P ART C -D e ci sion under Appea l The dec i s io n u n d e r appeal is the reconsid e ration decision of Social Innovat i on (the ministry ) dated August 15, 2014 denyin with disabi l i t i es (PWD). The ministry determined that the appellant di c riteria required for PWD designati o n a s set out in the Employme Disabiliti e s Act (EAPWDA) section 2. The minis try 18 years of age or older and, that in the opini on of a medical practitioner, continue for two or mor e years. However, the ministry determined that, based on the informat provided , the following criter i a as set out ih sect i on 2(2)( • The minis t er is satis fie d that the appe l la nt has a sever • In the opinion of a presc ribed profess ional, t ability to perform daily living activities (DLA) either cont periods; and • As a re su lt of the rest ri c tions, t h e appellant req anoth e r person to perf orm t he DLA res t ricted by he PART D -Relevant L e g i slati o n Employment and Assi stance for Per s ons wit h Disabilities Act Emp loyment and Assi stance for Per s ons w ith Disa b EAAT 003(10/06/01) the Minis try of Social Development and g the appellan t designat ion as a person d not meet three of the five n t and Assist a nce for Persons wit h found that the app el lan t meets the criter i a of being her impa i rm ent is l i k e ly to i on b ) of the EAP WDA w e re no t m e t : e mental or ph ysi c a l impairm en t ; he ap pella n t ' s impa irment si gnificantly restricts her i n uously or periodically for extended uir e s the sig nificant h el p o r sup e rv ision of r impairme n t. ( EAP WDA) -section 2 ilities Reg u lation (EA PW DR) -section 2
P A R T E Summary o f Facts The evidenc e before the mini stry at reconsideration consis 1. The appellan t 's PWD Designation Appl i c at ion, containing the foll • The appellant's S elf Re port (S R) completed February o The Physician R e port (PR ) dated Febru ary 18, 2014 completed by th doctor w ho has k n ow n the appellant for more than 2 years and ind 10 times in the pr eviou s year; and o The Assessor Report (AR) da t e d March 18, 201 2. Attached to the PWD applicati on were the f o his t o ry of a brain tumor and a pelvic abscess • A le tter dated Aug ust 5, 2010 fr o m a n eurolo regard ing J ul y 20, 2010 c o nsult ation with the ap pellant is blind in her left eye, the vision in suffered a seizure; • A radiol ogy re p ort dat ed A u g us t 2 2, 201 0 • A letter fro m a g ynec ologist t o t h e app ell ant regarding t h e admiss ion o f the app e llant t ab scess ; • R e p or t s of p el v ic ultrasound s of the app ell • A letter from a g y necologi st to t he app ellant's re g a rding a co n s ultation w ith the ap pell ant • A lett e r from a g yneco l o gis t to the appellan 2 010 regardin g the t r ea tmen t of th e a pp el 3. The appe l lant 's reque st f or reconsid eration dated July 18, had rec eive d fur the r inf o rmatio n fro m he r family doc atro phy on her le f t side i s ir rever s ibl e and to • A lett e r dat ed July 29, 2014 f r om the app co mplet ed the PR an d AR por tions of the • A letter dated October 21, 2009 to the appellant's former family doctor from the neurologist (subs equently retired) w ho performed su r • A radiology report dated March 16, 2012 of an MRI of the • A letter dated July 18, 2014 from a case manager at the local mental health team where the appellant's husban d receives treatment and wh Prior to the appeal hearing, the appellant submitted a medical history summary prepared by her family doctor and dated September 3, 2014 on which it is indicated problem list" is "blindnes s -left s ided -p o st meningioma r -meningioma -removed 2009 persistent headaches, dizziness, post op" and "hand weakness optic nerve injury -right arm-post meningioma removal 2009." indicates that the appellant's surgical history is "craniotomy: resection meningioma 03 Sept 2009 Post op -confirmed left optic nerve atrophy." The ministry did not object to the admission of the medical historv summarv. The panel admits the medical historv summarv under section 22(4) of the EAAT003(10/06/01) ted of the foll o w i ng: owing three parts: 1 7, 20 1 4; e appellant's f a m ily icated he had s een her 2-4 completed by the appel lant ' s family d octor. llowing reports regarding the appell ant ' s medical : gist t o t h e appellan t' s former f am ily doctor the appel lant, in whi c h the ne uro log ist confi r m s he r ri gh t eye is n o rmal, and she had of a n MRI of the ap pell ant 's h ead ; 's f o rme r fa mily do cto r da t e d August 4, 2 010 o ho spi tal in July 2010 for tre at men t of an ovaria n ant da ted O c tober 4 a nd No vemb er 17, 2 010 ; f o rmer fami ly doctor date d November 4 , 2010 ; and t ' s forme r fa mil y doc tor dat ed D ec emb er 30, lant 's o va r ian abscess. 20 1 4 on wh ich sh e wrote th at she tor an d speci alist in dic ati ng t ha t h er o ptic which were att ache d th e fol lowing documents : el lant's family doct or (the sam e phys ician who PW D a pplication); gery to remove a tumor in the a p pe llant's bra i n ; a ppellant's he ad; an d o knows the appellant. that the appellant 's "current esection, fronta l lobe 2009," "brain cancer The medical history summary also
E m p l o y m e n t a n d A s s i s t a n c e A c t a s i t r e s t a t e s i n f o r d e c i s i o n u n d e r a p p e a l w a s m a d e . A t t h e a p p e a l h e a r i n g , t h e a p p e l l a n t t o l d t h e p a n e l w e l l a s h e r p r e v i o u s d o c t o r , a l t h o u g h h e s p e a k s h e h e r a p p o i n t m e n t s . S h e s a i d t h a t s h e h a s n o t b e e n h e r h e a l t h p r o b l e m s a n d t h e e f f e c t s h e r c o n d i t i o n s a f r a i d a b o u t h e r h e a l t h . S h e t o l d t h e p a n e l t h a t t h e t e a m , w h o i s a n u r s e , k n o w s h e r a n d h e r f a m i l y w e T h e f o l l o w i n g i s a s u m m a r y o f t h e e v i d e n c e f r o m t h r e p o r t s , r e g a r d i n g t h e a p p e l l a n t ' s i m p a i r m e n t s a s t h p a n e l h a s a l s o i n c l u d e d r e f e r e n c e t o t h e a p p e l l a n t ' s s u b m i s s i o n s a t t h e h e a r i n g . S e v e ri t y o f i m p a i r m e n t s ( c r i t e r i a s e t o u t i n s u b s . 2 ( 2 I n t h e P R c o m p l e t e d F e b r u a r y 1 8 , 2 0 1 4 , t h e a p p e l l t u m o r a n d e p i l e p s y s i n c e 2 0 0 7 a n d t h i s i s c o n f i r m e r e p o r t s f r o m t h e n e u r o l o g i s t s . I n t h e J u l y 2 9 , 2 0 1 4 v i s i o n i n h e r l e f t e y e s i n c e J u l y 2 0 0 7 a n d i n t h e S e p f a m i l y d o c t o r n o t e s , " h a n d w e a k n e s s o p t i c n e r v e i n a p p e l l a n t ' s c o n d i t i o n s , t h e a p p e l l a n t ' s d o c t o r w r o t e s e i z u r e s s i n c e . " T h e a p p e l l a n t ' s d o c t o r i n d i c a t e s t h l i f e " t h a t i n t e r f e r e s w i t h " c o g n i t i v e f u n c t i o n . " I n t h e f u n c t i o n a l s k i l l s a s s e s s m e n t i n t h e P R , t h e f a 4 + b l o c k s u n a i d e d o n a f l a t s u r f a c e , t h a t s h e c o u l d ( 5 t o 1 5 l b s ) a n d c o u l d r e m a i n s e a t e d f o r l e s s t h a n 1 h e r J u l y 1 8 , 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 c o u l d n o t t o i n s t r u c t h e r h u s b a n d t o h e l p h e r . T h e f a m i l y d o c t w i t h c o m m u n i c a t i o n . I n t h e A R c o m p l e t e d b y t h e f a m t h e a p p e l l a n t ' s a b i l i t y t o c o m m u n i c a t e w a s s a t i s f a c t i n s p e a k i n g a n d r e a d i n g . T h e f a m i l y d o c t o r i n d i c a t e p e r f o r m a l l a r e a s o f m o b i l i t y a n d p h y s i c a l a b i l i t y ( w a s t a n d i n g , l i f t i n g a n d c a r r y i n g a n d h o l d i n g . I n h i s J u l y a p p e l l a n t h a s d i f f i c u l t y w a l k i n g u n a i d e d o n a f l a t s u r d a u g h t e r o r b y u s i n g a w a l k i n g a i d f o r b a l a n c e . T h i s h e a l t h c a s e w o r k e r i n h e r l e t t e r o f J u l y 1 8 , 2 0 1 4 a n d I n t h e P R , t h e a p p e l l a n t ' s f a m i l y d o c t o r i n d i c a t e d t h a e m o t i o n a l f u n c t i o n i n t h e f o l l o w i n g a r e a s : m e m o r y , m o t i v a t i o n , i m p u l s e c o n t r o l , m o t o r a c t i v i t y a n d a t t e n l e f t t h e c o m m e n t s s e c t i o n r e g a r d i n g t h e i d e n t i f i e d d e a p p e l l a n t ' s c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g , t h e i m p a i r m e n t h a d n o i m p a c t i n t h e a r e a s o f b o d i l y f u n c i m p a c t i n a l l o f t h e o t h e r l i s t e d a r e a s ( c o n s c i o u s n e s E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )m a t i o n t h a t w a s 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 t h e t h a t h e r c u r r e n t f a m i l y d o c t o r d o e s n o t k n o w h e r a s r l a n g u a g e a n d s h e d o e s n o t n e e d a t r a n s l a t o r a t h o n e s t w i t h h e r f a m i l y d o c t o r a b o u t t h e s e v e r i t y o f h a v e o n h e r d a i l y l i v i n g s h e i s c o n c e r n e d a n d c a s e m a n a g e r o f h e r h u s b a n d ' s m e n t a l h e a l t h l l a n d h a s u r g e d h e r t o a p p l y f o r P W D d e s i g n a t i o n . e P R a n d A R , i n c l u d i n g t h e r e l e v a n t m e d i c a l e y r e l a t e t o t h e t h r e e P W D c r i t e r i a a t i s s u e . T h e S R i n t h e P W D a p p l i c a t i o n , a s w e l l a s h e r ) E A P W D A ) a n t ' s f a m i l y d o c t o r d i a g n o s e d h e r w i t h a b r a i n d i n t h e i n f o r m a t i o n i n t h e c o n s u l t a t i o n a n d M R I l e t t e r , t h e fa m i l y d o c t o r c o n f i r m s t h a t s h e h a s l o s t t e m b e r 3 , 2 0 1 4 m e d i c a l h i s t o r y s u m m a r y , t h e j u r y . " I n h i s c o m m e n t r e g a r d i n g t h e s e v e r i t y o f t h e i n t h e P R , " 4 b r a i n t u m o r s r e m o v e d 2 0 0 9 , a t s h e i s t a k i n g a n t i c o n v u l s a n t m e d i c a t i o n " f o r m i l y d o c t o r i n d i c a t e d t h a t t h e a p p e l l a n t c o u l d w a l k c l i m b 5 + s t e p s u n a i d e d , t h a t s h e c o u l d l i f t 2 -7 k g h o u r . T h e m e n t a l h e a l t h c a s e w o r k e r r e p o r t e d i n l i f t m o r e t h a n 2 k g a f t e r t h e s u r g e r y a n d s h e h a s o r i n d i c a t e d t h a t t h e a p p e l l a n t h a d n o d i f f i c u l t i e s i l y d o c t o r o n M a r c h 1 8 , 2 0 1 4 , h e i n d i c a t e d t h a t o r y i n t h e a r e a s o f w r i t i n g a n d h e a r i n g , a n d g o o d d t h a t t h e a p p e l l a n t w a s a b l e t o i n d e p e n d e n t l y l k i n g i n d o o r s a n d o u t d o o r s , c l i m b i n g s t a i r s , 2 9 , 2 0 1 4 l e t t e r , t h e f a m i l y d o c t o r w r i t e s t h a t t h e f a c e a n d r e q u i r e s a s s i s t a n c e f r o m h e r h u s b a n d o r i n f o r m a t i o n w a s a l s o r e p e a t e d b y t h e m e n t a l b y t h e a p p e l l a n t a t t h e h e a r i n g . t s h e h a s s i g n i f i c a n t d e f i c i t s w i t h c o g n i t i v e a n d p e r c e p t u a l p s y c h o m o t o r , e m o t i o n a l d i s t u r b a n c e , t i o n o r s u s t a i n e d c o n c e n t r a t i o n . T h e f a m i l y d o c t o r f i c i t s b l a n k . I n t h e A R s e c t i o n r e g a r d i n g t h e f a m i l y d o c t o r i n d i c a t e d t h a t t h e a p p e l l a n t ' s m e n t a l t i o n s a n d p s y c h o t i c s y m p t o m s a n d a m i n i m a l s , e m o t i o n , i m o u l s e c o n t r o l , i n s i a h t a n d j u d a m e n t ,
attention/concentration, executive, memory, motivation, motor activity, language, other neuro psychological problems and other emotional or mental problems). The family doctor left the comments section blank. At the hearing, the appellant described the effects of her conditions to the panel. She said that because she cannot see out of her left eye, she has difficulty when she is walking (she has to make sure she turns her head so her right eye can see when crossing streets), she always has to wear glasses, does not have a good sense of direction and does not go out by herself and must rely on others to help guide her. She went to see an eye doctor who said that the vision in her right eye is declining but she does not want to go often because she has to travel on public transit and needs someone to accompany her. She said that she experiences pain and weakness in her right arm which makes it difficult for her to lift and carry things, but it is not all the time. She said that when it gets cold outside, she gets severe headaches because of the brain tumors. She has had epileptic seizures in the past and she is afraid she might lose consciousness. She believes she has more tumors in her brain, but she does not know this with certainty because she does not have a neurologist at this time and is afraid to find out. The appellant stated that, with her vision problems and how her condition may affect her in the future, no one will hire her for work. Ability to perform DLA (criteria set out in subs. 2(2/(b/ EAPWDA) In the PR, the appellant's family doctor indicated that the appellant's impairments restrict her ability to perform the DLA of management of medications, although he did not indicate whether this restriction was continuous or periodic. In the PR, beside the DLA of management of finances, the family doctor has written "7" In the AR, the family doctor wrote the comment "daily living ok, managing finance may be a bit hampered" in response to the question "what are the applicant's mental or physical impairments that impact his/her ability to manage Daily Living activities?" In the section of the AR indicating the degree of restriction the appellant's impairments cause on her DLA, the appellant's family doctor indicated that the appellant was independent in all of the listed tasks of the DLA of personal care, basic housekeeping, meals, medications, and transportation. For the DLA of shopping, the family doctor has indicated that the appellant can independently perform all of the listed tasks except "making appropriate choices" and has checked she requires periodic assistance, but did not provide any commentary. For the DLA of paying rent and bills, the family doctor has indicated that the appellant requires periodic assistance for all of the 3 listed tasks, but has not provided any commentary. In his July 29, 2014 letter, the family doctor indicated that the appellant requires assistance shopping for groceries and banking and that she has memory difficulties and requires daily reminders from her child to take her medications. In the July 18, 2014 letter, the mental health case manager also confirms that the appellant's daughter prompts her to take her medication. At the hearing the appellant said her daughter reminds her to take her medications and she explained that when she goes to the bank, she doesn't want anyone to know she has memory problems, so she will prepare her deposit and withdrawal slips before she goes in. At the hearing, the appellant said that she is able to dress herself, but will bathe with her child's assistance. She said she is able to do some shopping and prepare simple meals. In the PR, the appellant's family doctor indicated that the appellant's impairments restrict her ability to perform the DLA of social functioning continuously. In the AR, the family doctor indicated that the appellant required periodic support/supervision for all of the listed aspects of social functionini:i, that EMT 003(10/06/01)
s h e h a d g o o d f u n c t i o n i n g i n h e r i m m e d i a t e s o c i a l n n e t w o r k s , b u t d i d n o t p r o v i d e a n y c o m m e n t a r y . A s s i s t a n c e r e q u i r e d / p r o v i d e d ( c r i t e r i a s e t o u t i n s u b I n t h e s e c t i o n o f t h e A R d e s c r i b i n g t h e a s s i s t a n c e p " N / A " b e s i d e a l l t h r e e a r e a s ( a s s i s t a n c e p r o v i d e d b d e v i c e s , a n d b y a s s i s t a n c e a n i m a l s ) . A t t h e h e a r i n g h e r f r i e n d s w i l l h e l p h e r w i t h h e r s h o p p i n g a n d t h a t s h e d o e s n ' t f a l l . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )e t w o r k a n d m a r g i n a l f u n c t i o n i n g i n e x t e n d e d s o c i a l s . 2 ( 2 ) ( b )(i i) E A P W D A ) r o v i d e d f o r t h e a p p e l l a n t , t h e f a m i l y d o c t o r w r o t e y o t h e r p e o p l e , t h r o u g h t h e u s e o f a s s i s t i v e , t h e a p p e l l a n t t o l d t h e p a n e l t h a t h e r c h i l d a n d s h e w i l l b a t h e w i t h h e r c h i l d ' s a s s i s t a n c e s o t h a t
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 i n t h i s a p p e a l i s w h e t h e r 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 i n e d t h a t t h e a p p e l l a n t i s i n e l i g i b l e f o r P W D d e s i g n a t i o n b e c a u s e s h e d i d n o t m e e t a l l t h e r e q u i r e m e n t s i n s e c t i o n 2 o f t h e E A P W D A . S p e c i f i c a l l y , t h e m i n i s t r y d e t e r m i n e d t h a t t h e i n f o r m a t i o n p r o v i d e d d i d n o t e s t a b l i s h t h a t t h e a p p e l l a n t h a s a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t , t h a t h e r p h y s i c a l i m p a i r m e n t 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 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 s h e r a b i l i t y t o p e r f o r m d a i l y l i v i n g a c t i v i t i e s 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 e x t e n d e d p e r i o d s , a n d , 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 s h e r e q u i r e s h e l p t o p e r f o r m t h o s e a c t i v i t i e s . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D A a p p l i e s t o t h i s a p p e a l : 2 ( 1 ) I n t h i s s e c t i o n : " a s s i s t i v e d e v i c e " m e a n s a d e v i c e d e s i g n e d t o e n a b l e a p e r s o n t o p e r f o r m a d a i l y l i v i n g a c t i v i t y t h a t , b e c a u s e o f a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t , t h e p e r s o n i s u n a b l e t o p e r f o r m ; " d a i l y l i v i n g a c t i v i t y " h a s t h e p r e s c r i b e d m e a n i n g ; " p r e s c r i b e d p r o f e s s i o n a l " h a s t h e p r e s c r i b e d m e a n i n g . ( 2 ) T h e m i n i s t e r m a y d e s i g n a t e a p e r s o n w h o h a s r e a c h e d 1 8 y e a r s o f a g e a s a p e r s o n w i t h d i s a b i l i t i e s f o r t h e p u r p o s e s o f t h i s A c t 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 t h e p e r s o n h a s a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t t h a t ( a ) 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 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 t 2 y e a r s , a n d ( b ) 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 ( i ) 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 s t h e p e r s o n ' s a b i l i t y t o p e r f o r m d a i l y l i v i n g a c t i v i t i e s e i t h e r ( A ) c o n t i n u o u s l y , o r ( B ) 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 ( i i ) 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 p e r s o n r e q u i r e s h e l p t o p e r f o r m t h o s e a c t i v i t i e s . ( 3 ) F o r t h e p u r p o s e s o f s u b s e c t i o n ( 2 ) , ( a ) a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a i r m e n t i n c l u d e s a p e r s o n w i t h a m e n t a l d i s o r d e r , a n d ( b ) a p e r s o n r e q u i r e s h e l p i n r e l a t i o n t o a d a i l y l i v i n g a c t i v i t y i f , i n o r d e r t o p e rf o r m i t , t h e p e r s o n r e q u i r e s ( i ) a n a s s i s t i v e d e v i c e , ( i i ) 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 a n o t h e r p e r s o n , o r ( i i i ) t h e s 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 . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D R a p p l i e s t o t h i s a p p e a l : 2 ( 1 ) F o r t h e p u r p o s e s o f t h e A c t a n d t h i s r e g u l a t i o n , " d a i l y l i v i n g a c t i v i t i e s " , ( a ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e p h y s i c a l i m p a i r m e n t o r a s e v e r e m e n t a l i m p a i r m e n t , m e a n s t h e f o l l o w i n g a c t i v i t i e s : ( i ) p r e p a r e o w n m e a l s ; ( i i ) m a n a g e p e r s o n a l f i n a n c e s ; ( i i i ) s h o p f o r p e r s o n a l n e e d s ; ( i v ) u s e p u b l i c o r p e r s o n a l t r a n s p o r t a t i o n f a c i l i t i e s ; ( v ) p e r f o r m h o u s e w o r k t o m a i n t a i n t h e p e r s o n ' s p l a c e o f r e s i d e n c e i n a c c e p t a b l e s a n i t a r y c o n d i t i o n ; ( v i ) m o v e a b o u t i n d o o r s a n d o u t d o o r s ; ( v i i ) p e rf o r m p e r s o n a l h y g i e n e a n d s e l f c a r e ; ( v i i i ) m a n a g e p e r s o n a l m e d i c a t i o n , a n d ( b ) i n r e l a t i o n t o a n e r s o n w h o h a s a s e v e r e m e n t a l i m n a i r m e n t , i n c l u d e s t h e f o l l o w i n o a c t i v i t i e s : E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )
(i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. 2(2) For the purpose of the Act, "prescribed professional" means a person who is authorized under an enactment to practice the profession of (a) medical practitioner; (b) registered psychologist; (c) registered nurse or registered psychiatric nurse; (d ) occupational therapist; ( e ) physical therapist; (f) social worker; (g) chiropractor; or (h) nurse practitioner. Existence and severity of impairments The appellant told the panel that her family doctor does not know her as well as her former family doctor and she has not been honest with her family doctor about the extent to which she is affected by her impairments. The appellant told the panel that she has had a portion of her brain removed (the surgery to remove the tumor) and that as a result she can't see out of her left eye, she has memory problems, and has had epileptic seizures because she forgot to take her medications. All of these things mean that she has limited her activities and has to rely on her friends and her child. In the reconsideration decision, the ministry based its determination that the appellant's impairments were not severe on the information provided by the appellant's family doctor in the PR completed February 18, 2014 and in the AR completed March 18, 2014, as well as the additional information submitted by the doctor and mental health case manager in July 2014 and the medical reports. In the functional skills section of the PR, the family doctor notes some restriction with lifting (limited to 2-7 kg or 5-15 lbs) and remaining seated (less than one hour), but in the AR indicates independence in all aspects of mobility and physical abilities. The ministry also noted that the family doctor wrote in his July 29, 2014 letter that the appellant has difficulty walking on flat surfaces and requires assistance with balance. The ministry determined that the information provided did not establish the appellant has a severe physical impairment. In terms of the appellant's mental impairment, the ministry noted the answers of the appellant's family doctor in the PR that she had significant deficits with cognitive and emotional functioning in certain areas, but that in the AR, the impacts to the appellant's cognitive and emotional functioning were minimal (none were indicated to be moderate or major). The ministry also noted the information from the appellant's family doctor and mental health case manager in July 2014 that she has memory difficulties and requires help prompting from her child to take her medications. The ministry was not satisfied the information provided was evidence of a severe mental impairment. Analysis and decision The legislation provides that the minister may designate a person as a PWD if the minister is satisfied that the person has a severe mental or physical impairment that in the opinion of a medical practitioner is likely to continue for at least 2 years (subs. 2(2)(a) of the EAPWDA). The appellant's famil doctor confirmed in the PWD a lication and in his Jul 29, 2014 letter that her im airmen! is EAAT 003(10/06/01)
b rain tumor and e pi lepsy an d loss of v i s i on in he r lef l east 2 year s. Th e is su e be fore this p ane l i s whether informa ti on p r o v ided does not conf i rm tha t the appellant impair m ent. In the PW D appli cat i on fo rm, the ministry has pr o vi is not set o ut in th e appl ic a b le leg i sl a tion, offe rs g uid a n a pp lic a nt's i mpa i rme nt. T he min istry states, "im pai p s yc ho l ogical, an atomi cal o r p hy s iol o gi cal s truc t ur e f unctio n ind ependent ly , eff e ctiv e l y , appropri a tely or for severi t y of a n impai rment , there is bo th a c ause the t o which i t re stricts the ab ili t y t o funct i o n in depende d ura t ion. Ph y sical impai rm e n t In th is case, t he ap pellant 's physi cian has d i a gnos e vision in her left eye, t ogether wit h h and weakness. The ap pella nt's brain tumor and its re mo val m ay hav e bot pa ne l wil l addre ss the p h ysical com p on en t her e. Th l os s of visi on in h er le ft e ye and h an d w eakness. I n the t h at the appel lant' s loss of v i s i on af fec ts her ab ili ty to wal she re quires a ssista nce fo r balan ce. In the PR and restrict e d in l ifting items hea vi er than 2-7 kg ( 5-15 lbs) using n o a ids for her im p a irme nt, or ass istive dev ices. The p an el notes that the l e gislati on p rov ides that the at the d is cre tion of the mi n i ster, taki ng into acco u nt a H owever, t h e sta r t i ng po int must be the medic al ev i p r ovide d b y the ap pellan t's fa mi ly doc tor regardin g a ppe l lant su ffers so m e restri cti on in her abil it y to lift surfaces. The appellant' s family doctor confirms that sh of the DLA associated with physical ability (personal care, basic housekeeping, shopping -other than making appropriate choices, meals , and transportatio The panel finds that the ministry's det ermination that the information provided does not establish a severe physical impairment is reasonable. Mental Impairment It is established that th e appellant h a s had a brain t umo her vision in her left eye. The panel will addre ss the mental impac As stated previously, the panel notes that the determination of the severity of an impairment is at the di scretion of the minister, taking into acco unt all of the evidence, in that the starting point must be the medical evidence. appellant has significant deficits with cognitive and emotional function in several areas (memory, perceptual psychomotor, emotional disturbance, motivation, imoulse control, motor activity and EAAT003(10/06/01) t eye an d that the co n ditio n s w ill conti nue for a t the min istr y r e asona b ly con c lu ded t h a t t he has a s eve re p hy s ical a nd/or m en tal ded a def initio n of "impair m ent " whic h, although it ance in c on sideri n g the exi st ence an d s ev eri ty of rme nt" i s a " l os s or abno r m ality of or fun c t i on i n g c ausi ng a r e stric tion in t he ab il ity to a rea so n able duration . " T o det ermin e th e impa irm en t itsel f and an ef f e ct -the degree ntly, effectively, app ropr iately o r f o r a reaso nab le d her wit h a br ain tumor, epil epsy and los s of p a nel und erstan ds th at th e imp act of the h me ntal an d/or physical c omp o nen t s. Th e e physical impa i rme nt s the a pp el lant suffers a re J u ly 2 9, 2 014 lette r, t h e family d oc tor not e s k un aide d o n flat s u r fac es and as a re sul t, AR, the fa mi l y docto r has n o ted the appellant is and that she i s independ ent w i th her m obil ity, de term inat i on of th e se verity o f an impairm en t i s l l of t h e ev iden ce, including that of the appellant. den c e. The panel notes t h at t h e informati on the impact of he r l oss of visio n i s consistent -the heavier objects and to walk un aid ed on flat e is able to independe ntly p er form the tas ks n). r wh i ch w a s remov ed and which has affected t s of this impairment in this section. cluding that of the a ppellant, but In the PR, the physician confirmed that the
attention or sustained concentration), but did not provide any commentary to explain these answers. In the AR, the family doctor's answers regarding the impact of the appellant's mental impairment on her cognitive and emotional functioning indicates that her impairment has a minimal impact in all but two of the listed areas, for which it has no impact (bodily functions and psychotic symptoms). The family doctor does not provide any commentary to explain his answers. As well, in the AR the family doctor indicated that the appellant required periodic support in all aspects of social functioning, with good functioning with her immediate social network, and marginal functioning in her extended social networks, but without providing any commentary. In both the PR and the AR, the family doctor indicates that the appellant requires some periodic assistance with managing her personal finances, making appropriate choices when shopping, and taking medication (although in the AR, the family doctor indicated that she was able to independently perform all listed tasks). In the AR completed by the family doctor on March 18, 2014, he indicated that the appellant's ability to communicate was good or satisfactory in all areas. In the recent information from the appellant's family doctor and the mental health case manager, there is information restating that the appellant has memory difficulties such that she requires daily reminders from her child to taker her medications. Based on this evidence, the panel finds that without further information from the appellant's family doctor explaining the severity or restriction of her brain tumor on her "ability to function independently, effectively, appropriately or for a reasonable duration," the ministry's determination that it has not been established that the appellant has a severe mental impairment is reasonable. Direct and significant restrictions in the ability to perform DLA. The appellant told the panel that because of her loss of vision and her brain tumor, she finds it difficult to perform some of her DLA, in particular walking outdoors and any tasks associated with memory, such as banking and taking her medications. She relies on help from her family (husband and child) and friends when walking and shopping. The ministry determined that, based on the information provided by the appellant's family doctor, the ministry did not have enough evidence to confirm that the appellant's impairments significantly restrict her ability to perform her DLA continuously or periodically for extended periods. The ministry referred to the fact that the family doctor in the PR indicated that the appellant's impairment continuously restricted her social functioning, that it restricted her management of medications but he did not indicate if this was continuous or periodic, and that he was unsure if it restricted her management of finances. The ministry noted that in the AR, the family doctor indicated that the appellant could independently perform most of her DLA, but required periodic assistance making appropriate choices shopping, and banking, budgeting, paying rent and bills (all listed tasks of paying rent and bills) but did not provide information on how often the appellant requires assistance. The ministry further noted the more recent information that the appellant requires assistance from her child shopping and being reminded to take her medications, but that the majority of her DLA are considered independent and there is no indication that they take her significantly longer than typical to perform. Analysis and decision The legislation requires in subs. 2(2)(b) of the EAPWDA that a prescribed professional confirm that the a ellant's im airments direct! and significant! restrict her abilit to erform her DLA EAAT 003( 10/06/01)
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 e x t e n d e d p e r i o d s . T p r o f e s s i o n a l m a y i n d i c a t e t h a t , b e c a u s e o f a r e s t r i c 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 e x t e n d e d p e r i o d s , t b e i n g a " d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n . " T h e D L A i m p a i r m e n t a r e , a s s e t o u t i n s u b s . 2 ( 1 ) o f t h e E A P • P r e p a r e o w n m e a l s ; • M a n a g e p e r s o n a l f i n a n c e s ; • S h o p f o r p e r s o n a l n e e d s ; • U s e p u b l i c o r p e r s o n a l t r a n s p o r t a t i o n f a c i l i t i e • P e r f o r m h o u s e w o r k ; • M o v e a b o u t i n d o o r s a n d o u t d o o r s ; • P e r f o r m p e r s o n a l h y g i e n e a n d s e l f c a r e ; • M a n a g e p e r s o n a l m e d i c a t i o n ; W i t h a d d i t i o n a l D L A f o r a s e v e r e m e n t a l i m p • M a k e d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a • R e l a t e t o , c o m m u n i c a t e o r i n t e r a c t w i t h o t h e I n t h e a p p e l l a n t ' s c a s e , w h e n a l l o f t h e i n f o r m a t i o n f a m i l y d o c t o r ) i s r e a d t o g e t h e r , t h e f a m i l y d o c t o r h a p e r f o r m t h e m a j o r i t y o f t h e t a s k s o f a l l h e r D L A a s s s p e c i f i c a l l y r e l a t e d t o p e r s o n s w i t h a m e n t a l i m p a i r m s h e r e q u i r e s a s s i s t a n c e w i t h t h e t a s k o f m a k i n g a p p t o t a k e h e r m e d i c a t i o n s , m a n a g i n g h e r f i n a n c e s , a n i n d i c a t e s t h a t t h e a p p e l l a n t ' s c h i l d r e m i n d s h e r t o t a 2 0 1 4 l e t t e r . H o w e v e r , f o r t h e o t h e r D L A o f m a k i n g s o c i a l f u n c t i o n i n g , t h e r e i s n o i n f o r m a t i o n p r o v i d e d s h e r e q u i r e s a s s i s t a n c e ( t h e d u r a t i o n o f i t ) o r t h e n a m a n a g i n g f i n a n c e s , t h e f a m i l y d o c t o r w r o t e t h a t t h e T h e p a n e l f i n d s r e a s o n a b l e t h e m i n i s t r y ' s d e t e r m i n a d e m o n s t r a t e a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n s i g n i f i c a n t l y r e s t r i c t s h e r a b i l i t y t o p e r f o r m h e r D L A H e l p w i t h D L A T h e a p p e l l a n t t o l d t h e p a n e l t h a t s h e n e e d s h e l p f r o a n d t h a t s h e n e e d s h e l p w h e n w a l k i n g o u t s i d e ( s h e h e r k e e p h e r b a l a n c e a n d t o g u i d e h e r ) . T h e m i n i s t i n d i c a t e d i n h i s J u l y 2 9 , 2 0 1 4 l e t t e r t h a t s h e u s e s w a t h a t " t h e u s e o f a s s i s t i v e d e v i c e s s u c h a s w a l k i n g a i m p a i r m e n t . " T h e m i n i s t r y d e t e r m i n e d t h a t a s i t h a d a r 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 p e r s o n s . T h e l e g i s l a t i o n r e u i r e s i n s u b s . 2 ( b ) ( i i i ) t h a t i n t h e o E AA T 0 0 3 ( 1 0 1 0 6 1 0 1 )h e p a n e l n o t e s t h a t a l t h o u g h a p r e s c r i b e d t i o n , a n i n d i v i d u a l r e q u i r e s a s s i s t a n c e e i t h e r h i s d o e s n o t n e c e s s a r i l y m e e t t h e l e g i s l a t i v e t e s t o f t o b e c o n s i d e r e d f o r a p e r s o n w i t h a s e v e r e W D R , a s f o l l o w s : s ; a i r m e n t l i s t e d a s f o l l o w s : r e o r f i n a n c e s ; a n d r s e f f e c t i v e l y . f r o m t h e p r e s c r i b e d p r o f e s s i o n a l ( t h e a p p e l l a n t ' s s i n d i c a t e d t h a t t h e a p p e l l a n t c a n i n d e p e n d e n t l y o c i a t e d w i t h a p h y s i c a l i m p a i r m e n t . F o r t h e D L A e n t , t h e a p p e l l a n t ' s f a m i l y d o c t o r h a s i n d i c a t e d r o p r i a t e c h o i c e s w h i l e s h o p p i n g , b e i n g r e m i n d e d d w i t h s o c i a l f u n c t i o n i n g . T h e f a m i l y d o c t o r k e h e r m e d i c a t i o n o n a d a i l y b a s i s i n t h e J u l y 2 9 , a p p r o p r i a t e c h o i c e s , m a n a g i n g f i n a n c e s a n d b y t h e f a m i l y d o c t o r t o i n d i c a t e t h e e x t e n t t o w h i c h t u r e o f t h e a s s i s t a n c e s h e r e q u i r e s . F o r a p p e l l a n t i s " m a y b e a b i t h a m p e r e d . " t i o n t h a t t h e i n f o r m a t i o n p r o v i d e d d o e s n o t t t h a t 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 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 e x t e n d e d p e r i o d s . m h e r c h i l d t o r e m e m b e r t o t a k e h e r m e d i c a t i o n s n e e d s a f r i e n d , h e r h u s b a n d o r h e r c h i l d t o h e l p ry n o t e d t h a t t h e a p p e l l a n t ' s f a m i l y d o c t o r l k i n g a i d s w h e n w a l k i n g o u t d o o r s f o r b a l a n c e , b u t i d s d o e s n o t i n i t s e l f e s t a b l i s h a s e v e r e n o t b e e n e 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 h a t 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 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 , a s a r e s u l t o f
t h e a p p e l l a n t ' s r e s t r i c t i o n s , t h e a p p e l l a n t r e q u i r e s h 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 l l a n t n e e d s t o a s s i s t a n c e w a l k i n g u n a i d e d o n f l a t s u r f a c e s . I n t h p r o v i d e d f o r t h e a p p e l l a n t , h o w e v e r , t h e f a m i l y d o c p r o v i d e d b y o t h e r p e o p l e , t h r o u g h t h e u s e o f a s s i s t 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 ' s d e t e r m i n a t i o n t h a t b e 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 , i t c a n n o t b e d e t s e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A , i s r e a s o n a b l e . C o n c l u s i o n 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 e v i d e n c e t h e m i n i s t r y ' s d e c i s i o n t h a t t h e a p p e l l a n t w a s n o t e s u p p o rt e d b y t h e e v i d e n c e . T h e p a n e l t h e r e f o r e c o E AA T 0 0 3 ( 1 0 1 0 6 1 0 1 )e l p t o p e r f o r m D L A . T h e p a n e l n o t e s t h e e v i d e n c e b e r e m i n d e d t o t a k e h e r m e d i c a t i o n s a n d r e q u i r e s e s e c t i o n o f t h e A R d e s c r i b i n g t h e a s s i s t a n c e t o r w r o t e " N / A " b e s i d e a l l t h r e e a r e a s ( a s s i s t a n c e i v e d e v i c e s , a n d b y a s s i s t a n c e a n i m a l s ) . T h e c a u s e i t h a s n o t b e e n e s t a b l i s h e d t h a t D L A a r e e r m i n e d t h a t h e l p i s r e q u i r e d a s p r o v i d e d u n d e r 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 f i n d s t h a t l i g i b l e f o r P W D d e s i g n a t i o n i s r e a s o n a b l y n f i r m s t h e m i n i s t r y ' s d e c i s 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.