Ministry of Social Development and Poverty Reduction

Decision Information

Decision Content

PART C -Decision under Appeal The decision under a pp e al is the Mi nistry of Social D reconsideration decisi o n d ate d Jun e 3, 2014 w h ich denie transportation suppleme n t because, in regards t o: Ac commodations: t he least expens iv e and appro Mea ls: the appellant is not el i g i ble for t he $ 4 the cost of the accommodations or that sh ould prior to and after her tr ip a n d that her $ 40 per c over the a dditiona l cost of m e etin g her dietary Transpor t ation: the ministry was not provid e d appe llant claims w hic h vary immen se ly from the ministry's own ca P A R T D Relevant Legisl a t io n Employme n t an d A s si s t ance for P ersons W it h D isabil Employme n t an d A s si s t ance for Pe rsons W it h Disabil S ec tio n s 2( f). EMT 003(10/06/01) APPEAL# e velopmen t and S oci al Innovation (the ministry) d the appellant's requ es t for a medical priate acc om moda ti o ns were not were used; meal allowance for meals that we re i n cluded in have been c ons u med at t h e appellant's hom e m on th dietary s upplement a llowance s hou l d nee d s ; with a d e tailed d e sc ription of the kilomete rs the l cu l a t i on of the same tri p . ities Regul a t ion (EAPWDR) , S ect ion 62. ities R egulation ( EAPWDR) , S ch edule C ,
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 1 ) A 4 p a g e l e t t e r d e s c r i b i n g t h e r a t e s a n d a m m e d i c a l t r i p ; 2 ) A l e t t e r f r o m a d o c t o r i n d i c a t i n g t h e a p p e l l a n 1 6 a t 8 : 3 0 a m ) , a n d i n s t r u c t i o n s f o r t h e p r o c e 3 ) A R e q u e s t f o r N o n L o c a l M e d i c a l T r a n s p o r t c o m p l e t e d b y t h e a p p e l l a n t s i g n e d a n d d a t e 4 ) A p p o i n t m e n t c o n f i r m a t i o n f o r T h u r s d a y D e c 5 ) 2 c h e q u e s t u b s s h o w i n g p a y m e n t s o f $ 1 8 2 . 2 0 1 3 . 6 ) A 2 p a g e l e t t e r d a t e d F e b r u a r y 5 , 2 0 1 4 a n d a d v o c a t e ) s t a t i n g t h a t t h e a p p e l l a n t s u f f e r s f d e v e l o p m e n t a l l y c h a l l e n g e d , a n d n e e d s s p e T h e a d v o c a t e a l s o o u t l i n e s t h e p r o c e d u r e s t h o s p i t a l , a n d e x p l a i n s t h a t a l i f t e q u i p p e d m i a p p e l l a n t ' s p o w e r c h a i r f o r m o b i l i t y . T h e i t e m $ 7 0 4 . 2 8 , M e a l s ( 5 d a y s x 3 p e o p l e x $ 1 2 / d a $ 2 8 8 . 0 0 , P a r k i n g ( 3 d a y s @ $ 2 0 ) = $ 6 0 , a n d r e g i s t e r e d x 2 c r o s s i n g s ) = $ 1 7 . 0 0 f o r a t o t a r e c e i v e d f r o m t h e m i n i s t r y t h u s f a r . T h e a p p 7 ) A b i l l f r o m t h e h o t e l f o r a t o t a l o f $ 7 0 4 . 2 8 8 ) A l e t t e r f r o m a l o c a l p h y s i c i a n s i g n e d a n d d a a p p e l l a n t ' s m e d i c a l c o n d i t i o n s a n d d e v e l o p m s i s t e r ) a t t e n d a n t b e m a d e a v a i l a b l e f o r t h e o 9 ) A 4 p a g e l e t t e r d a t e d M a y , 6 , 2 0 1 4 a n d s i g n d e s c r i p t i o n o f t h e h o t e l r o o m s a n d a m e n i t i e s b e c h a r g e d t h e m e d i c a l r a t e f o r h e r r o o m w h H o w e v e r , t h e h o t e l y i e l d e d h e r r a t e t o t h e s e 1 0 ) A ( u n d a t e d ) l e t t e r f r o m t h e a p p e l l a n t ' s o u t o f h a d a n a p p o i n t m e n t o n D e c e m b e r 1 7 , 2 0 1 3 I n t h e R e q u e s t f o r R e c o n s i d e r a t i o n t h e a p p e l l a n t ' s c o s t s t h a t w e r e i n c l u d e d i n t h e l e t t e r d a t e d F e b r u a ry t h a t t h e m i n i s t r y c a n n o t p a y t h e f e e f o r a n u n r e g i s t e r e a s o n a b l e , t h e r e w a s n o b r e a k d o w n o f w h a t w a s p a i d s h e w o u l d a c c e p t t h e t r a n s p o rt a t i o n a m o u n t . T t h e m e a l a l l o w a n c e e i t h e r a n d t h a t d u e t o t h e a p p e l h o t e l w a s i n s u f f i c i e n t . T h e r e f o r e t h e r e w a s a n a d d i a d v o c a t e s t a t e s t h a t t h e r e w a s n o b r e a k d o w n p r o v o f $ 7 0 4 . 2 8 w a s s u b m i t t e d p r i o r t o t h e t r i p ( w i t h o u t q t h e o r i g i n a l r e q u e s t f o r a d d i t i o n a l p a y m e n t s . T h e r e t h e s e n i o r ' s r a t e . T h e a p p e l l a n t h a s u s e d t h i s h o t e l v e h i c l e r e q u i r e d f o r h e r p o w e r c h a i r . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # '. r e c o n s i d e r a t i o n d e c i s i o n c o n s i s t e d o f : e n i t i e s o f t h e h o t e l t h e a p p e l l a n t u t i l i z e d f o r h e r t ' s a p p o i n t m e n t l o c a t i o n , d a t e a n d t i m e ( D e c e m b e r d u r e s h e u n d e r w e n t ; a t i o n A s s i s t a n c e f o r m o r S e r v i c e R e q u e s t 1 d N o v e m b e r 2 7 , 2 0 1 3 ; e m b e r 1 7 a t 3 : 0 0 p m ; 5 0 a n d $ 7 9 2 . 5 8 t h a t w e r e d a t e d D e c e m b e r 1 1 , s i g n e d b y t h e a p p e l l a n t ' s s i s t e r ( w h o i s a l s o h e r r o m M y o t o n i c M u s c u l a r D y s t r o p h y ( M M D ) , i s c i a l i z e d c a r e t h a t i s o n l y a v a i l a b l e i n a n o t h e r c i t y . h e a p p e l l a n t u n d e r w e n t d u r i n g h e r v i s i t s t o t h e n i b u s w a s u s e d f o r t r a v e l i n g t o a c c o m m o d a t e t h e i z e d l i s t f o r e x p e n s e s i s a s f o l l o w s : H o t e l = y ) = $ 1 8 0 , T r a n s p o r t a t i o n ( 9 6 0 k m @ $ 0 . 3 0 / k m ) = B r i d g e T o l l s ( $ 8 . 5 0 f o r l a r g e v e h i c l e / n o n ­ l o f $ 1 2 4 9 . 2 8 . T h e p a y m e n t o f $ 9 7 5 . 0 8 h a s b e e n e l l a n t i s r e q u e s t i n g t h e d i f f e r e n c e o f $ 2 7 4 . 2 0 . t e d N o v e m b e r 1 9 , 2 0 1 3 t h a t s t a t e s t h a t d u e t o t h e e n t a l d e l a y s t h a t a s e c o n d ( i n a d d i t i o n t o h e r u t o f t o w n m e d i c a l a p p o i n t m e n t ; e d b y t h e h o t e l ' s g e n e r a l m a n a g e r , p r o v i d e s a , a n d e x p l a i n s t h a t o r i g i n a l l y t h e a p p e l l a n t w a s t o i c h w o u l d h a v e b e e n $ 1 6 0 p l u s t a x p e r n i g h t . n i o r ' s r a t e w h i c h w a s $ 1 5 3 . 1 0 p l u s t a x p e r n i g h t . t o w n c a r d i o l o g i s t ' s o f f i c e s t a t i n g t h a t t h e a p p e l l a n t a n d a r e t u r n v i s i t o n D e c e m b e r 1 8 , 2 0 1 3 . a d v o c a t e ( s i g n e d b u t n o t d a t e d ) s u m m a r i z e d t h e 5 , 2 0 1 4 . I t a l s o s t a t e d t h a t t h e a p p e l l a n t a c c e p t s r e d v e h i c l e , $ 6 0 f o r 3 d a y s o f p a r k i n g i s p a i d f o r t r a n s p o r t a t i o n a n d t h a t i f a l l b u t 4 k m w a s h e a p p e l l a n t s t a t e s t h a t t h e r e i s n o b r e a k d o w n o f l a n t ' s d i e t a r y n e e d s t h e b r e a k f a s t p r o v i d e d a t t h e t i o n a l c o s t f o r b r e a k f a s t . A s f o r t h e h o t e l c o s t s t h e i d e d f o r t h e h o t e l r e i m b u r s e m e n t . T h e h o t e l c o s t u e s t i o n ) , a n d t h e h o t e l r e c e i p t w a s s u b m i t t e d w i t h c e i p t s h o w s t h a t t h e m e d i c a l r a t e w a s a p p l i e d n o t i n t h e p a s t a s i t c a n a c c o m m o d a t e t h e o v e r s i z e d
I n t h e N o t i c e o f A p p e a l , t h e a p p e l l a n t s t a t e s t h a t s i n f o r m a t i o n r e q u i r e d , i n c l u d i n g t h e h o t e l r a t e b e f o r m i n i s t r y d i s p u t e d t h e h o t e l r a t e . A d m i s s i b i l i t y o f N e w I n f o r m 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 p r o v i d e d n e w e v i d e n c a d d i t i o n a l i n f o r m a t i o n r e g a r d i n g t h e h o t e l a c c o m m a d m i s s i b i l i t y o f t h e n e w e v i d e n c e . T w o p i c t u r e s s h r e l e v a n t t o t h i s c a s e , a n o t h e r s h o w s p a r k i n g a c c o m p r e v i o u s l y a p p r o v e d b y t h e m i n i s t r y , t h e t h i r d i s a p a n d h e r n e c e s s a r y e q u i p m e n t , a n d a f o u r p i c t u r e i s r o o m . T h i s i n f o r m a t i o n 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 a p p l i c a t i o n f o r a h e a l t h s u p p l e m e n t . A c c o r d i n g l y , t b e i n g i n s u p p o r t o f t h e i n f o r m a t i o n a n d r e c o r d s t h a 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 e c t i o n 2 2 ( 4 ) o 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 s i s t e r , w h o i s a l s o h e a r r a n g e m e n t s f o r t h e a p p e l l a n t t o a t t e n d h e r o u t o f S h e i s n o t p a i d t o m a n a g e t h e a f f a i r s o r c a r e o f h e r 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 : T h e a p p e l l a n t m u s t s e e a s p e c i a l i s t f o r h e r M d o e s n o t w o r k l o c a l l y ; S h e c o m p l e t e s t h e n e c e s s a r y r e q u e s t S R 1 1 w a s s u b m i t t e d o n N o v e m b e r 2 7 , 2 0 1 3 f o r t r a w e r e i n c l u d e d i n t h i s f o r m a t $ 7 0 4 . 2 8 ; T h e m i n i s t r y d i d n o t c o n t a c t h e r o r t h e a p p e l N o v e m b e r 2 7 , 2 0 1 3 a n d t h e r e f o r e w a s n e v e p r i o r t o t h e t r i p ; W h e n b o o k i n g a r o o m , s h e m u s t a c c e p t a n y a c c o m m o d a t e t h e a p p e l l a n t ' s e q u i p m e n t . S w a s a f a c t o r ; D u e t o t h e a p p e l l a n t ' s n o i s y e q u i p m e n t , s h e a s s i s t i n g h e r o n t h e t r i p . T h e r e f o r e , a r o o m T w o o f t h e a v a i l a b l e e s c o r t s t h a t a s s i s t t h e a w o r k e r s . T h e m i n i s t r y c a n n o t e x p e c t t h e a p p m a l e c a r e a i d w o r k e r s a n d t h e r e f o r e i t w a s n b e d s ; O n p r e v i o u s t r i p s f o r m e d i c a l a p p o i n t m e n t s s h a v e t a k e n t u r n s s l e e p i n g o n t h e h o t e l f l o o r w a v a i l a b l e . ; T h e m i n i s t r y h a s n e v e r a d v i s e d h e r t h a t h o t e d o w n o f i t s c o s V p a y o u t s t r u c t u r e ; W h e n c h o o s i n g a h o t e l , s h e m u s t a l s o e n s u r b u s u s e d t o t r a n s n o r t t h e a n n e l l a n t a n d h e r e E M T 0 0 3 ( 1 0 / 0 6 / 0 1 ) A P P E A L # h e p r o v i d e d a S e r v i c e R e q u e s t 1 f o r m w i t h a l l t h e e d e p a r t u r e . I t w a s o n l y a f t e r s h e r e t u r n e d t h a t t h e e , 5 c o p i e d p h o t o g r a p h s . T h e c o p i e s p r o v i d e d o d a t i o n s . T h e m i n i s t r y d i d n o t o b j e c t t o t h e o w t h e p a r k i n g a c c o m m o d a t i o n s a t t h e h o t e l m o d a t i o n s a t a n o t h e r h o t e l i n t h e s a m e c i t y i c t u r e o f t h e s h u t t l e u s e d t o t r a n s p o r t t h e a p p e l l a n t o f a m a l e c a r e a i d s l e e p i n g o n t h e f l o o r o f a h o t e l i t h r e s p e c t t o i s s u e s a d d r e s s e d i n t h e o r i g i n a l h e p a n e l h a s a d m i t t e d t h i s n e w i n f o r m a t i o n a s 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 t i m e o f 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 . r a d v o c a t e , p o i n t e d o u t t h a t s h e m a k e s a l l o f t h e t o w n m e d i c a l a p p o i n t m e n t s o n a v o l u n t a r y b a s i s . s i s t e r . S h e a l s o s t a t e d t h e f o l l o w i n g r e g a r d i n g t h e M D a n d o t h e r m e d i c a l n e e d s , a n d t h e s p e c i a l i s t 0 -1 4 d a y s p r i o r t o a n y t r i p . F o r t h i s t r i p , t h e f o r m v e l o n D e c e m b e r 1 5 , 2 0 1 3 , a n d t h e h o t e l c o s t s l a n t r e g a r d i n g a r e v i e w o f t h e S R 1 f o r m s u b m i t t e d r a d v i s e d t h a t t h e h o t e l c o s t w a s n o t a c c e p t a b l e r o o m t h a t i s a v a i l a b l e a t t h e t i m e t h a t c a n a l s o i n c e i t w a s c l o s e t o C h r i s t m a s r o o m a v a i l a b i l i t y m u s t h a v e a r o o m s e p a r a t e f r o m t h e o t h e r s w i t h a s e p a r a t e b e d r o o m i s n e c e s s a r y ; p p e l l a n t o n m e d i c a l t r i p s a r e m a l e c a r e a i d e l l a n t ' s s i s t e r / a d v o c a t e t o s h a r e a b e d w i t h t h e s e e c e s s a r y t o b o o k t h e r o o m t h a t h a d t h e 2 p u l l o u t h e ( t h e a p p e l l a n t ' s s i s t e r ) a n d t h e c a r e a i d w o r k e r h i l e t h e o t h e r s l e e p s i n t h e o n l y o t h e r b e d l c o s t s a r e c a p p e d o r p r o v i d e d h e r w i t h a b r e a k ­ e t h a t t h e h o t e l c a n p r o v i d e p a r k i n g f o r t h e s h u t t l e a u i n m e n t o t h e r w i s e a d d i t i o n a l m o n e y w o u l d b e
s p e n t f o r p a r k i n g ; T h e h o t e l d i d n o t c h a r g e t h e m e d i c a l r a t e b e x p e n s i v e r a t e ; T h e a d v o c a t e p o i n t s o u t t h a t s h e h a s u s e d a p p o i n t m e n t s a n d t h e m i n i s t r y h a s n e v e r q u I n t e r m s o f m e a l s , t h e a p p e l l a n t h a s a s p e c c a r b o h y d r a t e s . T h e c a r e a i d w o r k e r a n d t h d i e t a r y a n d o r m e d i c a l r e a s o n s . T h i s i s w h y c o n t i n e n t a l b r e a k f a s t p r o v i d e d b y t h e h o t e l ; N e i t h e r t h e a p p e l l a n t n o r t h e a d v o c a t e h a s a l l o w a n c e ; I n r e s p o n s e t o a q u e s t i o n , t h e a d v o c a t e s t a c o m p l i m e n t a r y c o n t i n e n t a l b r e a k f a s t c o n s i s c o l d c e r e a l ; T h e a d v o c a t e s p o i n t s o u t t h a t t h e m i n i s t r y w n e e d s , h o w e v e r , t h e m i n i s t r y i s s u e s h e r a s d i e t a r y n e e d s ; I n r e g a r d s t o t h e m i n i s t r y ' s s t a t e m e n t t h a t t h b e f o r e s h e l e a v e s f o r h e r t r i p , t h e a d v o c a t e t h i n g i n t h e m o r n i n g , e s p e c i a l l y w h e n a r o a d t i m e s b r e a k f a s t m u s t b e e a t e n o n t h e r o a d ; I n r e g a r d s t o t h e t r a n s p o r t a t i o n c o s t , t h e a d v a v a i l a b l e f o r t r a v e l f r o m t h e a p p e l l a n t ' s h o m O n e t a k e s l e s s t i m e b u t m o r e k i l o m e t r e s a r e k i l o m e t r e s a r e t r a v e l e d . T h e h i g h w a y t h a t i s n o t o n t h a t d a y t h e a p p e l l a n t c a n h a n d l e a l o I n r e s p o n s e t o a q u e s t i o n s , t h e a d v o c a t e c o t r a v e l o n D e c e m b e r 1 5 , 2 0 1 3 o r D e c e m b e r 1 T h e a d v o c a t e p o i n t s o u t t h a t t h e m i n i s t r y ' s m t h e a p p e l l a n t ' s h o m e t o t h e h o t e l i t i s a 3 9 4 I t t h e n s t a t e s t h a t f r o m t h e h o s p i t a l t o t h e a p T h e a d v o c a t e a c c e p t s t h e m i n i s t r y d e c i s i o n s T h e a d v o c a t e p o i n t s o u t t h a t s h e a n d t h e a p e v e n t h o u g h t h e y c a n n o t a f f o r d t o o . T h e a p e x p e n s e s . A t t h e h e a r i n g t h e m i n i s t r y r e l i e d o n i t s r e c o n s i d e r a O n c e s e r v i c e r e q u e s t a r e c o m p l e t e d , t h e r e i s s p e c i a l i z e d g r o u p o f m i n i s t r y w o r k e r s w h o h a a p p l i c a n t i s d o n e t o e n s u r e a l l o f t h e i n f o r m a E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 ): A P P F A L # u t r a t h e r t h e s e n i o r ' s r a t e w h i c h w a s t h e l e a s t t h i s h o t e l f o r t h e l a s t t w o y e a r s f o r m e d i c a l e s t i o n e d t h e r o o m r a t e s ; i a l i z e d h i g h p r o t e i n d i e t a n d t h e r e f o r e a v o i d s e a d v o c a t e a l s o a v o i d h i g h c a r b o h y d r a t e f o o d s f o r t h e y d i d n o t p a r t a k e o f t h e c o m p l i m e n t a r y b e e n a d v i s e d t h a t t h e r e i s o n l y a $ 4 p e r m e a l t e d t h a t s h e w a s n o t c e r t a i n w h a t t h e t e d o f b u t s h e b e l i e v e d i t w a s m u f f i n s , b a g e l s a n d a n t s c o n f i r m a t i o n o f t h e a p p e l l a n t ' s s p e c i a l d i e t a r y u p p l e m e n t o f $ 4 0 e v e r y m o n t h f o r h e r s p e c i a l e a p p e l l a n t i s e x p e c t e d t o e a t b r e a k f a s t a t h o m e s t a t e s t h a t t h e a p p e l l a n t c a n n o t a l w a y s e a t f i r s t t r i p b e g i n s e a r l y i n t h e m o r n i n g . T h e r e f o r e , a t o c a t e p o i n t s o u t t h a t t h e r e a r e t w o h i g h w a y s e t o w n t o t h e m a j o r c e n t r e w h e r e t h e d o c t o r w o r k s . t r a v e l e d , w h i l e t h e o t h e r t a k e s m o r e t i m e a n d l e s s u s e d d e p e n d s o n r o a d c o n d i t i o n s , o r w h e t h e r o r n g s t r e t c h o f d r i v i n g w i t h o u t s t o p s ; u l d n o t r e m e m b e r w h i c h h i g h w a y w a s u s e d f o r 9 , 2 0 1 3 ; i l e a g e c a l c u l a t i o n i s i n c o r r e c t a s i t s t a t e s t h a t f r o m k m d r i v e a n d f r o m t h e h o t e l t o t h e h o s p i t a l i s 4 k m . p e l l a n t h o m e t h e d r i v e i s 4 1 7 k m ; r e g a r d i n g t h e b r i d g e t o l l a n d p a r k i n g ; a n d p e l l a n t h a v e a l r e a d y p a i d f o r t h e c o s t o f t h e t r i p , p e l l a n t i s n o w l o o k i n g f o r r e i m b u r s e m e n t f o r h e r t i o n d e c i s i o n a n d a d d e d : a t h o r o u g h r e v i e w o f t h e a p p l i c a t i o n b y a n d a l l s e r v i c e r e q u e s t s . F o l l o w u p w i t h t h e t i o n i s a c c u r a t e .
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 a p p e a l i s w h e t h e r t h e m i n i s t ry ' s d e c i m e d i c a l t r a n s p o r t a t i o n s u p p l e m e n t b e c a u s e ( 1 ) t h e w e r e n o t w e r e u s e d , ( 2 ) 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 i n c l u d e d i n t h e c o s t o f t h e a c c o m m o d a t i o n s o r t h a t h o m e p r i o r t o a n d a f t e r h e r t r i p a n d t h a t h e r $ 4 0 p e c o v e r t h e a d d i t i o n a l c o s t o f m e e t i n g h e r d i e t a ry n e d e s c r i p t i o n o f t h e k i l o m e t e r s t h a t t h e a p p e l l a n t h a s o w n c a l c u l a t i o n o f t h e s a m e t r i p , w a s r e a s o n a b l y s 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 T h e r e l e v a n t l e g i s l a t i o n r e q u i r e s t h e f o l l o w i n g : S c h e d u l e C , s e c t i o n 2 ( 1 ) o f t h e E m p l o y m e n t a n d A ( E A P W D R ) s t i p u l a t e s t h e e l i g i b i l i t y r e q u i r e m e n t s a G e n e r a l h e a l t h s u p p l e m e n t s 2 ( 1 ) T h e f o l l o w i n g a r e t h e h e a l t h s u p p l e m e n t o a f a m i l y u n i t t h a t i s e l i g i b l e u n d e r s e c r e g u l a t i o n : ( f ) t h e l e a s t e x p e n s i v e a p p ( i ) a n o f f i c e , i n t h e p r a c t i t i o n e r , ( i i ) t h e o f f i c e o f t h e o r s u r g e r y i f t h e p e b y a l o c a l m e d i c a l p ( i i i ) t h e n e a r e s t s u t h o s e f a c i l i t i e s a r e d R e g u l a t i o n s , o r ( i v ) t h e n e a r e s t s u d e f i n i t i o n o f " h o s p i t p r o v i d e d t h a t ( v ) t h e t r a n s p o r t a t u n d e r t h e M e d i c a r e t h e H o s p i t a l I n s u r a n ( v i ) t h e r e a r e n o r e c o v e r t h e c o s t . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 ): A P P E A L # s i o n , w h i c h d e n i e d t h e a p p e l l a n t ' s r e q u e s t f o r a l e a s t e x p e n s i v e a n d a p p r o p r i a t e a c c o m m o d a t i o n s f o r t h e $ 4 m e a l a l l o w a n c e f o r m e a l s t h a t w e r e s h o u l d h a v e b e e n c o n s u m e d a t t h e a p p e l l a n t ' s r m o n t h d i e t a r y s u p p l e m e n t a l l o w a n c e s h o u l d e d s , a n d ( 3 ) t h e m i n i s t r y h a s n o d e t a i l e d c l a i m e d w h i c h v a r y i m m e n s e l y f r o m t h e m i n i s t r 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 a r e a s o n a b l e m s t a n c e s o f t h e a p p e l l a n t . s s i s t a n c e f o r P e r s o n s W i t h D i s a b i l i t i e s R e g u l a t i o n s : t s t h a t m a y b e p a i d f o r b y t h e m i n i s t e r i f p r o v i d e d t i o n 6 2 [ g e n e r a l h e a l t h s u p p l e m e n t s ] o f t h i s r o p r i a t e m o d e o f t r a n s p o r t a t i o n t o o r f r o m l o c a l a r e a , o f 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 n e a r e s t a v a i l a b l e s p e c i a l i s t i n a f i e l d o f m e d i c i n e r s o n h a s b e e n r e f e r r e d t o a s p e c i a l i s t i n t h a t f i e l d 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 i o n e r , i t a b l e g e n e r a l h o s p i t a l o r r e h a b i l i t a t i o n h o s p i t a l , a s e f i n e d i n s e c t i o n 1 . 1 o f t h e H o s p i t a l I n s u r a n c e A c t i t a b l e h o s p i t a l a s d e f i n e d i n p a r a g r a p h ( e ) o f t h e a l " i n s e c t i o n 1 o f t h e H o s p i t a l I n s u r a n c e A c t , i o n i s t o e n a b l e t h e p e r s o n t o r e c e i v e a b e n e f i t P r o t e c t i o n A c t o r a g e n e r a l h o s p i t a l s e r v i c e u n d e r c e A c t , a n d s o u r c e s a v a i l a b l e t o t h e p e r s o n ' s f a m i l y u n i t t o
T h e A p p e ll a n t ' s P o s i t i o n : 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 m i n i s t r y h a d a m p l e u n a c c e p t a b l e a s t h e S R 1 w a s s u b m i t t e d o n N o v e m S h e h a s u s e d t h i s s a m e h o t e l i n t h e p a s t w i t h o u t b m i n i s t r y c a n n o t e x p e c t a f e m a l e , w h o i s e s c o rt i n g t a n u n k n o w n o r u n r e l a t e d m a l e c a r e a i d w o r k e r , n o t h e h o t e l r o o m . T h e m i n i s t r y n e v e r a d v i s e d h e r t h a t h a t i t s h o u l d a l r e a d y b e a w a r e t h a t s h e h a s s p e c i a a d d i t i o n a l f u n d i n g t o s u p p o r t t h e s e n e e d s . T h e b r e a p p e l l a n t a n d t h e r e f o r e s h e h a d b r e a k f a s t e l s e w h e m o r n i n g a t t i m e s a n d t h e r e f o r e d i d n o t e a t b r e a k f a s a l s o a r g u e s t h a t t h e m i n i s t r y ' s c a l c u l a t i o n o f t h e m i t h a t i t d i d n o t t a k e i n t o c o n s i d e r a t i o n t h a t r o a d c o n d r o u t e c a n b e t a k e n . T h e M i n i s t ry ' s P o s i t i o n : 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 a p p e l l a n t d i d n o t m e d i c a l t r i p . R a t h e r t h a n t h e s t a n d a r d l a r g e o n e b s t a n d a r d o n e b e d r o o m s u i t e , w h i c h c o s t l e s s . T h e b r e a k f a s t a n d t h e m i n i s t r y p r o v i d e s h e r w i t h a s u p p h a v e p a r t a k e n o f t h e f o o d a v a i l a b l e a t t h e h o t e l d u e h e r t o m e e t t h o s e n e e d s f r o m h e r r e g u l a r s u p p o rt a t h a t t h e a p p e l l a n t h a s n o t p r o v i d e d a d e t a i l e d d e s c T h e r o u t e c a l c u l a t i o n p r o v i d e d b y t h e a p p e l l a n t i m m r e s o u r c e s . F o r t h e s e r e a s o n s , t h e m i n i s t ry h a s d e n $ 2 7 4 . 2 0 . T h e P a n e l D e c i s i o n : T h e m i n i s t r y h a s b a s e d i t s d e n i a l o n t h e l e g i s l a t i v e E A P W D R . T h i s l e g i s l a t i o n r e q u i r e s t h a t , p r o v i d e d t b e e n m e t , e l i g i b i l i t y f o r a h e a l t h s u p p l e m e n t t h e n m T h e m i n i s t r y h a s t a k e n t h e s t e p o f i t e m i z i n g i t s d e c I n r e g a r d s t o a c c o m m o d a t i o n s , t h e m i n i s t r y h a s s t a e x p e n s i v e a c c o m m o d a t i o n s w h i c h w o u l d h a v e b e e p e r n i g h t . T h e m i n i s t r y a l s o s t a t e s t h a t t h e r a t e c h a t h e m e d i c a l r a t e . T h e a p p e l l a n t a r g u e s t h a t t h e s t a p l u s h a m e n i t i e s b u t t o a c c o m m o d a t e a l l 3 i n d i v i d u a c o m f o r t a b l y a n d t h a t i t i s u n r e a s o n a b l e f o r t h e m i n i s a i d w o r k e r t o s h a r e a b e d . S h e a l s o a r g u e s t h a t t h e m e d i c a l r a t e a n d t h e r e f o r e i t w a s t h e l e a s t e x p e n s i v d e s c r i p t i o n o f t h e h o t e l r o o m s p r o v i d e d b y t h e h o t e l s u i t e h a s o n e p u l l o u t b e d w h i l e t h e s t a n d a r d l a r g e t w o i n d i v i d u a l s , ( i n t h i s c a s e t h e a p p e l l a n t ' s s i s t e r a a p p e l l a n t , t h e n i t i s r e a s o n a b l e t h a t t h e y e a c h b e p r f i n d s t h a t t h e h o t e l m a n a q e r ' s M a v 6 , 2 0 1 4 l e t t e r c o E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # t i m e t o a d v i s e h e r t h a t t h e h o t e l c o s t s w e r e b e r 2 7 , 2 0 1 4 f o r t r a v e l o n D e c e m b e r 1 5 , 2 0 1 3 . e i n g q u e s t i o n e d a b o u t t h e r o o m r a t e s . T h e h e a p p e l l a n t o n m e d i c a l t r i p s , t o s h a r e a b e d w i t h r c a n i t e x p e c t e i t h e r p e r s o n t o s l e e p o n t h e f l o o r o f t m e a l a l l o w a n c e s a r e c a p p e d a t $ 4 p e r m e a l a n d l d i e t a r y n e e d s b e c a u s e i t p r o v i d e s h e r w i t h a k f a s t a t t h e h o t e l d i d n o t m e e t t h e n e e d s o f t h e r e . A l s o , s h e c a n n o t e a t b r e a k f a s t f i r s t t h i n g i n t h e t a t h o m e p r i o r t o h e r m e d i c a l t r i p . T h e a p p e l l a n t l e a g e f o r t h i s m e d i c a l t r i p d o e s n o t c o m p u t e a n d i t i o n s a n d h e r h e a l t h a t t h e t i m e d e t e r m i n e w h i c h u s e t h e l e a s t e x p e n s i v e a c c o m m o d a t i o n s f o r h e r e d r o o m s u i t e , t h e a p p e l l a n t c o u l d h a v e u s e d t h e m i n i s t r y a l s o a r g u e s t h a t t h e h o t e l p r o v i d e s a f r e e l e m e n t f o r h e r h i g h p r o t e i n d i e t . I f s h e c a n n o t t o d i e t a r y n e e d s , s h e h a s t h e f u n d s a v a i l a b l e t o n d d i e t s u p p l e m e n t . F i n a l l y , t h e m i n i s t r y a r g u e s r i p t i o n o f t h e k i l o m e t r e s h e h a s c l a i m e d f o r t r a v e l . e n s e l y v a r i e s f r o m t h o s e f o u n d o n p u b l i c i e d t h e a p p e l l a n t a h e a l t h s u p p l e m e n t c l a i m o f c r i t e r i a f o u n d i n S c h e d u l e C , s e c t i o n 2 ( 1 ) o f t h e h e c r i t e r i a i n S e c t i o n 6 2 o f t h e E A P W D R h a v e u s t b e t h e l e a s t a p p r o p r i a t e f o r m o f t r a n s p o r t a t i o n . i s i o n . t e d t h a t t h e a p p e l l a n t d i d n o t u s e t h e l e a s t n t h e s t a n d a r d o n e b e d r o o m s u i t e t h a t c o s t $ 1 0 0 r g e d f o r t h e r o o m w a s t h e s e n i o r ' s r a t e a n d n o t n d a r d l a r g e o n e b e d r o o m w a s n o t c h o s e n f o r i t s l s ( t h e a p p e l l a n t , t h e a d v o c a t e a n d t h e c a r e a i d ) t r y t o e x p e c t t h e a p p e l l a n t ' s a d v o c a t e a n d c a r e ­ s e n i o r ' s r a t e w a s l e s s e x p e n s i v e t h a n t h e e a c c o m m o d a t i o n s . T h e p a n e l f i n d s t h a t t h e m a n a g e r c o n f i r m s t h a t t h e s t a n d a r d o n e b e d r o o m o n e b e d r o o m s u i t e h a s t w o p u l l o u t b e d s . S i n c e n d a c a r e a i d w o r k e r ) a r e a c c o m p a n y i n g t h e o v i d e d w i t h a b e d o r p u l l o u t b e d . T h e p a n e l a l s o n f i r m s t h a t t h e r a t e c h a r q e d t o t h e a o o e l l a n t , t h e
APPEAL# senior's rate, was lower than the medical rate by $6.90 per night. The panel finds that, based on the evidence, the ministry's decision that the hotel accommodations were not the least expensive appropriate accommodations was not reasonable in the case of the appellant. In regards to meals, the ministry argues that the appellant's hotel provided breakfast in the cost of the room and she had the opportunity to eat breakfast prior to her trip. Therefore it is unreasonable for the appellant to expect the ministry to cover the cost of meals that were already paid for. The ministry adds that if the appellant has a dietary need which prevented her from eating the breakfast provided at the hotel, this information must be confirmed by her physician. Finally the ministry argues that if breakfast at the hotel did not meet her dietary needs, the ministry does provide a dietary supplement to the appellant every month. .Therefore the appellant had the resources available to her to cover the additional expense of her meals. The appellant argues that the breakfast the hotel served consisted of high carbohydrate foods which do not meet the needs of her high protein diet. However, the appellant or her advocate were not able to confirm what the breakfast consisted, nor was any information regarding the contents of the hotel's continental breakfast available in the documentation provided by the hotel manager. The appellant also argues that the advocate and care-aid also avoid high carbohydrate foods for health reasons and they too could not eat the hotel breakfast. F inally, the appellant argues that she cannot eat breakfast first thing in the morning when she travels early. Therefore, she did not consume breakfast at home prior to her trip. The panel acknowledges that the ministry erred in its conclusion that the appellant did not have a dietary need as it does supply the appellant with a nutritional supplement of $40 per month to meet the needs of her special diet. The panel also accepts that the appellant cannot eat first thing in the morning on travel days. However, the panel finds that the appellant is provided with additional funds to meet her dietary needs, that there is no confirmation from the appellant or the hotel manager as to what the hotel's complimentary continental breakfast consisted of and that it is unreasonable to expect the ministry to accommodate the dietary choices of the appellant's assistants. Therefore the panel finds that based on the evidence, the ministry reasonably determined that it is not responsible for breakfast costs for the appellant and her 2 assistants. In regards to the transportation costs, the ministry argues that without a detailed description of the kilometres traveled by the appellant, it cannot be determined that the least expensive appropriate route was taken. The ministry also argues that according its own calculations of the trip's total kilometres, based on MapQuest and Google, differ immensely from the appellant's claim. The appellant argues that there are 2 different routes one could take from home to the hospital where the specialist works. Each has different travel times and total kilometres traveled. Which route is used depends on the weather and/or road conditions that day and/or the current state of the appellant's health. Finally, the appellant states that the ministry's calculation of the same trip, does not compute. The ministry states that the trip from the appellant's home to the hotel is 394km and from the hotel to the hospital is 4km, which would mean that it is either 398km or 390km from the appellant's home to the hospital. Yet the ministry determined that the trip from the hospital, to the appellant's home, is 417km. The panel finds that the ministry erred in its calculation of the kilometres traveled for this medical trip and therefore it cannot be determined, by the evidence provided, which calculation, that of the ministry or of the appellant, is accurate. The panel finds that based on the evidence, the ministry did not reasonably determine that the least expensive appropriate route was not used for travel for the appellant's medical trip. Conclusion: Havinq reviewed and considered all of the evidence and the relevant leqislation, the panel finds that EMT003(10/06l01)
APPFAI ii '. the ministry's reconsideration decision is not reasonably supported by the evidence in regards to the accommodation and travel allowances and was reasonably supported by the evidence in regards to the meal allowance. The panel therefore rescinds the ministry's decision and refers the decision back to the ministry to determine the amount of the allowance the appellant is entitled to. EMT 003(10/06/01)
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