PART C -Decision under Appeal The decision under appeal is the reconsideration decision of the Ministry of Social Development and Social Innovation (the ministry) dated 12 August 2014 denying the appellant designation as a person with disabilities (PWD). The ministry determined that the appellant did not meet all of the required criteria for PWD designation set out in the Employment and Assistance for Persons with Disabilities Act, section 2. Specifically, the ministry determined that the information provided did not establish that the appellant has a severe mental or physical impairment that in the opinion of a prescribed professional (i) directly and significantly restricts her ability to perform daily living activities (DLA) either continuously or periodically for extended periods; and, (ii) as a result of those restrictions, she requires help to perform those activities. The ministry determined that the appellant satisfied the other 2 criteria: she has reached 18 years of age and her impairment in the opinion of a medical practitioner is likely to continue for at least 2 years. PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Act (EAPWDA) -section 2 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) section 2 EAA T003(10/06/01)
PART E -Summary of Facts The evidence before the ministry at reconsideration consisted of the following: 1. The appellant's PWD Designation Application dated 29 November 2013. The Application contained: • A Physician Report (PR) dated 29 November 2013, completed by the appellant's general practitioner (GP) who has known the appellant since 2005 and has seen her 2-10 times in the past year. o An Assessor Report (AR) of the same date completed by the same GP. • A Self Report (SR) completed by the appellant. 2. The appellant's Request for Reconsideration, dated July 2014. (In the reconsideration decision, the ministry referred to a PWD application completed by the appellant's GP on 05 January 2014 and an AR completed on 05 March 2014. The panel can find no PR or AR of those dates in the appeal record. The only PR and AR in the appeal record are those referred to in paragraph 1. above. At the hearing the appellant stated that the only application she submitted was the one dated 29 November 2013. The ministry representative stated that the ministry's records show that the appellant was issued only one application package, explaining that the 05 January and 05 March dates must be a "clerical error." On this basis and as the reconsideration decision refers to evidence submitted in the 29 November application, the panel accepts the "clerical error" explanation.) In the PR, the GP diagnoses the appellant's impairments as thoracic kyphosis -congenital with scoliosis ( onset 1973), thoracic compression fractures due to trauma (onset 1981 ), chronic back pain (onset 1981), degenerative disc disease, lumbar spine (onset 1981), chronic headaches (onset October 2013). The GP adds: "Long term back pain. Significantly [worse since] 2004 + [increasing] since. Unable to work since Jan. 2013." There is no diagnosis of a mental health disorder. The panel will first summarize the evidence from the PR and AR relating to the appellant's impairments as it relates to the PWD criteria at issue. Severitv/health history Physical impairment PR: Under health history, the GP writes: "-Unable to work. Unable to do daily chores. Constant back pain daily. Daily headaches." Under additional comments, the GP writes: "Has seen multiple specialists, considered surgery, had facet joint injections but not improved. On medications to try to manage pain but not successful in allowing ability to return to work. EAAT003(10/06/01)
S p e c i a l i s t s h a v e d i a g n o s e d w i t h c h r o n i c f u r t h e r t h a t c a n b e d o n e f o r h e r . " T h e G P 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 h a s n o t b e e n p i n t e r f e r e w i t h h e r a b i l i t y t o p e r f o r m D L A . A s t o f u n c t i o n a l s k i l l s , t h e G P r e p o r t s t h a t t h e a p p e " t h e n s t o p s d u e t o p a i n " ) , c l i m b 5 + s t e p s , c a n l i f t u n M e n t a l i m p a i r m e n t P R : T h e G P 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 h a s n o d i f f i c u l t i T h e G P a s s e s s e s t h e a p p e l l a n t w i t h s i g n i f i c a n t d e f i a r e a s o f e m o t i o n a l d i s t u r b a n c e a n d m o t i v a t i o n , a n d G P . A R : T h e G P a s s e s s e s t h e a p p e l l a n t ' s a b i l i t y i n s p e a k i n g A b i l i t v t o p e r f o r m D L A A R : T h e G P r e p o r t s t h a t t h e a p p e l l a n t l i v e s w i t h f a m i l y . R e g a r d i n g 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 , t h e G P p r o v w a l k i n g 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 p e r i o d i c a s 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 ; s t a n d i n g -" l i m i t e d t a s s i s t a n c e f r o m a n o t h e r p e r s o n o r u n a b l e . T h e G P a n y o f t h e a b o v e . " W i t h r e g a r d t o 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 , i m p a i r m e n t a s h a v i n g a m o d e r a t e i m p a c t o n d a i l y f u a t t e n t i o n / c o n c e n t r a t i o n , e x e c u t i v e , m e m o r y , m o t i v a t a r e a s . T h e G P c o m m e n t s : " D u e t o c h r o n i c p a i n [ t h e o f i n c r e a s e d p a i n h a s d i f f i c u l t y w i t h t h e a b o v e f u n c t i T h e G P a s s e s s e s t h e a s s i s t a n c e r e q u i r e d f o r m a n a p a r e n t h e s e s ) : • P e r s o n a l c a r e : i n d e p e n d e n t f o r d r e s s i n g , g r o r e g u l a t i n g d i e t ; i n d e p e n d e n t a n d t a k e s s i g n i f i b e d a n d o n / o f f c h a i r . • B a s i c h o u s e k e e p i n g : p e r i o d i c a s s i s t a n c e f r o m t h a n t y p i c a l f o r l a u n d r y a n d b a s i c h o u s e k e e p • S h o n n i n a : p e r i o d i c a s s i s t a n c e f r o m a n o t h e r p E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )p a i n s y n d r o m e & d o n o t f e e l t h e r e i s a n y t h i n g r e s c r i b e d m e d i c a t i o n a n d / o r t r e a t m e n t s t h a t l l a n t c a n w a l k 1 t o 2 b l o c k s u n a i d e d ( t h e G P n o t e s : d e r 5 l b s . a n d c a n 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 . e s w i t h c o m m u n i c a t i o n . c i t s w i t h 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 t h e n o a d d i t i o n a l c o m m e n t s w e r e p r o v i d e d b y t h e , r e a d i n g , w r i t i n g a n d h e a r i n g a s g o o d . i d e s t h e f o l l o w i n g a s s e s s m e n t s : w a l k i n g i n d o o r s , i s t a n c e f r o m a n o t h e r p e r s o n a n d t a k e s i m e ; " 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 c o n t i n u o u s c o m m e n t s : " M u s t l i m i t a c t i v i t y s i g n i f i c a n t l y t o d o t h e G P a s s e s s e s t h e a p p e l l a n t ' s m e n t a l n c t i o n i n g i n t h e a r e a s o f e m o t i o n , i o n . N o i m p a c t i s r e p o r t e d i n t h e o t h e r 9 l i s t e d a p p e l l a n t ] e x p e r i e n c e s a n x i e t y & d u r i n g p e r i o d s o n s . " g i n g D L A a s f o l l o w s ( t h e G P ' s c o m m e n t s i n o m i n g , b a t h i n g , t o i l e t i n g , f e e d i n g s e l f a n d c a n t l y l o n g e r t h a n t y p i c a l f o r t r a n s f e r s i n / o u t o f a n o t h e r p e r s o n a n d t a k e s s i g n i f i c a n t l y l o n g e r i n g ( f a m i l y h a s t o h e l p w i t h m o s t c h o r e s ) . e r s o n a n d t a k e s s i a n i f i c a n t l v l o n a e r t h a n t y p i c a l
for going t o a n d fro m st ore s; ind epende nt for reading p choi ce s and p aying for purchas es; continu ou tak es signifi ca ntly longer than typ ical f o r car o Meal s: i n d epen d en t in all asp ect s. • P aying rent and b ills : independe n t in all aspects. • Medi catio n s: in dep en de n t in all asp ect s. • Tran s p o r ta t ion: peri odic assi st an c e fro m another p typical for getti n g in and out of a ve hi c le ; using publ a r ran g i ng transpor t a t ion -th e GP in d icate s Wit h resp ec t t o s o c i a l funct i oning the G P assesses a pprop riate social deci s io ns , developin g and maintain ot hers , d ealing a pp r op riat ely with un e x pe cted dem Under "other'' the GP refers to soc ia l outings and co unable to go dancing." Th e GP m a rk s " N / A " aga inst h ow t he appell a n t's m imm ediate a nd exte n de d soci al net w orks. H e lp pro vided/req ui red PR: T he G P i ndica tes that t he app ella nt requir e s a pros "U nabl e to w a l k in store w ithout a sh opping c ar t. Looking A R: F or assist ance pro v ided by o ther peopl e, the GP ind and th at "conti n uous hel p req uired w hen p ain wor se. Periodic daily bas t h e ap pellan t's pa rtner a nd family ha ve to d o all c ar ap pellant can avoid s trenu ou s work or car r ying/lif t i n Regar d ing the use of assistive devices, the GP indica shopping cart when out. For equipment required but not currently being used, the GP wrote: "wa sticks for walking." The GP marks " N/A" re garding support/supervision Self report I n h er SR, the ap pe ll ant writ es: "My disability is chronic back & hip pain was diagnosed with scoliosis when I was -[a child]. I learned about this after the fall I had. I was born with this condition. Over the years my back has been getting worse. I also now have degenerative disc disease [ and] compression fractures. "My disability has affected me all my life in many ways. I can no longer work due to chronic pain everv dav. I cannot w a lk very far before the oa EAAT 003(10/06/01) r ices a n d l ab els , making ap propria t e s ass ist a nce fr o m another pe r s on or un able and r y i n g purc h ases home . erso n and t akes sign ifi ca n t ly longer than ic trans it an d usin g transit sc h e dule s an d "Does not us e." the app ell ant as indep ende nt f o r mak in g ing relat io nsh i p s, in ter a c t ing app r opriate l y with an d s and se cu rin g assistance f rom ot h e rs. m ment s: "Has to avo i d ac ti v i ties due t o pain i .e . e ntal impair m e nt impa c t s her relat ion s h i p wit h he r theses or ai ds for her impai rme nt, comme nting : a t gettin g wa lki ng sticks." icat es t hat t he a ppell a n t' s fami ly and friends he lp is." T h e GP comment s t hat ry in g an d t h a t hou s ework is di vi ded so t hat t h e g. t es that the appellan t needs to ho ld onto a lk ing r eq uired f or s oc ial functioning. every day cau sing chron ic h eadaches ever y day. I in s tarts. I also cannot stand for verv
long. As far as daily chores go, I can only do cleaning for 5 -i O minutes, then I have to stop. I ask my children to help and do a lot of the chores I used to go out dancing a lot. I cannot do this anymore. When I go shopping it takes longer to get it done because 5 to i O minutes into walking around the store I have to lean on the shopping cart and go very slow because of the pain in my hips and back. This is getting me down a little, some days I cry because I am so sad and it is tiring being in pain all the time. I am thankful for my family and friends because they do a lot for me like carrying groceries & cleaning, and driving me around to where I need to go, for sometimes I am in so much pain I ask to be driven around to run errands. " In her Request for Reconsideration, the appellant writes: " .. . I now use a walker to help me. Stairs I find are now difficult [and] to climb I need help. My children are doing more around the house than usual to help me. I can only have showers now because sitting in the tub is hard to get up and out. I sometimes have a hard time driving, especially on bad days when the pain is so much I cannot move, so I ask to be driven where I need to go. "I have seen my specialist and he tells me that I need to go to a pain clinic just to help me with the pain and also need to do therapy. The pain will not totally go away and could get worse, for now I have developed arthritis. All that the pain clinic and therapy will do for me is to just help me cope with the pain that I constantly have." In her Notice of Appeal, dated 20 August 20i4, the appellant writes: ". .. It is getting harder and harder for me to climb stairs and I can no longer walk i or 2 blocks. I can walk half to i block and I use a walker. My kids are helping me more with cleaning and I find that getting harder for me." At the hearing, in her opening presentation and in answers to questions, the appellant provided the following testimony: • She explained that since she and her GP had completed the PWD Designation Application, her condition has deteriorated and her pain is getting worse, making it harder to walk up and down stairs and that she sometimes has really bad days when the pain is so bad that she cannot move: she can't even drive and the pain is too excruciating to do anything. She has more limitations than before as, over the years, her condition is getting worse and she is taking more medications. She is awaiting treatment at a pain clinic. • She described how her bad days happen one or two days a week. On most days, on a scale of i -10, her pain level is at the 6 or? level, but on bad days it goes up to 9 or 10. This happens if she is trying to do too much the day before. She takes a pain killer before going to bed at night and this helps her wake up in the morning without a headache. She cannot work because the pain becomes so bad. • She last saw her back specialist in 2012-it was that specialist who recommended a pain clinic. She had an MRI in July 2014, mainly to update her medical records since the last MRI report was from around 2003 or 2004. At about the same time as the MRI, she developed arthritis. Her back pain spreads through the soft tissue, shoulders, lower back and down her arms, makinq her hands tinaly and numb. She cannot wash dishes because her hands EAAT 003(10/06/01)
"cramp up" and the dishes might fall out of her hands. • She stated that she now has a walker, which she uses to go to and back from the 100 fl. to her mailbox. Her children are young and are a great help to her. They carry the laundry up and down the stairs and help with meal preparation. They will do the food preparation and the cleanup afterwards, though she will not allow them to handle hot items on the stove. If a meal doesn't involve cooking, they will make their own sandwiches, etc. If she carries a jug of milk in from the car, she will be in pain by the time she gets into the house. Sometimes she throws up because of intense pain. The ministry stood by its position at reconsideration. The panel finds that the information provided in the appellant's Notice of Appeal and in her testimony at the hearing is in support of the information and records before the ministry at reconsideration, as it is further to her description in her Request for Reconsideration as to how her medical condition has changed since the original PWD application was submitted. Accordingly, the panel admits this evidence under section 22(4) of the Employment and Assistance Act. EAA T003(10/06/01)
PART F -Reasons for Panel Decision The issue in this appeal is whether the ministry reasonably determined that the appellant is ineligible for PWD designation because she did not meet all the requirements in section 2 of the EAPWDA. Specifically the ministry determined that the information provided did not establish that the appellant has a severe mental or physical impairment that in the opinion of a prescribed professional (i) directly and significantly restricts her ability to perform daily living activities either continuously or periodically for extended periods; and, (ii) as a result of those restrictions she requires help to perform those activities. The ministry determined that she met the 2 other criteria in EAPWDA section 2(2) set out below. The following section of the EAPWDA applies to this appeal: 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, 1he person is unable to perform; "daily living activity" has !he 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. The following section of the EAPWDR applies to this appeal: 2 (1 )For the purposes of the Act and this regulation, "daily living activities", (a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities: (i) prepare own meals; (ii) manage personal finances; (iii) shop for personal needs; (iv) use public or personal transportation facilities; (v) perform housework to maintain the person's place of residence in acceptable sanitary condition; (vi) move about indoors and outdoors; (vii) perform personal hygiene and self care; (viii) manaoe personal medication, and EAA T003(1 0/06/01)
( b ) 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 m e n t a l ( i ) 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 ( i i ) 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 r s T h e p a n e l w i l l c o n s i d e r e a c h p a r t y ' s p o s i t i o n r e g a r u n d e r t h e a p p l i c a b l e P W D c r i t e r i a a t i s s u e i n t h i s a S e v e r i t y o f i m p a i r m e n t F o r P W D d e s i g n a t i o n , t h e l e g i s l a t i o n r e q u i r e s t h a t e s t a b l i s h e d . T h e d e t e r m i n a t i o n o f t h e s e v e r i t y o f i m i n t o a c c o u n t a l l t h e e v i d e n c e , i n c l u d i n g t h a t o f t h e a m e d i c a l e v i d e n c e , w i t h t h e l e g i s l a t i o n r e q u i r i n g t h a a p p e l l a n t ' s G P ) i d e n t i f y t h e i m p a i r m e n t a n d c o n f i r m y e a r s . I n t h e d i s c u s s i o n b e l o w c o n c e r n i n g t h e s e v e r i t y o f u p o n t h e m i n i s t r y ' s d e f i n i t i o n o f " i m p a i r m e n t " a s p r o a n d " i m p a c t " c o m p o n e n t s : " i m p a i r m e n t i s a l o s s o r p h y s i o l o g i c a l s t r u c t u r e o r f u n c t i o n [ t h e c a u s e ] c a u s i n d e p e n d e n t l y , e f f e c t i v e l y , a p p r o p r i a t e l y o r f o r a r e a s e t o u t a s a d i s e a s e , c o n d i t i o n , s y n d r o m e , i n j u r y o r b r e a t h ) . A s e v e r e i m p a i r m e n t r e q u i r e s t h e i d e n t i f i e d f u n c t i o n i n g . T h e l e g i s l a t i o n r e q u i r e s t h a t f o r P W D d e s i g n a t i o n , t 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 . F o r t h e m i i s s e v e r e , t h e p a n e l c o n s i d e r s i t r e a s o n a b l e f o r t h e p r e s e n t s a c l e a r a n d c o m p l e t e p i c t u r e o f t h e n a t u r e c o n d i t i o n s o n d a i l y f u n c t i o n i n g . P h y s i c a l i m p a i r m e n t I n t h e r e c o n s i d e r a t i o n d e c i s i o n , t h e m i n i s t r y n o t e s t w o r k . T h e m i n i s t r y s t a t e s t h a t t h e P W D a p p l i c a t i o n e m p l o y a b i l i t y i s n o t a c r i t e r i o n f o r P W D d e s i g n a t i o n 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 r e p o r t e d b y t h e G P ( c a n w a s s e s s m e n t t h a t t h e a p p e l l a n t r e q u i r e s c o n t i n u o u s a n d t h a t s h e r e q u i r e s p e r i o d i c a s s i s t a n c e a n d t a k e s i n d o o r s a n d 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 , t h o u g h n o a s s i s t a n c e i s r e q u i r e d o r h o w m u c h l o n g e r i t t a k e s . t h e a p p e l l a n t ' s G P 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 t h e i n f o r m a t i o n p r o v i d e d b y t h e G P , t h e p o s i t i o n o f e s t a b l i s h 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 . T h e p o s i t i o n o f t h e a p p e l l a n t i s t h a t , b e c a u s e o f h e r c h r o n i c p a i n t h a t i s w i t h h e r a l l t h e t i m e a n d s o m e t i m s c a l e o f 1 -1 O : s h e c a n n o t d o a n h i n o n t h o s e d a E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )i m p 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 g a c t i v i t i e s : o r f i n a n c e s ; e f f e c t i v e l y . d i n g t h e r e a s o n a b l e n e s s o f t h e m i n i s t r y ' s d e c i s i o n p p e a l . 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 b e p a i r m e n t 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 i s t e r , t a k i n g p p l i c a n t . H o w e v e r , t h e s t a r t i n g p o i n t m u s t b e t a m e d i c a l p r a c t i t i o n e r ( i n t h i s c a s e , t h e t h a t i m p a i r m e n t w i l l c o n t i n u e f o r a t l e a s t t w o t h e a p p e l l a n t ' s i m p a i r m e n t s , t h e p a n e l h a s d r a w n v i d e d i n t h e P R . T h i s d e f i n i t i o n c o n s i s t s o f " c a u s e " a b n o r m a l i t y o f p s y c h o l o g i c a l , a n a t o m i c a l o r i n g a r e s t r i c t i o n i n t h e a b i l i t y t o f u n c t i o n s o n a b l e d u r a t i o n [ i m p a c t ] . " T h e c a u s e i s u s u a l l y e v e n a s y m p t o m ( e . g . p a i n o r s h o r t n e s s o f c a u s e t o h a v e a s i g n i f i c a n t i m p a c t o n d a i l y h e m i n i s t e r m u s t b e " 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 n i s t e r t o b e " s a t i s f i e d " t h a t t h e p e r s o n ' s i m p a i r m e n t m i n i s t r y t o e x p e c t 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 a n d e x t e n t o f t h e i m p a c t s o f t h e p e r s o n ' s m e d i c a l h a t h e r G P w r o t e t h a t t h e a p p e l l a n t w a s u n a b l e t o i s n o t m e a n t t o a s s e s s e m p l o y a b i l i t y a n d t h a t . T h e m i n i s t r y g o e s o n t o r e v i e w t h e a p p e l l a n t ' s a l k 5 + b l o c k s , e t c . ) a n d r e f e r s t o t h e G P ' s a s s i s t a n c e w i t h 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 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 i n f o r m a t i o n i s p r o v i d e d o n h o w o f t e n s u c h I n t h e m i n i s t r y ' s o p i n i o n , t h e i m p a c t s d e s c r i b e d b y r a t e d e g r e e o f i m p a i r m e n t . T h e r e f o r e , b a s e d o n t h e m i n i s t ry 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 o m u l t i p l e m e d i c a l c o n d i t i o n s , s h e s u f f e r s f r o m e s o n 2 d a y s o f t h e w e e k r e a c h e s 9 o r 1 O o n a s . H e r c o n d i t i o n h a s d e t e r i o r a t e d s i n c e t h e P W D
appl icati o n wa s s ub m it ted in N ovember 2 0 13, to the block usi ng a walk er . S he submits th at it i s unreas o not have a severe physi c a l im p airm ent. Pa n e l f i ndin gs Th e evi dence is that GP has diag nosed t he appel l a cau se ch r oni c pain an d h eadaches a n d that she has bee healt h history secti o n of t he PR, wher e the GP is ask f ir st r efe ren ce is "unable t o work. " An d, in the ad ditional comm "not s ucces sful in all owing a bil ity to r etur n to work." For sec t ion 2 of th e EA PWDA r eq uir es t h a t the min istr y re strictions to a speci f i ed de gre e in cert ain speci fied areas of d t h a t f or PW D des igna tion, t he mi nis ter m ust be satisfied p h ysical i mpairm e nt t h a t . ...d ir ectl y and s i gn i fi cantly [pres cribe d] daily living act iviti es and a s a r esu l t of th assi sti v e devic e, t he signifi c ant help or s upe r vision of as sist ance ani m al to per form th ose acti v i tie s ."] As ability to search empl o yment is not l is ted as o ne of pre s c ribed D L A, the pa that em p l oyabil it y is n ot a f actor in ass e ss i n g e li gib ili The ap pell a nt , in h er Reque s t fo r R econsider ation, that her c ond itio n has de ter ior ated s i n c e th e original PWD a 201 3 : for ins tance, sh e now ca n w alk only o ne half t the extent of increa s e d limi ta tio ns in h er daily func tio PR, the GP indica t ed that t h e appe l la nt was, at th at she n e ed s t o h old on to a shoppin g car t w he n walki l evel a s 6 -8 , so m e times increas ing to 9 or 1 0 , on a appellant a wait ing tre at me n t at a pa in clin ic, the G P o f pain, o ther than to c o mment in the AR t hat some description of how this level of pain would b e exp ec As the ministry noted, in the AR, the GP has ass essed from another person and taking significantly longer than typical for walking indoors and outdoors and climbing stairs, b ut no ex pla nation is p rovided a s t o circumstances such periodic assist ance is required or how much longer than typical it takes comments: "Must limit activity significantly to d o any to what this means on an hourly or daily basis. In light of the above analysis, and considering that the GP has assess 1 -2 blocks u naided , climb 5+ sta i rs and lift up to 5 l reasonable in concluding that the impacts described by the GP are not sufficient evidence of a severe degree of impairment and that the ministry was reasonable in det impairment has not been established Mental impairment. EAA T003(10/06/01) point w h er e sh e can now only wal k one hal f to 1 nable that the m inis try w ould fin d th at s he do e s n t w ith m u ltiple m us cular -skele tal cond i t ions that n " unabl e to w or k si nce Jan . 2013". In the ed t o descri be the se veri t y of i mpair me n t, the e nts, t hat the pain m e dications ar e a n i m pai rmen t to b e a "s ever e impairment, " m ust b e s atis f i ed that th e evi d ence demons t ra tes aily functionin g. The legisl ation r eads t h at "the p erson h as a se v e re me ntal o r rest ricts the person 's ab ili ty to perf orm os e r estric tions, the pe rson require s help [an ano ther p erson, or the s er v ic es of an fo r, accept or continue i n n el fi nds t hat th e minis tr y r eason a b ly held ty for PWD designatio n . in he r N o t ice of Ap peal and at the hea ring, stated pp li cation w a s co m p l e t e d i n Nove m ber o 1 block, and only by u sin g a w a l ker. Howev er, ning has not been confirmed by the G P . In the tim e , "loo kin g at gettin g walking s tic ks " and that n g in a s tore, T h e a ppell ant is de scribi n g h er pai n sca le of 1 -10. Howe ver , wh i le r ef err ing to the h a s n ot pro vide d an y co n f ir mat i on o f this d egre e time s h er pa in is "w o rse " , or any de ta i led ted t o restrict daily functio ning. the app e llant a s requiring periodic a ssistance h ow often, in w h at way or under what . The GP of the above, " bu t no explanation is provided as ed the appellant as able to walk bs, th e p anel finds tha t th e ministry was ermining that a severe physical
In the recons ideration decis ion , t he ministr y no te s that the GP h signific a n t de fici ts w it h c ognitiv e and em o tiona l f u n m oti vation. I n assessing the impact s on cogniti ve an moderate imp acts with emotion, attention/conc e n tr her chronic pa i n . In addi t i on t h e GP i nd i ca te s tha t the c omm u n i c ation and he r abilit y in sp e a king, re adi ng in fo r mati on pr ov i de d b y the G P, t he pos i tion of the est ab l ish a se ver e mental impairment . The a ppell ant's po si t ion i s t hat, consi d eri ng t h e degree cogniti ve an d emo t ion al functio n ing ide nt i f i ed b y her GP, co g n it ive a nd emotional functioning, the re i s suffici impa i rm e n t. P ane l find in g s While the G P has id ent i fie d sig n ificant c og n it ive an com mentary), and ass ess e d m od e r ate imp a cts t o cogni t he p anel notes t hat no m ent a l h eal th cond ition has c og n it ive and emoti onal fu nct i oning specific a lly to the a pain." In add i ti o n, no diff i culti e s w it h com munication h s ocial f u n ct ion ing. Th erefo re, the pane l fin ds the minist ment al i m p airment has not bee n e st ablished Sign if ic an t rest ricti ons i n t h e ability to per f orm DLA. I n t he re c o n s ide rati on dec i sio n, t he ministry reviews t t h e appel lan t 's ab ility to per f o rm DLA. T he mi n i stry m ed ica l iss ues; however, consi dering a ll t h e informa minist ry is tha t there is not have eno ugh e vid ence to confirm t and signific a ntl y re s tri c t her a bil ity t o perform DLA eith period s. The position of the appellant is that there is s uffici ent si gnificantl y restricts her ability to perfor m DLA on an ongoing, daily basis. Panel findings The panel notes that, according to the legislation, the dir perform DLA must be a result of a severe mental or phys been established in this appeal. This DLA criterion must also be considered in terms of the preceding legis lative la nguage of section 2 of the EAPWDA, which provid person as a person with disabilities "if the minister is satisfied that" the criteria are met, including this one. In exer c ising the discretio n conferre d by the legislation, it is reasonable that the minister would expect that the opinion of a prescribed professional be substantiated by information from that professional that would satisfy the minister of direct and significant restrictions i DLA , either continuously or oeriodicallv for ex t e nded EM TOD3( 10/06/01) a s indicated that t h e a pp el la nt ha s ction i n g in the area s of emot ional di s tu rba nce an d d em o tiona l f u nc ti on i ng, th e GP a l s o i n di ca te d a ti on , ex ecut iv e, me mory an d mo t ivat ion due to appel lant does not have a ny diffi cu ltie s wi th , wr iting and li ste n i n g are go od. Based on the mi nistry is that the re i s n ot eno u gh evi den ce to o f p ain she suffers d ail y, t he defic it s t o and the mult i pl e mo derat e im p a c ts to her ent evi d e n ce to e stablish a severe m ental d emo t i onal de fic its in tw o areas (with no tive and em otional funct ion i n g in fiv e a reas, be en diagno s e d and the GP link ed the impa cts t o p pell ant's ex pe rience of "per io ds of incr eased a ve b e en report ed , and no is sues ide nti f i e d w it h ry was rea sonab l e in d e termi ning t ha t a severe he a sses sm ent s prov ided by th e G P r egardi ng ack nowl edged that the app ell an t has ser ious t ion pr ovid ed by th e GP, the p osit i on o f t he hat the app e lla nt' s imp air m e n ts d irec tly er continuou sl y or periodic al ly for extended ev idence to d emonst r ate that her chronic pai n e ct and significa n t restriction in the ability to i c al impairment, a criterion which has not es that the minister may designate a n t he a b il ity to pe rf o rm periods, b y p resen t in a a clea r and complet e
p i c t u r e o f t h e n a t u r e a n d e x t e n t o f t h e s e r e s t r i c t i o n T h e e v i d e n c e i s t h a t i n t h e A R t h e G P h a s a s s e s s e D L A r e q u i r i n g p h y s i c a l e f f o r t . F o r s o m e o f t h e s e , t h t h a t s h e t 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 , a s f • M o v i n g a b o u t i n d o o r s a n d o u t d o o r s : w a l k i n g • P e r s o n a l c a r e : t r a n s f e r s i n / o u t o f b e d , t r a n s A s n o t e d a b o v e , n o i n f o r m a t i o n i s p r o v i d e d a s t o h T h e G P a s s e s s e s t h e a p p e l l a n t a s r e q u i r i n g p e r i o d 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 f o r t h e f o l l o w i n g : • B a s i c h o u s e k e e p i n g ; l a u n d r y a n d b a s i c h o u • S h o p p i n g : g o i n g t o a n d f r o m s t o r e s . • T r a n s p o r t a t i o n : g e t t i n g i n a n d o u t o f v e h i c l e . H o w e v e r , n o i n f o r m a t i o n i s p r o v i d e d a s t o i n w h a t w a s s i s t a n c e i s p r o v i d e d o r h o w m u c h l o n g e r t h a n t y p T h e G P a s s e s s e s t h e a p p e l l a n t r e q u i r i n g c o n t i n u o u a s p e c t o f o n e D L A , n a m e l y s h o p p i n g a n d t h e a s p e t h a t " p a r t n e r & f a m i l y h a v e t o d o a l l c a r r y i n g . " G i v e n l i f t u p t o 5 l b s , t h e p a n e l f i n d s i t r e a s o n a b l e t h a t t h e p u r c h a s e s i n e x c e s s o f t h i s w e i g h t . T h e r e i s n o e v i d e n c e t o s u g g e s t t h a t , a s a r e s u l t o f a b i l i t y t o m a n a g e t h e d e c i s i o n m a k i n g o r s o c i a l f u n a c t i v i t i e s , c a r e o r f i n a n c e s a n d r e l a t e t o , c o m m u n i c A s n o t e d a b o v e , t h e e v i d e n c e i s t h a t w h i l e t h e a p p e p e r s o n o r i s u n a b l e t o c a r r y h e a v i e r p u r c h a s e s h o m i n d e p e n d e n t i n p e r f o r m i n g m o s t a s p e c t s o f m o s t D s h e i s r e s t r i c t e d i n o t h e r a s p e c t s o f D L A w h e r e a r e w a s r e a s o n a b l e i n d e t e r m i n i n g t h a t t h e r e i s n o t e n o i m p a i r m e n t s 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 h e r a 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 . H e l p w i t h D L A 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 a s i t h a s n o t b e e n e s t c a n n o t b e d e t e r m i n e d t 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 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 s h o p p i n g c a rt a n d i m p a i r m e n t . A t t h e h e a r i n g , t h e m i n i s t r y r e p r e s e n t a t s h o p p i n g c a r t w a s a n a s s i s t i v e d e v i c e , a s i t w a s n o T h e p o s i t i o n o f t h e a p p e l l a n t i s t h a t s h e r e q u i r e s t h e p a r t n e r a n d f r i e n d s f o r d r i v i n g h e r t o s t o r e s a n d a p p h e r c h i l d r e n f o r c h o r e s a r o u n d t h e h o m e , i n c l u d i n a E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )s . d t h e a p p e l l a n t a s i n d e p e n d e n t i n m o s t a s p e c t s o f i s a s s e s s m e n t i s c o m b i n e d w i t h a n a s s e s s m e n t o l l o w s : i n d o o r s , w a l k i n g o u t d o o r s , c l i m b i n g s t a i r s . f e r s o n a n d o f f c h a i r . o w m u c h l o n g e r t h a n t y p i c a l t h e s e a c t i v i t i e s t a k e . i c a s s i s t a n c e f r o m a n o t h e r p e r s o n a n d t a k i n g s e k e e p i n g . a y , h o w o f t e n o r u n d e r w h a t c i r c u m s t a n c e s s u c h i c a l t h e s e a c t i v i t i e s t a k e . s a s s i s t a n c e f r o m a n o t h e r p e r s o n o r u n a b l e i n o n e c t o f c a r r y i n g p u r c h a s e s h o m e , w i t h t h e c o m m e n t t h e a s s e s s m e n t i n t h e P R t h a t t h e a p p e l l a n t c a n a s s i s t a n c e r e q u i r e d f o r c a r r y i n g w o u l d b e f o r h e r i m p a i r m e n t s , t h e r e a r e a n y r e s t r i c t i o n s t o h e r c t i o n i n g D L A 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 t e o r i n t e r a c t w i t h o t h e r s e f f e c t i v e l y . l l a n t r e q u i r e s c o n t i n u o u s a s s i s t a n c e f r o m a n o t h e r e , g i v e n t h e e x t e n t t o w h i c h s h e i s a s s e s s e d a s L A a n d t h e l a c k o f e x p l a n a t i o n a s t o t h e d e g r e e s t r i c t i o n i s a s s e s s e d , t h e p a n e l f i n d s t h e m i n i s t r y u g h i n f o r m a t i o n t o 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 ' s i l i t y t o p e r f o r m D L A e i t h e r c o n t i n u o u s l y o r a b l i s h e d t h a t D L A 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 d f r o m o t h e r p e r s o n s . T h e m i n i s t r y n o t e s t h a t t h e w a l k i n g s t i c k 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 i v e s t a t e d t h a t i t w a s a n e r r o r t o i m p l y t h a t a t 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 D L A . s i g n i f i c a n t h e l p f r o m o t h e r s , i n p a r t i c u l a r f r o m h e r o i n t m e n t s a n d c a r r y i n g p u r c h a s e s h o m e a n d f r o m h e l o w i t h f o o d p r e p a r a t i o n a n d c l e a n u p
afterwards. She also now uses a walker to aid her mobility outside the home. Panel findings The panel notes that the legislation requires that in the opinion of a prescribed professional the need for help must arise from direct and significant restrictions in the ability to perform DLA that are either continuous or periodic for extended periods. While the evidence is that the appellant benefits from the help of her partner and others friends and from her children for some DLA, the panel finds that the ministry reasonably determined that since it has not been established that DLA are directly and significantly restricted, it cannot be determined that help is required as provided under section 2(2)(b)(ii) of the EAPWDA. Conclusion Having reviewed and considered all of the evidence and the relevant legislation, the panel finds that the ministry's decision that the appellant was not eligible for PWD designation was reasonably supported by the evidence. The panel therefore confirms the ministry's decision. 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.