PART C -Decision under Appeal The decision under appeal is the Ministry of Social Development and Social Innovation (the ministry) reconsideration decision of August 18, 2014 which found that the appellant was not currently in receipt of income or disability and not eligible for Medical Services Only (MSO) assistance and therefore only eligible for health supplements to meet a life threatening health need under section 69 of the Employment and Assistance for Persons with Disabilities Regulation (EAPWDR). Additionally, the ministry determined that the appellant was not eligible for the requested prescription medication (Penicillin G 120000) because: • Prescription medication is not any of the health supplements in Schedule C and, in particular, does not meet the criteria for medical or surgical supplies under section 2(1)(a) of Schedule C which specifically excludes prescription medications, and is not a health supplement set out in sections 2(1 )(f) and s. 3 to 3.11 • A direct and imminent life-threatening need for the prescription medication was not established. PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) section 69 and Schedule C Employment and Assistance Regulation (EAR) Section 76 and Schedule C [The ministry noted that the appellant's request could be considered under the legislation for health supplements to meet a life-threatening health need under either section 69 of the EAPWDR or section 76 of the EAR and chose to reference the EAPWDR in its decision as the appellant has disabilities and the legislation is essentially the same for both regulations.] EMT 003( 10/06/01 I
P A R T E S u m m a r v 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 w a s t h a t t h e a p p e d i s e a s e b y a p h y s i c i a n . I n a s u p p o r t i n g l e t t e r d a t e d t r e a t m e n t t h e c h r o n i c L y m e d i s e a s e i s a l i f e t h r e a t e P e n i c i l l i n G 1 2 0 0 0 0 I U o n c e w e e k l y f o r a n i n d e f i n i t e p h o t o g r a p h s o f t h e a p p e l l a n t ' s s k i n . W i t h t h e a p p e l l a n t ' s c o n s e n t , t w o m i n i s t r y o b s e r v e r 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 t h e p h o t o s b y t h e L y m e d i s e a s e . H e p r o v i d e d a c o l o u r c o p y o f d e s c r i b e d t h e i m p a c t o f L y m e d i s e a s e o n h i s f u n c t i o r e q u e s t e d m e d i c a t i o n a s t h e a l t e r n a t i v e i s a f o u r w e h o s p i t a l w h i c h h a s s h o r t t e r m r e s u l t s . H e s t a t e d t h a h e r e c e i v e d c o v e r a g e f o r t h e r e q u e s t e d p r e s c r i p t i o n r e c e i v e d 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 , t h e a p p e l l a n t D e c e m b e r 1 7 , 2 0 1 3 l e t t e r t o t h e a p p e l l a n t i n r e s p o n a s s i s t a n c e p r o v i d e d t o t h e a p p e l l a n t b e t w e e n 1 9 9 0 a s s i s t a n c e p a y m e n t s f r o m t h e m i n i s t r y t o t h e a p p e l l b e e n i n r e c e i p t o f 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 a n d u p o n h i s r e t u r n t o B C h e r e a p p l i e d a n d r e c e i v e d M S T h e a p p e l l a n t a l s o p r o v i d e d a c o p y o f a J u n e 2 3 , 2 0 i n f o r m a t i o n i s r e q u i r e d w h e n a p p l y i n g f o r s p e c i f i c m l i f e t h r e a t e n i n g m e d i c a l c o n d i t i o n . A t t h e h e a r i n g , t h e m i n i s t r y s t a t e d t h a t t h e d o c u m e n a p p e l l a n t w a s i n r e c e i p t o f m i n i s t r y a s s i s t a n c e i n t h e o f B C f o r a l o n g t i m e h e w o u l d n e e d t o m e e t t h e c u r w h e n t h e a p p e l l a n t w a s l a s t r e c e i v i n g m i n i s t r y a s s i s o r d e r t o b e e l i g i b l e f o r M S O , a p e r s o n m u s t h a v e b e n o t s o m e t i m e i n t h e p a s t . T h e m i n i s t r y a l s o s t a t e d t m e d i c a t i o n w a s t h r o u g h t h e M i n i s t r y o f H e a l t h a n d t p r e v i o u s l y o n t h e P h a r m a c a r e l i s t , b u t t h a t t h i s m i n i s m e d i c a t i o n w h i c h i s c o m p l e t e l y o u t s i d e i t s s c o p e . T h p r e s c r i p t i o n m e d i c a t i o n i s n o l o n g e r c o v e r e d b y P h a o b t a i n s p e c i a l a u t h o r i t y f r o m P h a r m a c a r e f o r c o v e r a T h e m i n i s t r y h a d n o o b j e c t i o n t o t h e a d m i s s i b i l i t y o f h e a r i n g , w h i c h a l s o i n c l u d e d a n a d d i t i o n a l c o p y o f t h v a r i o u s w o r k r e l a t e d c e rt i f i c a t e s . T h e p a n e l f i n d s t h a o f p r i o r m i n i s t r y a s s i s t a n c e a r e n o t a d m i s s i b l e u n d e r A c t b e c a u s e t h e y d o n o t c o r r o b o r a t e a n y o f t h e i n f o r h a v i n g b e e n i n t r o d u c e d o n l y o n a p p e a l . T h e p a n e l a p h o t o g r a p h s a n d o r a l t e s t i m o n y w h i c h f u r t h e r a d d r e s f o r t h e p r e s c r i p t i o n m e d i c a t i o n a s b e i n a i n s u p p o r t o E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )l l a n t h a d b e e n d i a g n o s e d w i t h c h r o n i c L y m e J u l y 1 8 , 2 0 1 4 , t h e p h y s i c i a n w r o t e t h a t w i t h o u t n i n g c o n d i t i o n a n d t h a t t h e c u r r e n t t r e a t m e n t i s d u r a t i o n . A l s o b e f o r e t h e m i n i s t r y w e r e 8 s a t t e n d e d t h e h e a r i n g . p r e v i o u s l y p r o v i d e d w e r e t o s h o w t h e r a s h c a u s e d p h o t o g r a p h s a s f u r t h e r e v i d e n c e o f t h i s r a s h a n d n i n g . T h e a p p e l l a n t e x p l a i n e d t h a t h e r e q u i r e s t h e e k l o n g d a i l y i n t r a v e n o u s t r e a t m e n t p r o v i d e d i n t w h e n p r e v i o u s l y i n r e c e i p t o f m i n i s t r y a s s i s t a n c e , m e d i c a t i o n . A s e v i d e n c e t h a t h e h a d p r e v i o u s l y p r o v i d e d a 2 0 p a g e s u b m i s s i o n t h a t i n c l u d e d a s e t o h i s r e q u e s t f o r m i n i s t r y r e c o r d s o f a n d 2 0 0 0 a n d c o p i e s o f d o c u m e n t s s h o w i n g a n t i n 1 9 9 7 . T h e a p p e l l a n t e x p l a i n e d t h a t h e h a d s u b s e q u e n t l y m o v e d t o a n o t h e r p r o v i n c e a n d t h a t O a s s i s t a n c e . 1 4 l e t t e r f r o m t h e m i n i s t r y t h a t e x p l a i n e d w h a t e d i c a l e q u i p m e n t o r s u p p l i e s i f a n a p p l i c a n t h a s a t s p r o v i d e d a t t h e h e a r i n g c o n f i r m t h a t t h e p a s t . H o w e v e r , s i n c e t h e n t h e a p p e l l a n t w a s o u t r e n t c r i t e r i a f o r M S O w h i c h a r e v e r y d i f f e r e n t f r o m t a n c e . I n p a r t i c u l a r , t h e m i n i s t r y s t a t e d t h a t i n e n o n a s s i s t a n c e a t t h e t i m e o f t h e m o v e t o M S O , h a t p a s t c o v e r a g e o f t h e r e q u e s t e d p r e s c r i p t i o n h e P h a r m a c a r e p r o g r a m , a s t h e m e d i c a t i o n w a s t r y h a s n e v e r p r o v i d e d c o v e r a g e f o r p r e s c r i p t i o n e m i n i s t r y a d v i s e d t h a t a s t h e r e q u e s t e d r m a c a r e , t h e a p p e l l a n t c o u l d a s k a p h y s i c i a n t o g e . t h e d o c u m e n t s s u b m i t t e d b y t h e a p p e l l a n t a t t h e e J u l y 1 8 , 2 0 1 4 p h y s i c i a n ' s l e t t e r a n d c o p i e s o f t t h e w o r k c e r t i f i c a t e s a n d t h e e v i d e n c e o f r e c e i p t s e c t i o n 2 2 ( 4 ) 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 m a t i o n b e f o r e t h e m i n i s t ry a t r e c o n s i d e r a t i o n , d m i t t e d t h e e v i d e n c e , i n c l u d i n g t h e c o l o u r s e d t h e a p p e l l a n t ' s m e d i c a l c o n d i t i o n a n d n e e d f 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 v a t
reconsideration in accord ance with s. 22(4) o f the Employm ent and Assistance Act. The panel finds as fact that: 1 ) The appel lant h a s requested coverage of the c ost for prescri p ti on medication. EMT003(10/06/01)
PART F -Reason s for Panel De c ision The i ssu e u n der a ppe al is whethe r the ministry decisi su pple me n t s to me et a li f e-threatenin g health need me dica t ion does no t me et t h e l egislate d r equir eme n and a life-th rea t ening nee d has not be en es tabl is h ed rea s o n ab l e ap pli c atio n o f t h e legisl a tion . Relevan t Le g i sl at ion -E A P WDR G ene ral h ealth sup pleme nts 62 ( 1) Subject to sub sections (1.1) and (1.2), the minister may sup pl ement se t out in sectio n 2 [g e nera and dev i ces] o f Sch edul e C to or f o r a f amily to or fo r a person in the family u nit who (a) a recipient of disability (b ) a person w ith di sabilities who h as ce ased to b e eligi (i) empl oyment incom spo use, if e i t her t he (A) i s under pr emium assist (B) i s a ged 65 receiving the fede guaranteed income supplement, (ii) a pension or other payment under (Canada), (iii) money received by the person or the person's spouse under the sett lement agreement approved by the Supre Action No. S50808, Kelowna Registry, or (iv) money or value received by the person or the person's spouse that is maintenan mainte nance agreement or other agre or the person's spouse A is und er EAAT003(10/06/01) on t h a t the a ppe ll a n t is only eligi bl e for health and that his re quest for coverage for pr e s c r iption t s as i t is no t a Sch e d ule C h ea l th sup plement , is reasonab ly supp o r ted by the e vidence or a p rov i de any healt h l he alt h su pplemen t s] o r 3 [ med i c al e q ui pmen t unit i f the health suppl ement is provi ded is a ss ista nce, who h as n ot reac hed 65 years o f a ge and bl e for dis ab i lity ass ist ance because of e earned b y t he person or the person's per s on or t he p ers o n 's s p ouse age 6 5 an d the fa mily unit is re c e i ving a n ce under the M ed i care Protection Act, o r or mo r e and a person in t he fa m ily unit is ral spouse's allowance or the fed eral the Ca nada Pension Plan m e Cou r t in c e under a maintenance order, ement, if ei t h er the per son a e 65 and the fa mil unit is receivin
premium assistance under the Medicare Pr ( B) is aged 65 or more re ceivi n g the federal spouse's allowance or gua ranteed (c) a person who was a recipi she became 65 yea rs of a depend ant was a d ependant of dependant of that person, (d) a dependant of a p ers ( d.1) a dep endant of a p erson ref a n y pe rson i n th e fa m ily ( i ) is und e r age 6 ass i s t a nce u n der the Medicare Protec (i i) i s aged 6 5 or r eceivi ng the federal spouse inco m e supplement, (d .2) a d e pendant o f a person re (d.3) a d e pendant o f a person i n t he fam ily un it ( i ) i s und e r age 65 a as sistanc e u n de r the Medicare P (ii) is aged 65 or more and a receiving the federa income supplement, (e) a dependent child of a recipient of har (f) a p erson wit h d i s a bilities assistance because of an award of compensation under the Criminal Injury Compensation Act or an awa Assis tance Act m ade to the person or the person's spouse, if ( i ) t he person is under age 65 an premium assistance under the Medicare Protection Act (ii) the person is aged 65 or more and any person in the family unit is receivin the federal s EAAT 003(10/06/01) otection Act, or and a ny person i n the fa m il y unit is t he federal income supplement, ent of disability as si s tance on th e day he or g e a n d a dependant of that p erson , if the t he person on tha t day and remains a o n re ferred to in par agraph (a ) or ( b ) (iii), erred to in paragraph (b) ( i) or (iv), if unit 5 and the fa m il y unit is r ec e i ving pr em ium t ion Act, or mo r e a nd any pe rson in the family un it is 's a llowanc e or t he federal g uaran teed fer red to i n pa rag ra ph (b) (ii), re fer red to i n paragraph ( f ) , if any p erson n d t he family unit i s receiving p remi u m ro te ction Act, or ny person i n t he family uni t is l spouse's allo w an ce or the federal guaranteed dship assistance, who has ce ased to be eligible for disability r d of b enefits u nder the Crime Vict im d the fa mily uni t is r eceiving , or ouse's allowance or the federal
g u a r a n t e e d i n c o m e ( g ) a p e r s o n w h o s e f a m i l a s s i s t a n c e b e c a u s e o f f i n a g r e e m e n t u n d e r s e c t i o n S e r v i c e A c t , d u r i n g t h e t e H e a l t h s u p p l e m e n t f o r p e r s o n s f a c i n g d i r e c t 6 9 T h e m i n i s t e r m a y p r o v i d e t o a f a m i l y u n i t ( a ) a n d ( f ) [ g e n e r a l h e a l t h s u p p l e m e n t s S c h e d u l e C , i f t h e h e a l t h s u p p l e m e n t i s w h o i s o t h e r w i s e n o t e l i g i b l e f o r t h e h e a m i n i s t e r i s s a t i s f i e d t h a t ( a ) t h e p e r s o n f a c e s a d i r t h e r e a r e n o r e s o u r c e s a v m e e t t h a t n e e d , ( b ) t h e h e a l t h s u p p l e m e n ( c ) t h e p e r s o n ' s f a m i l y u n M e d i c a r e P r o t e c t i o n A c t , a ( d ) t h e r e q u i r e m e n t s s p e c a s a p p l i c a b l e , a r e m e t : ( i ) p a r a g r a p h ( a ) ( i i ) s e c t i o n s 3 t o 3 S c h e d u l e C G e n e r a l h e a l t h s u p p l e m e n t s 2 ( 1 ) T h e f o l l o w i n g a r e t h e h e a l t h s u p p l 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 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 ) m e d i c a l o r s u r g i c a l s e i t h e r d i s p o s a b l e o r r e u f o l l o w i n q r e q u i r e m e n t s a E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )s u p p l e m e n t , o r y u n i t c e a s e s t o b e e l i g i b l e f o r d i s a b i l i t y a n c i a l a s s i s t a n c e p r o v i d e d t h r o u g h a n 1 2 . 3 o f t h e C h i l d , F a m i l y a n d C o m m u n i t y r m o f t h e a g r e e m e n 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 a n y h e a l t h s u p p l e m e n t s e t o u t i n s e c t i o n s 2 ( 1 ) ] a n d 3 [ 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 f p r o v i d e d t o o r f o r a p e r s o n i n t h e f a m i l y u n i t l t h s u p p l e m e n t u n d e r t h i s r e g u l a t i o n , a n d i f t h e e 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 n e e d a n d a i l a b l e t o t h e p e r s o n ' s f a m i l y u n i t w i t h w h i c h t o t i s n e c e s s a r y t o m e e t t h a t n e e d , i t i s r e c e i v i n g p r e m i u m a s s i s t a n c e u n d e r t h e n d i f i e d i n t h e f o l l o w i n g p r o v i s i o n s o f S c h e d u l e C , o r ( f ) o f s e c t i o n ( 2 ) ( 1 ) ; . 1 2 , o t h e r t h a n p a r a g r a p h ( a ) o f s e c t i o n 3 ( 1 ) . m e n t s t h a t m a y b e p a i d f o r b y t h e m i n i s t e r i f 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 u p p l i e s t h a t a r e , a t t h e m i n i s t e r ' s d i s c r e t i o n , s a b l e , i f 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 a l l o f t h e r e m e t :
(i) the supplies are required for one of the following purposes: (A) wound care; (B) ongoing bowel care required due to loss of muscle function; (C) catheterization; (D) incontinence; (E) skin parasite care; (F) limb circulation care; (ii) the supplies are (A) prescribed by a medical practitioner or nurse practitioner, (B) the least expensive supplies appropriate for the purpose, and (C) necessary to avoid an imminent and substantial danger to health; (iii) there are no resources available to the family unit to pay the cost of or obtain the supplies; (a.1) the following medical or surgical supplies that are, at the minister's discretion, either disposable or reusable, if the minister is satisfied that all the requirements described in paragraph (a) (ii) and (iii) are met in relation to the supplies: (i) lancets; (ii) needles and syringes; (iii) ventilator supplies required for the essential operation or sterilization of a ventilator; (iv) tracheostomy supplies; (a.2) consumable medical supplies, if the minister is satisfied that all of the following requirements are met: (i) the supplies are required to thicken food; (ii) all the requirements described in paragraph (a) (ii) and (iii) are met in relation to the supplies; (b) Reoealed. rs.c. Rea. 236/2003, Sch. 2, s. 2 (b). l EMT 003(10/06/01)
(c) subject to subsection (2), a service provided by a person described opposite that service in the following table, delivered in not more than 12 visits per calendar year, (i) for which a medical practitioner or nurse practitioner has confirmed an acute need, (ii) if the visits available under the Medical and Health Care Services Regulation, B.C. Reg. 426/97, for that calendar year have been provided and for which payment is not available under the Medicare Protection Act, and (iii) for which there are no resources available to the family unit to cover the cost: Item Service Provided by Registered with 1 acupuncture acup un ctu rist College of Traditional Chinese Medicine under the Health Professions Act 2 chiropractic chiropractor College of Chiropractors of British Columbia under the Health Professions Act 3 massage massage College of Massage Therapists of British Columbia therapy therapist under the Health Professions Act 4 naturopathy naturopath College of Naturopathic Physicians of British Columbia under the Health Professions Act 5 non-surgical podiatrist College of Podiatric Surgeons of British Columbia podiatry under the Health Professions Act 6 physical therapy physical College of Physical Therapists of British Columbia therapist under the Health Professions Act (d) and (e) Repealed. [B.C. Reg. 75/2008, s. (a).] (f) the least expensive appropriate mode of transportation to or from (i) an office, in the local area, of a medical practitioner or nurse practitioner, (ii) the office of the nearest available specialist in a field of medicine or surgery if the person has been referred to a specialist in that field by a local medical practitioner or nurse practitioner, iii the nearest suitable eneral hos ital or rehabilitation EAAT 003(10/06/01)
hospital, as those facilities are defined in section 1.1 of the Hospital Insurance Act Regulations, or (iv) the nearest suitable hospital as defined in paragraph (e) of the definition of "hospital" in section 1 of the Hospital Insurance Act, provided that (v) the transportation is to enable the person to receive a benefit under the Medicare Protection Act or a general hospital service under the Hospital Insurance Act, and (vi) there are no resources available to the person's family unit to cover the cost. (g) Repealed. [B.C. Reg. 75/2008, s. (a).] (1.1) For the purposes of subsection (1) (a), medical and surgical supplies do not include nutritional supplements, food, vitamins, minerals or prescription medications. Medical equipment and devices 3. (1) Subject to subsections (2) to (5) of this section, the medical equipment and devices described in sections 3.1 to 3.12 of this Schedule are the health supplements that may be provided by the minister if.. ........ Sections 3.1 to 3.12 set out the following health supplements: canes, crutches and walkers; wheelchairs; wheelchair seating systems; scooters; bathing and toileting aids; hospital bed; pressure relief mattresses; floor or ceiling lift devices; breathing devices; orthoses; hearing instruments; and, non-conventional glucose meters. The parties' positions The ministry argues that the appellant is not currently a recipient of disability or income assistance and as there is no record of being a recipient of disability assistance in the past, the appellant is also not eligible for MSO assistance. Therefore, the appellant is not eligible to apply for health supplements under section 62 of the EAPWDR [or section 67 of the EAR] and may only apply for a health supplement under section 69 of the EAPWDR [or section 76 of the EAR] which provides certain Schedule C health supplements to meet a direct and imminent life threatenina health if the EAA T003(10/06/01)
requirements of section 69 are met. The ministry argues that prescription medication is not any of the health supplements set out in Schedule C and further, that prescription medication is not medical or surgical supplies [section 2(1 )(a)], medical transportation [section 2(1 )(f)), or medical equipment and devices [section 3) which are the only Schedule C supplements that may be provided under section 69 to meet a life threatening health need. In particular, the ministry argues that prescription medication is not a medical or surgical supply under section 2 of Schedule C because the following legislated requirements are not met: • the prescription medication is not required for one of the listed purposes under section 2(1) (a)(i); • the information does not establish that the prescription medication is necessary to avoid an imminent and substantial danger to health as required by section 2(1) (a)(ii)(C); • the prescription medication is not one of the items listed in section 2(1)(a.1 ); and • section 2(1.1) states that medical and surgical supplies do not include prescription medications. Finally, the ministry argues that in addition to prescription medication not being one of the health supplements available under section 69 to meet a life threatening health need, the other requirements of section 69 have not been met because the information does not establish that the appellant faces a direct and imminent life threatening health need and the requirements specified in sections 2(1 )(a), (f) or 3 to 3.12 of Schedule C were not met. The appellant argues that the prescribed medication is a health supplement under section 2 of Schedule C because it is a "disposable" treatment prescribed by a medical practitioner, the least expensive supply, there are no other resources available to meet the cost, and is necessary to avoid imminent health danger. Additionally, the medication is required for the purpose of skin parasite care and circulation because without the treatment, his skin and circulation are impacted. The appellant also argues that he was a recipient of disability assistance from 1995 to 1997 and eligible for health supplements under MSO assistance. The Panel's Decision Eligibility to apply for health supplements Given the information available to the ministry at the time of reconsideration, the panel finds that the ministry reasonably determined that the appellant was not eligible to apply for health supplements as a recipient of income, disability or MSO assistance. Whether the appellant would be eligible for MSO assistance on the basis of having been a former recipient of assistance must first be decided by the ministry. The panel's jurisdiction is limited to reviewing the reasonableness of the ministry's reconsideration decision not making a new decision; that is the role of the ministry. The appellant would need to put this information before the ministry so that it could make a decision respecting all of the eligibility criteria for MSO assistance. EMT 003(10/06/01)
Is the prescription medication a Schedule C health supplement Regardless of whether the appellant is eligible to apply for health supplements as a recipient of MSO assistance, or only under the life threatening health needs section, the legislation only allows for the provision of health supplements set out in Schedule C and only if the criteria specific to a particular Schedule C health supplement are met. In this case, the ministry found, and the appellant does not dispute, that the requested prescription medication is not any of the Schedule C health supplements set out in section. 2(1) (f) [medical transportation], sections 3 -3.12 [medical equipment and devices] or sections 4 through 9 [includes dental, natal and nutritional supplements]. The panel finds that the ministry was reasonable in reaching this conclusion. In considering whether the prescription medication is a medical supply within the meaning of section 2(1)(a) of Schedule C, section 2(1.1) expressly states that prescription medication is not a medical or surgical supply for the purposes of subsection (1 )(a) and therefore the panel finds that the ministry has reasonably concluded that prescription medication is not a disposable or reusable medical or surgical supply for any of the set out purposes or necessary to avoid an imminent and substantial danger to health. Life threatening health need In considering the appellant's eligibility under the life threatening health needs legislation, the panel notes that section 69 only allows for the provision of some of the health supplements set out in Schedule C-medical and surgical supplies under section 2(1)(a), medical transportation under section 2(1 )(f) and the medical equipment and devices identified in sections 3 to 3.11. For the reasons above, the panel finds that the ministry reasonably determined that prescription medication is none of those health supplements and, consequently, the panel also finds that the ministry reasonably determined that the appellant is not eligible to receive coverage for prescription medication under section 69. Although that finding alone is determinative of ineligibility under section 69, the ministry also considered whether a direct and imminent life-threatening need was established and appears, by virtue of the italicization of imminent, to have determined that the threat was not imminent. The appellant argued that the information in the physician's letter was sufficient to meet this requirement. The panel finds that although the physician states that untreated Lyme disease is a life threatening condition, the ministry has reasonably viewed this information as falling short of conveying the degree of immediacy required to be considered imminent and that the appellant is not eligible under section 69 on this additional basis. Conclusion In conclusion, the panel finds that the ministry's decision that the appellant is not eligible for a health supplement for prescription medication is a reasonable application of the legislation in the circumstances of the appellant and confirms the reconsideration decision. EAAT 003(10/06/01)
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