I APPEAL# PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (the "ministry") reconsideration decision of May 28, 2014, which found that the appellant did not meet three of five statutory requirements of section 2 of the Employment and Assistance for Persons With Disabilities Act ("EAPWDA") for designation as a person with disabilities ("PWD"). The ministry found that the appellant met the age requirement and that in the opinion of a medical practitioner the appellant's 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 that • as a result of those restrictions, the appellant requires the significant help or supervision of another person, an assistive device, or the services of an assistance animal. 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 EAAT003(10/06/01)
PART E -S umma rv o f Facts The ministry di d not at tend. Having c onfirmed th at proce eded with the hearing in acco r dance with sectio Re gulation. The informatio n befor e the ministry at the time of reconsiderati • The appe l lant's P W D app l i cation form c onsisting 8, 2014) along with a physician's repo rt ("PR practi tioner of 4 y ea r s (dated D e cemb e r 24, 2013) and a a registered social worke r who had met the ap complet in g the AR (dated December 10, 2 013). • The appe l lant's 3-page hand wr itten recon s ideration submission dated May 20, 2014. Th e pa nel rev iewed the evi dence a s fol low s: D iag no ses • In t h e PR the p h y sician di agnosed t he appel persona l ity disorde r , multi -s u bstance ab use, and diab secon d ary to the d i abetes). The physician wrote m edi catio n for d iab etes, perip h e r al ne urop athy medicati on s wil l at tenuate her symptoms but • Th e physician wrote tha t i t will be diffi c u lt to as health issues a re l o ngsta ndin g, and her d iab only r e c ent l y begun . • Th e s ocial work e r reported the a p pel la nt 's i mpairmen c o ns ta nt pa in i n legs , hands, and fe et when sitt Ph y s i c al Imp air ment • T he physician comment ed in the health history portion peripheral neuropathy" causes painful bur ning activ i ty u ncomfo r t a b le for her. In terms of physical functioning t appell ant can wal k 2 to 4 blocks u na i ded on a f p ounds, and has no limitation with rem ai n i ng seated. • The social worker reported that the appellant mobility and physical ability "due to overwhelmin to 1 hour when walking, climbing stairs, and standing, and is limited to lifting/carrying/holding less than 20 pounds. • In her reconsideration submission the app el lant wrote that her pain "is so feels like I have been hit by a baseball bat and excruciating through out my day everyday." periods of time when she cannot walk or even stand for more than 6 minutes at a time. • In her oral testimony on appeal the appellant said that she had been traumatic stress disorder as a teenager, and that she spent many years addicted to drugs and alcohol. She is now "clean and sober", but while she was addicted she developed diabetes which went untreated for about 3 years, which caused nerve damaqe. EAA T003(10/06/01) AP PEAL# � th e ministry w as not ified o f the h earing, t h e p a nel n 86 (b) of the Employmen t an d A s sistance on included t he f ollowing: o f the appella nt's self-report (da t ed Janua ry ") compl et ed by the appella nt's general sse ssor's r eport ("AR") compl et ed b y pellant f or th e f i rst time f o r t he purpose of lant wi t h d e p re ssi on/a nxiety , bo r derline etes (with possib le p eripheral n europ athy t hat the ap pel lant h as been in iti ated o n a nd d epres sion/anxi ety, and stat ed that t he will no t c u r e t h em. sess the a p pel la nt 's pro gnoses a s her mental etes is of unkno wn duration and tr ea tment h as ts as " anx ie ty, dep ressi on, diabe tes and in g." of the PR that the appe ll ant's "possible in her han d s and fe et which will make a ny he physician r eported tha t t he l at s ur fa c e , c a n c l imb 5+ stairs, can lift 15 to 35 requires periodic assistance with all aspects of g pain." She indicat ed the appellant is limit ed bad that ev eryday it th e shooting pain that run s through my body is She stated that the diabetes pain causes long diagnosed with po st
• T h e a p p e l l a n t s t a t e d t h a t s h e c a n n o t s i t f o r p e r i o d o f t i m e , w h i c h c a u s e s h e r f e e t t o h u r M e n t a l I m p a i r m e n t • T h e p h y s i c i a n d e s c r i b e d t h e a p p e l l a n t ' s m e S h e w r o t e t h a t t h e y i m p a i r t h e a p p e l l a n t ' s a f r e q u e n t w o r k a b s e n c e s . • 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 g e e n a b l e t o m a k e p r o g r e s s o v e r t i m e . " • T h e p h y s i c i a n p r o v i d e d n o r e s p o n s e t o a q u d i f f i c u l t i e s w i t h c o m m u n i c a t i o n , a n d i n d i c a t e 1 2 c a t e g o r i e s o f c o g n i t i v e a n d e m o t i o n a l f u 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 t h a t t h e a p p e l l a • T h e s o c i a l w o r k e r r e p o rt e d t h a t t h e a p p e l l a n 1 4 c a t e g o r i e s o f c o g n i t i v e a n d e m o t i o n a l f u n d i s t u r b a n c e ) , e m o t i o n ( e x c e s s i v e a n x i e t y / d e n e u r o p s y c h o l o g i c a l p r o b l e m s ( l e a r n i n g d i s a i m p a c t o n o n e o t h e r c a t e g o r y : a t t e n t i o n / c o n o r n o i m p a c t s o n t h e r e m a i n i n g 9 c a t e g o r i e s • I n h e r o r a l t e s t i m o n y o n a p p e a l , t h e a p p e l l a n a n d o n o v e r t h e y e a r s , b u t t h a t e v e r y f e w m o t o l o s e h e r j o b a n d s h e w o u l d r e l y o n i n c o m e • T h e a p p e l l a n t s a i d t h a t s h e s e e s h e r p h y s i c i p s y c h i a t r i s t " r e g u l a r l y " . S h e s a i d t h a t t h e p s • T h e a p p e l l a n t s t a t e d t h a t s h e i s h i g h l y m o t i v • I n r e s p o n s e t o q u e s t i o n s f r o m t h e p a n e l , t h e ► S h e h a s b e e n s e e i n g h e r p s y c h i a t r i s t y e a r s ) , a n d r e c e n t l y a b o u t e v e r y 2 m o ► S h e d o e s n ' t k n o w w h y t h e p s y c h i a t r i s m e d i c a t i o n , b u t t h e p s y c h i a t r i s t p r e s c r a n t i d e p r e s s a n t . • I n r e s p o n s e t o a q u e s t i o n i n t h e P R a s t o w h m e d i c a t i o n s o r t r e a t m e n t s t h a t i n t e r f e r e w i t h " S h e m a y h a v e h y p o g l y c e m i c e p i s o d e s o n h c l o s e l y . " • 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 r e s c r i b e d D L A : m e a l p r e p a r a t i o n , b a s i c h o u h a n d s , w r i s t s a n d f e e t ) a n d u s e o f t r a n s p o rt a r e s t r i c t i o n s w i t h 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 a v o i d a n t b e h a v i o u r a n d s e l f m e d i c a t i o n ) . T h o f p e r s o n a l s e l f c a r e , m a n a g e m e n t o f p e r s o n f i n a n c e s , a n d m o b i l i t y i n d o o r s a n d o u t d o o r s . • T h e s o c i a 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 m o s t t a s k s o f m o s t D L A , a n d c o m m e n t e d t h a w h e n e v e r s h e g o e s o u t i n p u b l i c o r h e r a n x i e D L A o f s o c i a l f u n c t i o n i n , t h e s o c i a l w o r k e r c E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # m o r e t h a n 2 m i n u t e s , t h e n s h e h a s t o s t a n d f o r a t s o s h e h a s t o s i t d o w n a g a i n . n t a l i m p a i r m e n t s a s b e i n g " m o d e r a t e l y s e v e r e " . b i l i t y t o m a n a g e s t r e s s a p p r o p r i a t e l y a n d r e s u l t i n t t i n g o n g o i n g c o u n s e l l i n g w h i c h " h o p e f u l l y w i l l e s t i o n a s t o w h e t h e r t h e a p p e l l a n t e x p e r i e n c e s a n y d t h a t t h e a p p e l l a n t h a s s i g n i f i c a n t d e f i c i t s i n 2 o f c t i o n i n g : e m o t i o n a l d i s t u r b a n c e a n d m o t i v a t i o n . n t ' s a b i l i t y t o c o m m u n i c a t e i s g o o d i n a l l r e s p e c t s . t ' s m e n t a l i m p a i r m e n t h a d m a j o r i m p a c t s o n 4 o f c t i o n i n g : b o d i l y f u n c t i o n s ( e a t i n g p r o b l e m s / s l e e p p r e s s i o n ) , m o t i v a t i o n , a n d o t h e r b i l i t i e s ) . T h e s o c i a l w o r k e r r e p o r t e d a m o d e r a t e c e n t r a t i o n ( p o o r s h o r t t e r m m e m o r y ) , a n d m i n i m a l . t s a i d t h a t s h e h a s w o r k e d a t p a i d e m p l o y m e n t o f f n t h s h e r a n x i e t y a n d d e p r e s s i o n w o u l d c a u s e h e r a s s i s t a n c e . a n n o w a b o u t o n c e a w e e k , a n d s h e s e e s h e r y c h i a t r i s t r e c e n t l y t o o k h e r o f f a n t i d e p r e s s a n t s . a t e d , b u t t h a t h e r a n x i e t y h o l d s h e r b a c k . a p p e l l a n t s a i d t h a t : o f f a n d o n s i n c e t h e a g e o f 1 8 ( m o r e t h a n 2 0 n t h s . t t o o k h e r o f f h e r m o s t r e c e n t a n t i d e p r e s s a n t i b e d a n o t h e r m e d i c a t i o n w h i c h m a y c o n t a i n a n e t h e r t h e a p p e l l a n t h a s b e e n p r e s c r i b e d a n y h e r a b i l i t y t o p e r f o r m D L A , t h e p h y s i c i a n w r o t e e r d i a b e t i c m e d i c a t i o n i f s u g a r s a r e n o t m o n i t o r e d p e l l a n t h a s p e r i o d i c r e s t r i c t i o n s w i t h 4 o f t h e 1 O s e w o r k , d a i l y s h o p p i n g , ( b e c a u s e o f p a i n i n t i o n . S h e r e p o rt e d t h e a p p e l l a n t h a s c o n t i n u o u s ( b e c a u s e o f a n x i e t y / d e p r e s s i o n a n d r e s u l t i n g e p h y s i c i a n i n d i c a t e d n o r e s t r i c t i o n s w i t h t h e D L A a l m e d i c a t i o n s , m a n a g e m e n t o f p e r s o n a l t r e q u i r e s p e r i o d i c o r c o n t i n u o u s a s s i s t a n c e w i t h t t h e a p p e l l a n t " M u s t h a v e a f r i e n d w i t h h e r t y b e c o m e s o v e rw h e l m i n g . " W i t h r e s p e c t t o t h e o n c l u d e d t h a t t h e a e l l a n t i s f u n c t i o n a l t h o u h
m a r g i n a l l y w i t h r e s p e c t t o h e r i m m e d i a t e a p p e l l a n t " I s o l a t e s s e l f e x c e p t f e w g o o d f r i e u n l e s s p r o v o k e d " . T h e s o c i a l w o r k e r i n d i c a a p p r o p r i a t e s o c i a l d e c i s i o n s a n d i n t e r a c t s a p e r i o d i c s u p p o r t / s u p e r v i s i o n w i t h d e v e l o p i n s u p p o r t / s u p e r v i s i o n d e a l i n g a p p r o p r i a t e l y w f r o m o t h e r s . • W i t h r e s p e c t t o u s e o f t r a n s p o r t a t i o n , t h e s o 3 t i m e s l o n g e r t h a n t y p i c a l g e t t i n g i n a n d o u t h a n t a k e p u b l i c t r a n s p o r t a t i o n b e c a u s e o f a • 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 D L d a i l y d u e t o s e v e r e p a i n . S h e w r o t e t h a t " I n a n x i t y ( s i c ) i s v e r y h i g h a n d t e n d t o h a v e p a • I n h e r r e c o n s i d e r a t i o n s u b m i s s i o n t h e a p p e a l o n e . S h e s t a t e d t h a t " I n e e d h e l p w i t h i n m m e a l s , l a u n d r y , g r o c e r y s h o p p i n g . . . " • I n h e r o r a l t e s t i m o n y t h e a p p e l l a n t s a i d t h a t F e b r u a r y b e c a u s e o f s o m e o n e e l s e w h o w a h a s 2 r o o m m a t e s , a n d t h a t s h e h a s b e e n a d h e r c u s t o d y . • I n r e s p o n s e t o q u e s t i o n s f r o m t h e p a n e l , t h e ► W h e n h e r c h i l d r e n a r e h o m e s h e p l a n w h e n s h e ' s c o o k i n g f o r h e r s e l f s h e " k h a s b e e n d o i n g s o m e c o o k i n g f o r h e r ► S h e h a s h i g h a n x i e t y a n d h y p e r v e n t i l h a s t o t a k e a l i s t , a n d w i l l w a l k o u t o f a f r i e n d o r r o o m m a t e f o r s u p p o r t w h e s h o p p i n g b e c a u s e u s u a l l y i f s o m e o n e H e l p • T h e p h y s i c i a n a n d t h e s o c i a l w o r k e r b o t h i n d p r o s t h e s e s o r a i d s f o r h e r i m p a i r m e n t . T h e d o e s n o t h a v e a n a s s i s t a n c e a n i m a l . • T h e p 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 r e o p e n j a r s , a n d u s e u t e n s i l s f o r c u t t i n g f o o d d • T h e s o c i a l w o r k e r i n d i c a t e d t h a t t h e a p p e l l a n p s y c h i a t r i s t , a n d A A . A d m i s s i b i l i t y o f A d d i t i o n a l I n f o r m a t i o n I n h e r o r a l t e s t i m o n y t h e a p p e l l a n t p r o v i d e d a d d i t i o i m p a c t s o n h e r a b i l i t y t o m a n a g e D L A . T h i s i n f o r m a r e s p e c t t o m a t t e r s r a i s e d i n t h e o r i g i n a l P W D a p p l i c n e w i n f o r m a t i o n a s b e i n g i n s u p p o rt o f i n f o r m a t i o n a t i m e o f r e c o n s i d e r a t i o n , i n a c c o r d a n c e w i t h s . 2 2 ( 4 ) T h e m i n i s t r v d i d n o t a t t e n d t h e h e a r i n a a n d s u b m i t t E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # 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 , c o m m e n t i n g t h a t t h e n d s " a n d " i s o l a t e s s e l f a n d w i l l n o t c o m m u n i c a t e t e d t h a t t h e a p p e l l a n t i n d e p e n d e n t l y m a k e s p p r o p r i a t e l y w i t h o t h e r s , b u t t h a t s h e n e e d s g / m a i n t a i n i n g r e l a t i o n s h i p s , a n d c o n t i n u o u s i t h u n e x p e c t e d d e m a n d s a n d s e c u r i n g a s s i s t a n c e c i a l w o r k e r 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 t a k e s u p t o t o f " l o w e r c a r s " , a n d t h a t s h e p r e f e r s t o w a l k r a t h e r n x i e t y . A a r e d i f f i c u l t a n d s h e n e e d s s o m e o n e t o h e l p e e d h e l p s o m e t i m e s l e a v i n g m y h o m e a s m y n i c a t t a c k s r e g u l a r l y . " l l a n t w r o t e t h a t s h e d o e s n o t o f t e n l e a v e h e r h o m e y h o m e t o b a s i c h o u s k e e p i n g ( s i c ) , p r e p a r i n g h e r 2 c h i l d r e n w e r e r e m o v e d f r o m h e r h o m e i n s l i v i n g i n h e r h o m e . S h e s a i d t h a t s h e c u r r e n t l y v i s e d t h a t h e r c h i l d r e n a r e g o i n g t o b e r e t u r n e d t o a p p e l l a n t s t a t e d t h a t : s m e a l s f o r t h e m u p t o a w e e k a h e a d o f t i m e , b u t e e p [ s ] i t s i m p l e . " R e c e n t l y o n e o f h e r r o o m m a t e s . a t e s w h e n s h e h a s t o g o g r o c e r y s h o p p i n g . S h e t h e s t o r e i f t h e r e a r e a l o t o f p e o p l e . S h e r e l i e s o n n s h e g o e s t o t h e s t o r e , b u t s h e h a s t o g o e l s e d o e s i t f o r h e r t h e y g e t t h e w r o n g t h i n g s . 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 y s o c i a l w o r k e r a l s o c o n f i r m e d t h a t t h e a p p e l l a n t q u i r e s a s s i s t a n c e f r o m o t h e r s t o c a r r y g r o c e r i e s , u r i n g m e a l p r e p a r a t i o n . t r e c e i v e s a s s i s t a n c e f r o m h e r c h i l d r e n , f r i e n d s , n a l i n f o r m a t i o n r e g a r d i n g h e r i m p a i r m e n t a n d t h e i r t i o n g e n e r a l l y p r o v i d e s a d d i t i o n a l d e t a i l w i t h a t i o n . A c c o r d i n g l y , t h e p a n e l h a s a d m i t t e d t h i s n d r e c o r d s t h a t w e r e b e f o r e t h e m i n i s t r y a t t h e o f t h e E m p l o y m e n t a n d A s s i s t a n c e A c t . e d n o a d d i t i o n a l i n f o r m a t i o n .
I APPEAL# PART F -Reasons for Panel Decision The issue on this appeal is whether the ministry's decision to deny the appellant designation as a PWD was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. In particular, was the ministry reasonable in determining that the appellant does not have a severe physical or mental impairment, and that in the opinion of a prescribed professional the appellant's impairments do not directly and significantly restrict her from performing DLA either continuously or periodically for extended periods, and that as a result of those restrictions the appellant does not require help to perform DLA. The relevant legislation is as follows: EAPWDA: 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. EAAT003(10/06/01)
I APPEAL# EAPWDR section 2(1): 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; (iii) shop for personal needs; (iv) use public or personal transportation facilities; (v) perform housework to maintain the person's place of residence in acceptable sanitary condition; (vi) move about indoors and outdoors; (vii) perform personal hygiene and self care; (viii) manage personal medication, and (b) in relation to a person who has a severe mental impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. (2) For the purposes of the Act, "prescribed professional" means a person who is (a) authorized under an enactment to practise the profession of (i) medical practitioner, (Ii) registered psychologist, (Iii) registered nurse or registered psychiatric nurse, (iv) occupational therapist, (v) physical therapist, (vi) social worker, (vii) chiropractor, or (viii) nurse practitioner, or (b) acting in the course of the person's employment as a school psychologist by (i) an authority, as that term is defined in section 1 (1) of the Independent School Act, or (ii) a board or a francophone education authority, as those terms are defined In section 1 (1) of the School Act, if qualifications in psychology are a condition of such employment. ******* Severe Physical Impairment The appellant's position is that the pain she experiences as a result of her diabetes and related neuropathy constitutes a severe physical impairment. She said that she experiences constant pain which limits all physical activities. EAAT 003(10/06/01)
I APPEAL# The ministry's position, as set out in its reconsideration decision, is that the evidence does not establish a severe physical impairment. The ministry stated that the appellant's functional skills are not significantly restricted and that no assistive devices are routinely used. Panel Decision A diagnosis of a serious medical condition does not in itself determine PWD eligibility or establish a severe impairment. An "impairment" is a medical condition that results in restrictions to a person's ability to function independently or effectively. 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. A medical barrier to the appellant's ability to engage in paid employment is not a legislated criterion for severity. In making its determination the ministry must consider all the relevant evidence, including that of the appellant. While the legislation is clear that the fundamental basis for the analysis is the evidence from prescribed professionals, in exercising its decision-making power the ministry cannot merely defer to the opinion of the professionals with respect to whether the statutory requirements are met as that approach would amount to an improper fettering of discretion. The professional evidence has to be weighed and assessed like any other evidence. In the appellant's case, because the social worker had only met the appellant for the first time in order to complete the AR, and because the social worker did not have the benefit of the physician's diagnoses or clinical reports, the panel has given more weight to the physician's evidence where the two are inconsistent with each other. The evidence indicates that the appellant's physical impairment is substantially based on pain due to secondary peripheral neuropathy. The physician is tentative about the existence of neuropathy describing it as being "possible". The physician also wrote that the prognosis is uncertain and that the appellant had "only recently'' begun treatment. She indicated that time will be needed to determine how well the condition will respond to treatment. This evidence, in conjunction with the physician's description of the appellant's physical functioning which is in the mid-range of ability, supports the ministry's conclusion that the evidence does not establish a severe physical impairment. In the panel's view the ministry's determination on this criterion was reasonable. Severe Mental Impairment The appellant's position is that her depression, anxiety, and learning disability constitute a severe mental impairment. The appellant argues that she usually cannot leave her home alone, and so cannot independently manage her DLA. The ministry's position, as set out in its reconsideration decision, is that the evidence does not demonstrate a severe mental impairment. The ministry argues there is no recent psychiatric assessment to substantiate the appellant's evidence regarding the effects of her mental health condition. EAAT003(10/06/01)
P a n e l D e c i s i o n S e c t i o n 2 ( 1 ) ( b ) o f t h e E A P W D R p r e s c r i b e s t w o D L d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e o r f i n a n c e i n t e r a c t w i t h o t h e r s e f f e c t i v e l y ( s o c i a l f u n c t i o n i n g ) . T h e e v i d e n c e i n d i c a t e s t h a t t h e a p p e l l a n t i s n o t s i g i n t h a t a c c o r d i n g t o t h e p h y s i c i a n ' s e v i d e n c e s h f i n a n c e s a n d m a n a g i n g p e r s o n m e d i c a t i o n s . S h e t a s k s r e l a t e d t o s o c i a l f u n c t i o n i n g ( m a k e s a p p r o p r i a p p e l l a n t i n d i c a t e d t h a t s h e g e n e r a l l y p l a n s m e a l s w i t h h e r . T h e s o c i a l w o r k e r i n d i c a t e d t h a t t h e a p p a p p r o p r i a t e c h o i c e s d u r i n g t h e D L A o f d a i l y s h o p p i n a t u r e o f t h e s u p p o r t i s w i t h r e s p e c t t o d e a l i n g w i t h O n b a l a n c e t h e p a n e l c o n c l u d e s t h a t t h e e v i d e n c e m a k i n g . W i t h r e s p e c t t o s o c i a l f u n c t i o n i n g , t h e e v i d e n c e i n d l e v e l , s u f f i c i e n t t o m e e t h e r b a s i c n e e d s . S h e h a s n e t w o r k o f " f e w g o o d f r i e n d s " . W i t h r e s p e c t t o f u n c t i o n a l s k i l l s , t h e e v i d e n c e i n d i c a g o o d i n a l l r e s p e c t s . T h e s o c i a l w o r k e r h a s i n d i c a t e m o t i o n a l f u n c t i o n i n g , i n c o n t r a s t t o t h e p h y s i c i a n ' s d e f i c i t s . A s d i s c u s s e d a b o v e , t h e p a n e l h a s g i v e n p a n e l n o t e s t h a t a f t e r m o r e t h a n 2 0 y e a r s o f s e e i n g a p p e l l a n t w o u l d h a v e s u b m i t t e d s o m e c o r r o b o r a t i n g d e m o n s t r a t e t h e s e v e r i t y o f h e r i m p a i r m e n t a n d t h e A s d i s c u s s e d i n m o r e d e t a i l i n t h e s u b s e q u e n t s e c t R e s t r i c t i o n s t o D L A , a n y l i m i t a t i o n s r e s u l t i n g f r o m t t r a n s l a t e d i n t o 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 h e r a b i l i t y t o C o n s i d e r i n g t h e e v i d e n c e a s a w h o l e , t h e p a n e l c o n t h a t i t d o e s n o t d e m o n s t r a t e a s e v e r e m e n t a l i m p a i S i g n i f i c a n t R e s t r i c t i o n s t o 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 a b i l i t y t o p e r f o r m a n x i e t y . S h e a r g u e d t h a t p a i n l i m i t s v i rt u a l l y a l l o f h f r i e n d w i t h h e r w h e n e v e r s h e g o e s o u t i n p u b l i c o r 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 a s t h e a p p e l l a n t ' s f u n r e m e d i a l m e a s u r e s h a v e b e e n u n d e r t a k e n i n c l u d i n g i n f o r m a t i o n 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 d o e s t h e a o o e l l a n t ' s D L A e i t h e r c o n t i n u o u s l v o r p e r i o d i c a E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # A t h a t a r e s p e c i f i c t o m e n t a l i m p a i r m e n t m a k e s ( d e c i s i o n m a k i n g ) , a n d r e l a t e t o , c o m m u n i c a t e o r n i f i c a n t l y r e s t r i c t e d w i t h r e s p e c t t o d e c i s i o n m a k i n g e i s n o t r e s t r i c t e d i n t h e D L A o f m a n a g i n g p e r s o n a l a l s o i n d e p e n d e n t l y m a n a g e s t h e d e c i s i o n m a k i n g a t e s o c i a l d e c i s i o n s ) a n d m e a l p r e p a r a t i o n , a s t h e a w e e k i n a d v a n c e w h e n h e r c h i l d r e n a r e l i v i n g e l l a n t 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 w i t h m a k i n g n g , b u t t h e a p p e l l a n t ' s t e s t i m o n y i n d i c a t e d t h a t t h e h e r a n x i e t y , n o t w i t h m a k i n g a p p r o p r i a t e c h o i c e s . i n d i c a t e s t h e a p p e l l a n t m a n a g e s h e r o w n d e c i s i o n i c a t e s t h 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 a m a r g i n a l a t e n d e n c y t o s e l f i s o l a t e , b u t s h e a l s o h a s a t e s 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 c o m m u n i c a t e i s e d m a j o r i m p a c t s t o 4 c a t e g o r i e s o f c o g n i t i v e a n d e v i d e n c e t h a t 2 c a t e g o r i e s h a v e s i g n i f i c a n t m o r e w e i g h t t o t h e p h y s i c i a n ' s e v i d e n c e . T h e h e r p s y c h i a t r i s t , o n e w o u l d e x p e c t t h a t t h e m e d i c a l i n f o r m a t i o n f r o m h e r p s y c h i a t r i s t t o p r o g n o s i s f o r i t s t r e a t m e n t . i o n o f t h i s d e c i s i o n u n d e r t h e h e a d i n g S i g n i f i c a n t h e a p p e l l a n t ' s i m p a i r m e n t s d o n o t a p p e a r t o h a v e m a n a g e h e r D L A i n d e p e n d e n t l y . c l u d e 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 d e t e r m i n e d r m e n t . D L A i s 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 p a i n a n d e r p h y s i c a l a c t i v i t i e s , a n d t h a t s h e m u s t h a v e a e r a n x i e t y b e c o m e s o v e r w h e l m i n g . c t i o n a l s k i l l s a r e n o t s i g n i f i c a n t l y r e s t r i c t e d , a n d a s m e d i c a t i o n t o a m e l i o r a t e h e r s y m p t o m s , t h e n o t e s t a b l i s h t h a t i m p a i r m e n t s i g n i f i c a n t l y r e s t r i c t s l l v f o r e x t e n d e d p e r i o d s .
Pan e l Decisio n Th e le gislatio n -s. 2(2 ) (b ) (i) of the EAPWDA-requires the and s ignificant restri c tion s of DLA in consideration of the case the appellant's g eneral pra ctition e r. Thi s doesn't mean that other evidence shouldn't factored in as requ ired to provi d e clarificati o n of the language ma k e s it clear t hat th e prescri bed profess determination as to whether it is "satisfied". The legislat ion re quires that a s e v e re impairmen t direc ab i l i ty to perform DLA either con ti nuous l y or p eriodic m ean s that there must be a ca usal link between the severe impa restr iction must also be significa n t. Finally, there is a component related to time or duration. di r ect a n d significant re st r ic tion may be either conti ext e n ded ti m e . In h ere ntly, any analysis of p e r iodicit frequency. A l l other thi ng s being equal, a restriction t s ignificant th a n on e which o ccurs severa l t im e s a we evidence in dicates t ha t a rest riction aris es periodi c req ui re evidenc e o f the du rat ion and fr e quen cy of the re l eg islative cri t eri on i s met. There are re f e re nc es in the ev i dence to the i m pact the ap ab ility to work at p a id e mplo ym ent . Th e pane l notes that e regardi ng P WD desi g na tion -th e fo cus of the le gi slati The phy s ician indi c a t ed that the app ell ant's ability to per bas i c housew or k, daily shopp in g, and u s e of t ransportat (c ontinu ously). However , the exa m ples g i v en by th t h e restricti ons d o no t indicate t ha t th e rest ric tions are appellant periodically requi res assistance wi t h carrying gro pound lifti ng limit noted by the social worker), opening jars, and cutting food during meal prep With respect to use of transportation, the evidence of the social worker indicates that the appellant has d i fficulty get ting i n and out of "lower cars", and that she prefers to walk rather than to use public transit. With respect to basic housew o rk, the physici p eriodically has difficulty due to pain in hands, wr ists these periods occur or how long they l ast. The p a nel the appellant has only recently started on treatment to ameliorate the effects of the diabetes, and that it is too early to determine the extent to which treatm respec t to restrictions caused by the appella n t's m ental appellant's psychiatrist to v erify or d escr ibe the extent of The panel's assessment of the DLA of decision-making and social functioning was provided in the previous section under the heading Severe Mental Impairment. Considering the evidence as a whole, the pan e l is of the view that the ministry reasonably concluded that the evidence does not establish that the a ellant's im EAA T003(10/06/01) '. A PPEA L# m i nister to substantial ly assess direct opinion of a prescri bed professional, in th i s be p rof ess ional evidence, b u t the le gis lative io nal ' s opinion is fun d amen tal to t he m i nistry's tly and significantly restri cts the appell ant's ally for extended periods. T h e ter m " d i r ectly " ir m ent and the rest r ic tio n. The d ir ect The nuo us o r pe riod ic. If it is pe riodic it m ust be f o r a n y m ust also in cl u de con s ider ation of th e h at o nl y ari ses once a year is less l i kely t o b e ek. Acco rdingly , in ci r cumstance s wh ere t h e a l ly, it i s enti rely a p prop riate for the ministry to st r ic tion i n order to be "satisf i ed" th at thi s pe l lant 's medica l con di t i on s ha v e on her mployabil ity is not a statutory cri te ri on on is on t h e a bilit y to pe rfor m DLA. form 5 DLA is re s tr i ct ed: meal pre pa rat io n, io n (all period ically), and social functioning e p h ysician a nd t h e appe l lant a s to the n a t ure of "signifi cant" . Th e physi cian i n dicated t ha t the ceries (presumably in excess of the 20 arat i on. a n mer ely in d ic a ted t hat t he appellant and fee t. There is no indica t io n as t o how of t en notes al so that th e p hys ic ian has i ndicated tha t ent may reduce her symptoms. Similarly, with c ondition, there is no evidence from t h e t he r estrictions. airments si nificantl restrict her DLA
either co n t i nuously o r periodical ly f or extended periods. Help with D L A The appellant's posit ion is that she requires help fr all DLA. The ministry's positi on is that since it has not been established that signific antly re s tricted, it c annot be de termin e d that significant help is Panel De cisi on A finding that a severe impai rm ent direct ly and significantly res DLA e ither contin uously or period ic a lly for an extended period is a p " hel p" as defined by sectio n 2(3}(b} of the EAPWDA. pr econdi tion h a s n o t been satis fied on t he bal a n ce Ac co rdingly, the pane l fi n d s t hat th e minis t ry re asonably t he appe ll a n t req uires help wi th DLA as defin ed by s Co nc l u sion The pa ne l acknowle dg e s th at th e a ppe lla nt 's medical conditions affect Ho w ev er, h a ving r eview ed and c ons i der ed all of the evi find s th at t he m inistry 's d ecision find ing the a ppel lant ap pl i ca ti on of t he legislation in t he circum st a n ce s of th mini stry's dec is io n . EAA T003(10/06/01) APP E A L# : om her friends and roommate to perform v irtually the app e l l ant's DLA are re q uire d from other persons. t ricts a pers o n's ability to m anage her recon d ition to a person requiring For the reasons provi de d above, that of pr obab ilities in t h is case. conc lu ded i t could not be determined t hat e c tion 2 ( 3}( b} of the EAPW D A. her ability to funct i o n. denc e and th e relevant le g i s l ation, th e panel i neli g i ble for PW D d esignatio n is a re asonable e a ppel lant. Th e p ane l t her efore confirm s t he
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