I APPEAL# PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (the ministry) reconsideration decision dated March 26, 2014 which found that the appellant did not meet three of the five statutory requirements of Section 2 of the Employment and Assistance for Persons with Disabilities Act for designation as a person with disabilities (PWD). The ministry found that the appellant met the age requirement and that her impairment is likely to continue for at least two years. However, the ministry was not satisfied that the evidence establishes that: • the appellant has a severe physical or mental impairment; • the appellant's daily living activities (DLA) are, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods; and, • as a result of these restrictions, 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. PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Act (EAPWDA), Section 2 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR), Section 2
P A R T E S u m m a r v o f F a c t s 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 t h e t i m e o f t h e r D i s a b i l i t i e s ( P W D ) A p p l i c a t i o n c o m p r i s e d o f t h e a p p S e p t e m b e r 1 0 , 2 0 1 3 , a p h y s i c i a n r e p o r t ( P R ) a n d a n 2 0 1 3 a n d c o m p l e t e d b y a g e n e r a l p r a c t i t i o n e r w h o h T h e . e v i d e n c e a l s o i n c l u d e d t h e f o l l o w i n g : 1 ) L e t t e r d a t e d A u g u s t 1 , 2 0 1 3 f r o m t h e m i n i s t r y i n f o r m a t i o n f o r a d i e t s u p p l e m e n t ; 2 ) L e t t e r d a t e d S e p t e m b e r 1 0 , 2 0 1 3 f r o m t h e a p t h a t t h e a p p e l l a n t h a s s e v e r e i r r i t a b l e b o w e l s c o l i t i s a n d t h e g a s t r o e n t e r o l o g i s t w a n t s h e r t o f r u i t s a n d v e g e t a b l e s a n d w h o l e g r a i n s ; 3 ) L e t t e r d a t e d F e b r u a r y 3 , 2 0 1 4 f r o m t h e a p p e l s h e w r o t e t h a t t h e a d v o c a t e r e q u e s t e d t h a t s h E v e r y c o u p l e o f w e e k s s h e b u y s t h e a p p e l l a n v e h i c l e a n d g i v e s h e r t o b a c c o a n d f i l t e r s . T h e 3 t i m e s p e r m o n t h a n d d o e s n o t b r i n g h e r o w 4 ) L e t t e r d a t e d F e b r u a r y 3 , 2 0 1 4 f r o m t h e a p p e l t h e y w r o t e t h a t a b o u t a w e e k a n d a h a l f a f t e r g r o c e r i e s . T h e y u s u a l l y e n d u p e i t h e r g i v i n g 5 ) U n d a t e d D a i l y L i v i n g A c t i v i t i e s C h e c k l i s t ; 6 ) S u p p l e m e n t a l M e d i c a l O p i n i o n s i g n e d b y t h e 7 ) 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 d a t e d J a n u a r y 3 D i a g n o s e s I n t h e P R , t h e a p p e l l a n t w a s d i a g n o s e d b y t h e m e d i c o l i t i s d i a g n o s e d i n 2 0 1 3 , n i s s e n f u n d o p l a s t y i n t h e p a n d b l o a t i n g f o r y e a r s , c h r o n i c d i a r r h e a , G E R O [ g a s a n x i e t y . P h y s i c a l I m p a i r m e n t 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 r e p o r t e d t h a t : • I n t e r m s o f h e a l t h h i s t o r y , t h e a p p e l l a n t " s u f f e D u r i n g h e r a t t a c k s , s h e i s m o s t l y i n c a p a c i t a t e h a s s c a l d m a r k s o n h e r s k i n f r o m t h i s . S h e a m i c r o s c o p i c l y m p h o c y t i c c o l i t i s . " • T h e a p p e l l a n t d o e s n o t r e q u i r e a n y p r o s t h e s i s • I n t e r m s o f f u n c t i o n a l s k i l l s , t h e a p p e l l a n t i s a b s u r f a c e , 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 r e m a i n s e a t e d . I n t h e A 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 e a p p e l l a n t i s a s s e s s e d a s i n d e p e n d e n t w i t w a l k i n g i n d o o r s a n d o u t d o o r s , c l i m b i n g s t a i r s , n o t e : " d u r i n a e p i s o d e s o f P a i n a n d w r e t c h i n a w I A P P E A l # ------� e c o n s i d e r a t i o n d e c i s i o n i n c l u d e d t h e P e r s o n W i t h l i c a n t i n f o r m a t i o n a n d s e l f r e p o r t d a t e d a s s e s s o r r e p o r t ( A R ) b o t h d a t e d S e p t e m b e r 9 , a s k n o w n t h e a p p e l l a n t f o r 1 7 y e a r s . t o t h e a p p e l l a n t r e q u e s t i n g s u p p o r t i n g p e l l a n t ' s p h y s i c i a n t o t h e m i n i s t r y s t a t i n g i n p a r t y n d r o m e [ I B S ] a n d m i c r o s c o p i c l y m p h o c y t i c e a t l e s s f a t t y a n d p r o c e s s e d f o o d a n d m o r e f r e s h l a n t ' s s i s t e r ' T o w h o m i t m a y c o n c e r n , ' i n w h i c h e d e s c r i b e h o w o f t e n s h e h e l p s t h e a p p e l l a n t . t s o m e g r o c e r i e s t h a t s h e n e e d s a n d g a s f o r h e r a p p e l l a n t c o m e s t o h e r p l a c e t o d o l a u n d r y 2 t o n s u p p l i e s , m a y b e o n c e i n a w h i l e ; l a n t p a r e n t s ' T o w h o m i t m a y c o n c e r n , ' i n w h i c h t h e a p p e l l a n t ' s p a y d a y , s h e s t a r t s t o r u n o u t o f h e r $ 2 0 f o r g a s o r g r o c e r i e s e v e r y m o n t h ; a p p e l l a n t ' s p h y s i c i a n M a r c h 2 4 , 2 0 1 4 ; a n d , 0 , 2 0 1 4 . c a l p r a c t i t i o n e r w i t h m i c r o s c o p i c l y m p h o c y t i c a s t , s e v e r e r e c u r r e n t a b d o m i n a l p a i n , n a u s e a t r o e s o p h a g e a l r e f l u x d i s e a s e ] , g a l l s t o n e s , a n d r s f r o m f r e q u e n t , e p i s o d i c a b d o m i n a l p a i n . d a n d o f t e n s o a k s i n h o t b a t h s f o r h o u r s . S h e l s o h a s c h r o n i c d i a r r h e a [ i l l e g i b l e ] d u e t o o r a i d f o r h e r i m p a i r m e n t . l e t o w a l k 4 o r m o r e b l o c k s u n a i d e d o n a f l a t a s n o l i m i t a t i o n s w i t h l i f t i n g o r t h e t i m e s h e c a n h a l l m o b i l i t y a n d p h y s i c a l a b i l i t y , i n c l u d i n g 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 , w i t h a i l l i u s t c u r l u p o n b e d o r b e i n t h e b a t h t u b . "
I APPEAL JI • In the section of the AR relating to assistance provided through the use of assistive devices, none of the items have been indicated by the physician. In her self-report, the appellant wrote that: • Her life is a nightmare and everyday she wakes up feeling sick (nausea, stomach pain and she needs to have a hot bath). No matter what she does, the pain does not go away for at least 2 to 3 hours with medication. • She usually feels the pain in the morning, depending on what time she wakes up. • She also feels pain when she gets hungry and sometimes when she eats. • She usually baths whenever she feels pain. Sometimes, it will make her feel better. She gave herself third degree burns on her back but she has not burnt herself in a long time. The need to bathe will always be there. • II she is downtown when she starts to feel sick, she has to go home right away. The nausea causes her to start to dry heave and she usually ends up incontinent and the need for a bath happens. She needs the bath to help her feel better. It does not always work but about 60% of the time it makes her better. • She usually does not feel well after a bowel movement and the need to have a bath is extreme. It usually takes a couple of hours to feel better. • She has diarrhea constantly. In the Supplemental Medical Opinion dated March 24, 2014 the physician agreed that the appellant has a severe physical and/or mental impairment with a note: "severe abdominal pain and nausea of unknown causes." Mental Impairment In the PR, the appellant's physician reported that: • The appellant has no difficulties with communication. • There is a significant deficit with the appellant's cognitive and emotional function in the area of emotional disturbance. • In the additional comments, the physician wrote that "previous sexual abuse as child with ongoing chronic anxiety. Symptoms are daily for years and patient submerges herself in hot water to help with her symptoms. She has discolouration to her low back and flanks from previous scalding baths over the years. Patient usually experiences her symptoms daily from anywhere to 2 hours to 16 hours." In the AR, the physician indicated that: • The appellant has a good ability to communicate in all areas, including speaking, reading, writing and hearing. • There are major impacts to the appellant's cognitive and emotional functioning in the areas of emotion, impulse control and motor activity. • There are moderate impacts in the areas of bodily functions and motivation. • There are minimal impacts to insight and judgement, attention/concentration, executive, and memory and no impacts in the areas of consciousness, language, psychotic symptoms, and other neuropsychological problems. The physician did not add further comment. • The appellant is assessed as independent with all aspects of social functioning, including making appropriate social decisions, developing and maintaining relationships, interacting annropriatelv with others, dealinq annropriatelv with unexpected demands, and securinq
a s s i s t a n c e f r o m o t h e r s . • T h e a p p e l l a n t h a s g o o d f u n c t i o n i n g i n b o t h h I n h e r s e l f r e p o r t , t h e a p p e l l a n t w r o t e t h a t : • W h e n s h e s t a r t s t o f e e l s i c k , a f t e r g o i n g t o t h s t a r t s t o h a v e b a d a n x i e t y a t t a c k s a n d s h e c r t h i s a n y m o r e . S h e h a s b e e n s i c k f o r a b o u t 2 U n d a t e d D a i l y L i v i n g A c t i v i t i e s C h e c k l i s t , t h e a p p e l l a h e r t o d o t h e f o l l o w i n g a c t i v i t i e s i n t h e a r e a s o f m e n • C o p i n g w i t h a n x i e t y a n d a g i t a t i o n , d e p r e s s i o n • A t t e n d i n g t o t h e m o s t i m p o rt a n t t h i n g s f i r s t . • C o n t r o l l i n g i r r a t i o n a l ( u n r e a s o n a b l e ) i m p u l s e s • R e m e m b e r i n g i n f o r m a t i o n a n d a p p o i n t m e n t s • I n t e r a c t i n g w i t h f r i e n d s , f a m i l y , p a r t n e r a n d d e • B e i n g a b l e t o d e a l w i t h u n e x p e c t e d s i t u a t i o n 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 ) 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 d 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 r e s c r i b e d a n y m d a i l y l i v i n g a c t i v i t i e s . I n t h e A R , t h e p h y s i c i a n r e p o r t e d t h a t : • T h e a p p e l l a n t i s i n d e p e n d e n t w i t h m o v i n g a b o e p i s o d e s o f p a i n a n d w r e t c h i n g s h e w i l l b e i n • T h e a p p e l l a n t i s i n d e p e n d e n t i n 8 o u t o f 8 t a s b a t h i n g , t o i l e t i n g , f e e d i n g s e l f , r e g u l a t i n g d i e t , T h e a p p e l l a n t p h y s i c i a n n o t e d " e x c e p t w h e n s • T h e a p p e l l a n t i s i n d e p e n d e n t w i t h b a s i c h o u s n o t e b y t h e p h y s i c i a n " n o t d u r i n g a t t a c k s o f a • T h e a p p e l l a n t i s i n d e p e n d e n t i n p e r f o r m i n g 5 f r o m s t o r e s , r e a d i n g p r i c e s a n d l a b e l s , m a k i n c a r r y i n g p u r c h a s e s h o m e . T h e p h y s i c i a n r e f e a b d o m i n a l p a i n a n d n a u s e a . " • T h e a p p e l l a n t i s i n d e p e n d e n t w i t h 4 o u t o f 4 t p r e p a r a t i o n , c o o k i n g a n d s a f e s t o r a g e o f f o o d • T h e a p p e l l a n t i s i n d e p e n d e n t w i t h 3 o f 3 t a s k s b u d g e t i n g a n d p a y i n g r e n t a n d b i l l s . • T h e a p p e l l a n t i s i n d e p e n d e n t i n p e rf o r m i n g a l f i l l i n g / r e f i l l i n g p r e s c r i p t i o n s , t a k i n g a s d i r e c t e d • T h e a p p e l l a n t i s i n d e p e n d e n t i n p e r f o r m i n g a l i n a n d o u t o f a v e h i c l e , u s i n g p u b l i c t r a n s i t , a n t r a n s p o r t a t i o n . • T h e p h y s i c i a n n o t e d t h a t t h e a p p e l l a n t " . . . i s w r i d d e n o r s o a k i n g i n h o t b a t h d u r i n g t h e a t t a c k I n t h e S u o o l e m e n t a l M e d i c a l O n i n i o n d a t e d M a r c h 2 I A P P E A L # _ _ _ _ _ _ ___, e r i m m e d i a t e a n d e x t e n d e d s o c i a l n e t w o r k s . e b a t h r o o m o r e a t i n g o r w h e n h u n g r y , s h e u s u a l l y i e s a l o t b e c a u s e s h e d o e s n o t w a n t t o f e e l l i k e 8 y e a r s . n t i n d i c a t e d t h a t h e r d i s a b i l i t y m a k e s i t d i f f i c u l t f o r t a l , e m o t i o n a l a n d s o c i a l s k i l l s : a n d s t r e s s . . a n d c o m p l e t i n g t a s k s . 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 h i p s . . 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 i n t e r f e r e w i t h h e r u t i n d o o r s a n d o u t d o o r s , w i t h a n o t e t h a t d u r i n g b e d o r i n t h e b a t h t u b . k s o f t h e D L A p e r s o n a l c a r e : d r e s s i n g , g r o o m i n g , t r a n s f e r s i n / o u t o f b e d a n d t r a n s f e r s o n / o f f c h a i r . i c k . " e k e e p i n g , i n c l u d i n g d o i n g h e r l a u n d r y , w i t h t h e b d o m i n a l p a i n a n d n a u s e a . " o f 5 t a s k s o f t h e D L A s h o p p i n g : g o i n g t o a n d g a p p r o p r i a t e c h o i c e s , p a y i n g f o r p u r c h a s e s a n d r r e d t o h i s o t h e r c o m m e n t s : " n o t d u r i n g a t t a c k s o f a s k s o f t h e D L A m e a l s : m e a l p l a n n i n g , f o o d . o f t h e D L A p a y i n g r e n t a n d b i l l s : b a n k i n g , l 3 t a s k s o f m a n a g i n g h e r m e d i c a t i o n s : a n d s a f e h a n d l i n g a n d s t o r a g e . l 3 t a s k s o f m a n a g i n g h e r t r a n s p o rt a t i o n : g e t t i n g d u s i n g t r a n s i t s c h e d u l e s a n d a r r a n g i n g e l l w h e n a t t a c k s a r e n o t p r e s e n t b u t u s u a l l y b e d s . " 4 , 2 0 1 4 t h e o h y s i c i a n a m e e d t h a t :
• T h e a p p e l l a n t ' s a b i l i t y t o p e r f o r m h e r D L A i s a r e a s o f : p r e p a r i n g h e r o w n m e a l s , s h o p p i n g t r a n s p o r t a t i o n f a c i l i t i e s , p e r f o r m i n g h o u s e w o r m o v i n g a b o u t i n d o o r s a n d o u t d o o r s a n d m a n n o t e : " d u r i n g a t t a c k s o f a b d o m i n a l p a i n . " • T h e a p p e l l a n t ' s a b i l i t y t o p e rf o r m t h e s e D L A " . . . h a s d a i l y d e b i l i t a t i n g a t t a c k s o f a b d o m i n a l • T h e r e a r e n o r e s t r i c t i o n s i n d i c a t e d t o t h e t w o i m p a i r m e n t . • T h e a p p e l l a n t ' s a b i l i t y t o p e rf o r m D L A i s p e r i o m o s t m o r n i n g s I b e l i e v e . " • T h e f r e q u e n c y a n d d u r a t i o n o f t h e s e r e s t r i c t i o N e e d fo r H e l p T h e p h y s i c i a n r e p o r t e d i n t h e A R t h a t t h e h e l p r e q u i I n t h e s e c t i o n o f t h e r e p o 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 p h y s i c i a n d i d n o t i n d i c a t e t h a t a n y d e v i c e s a r e u s e d I n t h e S u p p l e m e n t a l M e d i c a l O p i n i o n d a t e d M a r c h 2 • H e i s " n o t s u r e " i f t h e a p p e l l a n t r e q u i r e s h e l p • H e i s " n o t s u r e " h o w m a n y t i m e s p e r w e e k h e I n h e r N o t i c e o f A p p e a l d a t e d M a r c h 1 0 , 2 0 1 4 , t h e a 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 c i s i o n a n d w r o t e t h a t s h l e g i s l a t i o n f o r P W D d e s i g n 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 a n d h e r a d v o c a t e s t a t e • S h e t a k e s m o r p h i n e f o r p a i n e v e ry d a y . W h e m e d i c a t i o n a n d , a b o u t 3 h o u r s l a t e r , s h e w i l l • S h e a l s o t a k e s m e d i c a t i o n , a s n e e d e d , f o r n a s o m e . S h e c a n t a k e i t u p t o 3 t i m e s p e r d a y p e r w e e k . • S h e i s b e t t e r i f s h e g e t s u p e a r l y . T h e r e i s a • D u r i n g a n a t t a c k s h e h a s t o l i e i n a h o t b a t h o d e p r e s s a n t s i n t h e p a s t b u t h e r f a m i l y p h y s i c i s e e a p s y c h i a t r i s t b u t s h e i s n o t c u r r e n t l y s e e • T h e a p p e l l a n t c o m p l e t e d t h e D L A c h e c k l i s t a n a r e a l s o i m p a c t e d . • H e r f a m i l y d o c t o r r e p o r t e d t h a t s h e s u f f e r s f r o t h e b a t h t u b f o r h o u r s . H e a l s o i n d i c a t e d t h a t h o u r s t o 1 6 h o u r s . " • S h e h a s e x p e r i e n c e d t h e s e a t t a c k s f o r 2 8 y e a s o m a n y t e s t s t o t r y t o f i g u r e o u t t h e c a u s e . T i t i s s o m e t h i n g t h a t s h e h a s e a t e n , w i t h n o s u • D i f f e r e n t t h i n g s c a n b r i n g o n a n a t t a c k , s u c h a b a t t l e f o r h e r e v e r y d a y . • S h e h a d s u r e a b o u t 1 6 e a r s a o w h i c h c l 1 A P P E A L # . . _ _ _ _ _ _ _ ___J s e v e r e l y r e s t r i c t e d d u e t o h e r i m p a i r m e n t i n t h e f o r p e r s o n a l n e e d s , u s i n g p u b l i c o r p e r s o n a l k t o m a i n t a 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 s , a g i n g p e r s o n a m e d i c a t i o n , w i t h a h a n d w r i t t e n i 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 e d , w i t h a n o t e : p a i n a n d n a u s e a . " D L A r e l a t i n g t o a p e r s o n w i t h a s e v e r e m e n t a l d i c a l l y r e s t r i c t e d , w i t h a n o t e : " u s u a l l y a t t a c k s a r e n s a r e " s e v e r a l h o u r s e a c h d a y . " r e d f o r D L A i s p r o v i d e d b y t h e a p p e l l a n t ' s f a m i l y . v i d e d t h r o u g h t h e u s e o f a s s i s t i v e d e v i c e s , t h e . 4 , 2 0 1 4 t h e p h y s i c i a n r e p o r t e d t h a t : t o p e r f o r m h e r D L A . l p i s r e q u i r e d . p p e l l a n t e x p r e s s e d h e r d i s a g r e e m e n t w i t h t h e e b e l i e v e s s h e h a s m e t a l l t h e c r i t e r i a i n t h e d : n s h e f e e l s t h e p a i n c o m i n g o n , s h e t a k e s t h e f e e l b e t t e r . u s e a . T h e m e d i c a t i o n f o r n a u s e a h a s h e l p e d a n d s h e t a k e s t h e m a x i m u m a m o u n t a b o u t 3 d a y s r a r e o c c a s i o n w h e n s h e w a k e s u p a n d f e e l s f i n e . r s h e c a n g e t " h y s t e r i c a l . " S h e h a s t a k e n a n t i a n h a s n o t c u r r e n t l y p r e s c r i b e d a n y . S h e u s e d t o i n g a s p e c i a l i s t . d i n d i c a t e d t h a t h e r e m o t i o n a l a n d s o c i a l s k i l l s m f r e q u e n t e p i s o d i c a b d o m i n a l p a i n a n d s o a k s i n h e r s y m p t o m s o c c u r d a i l y " f r o m a n y w h e r e t o 2 r s a n d t h e p a s t 1 0 y e a r s s h e h a s g o n e t h r o u g h h e y h a v e t r i e d t o d e t e r m i n e a p a t t e r n o r t o s e e i f c c e s s . H e r t w i n s i s t e r h a s t h e s a m e c o n d i t i o n . s a b o w e l m o v e m e n t o r w h e n s h e e a t s . I t i s a o s e d a v a l v e t o d e a l w i t h t h e a c i d r e f l u x .
I APPEAL# • Although the physician indicated that the appellant is well when she is not having an attack, he reported that she is usually bed ridden or soaking in a hot bath during the attacks and unable to perform her DLA. • The Supplemental Medical Opinion by the appellant's physician supports the original information in the PWD application and again indicates that she is not able to perform her DLA during her attacks. These attacks occur most mornings and several hours each day. • She has seen a gastroenterologist and he want her to eat less spicy foods. She does not eat in restaurants and is supposed to eat more fresh fruits and vegetables. Her stomach still feels the same but she is a bit more energetic when she is feeling well. She can get her house clean faster than she used to. • She does not have anyone to help her. Her parents help her financially but she has to do things for herself. • When she is feeling well, she can shop and cook and do her housework and other daily activities. She plans to get these things done when she is not having an attack. The ministry relied on its reconsideration decision. The ministry did not raise an objection to the admissibility of the information in the appellant's oral testimony. The panel admitted the information as it provided more detail relating to the impact of the appellant's previously diagnosed medical conditions and is in support of information before the ministry on reconsideration, pursuant to Section 22(4) of the Employment and Assistance Act.
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 o n t h e a p p e a l i s w h e t h e r t h e m i n i s t r y ' s r e c o n s i d e r a t i o n d e c i s i o n , w h i c h f o u n d t h a t t h e a p p e l l a n t i s n o t e l i g i b l e 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 b i l i t i e s ( P W D ) , w a s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e o r w a s a r e a s o n a b l e a p p l i c a t i o n o f t h e a p p l i c a b l e e n a c t m e n t i n t h e c i r c u m s t a n c e s o f t h e a p p e l l a n t . T h e m i n i s t r y f o u n d t h a t t h e a p p e l l a n t d o e s n o t h a v e a s e v e r e 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 a n d t h a t h e r 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 e n o 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 e d e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s a n d t h a t , a s a r e s u l t o f t h o s e r e s t r i c t i o n s , i t c o u l d n o t b e d e t e r m i n e d t h a t t h e a p p e l l a n 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 rv i s i o n o f 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 c e , 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 i m a l t o p e r f o r m D L A . T h e c r i t e r i a f o r b e i n g d e s i g n a t e d 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 ) a r e s e t o u t i n S e c t i o n 2 o f t h e E A P W D A a s f o l l o w s : P e r s o n s w i t h d i s a b i l i t i e s 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 f , 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 . ( 4 ) T h e m i n i s t e r m a y r e s c i n d a d e s i g n a t i o n u n d e r s u b s e c t i o n ( 2 ) . S e c t i o n 2 ( 1 ) ( a ) o f t h e E A P W D R d e f i n e s D L A f o r 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 o r m e n t a l i m p a i r m e n t a s f o l l o w s : D e f i n i t i o n s f o r A c t 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 ( 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 ) m a k e d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e o r f i ( i i ) r e l a t e t o , c o m m u n i c a t e o r i n t e r a c t w i t h o t h e r s e f f e c S e v e r e P h y s i c a l I m p a i r m e n t T h e a p p e l l a n t ' s p o s i t i o n i s t h a t a s e v e r e p h y s i c a l i m p s e v e r e r e c u r r e n t a b d o m i n a l p a i n , n a u s e a a n d c h r o n e v i d e n c e s h o w s t h a t t h e e p i s o d e s o f s e v e r e a b d o m i 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 t h e r e i s n o t e n o u g h i n f 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 e n t . a s s e s s m e n t , t h e 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 t h a t t c l i m b 5 o r m o r e s t a i r s u n a i d e d a n d s h e h a s n o l i m i t a 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 r a c t i t i o n e r i n d t o h e l p c o m p e n s a t e f o r i m p a i r m e n t . T h e m i n i s t r y a r g t h e a p p e l l a n t i s i n d e p e n d e n t i n a l l a s p e c t s o f h e r m o e p i s o d e s o f p a i n . P a n e l D e c i s i o n T h e d i a g n o s i s o f a m e d i c a l c o n d i t i o n i s n o t i t s e l f d e t e t h e s e v e r i t y o f a n i m p a i r m e n t o n e m u s t c o n s i d e r t h e a p p e l l a n t ' s a b i l i t y t o m a n a g e h e r D L A a s e v i d e n c e d D L A , a n d t h e d e g r e e o f i n d e p e n d e n c e i n p e r f o r m i n g w h e n i t d e f i n e s t h e w o r d " i m p a i r m e n t " i n t h e p h y s i c i a p s y c h o l o g i c a l , a n a t o m i c a l o r p h y s i o l o g i c a l s t r u c t u r e f u n c t i o n i n d e p e n d e n t l y , e f f e c t i v e l y , a p p r o p r i a t e l y o r f s e t o u t i n l e g i s l a t i o n a n d i s n o t b i n d i n g o n t h e p a n e l , d e s c r i b e s t h e l e g i s l a t i v e i n t e n t . T h e l e g i s l a t i o n c l e a r l y p r o v i d e s t h a t t h e d e t e r m i n a t i o t h e m i n i s t e r , t a k i n g i n t o a c c o u n t a l l o f t h e e v i d e n c e i n l e g i s l a t i o n i s a l s o c l e a r t h a t t h e f u n d a m e n t a l b a s i s f o p r o f e s s i o n a l r e s p e c t i n g t h e n a t u r e o f t h e i m p a i r m e n t T h e m e d i c a l p r a c t i t i o n e r , a p h y s i c i a n w h o h a s k n o w n d i a g n o s e d t h e a p p e l l a n t w i t h m i c r o s c o p i c l y m p h o c y t n a u s e a a n d b l o a t i n g f o r y e a r s , c h r o n i c d i a r r h e a , G E R t h e h e a r i n g t h a t s h e h a d t h e n i s s e n f u n d o p l a s t y s u r g s h e h a s e x e r i e n c e d t h e r e c u r r e n t a b d o m i n a l a i n a 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 ; 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 : n a n c e s ; t i v e l y . 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 o f h e r i c d i a r r h e a . T h e a d v o c a t e a r g u e d t h a t t h e n a l p a i n a r e d e b i l i t a t i n g a n d o c c u r d a i l y . o r m a t i o n f r o m t h e g e n e r a l p r a c t i t i o n e r t o c o n f i r m T h e m i n i s t r y a r g u e d t h a t , i n t e r m s o f f u n c t i o n a l h e a p p e l l a n t c a n w a l k 4 o r m o r e b l o c k s u n a i d e d , t i o n s i n l i f t i n g o r b e i n g a b l e t o r e m a i n s e a t e d . i c a t e d t h a t t h e a p p e l l a n t d o e s n o t r e q u i r e a n a i d u e d t h a t t 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 t h a t 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 e x c e p t d u r i n g r m i n a t i v e o f a s e v e r e i m p a i r m e n t . T o a s s e s s n a t u r e o f t h e i m p a i r m e n t a n d i t s i m p a c t o n t h e b y f u n c t i o n a l s k i l l l i m i t a t i o n s , t h e r e s t r i c t i o n s t o D L A . T h e m i n i s t r y d e s c r i b e s t h i s a p p r o a c h n r e p o r t a s b e i n g " a l o s s o r a b n o r m a l i t y o f o r f u n c t i o n c a u s i n g a r e s t r i c t i o n i n t h e a b i l i t y t o o r a r e a s o n a b l e d u r a t i o n . " T h i s d e f i n i t i o n i s n o t b u t i n t h e p a n e l ' s v i e w i t q u i t e a p p r o p r i a t e l y n o f s e v e r i t y o f i m p a i r m e n t i s a t t h e d i s c r e t i o n o f c l u d i n g t h a t o f t h e a p p e l l a n t . H o w e v e r , t h e r t h e a n a l y s i s i s t h e e v i d e n c e f r o m a p r e s c r i b e d a n d i t s i m p a c t o n d a i l y f u n c t i o n i n g . t h e a p p e l l a n t f o r a p e r i o d o f 1 7 y e a r s , i c c o l i t i s , s e v e r e r e c u r r e n t a b d o m i n a l p a i n , O , g a l l s t o n e s a n d 1 8 S . T h e a p p e l l a n t s t a t e d a t e r y a b o u t 1 6 y e a r s a g o t o d e a l w i t h t h e G E R O , n d n a u s e a f o r a b o u t 2 8 e a r s , a n d t e s t i n o v e r
I APPEAL jf the past 1 O years has not resulted in a definitive cause. In the Supplemental Medical Opinion dated March 24, 2014 the physician agreed with the statement that the appellant has a severe physical and/or mental impairment with a note: "severe abdominal pain and nausea of unknown causes." In her self-report, the appellant wrote that every day she wakes up feeling sick (nausea, stomach pain) and she needs to have a hot bath and, no matter what she does, the pain does not go away for at least 2 to 3 hours. At the hearing, the appellant explained that she takes medication every day for the pain and, as needed, to control the nausea. In the PR, the physician described her condition as "frequent, episodic abdominal pain" during which " ...s he is mostly incapacitated and often soaks in hot baths for hours." The physician also reported that the appellant does not require any aid or assistive device for her impairment and, in terms of functional skills, she is able to walk 4 or more blocks unaided on a flat surface, climb 5 or more steps unaided, and has no limitations with lifting or the time she can remain seated. In the AR, the appellant is assessed by her physician as independent with all mobility and physical ability, including walking indoors and outdoors, climbing stairs, standing, lifting and carrying and holding, with a note: "during episodes of pain and wretching will just curl up on bed or be in the bathtub." Given an opportunity to provide further comment in the Supplemental Medical Opinion dated March 24, 2014, the appellant's physician wrote that the attacks of abdominal pain occur for "several hours each day," usually in the morning. The physician also indicated that he is not sure if the appellant requires help to perform her DLA and he is not sure how many times per week help is required. At the hearing, the appellant stated that when she is feeling well, or not experiencing attacks of her abdominal pain, she is able to shop and cook and do her housework and other daily activities. In the AR, the physician noted that the appellant " ... is well when attacks are not present but usually bed ridden or soaking in hot bath during the attacks." The evidence of the physician and the appellant is that when the appellant is experiencing an attack of abdominal pain, she is incapacitated. These attacks occur mostly in the morning and, while the appellant describes pain occurring for at least 2 to 3 hours requiring significant medication, she is able to perform all of her DLA when she is not experiencing an attack. The panel finds that the ministry reasonably concluded that the evidence demonstrates that the appellant is completely independent with all of her mobility and physical abilities the majority of the time. The panel, therefore, finds that the ministry reasonably determined that there is not sufficient evidence to establish that the appellant has a severe physical impairment under section 2(2) of the EAPWDA. Severe Mental Impairment The appellant's position is that a severe mental impairment is established by the evidence of her anxiety and the impact to her emotional and social skills. The ministry's position is that there is insufficient evidence to establish that the appellant has a severe mental impairment. The ministry argued that the physician indicated that the appellant has deficits with cognitive and emotional functioning in the areas of emotional disturbance and, when assessing the impacts on daily functioning, the physician reported that there are major impacts in the areas of emotion, impulse control and motor activity and moderate impacts to bodily functions and motivation and minimal or no impacts to the remainder of her cognitive and emotional functioning. The ministry argued that the physician also indicated that the appellant has no difficulties with communication or any restrictions with social functioning.
APPEAL# I Panel Decision In the PR, the physician diagnosed on-going, chronic anxiety with experience of previous sexual abuse as a child. In the additional comments, the physician wrote that the appellant's symptoms are daily for years and she submerges herself in hot water to help with her symptoms. She has discolouration to her low back and flanks from previous scalding baths over the years. The physician further wrote that the appellant usually experiences her symptoms daily from anywhere to 2 hours to 16 hours and it is not clear whether the physician is there referring to the appellant's anxiety or the attacks of abdominal pain, or both, and how often the symptoms will last for the maximum16 hours. The appellant is assessed by her physician as having significant deficits in cognitive and emotional functioning in the area of emotional disturbance (e.g. depression, anxiety), with no further comment or description provided by the physician. The impacts to the appellant's daily functioning are assessed as major in the areas of emotion, impulse control and motor activity, moderate in the areas of bodily functions and motivation, and minimal or no impacts in the remaining 9 areas of functioning, with no further comment provided. In the DLA Checklist, the appellant indicated that her disability makes it difficult for her to do many activities including coping with anxiety, agitation, depression and stress, and controlling irrational (unreasonable) impulses. At the hearing, the appellant stated that, during an attack, she has to lie in a hot bath or she can get "hysterical;" she has taken anti depressants and was seen by a psychiatrist in the past, but her family physician has not currently prescribed any medication for her anxiety or referred her to a psychiatrist. In the AR, however, there is no further description provided by the physician of these impacts to cognitive and emotional functioning to explain whether they are episodic and possibly tied to a compulsion to bathe, as described by the appellant. The physician reported that the appellant has no difficulties with communication and has a good ability to communicate in all areas. In the DLA Checklist, the appellant indicated that her disability makes it difficult for her to interact with friends, family, partner, to develop and maintain relationships, and to deal with unexpected situations. However, in terms of social functioning, the appellant is assessed by the physician as independent in all areas: in making appropriate social decisions, developing and maintaining relationships, interacting appropriately with others, dealing appropriately with unexpected demands and securing assistance from others. The physician did not provide further comments to the appellant's social functioning and reported that the appellant has good functioning in both her immediate and extended social networks. The panel finds that the ministry reasonably concluded that, overall, the evidence of impacts to the appellant's social and cognitive/emotional functioning is not sufficient to establish a severe mental impairment, pursuant to section 2(2) of the EAPWDA. Restrictions in the ability to perform DLA The appellant's position is that her physical and mental impairments directly and significantly restrict her ability to perform DLA on an ongoing basis to the extent that she requires the significant assistance of another person. The advocate argued that her physician confirmed in the Supplemental Medical Opinion dated March 24, 2014 that she is severely restricted in 6 DLA: preparing meals, shopping for personal needs, using public or personal transportation facilities, performing housework to maintain acceptable sanitary conditions, moving about indoors and outdoors, and managing her personal medication. The ministrv's position is that the appellant's physician indicated that she is independent in all
a s p e c t s o f D L A a n d t h e r e i s n o i n d i c a t i o n t h a t s h e t a d u r i n g a t t a c k s o f a b d o m i n a l p a i n . T h e m i n i s t r y a c k n t o h e r m e d i c a l i s s u e s ; h o w e v e r , t h e e v i d e n c e f r o m t 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 a n d s i g n i f i c a n t l y r e s 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 . 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 s 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 n 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 a p p e l l a n t ' s p d e f i n e d i n s e c t i o n 2 ( 1 ) o f t h e E A P W D R a n d a r e a l s o t h e A R . T h e r e f o r e , a p r e s c r i b e d p r o f e s s i o n a l c o m p l w h i c h , i f a n y , D L A a r e s i 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 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 . 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 , h e r p h y s i c i a n r e p o i n d e p e n d e n t w i t h p e r f o r m i n g a l l o f h e r D L A , i n c l u d i n p h y s i c i a n n o t e d i n t h e A R t h a t t h e a p p e l l a n t " . . . i s w e r i d d e n o r s o a k i n g i n h o t b a t h d u r i n g t h e a t t a c k s . " I n a s s i s t a n c e f r o m a n o t h e r p e r s o n , o n a c o n t i n u o u s o r S u p p l e m e n t a l M e d i c a l O p i n i o n d a t e d M a r c h 2 4 , 2 0 1 t h e a p p e l l a n t ' s a b i l i t y t o p e r f o r m h e r D L A i s s e v e r e l y o f a b d o m i n a l p a i n " i n t h e a r e a s o f : p r e p a r i n g h e r o w 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 , p e r f o r m i n c o n d i t i o n s , m o v i n g a b o u t i n d o o r s a n d o u t d o o r s a n d i n d i c a t e d t h a t t h e f r e q u e n c y a n d d u r a t i o n o f t h e s e r e H o w e v e r , a s k e d w h e t h e r t h e a p p e l l a n t r e q u i r e s h e l p w e e k h e l p i s r e q u i r e d , t h e p h y s i c i a n w r o t e t h a t h e i s p r o v i d e t o t h e a p p e l l a n t , h e r p a r e n t s a n d h e r s i s t e r b f i n a n c i a l a s s i s t a n c e f r o m t i m e t o t i 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 s t a t e d t h a t w h e n s h e i s s h e c a n s h o p a n d c o o k a n d d o h e r h o u s e w o r k a n d o s h e h a s f e l t m o r e e n e r g y a n d c a n g e t h e r h o u s e w o r k c o m p l e t e h e r D L A w h e n s h e i s n o t h a v i n g a n a t t a c k f o r h e r s e l f . I n t h e S u p p l e m e n t a l M e d i c a l O p i n i o n , t h e p h y s i c i a n r e l a t i n g t o a p e r s o n w i t h a s e v e r e m e n t a l i m p a i r m e n a c t i v i t i e s , c a r e o r f i n a n c e s a n d r e l a t i n g t o , c o m m u n i c G i v e n t h a t t h e p h y s i c i a n r e p o r t e d t h a t t h e a p p e l l a n t t y p i c a l l y t h e m a j o r i t y o f t h e h o u r s i n a d a y , a n d s h e c t i m e s , 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 n a b l y c o a p p e l l a n t i s r e s t r i c t e d 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 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 r e i s n o t e n o u 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 i m p a i r m e n t s s i g n i f i c a n 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 n e r i o d s , t h e I A P P E A i # k e s s i g n i f i c a n t l y l o n g e r t o p e r f o r m t h e m , e x c e p t o w l e d g e d t h a t t h e a p p e l l a n t h a s l i m i t a t i o n s d u e h e p h y s i c i a n i s n o t s u f f i c i e n t t o c o n f i r m t h a t t h e t r i c t h e r a b i l i t y t o p e r f o r m D L A e i t h e r c o n t i n u o u s l y 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 t l y r e s t r i c t s h e r 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 h y s i c i a n i s 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 . D L A a r e l i s t e d i n t h e P R a n d , w i t h a d d i t i o n a l d e t a i l s , i n e t i n g t h e s e f o r m s h a 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 a p p e l l a n t ' s i m p a i r m e n t s e i t h e r c o n t i n u o u s l y o r r t e d i n t h e A R t h a t t h e a p p e l l a n t i s c o m p l e t e l y g m o v i n g a b o u t i n d o o r s a n d o u t d o o r s . T h e l l w h e n a t t a c k s a r e n o t p r e s e n t b u t u s u a l l y b e d t h e A R , t h e p h y s i c i a n d i d n o t i n d i c a t e a n e e d f o r a p e r i o d i c b a s i s , w i t h a n y D L A . I n t h e 4 t h e p h y s i c i a n a g r e e d w i t h t h e s t a t e m e n t t h a t r e s t r i c t e d d u e t o h e r i m p a i r m e n t " d u r i n g a t t a c k s n m e a l s , s h o p p i n g f o r p e r s o n a l n e e d s , u s i n g g h o u s e w o r k t o m a i n t a i n a c c e p t a b l e s a n i t a r y m a n a g i n g p e r s o n a l m e d i c a t i o n . T h e p h y s i c i a n s t r i c t i o n s a r e " s e v e r a l h o u r s e a c h d a y . " t o p e r f o r m h e r D L A a n d h o w m a n y t i m e s p e r n o t s u r e . A s k e d t o d e s c r i b e t h e h e l p t h e y o t h w r o t e i n t h e i r l e t t e r s t h a t t h e y p r o v i d e f e e l i n g w e l l , w h e n s h e i s n o t h a v i n g a n a t t a c k , t h e r d a i l y a c t i v i t i e s . W i t h c h a n g e s t o h e r d i e t , d o n e q u i c k e r , f o r e x a m p l e , a n d s h e p l a n s t o s i n c e s h e r e c e i v e s n o h e l p a n d h a s t o d o t h i n g s d i d n o t i n d i c a t e r e s t r i c t i o n s t o t h e t w o D L A t , n a m e l y m a k i n g d e c i s i o n s a b o u t p e r s o n a l a t i n g o r i n t e r a c t i n g w i t h o t h e r s . i s w e l l w h e n t h e a t t a c k s a r e n o t p r e s e n t , w h i c h i s a n i n d e p e n d e n t l y p e r f o r m a l l o f h e r D L A a t t h e s e n c l u d e d t h a t 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 d s o f t i m e . O v e r a l l , t h e p a n e l f i n d s t h a t t h e g h 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 t o t l y r e s t r i c t h e r a b i l i t y t o m a n a g e D L A e i t h e r r e b y n o t s a t i s f y i n q t h e l e a i s l a t i v e c r i t e r i o n o f
s e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A . 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 s 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 s 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 . T h e m i n i s t ry ' 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 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 e a p p e l l a n t d o e s n o t r e q u i r e a n y a s s i s t i v e d e v i c e s o r a 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 r 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 e 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 i T h e e v i d e n c e o f t h e p h y s i c i a n , a s a p r e s c r i b e d p r o f e p r o v i d e d b y t h e a p p e l l a n t ' s f a m i l y . I n t h e S u p p l e m e " n o t s u r e " i f t h 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 h r e a s o n a b l y d e t e r m i n e d t h a t , a s d i r e c t a n d s i g n i f i c a n D L A h a v e n o t b e e n 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 D L A 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 , a s d e f i n e d b y s C o n c l u s i o n H a v i n g r e v i e w e d a n d c o n s i d e r e d a l l o f t h e e v i d e n c e 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 c i s i o n w h i c h d e t e r m i n e d d e s i g n a t i o n w a s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n I A P P E A L # 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 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 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 t h e n a s s i s t a n c e a n i m a l . 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 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 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 m a l i n o r d e r t o p e r f o r m a D L A . s s i o n a l , i s t h a t t h e h e l p r e q u i r e d w i t h D L A i s n t M e d i c a l O p i n i o n , t h e p h y s i c i a n w r o t e t h a t h e i s e r D L A . 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 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 ' s a b i l i t y t o p e rf o r m i n e d t h a t t h e a p p e l l a n t r e q u i r e s h e l p t o p e r f o r m e c t i o n 2 ( 3 ) ( b ) o f t h e E A P W D A . a n d r e l e v a n t l e g i s l a t i o n , t h e p a n e l f i n d s t h a t t h e t h a t t h e a p p e l l a n t w a s n o t e l i g i b l e f o r P W D c e , a n d t h e r e f o r e c o n f i r m s t h e d e c i s i o n .
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.