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 ry o f S o c i a l " 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 o f J u l y 9 , 2 0 1 4 , o f f i v e s t a t u t o r y r e q u i r e m e n t s o f s e c t i o n 2 o f t h e E m D i s a b i l i t i e s A c t ( " E A P W D A " ) f o r d e s i g n a t i o n a s a p e t h a t t h e a p p e l l a n t m e t t h e a g e r e q u i r e m e n t a n d t h a t a p p e l l a n t ' s i m p a i r m e n t i s l i k e l y t o c o n t i n u e f o r a t l e a s a t i s f i e d t h a t : o t h e e v i d e n c e e s t a b l i s h e s t h a t t h e a p p e l l a n t h • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( " D L A " ) a d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t e d e i t h e r c o n 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 , t h e a p p e l l a n t a n o t h e r p e r s o n , a n a s s i s t i v e d e v i c e , o r t h e s 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 m p l o y m e n t a n d A s s i s t a n c e fo r P e r s o n s w i t h D i s a b 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 E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )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 w h i c h f o u n d t h a t t h e a p p e l l a n t d i d n o t m e e t t h r e e p l o y m e n t a n d A s s i s t a n c e fo r P e r s o n s W i t h r s o n w i t h d i s a b i l i t i e s ( " P W D " ) . T h e m i n i s t r y f o u n d i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r t h e s t t w o y e a r s . H o w e v e r , t h e m i n i s t r y w a s n o t a s a s e v e r e p h y s i c a l o r m e n t a l i m p a i r m e n t ; r e , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , 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 p e r i o d s ; a n d r e q u i r e s t h e s i g n i f i c a n t h e l p o r s u p e r v i s i o n o f e r v i c e s o f a n a s s i s t a n c e a n i m a l . i l i t i e s A c t ( " E A P W D A " ) , s e c t i o n 2 i l i t i e s R e g u l a t i o n ( " E A P W D R " ) , s e c t i o n 2
P A R T E S u m m a r v o f F a c t s W i t h t h e c o n s e n t o f t h e a p p e l l a n t , t h e m i n i s t r y h a d T h e i n f o r m a t i o n 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 o T h e a p p e l l a n t ' s P W D a p p l i c a t i o n f o r m c o n s i s 2 1 , 2 0 1 4 ) a l o n g w i t h a p h y s i c i a n ' s r e p o r t ( " P R g e n e r a l p r a c t i t i o n e r ( " G P " ) w h o h a d b e e n t h e d a t e d J a n u a r y 1 9 , 2 0 1 4 ) . • R e p o r t s p r e p a r e d b y a s p e c i a l i s t w h o a s s e s s ( t h e " S p e c i a l i s t " ) . • A r e p o r t d a t e d M a y 2 9 , 2 0 1 3 , p r e p a r e d b y a n f u n c t i o n a l c a p a c i t y e v a l u a t i o n o f t h e a p p e l l a n • A d i s a b i l i t y p a r k i n g t a g i s s u e d t o t h e a p p e l l a n • T h e a p p e l l a n t ' s w r i t t e n s u b m i s s i o n s d a t e d J a T h e p a n e l a s s e s s e d t h e r e l e v a n t e v i d e n c e a s i n c l u d D i a g n o s e s • I n t h e P R t h e G P d i a g n o s e d t h e a p p e l l a n t w i t r e c u r r e n t b a c k p a i n , d e p r e s s i o n , a n d i d i o p a t h P h y s i c a l I m p a i r m e n t • I n t h e P R t h e G P d e s c r i b e d t h e a p p e l l a n t ' s c o s h e r e p o r t e d t h a t t h e a p p e l l a n t c a n w a l k 2 -4 b p o u n d s , a n d r e m a i n s e a t e d l e s s t h a n 1 h o u r . • I n t h e A R t h e G P r e p o r t e d t h a t t h e a p p e l l a n t t o u t d o o r s a n d c l i m b i n g s t a i r s , a n d t h a t s h e r e q l i f t i n g / c a r r y i n g / h o l d i n g . • I n a r e p o r t d a t e d A p r i l 1 8 , 2 0 1 3 t h e S p e c i a l i s t c a l l u s b u i l d u p , a n d b i l a t e r a l h a l l u x v a l g u s d e f o " u r g e n t l y r e q u i r e s f o o t o r t h o t i c s a n d s i l i c o n e t o • I n h e r r e p o r t o f M a y 2 9 , 2 0 1 3 t h e O T r e p o r t e d ► t h e a p p e l l a n t ' s s p i n a l f l e x i o n r a n g e o f c o n t i n u o u s s i t t i n g t o l e r a t e d b y t h e t o l e r a n c e a s t h e d a y p r o g r e s s e d . ► t h e a p p e l l a n t d e m o n s t r a t e d a n a b o v ► t h e a p p e l l a n t w a s a b l e t o m a i n t a i n a t o 1 8 m i n u t e s , a n d w a s a b l e t o s t a t i c w i t h a d e c l i n i n g t o l e r a n c e f o r s t a n d i n ► t h e a n n e l l a n t d e m o n s t r a t e d t h e a b i l i t E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I , a n o b s e r v e r a t t e n d t h e h e a r i n g . c o n s i d e r a t i o n i n c l u d e d t h e f o l l o w i n g : t i n g o f t h e a p p e l l a n t ' s s e l f r e p o r t ( d a t e d J a n u a r y " ) a n d a s s e s s o r ' s r e p o r t ( " A R " ) c o m p l e t e d b y a a p p e l l a n t ' s p h y s i c i a n s i n c e M a y , 2 0 0 8 ( b o t h e d t h e a p p e l l a n t a t a n o u t p a t i e n t o r t h o t i c c l i n i c o c c u p a t i o n a l t h e r a p i s t ( " O T " ) a f t e r c o n d u c t i n g a t . t b y a l o c a l d i s a b i l i t y r e s o u r c e c e n t r e . n u a r y 2 1 , 2 0 1 4 a n d J u n e 1 0 , 2 0 1 4 . i n g t h e f o l l o w i n g : h p a i n f u l f e e t ( o s t e o a r t h r i t i s a n d p a i n f u l c a l l u s e s ) ; i c t h r o m b o c y t o p e n i a . n d i t i o n s a s " c h r o n i c " . I n t e r m s o f f u n c t i o n a l s k i l l s l o c k s u n a i d e d , c l i m b 5 + s t a i r s u n a i d e d , l i f t 5 -1 5 a k e s s i g n i f i c a n t l y l o n g e r t h a n t y p i c a l w i t h w a l k i n g u i r e s p e r i o d i c a s s i s t a n c e w i t h d e s c r i b e d e x t r e m e t e n d e r n e s s , t r e m e n d o u s r m i t i e s . T h e S p e c i a l i s t s t a t e d t h a t t h e a p p e l l a n t e s p a c e r s . " t h a t : o f m o t i o n w a s l i m i t e d , a n d t h a t t h e l o n g e s t p e r i o d a p p e l l a n t w a s 3 1 m i n u t e s , w i t h a d e c l i n i n g e n o r m a l r i g h t g r i p s t r e n g t h a n d n o r m a l l e f t g r i p . p r i m a ry s t a n d i n g / w e i g h t b e a r i n g p o s t u r e f o r u p a l l y s t a n d f o r o n e p e r i o d o f u p t o s i x m i n u t e s , g a s t h e d a y p r o g r e s s e d . y t o a s c e n d / d e s c e n d 1 o f 2 f l i a h t s o f s t a i r s , e a c h
fl ight consistin g of 11 st eps. ► the app e l l a n t was able to carry 5 po f ee t , and was able to car ry 10 pounds bila • In his letter of August 27, 2014, the S p e cialist si licone toe sp ace rs the app ell a nt's] co ndit ion mobil i ty. " M ental Impair me nt • In th e PR th e GP report e d that the a ppellant has i nd i ca ted tha t th e ap pellant h a s s ig nificant defici areas of emot ional d is tu r ba n ce a nd motivati on. • In the AR the GP indicated that th e ap pel lant's all respe cts . • I n the AR the GP c onfirmed t hat the a ppe lla n and mot i vation , as w ell as mod e r ate i mpact s at tent io n/conc entr at i o n (diff iculty focu si n g and functioni ng showed mi n i mal o r no impact. • W ith res p ec t to so cial funct ioning , the GP i ndi mana ges all a spe cts, but that she is so cial ly and maintain rel a tio nships . She r epor ted th at imm e diate an d ex tende d social n etworks. • In he r self-repor t the app ell ant repor ted tha t she m orn in g s a nd t hat sh e fee ls anx i ous and str essed. • In he r lett e r of Augus t 2 2, 2014 th e G P w rote disr u pt e d" an d th at she " woul d ben efi t fr om continuou [DLA]." • In h e r ora l test imony the appe ll an t st ated t hat advoc ate , though the advocate was unable to att • In the PR the GP did not indicate whether the app treatments t hat interfere with her ability to p erf • In the A R the GP not e d that the appellant independ DLA: ► personal self-care (though she avoids showers because of pain w ► manage personal finances. ► manage p ersonal medica t ion s. ► daily shopping (though she takes significantly longer than typical with going to and from stores, and carrying purchases home). ► me al p reparation (do esn't eat enough fruits and vegetables because she can't aff them ). ► use of trans ortation standing and waiting for a bus is EAAT 003(10/06/01) u nds in each of he r right and le f t hands for 50 t er al ly f o r 50 fe et. w r ote that "Without [custo m foo t orthotics a n d w ill wor sen and she will lose m or e of her no d i ffi cult ie s w ith commun i c ation, a n d t s with cogn it i ve and emotional function in th e ab il i ty to co mmunicate i s sati sfactory o r g o od in t exper ience s major imp ac ts in t erms o f em ot i o n with bod ily fu nctions (poor sleep) and memori z in g). The remaining ca tegor i e s of cate d in the AR that th e app e l l a n t independen t l y w ithd raw n a nd doesn't h ave a desire to dev elo p the a ppe lla n t functions m argin a lly with her ha s no m otivat ion to get out of bed in t he tha t t he ap pe ll ant's soc ial functioni ng i s "ve r y s sup port in s e c u r i ng as sista n c e wi th he r she h ad rec ently ob taine d the s upp ort o f a n end tod ay ' s hearing. ellant has been prescri bed any medication or o rm DLA. en tly manages all aspects of the follo wing ith standing). ord ainf ul).
e With respect to basic housekeeping, the GP noted that the appellant "Does not have anyone to help. Tries to manage on her own, but takes longer to do." o With respect to social functioning, the GP indicated that the appellant independently manages all aspects, except that with respect to the ability to develop and maintain relationships the GP commented "Socially withdrawn, lives alone, doesn't have a desire to develop and maintain relationships". The GP reported that the appellant is marginally functional with respect to both her immediate and extended social networks. • In the GP's letter of August 22, 2014 she wrote that the appellant reports taking twice as long as typical to dress herself, she can walk less than a block and climb less than 5 stairs, and that the appellant is unable to prepare meals since she can't stand for more than 2 or 3 minutes without experiencing pain. o In the Specialist's letter of August 27, 2014 he wrote that "[The appellant] is unable to perform many (DLA] independently ..." • In her oral testimony, in response to a question, the appellant said that she drives a vehicle, though the amount of time she can drive at any one time is limited. • In the AR the GP reported that the appellant requires assistive devices in the form of a cane and orthotics. • In her oral testimony the appellant advised that she relies on her roommate for basic housekeeping, laundry, and meal preparation. Admissibilitv of Additional Information Prior to the hearing the appellant submitted two supplementary documents to the Tribunal's offices: 1. A letter from the GP dated August 22, 2014. 2. A letter from the Specialist dated August 27, 2014. At the hearing, the ministry stated that it had no objection to the admissibility of these documents. The ministry also stated that if it had had these two letters at the time of reconsideration it likely would have resulted in an approval of the appellant's application. The panel is limited by section 22(4) of the Employment and Assistance Act ("EAA") to admitting as evidence only the information and records that were before the minister at the time of reconsideration, and "oral or written testimony in support ... " Since the panel is an appellate decision maker rather than a decision-maker at first instance, information "in support" must be information that tends to corroborate the evidence that was before the ministry at the time of reconsideration. With respect to the new physicians' letters proffered by the appellant, the GP's letter of August 22, 2014 states in part that that the appellant's medical conditions have "significantly deteriorated" in the six months since she submitted her PWD application, and that the appellant "is no longer able to live her life as an independent person; therefore her overall level of impairment should be described as severe." This information is significantly different that that provided by the GP to the ministry in the AR (wherein the GP indicated that the appellant independently manages virtually all tasks related to all DLA). However, it does tend to corroborate the information provided by the appellant in her written reconsideration submission where she wrote that "fThe Specialist] savs ... that mv feet are aettina EAAT 003( 10/06/01)
worst (sic) every day" and that "Because of the way I walk I cannot do stairs anymore." Accordingly, the panel finds that under the criterion provided in section 22(4) of the EAA, the GP's letter of August 22, 2014 is admissible as evidence. Similarly, the Specialist's letter of August 27, 20i 4 speaks of a "significant deterioration" and states that the appellant is now "unable to walk even as far as one block and avoids using stairs at all times". This information differs significantly from the professional evidence which was before the ministry at the time of reconsideration, where the appellant's physical functional skills were described in the PR as being able to walk 2 to 4 blocks unaided on a level surface, and being able to climb 5+ stairs unaided. However, it tends to support the evidence of deterioration in the appellant's conditions as reported by the appellant and is admissible in accordance with section 22(4). The appellant's oral testimony primarily offered more detail with respect to the restrictions she experiences with DLA, tending to corroborate the information that had been before the ministry at reconsideration. Accordingly, the panel has admitted it as oral testimony in support in accordance with section 22(4). With respect to the ministry's submissions, the ministry relied on its reconsideration decision and submitted no new information. EAAT003(10/06/01)
PART F -Reasons for Panel Decision The issue on this appeal is whether the ministry's decision to deny the appellant designation as a PWD was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. In particular, was the ministry reasonable in determining that the appellant does not have a severe physical or mental impairment, and that in the opinion of a prescribed professional the appellant's impairments do not directly and significantly restrict her from performing DLA either continuously or periodically for extended periods, and that the appellant does not require help to perform DLA as a result of those restrictions? The relevant legislation is as follows: EAPWDA: 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 ls unable to perform; "daily living activity" has the prescribed meaning; "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. EAAT 003(10/06/01)
EAPWDR section 2(1): 2 (1) F or th e purpo ses of the Act and this re (a) i n re latio n to a pe rson m enta l impair m e nt, means (i) pr ep a re o wn meal (ii) manage pers ona (iii) shop f or personal (iv) us e pub lic o r persona ( v ) perfor m h ou sework to acc ept ab le sani tary (vi ) mov e about i ndoo (vii) pe rf orm personal (viii ) man age per sona (b) in re lation to a p erson followi ng ac ti vities: (I) make dec i sio ns ( i i) r e late to, co m munic (2) For the purposes of the Ac t, "presc ri ( a) a uthorized u nde r a n enactmen (i ) med i c a l practitio (ii) r eg istered psy (i ii ) r e gis t ered nurs (iv) oc cupatio n al therapist, (v ) phys ic a l therapi (vi) s o cial wo rker, (vii) chiropractor, or (viii) nurse practitioner, (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 S c hool (ii) a board or a francophone education authority, as those terms are defined in section 1 (1) of if qualifications in p sychology are a condition of such employment. ******* Severe Physical Im p ai rment The appellant's posit i o n is that the co mbination of her di physical impairm e nt. She said that her mobility is significantly restrict GP and the Specialist have clea r ly described her impairments as being EAAT003(10/06/01) g ulat ion , "d ail y l i v in g activities" who has a severe phys i cal i mp a irment or a sev ere t h e following a ct ivities: s; l f i nance s ; needs ; l tr ansporta tion facil ities; main tain t h e p ers o n's place of residen ce i n co ndit ion ; r s and o utdo ors ; hygi ene a n d self care ; l medication, and who has a sever e ment a l imp airme n t, includes t h e abou t p ersonal ac ti vities, c ar e or fi nances; ate or i nteract w ith o the r s effectiv el y. bed professional" m ea n s a pe rso n who is t to practise the p r o fession o f ner, c holo gis t , e o r r eg istered ps y chiatric nu r se, s t , or Act, or the School Act, a gnosed conditions constitutes a severe e d by pain, and th a t bot h the " severe".
T h e m i n i s t r y ' s p o s i t i o n , a s s e t o u t i n i t s r e c o n s i d e r a d e s c r i b e d b y t h e G P i n t h e P W D a p p l i c a t i o n f o r m s i m p a i r m e n t . P a n e l D e c i s i o n A d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n d o e s n o s e v e r e i m p a i r m e n t . A n " i m p a i r m e n t " i s a m e d i c a l c a b i l i t y t o f u n c t i o n i n d e p e n d e n t l y o r e f f e c t i v e l y . T o a s s e s s t h e s e v e r i t y o f a n i m p a i r m e n t o n e m u s t c e x t e n t o f i t s i m p a c t o n d a i l y f u n c t i o n i n g a s e v i d e n c e w h i c h p e r f o r m i n g D L A i s r e s t r i c t e d . A m e d i c a l b a r r e m p l o y m e n t i s n o t a l e g i s l a t e d c r i t e r i o n f o r s e v e r i t y . d e t e r m i n a t i o n o f s e v e r i t y i s a t t h e d i s c r e t i o n o f t h e m i n c l u d i n g t h a t o f t h e a p p e l l a n t . H o w e v e r , t h e l e g i s l a t h e a n a l y s i s i s t h e e v i d e n c e f r o m a p r e s c r i b e d p r o f e I n e x e r c i s i n g i t s d e c i s i o n m a k i n g p o w e r t h e m i n i s t r y p r o f e s s i o n a l s w i t h r e s p e c t t o w h e t h e r t h e s t a t u t o r y r a m o u n t t o a n i m p r o p e r f e t t e r i n g o f d i s c r e t i o n . T h e p a s s e s s e d l i k e a n y o t h e r e v i d e n c e . I n t h e a p p e l l a n t ' s c a s e t h e e v i d e n c e i n d i c a t e s t h a t t c a l l u s e s o f t h e f e e t , a s w e l l a s r e c u r r e n t b a c k p a i n , f u n c t i o n i n g . T h e S p e c i a l i s t a n d t h e G P c o n f i r m t h a t s i g n i f i c a n t l y s i n c e s h e s u b m i t t e d t h e P W D a p p l i c a t i o d e t e r i o r a t e u n l e s s s h e r e c e i v e s c u s t o m f o o t o rt h o t i c n o t , h o w e v e r , p r o v i d e d a n y o p i n i o n a s t o t h e e f f e c t t m i t i g a t i n g t h e r e s t r i c t i o n s c a u s e d b y t h e a p p e l l a n t ' s A s d i s c u s s e d i n t h e s u b s e q u e n t s e c t i o n o f t h e s e r e a R e s t r i c t i o n s i n D L A , t h e a p p e l l a n t ' s i m p a i r m e n t d o r e s t r i c t i o n s t o h e r a b i l i t y t o m a n a g e h e r D L A . C o n s i d e r i n g t h e e v i d e n c e a s a w h o l e t h e p a n e l f i n d s s e v e r e p h y s i c a l i m p a i r m e n t w a s r e a s o n a b l y s u p p o r t S e v e r e M e n t a l I m p a i r m e n t T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h e r d e p r e s s i o n r e s t r i S h e r e f e r r e d t o t h e G P ' s e v i d e n c e t h a t s h e i s s e v e r e r e l a t i o n s h i p s . T h e m i n i s t r y ' s p o s i t i o n , a s s e t o u t i n i t s r e c o n s i d e r a t t o e s t a b l i s h a s e v e r e m e n t a l i m p a i r m e n t . T h e m i n i s a p p e l l a n t h a s n o d i f f i c u l t y w i t h c o m m u n i c a t i o n . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )t i o n d e c i s i o n , i s t h a t t h e f u n c t i o n a l s k i l l l i m i t a t i o n s a r e m o r e i n k e e p i n g w i t h a m o d e r a t e d e g r e e o f t i n i t s e l f d e t e r m i n e P W D e l i g i b i l i t y o r e s t a b l i s h a o n d i t i o n t h a t r e s u l t s i n r e s t r i c t i o n s t o a p e r s o n ' s o n s i d e r t h e n a t u r e o f t h e i m p a i r m e n t a n d t h e d b y f u n c t i o n a l s k i l l l i m i t a t i o n s a n d t h e d e g r e e t o i e r t o t h e a p p e l l a n t ' s a b i l i t y t o e n g a g e i n p a i d T h e l e g i s l a t i o n m a k e s i t c l e a r t h a t t h e i n i s t e r , t a k i n g i n t o a c c o u n t a l l o f t h e e v i d e n c e t i o n i s a l s o c l e a r t h a t t h e f u n d a m e n t a l b a s i s f o r s s i o n a l i n t h i s c a s e , t h e a p p e l l a n t ' s p h y s i c i a n . c a n n o t m e r e l y d e f e r t o t h e o p i n i o n o f t h e e q u i r e m e n t s a r e m e t a s t h a t a p p r o a c h w o u l d r o f e s s i o n a l e v i d e n c e h a s t o b e w e i g h e d a n d h e a p p e l l a n t s u f f e r s f r o m p a i n f u l o s t e o a r t h r i t i s a n d w h i c h l i m i t h e r m o b i l i t y a n d h e r p h y s i c a l t h e a p p e l l a n t ' s c o n d i t i o n h a s d e t e r i o r a t e d n a n d t h a t t h e p r o g n o s i s i s f o r i t t o c o n t i n u e t o s a n d s i l i c o n e t o e s p a c e r s . T h e p h y s i c i a n s h a v e h a t t h e o r t h o t i c s a n d t o e s p a c e r s m a y h a v e o n i m p a i r m e n t s . s o n s u n d e r t h e h e a d i n g S i g n i f i c a n t e s n o t s e e m t o h a v e t r a n s l a t e d i n t o s i g n i f i c a n t t h a t t h e m i n i s t r y ' s d e c i s i o n w i t h r e s p e c t t o e d b y t h e e v i d e n c e . c t s h e r a b i l i t y a n d h e r m o t i v a t i o n t o p e r f o r m D L A . l y w i t h d r a w n a n d i s o l a t e d f r o m h e r s o c i a l i o n d e c i s i o n , i s t h a t t h e r e i s n o t e n o u g h e v i d e n c e t r y e m p h a s i z e d t h e G P ' s e v i d e n c e t h a t t h e
Panel Decision Section 2(1)(b) of the EAPWDR prescribes two DLA that are specific to mental impairment-make decisions about personal activities, care or finances (decision making), and relate to, communicate or interact with others effectively (s ocial functioning). The evidence indicates that the appellant is not significantly restricted with respect to decision making in that -according to the GP's evidence in the AR -she independently manages the decision-making tasks related to the DLA of meal preparation (meal planning), daily shopping (making appropriate choices), management of personal finances (banking, budgeting), management of personal medications (filling/refilling/taking as directed}, and social functioning (appropriate social decisions). Regarding social functioning, the GP's evidence in the AR is that the appellant is marginally functional with respect to immediate and extended social networks. In her August 22, 2014 letter the GP indicated that the appellant's social functioning is "very disrupted", however has provided no evidence as to how this is manifested differently than it was at the time the AR was completed. With respect to functional skills, the evidence indicates that the appellant's ability to communicate is satisfactory or good in all respects. Considering the evidence as a whole, the panel concludes that the ministry reasonably determined that it does not demonstrate a severe mental impairment. Significant Restrictions to DLA The appellant's position is that her ability to perform DLA is significantly restricted by pain. She argued that pain limits virtually all of her physical activities, and that the physician has provided evidence of this. The ministry's position, as expressed in its reconsideration decision, is that the appellant's DLA are not significantly restricted. The ministry argued that the GP provided no information as to how much longer than typical it takes the appellant to perform DLA. The ministry stated that the information from the prescribed professionals does not establish that impairment significantly restricts the appellant's DLA either continuously or periodically for extended periods. Panel Decision The legislation requires that a severe impairment directly and significantly restricts the appellant's ability to perform DLA either continuously or periodically for extended periods. The term "directly" means that there must be a causal link between the severe impairment and the restriction. The direct restriction must also be significant. Finally, there is a component related to time or duration. The direct and significant restriction may be either continuous or periodic. If it is periodic it must be for an extended time. Inherently, any analysis of periodicity must also include consideration of the frequency. All other things being equal, a restriction that only arises once a year is less likely to be siqnificant than one which occurs several times a week. Accordinqlv, in circumstances where the EAAT003(10/06/01)
e v i d e n c e i n d i c a t e s t h a t a r e s t r i c t i o n a r i s e s p e r i o d i c a e v i d e n c e o f t h e d u r a t i o n a n d f r e q u e n c y o f t h e r e s t r i c r i t e r i o n i s m e t . T h e p a n e l n o t e s t h a t t h e r e a r e a n u m b e r o f s i m i l a r i t t h e G P a n d t h e S p e c i a l i s t i n A u g u s t a n d h a s c o n c l u p r e p a r e d b y t h e a p p e l l a n t ' s a d v o c a t e . B e c a u s e b o n a t u r e o f t h e D L A r e s t r i c t i o n s c a u s e d b y t h e a p p e l l a t h e A R , t h e p a n e l h a s g e n e r a l l y g i v e n l e s s w e i g h t t o s i g n i f i c a n c e o f t h e r e s t r i c t i o n s . T h e G P ' s e v i d e n c e f r o m t h e A R i n d i c a t e s t h a t w h i l e s h e i n d e p e n d e n t l y m a n a g e s a l m o s t a l l t a s k s r e l a t e d h e r A u g u s t 2 2 , 2 0 1 4 l e t t e r t h a t t h e a p p e l l a n t " i s n o l p e r s o n " , a n d b y t h e S p e c i a l i s t i n h i s A u g u s t 2 7 , 2 0 1 m a n y [ D L A ] i n d e p e n d e n t l y " a r e t o o g e n e r a l i z e d t o a r e s t r i c t i o n s t o i n d i v i d u a l D L A o r t h e e x t e n t t o w h i c h a p p l i c a t i o n f o r m s w e r e c o m p l e t e d . O n b a l a n c e , w h i l e a c k n o w l e d g i n g a d e g r e e o f i m p a r e a s o n a b l y d e t e r m i n e d t h a t t h e e v i d e n c e i s i n s u f f i c i t h e a p p e l l a n t ' s a b i l i t y t o m a n a g e h e r D L A i s s i g n i f i c a f o r e x t e n d e d p e r i o d s . H e l p w i t h D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t s h e r e q u i r e s t h e a s s t h a t s h e w o u l d n o t b e a b l e t o g e t b y o n h e r o w n . T h e m i n i s t r y ' s p o s i t i o n i s t h a t s i n c e i t h a s n o t b e e n e s i g n i f i c a n t l y r e s t r i c t e d , i t c a n n o t b e d e t e r m i n e d t h a t P a n e l D e c i s i o n F i n d i n g s t h a t a s e v e r e i m p a i r m e n t d i r e c t l y a n d s i g n i D L A e i 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 a n e x t e n d " h e l p " a s d e f i n e d b y s e c t i o n 2 ( 3 ) ( b ) o f t h e E A P W D A p r e c o n d i t i o n h a s n o t b e e n s a t i s f i e d o n t h e b a l a n c e o A c c o r d i n g l y , t h e p a n e l f i n d s t h a t t h e m i n i s t r y r e a s o n t h e a p p e l l a n t r e q u i r e s h e l p w i t h D L A a s d e f i n e d b y s C o n c l u s i o n T h e p a n e l a c k n o w l e d g e s t h a t t h e a p p e l l a n t ' s m e d i c a H o w e v e r , h a v i n g r e v i e w e d a n d c o n s i d e r e d a l l o f t h e f i n d s t h a t t h e m i n i s t r v ' s d e c i s i o n f i n d i n a t h e a n n e l l a n E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )l l y , i t i s a p p r o p r i a t e f o r t h e m i n i s t r y t o r e q u i r e c t i o n i n o r d e r t o b e " s a t i s f i e d " t h a t t h i s l e g i s l a t i v e i e s i n t h e t w o s u p p l e m e n t a r y l e t t e r s p r o v i d e d f r o m d e d t h a t t h e y a p p e a r t o h a v e b e e n s u b s t a n t i a l l y t h l e t t e r s p r o v i d e l i t t l e d e t a i l w i t h r e s p e c t t o t h e n t ' s i m p a i r m e n t s c o m p a r e d t o t h e l e v e l o f d e t a i l i n t h e s e l e t t e r s i n t e r m s o f a s s e s s i n g t h e t h e a p p e l l a n t d o e s e x p e r i e n c e s o m e r e s t r i c t i o n s , t o v i r t u a l l y a l l D L A . T h e s t a t e m e n t s b y t h e G P i n o n g e r a b l e t o l i v e h e r l i f e a s a n i n d e p e n d e n t 4 l e t t e r t h a t t h e a p p e l l a n t " i s u n a b l e t o p e r f o r m s s i s t i n d e t e r m i n i n g t h e s i g n i f i c a n c e o f t h e t h i s m a y h a v e c h a n g e d s i n c e t h e o r i g i n a l P W D i r m e n t , t h e p a n e l c o n c l u d e s t h a t t h e m i n i s t r y e n t t o s h o w o n t h e b a l a n c e o f p r o b a b i l i t i e s t h a t n t l y r e s t r i c t e d e i 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 i s t a n c e o f h e r r o o m m a t e t o m a n a g e h e r D L A , a n d s t a b l i s h e d t h a t t h e a p p e l l a n t ' s D L A a r e s i g n i f i c a n t h e l p i s r e q u i r e d f r o m o t h e r p e r s o n s . f i c a n t l y r e s t r i c t s a p e r s o n ' s a b i l i t y t o m a n a g e h e r e d p e r i o d i s a p r e c o n d i t i o n t o a p e r s o n r e q u i r i n g . F o r t h e r e a s o n s p r o v i d e d a b o v e , t h a t f p r o b a b i l i t i e s i n t h i s c a s e . a b l y c o n c l u d e d i t c o u l d n o t b e d e t e r m i n e d t h a t e c t i o n 2 ( 3 ) ( b ) o f t h e E A P W D A . l c o n d i t i o n s a f f e c t h e r a b i l i t y t o f u n c t i o n . e v i d e n c e a n d t h e r e l e v a n t l e g i s l a t i o n , t h e p a n e l l i n e l i a i b l e f o r P W D d e s i g n a t i o n i s a r e a s o n a b l e
a pplic ation o f the leg i s lati on in t he ci r c um s t an c e s of t he ap pella nt. Th e p anel t he ref o re confi rm s the mi nistry 's de c ision. EAA T003( 10/06/01)
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.