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 l 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 3 J u l y 2 0 1 4 w h i c h d a s s i s t a n c e w i t h t h e m e d i c a l t r a n s p o r t a t i o n h e a l t h s u s e t o u t i n S c h e d u l e C , s e c t i o n 2 ( 1 ) ( f ) o f t h e E m p l o y R e g u l a t i o n ( E A P W D R ) b e c a u s e t h e d o c t o r s h e w a s a s p e c i a l i s t a s d e f i n e d u n d e r S c h e d u l e C , s e c t i o n 1 S c h e d u l e C o f t h e 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 E A P W D R , s e c t i o n 6 2 a n d S c h e d u l e C , s e c t i o n 2 ( 1 ) E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A 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 m i n i s t r y ) e t e r m i n e d t h a t t h e a p p e l l a n t w a s n o t e l i g i b l e f o r p p l e m e n t b e c a u s e s h e d i d n o t m e e t t h e c r i t e r i a 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 h D i s a b i l i t i e s r e f e r r e d t o w a s n o t i n h e r l o c a l a r e a a n d w a s n o t o f t h e E A P W D R a n d r e q u i r e d b y s . 2 ( 1 ) ( f ) ( i i ) o f ( f ) .
P A R T E S u m m a r v o f F a c t s 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 t • T h e a p p e l l a n t i s d e s i g n a t e d a s a P e r s o n w i t h D s o l e r e c i p i e n t . • O n 3 J u n e 2 0 1 4 , t h e a p p e l l a n t c o m p l e t e d a n d s T r a n s p o r t a t i o n A s s i s t a n c e f o r m t o t r a v e l t o a m a p o d i a t r i c m e d i c i n e ( t h e p o d i a t r i s t ) t h a t w a s s c h e • A l e t t e r d a t e d 3 J u n e 2 0 1 4 b y t h e a p p e l l a n t a d v t r a n s p o r t a t i o n n e e d s a n d t h a t t h e f i r s t o n e w a s t a p p e l l a n t h a d s e e n t h e p r e v i o u s m o n t h . H e w a s a c c o m m o d a t i o n s w e r e t a k e n c a r e o f b u t s h e n e d a y s . • A f a x c o v e r f r o m t h e p o d i a t r i s t ' s o f f i c e d a t e d 3 0 o f 9 J u n e 2 0 1 4 a t 1 0 : 3 0 . o A l e t t e r d a t e d 6 J u n e 2 0 1 4 f r o m t h e m i n i s t r y t o t l o c a l m e d i c a l t r a n s p o r t a t i o n b e c a u s e p o d i a t r i s t s C o l l e g e o f P h y s i c i a n s a n d S u r g e o n s o f B C . • 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 1 9 J u n e s h e h a d e n o u g h w i t h t h e m i n i s t r y ' s i s s u e s a n d t h S h e a d d e d t h a t s h e w a s d i a b e t i c a n d l i v i n g f a r b w i t h a m i n i s t r y E m p l o y m e n t a n d A s s i s t a n c e W o w a s a s s u r e d t h a t t h e p o d i a t r i s t w a s a s p e c i a l i s t a p p r o v e d . S h e s t a t e d t h a t s h e w a s o n l y t o l d a t t a p p r o v e d b u t i t w a s t o o l a t e t o c a n c e l a s m o s t o S h e w o u l d n o t h a v e b o o k e d t h a t a p p o i n t m e n t h a a s s i s t a n c e f r o m t h e m i n i s t r y . S h e m e n t i o n e d t h a s p e c i a l i s t . S h e e n d e d u p b e i n g i n d e b t a n d w a s t h a t m o n t h a n d t h e n e x t . A t t a c h e d t o h e r r e q u e s d o c u m e n t s : o A l e t t e r d a t e d 1 4 M a y 2 0 1 4 b y a p h y s i c i a n t h i r d p a r t y f o r s e e i n g t h e a p p e l l a n t w i t h r e o A f a x f r o m t h e p o d i a t r i s t ' s o f f i c e d a t e d 6 J p o d i a t r i c m e d i c i n e a n d a f o o t s p e c i a l i s t . 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 0 J u l y 2 0 1 4 , t h e a p p c a u s e d h e r h a r d s h i p a n d d e b t . 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 s h e d o u b l w a s u s u a l l y d e a l i n g w i t h h e r f i l e t h a t t r a n s p o r t a t i o n a t r a v e l a n d a p p o i n t m e n t w i t h t h e p o d i a t r i s t a n d s h e w 5 p m t h a t i t w o u l d n o t b e c o v e r e d , t o o l a t e t o c h a n g e a l r e a d y p a i d . S h e t e s t i f i e d t h a t t h e m i n i s t ry w o r k e r w h e r m i s t a k e . S h e e x p l a i n e d t h a t s h e h a d s u f f e r e d i n a t t e n d i n g p h y s i c i a n r e a l i z e d t h e r e w e r e u r g e n t m e d i a d d r e s s e d b v a s p e c i a l i s t a n d h e r e f e r r e d h e r t o a p E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L h e t i m e o f r e c o n s i d e r a t i o n : i s a b i l i t i e s ( P W D ) a n d p r o v i d e d a s s i s t a n c e a s a i g n e d 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 j o r c i t y f o r a n a p p o i n t m e n t w i t h a d o c t o r o f d u l e d f o r 9 J u n e 2 0 1 4 . i s i n g t h e m i n i s t r y t h a t s h e h a d u p c o m i n g m e d i c a l o a t t e n d a n a p p o i n t m e n t t o s e e t h e p o d i a t r i s t t h e t o p e r f o r m m i n o r s u r g e r y o n h e r t o e . H e r e d e d t h e c o s t s o f t r a n s p o r t a t i o n a n d m e a l s f o r 3 M a y 2 0 1 4 c o n f i r m i n g t h e a p p e l l a n t ' s a p p o i n t m e n t h e a p p e l l a n t s t a t i n g s h e w a s n o t e l i g i b l e f o r n o n  a r e n o t c o n s i d e r e d a s p e c i a l i s t r e c o g n i z e d b y t h e 2 0 1 4 , t h e a p p e l l a n t r e q u e s t e d a n o r a l h e a r i n g a s a t s h e h a d a n u m b e r o f w i t n e s s e s t o p r e s e n t . e l o w t h e p o v e rt y l i n e a n d t h a t s h e h a d s p o k e n r k e r ( E A W ) w h e n b o o k i n g t h a t a p p o i n t m e n t a n d a n d t h e m e d i c a l t r a n s p o r t a t i o n w o u l d b e h e l a s t m i n u t e t h a t t h e a s s i s t a n c e w o u l d n o t b e f t h e a r r a n g e m e n t s h a d a l r e a d y b e e n p a i d f o r . d s h e k n o w n s h e w o u l d n o t r e c e i v e t r a n s p o r t a t i o n t s h e w a s t o l d t h e p o d i a t r i s t w a s a d o c t o r a n d a c o n c e r n e d s h e w o u l d r u n o u t o f f u n d s f o r f o o d t f o r r e c o n s i d e r a t i o n w e r e t h e f o l l o w i n g f r o m t h e m a j o r c e n t r e t h a n k i n g a n u n n a m e d g a r d s t o f o o t c a r e a n d p o d i a t r y s e r v i c e s . u n e 2 0 1 4 i n d i c a t i n g t h a t h e i s i n d e e d a d o c t o r o f e l l a n t s t a t e d i t w a s t h e m i n i s t r y ' s e r r o r t h a t e d c h e c k e d 3 t i m e s w i t h t h e m i n i s t r y w o r k e r w h o s s i s t a n c e w o u l d b e a p p r o v e d b e f o r e b o o k i n g h e r a s o n l y a d v i s e d o n t h e e v e o f h e r t r i p a r o u n d 4 o r h e r p l a n s a s m o s t o f t h e e x p e n s e s h a d b e e n h o g a v e h e r t h a t i n f o r m a t i o n a p o l o g i z e d l a t e r f o r j u r y a n d w a s t r e a t e d a t a c l i n i c w h e r e t h e c a l i s s u e s w i t h h e r f e e t t h a t n e e d e d t o b e o d i a t r i s t i n t h a t c i t v . S h e s t a t e d t h e o h y s i c i a n
k n e w s h e d i d n o t r e s i d e i n t h a t c i t y a n d w o u l d h a v e p o d i a t r i s t f r o m p a s t e x p e r i e n c e a n d t h a t h e c o u l d d r e a l i z e d t h e m i n i s t r y w o u l d n o t p a y f o r t r a v e l a s s i s t s u r g e r y o n t h e d a y t h a t s h e h a d t h a t a p p o i n t m e n t o h a v e b e e n s e t l a t e r t h i s y e a r f o r s u r g e r y o n b o t h f e T h e m i n i s t r y t e s t i f i e d t h a t t h e w o r k e r 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 d i d n o t r e c a l l h a v i n g m a d e t h o s e s t a t o t h e a p p e l l a n t h e r t r a v e l w o u l d b e a p p r o v e d i f t h e o f P h y s i c i a n s a n d S u r g e o n s o f B C . T h e m i n i s t r y w i c o m m e n t s t o t h e a p p e l l a n t . 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 rt o f t h p r o v i d i n g m o r e i n f o r m a t i o n o n t h e c i r c u m s t a n c e s o f T h e p a n e l n o t e s t h a t t h e r e i s a n i n c o n s i s t e n c y b e t w s h e w a s i n d u c e d t o b o o k h e r a p p o i n t m e n t a n d t r i p b w o u l d b e c o v e r e d a n d l a t e r a p o l o g i z e d w h i l e t h e m l e g i s l a t i o n ( a s p e c i a l i s t r e c o g n i z e d b y t h e B C C o l l e g t h e e v i d e n c e s h o w s p o d i a t r i s t s a r e n o t r e c o g n i z e d a S u r g e o n s o f B C . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A t o t r a v e l f o r h e r a p p o i n t m e n t s . S h e a l s o k n e w t h a t o m i n o r s u r g e r y i n h i s o f f i c e b u t g i v e n t h a t s h e a n c e , s h e d e c i d e d a g a i n s t g o i n g a h e a d w i t h n 9 J u n e 2 0 1 4 . S h e t e s t i f i e d o t h e r a p p o i n t m e n t s e t w i t h a d i f f e r e n t d o c t o r . m e n t i o n e d w a s a s k e d w h a t h a d h a p p e n e d a n d s h e t e m e n t s o n 3 o c c a s i o n s b u t r a t h e r t h a t s h e s a i d d o c t o r w a s a s p e c i a l i s t a c c o r d i n g t o t h e C o l l e g e t n e s s w a s n o t t h e r e w h e n t h e w o r k e r m a d e t 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 , t h e i s s u e s . e e n t h e a p p e l l a n t ' s t e s t i m o n y t o t h e e f f e c t t h a t y a E A W w h o t o l d h e r t h a t h e r t r a v e l e x p e n s e s i n i s t r y t e s t i f i e d t h a t t h e w o r k e r h a d o n l y s t a t e d t h e e o f P h y s i c i a n s a n d S u r g e o n s ) . T h e p a n e l f i n d s s s p e c i a l i s t s b y t h e C o l l e g e o f P h y s i c i a n s a n d
PART F -Reas on s for Pa nel Dec ision The issue under appeal is wh ether the ministry's decis ass istance with t he med ic al transportation healt h s was n ot in her local area and because he was no t a speciali EAP WD R was a r e asonabl e app lication of the legislatio The applicab le legislation can be found at Sc hedule C as a specialist : 1 In this Sche dule: ... "special ist" means a medical practit ioner recogn i zed as a specialist in ac cordan c e w ith the bylaws made by th e board for the College o Br itish Columbi a un de r s ection 19 (1) (k.3 ) and (k.4) o An d secti on 2 ( Gen er al H ealth S upple ments ) i ndicates transpo rtation ass istance: 2 (1) The following are t h e hea lt h su ppl ements th at fam i ly un it t hat is el ig ibl e un d er sect ion 62 [general hea (f) the le a s t e xp ens iv e appropriate mo de o f t ransportation (i) an office, i n t h e local area, of a medical practiti ( ii ) th e office o f the n earest avail a b le s p eci al i has b ee n re f er red t o a s peci a lis t i n t h at f ie ld pra ctitioner, ( iii) th e nea re st s uitab l e g ener a l ho s pital o r reha d e f i ned in section 1.1 of t he Ho s p i tal I nsuranc ( i v) the neares t su itable hospita l as defined in paragra se ction 1 of th e Hosp ital Ins ur ance Act, pr ovide d t hat (v) th e transportation is to ena b le t h e pers on Pro tect ion Act o r a gen er al ho spital serv ice under ( v i) there are no r es ources available to t h e person The mini st r y argu ed th at the ap pellant was n ot elig ible b ecause the s pecialist s he w as referred to in a ci ty ot recognized s pecialist by the College of Physicians and Surgeons of BC and even if he had been, because there was no evidence he was the closest podiatrist to the appellant's community. T h e app el lant argued she w as mislead by the m inistry in t travel would be paid for before she made the appointment arrangements and that the ministry should be held responsible for that mis EAW apologized for having made that error and that the EAW's statemen make a written sworn statement as to what happened. She required because of her medical cond i tio n and that a podiatrist is a specialist that can perform such surgery and the ministry should acknowle dge the doctor she saw is a specialist. The oanel's decision must be Quided by lei:iislation and its iurisdiction is set bys. 24 /1 \ of the EAA as EAAT 003(10/06/01)I APPEAi io n that the appellant was not el igible for u pplement b e cau se the doct or she w as referred to st under s. 2 of S chedule C of the n or reasonabl y s up porte d b y the ev idence. of th e E APWDR that f irst define w ho q ualifies i n a f ie l d o f m edicine or sur gery f Physicians a nd Surgeon s o f f the Heal t h Professi o n s Act. a t par agraph 1 (f) wh o is eligible for medical may be p a id for by th e mini ster i f provided to a l th s u p plements ) o f t h is regulatio n: . . . to or fr om o ner or n urs e p r actiti on er, s t in a field o f med icin e o r sur gery if th e pers on by a lo cal m e d ical p r actitio ner or nurse bilit a t ion hosp it al, a s t hose fac i l i t i es a r e e Act Reg ulations, or p h (e) of t h e d e finiti o n o f "hosp it al" i n to receiv e a b e n e fit under the Medicare the H o s pital I nsura nc e A ct, and 's family uni t to co v er t he cost. f o r medic al tran s por tation supplement h e r than t he a ppellant's loc a l a r e a was not a hat an EAW made h e r believe that her with the podiatrist and her travel take. She argued that the t is untrue and she should al so st ated that su rgery on her fe et is
I APPEAL to whether the reconsideration decision is reasonably supported by the evidence or a reasonable application of the applicable enactment in the circumstances of the appellant. In this case it is obvious that the appellant was under the impression she had been given the right information and that her medical travel would be covered by the ministry. However, the ministry's discretion in terms of medical travel is very limited as provided bys. 2 (1)(f), Schedule C of the EAPWDR and, as in the circumstances of the appellant, when medical travel must take place outside the local area of the patient, the ministry may only provide medical transportation supplement for travel to the office of the nearest available specialist in the field of medicine or surgery. In this case, the panel finds the doctor in question was a podiatrist and that he was not a specialist as defined by s. 1, Schedule C of the EAPWDR. Regardless of the alleged error by the EAW, the reconsideration officer had no discretion in applying the legislation and the panel finds the ministry reasonably determined the podiatrist was not a "specialist" under the legislation and thus, reasonably determined it had no authority to provide medical transportation supplement to the appellant. The panel did not consider the ministry's argument that in any event the podiatrist was not the nearest available specialist as there was no evidence whether he was or he was not the closest available specialist and as the issue was not considered at reconsideration. Further, this is a moot point since the panel found the podiatrist in question was not a specialist under the applicable legislation. Therefore, the panel finds the ministry's decision was a reasonable application of the applicable enactment in the circumstances of the appellant and confirms the decision. EAAT 003(10/06/01)
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