I APPEAL# PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (Ministry) Reconsideration Decision dated May 13, 2014, which denied the Appellant's request for Monthly Nutritional Supplement (MNS), specifically Ensure/Boost. The Ministry found that the Appellant's application did not meet the requirements of section 67(1) of the Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) and section 7(a) of Schedule C, EAPWDR. The Ministry found that a medical practitioner or nurse practitioner did not confirm that failure to obtain the requested items will prevent imminent danger to the Appellant's life and did not describe how the requested items will alleviate one or more of the symptoms described and provide caloric supplementation to a regular diet. PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) section 67; Schedule C, section 7 EAA T003(10/06/01)
APPEAL# I PART E -Summarv of Facts The Appellant and the Ministry attended the hearing scheduled for June 25, 2014. The Appellant's representative arrived late, after the Appellant had given oral evidence, and asked for an adjournment, which was granted, At the rescheduled hearing, the Appellant, his representative and the Ministry were not in attendance. After confirming that all of the parties were notified, the hearing proceeded under section 86(b) of the Employment and Assistance Regulation. Information before the Ministry at Reconsideration included: The Appellant's Application for Monthly Nutritional Supplement, dated January 20, 2014. The Ministry's Monthly Nutritional Supplement Decision Summary, dated April 15, 2014. A copy of the Ministry's letter to the Appellant advising him of their decision, dated April 15, 2014. The Appellant's Request for Reconsideration, dated May 7, 2014. At the hearing, the Appellant stated that he has had Hepatitis C for over 20 years and cannot keep food down. He stated that he weighs 130 pounds, not 150 as stated by the physician on his application for nutritional items. He stated that he has muscle mass loss and he has a strain of Hepatitis C that cannot be cured. He stated that he needs Ensure because he cannot keep solid food down and he needs it to stay alive. In response to questions from the Ministry, the Appellant stated that his physician did not weigh him at the clinic, but he has no confirmation of his weight loss, and he has no family doctor. He stated that he has seen the doctor who completed the form three or four times, but he did not consult any records when completing the form He stated that he has gastritis and no teeth, so he cannot eat vegetables or meat without vomiting. He stated that he can eat chicken or Ensure. In response to questions from the Panel, the Appellant stated that his nutritional problems started three years ago when the vomiting started; prior to that, he weighed 180 pounds. At this point, the June 25, 2014 hearing was adjourned. In the Reconsideration Decision, the Ministry stated that the Appellant's physician did not specify the expected duration of the need for nutritional items, answered 'no' to the question "Does this applicant have a medical condition that results in the inability to absorb sufficient calories to satisfy daily requirements through a regular dietary intake?", did not complete the section of the form describing how the nutritional items required will prevent imminent danger to the Appellant's life and indicated that the Appellant's body mass index (BMI) is within the normal range, therefore it cannot be established that the Appellant is underweight, requiring caloric supplementation to a regular dietary intake. The Ministry therefore concluded that the eligibility criteria set out in the relevant legislation had not been met. EMT003(10/06/01)
PA RT F -Reasons for Panel Decisio n The iss ue in this appeal is the reasonableness of the M which denied the Appe llant's requ e st for Monthly Nutritional Supplement (MN The Ministry found that the Appell an t's application did not meet the r E m pl oy me n t a nd Assistance fo r Persons with Disabili ties C, EAPW D R. T he M inistry f o und that a medical practitioner o obtai n the requested ite m s will prevent imminent danger t requested items will alle viate one or more of the symptoms described and provide caloric supplementa regular diet. Legislat ion EAPWDR Nutrition al sup plement 67 (1 ) The minister may provid e a nutrit ional s up plement s upplement] of Sched ul e C to or for a p er son w i as sistanc e un der ( a) s e c tion 2 [monthly s uppo rt all owa n ce], r oom and boar d ] or 9 [ p eop le i n emer g ency shelt (b) s e c tion 8 [pe ople re ceivi ng s pecial care] of alcoh ol o r d r ug treatme nt centr e, i f the mi nister is sati sfied t hat ( c) b ased on the i n f o rmation con t ai ned i n requirements s et out in s ubsecti o n (1.1 ) d isabil it i e s , (d) the pers on is n o t r e ceiving a s u ppl ement Sche dul e C, (e) the person is not receiving a supplement under subsection ( supplements], (f) the person complies with any requirement of the minister under subsection (2), and (g) the pers on's fam i ly unit does not have any resources available to pay the cost of or to o the items for which the supplement may be provided (1.1) In o rder for a p er so n w it h disabilities to receive a nutritional supplement minister must receive a requ est, in the form specified by the minister, completed by a medical practitioner or nurse practitioner, in which the practitioner has confirmed all of the following: (a ) the person with disabilities to whom the reques fo r a ch ronic, prog r essive deterioration of health (b) as a direct result of the chronic, progressive deterioration of health, the person displays two or more of the following symptoms: Ii\ ma l n u t r it ion; EAAT 003(10/06/01) APP EAL# I inistry' s rec ons iderat i o n d eci s i on dated M a y 13, 2 01 4, S } , specifically Ens u re/B o ost. equirements of s ec t ion 67 (1) of t h e Regulation (EAPWD R) and secti o n 7 (a ) of Schedule r nurse pr actitioner did not c o nfirm that failure to o t he Appel l a n t's life a n d di d not describe how the tion to a i n ac corda nce wit h sectio n ?[ mo n thly nu triti onal th di s ab ilities i n a famil y unit who re c e i v es d isability 4 [monthly sh el ter al lowance], 6 [peop le receiv ing ers a nd tr an s iti on hou ses ] of Schedul e A, o r Sche dule A, if t he spe ci al care faci lity is an t he form r e quired under subsect io n (1 .1 ), the (a) to (d} are me t in respect of th e p er son with und e r sec ti on 2 ( 3)[g ene ra l h ea lt h su pplemen t] of 3) o r secti on 66[diet btain . under t his section, the t relates is being treated by the practitioner on accou nt of a severe medical condition;
( i i ) u n d e r w e i g h t s t a t u s ; ( i i i ) s i g n i f i c a n t w e i g h t l o s s ; ( i v ) s i g n i f i c a n t m u s c l e m a s s l o s ( v ) s i g n i f i c a n t n e u r o l o g i c a l d e g e ( v i ) s i g n i f i c a n t d e t e r i o r a t i o n o f a ( v i i ) m o d e r a t e t o s e v e r e i m m u n ( c ) f o r t h e p u r p o s e o f a l l e v i a t i n g a s y m p t o n e o r m o r e o f t h e i t e m s s e t o u t i n s e c t i o ( d ) f a i l u r e t o o b t a i n t h e i t e m s r e f e r r e d t o p e r s o n ' s l i f e . ( 2 ) I n o r d e r t o d e t e r m i n e o r c o n f i r m t h e n e e d o r p r o v i d e d u n d e r s u b s e c t i o n ( 1 ) , t h e m i n i s t e o p i n i o n f r o m a m e d i c a l p r a c t i t i o n e r o r n u r s s u b s e c t i o n ( 1 ) ( c ) . ( 3 ) T h e m i n i s t e r m a y p r o v i d e a n u t r i t i o n a l s u p p l e f a m i l y u n i t i f t h e s u p p l e m e n t i s p r o v i d e d t o d e p e n d e n t c h i l d o f a r e c i p i e n t o f d i s a b i l i t y a ( a ) t h e r e c i p i e n t o r d e p e n d e n t c h i l d i s n o s e c t i o n o r s e c t i o n 2 ( 3 ) o f S c h e d u l e C , a ( b ) a m e d i c a l p r a c t i t i o n e r o r n u r s e p r a c t i t c h i l d h a s a n a c u t e s h o r t t e r m n e e d f o r c a p r e v e n t c r i t i c a l w e i g h t l o s s w h i l e r e c o v e r ( i ) s u r g e r y , ( i i ) a s e v e r e i n j u r y , ( i i i ) a s e r i o u s d i s e a s e , o r ( i v ) s i d e e f f e c t s o f m e d i c a l t r e a t m S c h e d u l e C M o n t h l y n u t r i t i o n a l s u p p l e m e n t 7 T h e a m o u n t o f a n u t r i t i o n a l s u p p l e m e n t t h a t m a y b e p t h i s r e g u l a t i o n i s t h e s u m o f t h e a m o u n t s f o r t h o s e r e q u e s t u n d e r s e c t i o n 6 7 ( 1 ) ( c ) : ( a ) f o r a d d i t i o n a l n u t r i t i o n a l i t e m s t h a t a r e p a r t o f u p t o $ 1 6 5 e a c h m o n t h ; ( b ) R e p e a l e d . [ B . C . R e g . 6 8 / 2 0 1 0 , s . 3 ( b ) . ] ( c ) f o r v i t a m i n s a n d m i n e r a l s , u p t o $ 4 0 e a c h m o 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 n e e d s t h e r e q u e s t e d d u e t o H e p a t i t i s C a n d c a n n o t t o l e r a t e s o l i d f o o d . H e a r f o r M N S d i d n o t w e i a h h i m a n d r e c o r d e d h i s w e i a h t i n a c E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I s ; n e r a t i o n ; v i t a l o r g a n ; e s u p p r e s s i o n ; o m r e f e r r e d t o i n p a r a g r a p h ( b ) , t h e p e r s o n r e q u i r e s n 7 o f S c h e d u l e C a n d s p e c i f i e d i n t h e r e q u e s t ; i n p a r a g r a p h ( c ) w i l l r e s u l t i n i m m i n e n t d a n g e r t o t h e c o n t i n u i n g n e e d o f a p e r s o n f o r w h o m a s u p p l e m e n t i s r m a y a t a n y t i m e r e q u i r e t h a t t h e p e r s o n o b t a i n a n e p r a c t i t i o n e r o t h e r t h a n t h e p r a c t i t i o n e r r e f e r r e d t o i n m e n t f o r a p e r i o d o f 3 c a l e n d a r m o n t h s t o o r f o r a o r f o r a r e c i p i e n t o f d i s a b i l i t y a s s i s t a n c e o r a s s i s t a n c e i f t r e c e i v i n g a s u p p l e m e n t u n d e r s u b s e c t i o n ( 1 ) o f t h i s n d i o n e r c o n f i r m s i n w r i t i n g t h a t t h e r e c i p i e n t o r d e p e n d e n t l o r i c s u p p l e m e n t a t i o n t o a r e g u l a r d i e t a r y i n t a k e t o i n g f r o m e n t . r o v i d e d u n d e r s e c t i o n 6 7 [ n u t r i t i o n a l s u p p l e m e n t ] o f o f t h e f o l l o w i n g i t e m s s p e c i f i e d a s r e q u i r e d i n t h e a c a l o r i c s u p p l e m e n t a t i o n t o a r e g u l a r d i e t a r y i n t a k e , n t h . i t e m s b e c a u s e h e h a s s i g n i f i c a n t m u s c l e m a s s l o s s g u e d t h a t t h e p h y s i c i a n w h o c o m p l e t e d t h e a p p l i c a t i o n c u r a t e l v , a n d h e a c t u a l l y w e i a h s 1 3 0 o o u n d s , n o t 1 5 0 .
APPEAL# I He argued that he requires the requested items to stay alive. The Ministry's position is that the Appellant's application does not meet the legislative requirements for approval of MNS. The physician did not confirm that failure to obtain the requested items will result in imminent danger to the Appellant's life and did not establish that the Appellant is experiencing significant weight loss, and therefore requires caloric supplementation to a regular dietary intake. The Panel notes that the EAPWDR, section 67(1.1) requires that a medical practitioner or nurse practitioner must confirm, among other things, that for the purpose of alleviating a symptom described (malnutrition, underweight status, significant weight loss, significant muscle mass loss, significant neurological degeneration, significant deterioration of a vital organ, moderate to severe immune suppression) failure to obtain the items referred to will result in imminent danger to the person's life. In the application for MNS submitted by the Appellant, that section is blank. With reference to the requirement for nutritional items, section 7 of Schedule C, EAPWDR refers to nutritional items that are part of a caloric supplementation to a regular dietary intake. The Panel finds that the Ministry reasonably determined that the information provided by the Appellant's physician does not confirm that the Appellant is experiencing significant weight loss or that he has a problem absorbing nutrients or has gastritis and vomiting. The Panel finds that the Ministry reasonably concluded that the eligibility criteria set out in EAPWDR section 67 and Schedule C, section 7 have not been met as the medical practitioner has not confirmed the need for Ensure as part of a caloric supplementation to a regular dietary intake to alleviate a listed symptom and prevent imminent danger to life. The Panel therefore confirms the Ministry's decision as reasonably supported by the evidence. EAA T003(10/06/01)
You are being directed to the most recent version of the statute which may not be the version considered at the time of the judgment.