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 M i n i s t r y o f S o c i a l r e c o n s i d e r a t i o n d e c i s i o n d a t e d A p r i l 2 4 , 2 0 1 4 w h i c f i v e s t a t u t o r y r e q u i r e m e n t s o f S e c t i o n 2 o f t h e E m p D i s a b i l i ti e s A c t f o r d e s i g n a t i o n a s a p e r s o n w i t h d i s a p p e l l a n t m e t t h e a g e r e q u i r e m e n t a n d t h a t h e h a s 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 a t i s f i e d t h a t t h e e v i d e n c e 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 p h y s i c a l i m p a i r m • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( D L A ) a r 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 e d e i t h e r c o n • a s a r e s u l t o f t h e 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 a n o t h e r p e r s o n , t h e u s e o f a n a s s i s t i v e d e v i p e r f o r m D L A . P A R T D R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a 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 I A P P E A L jf D e v e l o p m e n t a n d S o c i a l I n n o v a t i o n ( t h e m i n i s t r y ) h f o u n 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 h e 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 a b i l i t i e s ( P W D ) . T h e m i n i s t r y f o u n d t h a t t h e a s e v e r e m e n t a l i m p a i r m e n t t h a t , i n t h e o p i n i o n o f s t t w o y e a r s . H o w e v e r , t h e m i n i s t r y w a s n o t e n t ; e , 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 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 r e q u i r e s 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 c e , o r t h e s e rv 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 o b i li t i e s A c t ( E A P W D A ) , S e c t i o n 2 b ili t i e s R e g u l a t i o n ( E A P W D R ) , S e c t i o n 2
APPEAL# I PART E -Summary of Facts The evidence before the ministry at the time of the reconsideration decision included the Person With Disabilities (PWD) Application comprised of the applicant information dated August 14, 2013, a physician report (PR) dated September 20, 2013 completed by a general practitioner who has known the appellant for approximately 9 years and an assessor report (AR) dated December 2, 2013 completed by a registered social worker who has also known the appellant for approximately 5 months. The evidence also included the following: 1) Consultation Report dated June 3, 2008 from a neurologist who had seen the appellant for persistent altered behavior of a delirious nature following an unwitnessed collapse at work. He has a history of ongoing alcohol abuse, fall with left frontal and temporal contusions and epidural hematoma 2006, and ongoing cannabis use. 2 ) Letter dated July 4, 2013 from a dermatologist to the appellant's physician indicating that the appellant has had some lesions on his feet as well as painful feet, painful calves and a painful back for 1 7 years. He has suggested that the appellant get some orthotics for his shoes; 3) Letter dated July 16, 2013 from a specialist in neurology to the appellant's physician indicating that clinically the appellant does not appear to have a peripheral neuropathy though has risk factors for alcohol/nutritional neuropathy based on past history. Recommendation for an EEG to look for epileptiform activity; 4) EEG [Electroencephalography] test result dated July 24, 2013 of "normal record. No areas of focal slowing or epileptogenic activity are evident"; 5) Daily Living Activities for PWD checklist; 6) Photographs of bottom of feet; and, 7 ) Request for Reconsideration dated April 15, 2014 with attached revised page 10 of the PR stamped by the appellant's physician and noting under the degree and course of impairment that the appellant "sustained a severe head injury that he has not and will not recover from completely." Comments regarding the significant deficits identified with cognitive and emotional function (in the areas of executive, memory, impulse control, and attention or sustained concentration) are: "this is a disabling issue-poor decisions, poor judgement, impaired insight-pervasive and disabling." Page 11 of the PR is also attached but has not been modified from the original assessment. Diagnoses In the PR, the appellant was diagnosed by the general practitioner with traumatic brain injury (onset in 2006), bilateral foot calluses, mild cognitive impairment (onset in 2006), and alcohol abuse in remission. Physical Impairment In the PR, the general practitioner reported that: • In terms of physical health history, he has abnormally callused feet, with photos attached. The appellant states they cause him significant pain and disability. • The appellant requires an aid for his impairment as "orthotics would significantly aid his foot problem. He cannot afford them." • In terms of functional skills, the appellant can walk 4 or more blocks unaided on a flat surface, he can climb 5 or more stairs unaided, and has no limitation with lifting or with remaining seated.
I APPEAL# • In the additional comments, that "if one considers this man's issues on an individual bases, they do not appear significantly disabling. However, they all impact him all the time and, taken together, he is impaired on physical and cognitive levels." In the AR the social worker indicated that: • The appellant is assessed as taking significantly longer than typical with walking indoors, and requiring continuous assistance from another person with walking outdoors ("two blocks daily"), climbing stairs ("slowly with great pain"), standing ("none"), lifting ("not more than 10 lbs") and carrying and holding ("can't-takes cart home from grocery store"). The social worker commented that the appellant "pushes through but with severe pain-activity makes sores on feet far worse. Can't walk on gravel or uneven surfaces due to both brain injury and foot condition." • The section of the AR relating to assistance provided through the use of assistive devices is not completed. In the appellant's self-report, he wrote that: • For moving around inside his home, such as walking from room to room, going up or down stairs or ramps, getting in and out of chairs, "just thinking about these activities hurts. Even when my feet are resting on the ground while sitting my legs and back hurt." • For moving around outside his home, such as walking very far or on uneven ground, or going up or down stairs or ramps, he "can't walk on uneven ground at all without pain. Can't walk 2 blocks without taking a 5 to 1 O minute break." Daily Living Activities (DLA) In the PR, the general practitioner indicated that: • The appellant has not been prescribed any medication and/or treatment that interfere with his daily living activities. • The appellant has no difficulties with communication. • It is unknown whether the appellant's impairment directly restricts his ability to perform DLA. • The appellant is continuously restricted with mobility outside the home. • There are no other comments provided regarding the degree of restriction or the assistance needed with DLA. In the AR, the social worker reported that: • The appellant has a satisfactory ability to communicate in all areas: speaking, reading, writing and hearing. • The appellant takes significantly longer than typical with walking indoors and requires continuous assistance from another person with walking outdoors ("Two blocks daily.") • For the DLA personal care, the appellant requires continuous assistance from another person and takes significantly longer than typical with bathing (note: "can't stand in shower; 1 O times slower in/out of tub"), and requires continuous assistance with regulating his diet ("poor appetite; eats maybe once per day"). The appellant is independent with toileting and feeding self and takes significantly longer than typical with dressing and grooming ("everything extremely slow"), transfers in/out of bed and transfers on/off of chair ("1 O times slower"). • The appellant takes significantly longer than typical with basic housekeeping and laundry, with a note: "all extremely slow; waits for a good day. Can't do multiple tasks in one day." • For shoonina, the appellant is independent with 3 of 5 tasks, namelv reading prices and labels,
I APPEAL# -----� ----making appropriate choices and paying for purchases, and requires continuous assistance from another person with going to and from stores (note: "can't walk far enough") and carrying purchases home ("uses shopping cart to take all the way home"). The social worker commented that the appellant "plans tasks so he only has one to do each day. Cannot stand at sink to wash dishes. Feet hurt when not standing-pain is constant." • The appellant is independent in performing 2 of 4 tasks of the DLA meals, namely meal planning and safe storage of food, and requires continuous assistance from another person with food preparation and cooking. The social worker commented that the appellant cannot stand at the sink or lift pots. • The appellant is independent with all 3 tasks of the DLA paying rent and bills: banking, budgeting, and paying rent and bills. • The appellant is independent in performing all 3 tasks of managing his medications: filling/ refilling prescriptions, taking as directed and safe handling and storage. • The appellant requires continuous assistance from another person with using public transit ("can't walk far enough or stand at the bus stop"), he is independent with using transit schedules and arranging transportation, and takes significantly longer than typical with getting in and out of a vehicle. • In additional comments, noted that the appellant "has several bad days each week. Only leaves home once per week. Meds make him drowsy as well." • For additional information, the social worker wrote that the appellant is in constant pain all the time. He is "very limited. Can do one task and then pain becomes too much and cannot do anymore that day. Leave home once per week when has an appointment or absolutely has to go get groceries." • With respect to social functioning, the appellant is independent in all aspects, with good functioning in both his immediate and extended social networks. In the appellant's self-report, he wrote that: • For preparing meals, he cannot stand without pain, therefore cooking, standing at the stove or counter are out of the question. He sometimes goes without eating. He loses motivation to eat when in pain and he is unable to prepare something for himself. • With shopping, he can only make it out a couple of times per month when his uncle is able to drive him to the store. He helps him with carrying. He cannot walk by himself without the support of the shopping cart. • For housework, he vacuums at most once a month and has to sit down to rest every 20 minutes between all chores. • Using transportation, he cannot climb more than a couple of stairs without taking a rest. Standing and climbing are both very painful. He has to switch from foot to foot while standing, and can stand for 1 O minutes at most. • For personal hygiene, he is never able to take a bath due to his head injury. He is at risk of seizure and death. He feels unmotivated to do these activities when he is in pain. • With respect to mental and emotional skills, he has difficulty with planning ahead, remembering information and appointments, and "due to my head injury I suffer from short term memory loss." • He did not complete the sections of the checklist dealing with managing money and paying bills, social skills, taking medications, and communication.
N e e d fo r H e l p T h e s o c i a l w o r k e r i n d i c a t e d i n t h e A R t h a t t h e a s s i s a p p e l l a n t ' s f a m i l y a n d f r i e n d s a s w e l l a s c o m m u n i t y i s a v a i l a b l e , t h e s o c i a l w o r k e r n o t e d " n e e d s t r a n s p o h o u s e k e e p i n g a s s i s t a n c e . " T h e s e c t i o n o f t h e r e p o o f a s s i s t i v e d e v i c e s i s a l s o n o t c o m p l e t e d . I n h i s N o t i c e o f A p p e a l , t h e a p p e l l a n t e x p r e s s e d h i s d e c i s i o n , a n d w r o t e t h a t t h e m i n i s t r y f a i l e d t o c o n s i R e c o n s i d e r a t i o n . 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 t a t e d t h a t : • A l t h o u g h h e c a n w a l k m o r e t h a n 4 b l o c k s , h e l o n g t i m e t o g e t a n y w h e r e . T o w a l k a f e w b l h i m 4 0 m i n u t e s . • A t f i r s t t h e d o c t o r s d i d n o t k n o w w h a t w a s w t o l d h i s d o c t o r t h a t h e h a s a c o n d i t i o n c a l l e d p a i n i n h i s l e g . H e h a s s t a r t e d t a k i n g a n a s p s e i z u r e s . • H i s d o c t o r h a s t o l d h i m h e h a s t o w a l k e v e r y h i s l e f t l e g . H e h a s b e e n w a l k i n g b u t h i s l e f t b e c a u s e o f t h e w a l k i n g h e h a s b e e n d o i n g . • W h e n a s k e d a b o u t t h e c o m m e n t t h a t h e c a n b o t h h i s b r a i n i n j u r y a n d h i s f o o t c o n d i t i o n , t h a g g r a v a t e s t h e b o t t o m o f h i s f e e t a n d i s p a i n • H e d o e s n o t t a k e a n y p a i n m e d i c a t i o n b e c a u • H e w e a r s s l i p p e r s i n d o o r s a n d f l i p f l o p s i n t h • H e w a s g i v e n a r e f e r e n c e s h e e t b y h i s d o c t o h i s l i f e s t y l e a s a r e s u l t o f t h e d i a g n o s i s o f c l a d i s c o m f o r t a n d t h e l i f e s t y l e c h a n g e s r e q u i r e d e x e r c i s e , l i k e w a l k i n g . • H e s a w t h e s p e c i a l i s t a n d h a d a C T S c a n d o a n d h i s l e f t l e g i s 1 0 0 % b l o c k e d a b o v e h i s k n d r i n k i n g . H e s m o k e d f o r 4 0 y e a r s a n d i t w a s h i s f r i e n d s s m o k e a n d m a n y t h i n g s h e d o e s h • H e a l s o h a d a c h e s t X R a y a n d a n M R I s c a n b e c a u s e t h e r e w a s a n i n j u r y t o t h e l e f t s i d e o m e d i c a t i o n , h e d o e s n o t f e e l r i g h t . H e d o e s n • A l t h o u g h h e c a n c l i m b o v e r 5 s t e p s , h e h a s t o c a n n o t c l i m b a n y s t a i r s w i t h o u t t h e h a n d r a i l . • A l t h o u g h h e h a s n o l i m i t a t i o n w i t h r e m a i n i n g s i d e t o g e t c o m f o r t a b l e . • F o r l i f t i n g , h e c a n p i c k w e i g h t s u p a n d " p u t i t H e d o e s a n y l i f t i n g w i t h h i s r i g h t h a n d b e c a u s • F o r g o i n g a b o u t h i s d a i l y a c t i v i t i e s , i t t a k e s h i m i n t h e m o r n i n g , f o r e x a m p l e , a n d t h e n h a v e t o h a v e t o s i t d o w n t o r e s t .I A P P E A L # � -----� t a n c e r e q u i r e d f o r D L A i s p r o v i d e d b y t h e s e r v i c e a g e n c i e s . F o r h e l p r e q u i r e d w h e r e n o n e r t a t i o n a s s i s t a n c e , h e l p w i t h s h o p p i n g , r t i n d i c a t i n g a s s i s t a n c e p r o v i d e d t h r o u g h t h e u s e d i s a g r e e m e n t w i t h t h e m i n i s t r y ' s r e c o n s i d e r a t i o n d e r n e w i n f o r m a t i o n s u b m i t t e d w i t h t h e R e q u e s t f o r h a s t o r e s t a f t e r 2 b l o c k s . T h e r e f o r e , i t t a k e s a o c k s f r o m h i s p l a c e t o t h e h e a r i n g l o c a t i o n , i t t o o k r o n g w i t h h i s l e g s . I n O c t o b e r 2 0 1 3 , t h e s p e c i a l i s t " P A D " o r p e r i p h e r a l a rt e r i a l d i s e a s e w h i c h c a u s e s i r i n e v e r y d a y a l o n g w i t h h i s m e d i c a t i o n t o p r e v e n t d a y o r t h e r e i s a 5 0 % c h a n c e t h a t h e c o u l d l o s e c a l f w a s s w o l l e n t o t w i c e t h e s i z e o f h i s r i g h t c a l f n o t w a l k o n g r a v e l o r a n u n e v e n s u r f a c e d u e t o e a p p e l l a n t s t a t e d t h a t i f h e w a l k s o n g r a v e l , i t f u l . s e n o t h i n g i s e f f e c t i v e i n a l l e v i a t i n g t h e p a i n . e s h o w e r t o h e l p . r s e t t i n g o u t t h e c h a n g e s t h a t n e e d t o b e m a d e t o u d i c a t i o n d i s e a s e . T h e c o n d i t i o n c a u s e s i n c l u d e q u i t t i n g s m o k i n g a n d g e t t i n g m o r e n e a n d i t s h o w e d t h a t h i s r i g h t l e g i s 5 0 % b l o c k e d e e . H e w a s t o l d h e h a s t o q u i t s m o k i n g a n d v e r y d i f f i c u l t b u t h e " w e n t c o l d t u r k e y " b u t h a l f o f e a s s o c i a t e s w i t h s m o k i n g . . H e i s s u p p o s e d t o s e e t h e n e u r o l o g i s t a g a i n f h i s b r a i n . I f h e f o r g e t s t o t a k e h i s s e i z u r e o t h a v e s e i z u r e s i f h e t a k e s t h e m e d i c a t i o n . u s e t h e h a n d r a i l o r h i s l e f t k n e e w i l l " g o o u t . " H e s e a t e d , h e h a s t o s h i f t h i s w e i g h t f r o m s i d e t o  o n t h e c o u n t e r ' ' b u t h e c a n n o t c a r r y i t a n y w h e r e . e h e c a n n o t l i f t w i t h h i s l e f t h a n d . a l o n g t i m e t o d o a n y t h i n g . H e w i l l m a k e c o f f e e s i t d o w n t o r e s t . H e w i l l b r u s h h i s t e e t h a n d t h e n
• He lives on his own so he does th e dis hes and th that h e h a s considered using disposable pla • He cannot ca rry groceries home. He u s es the his uncle will pick him u p a n d g ive him a r i de • He will sit down to prepare a meal so it takes considerably • If he walks a mile, it takes him an h o ur because he has to sto • He so metimes wi ll con v ince a friend to do some vacuuming for him. • Otherwise, he has to get t hings done but it t • He also ha s to wri te ev erythin g down or he will forget it. a s 1 O minutes la ter. Sometimes he will wonder if t he water running. He left hi s c o f fee pot o n a • His head injury o ccu rr e d in 200 6 and, af t e r that, had to start wearing glasses because he could no • Asked why the sections o f t he PW D checkl is c om p le t e d, in partic u lar th ose that relate to man tak ing medic a t i on s, a n d com mu nication , t he ap plicab le . Fo r exam ple, h e do es no t hav e fr i ends and fa m il y try to hel p h im as m uch a strangers . He ge t s quite a b it o f hel p from h • W i t h t he am ount he rece i ve s in social as sis t $1 O l e ft t o feed hi s cat. He " lives at the soup • H e wor k ed up unt il Ma rch 2 013 and then wen his he alth cond itio ns. He kept forg etting t hings Admissib ili ty of New Inf ormatio n The ministr y did n ot rais e an objection to the ad mi ssi provi de d new info r ma tion re garding his impa irm e n t a provi d ed a d ditio nal d eta i l with re spect to t hose c onditions. as being in supp ort of info r mation and r ecor ds that rec o nsideration, in accorda nce w it h s . 22(4) of the Employ app ella nt also discussed his diagnosis of P AD and i nclud ed a s a diagno sis i n the PW D app licati o n. The pa in support of information and records that were before the ministry at the time of reconsideration. The ministry relied on its reconsideratio n decision. I APPEAL# e n si t s dow n for 5 minutes to r es t. He st a t e d tes to avoid doin g dish es. sh opping cart to bring the m all the way home o r h ome. l o nger than so meone else. p and rest so often. a kes him much longer. He ha s forgotten so mething as so on he h a s forgott e n to turn off the stov e or l eft nd ruined t he p ot. h e lo st his sense of smell and taste and he t see w el l. t that served as hi s self-report w here not agi ng m oney a n d pay ing bi lls , social ski ll s, app ell ant stated that he t hough t t hey were not an y m o ney t o "mana ge." For social skill s, his s po ssi ble but he do es not interact mu ch w it h is u ncle. a n ce, he pays h is rent and b il ls and t hen he has kitch e n " and goe s to the f o od bank. t on medical El [e m p l oyment insuran ce] d u e to and could no t p erf orm the job prop e rl y . bi li ty o f t he oral testimony . The app e l lant s diagnosed i n t h e PWD app lication, wh ich T he pa nel adm itt ed th is new inf orm a t io n were befor e the m inistry at t he t ime of m ent and As sis ta n c e A c t. H owever, t h e t h e impacts o f t h is co nditio n, which was not nel did no t admit thi s i nformation as it was n ot
APPEAL# I PART F -Reasons for Panel Decision The issue on the appeal is whether the ministry's decision, which found that the appellant is not eligible for designation as a person with disabilities (PWD) as he does not meet all the criteria in Section 2 of the EAPWDA, was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. The ministry found that the appellant has a severe mental impairment but that his daily living activities (DLA) are not, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods and that, as a result of those restrictions, it could not be determined that the appellant requires the significant help or supervision of another person, the use of an assistive device, or the services of an assistance animal to perform DLA. The criteria for being designated as a person with disabilities (PWD) are set out in Section 2 of the EAPWDA as follows: Persons with disabilities 2 (1) In this section: "assistive device" means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "prescribed professional" has the prescribed meaning. (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i) directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B) periodically for extended periods, and (ii) as a result of those restrictions, the person requires help to perform those activities. (3) For the purposes of subsection (2), (a) a person who has a severe mental impairment includes a person with a mental disorder, and (b) a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, {ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. (4) The minister may rescind a designation under subsection (2). Section 2(1 )(a) of the EAPWDR defines DLA for a person who has a severe physical or mental impairment as follows: Definitions for Act 2 (1) For the purposes of the Act and this regulation, "daily living activities" (a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities: (i) prepare own meals; (ii) manage personal finances;
( 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 ( 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 ( 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 ( 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 A t r e c o n s i d e r a t i o n , t h e m i n i s t r y w a s s a t i s f i e d t h a t t h m e n t a l i m p a i r m e n t , b u t w a s n o t s a t i s f i e d t h a t t h e i n p h y s i c a l i m p a i r m e n t . 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 , a s e x p r e s s e d b y t h e a d v o s e v e r e i m p a i r m e n t w h i c h i s a s a r e s u l t o f a c o m b i n h e a l t h c o n d i t i o n s . T h e a p p e l l a n t a r g u e d t h a t t h e p h o f t h e i m p a c t s a s a r e s u l t o f t h e s e v e r e h e a d i n j u r y t h e p a i n i n b o t h f e e t d u e t o b i l a t e r a l f o o t c a l l u s e s . T f u n c t i o n a l s k i l l s l i m i t a t i o n s a s s e t o u t i n t h e P R c a n t a k e s t o r e a c h t h e l i m i t s , w h i c h t h e a p p e l l a n t i s a b l e a d v o c a t e a r g u e d t h a t a n y i n c o n s i s t e n c i e s b e t w e e n s o c i a l w o r k e r a r e a s a r e s u l t o f t h e p r a c t i c a l i t i e s o f t i n t e r v i e w o f t h e a p p e l l a n t , c o m p a r e d t o t h e i n d e p t h N o t i c e o f A p p e a l , t h e a p p e l l a n t a r g u e d t h a t t h e m i n w i t h t h e 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 , w h i c h i n c l u d e a p p e l l a n t ' s p h y s i c i a n c l a r i f i e d s o m e e a r l i e r s t a t e m e T h e m i n i s t r y ' s p o s i t i o n i s t h e i n f o r m a t i o n p r o v i d e d b n o t s u f f i c i e n t 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 t h a t i n a s s e s s i n g t h e a p p e l l a n t ' s p h y s i c a l a b i l i t y , t h e a p p e l l a n t i s a b l e t o w a l k 4 o r m o r e b l o c k u n a i d e d , h n o l i m i t a t i o n w i t h l i f t i n g o r r e m a i n i n g s e a t e d . T h e m i s n o t c o n s i s t e n t w i t h t h a t o f t h e g e n e r a l p r a c t i t i o n e r p i c t u r e o f t h e d e g r e e o f r e s t r i c t i o n s t h e a p p e l l a n t h a s o c i a l w o r k e r r e p o r t e d t h e n e e d f o r c o n t i n u o u s a s s i s 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 t o s e v c o n d i t i o n a n d t h a t h e t a k e s s i g n i f i c a n t l y l o n g e r w i t h P a n e l D e c i s i o n A d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n d o e s n o t s e v e r e i m p a i r m e n t . A n " i m p a i r m e n t " i s a m e d i c a l c o a b i l i t y t o f u n c t i o n i n d e p e n d e n t l y o r e f f e c t i v e l y .A P P E A L # I 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 ; 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 : f i n a n c e s ; c t i v e l y . e i n f o r m a t i o n p r o v i d e d i s e v i d e n c e o f a s e v e r e f o r m a t i o n p r o v i d e d i s e v i d e n c e o f a s e v e r e c a t e a t t h e h e a r i n g , i s t h a t t h e a p p e l l a n t h a s a a t i o n o f i m p a c t s f r o m b o t h m e n t a l a n d p h y s i c a l y s i c a l i m p a i r m e n t i s e s t a b l i s h e d b y t h e e v i d e n c e t h e a p p e l l a n t s u s t a i n e d , t h e P A D d i a g n o s i s , a n d h e a d v o c a t e a r g u e d t h a t t h e a s s e s s m e n t f o r b e m i s l e a d i n g a s i t d o e s n o t s h o w h o w l o n g i t t o d e s c r i b e i n m o r e d e t a i l i n h i s t e s t i m o n y . T h e 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 h y s i c i a n a n d t h e h e s h o r t t i m e a c c o r d e d t h e p h y s i c i a n f o r h i s p r o c e s s f o l l o w e d b y t h e s o c i a l w o r k e r . I n h i s i s t r y f a i l e d t o c o n s i d e r n e w i n f o r m a t i o n s u b m i t t e d d p a g e s 1 O a n d 1 1 o f t h e P R i n w h i c h t h e n t s a n d a d d e d n e w i n f o r m a t i o n . y t h e g e n e r a l p r a c t i t i o n e r a n d t h e s o c i a l w o r k e r i s 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 m i n i s t ry a r g u e d g e n e r a l p r a c t i t i o n e r i n d i c a t e d i n t h e P R t h a t t h e e c a n c l i m b 5 o r m o r e s t e p s u n a i d e d a n d h e h a s i n i s t r y a r g u e d t h a t t h e s o c i a l w o r k e r ' s i n f o r m a t i o n a n d i t i s d i f f i c u l t t o d e v e l o p a c l e a r a n d c o h e s i v e s w i t h h i 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 i e s . T h e t a n c e w i t h w a l k i n g o u t d o o r s , c l i m b i n g s t a i r s , e r e p a i n f r o m b o t h h i s h e a d i n j u r y a n d f o o t w a l k i n g i n d o o r s . i n i t s e l f d e t e r m i n e P W D e l i g i b i l i t y o r e s t a b l i s h a n d i t i o n t h a t r e s u l t s i n r e s t r i c t i o n s t o a p e r s o n ' s
APPEAL# I To assess the severity of an impairment one must consider the nature of the impairment and the extent of its impact on daily functioning as evidenced by functional skill limitations and the degree to which performing DLA is restricted. In making its determination the ministry must consider all the relevant evidence, including that of the appellant. However, the legislation is clear that the fundamental basis for the analysis is the evidence from a prescribed professional in this case, the appellant's general practitioner and a social worker. The general practitioner, who had known the appellant for 9 years, diagnosed the appellant with traumatic brain injury and bilateral foot calluses. The general practitioner reported, in terms of physical health history, that the appellant has abnormally callused feet which the appellant states causes him significant pain and disability. The general practitioner indicated that the appellant requires an aid for his impairment as "orthotics would significantly aid his foot problem."· In the letter dated July 4, 2013, a dermatologist reported that the appellant has had some lesions on his feet as well as painful feet, painful calves and a painful back for 17 years and the dermatologist suggested that the appellant get some orthotics for his shoes. In terms of functional skills, the general practitioner reported that the appellant can walk 4 or more blocks unaided on a flat surface, he can climb 5 or more stairs unaided, and has no limitation with lifting or with remaining seated. The general practitioner also indicated in the PR that the appellant is continuously restricted with mobility outside the home. At the hearing, the appellant stated that he has been advised to walk every day but he has to stop and rest after walking about 2 blocks. The appellant also stated that when he walks a mile, it takes him a long time. He has to use the handrail when climbing stairs, he can only lift with his right arm and cannot carry weights any distance and he has to continually shift his weight when he remains seated. In the AR, the social worker indicated that the appellant is assessed as taking significantly longer than typical with walking indoors, and requiring continuous assistance from another person with walking outdoors ("two blocks daily"), climbing stairs ("slowly with great pain"), standing ("none"), lifting ("not more than 1 O lbs") and carrying and holding ("can't-takes cart home from grocery store"). In his self-report, the appellant wrote that he can stand up to 1 O minutes and, at the hearing, he stated that the restrictions to lifting are with his left arm. The social worker commented that the appellant "pushes through but with severe pain-activity makes sores on feet far worse. Can't walk on gravel or uneven surfaces due to both brain injury and foot condition." At the hearing, the appellant clarified that walking on gravel is painful on his feet. The appellant does not currently use orthotics, which were recommended by the specialist and which his general practitioner indicated would significantly aid his foot problem. With respect to his brain injury, the advocate pointed to the revised page 1 O of the PR in which the general practitioner described the appellant's head injury as "severe" and that the resulting poor decisions and judgment and impaired insight are "pervasive and disabling." The general practitioner identified significant deficits in the areas of memory as well as executive, impulse control, and attention or sustained concentration. The appellant stated at the hearing that a recent MRI showed an injury to the left side of his brain and that he has to meet with the neurologist again. He currently takes daily medication which prevents seizures. The appellant also stated that he has to write everything down or he will forget it, and he has forgotten something as soon as 1 O minutes later. Sometimes he will wonder if he has forgotten to turn off the stove or left the water running, and he left his coffee pot on and ruined the pot. However, as discussed in more detail in the subsequent section of this decision reviewing restrictions to DLA, any physical limitations resulting from the appellant's brain injury have not translated into anv sianificant restrictions in the appellant's ability to manage the
c o g n i t i v e t a s k s o f h i s D L A , a s a s s e s s e d i n d e t a i l b T h e p a n e l f i n d s t h a t t h e e v i d e n c e d e m o n s t r a t e s t h t o h i s p h y s i c a l a b i l i t i e s d u e t o h i s h e a d i n j u r y a n d f m o b i l i t y a n d c a n w a l k u p t o a m i l e o n a f l a t s u r f a c e h i s l e f t a r m . T h e p a n e l f i n d s t h a t t h e m i n i s t r y r e a s o a d m i s s i b l e i n f o r m a t i o n , t h e r e i s n o t s u f f i c i e n t c o n s i s e v e r e p h y s i c a l i m p a i r m e n t u n d e r s e c t i o n 2 ( 2 ) o f t h R e s t r i c t i o n s i n t h e a b i l i t v t o p e r f o r m D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h i s m e n t a l a n d p h y s h i s a b i l i t y t o p e r f o r m D L A o n a n o n g o i n g b a s i s t o t h o f a n o t h e r p e r s o n . T h e a p p e l l a n t a r g u e d t h a t h i s p o n a n i n d i v i d u a l b a s e s , t h e y d o n o t a p p e a r s i g n i f i c a t i m e a n d , t a k e n t o g e t h e r , h e i s i m p a i r e d o n p h y s i c a 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 a l t h o u g h t h e m i n i s t r y i m p a i r m e n t , t h e m i n i s t ry i s n o t s a t i s f i e d t h a t t h e a p p i m p a c t s t o t h e a p p e l l a n t ' s D L A a p p e a r t o b e r e l a t e d i m p a i r m e n t . T h e m i n i s t r y a r g u e d t h a t t h e g e n e r a l p l i m i t a t i o n s t o h i s f u n c t i o n a l s k i l l s a n d , t h e r e f o r e , t h e p i c t u r e o f t h e d e g r e e o f r e s t r i c t i o n s t h e a p p e l l a n t h a P a n e l D e c i s i o n S e c t i o n 2 ( 2 ) ( b ) o f t h e E A P W D A r e q u i r e s t h a t a p r e a p p l i c a n t ' s 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 f o r e x t e n d e d p e r i o d s . I n t h i s c a s e , t h e g e n e r a l p r a c p r o f e s s i o n a l s . D L A a r e d e f i n e d i n s e c t i o n 2 ( 1 ) o f t h w i t h a d d i t i o n a l d e t a i l s , i n t h e A R . T h e r e f o r e , a p r e s t h e o p p o r t u n i t y t o i n d i c a t e w h i c h , i f a n y , D L A a r e s i i m p a i r m e n t s 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 I n t h e a p p e l l a n t ' s c i r c u m s t a n c e s , t h e g e n e r a l p r a c t i w h e t h e r t h e a p p e l l a n t ' s i m p a i r m e n t d i r e c t l y r e s t r i c t s g e n e r a l p r a c t i t i o n e r r e p o r t e d t h a t t h e a p p e l l a n t i s c o h o m e a n d d i d n o t a s s e s s t h e a p p e l l a n t ' s f u n c t i o n i n g u p d a t e h i s a s s e s s m e n t a t t h e t i m e o f r e c o n s i d e r a t i o p a g e 1 1 o f t h e P R w h i c h h a d n o t b e e n r e v i s e d . W h c o m m e n t s t o t h e A R t h a t t h e a p p e l l a n t ' s m e d i c a t i o n r e p o r t e d i n t h e P R t h a t t h e a p p e l l a n t h a s n o t b e e n p i n t e rf e r e w i t h h i s D L A . T h e s o c i a l w o r k e r i n d i c a t e d i n t h e A R t h a t t h e a p p e w a l k i n g i n d o o r s a n d r e q u i r e s c o n t i n u o u s a s s i s t a n c e a p p e l l a n t s t a t e d a t t h e h e a r i n g t h a t h e c a n w a l k o u t d s i n c e h e h a s t o t a k e a b r e a k a f t e r 2 b l o c k s . T h i s i s a s s e s s m e n t i n t h e P R o f a n a b i l i t t o w a l k m o r e t h a n A P P E A L # I _ _ _ _ _ _ __, y t h e s o c i a l w o r k e r . a t w h i l e t h e a p p e l l a n t e x p e r i e n c e s s o m e l i m i t a t i o n s o o t c a l l u s e s , h e r e m a i n s i n d e p e n d e n t w i t h h i s , a l b e i t s l o w l y , a n d h i s r e s t r i c t i o n s t o l i f t i n g r e l a t e t o n a b l y c o n c l u d e d t h a t , c o n s i d e r i n g t h e a v a i l a b l e s t e n t 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 e E A P W D A . i c a l 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 s e p o i n t t h a t h e r e q u i r e s t h e s i g n i f i c a n t a s s i s t a n c e h y s i c i a n i n d i c a t e d t h a t t a k i n g h i s m e d i c a l i s s u e s n t l y d i s a b l i n g ; h o w e v e r , t h e y a l l i m p a c t h i m a l l t h e l a n d c o g n i t i v e l e v e l s . 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 m e n t a l e l l a n t 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 a n d t h e t o a p h y s i c a l i m p a i r m e n t r a t h e r t h a n a m e n t a l r a c t i t i o n e r r e p o r t e d t h a t t h e a p p e l l a n t h a s n o m i n i s t ry d o e s n o t h a v e a c l e a r a n d c o h e s i v e s w i t h h i s D L A . s c r i b e d p r o f e s s i o n a l p r o v i d e a n o p i n i o n t h a t a n n t l y r e s t r i c t s h i s D L A , 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 t i t i o n e r a n d t h e s o c i a l w o r k e r a r e t h e p r e s c r i b e d e E A P W D R a n d a r e a l s o l i s t e d i n t h e P R a n d , c r i b e d p r o f e s s i o n a l c o m p l e t i n g t h e s e f o r m s h a s g n i f i c a n t l y r e s t r i c t e d b y t h e a p p e l l a n t ' s d p e r i o d s . t i o n e r i n i t i a l l y r e p o r t e d i n t h e P R t h a t i t i s u n k n o w n h i s a b i l i t y t o p e r f o r m D L A . N e v e r t h e l e s s , t h e n t i n u o u s l y r e s t r i c t e d w i t h h i s m o b i l i t y o u t s i d e t h e i n t h e o t h e r l i s t e d D L A . G i v e n a n o p p o r t u n i t y t o n , t h e g e n e r a l p r a c t i t i o n e r p r o v i d e d a s e c o n d i l e t h e s o c i a l w o r k e r n o t e d i n t h e a d d i t i o n a l s m a k e h i m d r o w s y , t h e g e n e r a l p r a c t i t i o n e r r e s c r i b e d a n y m e d i c a t i o n a n d / o r t r e a t m e n t t h a t l l a n t t a k e s s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l w i t h f r o m a n o t h e r p e r s o n w i t h w a l k i n g o u t d o o r s . T h e o o r s u p t o a m i l e b u t i t t a k e s h i m a l o n g t i m e c o n s i s t e n t w i t h t h e g e n e r a l p r a c t i t i o n e r ' 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 w h i l e b e i n
APPEAL# I restricted with his outdoor mobility. As a result of his foot calluses, the appellant takes significantly longer than typical with his indoor mobility and stated at the hearing that he wears slippers to help as well as flip flops in the shower. For the DLA personal care, the social worker assessed the appellant as requiring continuous assistance from another person with 2 of 8 tasks, namely with bathing (note: "can't stand in shower; 10 times slower in/out of tub"), and regulating his diet ("poor appetite; eats maybe once per day"). The appellant is independent with toileting and feeding self and takes significantly longer than typical with dressing and grooming ("everything extremely slow"), transfers in/out of bed and transfers on/off of chair ("1 0 times slower''). In his self-report, the appellant wrote that he is never able to take a bath due to his head injury as he is at risk of seizure and he feels unmotivated to take care of his personal hygiene when he is in pain. The appellant also stated at the hearing that with the medication that he takes every day, he does not have seizures. The social worker indicated that the appellant takes significantly longer than typical with basic housekeeping and laundry, with a note: "all extremely slow; waits for a good day. Can't do multiple tasks in one day." In his self-report, the appellant wrote that he vacuums at most once a month and has to sit down to rest every 20 minutes between all chores. The appellant stated at the hearing that he needs to rest after each task and this makes all tasks requiring mobility take significantly longer to perform. For shopping, the appellant is independent with 3 of 5 tasks and requires continuous assistance from another person with going to and from stores (note: "can't walk far enough") and carrying purchases home ("uses shopping cart to take all the way home"). In his self-report, the appellant wrote that he can only make it out a couple of times per month for shopping, when his uncle is able to drive him to the store and help him with carrying. The appellant is independent in performing 2 of 4 tasks of the DLA meals and requires continuous assistance from another person with food preparation and cooking. The social worker commented that the appellant cannot stand at the sink or lift pots. The appellant wrote in his self-report that he sometimes goes without eating since he loses motivation to eat when in pain. The appellant stated at the hearing that he will sit down to prepare food but that takes much longer. In the additional information, the social worker wrote that the appellant is in constant pain all the time and he "can do one task and then pain becomes too much and cannot do anymore that day." The social worker assessed the appellant as requiring continuous assistance from another person with using public transit ("can't walk far enough or stand at the bus stop") and he takes significantly longer than typical with getting in and out of a vehicle. In his self-report, the appellant wrote that he has to switch from foot to foot while standing, and can stand for 10 minutes at most. With respect to the two DLA that are specific to mental impairment -make decisions about personal activities, care or finances (d ecision making), and relate to, communicate or interact with others effectively (social functioning), the evidence indicates that the appellant is not significantly restricted in either. With respect to decision making, the social worker reported in the AR that the appellant independently manages his finances (banking, budgeting, pay rent and bills) and his medications (taking as directed and safe handling) and the decision-making components of the DLA of daily shopping (making appropriate choices), meal preparation (meal planning and food storage) and transportation (using transit schedules and arranging transportation), and is also independent with making appropriate social decisions as part of his social functioning. While the appellant wrote in his self-report, with respect to mental and emotional skills, that he has difficulty with planning ahead, remembering information and appointments, and that he suffers from short term memory loss due to his head injury, this has not been confirmed by the social worker through an assessment of cognitive impacts to the appellant's DLA.
R e g a r d i n g t h e D L A o f 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 i n d e p e n d e n t i n d e v e l o p i n g a n d m a i n t a i n i n g r e l a t i o n s e c u r i n g a s s i s t a n c e f r o m o t h e r s . O v e r a l l , t h e s o c i a f u n c t i o n i n g i n b o t h h i s i m m e d i a t e a n d e x t e n d e d s o c o m m u n i c a t i o n . W h i l e t h e a p p e l l a n t ' s g e n e r a l p r a c t i t i o n e r o f 9 y e a r a n d e m o t i o n a l f u n c t i o n a s " h i s d i s a b l i n g i s s u e , " t h e s o c i a l w o r k e r r e l a t e t o t h e a p p e l l a n t ' s r e s t r i c t i o n s t o a p p r o p r i a t e n e s s o f t h e f u n c t i o n a l s k i l l s a s s e s s m e n h a s k n o w n t h e a p p e l l a n t f o r s o m e t i m e i n d i c a t e d t h s c a l e i n a l l a r e a s . T h e r e a r e r e s t r i c t i o n s r e p o r t e d b t h e a p p e l l a n t ' s f o o t c a l l u s e s , h o w e v e r , t h e p a n e l f i n e v i d e n c e o f 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 s i s n o t c o n o f t h e a p p e l l a n t . T h e p a n e l f i n d s t h a t t h e m i n i s t r y r e v i d e n c e f r o m 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 s t o e s t a r e s t r i c t s h i s a b i l i t y t o m a n a g e h i s D L A e i t h e r c o n t i n t h e r e b y n o t s a t i s f y i n g t h e l e g i s l a t i v e c r i t e r i o n o f s e c H e l p t o p e r fo r m D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h e r e q u i r e s t h e s i g n D L A , e v e n i f h e d o e s n o t c u r r e n t l y r e c e i v e h e l p w i t h 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 b e c a u s e i t h a s n o t b e 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 a s s i s t i v e d e v i c e s a r e u s e d a t t h i s t i m e a l t h o u g h t h e P a n e l D e c i s i o n S e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A r e q u i r e s t h a t , a s a b i l i t y t o p e r f o r m D L A , a p e r s o n r e q u i r e s h e l p t o p e s u b s e c t i o n ( 3 ) a s t h e r e q u i r e m e n t f o r a n a s s i s t i v e d a n o t h e r p e r s o n , o r 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 T h e s o c i a l w o r k e r i n d i c a t e d i n t h e A R t h a t t h e a s s i s a p p e l l a n t ' s f a m i l y a n d f r i e n d s a s w e l l a s c o m m u n i t y h e a r i n g t h a t h i s f r i e n d s a n d f a m i l y , p a r t i c u l a r l y h i s u h o u s e w o r k . H e a l s o r e l i e s o n s o u p k i t c h e n s a n d t h w h e r e n o n e i s a v a i l a b l e , t h e s o c i a l w o r k e r n o t e d " n e s h o p p i n g , h o u s e k e e p i n g a s s i s t a n c e . " T h e s e c t i o n o t h e u s e o f a s s i s t i v e d e v i c e s i s n o t c o m p l e t e d , b u t t h o r t h o t i c s w o u l d s i g n i f i c a n t l y a i d t h e a p p e l l a n t ' s f o o t f i n d s t h a t w h i l e s o m e a s s i s t a n c e i s p r o v i d e d t o t h e a a s d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n s i n t h e a p p e l l a n t ' e s t a b l i s h 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 t h e a p p e l l a t h o s e r e s t r i c t i o n s , a s d e f i n e d b y s e c t i o n 2 ( 3 ) ( b ) o f t h A P P E A L # I I l a n t i s a s s e s s e d b y t h e s o c i a l w o r k e r i n t h e A R a s s h i p s , i n t e r a c t i n g a p p r o p r i a t e l y w i t h o t h e r s , a n d l w o r k e r r e p o r t e d t h a t t h e a p p e l l a n t h a s g o o d c i a l n e t w o r k s a n d n o d i f f i c u l t i e s w i t h s i d e n t i f i e d t h e d e f i c i t s t o t h e a p p e l l a n t ' s c o g n i t i v e i m p a c t s t o t h e a p p e l l a n t ' s D L A a s d e t a i l e d b y t h e m o b i l i t y . W h i l e t h e a d v o c a t e t o o k i s s u e w i t h t h e t a s s e t o u t i n t h e P R , t h e g e n e r a l p r a c t i t i o n e r w h o a t t h e a p p e l l a n t f u n c t i o n s a t t h e h i g h e r e n d o f t h i s y t h e s o c i a l w o r k e r w i t h t a s k s o f D L A a s a r e s u l t o f 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 t h e s i s t e n t a n d a l s o d i f f e r s i n s o m e r e s p e c t s w i t h t h a t e a s o n a b l y c o n c l u d e d t h a t t h e r e i s n o t e n o u g h b l i s h 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 g n i f i c a n t l y 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 , t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A . i f i c a n t a s s i s t a n c e o f a n o t h e r p e r s o n t o p e r f o r m h i s D L A . e n e s t a b l i s h e d t h a t D L A a r e s i g n i f i c a n t l y e l p i s r e q u i r e d . T h e m i n i s t r y a r g u e d t h a t n o a p p e l l a n t r e q u i r e s o r t h o s e s f o r h i s f e e t . a r e s u l t o f d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n s i n t h e r f o r m t h o s e a c t i v i t i e s . H e l p i s d e f i n e d i n e v i c e , 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 i m a l i n o r d e r t o p e r f o r m a D L A . t a n c e r e q u i r e d f o r D L A i s p r o v i d e d b y t h e s e r v i c e a g e n c i e s . T h e a p p e l l a n t s t a t e d a t t h e n c l e , h e l p h i m w i t h s h o p p i n g a n d w i t h s o m e e f o o d b a n k f o r h i s m e a l s . F o r h e l p r e q u i r e d e d s t r a n s p o rt a t i o n a s s i s t a n c e , h e l p w i t h f t h e A R i n d i c a t i n g a s s i s t a n c e p r o v i d e d t h r o u g h e g e n e r a l p r a c t i t i o n e r r e p o r t e d i n t h e P R t h a t p r o b l e m b u t " h e c a n n o t a f f o r d t h e m . " T h e p a n e l p p e l l a n t , 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 s a b i l i t y t o p e r f o r m D L A h a v e n o t b e e n n t r e q u i r e s h e l p t o p e r f o r m D L A a s a r e s u l t o f e E A P W D A .
Conclusion Having reviewed and considered all of the evidence and relevant legislation, the panel finds that the ministry's reconsideration decision which determined that the appellant was not eligible for PWD designation was reasonably supported by the evidence, and therefore confirms the decision. APPEAL ii I
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.