Ministry of Social Development and Poverty Reduction

Decision Information

Decision Content

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 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 N o v e m b e r 4 , 2 0 1 4 w s u p p l e m e n t t o c o v e r t h e c o s t o f c u s t o m i z a t i o n o f a m 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 Wi t h D i s a b p r e s s u r e r e l i e f . 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 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 S e c t i o n s 3 , 3 . 6 a n d 3 . 7I I I 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 ( m i n i s t r y ) h i c h d e n i e d t h e a p p e l l a n t ' s r e q u e s t f o r a a t t r e s s u n d e r S e c t i o n 3 . 7 o f S c h e d u l e C o f t h e i li t i e s R e g u l a t i o n ( E A P W D R ) f o r t h e p u r p o s e s o f n ( E A P W D R ) , S e c t i o n 6 2 a n d S c h e d u l e C ,
APPEAL# I PART E -Summary of Facts The appellant did not attend the hearing but was represented by an advocate who he had previously authorized to attend the hearing on his behalf, being the Occupational Therapist who supported his request. The evidence before the ministry at the time of the reconsideration decision included: 1) Medical Equipment Request and Justification signed by the appellant on September 27, 2013 with the medical equipment recommended by the medical practitioner being a hospital bed with mattress as prescribed by Occupational Therapist (OT); 2) Undated Health Needs Request requesting a "mattress for fully electric hospital bed at an estimated cost of $1,251.32; 3) Product information sheet for an LT C 2500 basic comfort mattress, which is designed for clients with muscle weakness who find it difficult to move in bed; 4) Quote from a health product company dated April 15, 2014 for a Custom L TC 4000 Ultra 55 Mattress with incontinent cover (custom top memory foam layer thickness and transition layer density) for the total amount of $1,251.31; 5) Letter dated May 12, 2014 from the OT 'To Whom It May Concern' requesting funding for a hospital bed mattress. The OT wrote that that: • The appellant has severe spinal stenosis, Parkinsons, heart failure, renal failure, prostate cancer, diabetes, legal blindness and left hemiparesis from two cerebral vascular accidents. • The appellant has severe back pain caused by spinal stenosis and wears a custom back brace. He requires a very firm mattress. • The targeted outcomes are improved safety of transfers to and from bed, improved bed mobility, reduced falls, and improved sleep so physical function during the day can be maximized. • The equipment trialed included an LT C 3500, which was unsuccessful as the appellant's back pain aggravated and he could not tolerate it for an entire night. He slept poorly and he was up much of the night which disturbed his wife's sleep and she is his primary caregiver. • The L TC 4000, Ultra 55 was trialed and the appellant found this mattress better than the LT C 3500 but still requested a firmer mattress because of back pain. The manufacturer reports that this is their firmest mattress but they can make some customization to make it firmer. • The recommended equipment is the custom LT C 4000 with Ultra 55 Mattress with incontinent cover, customizations to increase the firmness of the mattress include reducing the top memory foam layer from 2" to 1.5" and increasing the thickness of the middle core foam to 2.5." • The appellant requires a firm mattress to minimize his back pain and improve his physical function. 6) Fax dated July 23, 2014 from the OT to the ministry stating in part that: • The L TC 2500 is the most basic foam mattress and is designed for those who are not at risk for pressure sore development at all. It is not appropriate for the appellant. • The appellant has the following risk factors for pressure sore development: urinary incontinence, poor mobility and chronic pain which limits positions he can sustain to offload. The appellant has Parkinson disease which is a progressive condition and his mobility is expected to decline.
• I t i s e s s e n t i a l t h e a p p e l l a n t h a s a m a t t r s e v e r e t h a t i t c a n i m p a i r h i s m o b i l i t y a t a k e s h i g h d o s a g e o f a n a l g e s i c a n d h e h a s t o l d h i m t h a t i t w o u l d n o t b e s a f e t • I t i s t h e O T ' s p r o f e s s i o n a l o p i n i o n t h a t m o s t a p p r o p r i a t e m a t t r e s s f o r t h e a p p 7 ) P u r c h a s e A u t h o r i z a t i o n d a t e d A u g u s t 2 6 , 2 0 1 t h i s m a t t r e s s i s t h e m a n u f a c t u r e r ' s b e s t c h o i c d e v e l o p m e n t a n d i n d i v i d u a l s r e q u i r i n g a f i r m u p c h a r g e f o r m o d i f i c a t i o n " i s a p p r o v e d a t a t o 8 ) M i n i s t ry f i l e n o t e s i n d i c a t i n g t h a t a d d i t i o n a l j u s a s t h e a p p e l l a n t r e q u i r e s a f i r m m a t t r e s s a n 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 n a n d n e e d f o r e a s o n a b l e t o f u n d t h e L T C 4 0 0 0 U l t r a 5 5 , l e s f i r m e r ; a n d , 9 ) R e q u e s t f o r R e c o n s i d e r a t i o n d a t e d O c t o b e r 1 S e p t e m b e r 4 , 2 0 1 4 w h i c h i n d i c a t e s a p r i m a r y s t e n o s i s , h e a r t f a i l u r e , d i a b e t e s a n d p r o s t a t e i n c r e a s e f i r m n e s s o f h o s p i t a l b e d m a t t r e s s ; t h a t t a c h e d i s a l e t t e r d a t e d O c t o b e r 2 2 , 2 0 1 4 i n • T h e a p p e l l a n t h a s s e v e r e b a c k p a i n c a b a c k b r a c e . • H e r e q u i r e s a v e r y f i r m m a t t r e s s . T h i s b u t i t i s a l s o t o i m p r o v e t h e a p p e l l a n t ' s b e t t e r o n a f i r m e r s u r f a c e b e c a u s e h i s b e t t e r d u r i n g t h e d a y a n d h e i s l e s s l i k e • T h e a p p e l l a n t a l s o w a k e s h i s w i f e u p l e c a r e g i v e r b u r n o u t . I n h i s N o t i c e o f A p p e a l d a t e d N o v e m b e r 2 6 , 2 0 1 4 , t h 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 e c i s i o n a n d w r o t e t h a t t h b a c k p a i n a n d p o o r s l e e p . A t t h e h e a r i n g , t h e a p p e l l a n t ' s a d v o c a t e s t a t e d : • T h e a p p e l l a n t h a s h a d t r i a l s o f t w o m a t t r e s s e s u n c u s t o m i z e d L T C 4 0 0 0 U l t r a 5 5 a t h o m e , w h a s i t w a s t h e b e s t o f t h e t w o t r i e d . • D u r i n g t h e d a y , t h e a p p e l l a n t w e a r s a c u s t o m b i n d i n g s , s i n c e h e e x p e r i e n c e s s i g n i f i c a n t c h r • T h e m i n i s t r y s e e m e d t o g e t h u n g u p o n t h e i s b u t t h e a p p e l l a n t d i d n o t r e q u e s t a n a d d i t i o n a s t a n d a r d w i t h t h e L T C 4 0 0 0 U l t r a 5 5 m a t t r e s s a m o u n t o f f u n d i n g f o r a n i n c o n t i n e n t c o v e r . • T h e a p p e l l a n t r e q u i r e s c u s t o m i z a t i o n t o m a k e u p c h a r g e o f $ 1 6 0 f o r t h e m a n u f a c t u r e r t o m a k o n l y f o r t h e c u s t o m i z a t i o n w o r k a n d d o e s n o t • T h e m a n u f a c t u r e r w i l l r e d u c e t h e t h i c k n e s s o f I A P P E A L # e s s t h a t h e c a n t o l e r a t e a s h i s b a c k p a i n i s s o n d h i s s l e e p a n d t h a t o f h i s w i f e . T h e a p p e l l a n t h a s d i s c u s s e d t h e i s s u e w i t h h i s p h y s i c i a n w h o o t a k e a n y m o r e a n a l g e s i c . t h e c u s t o m L T C 4 0 0 0 U l t r a 5 5 m a t t r e s s i s t h e e l l a n t . 4 i n d i c a t i n g t h a t b a s i c f u n d i n g w a s p r o v i d e d a s e f o r i n d i v i d u a l s a t r i s k f o r p r e s s u r e s o r e m a t t r e s s . T h e L T C 4 0 0 0 U l t r a 5 5 m a t t r e s s , " l e s s t a l c o s t o f $ 1 , 0 8 8 . 1 0 . t i f i c a t i o n w a s r e c e i v e d f o r t h e L T C 4 0 0 0 U l t r a 5 5 t h i s i s t h e s u p p l i e r ' s f i r m e s t m a t t r e s s . B a s e d o n r a m a t t r e s s f o r h i s h o s p i t a l b e d , i t s e e m s s t h e u p c h a r g e f o r t h e m o d i f i c a t i o n s t o m a k e i t 6 , 2 0 1 4 w i t h a t t a c h e d P r e s c r i p t i o n d a t e d d i a g n o s i s f o r t h e a p p e l l a n t o f P a r k i n s o n s , s p i n a l c a n c e r . T h e p h y s i c i a n o r d e r s " c u s t o m i z a t i o n t o e c u s t o m i z a t i o n i s m e d i c a l l y n e c e s s a r y . " A l s o w h i c h t h e O T w r o t e : u s e d b y s p i n a l s t e n o s i s a n d w e a r s a c u s t o m r e q u e s t i s n o t s i m p l y f o r t h e a p p e l l a n t ' s " c o m f o r t " p h y s i c a l f u n c t i o n d u r i n g t h e d a y . H e s l e e p s b a c k p a i n i s m i n i m i z e d a n d t h u s h i s m o b i l i t y i s l y t o f a l l . s s t h r o u g h o u t t h e n i g h t r e s u l t i n g i n l e s s e a p p e l l a n t e x p r e s s e d h i s d i s a g r e e m e n t w i t h t h e e m a t t r e s s a p p r o v e d i s t o o s o f t a n d r e s u l t s i n a t h o m e . T h e a p p e l l a n t s t i l l h a s a n i c h i s o n l o a n f r o m t h e h e a l t h p r o d u c t s u p p l i e r , b a c k b r a c e , w h i c h i s l i k e a c o r s e t w i t h m a n y t i g h t o n i c p a i n a n d t a k e s l o t s o f a n a l g e s i c s . s u e o f t h e i n c o n t i n e n t c o v e r w i t h t h e m a t t r e s s , l i n c o n t i n e n t c o v e r o t h e r t h a n t h e o n e t h a t c o m e s . T h e a p p e l l a n t d i d n o t r e q u e s t a n a d d i t i o n a l t h e m a t t r e s s e v e n f i r m e r a n d t h e r e i s a n e t h e s e a l t e r a t i o n s . T h i s a d d i t i o n a l a m o u n t i s i n c l u d e a n e x t r a a m o u n t f o r a n i n c o n t i n e n t c o v e r . t h e t o p f o a m l a v e r a n d i n c r e a s e t h e t h i c k n e s s o f
APPEAL# I the f o am in the middle of the mattress to make the mattress extra firm. • The appellant is very frail and lives at home. His wife is his main caregiver. They are trying to keep the appellant as home and out of residential care. • When the appellant does not have a restful sleep, he wakes up in pain and requires more analgesics. The appellant's physician has said that it is not safe for him to take any more analgesics than he already takes. • The advocate and the appellant were confused by the ministry's decision because it seemed to both approve and deny the customization for the L TC 4000 Ultra 55 mattress and they completed the paperwork because the appellant needs that additional customization to support his back and they thought this was the only way to clear up any confusion. • The original Purchase Authorization provided by the ministry dated August 26, 2014 was f o r approval of the LTC 4000 Ultra 55 mattress, "less upcharge for modification," at a total cost of $1,088.10. At the hearing, the appellant's wife stated: • She has a hard time sleeping when her husband cannot sleep. • Her husband suffered an attack many years ago where he was hit and had to have surgery on his back. • She sees her husband in pain the next day when he has not slept well. He grimaces. • They receive one hour of home care in the morning but otherwise she is caring for her husband and she sees the need for the mattress to be firmer. • The mattress the appellant is currently sleeping on has been lent to them and had previously been used by others. Her husband finds it too soft and she feels it is becoming urgent that he get the customization to make it firmer. • Her husband has been to a rehabilitation specialist who said that there is nothing more that can been done f o r him. There are no exercises or massage therapy or surgery that will help him. Admissibility of New Information The ministry did not raise an objection to the oral testimony on behalf of the appellant or the inf o rmation provided in his Notice of Appeal, which consisted of additional information regarding the appellant's need for customization of the subject mattress. The panel admitted this additional information as being in support of information and records that were before the ministry at the time of reconsideration, in accordance withs. 22(4)(b) of the Employment and Assistance Act. The ministry relied on its reconsideration decision. At the hearing, the ministry clarified that: • The appellant has been found eligible for the customization of the approved mattress, the LT C 4000 Ultra 55, under Section 3.6(1)(b) of Schedule C of the EAPWDR as the ministry considers the customization to make the mattress firmer as an "upgraded component of a hospital bed." While the original decision only approved the LT C 4000 Ultra 55 mattress without the customization, the ministry also approved the customization at reconsideration based on the additional information provided by the physician in the prescription and the letter from the OT. If the total amount for the LT C 4000 Ultra 55 mattress with customization to make it firmer is $1,251.31, as set out in the Quote from a health product company dated April 15, 2014, then that is the amount for which the ministry will issue a new Purchase Authorization. • The minist wants to ensure that all the le islation which ma be a licable is considered in
APPEAL# I the reconsideration decision and this is the reason that Section 3. 7 of Schedule C of the EAPWDR was considered. The ministry found that the appellant was not eligible for the customization to make the mattress firmer under the section which relates to pressure relief mattresses. • The ministry had originally considered the incontinent cover as a separate item for which the appellant is not eligible but clarified in the reconsideration decision that the approved mattress, the LT C 4000 Ultra 55, comes standard with an incontinent cover.
APPEAL# I PART F -Reasons for Panel Decision The issue on the appeal is whether the ministry's reconsideration decision, which denied the appellant's request for a supplement to cover the cost of customization of a mattress under Section 3. 7 of Schedule C of the Employment and Assistance for Persons With Disabilities Regulation (EAPWDR) for the purposes of pressure relief, is reasonably supported by the evidence or a reasonable application of the applicable enactment in the circumstances of the appellant. Pursuant to Section 62 of the EAPWDR, the applicant must be a recipient of disability assistance, or be a dependant of a person in receipt of disability assistance in a variety of scenarios. If that condition is met, Schedule C of the EAPWDR specifies additional criteria that must be met in order to qualify for a health supplement for various items. In this case, the ministry has not disputed that the requirement of Section 62 has been met in that the appellant has been approved as a recipient of disability assistance. At issue is whether the appellant's request for customization of a mattress meets the requirements under Schedule C of the EAPWDR. Section 3 provides in part: 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 (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: (a) a prescription of a medical practitioner or nurse practitioner for 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. Section 3.6 of Schedule C provides: Medical equipment and devices -hospital bed 3.6 (1) Subject to subsection (3) 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 facilitate transfers of a person to and from bed or to adjust or maintain a person's positioning in bed: (a) a hospital bed; (b) an upgraded component of a hospital bed; (c) an accessory attached to a hospital bed;
( d ) a p o s i t i o n i n g i t e m o n a h o s p i t a l b e d . ( 2 ) 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 d e s c r i b e d i n s u b s e c t i o n ( 1 ) o f t h i s s e c t i o n i s 5 y e a r s f r r e p l a c e d . ( 3 ) T h e f o l l o w i n g i t e m s a r e n o t h e a l t h s u p p l e m e n t s f o r t h e ( a ) a n a u t o m a t i c t u r n i n g b e d ; ( b ) a c o n t a i n m e n t t y p e b e d . S e c t i o n 3 . 7 o f S c h e d u l e C p r o v i d e s : M e d i c a l e q u i p m e n t a n d d e v i c e s p r e s s u r e r e l i e f m a t t r e s s 3 . 7 ( 1 ) A p r e s s u r e r e l i e f m a t t r e s 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 s a t i s f i e d t h a t t h e p r e s s u r e r e l i e f m a t t r e s s i s m e d i c a l l y e i n t e g r i t y . ( 2 ) 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 i n s u b s e c t i o n ( 1 ) o f t h i s s e c t i o n i s 5 y e a r s f r o m t h e d a t e M i n i s t ry ' s p o s i t i o n 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 t h e a p p e l l a n t i s e l i g i b l e o f t h e E A P W D R a n d t h e a p p e l l a n t i s e l i g i b l e f o r a s u m a t t r e s s u n d e r S e c t i o n 3 . 6 ( 1 ) ( b ) o f S c h e d u l e C , a s a r e q u e s t d o e s n o t m e e t a l l o f t h e a p p l i c a b l e c r i t e r i a o E A P W D R . I n p a r t i c u l a r , t h e m i n i s t r y s t a t e d t h a t t h e r e q u i r e s c u s t o m i z a t i o n o f t h e m a t t r e s s f o r t h e p u r p o s a p p e l l a n t ' s s e v e r e c h r o n i c b a c k p a i n . T h e m i n i s t r y s h a s n o t b e e n m e t a s t h e m i n i s t r y i s n o t s a t i s f i e d t h a t ' a p p r o p r i a t e ' m e d i c a l e q u i p m e n t o r d e v i c e a s t h e a p p a p p r o v a l o f t h e L T C 4 0 0 0 U l t r a 5 5 m a t t r e s s . A p p e l l a n t ' s p o s i t i o n 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 t h e a p p r o v e d L T C 4 0 t r i e d b u t h e r e q u i r e s c u s t o m i z a t i o n o f t h e m a t t r e s s t o p a i n . T h e a p p e l l a n t d i d n o t m a i n t a i n a p o s i t i o n t h a t t m e d i c a l l y e s s e n t i a l t o p r e v e n t s k i n b r e a k d o w n a n d m c l a r i f i e d t h a t t h e a p p e l l a n t d i d n o t r e q u e s t a s e p a r a t e i n t h e Q u o t e f r o m a h e a l t h p r o d u c t c o m p a n y d a t e d A o n l y f o r t h e c u s t o m i z a t i o n t o m a k e t h e m a t t r e s s f i r m e P a n e l d e c i s i o n T h e m i n i s t r y c l a r i f i e d a t t h e h e a r i n g t h a t t h e a p p e l l a n c u s t o m i z a t i o n o f a m a t t r e s s u n d e r S e c t i o n 3 . 6 ( 1 ) ( b ) o h o s p i t a l b e d a n d , i f t h e t o t a l a m o u n t f o r t h e L T C 4 0 0 f i r m e r i s $ 1 , 2 5 1 . 3 1 a s s e t o u t i n t h e Q u o t e d a t e d A p r m i n i s t r y w i l l i s s u e a n e w P u r c h a s e A u t h o r i z a t i o n . T h t h a t t h e a p p e l l a n t d i d n o t r e q u e s t a n a d d i t i o n a l i n c o n s t a n d a r d w i t h t h e a r o v e d L T C 4 0 0 0 U l t r a 5 5 m a t t r A P P E A L # I S 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 i t e m 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 h e i t e m b e i n g 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 c h e d u l e : e s 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 c h e d u l e i f t h e m i n i s t e r i s s s e n t i a l t o p r e v e n t s k i n b r e a k d o w n a n dl m a i n t a i n s k i n S 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 i t e m d e s c r i b e d 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 h e i t e m b e i n g r e p l a c e d . t o r e c e i v e h e a l t h s u p p l e m e n t s u n d e r S e c t i o n 6 2 p p l e m e n t t o c o v e r t h e c o s t o f c u s t o m i z a t i o n o f a n u p g r a d e d c o m p o n e n t o f a h o s p i t a l b e d , b u t h i s f S e c t i o n s 3 a n d 3 . 7 o f S c h e d u l e C o f t h e O T d i d n o t m a i n t a i n a p o s i t i o n t h a t t h e a p p e l l a n t e s o f p r e s s u r e r e l i e f b u t , i n s t e a d , t o a l l e v i a t e t h e t a t e d t h a t t h e r e q u i r e m e n t i n S e c t i o n 3 ( 1 ) ( b ) ( i i i ) t h e c u s t o m i z a t i o n i s t h e l e a s t e x p e n s i v e e l l a n t ' s n e e d s h a v e b e e n m e t t h r o u g h t h e 0 0 U l t r a 5 5 m a t t r e s s i s t h e b e s t m a t t r e s s o f t h o s e m a k e i t m u c h f i r m e r t o a l l e v i a t e h i s s e v e r e b a c k h e c u s t o m i z a t i o n t o t h e s u b j e c t m a t t r e s s i s a i n t a i n s k i n i n t e g r i t y . T h e a p p e l l a n t ' s a d v o c a t e i n c o n t i n e n t c o v e r a n d t h e a d d i t i o n a l u p c h a r g e , p r i l 1 5 , 2 0 1 4 f o r t h e t o t a l a m o u n t o f $ 1 , 2 5 1 . 3 1 , i s r . t i s e l i g i b l e f o r a s u p p l e m e n t t o c o v e r t h e c o s t o f f S c h e d u l e C , a s a n u p g r a d e d c o m p o n e n t o f a 0 U l t r a 5 5 m a t t r e s s w i t h c u s t o m i z a t i o n t o m a k e i t i l 1 5 , 2 0 1 4 , t h e n t h a t i s t h e a m o J n t f o r w h i c h t h e e a p p e l l a n t ' s a d v o c a t e c l a r i f i e d J t t h e h e a r i n g t i n e n t c o v e r o t h e r t h a n t h a t w h i c l il c o m e s e s s . T h e m i n i s t s t a t e d t h a t t h e a e l l a n t ' s
r e q u e s t f o r t h e c u s t o m i z a t i o n o f t h e a p p r o v e d m a t t r e S e c t i o n s 3 a n d 3 . 7 o f S c h e d u l e C o f t h e E A P W D R a p o s i t i o n a t t h e h e a r i n g . C o n cl u s i o n I n 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 r e a s o a s u p p l e m e n t t o c o v e r t h e c o s t o f c u s t o m i z a t i o n o f a 3 . 6 ( 1 ) ( b ) o f S c h e d u l e C a n d , i n c o n s i d e r a t i o n o f t h i s r e q u i r e m e n t s u n d e r S e c t i o n s 3 a n d 3 . 7 o f S c h e d u l e r e l i e f , a n d i 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 a p p l i c a b A P P E A L # I s s d o e s n o t m e e t a l l o f t h e a p p l ( c a b l e c r i t e r i a o f n d t h e a p p e l l a n t ' s a d v o c a t e d i d o t d i s p u t e t h i s n1 I n a b l y 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 ' s r e q u e s t f o r m a t t r e s s m e e t s t h e r e q u i r e m e n t s o f S e c t i o n d e t e r m i n a t i o n , d o e s n o t m e e t a l l o f t h e C o f t h e E A P W D R f o r t h e p u r p o s e s o f p r e s s u r e l e e n a c t m e n t i n t h e a p p e l l a n t ' s c i r c u m s t a n c e s .
 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.