P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t ry o f S o c i a l D A u g u s t 1 8 , 2 0 1 4 r e c o n s i d e r a t i o n d e c i s i o n d e n y i n g t h t r a n s p o r t a t i o n s u p p l e m e n t f o r h e r c h i l d Z t o v i s i t a n o d e t e r m i n e d t h a t a n " o r t h o d o n t i s t " i s n o t a " s p e c i a l i s t " E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s W i t h D i s a b o r t h o d o n t i s t d o e s n o t m e e t t h e r e q u i r e m e n t s o f s e c t i o m i n i s t r y d o e s n o t h a v e t h e a b i l i t y t o a s s i s t w i t h t r a n s p P A R T D R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s W i t h D i s a b i s e c t i o n s 1 a n d 2 ( 1 ) ( f ) . I n t e r p r e t a t i o n A c t , s e c t i o n 2 9 . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )e v e l o p m e n t a n d S o c i a l I n n o v a t i o n ( t h e m i n i s t r y ) e a p p e l l a n t ' s r e q u e s t f o r a n o n m e d i c a l r t h o d o n t i s t i n a n o t h e r c i t y b e c a u s e t h e m i n i s t r y a s d e f i n e d i n s e c t i o n 1 o f S c h e d u l e C o f t h e i l i t i e s R e g u l a t i o n , a n d t h e r e f o r e a v i s i t t o a n n 2 ( 1 ) ( f ) o f S c h e d u l e C . A c c o r d i n g l y , t h e o r t a t i o n c o s t s t o s e e a n o r t h o d o n t i s t . l i t i e s R e g u l a t i o n ( E A P W D R ) , S c h e d u l e C
P A RT E -Su mm a of F acts Th e ap pe l la nt d id not a pp ea r a t t he hea r in g. Af ter co nfi rming tha t t he a ppell a nt wa s n otified, t he hear i n g proceede d in ac cor dan ce with section 86( b) of the EAPWDR. The e vi d en ce before t he minis try a t r eco n si de ratio n includ e d t he fol lowing: In her re qu es t for rec onsideration d ated Jul y 2 9, 2014 , th e appel lant st ate s that the se trips w ere p revio usly fu nded, wit h th e las t o ne be ing on Nov embe r 22 , 201 3. Be fore tha t was May/Jun e 20 13. Th e orthod onti s t is seei ng h er child Z t o ke ep a n eye on her teeth . A requ est f o r no n-lo cal m e dica l tra ns po rta tion as sist anc e date d May 20, 20 14 , f or th e appellant's children Y an d Z for an appointment on July 1 8, 2014 t o an orthodontist in an othe r city. At t he end of th e form th e app ellant w r ites: "Need fe rry far es f or Z. Y i s cover ed. " From mi n i stry files: The app ellan t's fa mi ly u nit i s designated as Persons W i th Disabili ties. Th er e are no re s o urces ava i la ble for the app el lant to c over the cost s of tr ansp or t at ion. The appell ant ha d r e qu este d medi cal t ransp ortati on in Nov ember 20 13 for Y and Z to atte nd ortho don tic appoint m ent s. This requ est was denied . There w ere no f u rther requ ests mad e in May/June 2 013 . Ad ditional information provided on a ppea l : With her Noti c e o f Ap pe a l da ted Se ptembe r 2, 2014 the appellant submitt ed a letter in w h ich she is ask ing for coverage t o trave l to anothe r ci t y so t ha t her chi ldren Y and Z can s ee an ortho do ntist. The a p pe llant writes: " Bo th Y [ it is u ncl ea r whet h er th e a ppe llan t is refer rin g t o Y al one or to both Y a nd Z] h av e been s e en a nd m onit or ed by t h e prac t it ioner on June 15 , 2012, Marc h 22 , 2013, Nov ember 22 , 201 3, which MSD has cove red t he t ran sportation costs for al l of these da t e s. MSD "claims" t h ey deni ed the transpor t ati on co sts f or Novembe r 22, 2013 ap pointment. What the y fail t o see is that t h ey refu s e d to give m e an y extr a f u nding f or Z , as they had already paid me for the tra vel e x p enses to cover Z's ophthal molo gist ap po intment which was can celled on Nove m b er 7, 2013, d ue to transp o rt ation no t running first thin g in the morning. That appoint ment was rescheduled to November 2 2, 2013. [ My city] d oes no t have an orthodontist, which i s why we have to travel to [another city]. On August 25, 2014, Y and Z had appointments to see [the orthodontist], they were originally supposed to see him on July 18, 2014 but ha d to reschedule." The appellant explains tha t the reason for rescheduling were Y's medical issues. The m i n ist ry relied on it s reconsideration decis ion and added the following information: It may be poss ible that in the p ast the ministry is sued fu nds in err or. With exception to the information respecting the ophthalmologist appointment the panel admits the appellant's letter a s b ei n g in supp ort of the information that was befo re the minis t ry at reconside r a tion pursuant to section 2 2(4) of the Em p l o ym en t and Assistance Act; the appellant is providing additional details about her child Z's orthodontist a ointments, EM T003(10/06/01)
PART F -Reasons for Panel Decision The issue in this appeal is whether the ministry was reasonable in denying the appellant's request for a non-medical transportation supplement for her child Z to visit an orthodontist in another city because the ministry determined that an orthodontist is not a "specialist" as defined in section 1 of Schedule C of the Employment and Assistance for Persons With Disabilities Regulation, and that therefore a visit to an orthodontist does not meet the requirements of section 2(1)(1) of Schedule C. The following sections apply to this appeal: sections 2 and 3 of Schedule C of the EAPWD 1 In this Schedule: "specialist" means a medical practitioner recognized as a specialist in a field of medicine or surgery in accordance with the bylaws made by the board for the College of Physicians and Surgeons of British Columbia under section 19 (1) (k.3) and (k.4) of the Health Professions Act. General health supplements 2 (1) The following are the health supplements that may be paid for by the minister if provided to a family unit that is eligible under section 62 [general health supplements] of this regulation: ... (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 general hospital or rehabilitation 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 Hosoital Insurance Act, and EAAT 003(10/06/01)
( v i ) t h e r e a r e n o r e s c o v e r t h e c o s t . A n d s e c t i o n 2 9 o f t h e I n t e r p r e t a t i o n A c t : " m e d i c a l p r a c t i t i o n e r " m e a n s a r e g i s t r a n t o f t h e C o l l e g e o f P h t h e H e a l t h P r o f e s s i o n s A c t t o p r a c t i s e m e d i c i n e a n d t o u s e t h e ti T h e a p p e l l a n t a r g u e s t h a t c h i l d r e n h a v e t h e r i g h t t o g l o c a l o rt h o d o n t i s t a v a i l a b l e s h e h a s t o t r a v e l o u t o f t o W h e n s h e c o m b i n e d Z ' s v i s i t s i n t h e p a s t w i t h t h o s e o f u n d e d b e t h e m i n i s t r y . T h e p o s i t i o n o f t h e m i n i s t r y i s t h a t o r t h o d o n t i s t s a r e n a r e t h e y r e c o g n i z e d a s s p e c i a l i s t s i n t h e f i e l d o f m e d i S u r g e o n s o f B C ; f o r t h e s e r e a s o n s s e c t i o n 2 ( 1 ) ( f ) ( i i ) o c a s e . I n a d d i t i o n , t h e a p p e l l a n t ' s r e q u e s t d o e s n o t f i t m e d i c a l t r a n s p o r t a t i o n p u r s u a n t S c h e d u l e C s e c t i o n 2 l o c a l a r e a , o f a m e d i c a l p r a c t i t i o n e r o r n u r s e p r a c t i t i o n g e n e r a l h o s p i t a l o r r e h a b i l i t a t i o n h o s p i t a l a s s e t o u t i n h o s p i t a l a s d e f i n e d i n p a r a g r a p h ( e ) o f t h e d e f i n i t i o n o A c t ( s e c t i o n 2 ( 1 ) ( f ) ( i v ) . T h e m i n i s t r y a r g u e s f u rt h e r t h a B C ' s M e d i c a r e P r o t e c t i o n A c t . I f i n t h e p a s t t h e m i n i s t t o c o n t i n u e d o i n g s o . P a n e l d e c i s i o n : T h e l e g i s l a t i o n p r o v i d e s t h a t t h e m i n i s t r y m a y p a y a m a n d n o n l o c a l t r a v e l o n l y u n d e r s p e c i f i c c i r c u m s t a n c e n u r s e p r a c t i t i o n e r l o c a l l y , t o t h e n e a r e s t s u i t a b l e h o s p a v a i l a b l e " s p e c i a l i s t " ; t h e s e p r o v i s i o n s a r e s e t o u t i n S " s p e c i a l i s t " i s d e f i n e d i n S e c t i o n 1 o f S c h e d u l e C o f t h r e c o g n i z e d a s a s p e c i a l i s t i n a f i e l d o f m e d i c i n e o r s u t h e b o a r d f o r t h e C o l l e g e o f P h y s i c i a n s a n d S u r g e o n s d e f i n e d i n s e c t i o n 2 9 o f t h e I n t e r p r e t a t i o n A c t a s a r e g p r a c t i t i o n e r r e q u i r e s g r a d u a t i o n f r o m a r e c o g n i z e d m e M e d i c i n e ( M . D . o r e q u i v a l e n t ) . Z ' s o r t h o d o n t i s t d o e s n D o c t o r o f D e n t a l S u r g e ry o r D . D . S . , a n d t h e r e f o r e i s n d e f i n e d i n 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 , e v e n t h o u m i n i s t r y 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 a v i s i t t o d e f i n e d i n t h e l e g i s l a t i o n a n d t h a t t h e r e f o r e t h e m i n i s t c o s t s t o h i s o f f i c e . F o r t h e s e r e a s o n s , t h e p a n e l f i n d s t h a t t h e m i n i s t ry w r e q u e s t f o r m e d i c a l t r a n s p o r t a t i o n a s s i s t a n c e f o r h e r c w a s a r e a s o n a b l e a p p l i c a t i o n o f t h e l e g i s l a t i o n i n t h e t h e r e f o r e c o n f i r m s t h e m i n i s ! ' s d e c i s i o n . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )o u r c e s a v 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 t o y s i c i a n s a n d S u r g e o n s o f B r i t i s h C o l u m b i a e n t i t l e d u n d e r t l e " m e d i c a l p r a c t i t i o n e r " ; e t m e d i c a l c a r e a n d t r e a t m e n t s ; s i n c e t h e r e i s n o w n t o r e c e i v e m e d i c a l s u p p o r t f o r h e r c h i l d Z . f h e r o t h e r c h i l d Y t h e s e a p p o i n t m e n t s w e r e o t r e c o g n i z e d a s m e d i c a l p r a c t i t i o n e r s , n e i t h e r c i n e o r s u r g e ry b y t h e C o l l e g e o f P h y s i c i a n s a n d f S c h e d u l e C d o e s n o t a p p l y i n t h e a p p e l l a n t ' s a n y o f t h e r e m a i n i n g e l i g i b i l i t y c a t e g o r i e s f o r ( 1 ) ( ! ) : t r a n s p o r t a t i o n t o a n d f r o m a n o f f i c e , i n t h e e r ( s e c t i o n 2 ( 1 ) ( f ) ( i ) ) ; t h e n e a r e s t s u i t a b l e s e c t i o n 2 ( 1 ) ( ! ) ( i i i ) ; o r t h e n e a r e s t s u i t a b l e f " h o s p i t a l " i n s e c t i o n 1 o f t h e H o s p i t a l I n s u r a n c e t o r t h o d o n t i c s e r v i c e s a r e n o t s e t o u t u n d e r r y h a s i s s u e d f u n d s i n e r r o r i t i s n o t c o m p e l l e d e d i c a l t r a n s p o r t a t i o n s u p p l e m e n t f o r l o c a l s : t o t h e o f f i c e o f a m e d i c a l p r a c t i t i o n e r o r i t a l i n B C , o r t o t h e o f f i c e o f t h e n e a r e s t e c t i o n 2 ( 1 ) ( f ) o f S c h e d u l e C o f t h e E A P W D R . A e E A P W D R a s a m e d i c a l p r a c t i t i o n e r r g e r y i n a c c o r d a n c e w i t h t h e b y l a w s m a d e b y o f B C ( C P S B C ) . A m e d i c a l p r a c t i t i o n e r i s i s t r a n t o f t h e C P S B C . R e g i s t r a t i o n a s a m e d i c a l d i c a l s c h o o l , w i t h a d e g r e e a s a D o c t o r o f o t h a v e a m e d i c a l d e g r e e , b u t t h e d e g r e e o f o t e l i g i b l e t o q u a l i f y a s a m e d i c a l p r a c t i t i o n e r a s g h Z ' s o r t h o d o n t i s i s a d e n t a l s p e c i a l i s t , t h e h i s o f f i c e w o u l d n o t b e a v i s i t t o a " s p e c i a l i s t " a s r y h a s n o a b i l i t y t o a s s i s t w i t h t r a n s p o rt a t i o n a s r e a s o n a b l e i n d e n y i n g t h e a p p e l l a n t ' s h i l d t o s e e a n o r t h o d o n t i s t a n d t h i s d e c i s i o n c i r c u m s t a n c e s o f t h e a p p e l l a n t . T h e p a n e l
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.