P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t r y o f S o c i a " M i n i s t r y " ) r e c o n s i d e r a t i o n d e c i s i o n d a t e d M a y 2 8 , c r i s i s s u p p l e m e n t f o r a n e l e v a t i n g l i f t c h a i r p u r s u a n 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 ( t h e " E A P W T h e M i n i s t r y f o u n d t h a t t h e a n e l e v a t i n g l i f t c h a i r w A p p e l l a n t h a d t h e r e s o u r c e s a v a i l a b l e t o m e e t t h i s r e s u l t i n i m m i n e n t d a n g e r t o t h e A p p e l l a n t ' s p h y s i c c o n s i d e r e d a h e a l t h c a r e g o o d i n S c h e d u l e " C " a n d E A P W D R . P A R T D R e l e v a n t L e g i s l a t i o n T h e M i n i s t r y r e l i e d o n t h e f o l l o w i n g l e g i s l a t i o n i n m • E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t • E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t 5 7 a n d S c h e d u l e " C " E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L l D e v e l o p m e n t a n d S o c i a l I n n o v a t i o n ( t h e 2 0 1 4 w h i c h h e l d t h a t t h e A p p e l l a n t w a s d e n i e d a t t o s e c t i o n 5 7 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 D R " ) . a s n o t a n u n e x p e c t e d n e e d o r e x p e n s e ; t h a t t h e n e e d ; t h a t t h e f a i l u r e t o o b t a i n t h e i t e m w o u l d n o t a l h e a l t h a n d t h a t t h e a n e l e v a t i n g l i f t c h a i r i s n o t p e r m i s s i b l e u n d e r s e c t i o n 5 7 o f t h e a k i n g t h e i r d e t e r m i n a t i o n : h D i s a b i l i t y A c t ( t h e " E A P W D A " ) , s e c t i o n 5 h D i s a b i l i t y R e g u l a t i o n ( t h e " E A P W D R " ) , s e c t i o n
I APPEA PART E -Summary of Facts The evidence before the Ministry at reconsideration included the following: Employment and Assistance Request for Reconsideration dated May 28, 2014 with the following attached documents: 1. Crisis Request for the Appellant date unknown requesting bank statements and general information requesting an elevating lift chair. The following are answers to questions posed on the form: a. What is needed? The response was a "motorized lift chair." b. What was the unexpected event or expense that prevented you from meeting this need? The response was "to prevent my edema from flaring." c. What resources have you accessed to try to meet this need? The following were checked: friends and family, set up payment plan, attend thrift stores, local resources and tried to reduce expenses. d. Other resources accessed? The response was "two thrift stores." e. What is the direct threat to your health and safety? The response was "to stop blood clots and my edema from spreading." 2. TD Account Activity account showing the Appellant's March expenditures. The Appellant had a starting balance on March 3, 2014 of $2,473.25 and ending balance on March 25, 2014 of $50.35. 3. TD Account Activity account showing the Appellant's February 3 expenditures. The Appellant had a negative balance on February 3, 2014 of ($10.70) and ending balance on February 28, 2014 of $1,473.25. 4. Letter from the Appellant dated March 25, 2014 to "whom it may concern" stating that he is applying for a crisis supplement for a comforter chair and that he is applying for the chair to keep his legs elevated so his edema does not bother him. 5. Sales quotation dated March 3, 2014 for a comforter wide large dual motor life chair with deluxe heat and massage system in the total amount of $2,789.10. The Appellant additionally submitted in his Notice of Appeal dated June 18, 2014 that he did not agree with the decision. He stated that the reclining chair will prevent imminent danger to his physical health and that it's not an item in Schedule "C." At the hearing, the Appellant relied on the following documentation: 1. Letter from the Appellant's medical practitioner dated May 29, 2014 to "whom it may concern" (the "Letter") stating the following: "[The Appellant] has been my patient for more than ten years and in that time he has experienced edema and a number of blood clots in addition to his severe arthritis. In order to avoid further life threatening blood clots and edema, I recommend that [the Appellant] use a reclininQ chair with capabilities of also liftinQ him forward to help him Qet up from the EAAT003(10/06101)
APPEAL I sitting/reclining positions." 2. An internet article titled "Blood clots can be deadly, but they are often preventable and treatable" listing the dangers of clots, who's at risk, prevention measures, recognizing symptoms and treatment. 3. An online website question and answer article with the question "Can the ministry make me use money from my trust to pay for something that would usually be paid for by the ministry? For example, can the ministry ask me to pay for a health expense out of my trust that the ministry usually pays for under schedule c of the BCEA legislation?" The answer: "No. Ministry policy says that a person will not be disqualified from receiving disability assistance just because the person has a trust. The amount the person can spend on disability costs from a trust is meant to pay for the things that are not covered by the ministry or for fees for services that are covered but which exceed the maximum allowable amount." The appellant stated he was using a borrowed elevating lift chair and no longer has use of that chair. The Ministry acknowledged that they received the above documents prior to the appeal hearing but after the decision was rendered. The Ministry stated that the additional documents were taken into consideration after the decision was rendered and it did not change the decision. The elevating lift chair has also been referred to in the Record of the Ministry Decision as a motorized lift chair, elevating chair, and reclining chair. The Panel will refer to the chair as the elevating lift chair for clarity. The Panel finds that the additional documents provided by the Appellant clarified his situation and was admissible under section 22(4) of the Employment and Assistance Act as it was in support of the records before the Ministry at reconsideration. EAAT 003(10/06/01)
APPEA I PART F -Reasons for Panel Decision The issue is whether the Ministry's decision to deny the Appellant an elevating lift chair is a reasonable application of the legislation in the circumstances of the Appellant or is reasonably supported by the evidence. The Ministry relied on section 57 of the EAPWDR to find that the Appellant was not eligible for a crisis supplement. The section has been reproduced below: (A) Crisis supplement 57 (1) The minister may provide a crisis supplement to or for a family unit that is eligible for disability assistance or hardship assistance if (a) the family unit or a person in the family unit requires the supplement to meet an unexpected expense or obtain an item unexpectedly needed and is unable to meet the expense or obtain the item because there are no resources available to the family unit, and (b) the minister considers that failure to meet the expense or obtain the item will result in (i) imminent danger to the physical health of any person in the family unit, or (ii) removal of a child under the Child, Family and Community Service Act. (2) A crisis supplement may be provided only for the calendar month in which the application or request for the supplement is made. (3) A crisis supplement may not be provided for the purpose of obtaining (a) a supplement described in Schedule C, or (b) any other health care goods or services. (4) A crisis supplement provided for food, shelter or clothing is subject to the following limitations: (a) if for food, the maximum amount that may be provided in a calendar month is $20 for each person in the family unit, (b) if for shelter, the maximum amount that may be provided in a calendar month is the smaller of (i) the family unit's actual shelter cost, and (ii) the maximum set out in section 4 of Schedule A or Table 2 of Schedule D, as applicable, for a family unit that matches the family unit, and (c) if for clothing, the amount that may be provided must not exceed the smaller of (i) $100 for each person in the family unit in the 12 calendar month period preceding the date of application for the crisis supplement, and (ii) $400 for the family unit in the 12 calendar month period preceding the date of application for the crisis supplement. EAAT003(10/06/01)
I APPEAi (5) The cumulative amount of crisis supplements that may be provided to or for a family unit in a year must not exceed the amount calculated under subsection (6). (6) In the calendar month in which the application or request for the supplement is made, the amount under subsection (5) is calculated by multiplying by 2 the maximum amount of disability assistance or hardship assistance that may be provided for the month under Schedule A or Schedule D to a family unit that matches the family unit. (7) Despite subsection (4) (b) or (5) or both, a crisis supplement may be provided to or for a family unit for the following: (a) fuel for heating; (b) fuel for cooking meals; (c) water; (d) hydro. Schedule "C" is the section that defines health supplements for the purposes of the EAPWDR. Schedule "C" has not been reproduced given the large volume of this section but will be discussed and referenced below. Ministry Argument In determining that the Appellant was not eligible for an elevating lift chair for failure to meet the legislative requirements pursuant to section 57 of the EAPWDR, the Ministry stated the following: Crisis supplements are available to recipients of income assistance, disability assistance, and hardship. To meet the crisis supplement criteria the requested item must be required to meet an unexpected expense, or obtain an item unexpectedly needed, the family unit has no resources available to meet the need, and failure to provide the item will result in imminent danger to the physical health of one or more of the family members or removal of a dependent child by MCFD. A supplement may not be provided for the purpose of obtaining a supplement described in Schedule C, or any other health care goods or services. The Ministry argued that the Appellant was not eligible for a crisis supplement as the requirements as defined under section 57(a)(b) of the EAPWDR were not met by the Appellant. The Ministry concluded that the Appellant had not established that the item was an unexpected need, that he did not have the resources to purchase the lift chair on his own and that the failure to purchase the item will result in imminent danger to the Appellant's physical health. The Ministry further concluded that the elevating lift chair was described in Schedule "C" and therefore a health supplement that is not eligible under section 57(3) of the EAPWDR. Appellant Argument The Appellant argued that he is applying for the crisis supplement to purchase an elevating lift chair to keep his legs elevated so his edema does not bother him and to further prevent edema flare ups and related blood clots. He further submitted an elevating lift chair is not an item in Schedule "C" and therefore permissible under section 57 of the EAPWDR. EMT003(10/06/01)
I APPEAL Panel Decision Unexpected Expense or Need Section 57(1 )(a) of the EAPWD states that the Ministry may provide a crisis supplement to or for a family unit that is eligible for disability assistance if the family unit or person in the family unit requires the supplement to meet an unexpected expense or obtain an item unexpectedly needed. The Ministry stated at the appeal hearing that the Appellant's edema has been an ongoing issue and the requirement of the elevating lift chair has also been ongoing therefore did not meet the definition of "unexpected." The Ministry stated that in order for the Appellant to be able to rely on the argument that the elevating lift chair was an unexpected expense or an item unexpectedly needed the requirement of the elevating lift chair had to be unforeseen or not expected. The Ministry held that the elevating lift chair was neither an unexpected expense nor an item unexpectedly needed as the Appellant ought to have anticipated or expected that he would eventually have to purchase a similar elevating lift chair to the one he was using given his ongoing medical condition. The Appellant argued that the immediate and unexpected requirement of an elevating lift chair is to prevent blood clots and his edema from spreading as recommended by his doctor. The unexpected expense and need he suggested is therefore related to his medical condition. The Appellant explained that although he has had edema for a number of years he did not need an elevating lift chair as he had access to a similar chair. When he no longer has access to that particular chair he informed his doctor and his doctor, in turn, agreed and recommended the Appellant use an elevating chair to avoid further life threatening blood clots and the spread of his edema. While the Appellant argues the requirement of the elevating lift chair is to prevent blood clots and the spread of his edema, there is insufficient evidence to substantiate the need for the elevating lift chair is an unexpected expense or unexpectedly needed. Given the history of the Appellant's medical condition, his former reliance on a similar "borrowed" chair and past discussion with his doctor regarding the need for the elevating lift chair, the evidence supports that the elevating lift chair is more an item that the Appellant knew he needed for a considerable time prior to his request for a crisis supplement and could have reasonably anticipated that eventually he would be required to obtain his own. For these reasons, the Panel finds the Ministry was reasonable in their findings that the purchase of the an elevating lift chair was not an unexpected cost or an item that was unexpectedly needed pursuant to section 57(1 )(a) of the EAPWDR. Unable to Meet the Expense Section 57(1) (a) of the EAWDR also requires that the family unit or a person in the family is unable to meet the expense or obtain the item because there are no resources available to the family unit. EAAT 003(10/06/01)
The Ministr y argued that the Appel lant had resources availa the expe nse. The Ap pellant ar g ued that he did n ot an e levating l i f t cha i r and expla ined at t h e appeal hear was no t entitled to the m o ney. The Appellant argued that he did not fe el the Ministry had the au monie s t hat di d not belo n g to him. The Appellant submitted an online question and answer (the "Q&A ") that addressed whether or not the Ministry could compe trust to pa y for somet hing that t he Ministry woul d ot wi l l not be disqualifi ed from receiving d is a bility benefits jus The Appellant sub mitted th e Q&A t o confirm that he could not m on ies on policy grounds , but the facts before the Panel can be distinguishe submitted by the Appellant. The Q&A assumes the item the recipient is bein o f trust is a n it em t hat is a s sume d to be "us ual ly" paid for th e Min i s try h as det ermine d the eligib ilit y o f the ap s up plement. Section 5 7(1 )(a) requires th at the famil the r e are no reso u rc es avai lable t o th e family. The th e Appellant, th at b eing hi s wife's t rust monie s, a nd financ e th e elevat i ng lift chai r . T h e Ap pellant i s re q u ired under thi s section to establish that to o btai n the i tem requested . The Appell an t in his Cr isis R equest did respo nd that offse t the c o s t of the e leva t in g lif t cha i r, inc luding r ed and ask ing f ri end s and fami l y but a t the a ppea l h e aring he e fforts. With re spect t o r educ ing h i s sp ending ha bits, the Ap g iv en his l imit ed i ncome. T h e Appel lant sta t e d th a bu t this is no t r e flected i n the b ank statements he submitted to the Mi The Appellant also indicated that he di d not set up a payment plan with the company th elevating lift chairs as t he c o mpany did not offer this service. sought out other similar companies to see if this could be an option. The panel fi nds th e appellant is part of a family unity and th available to the appellant; as well, there is insufficient evidence that thre are not other resource a vailable. d A s s u c h, the panel det ermines that the reso ur ces available to him t o pu rchase an elevat i n g 57(1)(a) of the EAPWDR. Imminent Danger to Physical Health Section 57(1 )(b) also requ ires the Ministry to consider whether obtain the item will result in imminent danger to the physical health. EAAT 003(10/06/01) I APPEAL bl e to him that were hel d i n t rust to meet have resources in t rust t o c o ve r th e c o s t s o f the in g that the trust was in his wife's name and he thori ty to compel h i m to u se trust l the Appellant t o use money from his herwise pa y fo r . The answ er stated that a person t for having a tr ust. be compelled to use h is wife's trust d from the Q&A g enc our ag ed to pay o ut b y the Ministry . In this case is one whe r e pell an t to o btain t he i tem under s ecti on 5 7, a cr isi s y unit is una ble to m e et the e xpense be c a use Ministry held t hat t her e is a r esour ce av ailab le to tha t the App ell a n t co u ld r e l y on this r e s o ur ce to there are no other reso u r ces or means he h as made e ffort s to find other r e s o urc e s to uci n g h is s pend ing , s e tt ing up a pa y me n t plan ga ve ev i d ence th at di d n ot supp o rt t h e se pellant clai m e d t hat t his w as near i mp o ssible t he did eve ntual t r y t o re duce h is s p e nding habi t nistry. a t sells The Appellant did not reveal if he a t hi s wife's trust fund is a resou rce s Mi nistry's de ci si o n t hat the Ap pellant does have lift chair was r easonable pursuant t o section the failure to meet the expense or
The Min is t ry was not sat i s fied that the Appell a nt esta c hair would result in imm ine n t d ang e r t o the A ppel he ne eded an elevatin g li ft cha i r to pr event hi s ed e W hile th e Appell an t h as s uf fered a n on g oi ng ba ttle h elp minimize t he s ide ef fe c t s in the pa s t t here is in i na bi lity to ob tain t he e l e vatin g lift ch ai r will result in imminent dan Firs t , i f t here i s lack o f p roof or medical ba sis to s u s pre ad of e dema or blood clots. The App e l la nt su b cl ots whic h of fers tips and remed ies to help preve nt poi nt and d oes not disc u s s bloo d clots and th e p reve article mer ely p oints o u t that b loo d cl o ts ca n be deadly but and oth er m ore h olistic me a su res. Non e of wh ic h ar oth erwi se . The Appell ant also submi t ted a n o te fro m h is doc t or recommending the us pre vent life threat e n i n g bl ood clots. The panel not e on th e doctor's letterh e a d and also l a cks th e medic t o see on a d octor's note. None th e less, wh i le t he n o t a d isp uted f ac t , th ere i s ins u f ficient evid en ce that fai r e sult in im mi n e n t danger to h ealth . F o r thes e r e ason s, t he panel de termines t he Minist woul d res ul t in imm i n e nt danger t o the app el lan t's physi evid ence. Sc he dule "C" Section 57(3) o f t he EAPWD R states th at th e cri s i s o f obt aining a sup pl e ment t hat i s d e scribe d in S ch ed The Ministry arg ue d that whi l e t he ele vating l ift cha Sche dul e "C" i s not an exhaustive list and does not supplement but describes health care supplements in general. i ndustry st an d ards co n side r s or defines th e elevated f a ll s w ithin the a m bit o f Schedule "C." The Appellan t argued that the elevating lift chair was not listed in Schedule "C" and therefore was an i t em th at could be covered as a crisis supplement. On rev i e w of Schedu l e " C" it is cl ear that an elevating li section. While it would appear t hat an e levating lift chair could suppleme nt it is nevertheless not s pecifically in c luded within this section. For these reasons, the Panel fin d s the Minist ry was not reasonable in their findings that the elevating lift chair is described in Schedule "C" of the EAPWDR EM T003(10/06/01) APP EAi I blishe d the failure to o btain th e el evati ng lift lant ' s p hy sical hea lt h . T he Appel lant arg ues t hat ma fr om spr ea ding a nd s top rel ated bloo d clots. w ith ede ma and has used an elevatin g lift chair t o suffi c ie nt evi denc e to s u pport tha t t he A ppellan t's ger to hi s h ea lt h . g gest tha t an el evat ing l ift chair w ill pre vent th e mi t ted a n article ex p laining the da nge rs o f blood them from oc curr i n g, but the a rticle is not on ntion in relation to an eleva tin g lift chair. The preve ntable wi th the use of m e dication e r e lat e d t o " chairs" be it ele vat ing, rec l ining or e o f an e l eva t in g lift chair t o s that the le t te r i s w ritten on p l ain white p ape r not a l vocabul ary a nd co ntent t ha t one w oul d exp e ct le tter st ates blo od cl ots a r e threa tenin g , an d th at is lure to provide th e e levating lift ch air w oul d ry tha t failure to obta in the ele v a ti n g l if t chair cal heal th w a s reas onably s up porte d b y the s u ppleme nt may not b e prov id ed for th e pur pose ule "C" of th e EAP W DR. i r is not s pecifically me n tioned in Schedule "C" th at spec if ic a lly c ov e r e very applicable health care The Ministry explaine d that the lif t cha ir as a health care equipment and as such ft chai r i s not specific a l ly defined within the be characterized as a health care in Schedule "C" and therefore d oes not fall a nd not ner mi s sible u nder sectio n 57 of the
I APPEAL EAPWDR. As the requirements of section 57 of the EAPWDR were not met, the Panel finds the Ministry's determination that the Appellant be denied a crisis supplement for an elevating lift chair was reasonably supported by the evidence and confirms the decision. EAAT 003(10/06/01)
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