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 r y o f S o c i a l R e c o n s i d e r a t i o n D e c i s i o n d a t e d O c t o b e r 3 0 , 2 0 1 4 r e p l a c e m e n t c u s t o m m a d e f o o t o rt h o t i c s a s a h e a l t s u b s e c t i o n s 3 ( 3 ) a n d 3 . 1 0 ( 1 0 ) o f S c h e d u l e C , o f t h D i s a b i l i t i e s R e g u l a t i o n ( E A P W D R ) , w e r e n o t m e 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 l l t h e l e g i s l a t i v e c r i t e s u b s e c t i o n 3 ( 1 ) a n d 3 . 1 0 s u b s e c t i o n s ( 1 ) ( 2 ) a n d ( 3 o f t h e c r i t e r i o n s e t o u t i n s u b s e c t i o n 3 ( 3 ) ( b ) . T h i s l e r e s p e c t t o r e p l a c e m e n t o f a n o r t h o s i s i s t h r e e ( 3 ) y t h e o r t h o s i s b e i n g r e p l a c e d . T h e m i n i s t r y n o t e d t h a o r t h o t i c s o n N o v e m b e r 8 , 2 0 1 2 a n d t h e r e f o r e n o t e f o r t h i s r e a s o n s h e i s i n e l i g i b l e t o r e c e i v e t h e r e q u e 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 S c h e d u l e C , S e c t i o n s 3 a n d 3 . 1 0 . EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I D 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 ) w h i c h h e l d t h a t t h e a p p e l l a n t i s n o t e l i g i b l e f o r h s u p p l e m e n t a s t h e c r i t e r i a p u r s u a n t t o e E m p l o y m e n t a n d A s s i s t a n c e fo r P e r s o n s w i t h r i a s e t o u t i n t h e E A P W D R e g u l a t i o n , S c h e d u l e C , ) h a d b e e n m e t b y t h e a p p e l l a n t w i t h t h e e x c e p t i o n g i s l a t i o n s t i p u l a t e s t h a t t h e p e r i o d o f t i m e w i t h e a r s f r o m t h e d a t e o n w h i c h t h e m i n i s t e r p r o v i d e d t t h e a p p e l l a n t w a s a p p r o v e d f o r c u s t o m m a d e l i g i b l e f o r a r e p l a c e m e n t u n t i l N o v e m b e r 2 0 1 5 a n d s t e d b e n e f i t . b 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 a n d
P A R T E S u m m a ry o f F a c t s T h e e v i d e n c e b e f o r e t h e m i n i s t r y a t r e c o n s i d e r a t i o • A c o m p l e t e d O r t h o s e s R e q u e s t a n d J u s t i f i c s i g n e d b y t h e a p p e l l a n t ' s p e d o r t h i s t . • T h e a p p e l l a n t ' s R e q u e s t f o r R e c o n s i d e r a t i o a t t a c h m e n t s : o A c o p y o f t h e a p p e l l a n t ' s C T S c a n C 2 0 1 4 w i t h t h e f o l l o w i n g I m p r e s s i o n ; 1 . R i g h t L 5 S 1 d i s c p r o t r u s i o n a ff e c t i n 2 . M o d e r a t e t o s e v e r e s p i n a l s t e n o s i s t h i s l e v e l . 3 . M u l t i p l e s i t e s o f f a c e t a r t h r o p a t h y a 4 . D e x t r o s c o l i o s i s a n d r i g h t l a t e r a l s u o A B i o m e c h a n i c a l A s s e s s m e n t R e p o r t C l i n i c a l O b s e r v a t i o n s a s f o l l o w s : t h e a n d r e a r f o o t v a l g u s d e f o r m i t y ; p a i n w l o w e r b o d y ; o n l y t o l e r a t e s f u l l s o f t o r t b e c a u s e o f s o ft n a t u r e o f m a t e r i a l s ; a c o r r e c t i v e s u p p o r t a n d s h e r e q u i r e s a o A q u o t e f o r a c u s t o m o rt h o t i c f u l l s o o A p r e s c r i p t i o n f o r t h e a p p e l l a n t ' s c u s t 2 0 1 4 . o A l e t t e r f r o m t h e a p p e l l a n t ' s O r t h o p a e i n d i c a t e d t h a t h e a s s e s s e d h e r o n J u b a c k p a i n a n d a l i m p i n g g a i t . H e r l e g a p p r o x i m a t e l y ½ i n c h l o n g e r . I t i s s t r o r i g h t o r t h o t i c h a v i n g 3 / 1 6 " t o 1 / 4 " h e o A l e t t e r f r o m t h e a p p e l l a n t ' s P e d o r t h i s t h e r e a r e t w o ( 2 ) m a i n t y p e s o f f o o t o s u c h a s p o l y p r o p e l e n e o r s u b o r t h y l e n u s e d w h e n t h e p a t i e n t r e q u i r e s s o ft n e a p p e l l a n t ' s c a s e t h e r e i s a l o s s o f s o f fo r o s t e o a r t h r i t i s a n d l o w e r b a c k p a i n m a n u f a c t u r e a s o f t E V A t y p e f o o t o r t h E V A d o e s n o t h a v e t h e l i f e s p a n o f t h e l a s t s f o r a p p r o x i m a t e l y 2 y e a r s d e p e n a p p e l l a n t ' s p r e v i o u s fo o t o rt h o s e s w e o A l e t t e r f r o m t h e a p p e l l a n t d a t e d O c t o f o r o r t h o t i c s ; S h e h a s n e e d e d o r t h o t i c s s i n c e s h o s t e o p o r o s i s a t 4 5 y e a r s w h i c h w a A ft e r f a l l i n g t w i c e i n t h e s n o w i n 2 0 A b o u t 2 y e a r s l a t e r a b o n e d e n s i t y r e s u l t e d i n s c i a t i c p a i n . W i t h t h i s n e w p a i n , s h e c o n s u l t e d h e r l e g l e n g t h s d e t e r m i n e d t h a t h e r e q u i r e d h e r t o q e t n e w o rt h o t i c s w EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # n c o n s i s t e d o f t h e f o l l o w i n g : a t i o n f o r t h e a p p e l l a n t d a t e d J u n e 2 8 , 2 0 1 4 a n d n d a t e d O c t o b e r 2 1 , 2 0 1 4 W i t h t h e f o l l o w i n g T L u m b a r S p i n e n o n C o n t r a s t d a t e d J u n e 1 8 , g t h e r i g h t S 1 n e r v e r o o t . L 4 -5 . T h e r e i s a l s o r i g h t f o r a m i n a l n a r r o w i n g a t r e s e e n . b l u x a t i o n o f L 4 u p o n L 5 . d a t e d J u n e 2 4 , 2 0 1 4 t h a t n o t e d S i g n i f i c a n t a p p e l l a n t p r e s e n t s w i t h s e v e r e b i l a t e r a l p e s p l a n u s h i l e w e i g h t b e a r i n g ; p a i n i n m a n y a r e a s o f t h e h o t i c s w h i c h a r e p r o n e t o b r e a k d o w n q u i c k e r n d , p r e v i o u s o r t h o t i c s a r e n o l o n g e r p r o v i d i n g n e w s e t . f t E V A d a t e d J u l y 1 , 2 0 1 4 t o t a l i n g $ 4 5 0 . o m m a d e b i l a t e r a l f o o t o r t h o t i c s d a t e d J u l y 9 , d i c T h e r a p i s t d a t e d O c t o b e r 1 6 , 2 0 1 4 w h i c h n e 2 , 2 0 1 4 w h e n s h e p r e s e n t e d w i t h c h r o n i c l o w e r l e n g t h s m e a s u r e m e n t s h o w e d t h a t h e r l e ft l e g w a s n g l y r e c o m m e n d e d t h a t s h e b e f i t t e d f o r o r t h o t i c s e l r i s e . t d a t e d O c t o b e r 2 0 , 2 0 1 4 w h i c h e x p l a i n e d t h a t rt h o s e s : t h e f i r s t a r e m a d e u s i n g a r i g i d m a t e r i a l e ; w h i l e t h e s e c o n d a r e f u l l s o ft o r f u l l l e n g t h E V A , s s , c u s h i o n i n g , a c c o m m o d a t i v e s u p p o r t . I n t h e t t i s s u e o n t h e p l a n t a r s u r f a c e o f t h e f o o t , p o t e n t i a l . F o r t h e s e r e a s o n s s p e c i f i c a l l y h e d e c i d e d t o o s e s t o t r e a t t h e a p p e l l a n t ' s d i s c o m f o r t . T h e s o ft m o r e t r a d i t i o n a l r i g i d b a s e s o r t h o s e s a n d u s u a l l y d i n g o n t h e u s a g e . T h e P e d o r t h i s t o p i n e s t h a t t h e r e n o t p r o v i d i n g h e r w i t h a d e q u a t e s u p p o r t . b e r 2 0 1 4 r e l a t i n g t h e h i s t o r y o f h e r c u r r e n t n e e d e w a s 5 y e a r s o l d , w a s d i a g n o s e d w i t h s t h e n f o l l o w e d b y d e g e n e r a t i v e d i s c d i s e a s e . 0 7 o n h e r r i g h t s i d e , s h e d e v e l o p e d s c o l i o s i s . s c a n c o n f i r m e d d a m a g e i n h e r l u m b a r w h i c h h a s a n O r t h o p a e d i c T h e r a p i s t w h o a f t e r m e a s u r i n g r r i g h t l e g w a s ½ i n c h s h o r t e r t h a n h e r l e f t w h i c h i t h a r a i s e d r i q h t h e e l .
APPEAL# I She then saw her pedorthist who has recommended new shoes with a strong construction to help her heels to refrain from bending to the left or right, and with a firm sole to prevent rear foot pronation or supponation. She has borrowed money from friends to purchase new orthotics and new shoes. On appeal the appellant wrote that she disagreed with the ministry's reconsideration decision because her need is to replace former orthotics and orthopaedic shoes due to limping from right leg being ½ inch shorter and from falls in 2007, and to alert the provincial government that soft orthotics are needed every two (2) years rather than three (3). On appeal the appellant submitted 2 new documents as follows: 1. An incomplete Orthoses Request and Justification form dated November 6, 2014 signed by the appellant's Pedorthist. 2. A letter from a medical liaison person at a footwear store which states that orthotics and shoes work together and thus the need to be careful not to compromise the objective of orthoses with an inappropriate shoe. At the hearing, the appellant indicated that the first new document, an Orthoses Request and Justification form dated November 6, 2014, is for her next request to the ministry and should therefore not be considered at this time. The appellant stated that the second new document was for information purposes only. At the hearing, the appellant expressed her concern that the ministry had only stated in its decision that the required three years had not yet elapsed, and that in her opinion the ministry had not seemed to understand that her situation constituted an emergency. She cited the language in EAPWDR, Schedule C, subsection 3(3), which refers to "medical equipment or a medical device ..... that is damaged, worn out or not functioning." She argued that the orthotics in question, which are made of a rigid material, meet that definition and are in fact impossible to repair. She also expressed concern for others who might find themselves in a similar situation. The ministry stood by its decision, stating that the ministry had no discretion but to refuse to provide new orthotics. This is because the EAPWDR states that the legislated time period for replacement orthotics is three years, and the appellant had received approval for orthotics in November 8, 2012, and is therefore ineligible for replacements to be considered until November of 2015. The ministry agreed that all other conditions had been satisfied, apart from meeting the stipulated time frame. The ministry had no objection to the appellant's second new document being submitted. The panel finds that the second document from a medical liaison person at a footwear store provided by the appellant prior to the hearing does corroborate the appellant's need for orthotics and therefore admissible as evidence pursuant to section 22(4) of the Employment and Assistance Act. Findings of Fact The appellant was approved for custom-made orthotics on November 8, 2012. EAAT 003(10/06/01)
APPEAL# I PART F -Reasons for Panel Decision The issue in this appeal is whether the ministry's determination that the appellant is not eligible for replacement custom-made foot orthotics is a reasonable application of the legislation or reasonably supported by the evidence. Specifically, the ministry determined that all the necessary legislative criteria set out in the EAPWD Regulation, Schedule C, had been met by the appellant with the exception of the criterion set out in subsection 3(3)(b). This legislation stipulates that the period of time with respect to replacement of an orthosis is three (3) years from the date on which the minister provided the orthosis being replaced. Relevant Legislation EAR Schedule C Medical equipment and devices 3 (1) Subject to subsections (2) to (5) of this section, the medical equipment and devices described in sections 3.1 to 3.12 of this Schedule are the health supplements that may be provided by the minister if (B.C. Reg. 197/2012) (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 f o r the medical equipment or device. (2.1) For medical equipment or devices referred to in section 3.9 (1) (b) to (g), in addition to the requirements in that section 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: (a) a prescription of a medical practitioner or nurse practitioner fo r the medical equipment or device; (b) an assessment by a respiratory therapist, occupational therapist or physical therapist confirming the medical need for the medical equipment or device. (3) Subject to subsection (6), the minister may provide as a health supplement a replacement of medical equipment or medical device, previously provided by the minister under this section, that is damaged, worn out or not functioning if (a) it is more economical to replace than to repair the medical equipment or device previously provided by the minister, and (b) the period of time, if any, set out in sections 3.1 to 3.12 of this Schedule, as applicable, for the purposes of this paragraph, has passed. (B.C. Reg. 197/2012) (4) Subject to subsection (6), the minister may provide as a health supplement repairs of medical equipment or a medical device that was previously provided by the minister if it is more economical to repair the medical equipment or device than to replace it. (5) Subject to subsection (6), the minister may provide as a health supplement repairs of medical equipment or a medical device that was not previously provided by the minister if (a) at the time of the repairs the requirements in this section and sections 3.1 to 3.12 of this Schedule, as applicable, are met in respect of the medical equipment or device being repaired, and (B.C. Reg. 197/2012) (b) it is more economical to repair the medical equipment or device than to replace it (6) The minister may not provide a replacement of medical equipment or a medical device under subsection (3) or repairs of medical equipment or a medical device under subsection (4) or (5) if the minister considers that the medical equipment or device was damaged through misuse. Medical equipment and devices -orthoses 3.10 (1) In this section, "off-the-shelF, in relation to an orthosis, means a prefabricated, mass-produced orthosis that is not unique to a particular person; "orthosis" means; EAAT 003(10/06/01)
( a ) a c u s t o m m a d e o r o f f t h e s h e l f f o o t o r t h o t i c ; ( 2 ) S u b j e c t t o s u b s e c t i o n s ( 3 ) t o ( 1 1 ) o f t h i s s e c t i o n , a n o rt h o t h i s S c h e d u l e i f ( a ) t h e o r t h o s i s i s p r e s c r i b e d b y a m e d i c a l p r a c t i t i o n e r o r a n u ( b ) 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 o r t h o s i s i s m e d i c a l l y e s s e ( c ) 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 o r t h o s i s i s r e q u i r e d f o r o n e ( i ) t o p r e v e n t s u r g e r y ; ( i i ) f o r p o s t s u r g i c a l c a r e ; ( i i i ) t o a s s i s t i n p h y s i c a l h e a l i n g f r o m s u r g e r y , i n j u r y o r d i s e a s ( i v ) t o i m p r o v e p h y s i c a l f u n c t i o n i n g t h a t h a s b e e n i m p a i r e d b y ( d ) t h e o r t h o s i s i s o f f t h e s h e l f u n l e s s ; ( B . C . R e g . 1 4 4 / 2 0 1 1 ) ( i ) 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 e r c o n f i r m s t h a t a ( i i ) t h e c u s t o m m a d e o r t h o s i s i s f i t t e d b y a n o r t h o t i s t , p e d o r t h ( 3 ) F o r a n o r t h o s i s t h a t i s a c u s t o m m a d e f o o t o r t h o t i c , i n a d d o f t h e f o l l o w i n g r e q u i r e m e n t s m u s t b e m e t : ( a ) 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 e r c o n f i r m s t h a t a ( b ) t h e c u s t o m m a d e f o o t o r t h o t i c i s f i t t e d b y a n o r t h o t i s t , p e d p o d i a t r i s t ; ( c ) R e p e a l e d ( B . C . R e g . 1 4 4 / 2 0 1 1 ) ( d ) t h e c u s t o m m a d e f o o t o r t h o t i c m u s t b e m a d e f r o m a h a n d ( e ) t h e c o s t o f o n e p a i r o f c u s t o m m a d e f o o t o r t h o t i c s , i n c l u d i 1 4 4 / 2 0 1 1 ) ( 4 ) F o r a n o r t h o s i s t h a t i s c u s t o m m a d e f o o t w e a r , i n a d d i t i o n o f t h e c u s t o m m a d e f o o t w e a r , i n c l u d i n g t h e a s s e s s m e n t f e e , ( 4 . 1 ) F o r a n o r t h o s i s t h a t i s o f f t h e s h e l f f o o t w e a r , i n a d d i t i o n ( a ) t h e f o o t w e a r i s r e q u i r e d t o a c c o m m o d a t e a c u s t o m m a d e ( b ) t h e c o s t o f t h e fo o t w e a r m u s t n o t e x c e e d $ 1 2 5 . ( 4 . 2 ) F o r a n o r t h o s i s t h a t i s o f f t h e s h e l f o r t h o p a e d i c f o o t w e a r s e c t i o n , t h e c o s t o f t h e f o o t w e a r m u s t n o t e x c e e d $ 2 5 0 . ( B . C . ( 5 ) F o r a n o r t h o s i s t h a t i s a k n e e b r a c e , i n a d d i t i o n t o t h e r e q u 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 e r w h o p r e s c r i b e d t h e k n e e b r a l e a s t 6 h o u r s p e r d a y . ( 6 ) F o r a n o r t h o s i s t h a t i s a n u p p e r e x t r e m i t y b r a c e , i n a d d i t i o u p p e r e x t r e m i t y b r a c e m u s t b e i n t e n d e d t o p r o v i d e h a n d , f i n g ( 7 ) F o r a n o rt h o s i s t h a t i s a c r a n i a l h e l m e t , i n a d d i t i o n t o t h e r h e l m e t m u s t b e a h e l m e t p r e s c r i b e d b y a m e d i c a l p r a c t i t i o n e r c a s e s o f s e l f a b u s i v e b e h a v i o r , s e i z u r e d i s o r d e r , o r t o p r o t e c t ( 8 ) F o r a n o r t h o s i s t h a t i s a t o r s o o r s p i n e b r a c e , i n a d d i t i o n t o m u s t b e i n t e n d e d t o p r o v i d e p e l v i c , l u m b a r , l u m b a r s a c r a l , t h o c e r v i c a l s p i n e s u p p o r t . ( 9 ) S u b j e c t t o s e c t i o n 3 o f t h i s S c h e d u l e , t h e l i m i t o n t h e n u m a s a h e a l t h s u p p l e m e n t f o r t h e p u r p o s e s o f s e c t i o n 3 o f t h i s S o p p o s i t e t h e d e s c r i p t i o n o f t h e a p p l i c a b l e o r t h o s i s i n C o l u m n T a b l e 1 I t e m C o l u m n 1 O r t h o s i s C o l u m n 2 L i m i t -1 c u s t o m m a d e f o o t o r t h o t i c , 1 o r 1 p ( 1 0 ) T h e p e r i o d o f t i m e r e f e r r e d t o i n s e c t i o n 3 ( 3 ) ( b ) o f t h i s S n u m b e r o f y e a r s f r o m t h e d a t e o n w h i c h t h e m i n i s t e r p r o v i d e d T a b l e 2 o p p o s i t e t h e d e s c r i p t i o n o f t h e a p p l i c a b l e o rt h o s i s i n C T a b l e 2 I t e m C o l u m n 1 O r t h o s i s C o l u m n 2 T i m e P e r i o d -1 c u s t o m m a d e f o o t o r t h o t i c , 3 y e EM T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I s i s i s a h e a l t h s u p p l e m e n t f o r t h e p u r p o s e s o f s e c t i o n 3 o f r s e p r a c t i t o n e r , n t i a l t o a c h i e v e o r m a i n t a i n b a s i c f u n c t i o n a l i t y , o r m o r e o f t h e f o l l o w i n g p u r p o s e s : e ; a n e u r o m u s c u l o s k e l e t a l c o n d i t i o n , a n d c u s t o m rn m a d e o rt h o s i s i s m e d i c a l l y r e q u i r e d , a n d i s t , o c c u p a t i o n a l t h e r a p i s t , p h y s i c a l t h e r a p i s t o r p o d i a t r i s t . i t i o n t o t h e r e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , a l l c u s t o m m a d e f o o t o r t h o t i c i s m e d i c a l l y r e q u i r e d ; o r t h i s t , o c c u p a t i o n a l t h e r a p i s t , p h y s i c a l t h e r a p i s t o r c a s t m o l d ; n g t h e a s s e s s m e n t f e e , m u s t n o t e x c e e d $ 4 5 0 . ( B . C . R e g . t o t h e r e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , t h e c o s t m u s t n o t e x c e e d $ 1 6 5 0 . t o t h e r e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , o r t h o s i s , a n d , i n a d d i t i o n t o t h e r e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s R e g . 1 4 4 / 2 0 1 1 ) i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , t h e m e d i c a l c e m u s t h a v e r e c o m m e n d e d t h a t t h e k n e e b r a c e b e w o r n a t n t o t h e r e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , t h e e r , w r i s t , e l b o w o r s h o u l d e r s u p p o r t . e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , t h e c r a n i a l o r n u r s e p r a c t i t i o n e r a n d r e c o m m e n d e d f o r d a i l y u s e i n o r f a c i l i t a t e h e a l i n g o f c h r o n i c w o u n d s o r c r a n i a l d e f e c t s . t h e r e q u i r e m e n t s i n s u b s e c t i o n ( 2 ) o f t h i s s e c t i o n , t h e b r a c e r a c i c l u m b a r s a c r a l , c e r v i c a l t h o r a c i c l u m b a r s a c r a l , o r b e r o f o r t h o s e s t h a t m a y b e p r o v i d e d fo r t h e u s e o f a p e r s o n c h e d u l e i s t h e n u m b e r s e t o u t i n C o l u m n 2 o f T a b l e 1 1 . a i r c h e d u l e w i t h r e s p e c t t o r e p l a c e m e n t o f a n o r t h o s i s i s t h e t h e o r t h o s i s b e i n g r e p l a c e d t h a t i s s e t o u t i n C o l u m n 2 o f o l u m n 1 . ( B . C . R e g . 6 1 / 2 0 1 0 ) a r s ( B . C . R e g . 1 4 4 / 2 0 1 1 )
I APPEAL# The ministry's position is that information was not submitted to establish that the appellant's current custom-made orthotics are damaged, worn out or not functioning; that it is more economical to replace than to repair the custom made foot orthotics previously provided by the minister; or that the period of time set out in section 3.10 of Schedule C has passed. The ministry argues that although the Pedorthist submits that the appellant's required EVA-type foot orthoses have a shorter lifespan than the more traditional rigid based orthoses, and that usually a soft EVA orthotic only lasts for approximately 2 years depending on the usage, the legislation does not allow for this type of discretion. The replacement period is clearly outlined as 3 years for custom-made foot orthotics and this time has not passed. The appellant's position is that in her opinion the ministry had not seemed to understand that her situation constituted an emergency. She cited the language in EAPWDR, Schedule C, subsection 3(3), which refers to "medical equipment or a medical device .....t hat is damaged, worn out or not functioning." She argued that the orthotics in question, which are made of a rigid material, meet that definition and are in fact impossible to repair. She also expressed concern for others who might find themselves in a similar situation. The panel finds that although the appellant's Pedorthist reports that the appellant's previously government supplied orthotics were not functioning, the ministry has no discretion to authorize the appellant's requested replacement custom-made foot orthotics outside of the legislation as set out in subsections 3(3) and 3.10(10) of Schedule C, of the EAPWDR. Specifically, the appellant did not meet the program criteria as the replacement time period of 3 years has not yet passed since the ministry last funded custom-made foot orthotics. The panel finds that the ministry reasonably determined that the appellant would not be eligible for replacement foot orthotics for three (3) years from the date of the last issue of the requested item, November 8, 2012, pursuant to Schedule C Health Supplements sections 3 and 3.10 of the EAPWDR. Therefore, the panel confirms the ministry's reconsideration decision. EAAT 003(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.