b e h a v i o u r s e v e r a l t i m e s t h a t t h e a p p e l l a n t ' s " e p i s o d e s c a n b e a s f r e q u e n t a s t h e a p p e l l a n t r e q u i r e s w i t h h e r D L A , t h e p h y s i c i a n w d r e s s , u s e m e d i c a t i o n s , e m o t i o n a l s u p p o r t , a p p o i n t m [ d o c t o r s ] . " T h e n u r s e c o m p l e t e d t h e A R a f t e r o n e m e e t i n g w i t h i m p a i r m e n t s t h a t i m p a c t h e r a b i l i t y t o m a n a g e h e r D L h a s f r e q u e n t d i a r r h e a n e e d s t o b e c l o s e t o a t o i l e t b r e a t h e , s e l f m u t i l a t e s c r i e s a l o t h a d s e x u a l & e m E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L I e n t s ( c r i t e r i a s e t o u t i n s u b s . 2 ( 2 ) E A P W D A ) h a t t h e a p p e l l a n t m e e t s t h e a g e c r i t e r i o n a s s h e i s r h a s c o n f i r m e d t h a t h e r i m p a i r m e n t i s l i k e l y t o y s i c i a n i n t h e P R , m e e t i n g t h e s e c o n d c r i t e r i o n . s n o t c h a l l e n g e t h e m i n i s t r y ' s d e t e r m i n a t i o n t h a t 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 . p a i r m e n t s a s g e n e r a l i z e d a n x i e t y d i s o r d e r w i t h e p r e s s i o n a n d m i g r a i n e h e a d a c h e s , a s w e l l a s r a t i o n d e c i s i o n t h e i n f o r m a t i o n f r o m t h e w i t h c o g n i t i v e a n d e m o t i o n a l f u n c t i o n s i n t h e e c o n t r o l a n d m o t o r a c t i v i t y , e x p l a i n i n g t h a t s h e i s t o h e r O C D ( o b s e s s i v e c o m p u l s i v e d i s o r d e r ) l a c k s o u t . T h e m i n i s t r y a l s o n o t e s t h e n t ' s i m p a i r m e n t c a u s e s m a j o r i m p a c t s t o b o d i l y n d m o d e r a t e i m p a c t s t o i m p u l s e c o n t r o l , i n s i g h t l o g i c a l p r o b l e m s . T h e r e c o n s i d e r a t i o n d e c i s i o n n f o r m a t i o n p r o v i d e d i n t h e P W D a p p l i c a t i o n m p a i r m e n t ( t h e t h i r d c r i t e r i o n f o r P W D b ) E A P W D A ) e a p p e l l a n t ' s i m p a i r m e n t s d i r e c t l y r e s t r i c t h e r s e l f c a r e , 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 n i n g . 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 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 a n d 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 L A o f p e r s o n a l s e l f c a r e a n d u s e o f 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 o t e t h e c o m m e n t e x p l a i n i n g h i s i n d i c a t i o n t h a t t h e e n c i n g p a n i c e p i s o d e s , r e q u i r e s a s s i s t a n c e f r o m a n t ' s p h y s i c i a n r e f e r r e d t o h i s p r e v i o u s c o m m e n t e n t o n h e r s o c i a l f u n c t i o n i n g ; t h a t i s , " u n a b l e t o e v e r e p a n i c a t t a c k s [ w i t h ] p h y s i c a l s y m p t o m s p e r w e e k . " T h e a p p e l l a n t ' s p h y s i c i a n a l s o w r o t e 3 -4 X / w e e k . " I n c o m m e n t i n g o n t h e a s s i s t a n c e r o t e , " r e m i n d e r t o e a t o n r e g u l a r b a s i s , s h o w e r , e n t s f o l l o w u p [ w i t h ] m e & m e n t a l h e a l t h t h e a p p e l l a n t . I n d e s c r i b i n g t h e a p p e l l a n t ' s A , t h e n u r s e w r o t e , " c h r o n i c a b d o m i n a l p a i n s u f f e r s f r o m a n x i e t y h a s p a n i c a t t a c k s c a n ' t o t i o n a l a b u s e a s c h i l d a n d s t i l l s u f f e r s f r o m
e f f e c t s , p o o r t r u s t o r e l s e o v e r t r u s t s & g e t s h u rt r t i r e d . " I n t h e s e c t i o n o f t h e A R i n d i c a t i n g t h e d e g r e c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g , t h e n u r s e h a s f u n c t i o n s ( c i r c l i n g t h e w o r d s " e a t i n g p r o b l e m s , t o i l e c o n s c i o u s n e s s , e m o t i o n ( c i r c l i n g t h e w o r d s " a n x i e t y i n d i c a t e d a m o d e r a t e i m p a c t f o r t h e a r e a s o f i m p u l s " u n s a f e b e h a v i o u r " ) , m o t o r a c t i v i t y , a n d o t h e r e m o t i m i n i m a l i m p a c t f o r t h e a r e a s o f a t t e n t i o n / c o n c e n t r a m e m o r y a n d l a n g u a g e . T h e n u r s e a t t a c h e d w i t h h e o f n o t e s r e g a r d i n g h e r a n s w e r s . I n t h e e x t e n s i v e c o " e i t h e r d o e s n ' t e a t & n e e d s t o b e t o l d t o e a t o r e l s e w r i t e s , " s h e d o e s n o t t h i n k a b o u t s h o w e r i n g f o r 4 o r c a n ' t s h o w e r w h e n a l o n e i n t h e h o u s e a s t h a t w a s w b a t h e a l o n e . " T h e n u r s e w r i t e s t h a t t h e a p p e l l a n t s t i m e . T h e n u r s e w r i t e s t h a t s h o w e r i n g c a u s e s t h e a s o m e w h e r e u n f a m i l i a r . T h e n u r s e d e s c r i b e d t h e a p u n c o n t r o l l e d c r y i n g , s h a k i n g a n d r o c k i n g , s c r a t c h i n g h a s d i f f i c u l t y b r e a t h i n g a n d l o s e s c o n t r o l o f h e r m o t e p i s o d e s d a i l y b a s i s . " F u r t h e r i n t h e c o m m e n t a r y , t " c r i e s d a i l y , a l w a y s s a d . . . w i t h d r a w s s o c i a l l y o r e l s e n o t e s t h e a p p e l l a n t l o s e s c o n t r o l o f h e r i m p u l s e s a n s t r e s s a n d w i l l s c r a t c h h e r a r m s , p u l l s h e r h a i r , r o c k " p r e c i p i t a t e d b y p a n i c a t t a c k s w h i c h o c c u r 2 o r 3 t i m h o u r s a t a t i m e a n d a r e w o r s e w h e n s h e i s a l o n e t a p p e l l a n t ' s p a n i c a t t a c k s c a n c a u s e h e r t o b l a c k o u t I n t h e s e c t i o n o f t h e A R r e g a r d i n g t h e a s s i s t a n c e r e n u r s e 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 a n i n d e p e n d e n t l b a t h i n g ( t h e n u r s e i n d i c a t e s s h e r e q u i r e s c o n t i n u o u s g e t d r e s s e d p u t o n c l e a n c l o t h e s b u t c a n ' t d o i t i f o r d a y s " ) , u s i n g p u b l i c t r a n s i t a n d u s i n g t r a n s i t s c h e a l w a y s f e a r s s h e w i l l m i s s h e r b u s g e t s t u c k d o w n t o g e t t i n g l o s t i f s h e t a k e s t h e w r o n g b u s u s u a l l y g e t s i n c o n s i s t e n t w i t h m e n t a l h e a l t h a p p o i n t m e n t s a s s h e I n t h e s e c t i o n o f t h e A R l i s t i n g t h e i m p a c t o f t h e a p p n u r s e h a s 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 i n d e p e n d e n a b l e t o 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 , i n t e r a c t s a p p r o p r i a t e l y w i t h u n e x p e c t e d d e m a n d s , a n d a b l e t o n o t p r o v i d e d a n y e x p l a n a t i o n f o r t h e s e a n s w e r s . T h f u n c t i o n i n g w i t h 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 m n e t w o r k , b u t d o e s n o t p r o v i d e a n y a d d i t i o n a l c o m m e A t t h e h e a r i n g , t h e a p p e l l a n t t o l d t h e p a n e l t h a t s h e ( p r i m a r i l y b a t h i n g ) w i t h o u t c o n t i n u o u s a s s i s t a n c e s h e r a p a r t m e n t o t h e r w i s e s h e w i l l n o t t a k e a s h o w e r a a o o e l l a n t l i v e s w i t h a r o o m m a t e , w h o t h e a o o e l l a n t s E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L e g r e t s c h o i c e s h a s h e a d a c h e s & i s a l w a y s e t h a t t h e a p p e l l a n t ' s i m p a i r m e n t s i m p a c t h e r i n d i c a t e d a m a j o r i m p a c t f o r t h e a r e a s o f b o d i l y t i n g p r o b l e m s , p o o r h y g i e n e , s l e e p d i s t u r b a n c e " ) , " a n d " d e p r e s s i o n " ) , a n d m o t i v a t i o n . T h e n u r s e e c o n t r o l , i n s i g h t a n d j u d g m e n t ( c i r c l i n g t h e w o r d s o n a l o r m e n t a l p r o b l e m s . T h e n u r s e i n d i c a t e d a t i o n a n d e x e c u t i v e , a n d n o i m p a c t f o r t h e a r e a s o f r c o m m e n t a r y i n t h i s s e c t i o n t w o a d d i t i o n a l p a g e s m m e n t a r y , t h e n u r s e w r i t e s t h a t t h e a p p e l l a n t o v e r e a t s n e v e r a h a p p y b a l a n c e . " T h e n u r s e 5 d a y s t h e n m o t h e r w i l l t e l l h e r t o s h o w e r b u t s h e h e r e s h e w a s w h e n ( s h e w a s m o l e s t e d ] s o c a n ' t l e e p s p o o r l y a n d w i l l o n l y s l e e p f o r 2 h o u r s a t a p p e l l a n t a n x i e t y , a s d o e s h a v i n g t o g o p e l l a n t ' s a n x i e t y a t t a c k s , n o t i n g t h a t s h e h a s a t h e r a r m s , p u l l i n g a t h e r h a i r , p u n c h e s a t w a l l s , o r f u n c t i o n s . T h e n u r s e n o t e s , " g e t s t h e s e h e n u r s e d e s c r i b e s t h e a p p e l l a n t ' s d e p r e s s i o n , g e t s s o b u s y t h a t s h e b l o c k s i t o u t . " T h e n u r s e d a b i l i t y t o m a k e g o o d d e c i s i o n s w h e n u n d e r s & s o b s u n c o n t r o l l a b l y a n d t h a t t h i s i s e s p e r w e e k . " T h e p a n i c a t t a c k s c a n l a s t u p t o 2 h e y w i l l l a s t l o n g e r . T h e n u r s e n o t e s t h a t t h e a n d t h a t s h e a l s o s u f f e r s f r o m f l a s h b a c k s . q u i r e d b y t h e a p p e l l a n t t o p e r f o r m h e r D L A s , t h e y p e r f o r m a l l t a s k s o f t h e l i s t e d D L A s e x c e p t a s s i s t a n c e a n d w r i t e s , " n e e d s t o b e r e m i n d e d t o f s h e i s a l o n e a t h o m e s o o f t e n l e a v e s s h o w e r i n g d u l e s ( t h e n u r s e w r i t e s , " h a t e s t o u s e t h e b u s w n , r e a d i n g s c h e d u l e s f r e a k s [ h e r ] o u t , . . . f e a r s r i d e s f r o m f a m i l y & f r i e n d s t h e r e f o r e h a s b e e n c a n ' t a l w a y s g e t a r i d e . " ) e l l a n t ' s i m p a i r m e n t o n h e r s o c i a l f u n c t i o n i n g , t h e t i n a l l l i s t e d a r e a s ( a p p r o p r i a t e s o c i a l d e c i s i o n s , a p p r o p r i a t e l y w i t h o t h e r s , a b l e t o d e a l s e c u r e a s s i s t a n c e f r o m o t h e r s ) . T h e n u r s e h a s e n u r s e i n d i c a t e s t h a t t h e a p p e l l a n t h a s g o o d a r g i n a l f u n c t i o n i n g w i t h h e r e x t e n d e d s o c i a l n t a r y . c a n n o t p e r f o r m h e r D L A o f p e r s o n a l c a r e h e n e e d s s o m e o n e s h e t r u s t s t o b e w i t h h e r i n n d c a n g o s e v e r a l d a y s w i t h o u t b a t h i n g . T h e a i d w i l l r e m i n d h e r t o a e t u p i n t h e m o r n i n a a n d
f e e d h e r s e l f . T h e a p p e l l a n t a l s o t e s t i f i e d t h a t h e r m t o t a k e h e r m e d i c a t i o n s o t h e rw i s e s h e w o u l d n o t r e m o t h e r a l s o r e m i n d s h e r t o e a t a n d t h a t h e r m o t h e r t a k e s h e r m e d i c i n e a n d m a k e s h e r s e l f s o m e t h i n g s s a y s w i t h o u t t h e r e m i n d e r s a n d u r g i n g o f h e r r o o m m h e r m e d i c a t i o n s o r t o f e e d h e r s e l f . T h e a p p e l l a n t a l a n x i e t y s o r e g u l a r l y t h a t s h e w i l l n o t g o o u t b y h e r s p e r w e e k a n d d o e s t h e a p p e l l a n t ' s l a u n d r y f o r h e r , a p p e l l a n t s a i d t h a t h e r m o t h e r w i l l d r i v e h e r t o t h e b h e r m o t h e r m a n a g e s a l l o t h e r f i n a n c e s f o r t h e a p p e h e r r o o m m a t e o r h e r m o t h e r w i l l d r i v e h e r t o h e r a p w i l l t r i g g e r a n a n x i e t y a t t a c k f o r h e r . I n h e r s e l f r e p d o e s n ' t b o t h e r g e t t i n g d r e s s e d a n d u s u a l l y e a t s a f t e r o o m m a t e . T h e a p p e l l a n t a l s o w r o t e t h a t s h e r e l i e s w h e n s h e i s h a v i n g a p a n i c a t t a c k w h e n s h e h a s h e r s e l f o n h e r a r m s a n d n e c k a n d p u l l s o u t h e r h a i r h e a l t h a p p o i n t m e n t s t w o t i m e s p e r w e e k , b u t w h e n c o u n s e l o r t o a n o t h e r , s h e m i s s e d s o m e a p p o i n t m e n a p p o i n t m e n t s b e c a u s e h e r r o o m m a t e d i d n ' t h a v e a f r o m h e r m o t h e r w h o l i v e s i n a n o t h e r t o w n . S h e s a a p p l i c a t i o n w a s b e i n g c o m p l e t e d . A s s i s t a n c e r e q u i r e d / p r o v i d e d ( c ri t e r i a s e t o u t i n s u b 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 i n d i c a t e d t h a t t h " o n a f r i e n d ' s s u p p o r t t o h e l p h e r d u r i n g s t r e s s f u l p e a n d , f u rt h e r i n t h e P R , t h e p h y s i c i a n i n d i c a t e s s h e r " r e m i n d e r t o e a t o n r e g u l a r b a s i s , s h o w e r , d r e s s , u s f o l l o w u p w i t h [ h e r p h y s i c i a n ] a n d m e n t a l h e a l t h . " I n t h e s e c t i o n o f t h e A R d e s c r i b i n g t h e a s s i s t a n c e p t h e a p p e l l a n t r e c e i v e s h e l p f r o m f a m i l y a n d f r i e n d s w h a d c o u n s e l i n g s i n c e g r a d e 6 . " T h e n u r s e d i d n o t c h t h e A R a n d c h e c k m a r k e d " n o " t h a t t h e a p p e l l a n t d o I n t h e M a y 3 , 2 0 1 4 l e t t e r , t h e a p p e l l a n t ' s m o t h e r w r o h e l p i n g h e r d a u g h t e r , b u t s h e c a n o n l y d o s o m u c h . n e e d s h e l p w i t h d e p r e s s i o n a n d a n x i e t y , w r i t i n g t h a t h e r m e d i c a t i o n " a n d r e m e m b e r d o c t o r ' s a p p o i n t m e n h y g i e n e , p r o p e r n o u r i s h m e n t , e a t i n g a n d s l e e p i n g s E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A i I o t h e r w i l l c a l l h e r e v e r y s i n g l e d a y a n d r e m i n d h e r m e m b e r t o t a k e t h e m . T h e a p p e l l a n t s a i d t h a t h e r s t a y s o n t h e p h o n e a n d l i s t e n s w h i l e t h e a p p e l l a n t i m p l e s u c h a s t o a s t a n d e a t s i t . T h e a p p e l l a n t a t e a n d m o t h e r , s h e w o u l d n o t r e m e m b e r t o t a k e s o t o l d t h e p a n e l t h a t s h e g e t s p a n i c a t t a c k s a n d e l f a n d h e r m o t h e r c o m e s i n t o t o w n o n c e o r t w i c e a s w e l l a s h e r s h o p p i n g a n d h o u s e c l e a n i n g . T h e a n k w h e r e t h e a p p e l l a n t w i l l c a s h h e r c h e q u e , b u t l l a n t ( p a y s h e r r e n t , e t c . ) . T h e a p p e l l a n t s a i d t h a t p o i n t m e n t s , b u t s h e c a n ' t t a k e p u b l i c t r a n s i t a s i t o r t , t h e a p p e l l a n t w r o t e t h a t m o s t d a y s , s h e r r e m i n d e r s f r o m h e r m o t h e r a n d / o r h e r o n h e r m o t h e r o r h e r r o o m m a t e t o t a l k h e r d o w n p a n i c a t t a c k s , s h e c r i e s u n c o n t r o l l a b l y , s c r a t c h e s . T h e a p p e l l a n t s a y s t h a t s h e g o e s t o h e r m e n t a l s h e w a s t r a n s i t i o n i n g f r o m o n e m e n t a l h e a l t h t s . S h e a l s o s a i d s h e m i s s e d s o m e o f h e r c a r a n d s h e c o u l d n ' t g e t a r i d e t o t h e a p p o i n t m e n t i d t h i s h a p p e n e d a r o u n d t h e t i m e t h e P W D s . 2 ( 2 ) ( b /O i! E A P W D A ) e a p p e l l a n t r e q u i r e s a s s i s t a n c e t h a t s h e r e l i e s r i o d s o f t i m e t o a s s i s t h e r t o h e r a p p o i n t m e n t s " e q u i r e s a s s i s t a n c e i n t h e f o r m o f t h e f o l l o w i n g : e m e d i c a t i o n s , e m o t i o n a l s u p p o r t , a p p o i n t m e n t r o v i d e d f o r t h e a p p e l l a n t , t h e n u r s e i n d i c a t e d t h a t r i t i n g , " s e e s c o u n s e l o r a t m e n t a l h e a l t h h a s e c k a n y o f t h e l i s t e d a s s i s t i v e d e v i c e s s e t o u t i n 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 e t h a t s h e d e v o t e s a g r e a t d e a l o f h e r t i m e T h e a p p e l l a n t ' s m o t h e r w r o t e t h a t t h e a p p e l l a n t t h e a p p e l l a n t n e e d s " c o n s t a n t r e m i n d e r s t o t a k e t s , a n d f o r " s i m p l e t h i n g s , s u c h a s p e r s o n a l c h e d u l e s . "
A P P E A l I 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 i n t h i s 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 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 a p p e l l a n t i s i n e l i g i b l e f o r P W D 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 r e q u i r e m e n t s i n s e c t i o n 2 o f t h e E A P W D A . S p e c i f i c a l l y , 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 i n f o r m a t i o n p r o v i d e d d i d n o t 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 s e v e r e m e n t a l i m p a i r m e n t , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , 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 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 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 , 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 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 . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D A a p p l i e s t o t h i s a p p e a l : 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 r f o r m ; " d a i l y l i v i n g a c t 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 r f 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 t i v i t y i i , i n o r d e r t o p e r f 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 r v 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 . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D R a p p l i e s t o t h i s a p p e a l : 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 r y c o n d i t 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 : m m a k e d e c i s i o n s a b o u t o 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 ; E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )
(i i) relat e t o, com municat e o r interact with oth er s eff Sign if icant r estr i c ti ons i n t he a bili tv to perfo rm DLA . In th e r ec onsi derat io n de c ision, t h e min istry wro te that li mita ti o ns re gard in g her phy sica l and men ta l issu es, t he app ell ant's physician and t he nurse, th e ministry "do t he app ell ant's impairme nts directly and sign i ficantly conti n u ously or p erio dically f or e x tended peri ods. Th f ro m th e appellant's physician tha t th e appellant r equir c a re a n d use of tran spo r tation , a n d t hat sh e requi res meal pr epara ti on, m a n a gem ent of m ed icati ons and socia i n formati on of t h e n u rse i n the AR tha t t he appe ll ant r t hat she i s i nd e p en dent in t h e remainder o f her DLA " s c hed ules as [ t h e ap pellant doe s] no t use t hem)" and a ppell ant] significantly l onge r to perform" the re s t of h als o note d th e in form ati o n f r om the nurs e in th e AR that of her s ocial f unction i n g and t h a t she has good fun ct m a rg i nal functioning wi th extended soci al n etworks . that whil e t he appe l la nt's physician i ndic a te s s he req care and us e of tr ans por t ati o n a n d p er iodic ass i s ta n m e dicat ions a n d socia l func t ioning, " the mi n i s t ry find p i cture o f th e degree of restr icti o ns [ t h e app e llant has] with The a ppella n t a rgues tha t the ministr y's recon siderati on t he inf or mat ion p rovide d by th e a ppellant's physi the a ppell a n t in h e r s el f r epo r t a n d in h er s u bmi ssi on her s evere m e n tal impairment d irec tl y a n d sig n ifican and she points to the evidenc e of he r phy si c i an in the PR tha her DLAs o f per s on al self ca re an d use of t ranspo r tat sev ere m e n tal impai rment dir ectly and si gnific antly res extended p er iods and again po ints to th e eviden ce pr i n di cate d that her DLAs of mea l pr epar ation, man a gement of medic perio dically restricted. The appellant argues that in completing the AR, the nurse was confused about the im pact of the appell a nt's anxiety a bout her Crohn's d c om p let ed was not diagnosed -and her ongoing anxiety and panic attacks, and that the nurse did not accurately indicate the i mpac t of the app e llant's severe mental impairme funct i o ning an d ot her tasks of her DLAs. The appellant sect ion of t he AR with r eference o nly to the appellant's undiagnosed Crohn's ref erence to her me ntal impairments. The legislation requires that in the opinion of a prescribed professional, the appellant's severe mental impairment directly and significantly restrict her ability to perform daily livi continuously or periodically for extended periods. In the reconsideration decision, the ministry wrote that it based the reconsideration decision on "current information" in the appellant's PWD application -in other words, the information provided by the appellant's physician in the PR and the nurse in the AR. The minis! indicates in its reconsideration decision that the information EAAT003(10/06/01) I A PPE A ec tively. wh il e i t ac knowle dged t h at the ap pellant h as c o n side r ing all o f the i n form a tion pro vided by e s no t h av e e noug h evidenc e to co nf ir m " th at restrict her abil ity to pe rform her D L A eit h er e m i n i stry referred to the i nf or m a ti on i n the PR es cont inuous ass ist anc e wi th personal sel f "perio dic a s sista nce (3 -4 ti me s a week) " w it h l functio n i n g . The m inist ry a l s o r ef er s to the equi r es c ontin uous as si st ance wi th bath i ng, b ut (exc ept using pu bl i c tr ansit o r using tra nsit tha t "t he r e was no in d i cation that t hey tak e [the e r D L A from the nur s e in the AR. The ministry the ap pell ant w a s in depe n dent in all aspects ioning wi th h er immedia te s o c ial net work s a n d The ministr y wrote in its r e consi dera t ion decision u i re s continuous assi s t ance w i t h person a l s e lf ce with meal prepar ation , management of s it diffi c ult t o devel op a c lea r and cohesiv e [ her] dai ly liv ing ac tivities." o n d ec ision does not p l ac e appropr iate wei ght cian i n the PR a n d on th e infor ma ti on p rovided by s on reconside r a ti on . T he a ppe ll a nt a rgues that tl y restric ts two of her D L A on a continuo us basis t her impairmen t con ti n uousl y res t rict s ion. The appel lant ar gues fu r ther t hat her tric t s thre e o f h er DLA on a peri od i c b a sis fo r o v ided by her phys ician i n the P R where h e a tions a n d so cial f unctioning are isease -w hi c h at the time the AR was nt on her social submitted t h at the n urse com pl e ted the DLA disease, and not with n g activities either rovided b the
appel lant's physician in the PR (that she has continuou rest r iction i n thr ee o t h er D LA) co ntrast s to t h e i nformation a ppellant can independen t l y pe rf or m al m o s t al l her DLA except the task of bathing and using transit and transit schedul es). The panel no tes that t he m i nistry in its r econsideration completed the AR did so after one meeting with the appell completed the PR indicated that he h a d seen the ap months. The appell ant told the panel at the hearing that the nurse who completed the AR aft e r a o ne-hour meeting with her, whereas she has an ongoing relations had see n hi m several time s before he compl eted the PR. The pane provide d by the nurse in t h e AR is i nt ernally in consistent. mental impai rment as causing a maj or impact and a mode cogniti v e and emotion al functioning, and addin g commentary that includ severe anxiety wh ic h can be trigge red by simple thi withd r aws s o ci al ly a n d ca n enga g e in un safe b e hav that the ap pel lant is indepe n de n t in a ll soc i al f u nct ion unexp ected demands." Accor d ingly , give n th at the p relations h ip with the appell ant consis ting o f nearly month nur s e wh o had one meeting with the app ell ant for the the i nterna l incon siste ncies in the AR, the panel places more th e app ellan t 's p hysician in th e P R th an on t he infor In her subm issions on r econsiderati on and before the p B.C. Su p r eme Court in Hud son -in p a rticula r, t o pa "The ord inary mean i n g of th e plur al "a ctivitie s" in [secti must be evidence f ro m a pre sc r ibed profes si o nal ind l east two daily liv in g a ctiv iti es." In add it ion to a r estriction pres crib ed professi ona l must ind ica t e t ha t t h e restriction ex tended peri od s " (a s per section 2(2)(b)(i ) ). The Hud provis ion in sec tion 2(2 )(b ) (i) of th e E A PWDA that t he and significant restriction to DLA caused by the impairment be either continuous extended periods." The direct and significant restriction m per i o dic it must be for an extended t i me. I n herently, consideration of the fre quency. All other things being equal, a restrict is less likely to be significant than one that occurs several times a week. be i n te rpreted in a larg e and liberal ma nner, t here stil le g isl at ive crit eria to reasonably satisfy th e ministry tha circumstances where the evidence indicates that a restri appropriate fo r the ministry to require evidence of the duration and frequ order to be "satisfied" that this legislative criterio n is met. In the PR, the appellant's physician expressly indicated that her severe mental impairment directly restricts her ability to perform the DLA of "personal self care" and "use of transportation" continuously -this section of the PR does not list separate tasks under each DLA (as is done in the AR) so the information before the ministry and the panel from the appellant's physician is limited by the PR form. Althouah the panel aives less weiaht to the information from the nurse in the AR, the panel notes that EMT 003(1 0/06/01) APPEAi .. � I s restriction s in two of her DLA and periodic provided by the n urse in the AR (that the doe s not refer to the f act that the nurse w ho ant, wher eas t h e appellant's physic ian who pellant more than 11 times in the p r evious 12 di d so h ip with her physic ian a n d l a ls o n otes that the informat i on After describing the a pp e llant's s evere rat e impact o n a to tal of 8 areas of es that the appell ant has n g s and results in pa nic attack s, and.that sh e io ur wher e sh e hu rt s herself, the nur s e indicat es i n g, i n c l udi n g "ab le t o d eal a ppropriat e ly wi th hysici an has ha d a long er pr o fessional l y vis its for o n e y ea r , as c ompared to th e sole pu r pose of c o mpleti n g th e A R, and give n we i ght on the in fo r mation pro v ide d b y m ation prov i ded b y th e n urse i n the AR. an el, t he app e llant ref er s t o t he decision of the ragraph 43 o f H u ds on in whic h the Cou rt st a t e s : o n 2(2) o f t he EAPW DA] di ctate s t hat th ere ica ting a di r ect and si g nificant re str ic tio n on a t on at lea st two DLA (as per Hudson) , t h e is either "continuo us or p e ri odical ly for son decision d o es not expre s sly an alyze the p r escribed pro f e ssiona l opine tha t t he direct ly or "periodi c ally for a y be either continuous or period ic. If it is an analysis of pe riodici t y must also include ion that only arises once a year While the legislation must l must b e sufficient e vidence on eac h of the t they have be en met. Accordingly, i n c t ion arises periodically, it is entirely ency of the restrict ion in
t h e nurse in dicate d in the AR that th e appellant was und e r the DL A of p ers onal ca re ) an d tha t the app ella her bodily f unct ions (t oil e ti n g probl e ms and poor hy commentary in the A R t hat the appel l an t " do es not t w ill te l l her to sho w er bu t she can 't sho w er when alone in the house." in the AR cor r oborat es t h e i n format ion from th e appellan c ontinuous r est ricti o n t o t h e app el la n t's ability to bathe personal se lf care . In t he AR , the nu rse a lso i nd i cat per form 2 of the 3 l iste d t a s ks under the DLA o f "transpo task of "get ting in an d out of a ve h i cle") . In t h e AR, the nu i mpairm ent r es tri cted her u se o f tran sp or tation contin ap pe ll ant does not u se tr a n s i t as i t creates a n x i ety, that s lost. Ag ai n, al t h ough the pan el p lace s less weig h t o on the ph y s ici an ' s inf ormat ion in the P R , th e pa n el no the DLA o f transportation in the AR corrobor a t es t ha The appel lant's physici an ind i cate s in t he PR that the appellan restr icts h er abi lit y t o perf or m the DLA o f "meal prep func t ion ing" on a period ic ba s i s f or extended p eriods form. T h e physic i an's c o m men t a ry in th is section o f a ssi s t a nce f or th ese DLA w hen s he is experie n cin g wee k " and that t he a p pel lant n eeds " r em inder to ea t medic atio ns , emot ion al support . .. " . In the AR , as noted decision, the nurse c h ec k ed that th e a p pella nt could i the DLA of "mea l s," "me d i c at ion s," and "so c ial function p r ovided by t h e p h ysi cian in the P R. Howev er , as t he of co m men t a ry p r ovided by the n urse in the AR , the nur for "meals" and "social functio nin g" the n u r s e e xpr essl & needs t o be t old to e at or else ov er eats never a an x iety at tacks noti ng she "ge ts these epi sodes daily basis," d e p r es sion, the ap pellan t, "c r i e s d a ily , al way s sa d ... b l o cks it o ut." The pan el fi n d s that t he i nform ation provided b AR -which is more descriptive than the check marks on the DLA -p ro v ided by the ph y sici an i n the PR that the appellant's se restricts h er ability to perform DLA, in particular, meals and social functioning. the information provided in the PR and the AR does not describe the duration of the periods the appellant's impairment restricts her performance of the noted DLA, other than "up to 3-4 X week." The panel finds that the information provided by the appellant's physician in the PR establishes the appellant's mental impairment se v e rely restricts her ability to continuously perform the DLA of transportation and the task of bathing under the DLA of personal self care. Th there is information provided by the prescribed professionals -both the physician and the nurse that the a p pellant's m en t al impairment severely restricts such as meal preparation and social functioning, but that the information about the duration of the "periodic" restriction is limited. Accordinalv, the oanel finds the ministrv's determination that there was not enouah evidence from the EAAT 003(10/06/01) I APPEAL ,, co nti nuou sly re s tr icte d i n bathing ( a lis ted task nt's mental imp airment ha s a m a jor impact on g ien e ) and the informa tio n in the nu r s e ' s hink about s ho we rin g for 4 or 5 days th en mother Th is information fr om the nurse t's physi cian in t h e P R re g arding the and clean he rsel f -a task o f t h e DLA of ed that th e ap pellant could not in dependently r tati o n " ( sh e co uld inde p e ndently per fo r m the rse di d not check wheth er the appellant's uously or peri odically, but wrot e that the he fears sh e 'l l g et s t u ck down town and/or n the inf or mati o n f r om t h e nurse in t he A R than t es the nu r se's inform ation and commen tary on t of the appe l lan t 's phys ician i n t h e P R. t's s e v ere men tal i m p airm ent also arati on ," "manageme n t of medication " an d "social . Th e PR form is less d escripti v e than the AR t he PR i s tha t the ap pell a nt r equires per i o di c a panic e pisode wh i ch can o cc u r "up to 3-4 X o n regular basi s, showe r, dre s s, u se b y the m in i s t ry in it s r ec o ns ideration ndep e ndentl y p erf orm all the liste d t as ks u nd er i n g " which contras ts to the informati on p a nel n o ted previousl y, in the a d dit ional page s se's info rmati o n co n tr adict s t he che c k marks y states t hat t he ap pel lan t "ei ther doesn' t ea t happ y ba lan ce," describ es the a ppe lla n t's an d writes t hat a s a resul t of her w i thd raws social ly or else gets so b usy tha t she y the nurse in her commentary in the corroborat es the information v e re menta l impairme n t periodically The panel notes that in which that e p ane l a lso finds t h a t her abili ty to perfor m other DLA periodically,
APPEAL I appellant's prescribed professionals to establish the appellant was significantly restricted in her ability to perform DLA as required under subs. 2(2)(b)(i) was reasonable based on the evidence set out by the prescribed professional (the appellant's physician in the PR and in the corroborating commentary by the nurse in the AR). Help with DLA In its reconsideration decision, the ministry determined that as it "has not been established that [DLA] are significantly restricted (criterion 4); therefore, it can be determined that significant help is not required from other persons." The ministry also wrote, that "no assistive devices are required" and that the appellant does "not require the services of an assistance animal." The legislation (section 2(2) of the EAPWDA) states that the minister may designate a person as a person with disabilities for the purposes of the Act if the person meets the criteria of having a severe mental or physical impairment that in the opinion of a medical practitioner is likely to continue for at least 2 years, and in the opinion of a prescribed professional directly and significantly restricts the person's ability to perform DLA either continuously or periodically for extended periods, and as a result of those restrictions, the person requires help to perform those activities. Further, subs. 2(3) of the EAPWDR provides that for the purposes of subs. (2), "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 assistive animal." The panel notes the evidence before the ministry at the reconsideration as set out by the appellant's physician in the PR indicated that the appellant needs reminders to eat on a regular basis, and needs reminders to shower, dress, and use medications. The appellant's physician also wrote in the PR that the appellant relies on a "friend's support to help her during stressful periods of time to assist her to appointments" and that she requires assistance from friends/family "up to 3-4 X/week" when she is experiencing panic episodes. The information provided by the nurse in her commentary in the AR is that the appellant "doesn't think about showering for 4 or 5 days and then her mother will tell her to shower but she can't shower when she is alone in the house" and that the appellant' doesn't use public transit as it will trigger a panic attack (it "freaks her out") and that she relies on her mother and/or her roommate to take her to her appointments. This information was repeated by the appellant in her submissions on reconsideration and to the panel, and was stated by the appellant's mother in her letter of May 3, 2014. The appellant also told the panel that her mother does all of her personal shopping for her and that her mother will drive her to the bank so that she can cash a cheque, but that her mother otherwise manages all of the appellant's finances, although this information was not provided in the PR or AR by the prescribed professionals. This panel has upheld the ministry's determination that there was not enough evidence from the appellant's prescribed professionals to establish that she is significantly restricted in her ability to perform her DLA, as required by subs. 2(2}(b}(i) of the EAPWDA. While the panel notes that the appellant's physician has indicated that the appellant requires the help of her mother and/or her roommate (which is also corroborated in the nurse's evidence), the panel finds that the ministry's determination that "as it has not been established that [DLA] are significantly restricted (criterion 4}; therefore, it can be determined that significant help is not required from other persons" is reasonable based on the evidence. EAAT003(10/06/01)
I APPEA Conclusion Having reviewed and considered all of the evidence, and the relevant legislation, the panel finds that the ministry's decision that the appellant was not eligible for PWD designation is reasonable based on the evidence. The panel therefore confirms the ministry's decision. EAAT 003( 10/06/01)
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.