Ministry of Social Development and Poverty Reduction

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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 D e v e r e c o n s i d e r a t i o n d e c i s i o n o f J u l y 2 4 1 \ 2 0 1 4 w h e r e i n t h e m o r t h o s e s ( u p p e r e x t r e m i t y b r a c e m e t a l f i n g e r s p l i n t s ) a s 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 h D i s a b i l i t i e s m e t a l f i n g e r s p l i n t s , a r e n o t t h e l e a s t e x p e n s i v e a p p r o p r i 3 . 1 ( 1 ) ( b ) ( i i i ) 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 c h e d u l e C , s e c t i o n 3 ( 1 ) a n d 3 . 1 0 E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # 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 " ) i n i s t r y d e n 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 , a n s e t o u t i n S c h e d u l e C , s e c t i o n 3 . 1 0 o f t h e 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 o r t h o s e s , t h e a t e d e v i c e a s r e q u i r e d b y S c h e d u l e C , s e c t i o n
P A R T E S u m m a rv 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 r e c o n s i d • O r t h o s e s R e q u e s t a n d J u s t i f i c a t i o n F o r m s i g n e d b y a n o c c u p a t i o n a l t h e r a p i s t o n M a r c h 2 0 t h , 2 0 1 4 • 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 J u l y 1 0 t h , 2 0 1 O n M a r c h 2 7 t h , 2 0 1 4 t h e a p p e l l a n t s u b m i t t e d a R e q u e s t b r a c e t o t h e m i n i s t r y . H e r d o c t o r p r e s c r i b e d a n o r t h o s e s u f f e r s f r o m p o l y a r t h r i t i s a n d t h e o c c u p a t i o n a l t h e r a p i s t ( r e c o m m e n d e d m e t a l a n t i s w a n f i n g e r s p l i n t s a s t h e o r t h o O T s t a t e d t h a t d u e t o i n f l a m m a t o r y a r t h r i t i s t h e a p p e l l a n t " l o c k i n g . " T h e s p l i n t s w i l l p r e v e n t t h e h y p e r e x t e n s i o n a t t h a n d f u n c t i o n a n d i m p r o v e p h y s i c a l f u n c t i o n i n g t h a t h a s c o n s u l t a t i o n w i t h t h e H A B p h y s i o t h e r a p i s t c o n s u l t a n t , i s . r e c o m m e n d e d b y t h e O T a r e t h e l e a s t e x p e n s i v e a p p r o p S c h e d u l e C E A P W D R . O n t h e a p p e l l a n t ' s 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 O T w c e n t r e v e r y YID. f e w c l i e n t s w i t h s w a n n e c k d e f o r m i t i e s c s p l i n t s , s o I p r e f e r t o u s e t h e b e t t e r c o n t r o l l i n g m e t a l s p l i h a v e t r i e d t h e O v a l 8 ' s t o d a y a n d s h e i s o n e o f t h e r a r e c ( u n l e s s t h e S N ' s w o r s e n ) " . I n t h e N o t i c e o f A p p e a l d a t e d J u l y 3 1 5 ' , 2 0 1 4 u n d e r t h e h d e c i s i o n " , t h e a p p e l l a n t w r o t e , " I h a v e n o w t r i e d t h e l e s s t h e m i n a c c o r d w i t h t h e f l u c t u a t i n g s w e l l i n g i n m y j o i n t s r e a d i l y a d j u s t t h e m e t a l s p l i n t s . " A t t a c h e d t o t h e N o t i c e o f A p p e a l w a s a l e t t e r f r o m t h e O T w e e k t r i a l o f t h e O v a l 8 s p l i n t s . T h e O T s t a t e d t h a t d u e t o t h e O v a l 8 s p l i n t s d o n o t w o r k f o r h e r , e x c e p t f o r a f e w h a n d l o o s e a n d i n e f f e c t i v e i n t h e a f t e r n o o n o r v i c e v e r s a . a d j u s t a b l e b y a t r a i n e d t h e r a p i s t w i t h a h e a t g u n w h e r e a s b e a d j u s t e d b y c l i e n t s ( t h e a p p e l l a n t ) . T h e O T s t a t e d t h a 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 p a n e l r e c e i v i n g t h e l e t t e T h e p a n e l f i n d s t h a t s i n c e t h e m i n i s t r y w a s n o t a w a r e o f o f r e c o n s i d e r a t i o n , t h e l e t t e r f r o m t h e O T d a t e d J u l y 3 1 5 ' , A p p e a l t h a t r e l a t e t o t h i s t r i a l p e r i o d c a n ' t b e s a i d t o b e " i t h e m i n i s t r y a t 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 n d t h e r e f o r e 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 t a t e d t h a t w h e n t h e m i n i s t r y s p l i n t s s h e h a d n o t t r i e d t h e p l a s t i c s p l i n t s s o t h e O T p u t s p l i n t s a p p e a r e d t o l i t q u i t e w o r k q u i t e w e l l o n t h e a p p e l l a O v a l 8 p l a s t i c s p l i n t s o n l y p r o v i d e d s u p p o r t f o r 3 o r 4 h o u w h e n t h e p l a s t i c s p l i n t s w e r e f i t t e d b y t h e a f t e r n o o n t h e s w o u l d n o t p r o v i d e t h e p r o p e r s u p p o r t . T h e a p p e l l a n t a d d d a y t h e n t h e d i s e a s e w i l l o n l y e x t e n d t h e m i d d l e k n u c k l e o v e r s t r e t c h e d . T h e a n n e l l a n t s t a t e d t h a t a s o e c i a l h e a t a E AA T 0 0 3 ( 1 0 / 0 6 1 0 1 )'. A P P E A L # e r a t i o n : b y a m e d i c a l p r a c t i t i o n e r M a r c h 1 8 t h , 2 0 1 4 a n d s i g n e d ; 4 . a n d J u s t i f i c a t i o n f o r a n o r t h o s e s u p p e r e x t r e m i t y s ( m e t a l a n t i s w a n f i n g e r s p l i n t s ) a s t h e a p p e l l a n t O T ) c o m p l e t e d t h e a s s e s s m e n t . T h e O T s e s r e q u i r e d t o b e s t m e e t t h e a p p e l l a n t ' s n e e d s . T h e h a s s w a n n e c k d e f o r m i t i e s i n h e r f i n g e r s w h i c h a r e h e P I P j o i n t s , a l l o w i n g f l e x i o n f o r g r a s p i n g a n d o t h e r b e e n i m p a i r e d b y h e r c o n d i t i o n . T h e m i n i s t r y , i n n o t s a t i s f i e d t h a t t h e m e t a l a n t i s w a n f i n g e r s p l i n t s r i a t e m e d i c a l d e v i c e a s s e t o u t i n s e c t i o n 3 ( 1 ) ( b ) ( i i i ) o f r o t e , " I n t h e m a n y y e a r s I h a v e w o r k e d a t t h e a r t h r i t i s a n b e a d e q u a t e c o n t r o l l e d b y t h e c h e a p e r O v a l 8 n t s , w h i c h a l s o f i t b e t t e r . H o w e v e r , w i t h t h i s c l i e n t , w e a s e s w h o m a y b e a b l e t o u s e t h e p l a s t i c s p l i n t s e a d i n g o f ' ' T e l l u s w h y y o u d i s a g r e e w i t h t h e m i n i s t r y ' s e x p e n s i v e O v a l 8 S N S ' s f o r 2 1 d a y s . I c a n n o t a d j u s t s o t h e y a r e e i t h e r t o o t i g h t o r n o t c o r r e c t i n g . I c a n w h o s t a t e d t h a t t h e a p p e l l a n t h a s u n d e r g o n e a 3 t h e f l u c t u a t i n g s w e l l i n g i n t h e a p p e l l a n t ' s P I P j o i n t s o u r s o f t h e d a y , t h a t t h e y a r e e i t h e r t i g h t i n t h e m o r n i n g T h e O T s t a t e d t h a t t h e O v a l 8 s p l i n t s a r e o n l y t h e c u s t o m m a d e m e t a l a n t i s w a n f i n g e r s p l i n t s c a n t t h e a p p e l l a n t i s a b l e t o d o t h e s e m i n o r a d j u s t m e n t s . r f r o m t h e O T f o r c o n s i d e r a t i o n a s n e w e v i d e n c e . t h e t r i a l p e r i o d f o r t h e O v a l 8 p l a s t i c s p l i n t s a t t h e t i m e 2 0 1 4 a n d t h e s t a t e m e n t s i n t h e a p p e l l a n t ' s N o t i c e o f n s u p p o r t ' ' o f i n f o r m a t i o n a n d r e c o r d s t h a t w e r e b e f o r e a r e n o t a d m i s s i b l e . i n i t i a l l y t u r n e d d o w n h e r r e q u e s t f o r t h e m e t a l f i n g e r t h e p l a s t i c s p l i n t s o n t h e a p p e l l a n t ' s f i n g e r s a n d t h e n t ' s f i n g e r s . T h e a p p e l l a n t a n d t h e O T l e a r n e d t h e r s b e c a u s e i i t h e f i n g e r s w e r e s w o l l e n i n t h e m o r n i n g w e l l i n g h a d s u b s i d e d a n d t h e s p l i n t s w e r e l o o s e a n d e d t h a t i i t h e s p l i n t s d o n o t p r o v i d e s u p p o r t f o r t h e f u l l a s t h e t e n d o n s a n d l i g a m e n t s a r e a l r e a d y u n i s n e e d e d t o s o f t e n t h e o l a s t i c f i n a e r s o l i n t s f o r
f i t t i n g a n d y o u m u s t k n o w w h a t y o u a r e d o i n g w h e n y o u n o t h a v e t h e k n o w l e d g e a n d s k i l l t o p e r f o r m t h i s a d j u s t m a p p o i n t m e n t w i t h t h e O T . T h e a p p e l l a n t s t a t e d t h a t t h e i m e t a l s p l i n t s b e c a u s e s h e c a n a d j u s t t h e m e t a l a n t i s w a T h e p a n e l f i n d s t h e a p p e l l a n t ' s o r a l t e s t i m o n y , e x c e p t h e 8 p l a s t i c f i n g e r s p l i n t s , d o e s c o n t a i n i n f o r m a t i o n t h a t i s i n t h e m i n i s t r y a t t h e t i m e t h e r e c o n s i d e r a t i o n d e c i s i o n w a s w i t h s e c t i o n 2 2 ( 4 ) E A A . 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 t i o n d e c i s i o n a n d p T h e p a n e l m a k e s t h e f o l l o w i n g f i n d i n g s o f f a c t : 1 . T h e a p p e l l a n t i s a r e c i p i e n t o f d i s a b i l i t y a s s i s t a n c S c h e d u l e C E A P W D R . 2 . T h e m i n i s t r y a g r e e d t o f u n d t h e l e a s t e x p e n s i v e a 3 . T h e a p p e l l a n t d o e s n o t h a v e t h e r e s o u r c e s t o p a y 4 . T h e m i n i s t r y h a d p r o v i d e d t h e a p p e l l a n t w i t h O v a E AA T 0 0 3 ( 1 0 / 0 6 / 0 f )I A P P E A L # d o t h e a d j u s t m e n t . 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 o e s e n t a n d i t u s u a l l y t a k e s t w o w e e k s t o g e t a n n f l a m m a t i o n i s a l w a y s p r e s e n t a n d s h e n e e d s t h e n f i n g e r s p l i n t s h e r s e l f t o m e e t h e r n e e d s . r r e m a r k s r e g a r d i n g t h e t r i a l p e r i o d o f t e s t i n g t h e O v a l 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 t h a t w a s b e f o r e m a d e a n d i s a d m i s s i b l e a s e v i d e n c e i n a c c o r d a n c e r o v i d e d n o a d d i t i o n a l i n f o r m a t i o n e a n d e l i g i b l e t o r e c e i v e a h e a l t h s u p p l e m e n t s e t o u t i n p p r o p r i a t e m e d i c a l d e v i c e o r t h o s e s f i n g e r s p l i n t s ; t h e c o s t o f t h e o r t h o s e s ; l 8 p l a s t i c s p l i n t s ;
A P P F A I # : 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 u n d e r a p p e a l i s t h e r e a s o n a b l e n e s s o f t h e m i n i s t r y ' s r e c o n s i d e r a t i o n w h e r e i n t h e m i n i s t r y d e t e r m i n e d t h e h e a l t h s u p p l e m e n t , t h e m e t a l f i n g e r s p l i n t s , a s s e t o u t i n S c h e d u l e C , s e c t i o n 3 . 1 0 o f t h e E A P W D R a r e n o t t h e l e a s t e x p e n s i v e a p p r o p r i a t e m e d i c a l d e v i c e a s r e q u i r e d b y S c h e d u l e C , s e c t i o n 3 ( 1 ) ( b ) ( i i i ) E A P W D R . T h e l e g i s l a t i o n c o n s i d e r e d : E A P W D R M e d i c a l e q u i p m e n t a n d d e v i c e s S e c t i o n 3 ( 1 ) S u b j e c t t o s u b s e c t i o n s ( 2 ) t o ( 5 ) o f t h i s s e c t i o n , t h e m e d i c a l e q u i p m e n t a n d d e v i c e s d e s c r i b e d i n s e c t i o n s 3 . 1 t o 3 . 1 1 o f t h i s S c h e d u l e a r e t h e h e a l t h s u p p l e m e n t s t h a t m a y b e p r o v i d e d b y t h e m i n i s t e r i f ( a ) t h e s u p p l e m e n t s a r e p r o v i d e d 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 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 e g u l a t i o n , a n d ( b ) a l l o f t h e f o l l o w i n g r e q u i r e m e n t s a r e m e t : ( i ) t h e f a m i l y u n i t h a s r e c e i v e d t h e p r e a u t h o r i z a t i o n o f t h e m i n i s t e r f o r t h e m e d i c a l e q u i p m e n t o r d e v i c e r e q u e s t e d ; ( i i ) t h e r e a r e n o r e s o u r c e s a v a i l a b l e t o t h e f a m i l y u n i t t o p a y t h e c o s t o f o r o b t a i n t h e m e d i c a l e q u i p m e n t o r d e v i c e ; ( i i i ) t h e m e d i c a l e q u i p m e n t o r d e v i c e i s t h e l e a s t e x p e n s i v e a p p r o p r i a t e m e d i c a l e q u i p m e n t o r d e v i c e . M e d i c a l e q u i p m e n t a n d d e v i c e s o r t h o s e s 3 . 1 0 ( 1 ) I n t h i s s e c t i o n , o f f t h e s h e l f i n r e l a t i o n t o a n o r t h o s i s , m e a n s a p r e f a b r i c a t e d , m a s s p r o d u c e d o r t h o s i s t h a t i s n o t u n i q u e t o a p a r t i c u l a r p e r s o n ; o r t h o s i s m e a n s ; ( a ) a c u s t o m m a d e o r o f f t h e s h e l l f o o t o rt h o t i c ; ( b ) c u s t o m m a d e f o o t w e a r ; ( c ) a p e r m a n e n t m o d i f i c a t i o n t o f o o t w e a r ; ( d ) o f f t h e s h e l f f o o t w e a r r e q u i r e d f o r t h e p u r p o s e s e t o u t i n s u b s e c t i o n ( 4 . 1 ) ( a ) ; ( e ) o f f t h e s h e l f o r t h o p a e d i c f o o t w e a r ; ( f ) a n a n k l e b r a c e ; ( g ) a n a n k l e l o o t o r t h o s i s ; ( h ) a k n e e a n k l e f o o t o r t h o s i s ; ( i ) a k n e e b r a c e ; U ) a h i p b r a c e ; ( k ) a n u p p e r e x t r e m i t y b r a c e ; ( I ) a c r a n i a l h e l m e t u s e d f o r t h e p u r p o s e s s e t o u t i n s u b s e c t i o n ( 7 ) ; ( m ) a t o r s o o r s p i n e b r a c e ; ( n ) a f o o t a b d u c t i o n o r t h o s i s ; ( B . C . R e g . 1 9 7 / 2 0 1 2 ) ( o ) a t o e o r t h o s i s . ( B . C . R e g . 1 9 7 / 2 0 1 2 ) ( B . C . R e g . 1 4 4 / 2 0 1 1 ) ( 2 ) S u b j e c t t o s u b s e c t i o n s ( 3 ) t o ( 1 1 ) o f t h i s s e c t i o n , a n o r t h o s i s i s a h e a l t h s u p p l e m e n t f o r t h e p u r p o s e s o f s e c t i o n 3 o f t h i s S c h e d u l e i f ( a ) t h e o r t h o s i s i s p r e s c r i b e d b y a m e d i c a l p r a c t i t i o n e r o r a · n u r s e p r a c t i t i o n e r , ( b ) t h e m i n i s t e r i s s a t i s f i e d t h a t t h e o r t h o s i s i s m e d i c a l l y e s s e n t i a l t o a c h i e v e o r m a i n t a i n b a s i c f u n c t i o n a l i t y , ( c ) t h e m i n i s t e r i s s a t i s f i e d t h a t t h e o r t h o s i s i s r e a u i r e d f o r o n e o r m o r e o f t h e f o l l o w i n a o u r o o s e s : E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )
�APPEAL# (i) to prevent surgery; (ii) for post-surgical care; (iii) to assist in physical healing from surgery, injury or disease; (iv) to improve physical functioning that has been impaired by a neuro-musculo-skeletal condition, and (d) the orthosis is off-the-shelf unless; (B.C. Reg. 144/2011) (i) a medical practitioner or nurse practitioner confirms that a custom-made orthosis is medically required, and (ii) the custom-made orthosis is fitted by an orthotist, pedorthist, occupational therapist, physical therapist or podiatrist. (3) For an orthosis that is a custom-made foot orthotic ... (4) For an orthotic that is custom-made footwear ... (5) For an orthosis that is a knee brace ... (6) For an orthosis that is an upper extremity brace, in addition to the requirements in subsection (2) of this section, the upper extremity brace must be intended to provide hand, finger, wrist, elbow or shoulder support. (7) For an orthosis that is a cranial helmet ... (8) For an orthosis that is a torso or spine brace, in addition to the requirements in subsection (2) of this section, the brace must be intended to provide pelvic, lumbar, lumbar-sacral, thoracic-lumbar-sacral, cervical­ thoracic-lumbar-sacral, or cervical spine support. (9) Subject to section 3 of this Schedule, the limit on the number of orthoses that may be provided for the use of a person as a health supplement for the purposes of section 3 of this Schedule is the number set out in Column 2 of Table 1 opposite the description of the applicable orthosis in Column 1. (10) The period of time referred to in section 3 (3) (b) of this Schedule with respect to replacement of an orthosis is the number of years from the date on which the minister provided the orthosis being replaced that is set out in Column 2 of Table 2 opposite the description of the applicable orthosis in Column 1. Health supplement for persons facing direct and imminent life threatening health need Section 69 The minister may provide to a family unit any health supplement set out in sections 2 (1) (a) and (f) [general health supplements] and 3 [medical equipment and devices] of Schedule C, if the health supplement is provided to or for a person in the family unit who is otherwise not eligible for the health supplement under this regulation, and if the minister is satisfied that (a) the person faces a direct and imminent life threatening need and there are no resources available to the person's family unit with which to meet that need, (b) the health supplement is necessary to meet that need, (c) the person's family unit is receiving premium assistance under the Medicare Protection Act, and (d) the requirements specified in the following provisions of Schedule C, as applicable, are met: (i) paragraph (a) or (f) of section (2) (1 ); (ii) sections 3 to 3.12, other than paragraph (a) of section 3 (1). (B.C. Reg. 61/2010) (B.C. Reg. 197/2012) The ministry argued that the appellant did not meet all the criteria set out in Schedule C, section 3(1 )(b)(iii) EAPWDR, that the medical equipment or device requested, the metal finger splints, are not the least expensive appropriate medical equipment or device. The ministry argued that in the Request for Reconsideration the OT wrote "that very few clients with swan neck deformities can be adequately controlled with the cheaper Oval 8 splints, however, you are (the appellant) the rare case where the plastic splints may work", which supports the ministry's decision. The ministry stated that they do recognize that new information was received by the ministry as part of the aooeal packarie after the reconsideration decision was made, but at EAAT 003(10/06101)
t h e t i m e , t h e r e c o n s i d e r a t i o n d e c i s i o n w a s a r e a s o n a b l e b e f o r e t h e m . W h i l e t h e a p p e l l a n t a r g u e d t h a t t h e m e t a l a n t i s w a n f i n g w i t h t h e p r o p e r s u p p o r t t h a t s h e n e e d s , t h e p a n e l c a n n o t o t h e t r i a l p e r i o d f o r t h e O v a l 8 p l a s t i c f i n g e r s p l i n t s i s n o n o r t h e O T k n e w h o w t h e p l a s t i c s p l i n t s w o u l d w o r k s o t h t h e y t r i e d t h e m b u t t h e y s o o n d i s c o v e r e d t h e s p l i n t l o o s e T h e e v i d e n c e b e f o r e t h e p a n e l i s t h a t t h e a p p e l l a n t i s e l i h a d m e t a l l t h e l e g i s l a t e d c r i t e r i a e x c e p t t h a t t h e m e t a l a m i n i s t r y ' s o p i n i o n , t h e l e a s t e x p e n s i v e a p p r o p r i a t e m e d i c p l a s t i c s p l i n t w a s a p p r o p r i a t e . O n t h e a p p e l l a n t ' s R e q u e s m i n i s t r y ' s p o s i t i o n b y s t a t i n g t h a t t h e a p p e l l a n t i s o n e o f w o r k . T h e a p p e l l a n t ' s d o c t o r h a d p r e s c r i b e d t h e m e t a l a n t h e m i n i s t r y a t r e c o n s i d e r a t i o n , n o r i s t h e r e a n y e v i d e n c e r e c o n s i d e r a t i o n , t h e l e s s e x p e n s i v e O v a l 8 p l a s t i c s p l i n t s t o m e e t t h e a p p e l l a n t ' s n e e d s . T h e r e f o r e , t h e p a n e l f i n d s 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 a p p r o p r i a t e m e d i c a l e q u i p m e n t o r d e v i c e a n d t h e m i n i s t r s w a n f i n g e r s p l i n t s w a s r e a s o n a b l e . I n r e f e r e n c e t o s e c t i o n 6 9 E A P W D R , a h e a l t h s u p p l e m e n t h r e a t e n i n g h e a l t h n e e d , t h e r e i s n o e v i d e n c e b e f o r e t h e l i f e t h r e a t e n i n g n e e d f o r t h e o r t h o s e s . T h e r e f o r e , t h e m i n s u p p l e m e n t , a n o r t h o s e s , b e c a u s e s h e w a s f a c i n g a d i r e r e a s o n a b l e . T h e p a n e l f i n d s t h e m i n i s t r y ' s d e c i s i o n i s a r e a s o n a b l e a p t h e t i m e o f t h e d e c i s i o n a n d c o n f i r m s t h e m i n i s t r y ' s d e c i s 2 4 ( 2 ) ( a ) E A A . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # : a p p l i c a t i o n o f t h e l e g i s l a t i o n b a s e d o n t h e i n f o r m a t i o n e r s p l i n t s a r e t h e o n l y f i n g e r s p l i n t s t h a t w i l l p r o v i d e h e r t c o n s i d e r t h i s a r g u m e n t b e c a u s e t h e e v i d e n c e r e l a t i n g t a d m i s s i b l e . T h e a p p e l l a n t a r g u e d t h a t n e i t h e r s h e e y t r i e d t h e m a n d t h e y s e e m e d t o f i t q u i t e w e l l t h e d a y n e d a n d d i d n ' t p r o v i d e t h e n e c e s s a r y s u p p o r t . g i b l e t o r e c e i v e a h e a l t h s u p p l e m e n t o r t h o s e s a n d n t i s w a n f i n g e r s p l i n t ( o r t h o s e s ) w a s n o t , i n t h e a l e q u i p m e n t o r d e v i c e a v a i l a b l e ; t h a t a n O v a l 8 t f o r R e c o n s i d e r a t i o n f o r m t h e O T s u p p o r t e d t h e t h e r a r e c a s e s w h e r e t h e O v a l 8 p l a s t i c s p l i n t s m a y t i s w a n f i n g e r s p l i n t b u t t h e r e w a s n o e v i d e n c e b e f o r e b e f o r e t h e p a n e l t o d e t e r m i n e t h a t a t t h e t i m e o f a r e n o t t h e a p p r o p r i a t e m e d i c a l e q u i p m e n t o r d e v i c e i n e d t h a t t h e O v a l 8 p l a s t i c f i n g e r s p l i n t s w e r e t h e y ' s d e c i s i o n t o d e n y t h e a p p e l l a n t ' s r e q u e s t f o r a n t i ­ t f o r p e r s o n s f a c i n g d i r e c t a n d i m m i n e n t l i f e p a n e l t h a t t h e a p p e l l a n t f a c e s a d i r e c t a n d i m m i n e n t i s t r y ' s d e c i s i o n n o t t o p r o v i d e t h e a p p e l l a n t a h e a l t h c t a n d i m m i n e n t l i f e t h r e a t e n i n g h e a l t h n e e d w a s p l i c a t i o n o f t h e l e g i s l a t i o n b a s e d o n t h e i n f o r m a t i o n 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 4 ( 1 ) ( b ) a n d s e c t i 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.