PART C -De cision u n de r A p peal Th e M i nistry of S o ci al D e v e l o pment an d So c ial Inn d ated 4 July 2014 d etermin ed t h at t h e app ell ant did section 2 of the Emp loyment and Ass ista nce for P perso n with dis a bi l i t i es (PWD). The mi n is t r y found he r i mpai rme nt is likely to continu e for at le a s t 2 years and imp airme nt. Ho we v e r, th e mini st ry was no t sa t isfi e c o -e x isting me nt al conditio ns , in the o p inion of a prescribed pro re s t r icte d her daily living ac t i v ities ( DLA ) e i th er continuo mi n is t ry was also not sat i sfied that a s a re sul t of tho pr of ess iona l , the a ppella nt r equ i res hel p t o p e r form DL PART D -R el evant Legislat ion Employ ment and As sistance fo r Persons wi th D i sa Emp loyment and Ass i s tance f or Persons wi t h D isab EAAT003(10/06/01) I APP EAL. ovat i on (the m i nistry) reconsiderat io n decisi on not me et 2 of the 5 statu tor y req u ire ments of erso ns w i th Disab ilities Ac t for d esi gna t ion as a that the a ppellan t me t the a g e re quireme n t, th at that the ap pe l lant ha d a s eve re d th at the ap pe ll ant's co m bination of physical and fess ional , directly a nd s i g n ific antly usly or pe r iodical ly fo r exte nded p e riods. Th e s e restrict i ons, in t he opini on o f a presc ribed A. b il i ties Act ( EA P WDA), sec tion 2 i lities R egulati on (EAPWD R), se c tio n 2
P A R T E S u m m a r v o f F a c t s T h e m i n i s t r y w a s n o t i n a t t e n d a n c e a t t h e h e a r i n g h e a r i n g p r o c e e d e d u n d e r s . 8 6 ( b ) o f t h e E m p l o y m T h e f o l l o w i n g e v i d e n c e w a s b e f o r e t h e m i n i s t r y a t • A 4 p a g e P W D A p p l i c a t i o n s e l f r e p o r t d a t e d 2 s t a t i n g t h e f o l l o w i n g : o S h e h a s b e e n s u f f e r i n g f r o m a n o r e x i a n o v e r a l l p h y s i c a l a n d m e n t a l d e t e r i o r a t i o n o A s a r e s u l t s h e a l s o s u f f e r e d f r o m d e p r e i n d e p e n d e n c e , s e n s e o f b e l o n g i n g a n d o H e r d a y t o d a y a c t i v i t i e s h a v e b e c o m e s h a r d s h i p . o S h e w a s h o s p i t a l i z e d 6 t i m e s i n r e s p e c t o S h e d e v e l o p e d o s t e o p o r o s i s a n d h a s l o o S h e i s u n a b l e t o l i f t h e a v y o b j e c t s a n d s t i m e c a u s e s t h e e n t i r e l o w e r h a l f o f h e r b o S h e g e t s a n x i o u s a s a r e s u l t o f n e a r l y e v m i n o r i t c o u l d b e . o S h e n o w h a s d i f f i c u l t i e s c o n c e n t r a t i n g a c e r t a i n p e r i o d o f t i m e . o S h e w a n t s t o r e s t o r e h e r w e i g h t t o a h e a r a n g e t e r r i f i e s h e r . o S h e w o u l d l i k e t o g e t b a c k t o w o r k b u t h p h y s i c a l l y a s p a s t e x p e r i e n c e s s h o w e d t e n d e d u p i n h o s p i t a l . F o r i n s t a n c e s h e a a m a j o r c e n t r e a n d e n d e d u p b e i n g h o s p l i v e w i t h h e r m o t h e r . o W h e n s h e w o r k s o r s t u d i e s f u l l t i m e , s h e n e e d s . o W h e n s h e r e t u r n e d t o h e r h o m e c o m m u c e n t r e a n d t h e s e r v i c e s i n t h e r e g i o n a l c s h e w o u l d l i k e t o b e a b l e t o r e t u r n t o t h e • A 8 p a g e P h y s i c i a n R e p o r t ( P R ) d a t e d 7 M a y 2 p h y s i c i a n i n d i c a t e s t h e f o l l o w i n g : o S p e c i f i c d i a g n o s i s : A n o r e x i a n e r v o s a , d e T h e p h y s i c i a n c o m m e n t s : " L o n g s t a n d i n g a n x i e t y . " o H e a l t h h i s t o r y : S i g n i f i c a n t s t r u g g l e w i t h a f o o d r e s t r i c t i o n a n d e x c e s s i v e e x e r c i s e p n u m b e r o f t i m e s f o r d a n g e r o u s l y l o w B M w i t h d e p r e s s i o n / a n x i e t y t h a t m a k e i t d i f f s h o u l d b e f o c u s i n g o n r e c o v e r i n g f r o m h h e a l t h y w e i g h t . S h e a l s o h a s c o g n i t i v e s l f u n c t i o n i n a . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A i . A f t e r c o n f i r m i n g t h a t t h e m i n i s t r y w a s n o t i f i e d , t h e e n t a n d A s s i s t a n c e R e g u l a t i o n . t h e t i m e o f r e c o n s i d e r a t i o n : A p r i l 2 0 1 4 c o m p l e t e d a n d s i g n e d b y t h e a p p e l l a n t e r v o s a f o r 8 y e a r s w i t h u n h e a l t h y w e i g h t l o s s a n d . s s i o n a n d a n x i e t y , l o s i n g h e r f r e e d o m , h a p p i n e s s . t r e n u o u s c h o r e s a n d s i m p l e t a s k s t u r n i n t o m a s s i v e o f t h i s c o n d i t i o n i n o r d e r t o r e s t o r e h e r w e i g h t . s t m o s t o f h e r s t r e n g t h . t a n d i n g , w a l k i n g a r o u n d , m o v i n g f o r l o n g p e r i o d s o f o d y t o a c h e . e r y s i t u a t i o n o r o b s t a c l e t h a t a r i s e s , n o m a t t e r h o w n d s h e t e n d s t o l o s e f o c u s a n d g i v e u p a f t e r a l t h y l e v e l b u t t h e i d e a o f b e i n g i n a h e a l t h y w e i g h t e r c o n d i t i o n m a k e s i t h a r d f o r h e r e m o t i o n a l l y a n d h a t t h i s h a d b e e n h e r b i g g e s t d o w n f a l l a n d s h e h a d t t e n d e d c o l l e g e f u l l t i m e w h e n l i v i n g o n h e r o w n i n i t a l i z e d a n d f o r c e d b a c k t o h e r h o m e c o m m u n i t y t o c a n n o t b a l a n c e h e r e a t i n g h a b i t s t o s a t i s f y h e r n i t y , s h e l o s t t h e s u p p o r t s h e h a d i n t h e l a r g e r e n t r e c l o s e s t t o h e r c o m m u n i t y a r e v e r y l i m i t e d a n d l a r g e c e n t r e a n d r e c o n n e c t w i t h h e r s u p p o r t g r o u p . 0 1 4 c o m p l e t e d a n d s i g n e d b y t h e a p p e l l a n t ' s p r e s s i o n , a n x i e t y a n d o s t e o p o r o s i s s i n c e 2 0 0 6 . h i s t o ry o f a n o r e x i a w i t h c o e x i s t i n g d e p r e s s i o n / n o r e x i a s i n c e 2 0 0 6 a n d d e v e l o p e d a p a t t e r n o f e r v a d i n g h e r d a i l y l i f e . S h e w a s h o s p i t a l i z e d a I ( B o d y M a s s I n d e x ) . " S h e h a s s i g n i f i c a n t i s s u e s i c u l t f o r h e r t o f u n c t i o n i n a n o r m a l c a p a c i t y . " S h e e r e a t i n g d i s o r d e r a n d a c h i e v i n g / m a i n t a i n i n g a o w i n g a n d f a t i g u e s e a s i l y w h i c h i n t e r f e r e s w i t h h e r
o H e r h e i g h t i s 1 7 3 . 5 c m a n d s h e w e i g h s o F o r p r e s c r i b e d m e d i c a t i o n a n d / o r t r e a t m i n d i c a t e s : " C a l o r i c c o u n t s , d o c u m e n t i n g a t t h i s p o i n t " . o S h e 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 e s o r o T h e i m p a i r m e n t w i l l c o n t i n u e f o r 2 y e a r s i m p a i r m e n t i s o f i n d e f i n i t e d u r a t i o n . H e r h a d m u l t i p l e h o s p i t a l i z a t i o n s a n d i s a t h i r e q u i r i n g r e a d m i s s i o n " a n d s h e i s r e g u l a o S h e c a n w a l k m o r e t h a n 4 b l o c k s o n a f l o S h e c a n c l i m b m o r e t h a n 5 s t e p s u n a i d e o S h e i s l i m i t e d t o l i f t i n g 2 t o 7 k g . o S h e h a s n o l i m i t a t i o n f o r r e m a i n i n g s e a t o S h e h a s n o d i f f i c u l t i e s c o m m u n i c a t i n g . o T h e p h y s i c i a n i d e n t i f i e s 4 a r e a s o f s i g n i f • E m o t i o n a l d i s t u r b a n c e ; m o t i v a t i o n i s s u e s r e : b o d y i m a g e I w e i g h t / s s l o w i n g . o E v e n t h o u g h t h e p h y s i c i a n d i d n o t c o m p s e c t i o n E , D L A o f t h e f o r m . o I n A d d i t i o n a l C o m m e n t s h e w r i t e s t h a t t h a n o r e x i a n e r v o s a a n d h e r c l i n i c a l c o n d i t i m a i n t a i n a h e a l t h y w e i g h t a n d i s a t v e ry c a n n o t f u n c t i o n n o r m a l l y d u e t o f a t i g u e / a n x i e t y a n d i t i s i m p o r t a n t t h a t s h e f o c u s o n h e r a n d s h e w o u l d l i k e l y d e t e r i o r a t e . o T h e p h y s i c i a n h a s s e e n t h e a p p e l l a n t 2 t p a t i e n t b u t t h e a p p e l l a n t h a s b e e n a p a t i • A n 1 1 p a g e A s s e s s o r R e p o rt ( A R ) d a t e d 2 4 A p p r a c t i t i o n e r , i n d i c a t i n g t h e f o l l o w i n g : o T h e a p p e l l a n t l i v e s w i t h f a m i l y , f r i e n d s o r o 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 b o I n t e r m s o f 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 , t w a l k i n g o u t d o o r s , c l i m b i n g s t a i r s , s t a n d 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 f o r l i f t i n g o I n t e r m 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 c t i m p a i r m e n t o r b r a i n i n j u r y t h e A R i n d i c a t e • N o i m p a c t f o r c o n s c i o u s n e s s , l a n g 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 a n d • M i n i m a l i m p a c t f o r b o d i l y f u n c t i o n s • M o d e r a t e i m p a c t f o r e m o t i o n , i m p • M a j o r i m p a c t f o r a t t e n t i o n / c o n c e n t • T h e a s s e s s o r c o m m e n t s t h a t d u e m a j o r i m p a i r m e n t s w i t h c o g n i t i v e a o I n t e r m s o f a s s i s t a n c e r e q u i r e d r e l a t e d t o a b i l i t v t o m a n a q e D L A , t h e a s s e s s o r i n d i c E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A i 4 5 . 3 k g . e n t s i n t e r i e r i n g w i t h h e r D L A , t h e p h y s i c i a n e v e r y t h i n g s h e e a t s . " A n d t h e l e n g t h i s " I n d e f i n i t e a i d s f o r h e r i m p a i r m e n t . o r m o r e . T h e p h y s i c i a n i n d i c a t e s t h a t t h e c o n d i t i o n i s c h r o n i c a n d o n g o i n g s i n c e 2 0 0 7 . S h e g h r i s k f o r " p r o b l e m s r e : d e c r e a s i n g w e i g h t r l y f o l l o w e d f o r m e d i c a l r e a s o n s . a t s u r i a c e u n a i d e d . d . e d . i c a n t d e f i c i t s w i t h c o g n i t i v e a n d e m o t i o n a l f u n c t i o n : ; a t t e n t i o n o r s u s t a i n e d c o n c e n t r a t i o n ; s i g n i f i c a n t e l f e s t e e m a n d c o m m e n t s : S o m e g e n e r a l c o g n i t i v e l e t e t h e a s s e s s o r ' s r e p o r t , h e d i d n o t c o m p l e t e e a p p e l l a n t h a s b e e n s e v e r e l y a f f e c t e d b y o n i s e x t r e m e l y t e n u o u s a s s h e h a s b e e n u n a b l e t o h i g h r i s k o f r e h o s p i t a l i z a t i o n . H e a d d s t h a t s h e w e a k n e s s / c o g n i t i v e s l o w i n g / d e p r e s s i o n I o n h e r h e a l t h . W o r k i n g w o u l d p l a c e u n d u e s t r e s s o 1 0 t i m e s d u r i n g t h e o n e y e a r s h e h a s b e e n h e r e n t a t t h a t c l i n i c s i n c e 2 0 0 4 . r i l 2 0 1 4 c o m p l e t e d a n d s i g n e d b y a n u r s e c a r e g i v e r . y s p e a k i n g , r e a d i n g , w r i t i n g a n d h e a r i n g i s g o o d . 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 a l k i n g i n d o o r s , g a n d c a r r y i n g a n d h o l d i n g ; s h e n e e d s p e r i o d i c b u t n o e x p l a n a t i o n i s p r o v i d e d . i o n i n g f o r s o m e o n e w h o h a s a n i d e n t i f i e d m e n t a l s : u a g e , p s y c h o t i c s y m p t o m s , o t h e r o t h e r e m o t i o n a l o r m e n t a l p r o b l e m s . , m e m o r y a n d m o t o r a c t i v i t y . u l s e c o n t r o l , i n s i g h t & j u d g m e n t a n d e x e c u t i v e . r a t i o n a n d m o t i v a t i o n . t o h e r l o w B M I , t h e a p p e l l a n t h a s m o d e r a t e t o n d e m o t i o n a l f u n c t i o n i n g . i m p a i r m e n t s t h a t d i r e c t l y r e s t r i c t t h e a p p e l l a n t ' s a t e s t h a t s h e i s i n d e p e n d e n t f o r a l l a r e a s e x c e p t
f o r 4 w h e r e s h e n e e d s p e r i o d i c a s s i s t a n a p p r o p r i a t e c h o i c e s , c a r r y i n g p u r c h a s e s e x p l a n a t i o n s o r d e s c r i p t i o n b u t t h e a s s e a s s i s t a n c e f o r m e a l p l a n n i n g d u e t o h e r t h e p a s t b y a n u t r i t i o n i s t . o S h e i s i n d e p e n d e n t i n 4 o u t o f 5 a r e a s o s u p e r v i s i o n t o d e a l a p p r o p r i a t e l y w i t h u n d e s c r i p t i o n . o S h e e x h i b i t s m a r g i n a l f u n c t i o n i n g i n t e r m r e l a t i o n s h i p w i t h h e r i m m e d i a t e s o c i a l n e d i s r u p t i v e b e h a v i o u r : m a j o r s o c i a l i s o l a t i n e t w o r k s . o N o a s s i s t a n c e i s p r o v i d e d b y o t h e r p e o p o T h e a p p e l l a n t d o e s n o t u s e a n y a s s i s t i v e o N o a s s i s t a n c e i s p r o v i d e d b y a s s i s t a n c e o T h e a s s e s s o r p r o v i d e d a d d i t i o n a l i n f o r m a n o r e x i a f o r t h e p a s t s e v e r a l y e a r s a n d c a p a c i t y t h a t w o u l d r e q u i r e p r o l o n g e d s t e x t r e m e l y l o w B M I , h e r c o g n i t i v e f u n c t i o n w e i g h t r e s t o r a t i o n s a n d t h e a s s e s s o r i n d b e . o T h e a s s e s s o r ' s s o u r c e o f i n f o r m a t i o n i s t h a s k n o w n h e r s i n c e 2 0 1 1 , h a v i n g s e e n e x p l a i n s t h a t s h e h a s s e e n t h e a p p e l l a n t a s i d e f r o m t h e t i m e s h e s p e n t i n h o s p i t a l e x a m i n a t i o n , l a b o r a t o ry t e s t i n g a n d p r e s • I n h e r 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 2 4 J u n o S h e a g r e e d n o t b e i n g a b l e t o l i f t a n y t h i n g r e q u i r e m e n t s b e c a u s e s h e d o e s n o t c o n s h e n o t e d t h a t v e r y f e w j o b s d o n o t r e q u j o b s t h a t a r e l e f t a r e m e d i o c r e , h a r d l a b o o S h e a l s o a g r e e d s h e c o u l d w a l k s h o r t d i s t h a t i t d i d n o t m e a n s h e w a s i n a p h y s i c a o S h e r e c e n t l y s t r a i n e d h e r k n e e s i m p l y w a n o t y e t h e a l e d a n d s h e w a s b a s i c a l l y h o u o S h e u r g e d t h e m i n i s t r y t o c o n t a c t a n u m b a b o u t h e r h e a l t h c o n d i t i o n t h a n h e r p h y s o I n t e r m s o f D L A , s h e s t a t e d s h e h a d b e e r e c e i v e d b y a d i e t i t i a n . S h e h a d a d a i l y c a s s e s s h e r c o n d i t i o n . T h i s w i l l t a k e p l a c e e x t e n d e d p e r i o d o f t i m e . o S h e w r o t e : " I a m s t i l l n o w h e r e n e a r a h e a w o r k i n g f u l l t i m e , l e t a l o n e t r y a n d m a i n t a a j o b . " o S h e f e l t h e r m e d i c a l c o n d i t i o n w a s n o t p r e d u c a t e d a b o u t a n o r e x i a a n d b e l i e v e t h i s E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L c e f r o m a n o t h e r p e r s o n : r e g u l a t e d i e t , m a k i n g h o m e a n d m e a l p l a n n i n g . T h e r e a r e n o a d d i t i o n a l s s o r c o m m e n t s t h a t t h e a p p e l l a n t r e q u i r e s e a t i n g d i s o r d e r a n d t h a t s h e h a d h a d g u i d a n c e i n f s o c i a l f u n c t i o n i n g , r e q u i r i n g p e r i o d i c s u p p o r t / e x p e c t e d d e m a n d s b u t w i t h o u t a n y e x p l a n a t i o n o r s o f i m p a c t o f h e r m e n t a l i m p a i r m e n t o n h e r t w o r k b u t v e r y d i s r u p t e d f u n c t i o n i n g o v e r l y o n i n h e r r e l a t i o n s h i p w i t h e x t e n d e d s o c i a l l e a n d n o s u c h a s s i s t a n c e i s n e c e s s a r y . d e v i c e n o r i s s u c h e q u i p m e n t n e e d e d . a n i m a l s . a t i o n : T h e a p p e l l a n t h a s b e e n s t r u g g l i n g w i t h a t t h i s t i m e s h e i s n o t p h y s i c a l l y a b l e t o w o r k i n a a n d i n g o r a n y l i f t i n g . S h e a d d s t h a t d u e t o h e r i n g i s i m p a i r e d a n d h e r m a i n g o a l a t p r e s e n t i s i c a t e s t h a t s h e f e e l s i t i s w h a t h e r f o c u s n e e d s t o h r o u g h o f f i c e i n t e r v i e w w i t h t h e a p p e l l a n t a n d s h e h e r o v e r 1 1 t i m e s d u r i n g t h e p r e v i o u s y e a r . S h e i n c l i n i c e v e r y 1 t o 2 w e e k s i n t h e p a s t 3 y e a r s . S h e p r o v i d e s h e r w i t h w e i g h i n g , p h y s i c a l c r i p t i o n r e f i l l s a n d l i a i s e s w i t h o t h e r c l i n i c s . e 2 0 1 4 a n d s i g n e d b y t h e a p p e l l a n t , s h e i n d i c a t e d : o v e r 1 5 I b s d o e s n o t i m p a c t h e r d a i l y f u n c t i o n i n g s t a n t l y h a v e t o l i f t o b j e c t s t h a t a r e o v e r 1 5 I b s b u t i r e l i f t i n g o b j e c t s t h a t a r e m o r e t h a n 1 5 1 b s a n d t h e u r a n d m i n i m u m w a g e . t a n c e s a n d c l i m b m o r e t h a n 5 s t e p s b u t s t a t e d l c o n d i t i o n t o p e r i o r m a f u l l t i m e j o b . l k i n g a r o u n d t o w n f o r a n a p p o i n t m e n t a n d i t h a d s e b o u n d b u t w a s r e f e r r e d t o a p h y s i o t h e r a p i s t . e r o f r e s o u r c e p e o p l e t h a t w o u l d k n o w m o r e i c i a n w h o o n l y m e t h e r 3 t i m e s . n m a k i n g h e r e a t i n g c h o i c e s b a s e d o n a d v i c e s h e a l o r i c g o a l t o m e e t a n d h a d w e e k l y c h e c k i n s t o u n t i l h e r w e i g h t i s f u l l y r e s t o r e d , m e a n i n g a n l t h y e n o u g h w e i g h t t o h a n d l e t h e d e m a n d s o f i n a r e g u l a r e a t i n g s c h e d u l e w h i l e t r y i n g t o h a n d l e o p e r l y a s s e s s e d b y p e o p l e w h o a r e n o t f u l l y i s a m i n o r a i l m e n t , n o t i m o a c t i n a h e r l i f e a t a l l ,
t h e r e a l i t y b e i n g q u i t e t h e c o n t r a r y , a s i t o S h e h a d n o t w o r k e d f o r o v e r 2 y e a r s b e c d i f f i c u l t y d e a l i n g w i t h t h e d e m a n d s o f f u l o S h e p r o v i d e d a l i s t o f c o n t a c t p e o p l e t o t t h e m d o w n . o A p r e s c r i p t i o n b y a p h y s i c i a n d a t e d 2 4 J u n e 2 0 • A d o c t o r ' s c e r t i f i c a t e f r o m a p h y s i o t h e r a p y c l i n i c k n e e i s i n p a i n a n d t r e a t m e n t i s r e c o m m e n d e d . • A d o c t o r ' s c e r t i f i c a t e d a t e d 2 4 J u n e 2 0 1 4 i n d i c a a n d 2 4 J u n e r e g a r d i n g h e r r i g h t k n e e a n d t h a t f • A n I m a g i n g R e q u i s i t i o n s i g n e d b y a p h y s i c i a n , x r a y f o r h e r r i g h t k n e e , i n d i c a t i n g r i g h t m e d i a l j I n h e r N o t i c e o f A p p e a l d a t e d 1 4 J u l y 2 0 1 4 , t h e a p u n d e r s t a n d 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 , t h a t t h e D L A , t h a t s h e i s u n a b l e t o l i v e i n d e p e n d e n t l y a s a r c a u s e d b y h e r a n o r e x i a a n d r e c e i v i n g p h y s i o t h e r a p A t t h e h e a r i n g , t h e a p p e l l a n t t e s t i f i e d t h a t : • I n h e r c o m m u n i t y , s h e h a s n o a c c e s s t o p r o f e s s w a l k i n c l i n i c a n d s e e s a l o c u m o n d u t y . • S h e d o e s n o t h a v e a c c e s s t o a v e h i c l e t o d r i v e m u s t t a k e a b u s t h a t r u n s o n l y o n M o n d a y s a n d T u e s d a y s a n d T h u r s d a y s . S h e c a n h a r d l y a f f o r d • H e r p h y s i c a l c o n d i t i o n s w o r s e n e d s i n c e h e r k n e w e e k a n d s h e b e l i e v e s i t w a s c a u s e d b y m u s c l e c o s t s h e r $ 1 0 , a m o u n t i n g t o $ 4 0 p e r m o n t h t h a t • H e r m o t h e r c a n d r i v e h e r a r o u n d h e r c o m m u n i t y t o c o n t i n u e . • S h e n e e d s a P W D d e s i g n a t i o n t o i n c r e a s e h e r m a c t u a l a s s i s t a n c e o f $ 6 0 0 p e r m o n t h . S h e c a n b s u p p l e m e n t t o h e l p h e r b e i n d e p e n d e n t . • S h e d i d n o t h a v e a c c e s s t o a p s y c h i a t r i s t t o c o m s h e b e l i e v e s a s p e c i a l i s t w o u l d h a v e b e e n i n a b i m p a i r m e n t o n h e r D L A . • S i n c e h e r i n c i d e n t w i t h h e r k n e e , h e r c o n d i t i o n s i m p r o v i n g b u t s h e f e a r s t h a t t h e r e w i l l b e l a s t i n g c a n o n l y w a l k 1 o r 2 b l o c k s n o w a n d c a n h a r d l y h e r i n j u r e d k n e e . • S h e h a s t o e a t 6 t i m e s a d a y t a k e s ½ h o u r t o e i n t e r f e r e s w i t h h e r a b i l i t y t o f i n d e m p l o y m e n t , a s S h e p r e p a r e s h e r o w n m e a l s . • S h e g e n e r a l l y s i t s i n h e r m o t h e r ' s a p a r t m e n t w a e a t i n g t o o f a s t g i v e s h e r a s t o m a c h a c h e . T h e r e i s n o t a b l e t o q e t o u t . S h e d o e s h a v e a v e r v l i m i t E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A ' i m p a c t s h e r e v e r y s e c o n d o f h e r d a y . a u s e o f t h a t e a t i n g d i s o r d e r a n d s t i l l h a d " e x t r e m e l a n d e v e n p a r t t i m e w o r k " . h e m i n i s t r y s i n c e s h e d i d n o t h a v e t i m e t o t r a c k 1 4 f o r t o p i c a l m e d i c a t i o n f o r h e r k n e e . d a t e d 2 4 J u n e 2 0 1 4 t o t h e e f f e c t t h a t h e r r i g h t t i n g t h a t t h e a p p e l l a n t w a s s e e n i n h i s o f f i c e o n 6 u r t h e r i n v e s t i g a t i o n s w e r e p e n d i n g . u n d a t e d b u t s t a m p e d o n 2 4 J u n e 2 0 1 4 , r e q u e s t i n g o i n t l i n e p a i n a n d o s t e o p o r o s i s . p e l l a n t w r o t e t h a t t h e m i n i s t r y d i d n o t f u l l y y w e r e m i s i n f o r m e d a s t o h o w m u c h i t i m p a c t s h e r e s u l t . S h e i n d i c a t e d r e c o v e r i n g f r o m a k n e e i n j u r y y . i o n a l e a t i n g d i s o r d e r p h y s i c i a n s b u t o n l y t o a t o h e r r e g i o n ' s m a j o r c e n t r e -2 h o u r s a w a y , b u t W e d n e s d a y s w h i l e h e r s p e c i a l i s t i s o n l y t h e r e o n t h a t b u s r i d e a s i t c o s t s h e r $ 2 0 r e t u r n . e i n j u r y a s s h e h a s t o s e e a p h y s i o t h e r a p i s t e a c h l o s s a s a r e s u l t o f h e r e a t i n g d i s o r d e r . E a c h v i s i t s h e c a n h a r d l y a f f o r d . b u t a s o f S e p t e m b e r s h e w i l l n o t b e i n a p o s i t i o n o n t h l y a s s i s t a n c e a s s h e c a n b a r e l y l i v e w i t h h e r a r e l y p a y h e r r e n t a n d f o o d a n d n e e d s t h e p l e t e t h e p h y s i c i a n a n d t h e a s s e s s o r r e p o r t s a n d e t t e r p o s i t i o n t o d e s c r i b e t h e i m p a c t o f h e r h a s s i g n i f i c a n t l y d e t e r i o r a t e d b u t n o w i t i s c o n s e q u e n c e s f o r h e r k n e e , i n t h e l o n g t e r m . S h e c l i m b s t a i r s , h a v i n g t o d o i t s l o w l y w i t h o u t b e n d i n g a t a s n a c k a n d 1 h o u r t o e a t a m e a l a n d t h a t s h e c o u l d n o t h a v e t h e f r e e t i m e t o e a t o n t h e j o b . i t i n g f o r t h e n e x t m e a l a n d s h e i s a s l o w e a t e r a s i s n o t h i n g t o d o i n h e r h o m e c o m m u n i t y a n d s h e e d s o c i a l l i f e b u t i s a b l e t o s o c i a l l v i n t e r a c t .
• T h e p u r p o s e f o r h e r t o g e t P W D s t a t u s w o u l d b m o v e t o o t h e r c o m m u n i t i e s a n d h a v e a c c e s s t o • S h e d o e s n o t c u r r e n t l y n e e d h e l p f r o m a n o t h e r • S h e s p e n t s o m e t i m e i n a m a j o r c i t y h o s p i t a l w h d i s c h a r g e d h e r s e l f a f t e r 1 ½ m o n t h . T h e p a n e l d e t e r m i n e d t h e a d d i t i o n a l o r a l e v i d e n c e a n d A s s i s t a n c e A c t ( E A A ) a s i t w a s i n s u p p o r t o f t h p r o v i d i n g m o r e d e t a i l s a s t o t h e a p p e l l a n t ' s c o n d i t i o E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )L A _ P _ P E _ A _ I ------� _J I I e t o h e l p h e r t o b e i n d e p e n d e n t , b e i n g a b l e t o m o r e r e s o u r c e s f o r h e r c o n d i t i o n . p e r s o n o r d e v i c e o r a n i m a l f o r h e r D L A . e r e s h e c o u l d s e e a p s y c h i a t r i s t b u t s h e w a s a d m i s s i b l e u n d e r s . 2 2 ( 4 ) o f t h e E m p l o y m e n t e r e c o r d s b e f o r e t h e m i n i s t e r a t r e c o n s i d e r a t i o n a s n a n d i t s i m p a c t o n h e r D L A .
I APPEP PART F -Reasons for Panel Decision The issue under appeal is whether the ministry's determination that the appellant has not met all of the eligibility criteria for designation as a PWD because it was not satisfied that the appellant had a severe physical and mental impairment that, in the opinion of a prescribed professional, directly and significantly restricts her ability to perform DLA either continuously or periodically for extended periods resulting in the need for help to perform DLA was either a reasonable application of the legislation or reasonably supported by the evidence. The ministry determined that the age requirement had been met and that the appellant has an impairment that will last for 2 years. The criteria for being designated as a person with disabilities (PWD) are set out in s. 2 of the EAPWDA ands. 2 of the EAPWDR, which are set out below. Section 2 of the EAPWDA states: 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; "health professional" repealed "prescribed professional" has the prescribed meaning; (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i) directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B) periodically for extended periods, and (ii) as a result of those restrictions, the person requires help to perform those activities. (3) For the purposes of subsection (2), (a) a person who has a severe mental impairment includes a person with a mental disorder, and (b) a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, (ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. (4) The minister may rescind a designation under subsection (2). Section 2 of the EAPWDR provides further clarification: 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; EMT 003(10/06/01)
I APPEA (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. The ministry acknowledges that the appellant meets 3 of the conditions for PWD designation in that she is at least 18 years of age, her impairment is likely to continue for 2 years or more and that she has a severe physical and mental impairment. However, the ministry argues that she does not meet the 2 other criteria. Daily Living Activities (DLA): The ministry argues that there is not enough evidence demonstrating that the severe impairment directly and significantly restricts the appellant's DLA since she is described as "independent" in a large majority of them and that she does not need continuous assistance. The few restrictions, for instance for lifting and walking, do not amount to being significant and while the AR mentions that the appellant had assistance with meal planning, regulating diet, making appropriate choices and carrying purchases home. She has had some assistance from a nutritionist in the past but there is no explanation as to why this assistance is not required anymore. The AR mentions that the appellant's is restricted in terms of being able to work but the PWD criteria is not intended to assess employability or vocational abilities. The ministry notes some restrictions in terms of social functioning but is not satisfied that it amounts to a direct and significant restriction. The appellant argues that she is significantly restricted in her DLA because of her anorexia and that this eating disorder impacts every second of her life, for extended period of times. She cannot work because she needs to restore her BMI and would need to eat many times during the day and that no job would be able to accommodate that condition. Further, she argues that she cannot lift more than 1 Slbs, which would also prevent her from aettinq emplovment. She states she needs the resources EAA T003(10/06101)
pr ovid e d fo r tho se who have a PWD desi gnat ion to t he med i cal fa c ili t i es t h a t c an d eal w ith he r ea tin g quite rar e a nd t hat t here are o n ly a f e w speciali sts sp ec ialists to c omplet e th e r eport s t h a t she r equired di d no t get al l the i nfor mat ion n e eded to prop erly a T he pane l notes t h at the cri teri a for a PW D designa in c l ude e mplo yab il i t y or the abil ity to access e m p loymen addr ess th o se i s su es as t he p hysician did not complete pro vide a ny co n c r e t e infor m atio n in tha t r espect. The A the vast ma j ority o f DL A and in the few in stan c es whe a ssista nc e from a nother person, i t does not explai re qui re d. T he app e l la nt in he r testimony conf irms that a ny part icula r help from other peopl e . T h e panel as we l l n otes that the a pp e l lant liv es in a a re few service s for someone w ho s uf fe r s from a n professi onal ca re ; howeve r, the evi dence does not d impair m en t. The p anel a l so n o t es that t he ap pellan mo n t h. Th ere is no ev idence pr ovided th at woul d support th prescribed professiona l s that com pl e ted th e P R a nd that a s pe ciali s t or a psychiatrist wou ld be in a better th e appel lant t o select the app ro p riate pr e scrib e d profes Whil e the pa nel ackn o wle dg e s th e sev ere im pa ct of her m suppor t a direct and sign ifican t restr ic t ion to her DLA, co periods. G iv en t he ev idenc e provided by th e appella nt' s ph ys into a c count t he a pp el lan t's expla nati ons, th e p anel determ ined that t he evi dence w a s n ot suff ici ent to directly a nd sign i f i c ant ly rest ricte d her a bi lity t o perform D extended p eriods. Help required to perform OLA: Th e minis try argues that since DLA are not sig ni f ic significant help is required from other persons and tha assistance animal. The appellant did no t arg ue that she nee d e d help to perfo additional financi a l resources to b ecome mo r e independen care that her medical condition needs. The panel finds there is little if any evidence the appellant needed help to perform her DLA. In her testimony, she stated she did not need or have help from other people or any assistive device. Thus, the oa nel fi nd s the ministrv reasonablv determined the annellant did not meet the leaislative test of EMT 003(10/06/01) I APPEA a llo w h er to b e i nde p ende n t and have a c ces s to disord er. She ar gues that her medical co n dition is in that field and s h e did not ha ve acc ess to such to pro vide t o t he min istry and that the mi n i s t ry sse ss her con dit ion . t ion are c lea rly establish ed by law an d do no t t. I n te rms o f DL A , the PR does not direc t ly that part of her repor t and di d n o t real ly R sta tes that t he app e l la nt is indep ende nt in re it is ind ic a te d t hat she need s p e r iodi c n the n ature, e xt e n t and durat i on of t he ass i s ta nce s h e is mos t ly in dependent and doe s n o t need n isolat ed community an d a re gio n where t here eat i n g d i sorder because o f the a bse n ce o f e monst rat e that t his impa cts d i rectly o n h e r t check e d hers elf out o f p r o fessional care a ft e r 1 ½ e ap pellant ' s argument t hat th e th e AR d id n ot provid e adequate infor m a tion and p o sitio n to a ssess her DL A. It is in cumbent on sionals and provide e vide n ce in that r es p ect. ed i c al c ondition, the e vi d e nc e does not n tinuo usly o r periodicall y for extended ician and t he p rescribed prof e ssio n al, and ta king concl ud es t ha t t he min is t ry reasonably det ermine that t he appellan t's s ev ere i mp airme n t L A either cont i n uo usly or perio d i ca lly f or an tly restricted, it cannot be determined t hat t n o a ssisti ve d evices a r e requ i r ed nor an r m her DLA but rather tha t she n e eded t and b e abl e to access the specialized
t h e n e e d f o r h e l p a r i s i n g f r o m s i g n i f i c a n t r e s t r i c t i o n 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 . C o n cl u s i o n : T h e p a n e l c o m e s t o t h e c o n c l u s i o n t h a t a l t h o u g h t i m p a i r m e n t , t h e m i n i s t r y r e a s o n a b l y d e t e r m i n e d s h s i g n i f i c a n t l y r e s t r i c t e d h e r a b i l i t y t o p e r f o r m D L A e i 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 , s s . 2 ( 2 ) o f t h e E A P W D A . C o n s e q u e n t l y , t h e p a n e l f s u p p o r t e d b y t h e e v i d e n c e a n d c o n f i r m s t h e d e c i s i E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I AP P E AL s 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 o r h e a p p e l l a n t h a s a s e v e r e m e n t a l a n d p h y s i c a l e d i d n o t e s t a b l i s h t h a t t h i s i m p a i r m e n t d i r e c t l y a n d 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 h e r e q u i r e d 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 u n d e r i n d s t h e m i n i s t r y ' s d e c i s i o n w a s r e a s o n a b l y 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.