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 D " m i n i s t r y " ) r e c o n s i d e r a t i o n d e c i s i o n o f O c t o b e r 9 , 2 0 f o u r o f f i v e s t a t u t o r y r e q u i r e m e n t s o f s e c t i o n 2 o f t h e D i s a b i l i t i e s A c t ( " E A P W D A " ) f o r d e s i g n a t i o n a s a p e t h a t t h e a p p e l l a n t m e t t h e a g e r e q u i r e m e n t . H o w e v e • I n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r t h e a p c o n t i n u e f o r a t l e a s t t w o y e a r s ; • t h e e v i d e n c e e s t a b l i s h e s t h a t t h e a p p e l l a n t h a • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( " D L A " ) a r d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t e d e i t h e r c o n t h a t • a s a r e s u l t o f t h o s e r e s t r i c t i o n s , t h e a p p e l l a n t a n o t h e r p e r s o n , a n a s s i s t i v e d e v i c e , o r t h e s 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 A P W D A , s e c t i o n 2 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 E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I 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 1 4 , w h i c h f o u n d t h a t t h e a p p e l l a n t d i d n o t m e e t 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 s o n w i t h d i s a b i l i t i e s ( " P W D " ) . T h e m i n i s t r y f o u n d r , t h e m i n i s t r y w a s n o t s a t i s f i e d t h a t : p e l l a n t h a s a n i m p a i r m e n t t h a t i s l i k e l y t o s a s e v e r e p h y s i c a l o r m e n t a l i m p a i r m e n t ; e , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s ; a n d r e q u i r e s t h e s i g n i f i c a n t h e l p o r s u p e r v i s i o n o f r v i c e s o f a n a s s i s t a n c e a n i m a l . 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 2
APPEAL# I PART E -Summa of Facts With the consent of the parties the hearing was conducting in writing, in accordance with section 22(3) of the Employment and Assistance Act. The information before the ministry at the time of reconsideration included the following: • The appellant's PWD application form consisting of the appellant's self-report dated January 9, 2014 along with a physician's report ("PR") completed by the appellant's general practitioner dated March 25, 2014 and assessor's report ("AR") completed by a social worker, dated May 6, 2014. • The appellant's Request for Reconsideration form, dated September 24, 2014, stamped "Received" by the ministry on September 25, 2014. • The appellant's two-page handwritten reconsideration submission, dated September 24, 2014. With her Notice of Appeal the appellant submitted a letter written by the social worker dated September 24, 2014. The appellant wrote in her Notice of Appeal that she had submitted this letter to the ministry's office along with her Request for Reconsideration form, but that the letter appears not to have been considered by the ministry in its reconsideration decision. The panel notes that in her Request for Reconsideration form, which was received by the ministry on September 25, 2014 the appellant referenced the social worker's letter as follows: "Also attached is a letter from the assessor who had filled out that portion of my initial application to provide further information." This is consistent with the dates being the same on the Request for Reconsideration form, the appellant's reconsideration submission, and the social worker's letter. Based on this information, the panel concludes that the social worker's letter was before the ministry at the time of reconsideration. Admissibility of Additional Information Prior to the hearing, the appellant submitted to the Tribunal office a three-page handwritten statement dated November 7, 2014. This statement substantially reiterates the information that was in her reconsideration submission, and also includes written argument. The panel finds that the statement is consistent with, and tends to corroborate, information that was before the ministry regarding the effects of the appellant's impairment. Accordingly, the panel has admitted the above-noted statement partly as argument, and partly as written testimony in support, in accordance with section 22(4) of the Employment and Assistance Act. The ministry relied on its reconsideration decision and submitted no new information. * * * The panel reviewed the evidence as follows: Diagnoses In the PR the appellant's physician provided diagnoses of anxiety disorder, mood disorder/dysthymia, "? Personality Disorder (awaiting assessment by psychiatrist)", and patellofemoral syndrome, backache (MSK). EAAT 003(10/06/01)
The p hysician comme nt e d " H er main impairme n t is her mood, lac exp ected to see p syc hiatrist in e arly Apr i l . (i n i tial app res ched u le t h ou gh. ) ... Her o t h er c omplaints are ba c ka report ed financ ia l difficulties she was not a ble to enga p hysio tx [t h e r a p y] sess ions) I d o n ' t b eli eve her MSK-diag h e r from find ing empl oymen t i n the future." In the A R th e social worker (w ho has k no w n the appellant to t e n times) described t h e appellant's i mpa i rment a 10/14 by [ psyc hiatr ist's n a m e] . Qu e r y B o r derline Personal In her le tter o f Se ptember 2 4, 2014 the social wo rker the loc a l m e ntal he a lt h centre) rep orted that : • A psyc hia tric ass ess ment c o mplete d on A pri l 10 Border l in e Per son ality Dis o rder . " • At th is time the app e llant h as not been g i ven Borderline Perso na lity Di s order ("B PD") trait s. t h e refore a diagnosis of a disorder rather t han • The appel lan t h as de cli ne d ph a r m ace uti c al treatme not consider her to hav e dec l ined treatment. The c ou nselling a nd is "pre-conte m p l at i ve" regardi Duration In respons e t o the que s ti o n " Is the impair ment lik ely to the P R, the physi cia n did n o t mark either th e "yes" or the "no" box. "Pa t ientwould benef it f ro m phy s i ot h erapy/c oun s e l ling/CST [ an tianxiety/ a ntidepress a nt ther apy (medica ti on) off ered, psyc hi a tris t opinion ." In h er lett er of Septem ber 24 , 201 4 t h e soc ial w o r ker • The appel lan t ' s socia l anxiety has b e en l ife l on • She c onsi d e r s the treatment to be lo n g ter m, • Treatment for BPD has a target treatment time of minim Physical Impairment • In the PR the physician reported no limitations to the appellant's physical functional skills. • In the AR the social worker reported the appellant independently manages all aspects of mobility and physical ability, except that she requir comm e nting "She has p ate l lofemor al syn drome a times is limited." In her self-report the appellant wrote that: • Pain in her knees come s a nd goes depending • Back pain can ge t ve r y bad -standing or sitting for long period • She has been told to do exercises but even those can cause EAAT 003(10/06/01) I AP PE AL# k of intere st and m ot ivat ion . .. is ointme nt b oo k ed in F e b r ua r y, s h e ha d to ch e & re c urrent bilateral kn ee p ai n ... Due to ge i n ongo i n g rehabil itat ion (att en ded? abo ut 2 noses are s ignific a n t e nough to p r e v e n t since Jan uary 201 4 and has seen her tw o s " Soc i al Anxiet y Dis o rd e r-D iag n os ed A pr il ity Disord er -still a ssessin g." ( who sign ed the letter as a cli n i cal th erapist at , 2014 pr o vided "a possibl e d i agnosis of the f u ll diagnosi s, but at a mi n i mum ha s BPD r e quires a longer process to diagnose and t r ait s has n o t bee n rul ed out . n t at this ti me, but t h e soc ial worker d o es app e llant is hopin g to i mprov e thro ugh ng treatment. con t in ue for two yea r s o r m or e f rom t oday?" i n Instead the p h ysi c i an wro te cognitive-be havio u ral ther a py] p a tient decl in e d a t pr esen t. She is a w a i ting wrot e th at: g and t he C B T tr eatment is not a q u ick fix . b ut "canno t state how long that would be." u m two years. es per i o dic as sistanc e with carryi ng/holding, n d al t h o ugh i s i nd ependent with mobil ity , at o n her activities. s makes i t w orse. ain.
Mental Impairment • In the PR th e p hysician reported th at the a p pellant i ndic ated that the app ellant has significant deficits with three of twelve categories of cognitive and em oti on al function (emotional disturbance, motivati commented "Pati ent reports d ue to her social an peop le, she has been a voi d in g to a t t e nd any learning/further education." • The ph ysician d escribed the appellant as being she h as see n the appella nt 11 or more times see n regar d ing di fferen t compla in ts, pr o b l e ms 2014". • The physician wrote " cl inical improvement expected with the c oping sk ills." • In t he AR the so c ial worke r rep orted t ha t the appellant ha areas e x c ept for speaking , commen ting "has much diffi • In te rms of cognitive an d emotiona l fu n ctionin experien c e s ma jo r im p a cts in o ne of fourt e en c mod erate im p acts in the six cat e gories of in sigh mem o ry, m o t ivat ion, and motor activ ity . S he sle ep." I n the remai ning c ateg ories t he social In h er s e lf-re port the appel lant wrote that : • She is uneasy around gr oups o f people an d doesn't a r e staurant. • He r an xiety wa s so ba d s he mi s sed goi ng t o work in vo l ving being around p e o ple. In her reconsi der a t i on subm iss ion th e a ppellant wr o • S h e had neve r fully d isc u ssed her is sue s with • The physician completed the PR on her own opportunity to d is cu s s thing s with her beforehand. In her written statement of November 7, 2014 the appellant wr • Her physicia n had been reluctant to complete the PR and regarding any of the q u estions. • Th o u gh the physician provided the diagnosis of social anxiety disorder, the physician was not aware of how serious it was since the appellant never rea • She has suf f er ed with social anxiety her entire life. • She can't go anywhere or do anyth i ng without a close friend or relative going with her to keep her calm and focused. • She suffers anxiety when she is not around people as well. EAAT 003(10/06/01) APPEAL# I h as no d ifficulti e s with communi c ati on. S h e o n, and impuls e control). She xiety she is not able to function in a group of g r oup sessions e ven fo r the purpose of " known to me sinc e 2010", and reported that in the past 12 months. She commented "was [with] anxiety/mood n ot repo rted until Janu a ry rapy, patient need s to work on s good commu nication ski lls in all cul ty d ue to social a nxiet y." g, the s o cial worker in dicate d t ha t t he appell a nt a t e gor i es of fun c tion ing : e m o tion. She rep orted t /j ud gment, at te nti o n/c o nc en t rati o n, ex ec ut ive, comment e d "A nxi e ty has a sub sta ntia l im p act on wo r ke r n o ted min imal or no impact s. lik e goin g to the gr ocer y store or eati n g in he r gr aduat ion , a n d she ca nnot do any kin d of t e that: h er physi c i an . and the appellant had only the briefest o te that: did not consu lt the a ppellant onc e lly discussed th i n gs wi th her.
APPEAL# I In the PR the physician reported that: • The appellant has not been prescribed any medication or treatments that interfere with her ability to perform DLA. • The appellant is not restricted in any DLA except for social functioning. She indicated that the appellant is periodically restricted with social functioning and explained "periodic" by commenting "no anxiety observed clinically on one-to-one basis." • The appellant is "coping by avoiding situations where more people involved/present/lack of motivation." In the AR the social worker reported that: • The appellant independently manages all aspects of the six DLA of personal self-care, basic housekeeping ("back pain has some impact"), daily shopping ("although appellant is physically + intellectually capable of managing shopping, anxiety severely limits her abilities"), management of personal finances ("She does all her banking on line as anxiety limits her ability for social connection"), management of personal medications ("She is not on anything but could manage"), and use of transportation. • With respect to the DLA of meal preparation, the appellant independently manages the task of safe storage of food, but requires continuous assistance with meal planning, food preparation, and cooking, commenting "does not have motivation or desire. Relies on roommates." • Regarding the DLA of social functioning, the social worker wrote that the appellant independently manages the task of making appropriate social decisions, but that she needs continuous support/supervision to develop/maintain relationships, interact appropriately with others, deal appropriately with unexpected demands, and secure assistance from others. She reported that the appellant has very disrupted functioning regarding her immediate social network, and marginal functioning regarding her extended social network. In her letter of September 24, 2014 the social worker wrote that: • High anxiety does not only limit the appellant's ability to work and participate in normal activities, but it also limits her ability to quickly engage in counselling. • Her anxiety and BPD traits are always restricting and limiting her ability to function and it is more than periodic. In her reconsideration submission the appellant wrote that: • She can't go anywhere without a close friend or relative being with her. • She is depressed at times and sometimes can't get motivated to take a shower for days. • Her BPD causes her to have a very hard time getting along with people who are in her life. Help • In the PR the physician reported that the appellant does not have any prostheses or aids for her impairment, but commented "She would benefit from financial assistance -for ongoing physiotherapy, getting a knee brace, assessment for custom made orthotics." • In the AR the social worker indicated that the appellant does not routinely use an assistive device, and that she does not have an assistance animal. She commented "Roommates EMT 003(10/06/01)
p r o v i d e a l l t h e g r o c e r y s h o p p i n g + c o o k i n g . " • I n h e r s e l f r e p o r t t h e a p p e l l a n t w r o t e t h a t i f a n a r o u n d p e o p l e s h e w i l l h a v e s o m e o n e d o i t f o f r i e n d s b e c a u s e s h e d o e s n ' t g e t o u t m u c h t o • I n h e r r e c o n s i d e r a t i o n s u b m i s s i o n t h e a p p e l l a h e l p f r o m h e r r o o m m a t e s a n d p e o p l e i n h e r l i w i l l n e e d t h e h e l p o f c o u n s e l l o r s a n d t h e r a p y . EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # � y t h i n g n e e d s t o b e d o n e t h a t i n v o l v e s b e i n g r h e r i f s h e c a n , t h o u g h s h e d o e s n ' t h a v e m a n y m e e t n e w p e o p l e . n t w r o t e t h a t s h e n e e d s c o n s t a n t s u p p o r t a n d f e w i t h m a n a g i n g d a y t o d a y s t r u g g l e s . S h e a l s o
P A RT F -Re asons f o r Pan e l Deci s i on The i ssue on thi s a ppea l is wh ether t he minist ry' s dec PW D wa s reasona bly sup por t ed by t h e evide nce or w en actmen t in th e circ um s t anc es of the app e llant. I n determining that: • t h e appellan t does not h av e a seve r e ph ys ical m edica l pra ctitio n er i s like ly to last fo r at lea st • in the opinion of a presc ribed professio n al the significan t ly restri ct her from perfo r ming DLA either cont per io d s ; and • th at a s a resul t o f th o se re s trictio ns t he appe The relev ant l egisla t io n is as follo w s : EAPW DA: 2 (1) I n th i s sect i on: "assistiv e device" means a devic e d e sig ned activity that , b e c au se of a se ver e me n t al perform ; " d aily l ivin g a ct ivi ty" ha s the p re scr " p rescrib ed profess i o nal " ha s th e (2) The minister may d e si gn at e a person who dis abilit ie s f o r the purp oses of t h is Act if t ment al or p h ysical imp airment t hat (a ) in the opini o n of a m edical years, and ( b) in the opinion of a prescribed professional (i) directly and sign ificantly living ac t ivities e i t her (A) c ontin uo u sly, (B) periodically (ii) as a result of those restrictions, th tho s e activities. (3) For the purposes of s ubsection (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, EAAT 003(10/06/01) AP PEAL# I i s i o n to deny the ap pellant de signation as a a s a r e asonab l e a pp lication of the appl i c ab l e part icul ar , was the mini stry reas onable in or m ental im pairment that i n t h e opinion of a tw o y ears ; a pp ellan t ' s impairments do not direc t l y an d inuo usl y or periodically f or e xte nde d ll an t does no t re quir e h el p t o p e r fo rm DLA . to e n a bl e a pe rson t o p erform a da il y liv i ng or ph y si cal im p airment, the pe rson i s u na ble to i b ed mean i n g ; pres cribed mean i ng. has reac hed 18 y ears o f age as a person with h e min i st er i s s a tis fied that th e person ha s a seve r e practitioner i s li ke ly t o continue f o r at l e ast 2 restricts the person's ability to perform d aily o r fo r extended periods, and e person requires h elp to pe r f or m
APPEAL# I (ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. EAPWDR section 2(1): 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) manage personal medication, and (b) in relation to a person who has a severe mental impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. (2) For the purposes of the Act, "prescribed professional" means a person who is (a) authorized under an enactment to practise the profession of (i) medical practitioner, (ii) registered psychologist, (iii) registered nurse or registered psychiatric nurse, (iv) occupational therapist, (v) physical therapist, (vi) social worker, (vii) chiropractor, or (viii) nurse practitioner, or (b) acting in the course of the person's employment as a school psychologist by (i) an authority, as that term is defined in section 1 (1) of the Independent School Act, or (ii) a board or a francophone education authority, as those terms are defined in section 1 (1) of the School Act, if qualifications in psychology are a condition of such employment. ******* EAAT 003(10/06/01)
APPEAL# I Duration The appellant's position is that she satisfies the duration requirement. She argued that her social anxiety has been life-long, and that she has been diagnosed with BPD traits and may yet be diagnosed with the disorder rather than traits. She relied on her social worker's letter of September 24, 2014 to argue that BPD has a target treatment time of a minimum of two years. The ministry's position, as set out in its reconsideration decision, is that the physician has not indicated that the appellant's impairment is likely to continue for two years or more. Panel Decision Section 2 of the EAPWDA requires that a medical practitioner provide an opinion that an applicant's impairment is likely to continue for at least two years. The appellant's physician was equivocal with respect to duration of both the mental and physical impairments, and did not provide a direct response when offered the opportunity in the PR form. She indicated that she expected both types of impairment would benefit from treatment, but also indicated that the appellant has not followed up with physiotherapy and has so far decided not to accept the physician's recommendation of antidepressant/antianxiety medication. The social worker referred to a psychiatric assessment of possible BPD, and then expressed her view that such a diagnosis indicates a minimum treatment time of two years. The panel notes that we have not been provided with the psychiatric assessment, and that there is no evidence that the social worker is a medical practitioner. Accordingly, the panel can give little weight to the social worker's evidence on duration. In the panel's view, the ministry reasonably concluded that the evidence does not show that it is a medical practitioner's opinion that the appellant's impairment is likely to last for at least two years. Severe Physical Impairment The appellant did not expressly advance an argument with respect to having a severe physical impairment, though she did argue that she has knee pain that comes and goes and that her back pain can be very bad. The ministry's position is that the information provided is not evidence of a severe physical impairment. It argues that the physician reported no limitation to the appellant's physical functioning, and that the only limitation reported by the social worker is that the appellant needs periodic assistance with carrying/holding. Panel Decision A diagnosis of a serious medical condition does not in itself determine PWD eligibility or establish a severe impairment. An "impairment" is a medical condition that results in restrictions to a person's ability to function independently or effectively. To assess the severit airment and the EAAT 003(10/06/01)
extent of its im pact on dai l y func tion ing a s e vidence w hich perf orm i ng DLA is re stricted . The legisla ti on m at the discret io n o f the ministe r, taki ng into ac count also cle a r t hat the f undamental bas i s for the analysis in this case , t he phys ic ian and the social wo rke r. T he phy sici an i ndic a ted virtual ly no l i mit a t ions to t h e indicate d that the a ppellant might benef it fr o m fin anc a nd asses sment f o r custo m made ort h ot ics. The p h a p pella nt's MSK (musculoske let a l ) diagno s es are n emp loymen t in the future. In t he pan el' s v i e w finding a h i gher level of functioning than perfo r m i ng D LA. The onl worke r are that t h e appella nt periodic ally n e eds hel p limited with m ob il ity ev en thoug h s he manages independe on her a bility to mana ge basic ho u se k e epi ng. The app and g oes, a n d ba c k pain that c a n get " very b ad", b ut t sig nif ican tl y restric ted by h e r physical heal th . The panel f inds that the min istry rea so na bly concluded the app e ll ant has a s eve re phy sic a l im pairment . Se ver e M ent al Impairme nt The appella n t 's po s ition i s tha t she suf fe r s from a li fe-She argu ed that t hes e c ondition s cause h er severe d fu ncti o n . S h e argue d th at the panel sh ou ld give m ore t h e app e llan t had not shared a s muc h i nfor m atio n with he t he PR w ith min ima l input fro m th e appell an t . The mi n i s try ' s positi on is that th e e viden ce doe s n ot es m in istry a rgued that t he evidence of b o t h pres cribed not have an y s i gn i fic ant difficulties with communication. worker id enti fied a m ajor imp act to only one a rea co t hat all the rem a ining categories sho wed only mod erate, Panel Decision Section 2(1)(b) of the EAPWDR prescribes two DLA that are specific to mental impairment-make decisions about personal activities, care or finances (decision making), and relate to, communicate or interact with o thers effectively (social functioning). T he social w orker's evidence in dicates that t he appell decision making in that she independently manages the decision making aspects of daily shopping (making appropriate choices), manage personal medication (filling/refilling/taking as directed), manage personal finances (banking, budgeting) and social functioning (appropriate social decisio Both the h sician and the social worker confirmed that the a EAAT 003(10/06/01) APPE A L# I d b y f unctional ski l l l imitations and th e d egr ee t o a k es it clea r that t h e de termina tion o f s eve rity i s all o f t h e evidenc e. Howev er , t h e leg i slation i s i s t he evidenc e f rom a prescr ibed prof es sional- ap pellant' s phys ica l functio nal skills, b ut ial ass i sta n ce for physiotherapy, a knee br ace, y sicia n also offered her opini on th a t the ot si gn i fi c an t e n ough to preve nt her from fin ding and maintaining employm e n t gener ally requires y phys ical lim itations no ted b y t he social wit h car ryin g /holdin g , t h at she "a t t i m es " is ntly, and that back pa in has "some impa ct " el lant wr o te th at she has k nee p ain tha t comes h e re is n o e vide nce t hat her activities are tha t the evidence do es n ot demons trate t h a t long s o ci al anx iet y disord er and p o ssi ble BPD . is tr es s and sign ificant ly re strict he r abil ity to weig h t to the soci a l wo r ker's evi d en ce sin ce r p hy sician, and t he phy sici a n com plet ed tabl i s h a se vere mental i mpairment. The profes sion a ls indicated tha t th e a p pe l l ant does The ministry als o argues that the social g nit ive a n d emo t i ona l funct ioning (emo tion ), and minimal or no i m pa ct. ant is not significantly restrict ed with respect to ns). ellant is makin her own decisions
w i t h r e s p e c t t o w h e t h e r t o t a k e a n t i a n x i e t y / a n t i d e p r e d e s c r i b i n g t h e a p p e l l a n t a s b e i n g " p r e c o n t e m p l a t i v W i t h r e s p e c t t o t h e D L A o f s o c i a l f u n c t i o n i n g , t h e p h e x p e r i e n c e p e r i o d i c r e s t r i c t i o n s , b u t s t a t e d t h a t s h e T h e e v i d e n c e o f t h e s o c i a l w o r k e r a n d t h e a p p e l l a n t g r o u p s e t t i n g s . T h e p a n e l n o t e s t h a t w h i l e t h e s o c i a c o n t i n u o u s s u p p o rt a n d s u p e r v i s i o n w i t h r e s p e c t t o h a s " v e r y d i s r u p t e d f u n c t i o n i n g " w i t h r e s p e c t t o h e r i n d i c a t e d t h a t w h e n e v e r s h e g o e s o u t s h e d o e s s o i a n d t h a t s h e r e l i e s h e a v i l y o n h e r r o o m m a t e s f o r m e a n d f o r g r o c e r y s h o p p i n g . T h i s i n d i c a t e s t o t h e p a n f r o m o t h e r s w h e n r e q u i r e d , a n d t h a t s h e d o e s h a v e s o c i a l w o r k e r ' s e v i d e n c e w i t h r e s p e c t t o t h e a p p e l l a a p p e l l a n t m a n a g e s t o f u l f i l l h e r b a s i c n e e d s i n t h i s a W i t h r e s p e c t t o t h e i m p a c t s t o c o g n i t i v e a n d e m o t i o i n d i c a t e d t h a t w h i l e t h e a p p e l l a n t d o e s e x p e r i e n c e a i m p a c t s a r e m o d e r a t e t o m i n i m a l . C o n s i d e r i n g t h e e v i d e n c e a s a w h o l e , i n c l u d i n g e v i d a r e g o o d i n v i rt u a l l y a l l r e s p e c t s , a n d t h a t t h e a p p e l l B P D , t h e p a n e l c o n c l u d e s t h a t t h e m i n i s t r y r e a s o n a s e v e r e m e n t a l i m p a i r m e n t . S i g n i f i c a n t R e s t r i c t i o n s t o D L A T h e a p p e l l a n t ' s p o s i t i o n i s t h a t h e r s o c i a l a n x i e t y a n p e r f o r m D L A , p a r t i c u l a r l y t h o s e t h a t r e q u i r e i n t e r a c t a l o n g w i t h h e r k n e e a n d b a c k p a i n , t o g e t h e r s i g n i f i c 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 s i n c e t h e a p p e l l a n t m a m e a l p r e p a r a t i o n a n d s o m e a s p e c t s o f s o c i a l f u n c t i o a b i l i t y t o m a n a g e D L A c o n t i n u o u s l y o r p e r i o d i c a l l y f o p r o f e s s i o n a l e v i d e n c e d o e s n o t p r o v i d e i n f o r m a t i o n s u p p o r t / s u p e r v i s i o n t h e a p p e l l a n t r e q u i r e s m a n a g i n g 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 s . 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A r e q u a n d s i g n i f i c a n t r e s t r i c t i o n s o f D L A i n c o n s i d e r a t i o n o c a s e t h e a p p e l l a n t ' s p h y s i c i a n a n d s o c i a l w o r k e r . T fa c t o r e d i n a s r e q u i r e d t o p r o v i d e c l a r i f i c a t i o n o f t h e l a n g u a g e m a k e s i t c l e a r t h a t t h e p r e s c r i b e d p r o f e s s d e t e r m i n a t i o n a s t o w h e t h e r i t i s " s a t i s f i e d " . T h e l e i s l a t i o n r e u i r e s t h a t a s e v e r e i m a i r m e n t d i r EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # s s a n t m e d i c a t i o n , w i t h t h e s o c i a l w o r k e r e " r e g a r d i n g t r e a t m e n t . y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t d o e s h a d o b s e r v e d n o a n x i e t y o n a o n e t o o n e b a s i s . 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 f e e l s m o s t a n x i o u s i n l w o r k e r h a s i n d i c a t e d t h a t t h e a p p e l l a n t r e q u i r e s m o s t a s p e c t s o f s o c i a l f u n c t i o n i n g , a n d t h a t s h e i m m e d i a t e s o c i a l n e t w o r k , t h e a p p e l l a n t h a s n t h e c o m p a n y o f a " c l o s e f r i e n d " o r a r e l a t i v e , a l p r e p a r a t i o n b e c a u s e o f a l a c k o f m o t i v a t i o n , e l t h a t t h e a p p e l l a n t i s a b l e t o s e c u r e a s s i s t a n c e a c i r c l e o f s u p p o r t i v e f r i e n d s a n d r e l a t i v e s . T h e n t ' s e x t e n d e d s o c i a l n e t w o r k i n d i c a t e s t h a t t h e r e a . n a l f u n c t i o n i n g , t h e s o c i a l w o r k e r i n t h e A R m a j o r i m p a c t i n t e r m s o f e m o t i o n , a n y o t h e r e n c e t h a t t h e a p p e l l a n t ' s c o m m u n i c a t i o n s k i l l s a n t i s s t i l l i n t h e p r o c e s s o f b e i n g a s s e s s e d f o r b l y d e t e r m i n e d t h a t i t d o e s n o t d e m o n s t r a t e a d B P D t r a i t s s i g n i f i c a n t l y l i m i t h e r a b i l i t y t o i o n w i t h o t h e r s . S h e a r g u e d t h a t t h e s e f a c t o r s , a n t l y l i m i t h e r a b i l i t y t o p e r f o r m D L A . n a g e s v i r t u a l l y a l l D L A i n d e p e n d e n t l y , e x c e p t f o r n i n g , s h e i s n o t s i g n i f i c a n t l y r e s t r i c t e d i n h e r r e x t e n d e d p e r i o d s . T h e m i n i s t r y a r g u e d t h a t t h e t o e x p l a i n t h e t y p e , d e g r e e a n d t h e d u r a t i o n o f t h e s o c i a l f u n c t i o n i n g . i r e s t h e m i n i s t e r t o s u b s t a n t i a l l y a s s e s s d i r e c t f t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , i n t h i s h i s d o e s n ' t m e a n t h a t o t h e r e v i d e n c e s h o u l d n ' t b e p r o fe s s i o n a l e v i d e n c e , b u t t h e l e g i s l a t i v e i o n a l ' s o p i n i o n i s f u n d a m e n t a l t o t h e m i n i s t r y ' s e c t l
ability t o perform DLA e ither c ontinuously or periodically for extended peri means t hat t here must be a causa l link between t h e r estriction must also be signif icant. Finally, th ere is dire ct and significant restriction may be eit her co ntinuous exten ded time. Inherently, any ana l y sis of p e riodicity m fre quency. All other th ings b eing eq u al, a restric tion signifi cant t h an one whi ch o ccurs several t imes a week. ev idence indicate s that a r estriction arises period ica evidence of the duration and frequenc y of the re st r ic cr iterion i s met. In the appellant's case, the ev id e nce of th e two profe i ndependent ly m an ages virtua l ly a l l tasks rel ated to almost all DLA. in finding that the appellant i s restricted in a spec ts of reported tha t the a ppellant requires continuous assistan to lack of motiv ation, and t h at she re lies on her roomma T he panel not es t hat ther e i s c onf l ic ting e v idence wit res trictions t o the ap pella n t's abi lit y to p e r fo rm DLA. p er iodi c a s si s t ance wit h social funct ioning, sinc e she ap s o ci al wor ker's view, the a ppell a nt is continu ously restricted T he e v id ence indica tes t o t h e panel t hat t h e appel lant that she is st ill in the pr oces s of be ing assessed for functionin g wit h treatme n t. Consi de rin g the e vi denc reaso nably de termi ned that the ev idence is insufficient to show the appellant' s abi li ty to per form her DL A is s i g nifi cantl for e x t end ed per io d s. Help wi th DL A The ap pellant's position is tha t s he requi res co ns ta n d ue t o the re st rict ions sh e e xp e riences. T he mi nistry's posit ion is that since it has not been established that the appe significan tly restricted, it can not be dete rm ine d that significant h Pa n el Decision A finding t hat a sev e re impairment directly and s i gnificantly DLA e i ther c ontinuously or periodically for an exte n de "help" as defined by se c tion 2(3)(b) of the EAPWDA. precondition has not been satisfied on the balance of probabilities in this case. Accordingly, the panel find s that the minis t ry reasonably concluded it co the appellant requires help with DLA as defined by section 2(3)(b) of the EAPWDA. EAAT 003(10/06/01) AP PE A L # ! od s. The ter m "di rectly" severe impairment and th e restriction . The dire ct a component re lated to time o r duratio n. The or periodic. If it is periodi c it must be for an ust also include consider a t ion of the that only ari s e s o n ce a year i s less li kely to be Accordingly, in c ircum st ances wh e re the ll y , it is appropri a t e for the ministry t o r equire tion in orde r to be "satisfied" that thi s legislativ e ss io n als is consistent that the a ppell a n t B o t h professionals are consisten t social functioning. The social work er has also ce with most aspects of meal preparation due tes for this f u nc tio n. h respe ct t o the tim e or dura ti on of the The physic ian n o ted tha t the ap pell ant requi res pears t o functi on w e l l one -o n -o ne . I n the by her impairme n ts. ma n a g e s most a sp ec ts of DLA ind e pend e n t ly, BPD, and that ther e is a prospe c t o f i mpr o ved e as a wh ole , the pa ne l finds t hat t h e mini s t ry o n t h e balan ce o f probabilitie s t hat y restricted either conti nu o us l y o r per iod ically t help wi th DLA fr om ro ommates and re latives llant's DLA a r e elp is req u ire d f ro m other persons. restricts a person's ability to manage her d period is a pr ec ondition to a person r equiring Fo r the reasons provided above, that uld not be determine d tha t
C o n c l u s i o n T h e p a n e l a c k n o w l e d g e s t h a t t h e a p p e l l a n t ' s m e d i c a H o w e v e r , h a v i n g r e v i e w e d a n d c o n s i d e r e d a l l o f t h e f i n d s t h a t t h e m i n i s t r y ' s d e c i s i o n f i n d i n g t h e a p p e l l a n 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 c i r c u m s t a n c e s o f m i n i s t r y ' s d e c i s i o n . EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # l c o n d i t i o n s a f f e c t h e r a b i l i t y t o f u n c t i o n . e v i d e n c e a n d t h e r e l e v a n t l e g i s l a t i o n , t h e p a n e l t i n e l i g i b l e f o r P W D d e s i g n a t i o n i s a r e a s o n a b l e t h e a p p e l l a n t . T h e p a n e l t h e r e f o r e c o n f i r m s t h e
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.