P A R T C D e c i s i o n UJ1 d e r A p p e a l T h e M i n i s t r y o f S o c i a l D e v e l o p m e n t a n d S o c i a l I n n o 2 0 1 4 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 w a s n o t e l i g i b l e a n d p o w e r e l e v a t i n g l e g r e s t s a s a c c e s s o r i e s t o t h e n o t t h e l e a s t e x p e n s i v e a p p r o p r i a t e d e v i c e s , t h e r e w t h e y w e r e n o t m e d i c a l l y e s s e n t i a l t o a c h i e v e o r m a i d e v i c e s t o e n h a n c e h e r m o b i l i t y i n s i d e h e r a p a r t m e c r i t e r i a s e t a t s . 3 ( 1 ) ( b ) ( i i i ) , 3 ( 2 ) ( b ) a n d 3 . 2 ( 2 ) o f S c h P e r s o n s w i t h D i s a b i l i t i e s R e g u l a t i o n . 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 E A P W D R , S c h e d u l e C , s e c t i o n s 3 a n d 3 . 2 . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # v a t i o n ( t h e m i n i s t r y ) d e c i s i o n d a t e d 3 0 S e p t e m b e r f o r m e d i c a l e q u i p m e n t , a p o w e r r e c l i n e f e a t u r e a p p e l l a n t ' s w h e e l c h a i r b e c a u s e t h e i t e m s w e r e a s n o m e d i c a l n e e d f o r t h o s e p o w e r d e v i c e s a n d n t a i n b a s i c m o b i l i t y a s t h e a p p e l l a n t h a d s u f f i c i e n t n t a n d c o n s e q u e n t l y d i d n o t m e e t t h e e l i g i b i l i t y e d u l e C 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 f o r i l i t i e s R e g u l a t i o n ( E A P W D R ) , s e c t i o n 6 2 .
P A R T E S u m m a r y o f F a c t s T h e a p p e l l a n t w a s n o t i n a t t e n d a n c e a t t h e h e a r i n g . t h e h e a r i n g p r o c e e d e d u n d e r s . 8 6 ( b ) o f t h e E m p l o y T h e f o l l o w i n g e v i d e n c e w a s b e f o r e t h e m i n i s t r y a t t h • T h e a p p e l l a n t i s d e s i g n a t e d b y t h e m i n i s t ry a s a m e d i c a l s e r v i c e s o n l y a n d e l i g i b l e f o r h e a l t h s u p p • A 5 p a g e r e q u e s t f o r f u n d i n g f o r a p o w e r w h e e l c r e c l i n e a n d r e h a b s e a t i n g d a t e d 2 9 J a n u a r y 2 0 1 4 i n c l u d e s t h e f o l l o w i n g : o T h e a p p e l l a n t ' s m o b i l i t y i s d e c l i n i n g . o T h e g o a l o f t h e r e q u e s t i s t o p r o v i d e i n d e p r e d u c e p a i n i n s i t t i n g , a l l o w t h e a p p e l l a n t l e g s . o T h e a p p e l l a n t ' s m e d i c a l s t a t u s i s d e s c r i b e d i s e a s e a n d d e g e n e r a t i n g d i s c d i s o r d e r , c c h r o n i c l o w e r b a c k p a i n , p o o r b a l a n c e a n d o P h y s i c a l S t a t u s : • U p p e r e x t r e m i t y f u n c t i o n : n o t i c e a b l d u e t o r h e u m a t o i d a r t h r i t i s ( R A ) . • L o w e r e x t r e m i t y f u n c t i o n : w e a k n e s n e e d s t o h o l d o n t o b a r s / p o l e s e t c . • B a l a n c e : n e e d s s u p p o r t t o s t a n d . • S i t t i n g p o s t u r e : c o m p l a i n s o f p a i n i n d e g r e e a n g l e f o r c o m f o r t w h i l e s i t t i n r e p o s i t i o n i n g h e r s e l f d u e t o p a i n a n b e a t 1 1 0 ° f o r c o m f o r t . o F u n c t i o n a l S t a t u s : • M o b i l i t y : d u e t o h e r a r t h r i t i s , s h e c a u s e s a g u t t e r w a l k e r a n d i n t h e w i n s h e o n l y l e a v e s h e r h o m e o n c e o r o E q u i p m e n t r e c o m m e n d a t i o n a n d j u s t i f i c a t • P o w e r e l e v a t i n g l e g r e s t s w i t h c e n t e l e v a t i n g l e g r e s t s f o r s i t t i n g t o l e r a n w h e n m a n e u v e r i n g i n h e r s u i t e . S h h e r a r t h r i t i c h a n d s a n d s h e l i v e s a l o h e r e d e m a i t w o u l d b e m o s t e ff e c e l e v a t i o n o f t h e l e g s a b o v e h e a r t l e • P o w e r r e c l i n e : T h e a p p e l l a n t h a s a s p e n d 1 6 -2 4 h o u r s / d a y i n h e r p o w e s i t t i n g i s a b o u t 1 1 0 -1 1 5 ° a t t h e h i p , a c t i v i t i e s o f d a i l y l i v i n g s u c h a s e a t i s i t i n a p o s i t i o n o f c o m f o r t , a n d t h e n a n d r e c l i n e f e a t u r e s p r o v i d e t h e m o t h e a p p e l l a n t i s e x p e c t e d t o s p e n d EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # A f t e r c o n f i r m i n g t h a t t h e a p p e l l a n t w a s n o t i f i e d , m e n t a n d A s s i s t a n c e R e g u l a t i o n . e t i m e o f r e c o n s i d e r a t i o n : p e r s o n w i t h d i s a b i l i t i e s ( P W D ) i n t h e c a t e g o r y o f l e m e n t s u n d e r s . 6 2 o f t h e E A P W D R . h a i r w i t h t i l t , p o w e r e l e v a t i n g l e g r e s t s , p o w e r b y a n o c c u p a t i o n a l t h e r a p i s t ( O T ) . T h e r e q u e s t e n d e n t b a s i c m o b i l i t y i n d o o r s a n d o u t d o o r s , t o s l e e p i n i t a t n i g h t a n d r e d u c e e d e m a i n l o w e r d a s s e v e r e r h e u m a t o i d a r t h r i t i s , C O P D , v a s c u l a r a u s i n g h e r s t i f f n e s s a n d p a i n i n m u l t i p l e j o i n t s , p o o r e n d u r a n c e . e a r t h r i t i c d e f o r m i t i e s , p o o r s t r e n g t h a n d d e x t e r i t y s , p a i n a n d s t i f f n e s s i n j o i n t s d u e t o a r t h r i t i s , t o s t a n d , c h r o n i c l o w e r l e g d e p e n d e n t s w e l l i n g . h e r t a i l b o n e , n e e d s k n e e s a t a p p r o x i m a t e l y 6 5 g , m i l d s c o l i o s i s i n h e r b a c k , h a s d i f f i c u l t y d w e a k n e s s i n a r t h r i t i c j o i n t s , b a c k r e s t n e e d s t o n o n l y w a l k a b o u t 1 0 -2 0 m ; i n t h e s u m m e r s h e t e r a 4 w h e e l e d w a l k e r . D u e t o h e r p o o r m o b i l i t y , t w i c e a m o n t h f o r m e d i c a l a p p o i n t m e n t s . i o n : r e m o u n t f o o t p l a t e s : T h e a p p e l l a n t n e e d s c e . S h e n e e d s t o b e a b l e t o l o w e r t h e f o o t r e s t e i s u n a b l e t o m a n a g e a m a n u a l s y s t e m d u e t o n e . S h e a l s o n e e d s e l e v a t i n g l e g r e s t s t o c o m b a t t i v e w h e n u s e d i n c o m b i n a t i o n w i t h t i l t t o a l l o w v e l . h i s t o r y o f s l e e p i n g i n h e r r e c l i n e r s h e w i l l r w h e e l c h a i r a n d h e r p o s i t i o n o f c o m f o r t f o r h o w e v e r t h i s i s n o t f u n c t i o n a l t o e n g a g e i n n g , g r o o m i n g e t c . P o w e r r e c l i n e w i l l a l l o w h e r t o m o v e f o rw a r d f o r f u n c t i o n a l t a s k s . A s w e l l , t i l t s t p r e s s u r e r e l i e f w h e n u s e d i n c o m b i n a t i o n . A s 1 6 -2 4 h o u r s / d a y i n t h e w h e e l c h a i r , t h e
c o m b i n a t i o n o f t i l t a n d r e c l i n e w i l l p • A M e d i c a l E q u i p m e n t R e q u e s t a n d J u s t i f i c a t i o n o S e c t i o n 1 f r o m a s o c i a l w o r k e r , s i g n e d a n a p p e l l a n t w a s e l i g i b l e t o a c c e s s m e d i c a l e w e r e n o o t h e r r e s o u r c e s a v a i l a b l e t o p r o v o S e c t i o n 2 f r o m a m e d i c a l p r a c t i t i o n e r , a p d e s c r i b 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 h e a r t d i s e a s e . T h e p h y s i c i a n r e c o m m e n d p o w e r r e c l i n e a n d p o w e r e l e v a t i n g l e g r e s • A q u o t e f r o m a r e c o g n i z e d s u p p l i e r o f t h e m i n i s t w i t h a l l t h e a c c e s s o r i e s r e c o m m e n d e d b y t h e p h • A q u o t e f r o m a r e c o g n i z e d s u p p l i e r o f t h e m i n i s t s e a t i n g f o r $ 9 , 9 0 3 . 7 5 . • A l e t t e r d a t e d 3 J u l y 2 0 1 4 f r o m t h e a p p e l l a n t ' s O h a d b e e n a p p r o v e d f o r a n a m o u n t o f $ 9 , 9 0 3 . 7 5 a c c e s s o r i e s w a s f o r a t o t a l o f $ 2 3 , 7 5 9 . 5 0 . T h e O a p p r o v e d a n d r e q u e s t e d a l e t t e r f r o m t h e m i n i s t r s o t h a t s h e c o u l d a p p e a l . S h e s t a t e d : " I f t h e a p p c h a r i t i e s , w h o o f t e n w a n t p r o o f t h a t a n i t e m w a s • A 2 p a g e M e d i c a l E q u i p m e n t R e q u e s t T r a c k i n g m i n i s t r y w o r k e r s i n d i c a t e d t h e s t e p s f o l l o w e d t o a c c e s s o r i e s . A t a n e n t ry d a t e d 8 M a y 2 0 1 4 , i t w a t o b a t h r o o m i n a p a r t m e n t " . A s w e l l , i t w a s i n d i c a p o s i t i o n i n g f e a t u r e s w h e n c l i e n t w a s a m b u l a t o r y a d v i s e d o f t h i s . F o r 5 J u n e 2 0 1 4 i t w a s i n d i c a t e d p r o g r a m w i l l n o t f u n d t i l t " . T h e s a m e d a y a p o w e $ 9 , 9 0 3 . 7 5 . • O n 5 J u n e 2 0 1 4 , a l e t t e r f r o m t h e m i n i s t r y t o t h e w h e e l c h a i r s e a t i n g h a d b e e n a p p r o v e d f o r h e r . • I n r e s p o n s e t o t h e m i n i s t r y ' s d e c i s i o n , a l e t t e r f r o p o w e r t i l t a n d r e c l i n e , p o w e r r e c l i n e s e a t f r a m e , h e a d r e s t s y s t e m f o r t h e a p p e l l a n t ' s p o w e r w h e e a c c e s s o r i e s , t h e a p p r o v e d p o w e r w h e e l c h a i r w o c o n t i n u e t o b e b e d a n d c h a i r r i d d e n . o J u s t i f i c a t i o n f o r p o w e r e l e v a t i n g l e g r e s t s : i t w a s t o o p a i n f u l f o r t h e a p p e l l a n t t o t o l e r l e g r e s t s w e r e t r i e d b u t b e c a u s e o f h e r a r m a n a g e t h e m . S h e c o u l d n o t h a v e t h e l e g c o m f o r t a b l e w i t h ) b e c a u s e t h i s w o u l d i n c r w o u l d n ' t f i t i n h e r e l e v a t o r . o J u s t i f i c a t i o n f o r p o w e r r e c l i n e : w h i l e t h i s w r e c o m m e n d e d b e c a u s e t h e a p p e l l a n t h a s s p e n d 1 6 -2 4 h o u r s / d a y i n h e r w h e e l c h a i r 2 9 J a n u a r y 2 0 1 4 r e q u e s t . o J u s t i f i c a t i o n f o r h e a d r e s t : i f p o w e r t i l t i s a p w h e n i t i s t i l t e d b a c k i n a n y e v e n t , w i t h E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L r o v i d e t h e b e s t p r e s s u r e r e d u c t i o n . f o r m c o m p l e t e d i n 2 p a r t s : d d a t e d o n 2 4 O c t o b e r 2 0 1 3 , i n d i c a t e d t h a t t h e q u i p m e n t u n d e r t h e E A P W D R a n d t h a t t h e r e i d e t h e r e q u e s t e d m e d i c a l e q u i p m e n t . h y s i c i a n , s i g n e d a n d d a t e d o n 1 9 J a n u a r y 2 0 1 4 , n a s r h e u m a t o i d a r t h r i t i s , C O P D a n d i s c h e m i c e d a p o w e r w h e e l c h a i r , r e h a b s e a t i n g , p o w e r t i l t , t s . r y d a t e d 2 1 J a n u a r y 2 0 1 4 f o r a p o w e r w h e e l c h a i r y s i c i a n f o r a n e s t i m a t e d c o s t o f $ 2 3 , 7 5 9 . 5 0 . r y d a t e d 4 J u n e 2 0 1 4 f o r a p o w e r w h e e l c h a i r a n d T i n d i c a t i n g t h a t a p o w e r w h e e l c h a i r a n d s e a t i n g w h i l e t h e o r i g i n a l r e q u e s t i n c l u d i n g t h e T a s k e d w h e t h e r m a n u a l e l e v a t i n g l e g r e s t s w e r e y i n d i c a t i n g w h e t h e r a n y o f t h e i t e m s w e r e d e n i e d e a l i s u n s u c c e s s f u l , [ t h e a p p e l l a n t ] m a y a p p r o a c h d e n i e d . " S h e e t b e t w e e n 1 4 A p r i l 2 0 1 4 a n d 5 J u n e 2 0 1 4 b y d e t e r m i n e t h e e l i g i b i l i t y f o r t h e w h e e l c h a i r a n d s m e n t i o n e 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 w a l k t e d t h a t t h e p r o g r a m d i d n o t u s u a l l y f u n d p o w e r  , e v e n f o r s h o r t d i s t a n c e s a n d t h e O T w a s : " A s c l i e n t i s a b l e t o a m b u l a t e s h o r t d i s t a n c e s r w h e e l c h a i r a n d s e a t i n g a r e a p p r o v e d f o r a p p e l l a n t i n d i c a t e d t h a t a p o w e r w h e e l c h a i r a n d m t h e O T d a t e d 1 4 A u g u s t 2 0 1 4 r e q u e s t e d a p o w e r c e n t r e m o u n t e l e v a t i n g l e g s r e s t s a n d a l c h a i r . S h e i n d i c a t e d t h a t w i t h o u t t h o s e u l d n o t b e u s e f u l f o r t h e a p p e l l a n t a n d s h e w o u l d s h e s t a t e d t h a t w h e n r e g u l a r l e g r e s t s w e r e t r i e d , a t e m o r e t h a n a f e w m i n u t e s . M a n u a l e l e v a t i n g t h r i t i c c o n d i t i o n i n h e r h a n d s , s h e c o u l d n o t r e s t s p e r m a n e n t l y s e t a t 6 5 ° ( t h e p o s i t i o n s h e i s e a s e t h e o v e r a l l l e n g t h o f t h e w h e e l c h a i r a n d i t a s n o t a s i m p o r t a n t a s t h e o t h e r f e a t u r e , i t w a s a h i s t o r y o f s l e e p i n g i n h e r r e c l i n e r a n d w o u l d . S h e r e i t e r a t e d t h e a r g u m e n t s p r e s e n t e d i n h e r p r o v e d , t h e a p p e l l a n t w o u l d n e e d a h e a d r e s t f o r o r w i t h o u t t i l t , s h e w a s e x p e c t e d t o s p e n d s e v e r a l
I APPEAL# hours per day in the wheelchair and would periodically need to rest her head. • In her request for reconsideration dated 19 August 2014, the appellant indicated that she required the accessories recommended because she could not sit upright any amount of time as a result of pressure on spine and she could not endure pressure on her tailbone for any length of time for pain and discomfort. She was concerned that the wheelchair would not respond to her needs because since surgery, years ago, she hasn't been able to sit without her legs elevated. She required seating in a semi-elevated position. In her Notice of Appeal dated 8 October 2014, the appellant stated: "I need my legs elevated because if they are straight down it pulls on my back and causes pain. I cannot manage manual elevating leg rests because of my arthritic hands. How can I lower manual leg rests to fit in the elevator and then raise again when I'm out?" At the hearing, the ministry testified that the appellant might be able to rely on third parties (like home care support or Handi Dart) to elevate and lower her wheelchair's manual leg rests when going to her doctor's appointments but was not certain whether that service could be available in the appellant's region. The ministry could not provide any information as to whether the headrest had been approved for funding or not. The panel determined the additional oral evidence was admissible under s. 22(4) of the Employment and Assistance Act as it was in support of the records before the minister at reconsideration, providing more information about possible resources to improve the appellant's mobility but the panel finds it cannot give that evidence much weight given its uncertainty. EAAT 003( 10/06/01)
I APPEAL# 7 PART F -Reasons for Panel Decision The issue under appeal is whether the ministry's decision that the appellant was not eligible for a medical equipment, a power recline feature and power elevating leg rests as accessories to the appellant's wheelchair because the items did not meet the eligibility criteria set at s. 3(1)(b)(iii), 3(2)(b) and 3.2(2) of Schedule C of the EAPWDR, was a reasonable application of the legislation or reasonably supported by the evidence. The ministry acknowledges the appellant meets the conditions set at s. 62 of the EAPWDR. Schedule C of the EAPWDR provides for what specific items the minister may approve. Medical equipment and devices are provided for at s. 3, 3.2 and 3.3. The relevant parts are as follows: 3 (1) Subject to subsections (2) to (5) of this section, the medical equipment and devices described in sections 3.1 to 3.11 of this Schedule are the health supplements that may be provided by the minister if (a) the supplements are provided to a family unit that is eligible under section 62 [general health supplements] of this regulation, and (b) all of the following requirements are met: (i) the family unit has received the pre-authorization of the minister for the medical equipment or device requested; (ii) there are no resources available to the family unit to pay the cost of or obtain the medical equipment or device; (iii) the medical equipment or device is the least expensive appropriate medical equipment or device. (2) For medical equipment or devices referred to in sections 3.1 to 3.8 or section 3.12, in addition to the requirements in those sections and subsection (1) of this section, the family unit must provide to the minister one or both of the following, as requested by the minister: (B.C. Reg. 197/2012) (a) a prescription of a medical practitioner or nurse practitioner for the medical equipment or device; (b) an assessment by an occupational therapist or physical therapist confirming the medical need for the medical equipment or device ... 3.2 (1) In this section, "wheelchair" does not include a stroller. (2) Subject to subsection (4) of this section, the following items are health supplements for the purposes of section 3 of this Schedule if the minister is satisfied that the item is medically essential to achieve or maintain basic mobility: (a) a wheelchair; (b) an upgraded component of a wheelchair; (c) an accessory attached to a wheelchair ... 3.3 (1) The following items are health supplements for the purposes of section 3 of this Schedule if the minister is satisfied that the item is medically essential to achieve or maintain a person's positioning in a wheelchair: (a) a wheelchair seating system; (b) an accessory to a wheelchair seating system ... As mentioned above, the ministry acknowledged that the appellant is eligible for health supplements set out in s. 3 and 3.1 to 3.12 of Schedule C of the EAPWDR. EAAT003(10/06/01)
I APPEAL-// Of the many devices requested by the appellant, only 2 were determined by the ministry not to be eligible for funding: the power recline feature and the power elevating leg rests to her power wheelchair. The power recline feature: The ministry argued that this item was not eligible for funding in the circumstances of the appellant because it was not the least expensive appropriate device, since a powered device is more expensive than a manual device; that the appellant had not established there was a medical need for that device and that there was not enough evidence to satisfy the ministry that the device was medically essential to achieve or maintain basic mobility, in particular because the appellant's main reason to request this item was to use it 16 to 24 hours/ day, including sleeping and pain management that are not mobility related. The ministry also argued that in the past, the appellant had been provided with numerous items to facilitate her basic mobility, including a hospital bed, an egg crate foam overly for her mattress, an over-the-bed trapeze frame for bed mobility, floor-to-ceiling poles in her bathroom and bedroom to assist with transfers, a tub transfer bench, a raised toilet seat with arms, walkers and bilateral lacer wrist splints. The appellant argued that this device was needed because she would spend 16 to 24 hours/ day in her power wheelchair and that her position of comfort for sitting is about 110-115 ° at the hip but that is not functional for her daily activities like eating, grooming etc. Thus, power recline would allow her to sit in a position of comfort and then move forward for functional tasks. This device would allow her the best pressure reduction. Least expensive (s. 3(1)(b)(iii), Schedule C, EAPWDR): The panel notes that the appellant has numerous items at her disposition to manage her basic mobility and that the power recline feature's purpose is mainly to make her more comfortable over long periods of time and to reduce pressure while sitting. Thus, the panel finds the ministry reasonably determined the appellant had not demonstrated this device was the least expensive appropriate device in those circumstances. Medical need (s. (3)(2)(b), Schedule C, EAPWOR): While the panel notes the appellant's physician recommended power recline for her wheelchair, there is no indication in his report as to why it is medically needed. The OT's report refers to a number of studies showing that lower pressure on seating interface is between 110 ° and 150 ° of recline but there is no indication in her report that this item is needed for medical reasons and, further, the OT admits in a later report (14 August 2014) that this item "is not as important as the other two features". The panel finds the ministry reasonably determined the evidence was insufficient to demonstrate a medical need for that device. Medically essential for basic mobility (s. 3.2(2), Schedule C, EAPWDR): The panel notes the evidence demonstrating that this device is medically "essential" to achieve or maintain basic mobility is lacking. There is no doubt that this device would enhance the appellant's comfort but there is no evidence that it is "essential" for her basic mobility -it actually does not affect the appellant's mobility at all since she can move around and perform her dailv activities with her EAA T003( 10/06/01)
actual devices and the pow er rec lin e f e a ture on l y a ffects between 110-115 ° an d si tti ng u p right . As ment ioned without indicat ing whethe r it was med ic all y es sentia fi nds the min ist ry r easo nab ly determin ed th e dev ice main tain the app ell ant ' s basic m o b ility . The power el eva t ing leg rests to the ap pell ant's L ike for the p o wer rec lin e f ea t ure, t he minis t ry argu e wa s n o t the lea st e xp ensive (t he minist ry ha d app r o ther e w as no m edical n eed nor w er e th ey m edical ly ess n ot dispute her p ow e r wheelchair n eed ed leg rests the ma nua l leg rests but a rg u ed that the p o wer leg r th ere w as a l e s s expensiv e a lter na tive. Th e ministry finally argued a nd r aise her le g r ests w hen she ne eds to take the eleva assis tan c e of a thi r d part y , th us not needin g p ower T he ap pellan t argued t hat s he nee ded p o wer elev a ted leg about 65 ° to be a ble to sit any l ength of t i m e b ut s h e in or o u tside of her s u i te as the ele vated leg rests are he r suite and to fit in t he ele v ator where she l ive s. S rests b ut because o f s evere RA i n her h a nds, she coul Least expens ive ( s . 3( 1)( b)(iii ), Schedu l e C, E APWO Whi le it is obvious th a t p ower l eg res t s are more ex add res s whet her t he less e x pensiv e device is appro pane l notes the eviden ce sho ws that the app ellant c having R A i n he r h a nds. As an a lternati ve , t h e m inis parties m ana gin g t h e l e g res ts wh en she t akes the f inds t h is al te r native is not r ea l is tic giv en that the a ppellan cons tantly with h er to r aise and lowe r he r l e g res t s wh well. Als o, there was n o ev i de nce that such h e l p w ould s ince she lives alone. Thus, the panel come s to the conclus be useful for t h e a ppellant a n d that it w as unreasonab eligible for funding for power elevat i n g leg rests, si nce he r w hee lch a ir wi t hout p ower leg rests woul d be bas Medical need (s. (3)(2) (b ) , Schedule C , E A PWOR): The panel notes the appellant's physician confirmed RA and recomme The panel also notes that the appellant tried manual leg rests but was unable to manage them because of her RA, a medical condition. This was confirmed by the OT who described how the RA caused the appellant to be unable to manage the manual leg rests because of the arthritic in her hands. Thus, the panel finds the ministry unreasonabl establis hed a medical need for power elevating leg rests. Medically essential for basic mobility (s. 3.2(2), Schedule C, EAPWDR): EMT 003(10/06/01) I APPEAL# indi rectly her m o b ility, i. e. fo r tra nsit ionin g above, the phy sicia n re commende d that device l for he r bas ic mo bility . C onse q u ently, t he p ane l w as not m edica l ly es sent ial t o achieve or power wheelc hai r: d tha t t h is dev ice w as not elig ible for fundi ng as it v e d t he m anual leg rest s that are l ess ex pen s ive), en tia l fo r her b a si c m o b ili ty. The m i n is t r y did in the circum stances of th e appella nt as i t fu nd e d ests were not el igible for f unding m ainly b ecause that she cou l d g et he l p t o l ower t or as s he w o uld i n all l ikelihoo d ha v e t he elevatin g l eg rest s. r e s ts becau se he r knees n e ed t o be at a lso ne eded to lo we r the footrest wh en moving too la rge to allo w her wheelchai r to circulate in h e a r g u ed t h a t she tri ed ma nua l e l e vated leg d n ot manage t he m . R): pensi ve than manu a l on es , the p a n el must a lso priate i n the circum s t ances o f the app e llant. The annot ma na ge ma nual leg res t s b ecause of try suggests that s h e could use he l p f rom th i r d eleva t or t o go t o a do ctor's a ppoint ment; th e panel t w ould need t o have a th i rd pa rt y en she wa n ts to move around in h er suite as be avai l able w hen the app ell ant nee ds th em ion that manual leg r est s are unlikely to le for the min istry to determine that she was not according to the e viden ce b e fo r e the pa nel, ic a lly useless mo s t of the time . nded power elevating le g rest s. condition y determined the appellant had not
T h e r e i s n o i s s u e t h a t t h e a p p e l l a n t n e e d s a p o w e r r e c o g n i z e d a n d f u n d e d t h e d e v i c e . H o w e v e r , t h e e v m a n u a l l e g r e s t s b e c a u s e o f h e r R A a n d i t s i m p a c t i s s u e i s w h e t h e r t h i s s i t u a t i o n w o u l d h a v e a n i m p a c s h e h a s o t h e r d e v i c e s a t h e r d i s p o s a l t o m o v e a r o u b u t d i d n o t o f f e r a n y e v i d e n c e a s t o h o w t h o s e d e v i c t h a t t h e m i n i s t r y f u n d e d . T h e p a n e l f i n d s t h e a l t e r n a r e p l a c e a p o w e r w h e e l c h a i r a s i t w o u l d r e d u c e t h e a c o n s t a n t l y t r a n s f e r b e t w e e n t h e w h e e l c h a i r a n d t h e s u i t e . T h u s , t h e p a n e l f i n d s t h e p o w e r l e g r e s t s a r e w i t h o u t t h e m t h e e v i d e n c e s h o w s t h e a p p e l l a n t c o u s u i t e o r t a k e t h e e l e v a t o r t o g e t o u t o f h e r b u i l d i n g b 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 n r e a s o n a b l y d e t e r m i n e e s s e n t i a l t o a c h i e v e o r m a i n t a i n t h e a p p e l l a n t ' s b a s C o n c l u s i o n : T h e p a n e l f i n d s t h a t t h e m i n i s t r y ' s r e c o n s i d e r a t i o n d a p p e l l a n t ' s p o w e r w h e e l c h a i r w a s r e a s o n a b l y s u p p o T h e p a n e l f u r t h e r f i n d s t h a t t h e m i n i s t ry ' s r e c o n s i d e n o t s u p p o r t e d b y t h e e v i d e n c e a n d t h e r e f o r e r e s c i n d d e c i s i o n r e g a r d i n g t h e p o w e r l e g r e s t s i s o v e r t u r n e d E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # w h e e l c h a i r t o m o v e a r o u n d a s t h e m i n i s t r y i d e n c e s h o w s t h e a p p e l l a n t c a n n o t r a i s e o r l o w e r o n h e r a b i l i t y t o u s e h e r h a n d s . T h e r e f o r e , t h e t o n h e r b a s i c m o b i l i t y . T h e m i n i s t r y a r g u e d t h a t n d h e r s u i t e , l i k e w a l k e r s a n d t r a n s f e r e q u i p m e n t e s w o u l d b e a b l e t o r e p l a c e t h e p o w e r w h e e l c h a i r t i v e d e v i c e s s u g g e s t e d b y t h e m i n i s t ry c a n n o t p p e l l a n t ' s m o b i l i t y s i g n i f i c a n t l y , f o r c i n g h e r t o d e v i c e s e a c h t i m e s h e w a n t s t o m o v e a r o u n d h e r e s s e n t i a l f o r t h e a p p e l l a n t ' s b a s i c m o b i l i t y s i n c e l d n o t u s e h e r w h e e l c h a i r t o m o v e a r o u n d h e r e c a u s e o f h e r m e d i c a l c o n d i t i o n . C o n s e q u e n t l y , d t h e p o w e r e l e v a t e d l e g r e s t s w e r e n o t m e d i c a l l y i c m o b i l i t y . e c i s i o n r e g a r d i n g t h e p o w e r r e c l i n e f e a t u r e f o r t h e r t e d b y t h e e v i d e n c e a n d c o n f i r m s t h a t d e c i s i o n . r a t i o n d e c i s i o n r e g a r d i n g t h e p o w e r l e g r e s t s w a s s t h a t d e c i s i o n . T h e r e f o r e , t h e m i n i s t ry ' s i n f a v o u r o f t h e a p p e l l a n t .
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.