I APPEAL# PART C -Decision under Appeal The Ministry of Social Development and Social lnnovatiol) (the ministry) reconsideration decision dated 16 October 2014 determined that the appellant did not meet 3 of the 5 statutory requirements of section 2 of the Employment and Assistance for Persons with Disabilities Act for designation as a person with disabilities (PWD). The ministry found that the appellant met the age requirement and that his impairment is likely to continue for at least 2 years. However, the ministry was not satisfied that the appellant had a severe mental or physical impairment and that the appellant's mental or physical conditions, in the opinion of a prescribed professional, directly and significantly restricted his daily living activities (DLA) either continuously or periodically for extended periods. The ministry was also not satisfied that as a result of those restrictions, in the opinion of a prescribed professional, the appellant requires help to perform DLA. PART D -Relevant Legislation Employment and Assistance for Persons with Disabilities Act (EAPWDA), section 2 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR), section 2 EAAT003(10/06/01)
P A R T E S u m m a r y o f F a c t s 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 e • A 3 p a g e P W D A p p l i c a t i o n A p p l i c a n t I n f o r m a t i o n b e f o r e a w i t n e s s i n d i c a t i n g t h a t h e s u f f e r s f r o m m u w h e n h i s c o n d i t i o n i s s u c h t h a t h e c a n n o t g e t o u t o s t a t e d t h a t w h e n h e i s i n p a i n , i t ' s h a r d t o g o o u t , e m u c h w o r k h e c a n d o w i t h o u t g e t t i n g t i r e d . H e f o u n a r m a s w e l l a s w r i t i n g f o r a n y l e n g t h o f t i m e . B e c a u n i v e r s i t y a s a r e s u l t o f h i s c o n d i t i o n , h i s f i n a n c i a l a n d d e p l e t e d h i s a s s e t s . • A 8 p a g e P h y s i c i a n R e p o r t ( P R ) d a t e d 3 0 M a y 2 0 1 p h y s i c i a n i n d i c a t e d t h e f o l l o w i n g : o S p e c i f i c d i a g n o s i s : M S , m o o d d i s o r d e r s a n d o H e a l t h h i s t o r y : D i a g n o s e d w i t h M S i n e a r l y s h o w i n g h e a d , b a c k a n d l u m b a r p u n c t u r e . H a n t i d e p r e s s a n t s . H e e x p e r i e n c e s m o d e r a t e d i f f u s e p a r e s t h e s i a s , p a i n t o n e c k , b a c k a n d o S o m e p r e s c r i b e d m e d i c a t i o n o r t r e a t m e n t i n D L A b e c a u s e t h e y c a n c a u s e d r o w s i n e s s a a n t i c i p a t e d d u r a t i o n o f " m e d i c a t i o n s / t r e a t m o I n t e r m s o f f u n c t i o n a l s k i l l s t h e a p p e l l a n t d o n o t b e i n g a b l e t o l i f t m o r e t h a n 1 6 k g a n d n h o u r s . o I n t e r m s o f s i g n i f i c a n t d e f i c i t s w i t h c o g n i t i v e i d e n t i f i e s 7 a r e a s : c o n s c i o u s n e s s , e x e c u t i v e m o t o r a c t i v i t y a n d a t t e n t i o n o r s u s t a i n e d c o e m o t i o n a l s t a t e " i s a f f e c t i n g h i s f u n c t i o n t o a o I n t e r m s o f a d d i t i o n a l c o m m e n t s , t h e p h y s i c f r e q u e n t f l a r e u p s o f h i s M S a n d n e e d e d t o m a n a g e m e n t o f h i s s y m p t o m s , b e i n g u n a b l u s u a l l y b e d r i d d e n . H i s c o n d i t i o n p r e v e n t e d g o i n g t o s c h o o l o r w o r k i n g . H e w a s w a i t i n g o T h e a p p e l l a n t h a d b e e n h e r p a t i e n t s i n c e D 1 0 t i m e s s i n c e t h e n . • A n 1 1 p a g e A s s e s s o r R e p o rt ( A R ) a l s o d a t e d 3 0 M p h y s i c i a n a s t h e P R , i n d i c a t e d 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 l i v e s a l o n e . o D e p r e s s i o n a n d a n x i e t y i n t e r f e r e w i t h h i s a b c h r o n i c p a i n a f f e c t h i s a b i l i t i e s t o m a n a g e D o T h e a p p e l l a n t ' s a b i l i t y t o c o m m u n i c a t e b y s o I n t e r m s o f m o b i l i t y a n d p h y s i c a l a b i l i t y h e i p r o l o n g e d p e r i o d s o f t i m e a n d u n a b l e t o p e o I n t e r m s o f c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i m p a i r m e n t o r b r a i n i n j u r y , h i s m e n t a l i m p a i a s a m a j o r i m p a c t f o r b o d i l y f u n c t i o n s a n d e E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # t i m e o f r e c o n s i d e r a t i o n : d a t e d 2 M a y 2 0 1 4 a n d s i g n e d b y t h e a p p e l l a n t l t i p l e s c l e r o s i s ( M S ) a n d t h a t t h e r e a r e d a y s f b e d . H e h a d t o d r o p o u t o f u n i v e r s i t y . H e x e r c i s e o r g e t g r o c e r i e s a n d i t i m p a c t s o n h o w d i t h a r d t o l i f t a n y t h i n g b e c a u s e o f p a i n i n h i s u s e h e s t o p p e d w o r k i n g a n d d r o p p e d o u t o f s i t u a t i o n d e t e r i o r a t e d a n d h e h a d g o n e i n t o d e b t 4 c o m p l e t e d a n d s i g n e d b y t h e a p p e l l a n t ' s a n x i e t y d i s o r d e r s . 2 0 1 3 , c o n f i r m e d b y n e u r o l o g i s t a n d M R I e h a s t r i e d a n u m b e r o f m e d i c a t i o n s a n d t o s e v e r e f a t i g u e , g e n e r a l i z e d w e a k n e s s , e x t r e m i t i e s , a n x i e t y , i n s o m n i a a n d d e p r e s s i o n . t e r f e r e s w i t h t h e a p p e l l a n t ' s a b i l i t y t o p e r f o r m n d c o n s t i p a t i o n a s w e l l a s s o m e f a t i g u e a n d t h e e n t s " i s i n d i c a t e d a s " u n c e r t a i n " . e s n o t h a v e a n y l i m i t a t i o n i d e n t i f i e d o t h e r t h a n o t b e i n g a b l e t o r e m a i n s e a t e d f o r m o r e t h a n 2 a n d e m o t i o n a l f u n c t i o n s , t h e p h y s i c i a n , m e m o r y , e m o t i o n a l d i s t u r b a n c e , m o t i v a t i o n , n c e n t r a t i o n a n d c o m m e n t s t h a t t h e a p p e l l a n t ' s s i g n i f i c a n t d e g r e e . " i a n w r o t e t h a t t h e a p p e l l a n t e x p e r i e n c e d a t t e n d E m e r g e n c y r e g u l a r l y f o r a c u t e e t o f u n c t i o n d u r i n g t h o s e t i m e s a n d b e i n g h i m f r o m d o i n g a n y p r o l o n g e d a c t i v i t i e s l i k e f o r a t r i a l o f n e w m e d i c a t i o n . e c e m b e r 2 0 1 3 a n d t h a t s h e h a s s e e n h i m 2 t o a y 2 0 1 4 , c o m p l e t e d a n d s i g n e d b y t h e s a m e i l i t y t o w o r k a n d p o o r m o t o r s t r e n g t h a n d L A . p e a k i n g , r e a d i n g , w r i t i n g a n d h e a r i n g i s g o o d . s i n d e p e n d e n t w i t h a l l a c t i v i t i e s b u t n o t f o r r f o r m i f h e h a s a n a t t a c k . i n g w h e n t h e r e i s a n i d e n t i f i e d m e n t a l r m e n t r e s t r i c t s o r i m p a c t s h i s d a i l y f u n c t i o n i n g m o t i o n , m o d e r a t e i m p a c t o n m o t i v a t i o n , m o t o r
activity and o th er m en t al prob lems, and m inimal a ttenti o n /conc e n tration, executive and memory. There are no impacts wrote in comments that depr ession an d an xiety educa tional plans, being unable t o focus, conce counseling and was on a wait list for a psychia o In terms of DLA, he i s ind ependen t exc ept for the f • Basic housekee p i ng : Has assistance • Cooking: Needs help when fatigued. • As a g e neral comment, the ph ysician other activiti es ex cept when he had a o His mental impairment was described as impacti social network as mar g inal func tioni ng since he has issues wit depress ed or anxious as he gets angry at times. I d es cribed as g o od functioning. o The appell ant has as sistance fr o m f amil y a co u ns e li ng is p aid fo r by the appellant . o H e did no t need a s sistive devi ce s or h ave an ass o T he a p pel l ant wa s co m p liant w ith treatm e n exper ienced side effect s. He tri ed to keep w en ded u p to be un abl e to work . He al s o tried to re o The AR' s au thor is the appellant ' s fa mily physi m e n tal and ph ysi cal sy mptoms and she se es • A l ong w i th the PR a nd t h e AR w e r e 7 medi c al reports o Fr om a consu lta nt neur ol ogist, 3 repo rts d ated A u gust 2 0 1 3 d ealing w ith symptoms the appella w it h his MS . o Fro m a physician at an outpa tient c l inic, o ne repor appell a nt had " a n ep i sode of ne ck do wn n umbness l ar ge l y res o l ved but h e has so me residual h ri ght eye and eye moveme n t pain for a we ek p h y sicia n noted t hat he reassured the appellant pr o babl y back to normal." o F r om t h e app e ll ant ' s neur olo gi st, 3 rep orts and 25 Ap ril 201 4 indicated t hat he discussed wit t he appellant was undecided about, the appellant went abroad and upon his retu this trip, that he went back for follow up and that the appellant wa h ad no c lea r relapses but c ontinued s uffering would see him in 6 mont h s. He c oncluded: as 2, with none of the symptoms with objective findings. Chronic pain seems to b issue." • A letter from the appellant's physician dated 19 August 2014 approval of his PWD designation "as he will be attending school on Sept. 3, 2014 and requires financial assistance prior to that" and that his employment insurance payments expired on 16 August 2014. • A 7-page report by a prescribed professional (a registered nurse -RN) dated 29 September 2014 indicated the following: EAAT 0 03(1 0 /06/ 0 1 ) I A PPEAL# impa ct on consciousne ss , on o ther areas. She caused the appellant to withdraw from his n trate or keep motiv ated. H e was att e n ding trist. ollowing a ctivities: with cleaning due to pain and fatigue. mentioned t hat he was in d e p e ndent w i th the fla r e up of his MS . ng his relation ship w i th his immediate h h i s family when he is n terms of extende d social networks it is nd friends when he i s sic k. Housecl eaning and is tanc e a n imal. t and medi cation t hat wer e t r ied an d o rking but p rove d to be i n credibly di f f icul t and ma in active. c i a n th a t is coor dinating his cur e for h is him on a reg ul a r basi s. pertain ing to the ap pe l lant a s follows: 22 J a n ua ry 2013, 27 Ju ne 2 0 13 and 23 n t had and the d i f fi c ul ties he h a d t o dea l t date d 2 3 A pr il 2013 ind icated tha t t he th at laste d 2 or 3 mo nths whic h i s and numbness. He ha d blurred vi sio n i n t h e r e c en t l y th at h e says is b ack to no r mal ." The "tha t h is r ec ent po ss ib le optic neuritis is da ted 2 9 N ov e mber 2013, 20 Dece m be r 2013 h the appellant the possible therapies that rn from s doing qu ite well a s h e fro m significant genera lized pain and h e "His ED S S score remains low . I wou l d grade it e the main indicated t hat he ne eded u rgent
I APPEAL# o Ability to communicate: • He mumbles and slurs his speech when tired so people may think he is impaired and that bothers him. • He can read for about 5 minutes, then will lose focus and it takes him more time to read more challenging concepts. • It takes him 2-3 times longer than normal to write because of his impairment and it is illegible. He had to relearn typing and it takes him 2-3 times longer to type school assignments. • He has no hearing limitation. o Mobility and physical ability: • Walking indoors: frequently bumps into walls, furniture and doors; is anxious about walking in school; he trips several times a week; condition is worse when tired but can happen anytime. • Walking outdoors: he seldom walks outdoors, only when he needs to and it's as short as possible; he can walk 2-3 minutes then drags is feet and must stop to rest about every 2 minutes. • Climbing stairs: he can climb stairs as long as he can use the railing and if longer, he sits on a stair half way up. • Standing: cannot stand long without feeling off balance and fatigued; can stand about 5 minutes and must sit down but cannot sit for long periods either -so it's constantly up and down; if he stands, he must lean against a counter but is unable to stand for long periods as he is unable to accomplish anything. • Lifting: he works out and can lift 15-20 lbs and has a personal trainer; he wears a backpack at school and has a locker so that he does not have to carry more than 10 lbs at a time; the backpack worsens his balance and he must walk slower. • Carrying and holding: he does not carry heavy things at home and packs his grocery bags lighter, 5-7 lbs each and makes more trips bringing them into his home; at his sister's place, she carries groceries. o Cognitive and emotional functioning: • Bodily functions: he has chronic sleep issues; he is conscientious about eating a proper diet; he takes short, 5 minutes showers once a day and shaves every 3 days or wears a beard. • Consciousness: drowsy when fatigued and disoriented when wakes up. • Emotion: depression, anxiety and obsessive compulsive disorder (OCD); frustrated that he cannot do things that his friends can do; must leave store if he has a panic attack or where he feels trapped; needs to call friends, family or counselor every day to talk him through his panic attacks; without support from others, he would not do anything and stay home. • Impulse control: needs to have his cell phone with him at all times or will get anxious; reviews his bank account every day because of his anxiety; obsessed with cleanliness, personal hygiene. • Insight and judgment: over aware of himself, his health and safety. • Attention I concentration: poor short term memory; needs to keep note of everything; cannot maintain concentration for the duration of his classes, can only focus well for 30 minutes; difficulties remembering. • Executive: does very well but not as easy as before; takes lonQer to solve problems EAAT 003(10/06/01)
I APPEAL# and must use paper because he cannot remember; takes twice as long as usual to solve problems. • Memory: forgets names, acronyms etc; must consult charts and tables for homework; more disorganized than usual; cannot find things as easily as before; frequently misplaces wallet and keys; it takes him 3 times as long to learn new things. • Motivation: must be pushed and encouraged by others to continue on; easily overwhelmed; needs to talk to other people to get through. • Motor activity: washes hands every hour because of OCD; showers up to 3 times daily; cannot leave things on the counters or out of place; needs to put it away or straigthen things up, put them back where they belong. • Language: speaks English and another language and mixes both sometimes so others may not understand what he is saying; • Psychotic episodes: he mixes things in his head when talking about one thing and others tell him he doesn't make sense; needs to stop and reorganize his thinking but sometimes he will just walk away. o DLA: • Personal care: grooms himself not as often as before; • Toileting: experiences urgency and frequency with his bladder but it takes him twice as long to go to the bathroom. • Feeding self/ regulate diet: cooks very basic simple meals; sometimes does not eat at all if he feels depressed. • Transfers: can get out of bed on his own but need a couple of minutes for his head to clear and to start walking away. • Laundry: his sister does his laundry, if not he does small loads that he can handle. • Basic housekeeping: too much for him and he doesn't care -has a housekeeper. • Shopping: going to and from stores: avoids busy times so that he can park closer to store; never goes alone and can only last ½ hour; mostly his sister shops for groceries. • Carrying purchases home: makes frequent trips of light weight bags 5-7 lbs; must rest 20 minutes after shopping. • Meal planning: mostly done by his sister or very plain and basic on his own; does very little preparation work. • Food preparation: very easy or not at all. • Pay rent and bills: does own banking and budgeting. • Medications: mixes up medications and forgets to take them at times. • Transportation: cannot tolerate public transportation; has his own standard car but at times if his leg is painful and numb, he cannot drive it -he stays at home. • Social functioning: maintains relationships but hesitant to start new ones; does not respond well to unexpected events or change as he becomes anxious and cannot deal with it, getting frustrated, angry and shutting down. • Immediate social network: marginal functioning; if frustrated and stressed, will yell at his family or hang up on them. • Extended social network: marginal functioning; will interact to take care of business. o Requires help: uses the support of counselor, family and friends to encourage him to keep going when he wants to quit or give up; has new crisis about every second day and relies EAAT 003(10/06/01)
o n t h e m t o k e e p g o i n g ; h a s b e e n s e e i n g a p s y c h i a t r i s t e v e r y m o n t h f o r t h e p r e v i o u s 4 o A s s i s t a n c e p r o v i d e d t o t h e a p p e l l a n t : f a m i l s e r v i c e s , f a m i l y d o c t o r a n d h o u s e k e e p e r . o A s s i s t i v e d e v i c e s / a n i m a l s : h e a l w a y s u s e s c h o o l a n d h a s a p e t d o g a s c o m p a n i o n t o o S h e h a s k n o w n t h e a p p e l l a n t f o r 1 8 m o n t h o T h i s i s a M S c l i n i c p r o v i d i n g f o l l o w u p , e d u s y m p t o m m a n a g e m e n 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 2 2 O c t o b e r 2 0 1 4 , t h e a a d h e r e d t o a p e r m a n e n t d i s a b i l i t y a n d t h a t h e c o u l d n b e e n v e r y r u d e o n t h e p h o n e a n d t h a t c o n v e r s a t i o n i m P r i o r t o t h e h e a r i n g , t h e a p p e l l a n t p r o v i d e d t h e f o l l o w • A l e t t e r f r o m a p h y s i c i a n , o t h e r t h a n t h e a p p e l l a n t a p p e l l a n t , d a t e d 8 O c t o b e r 2 0 1 4 i n d i c a t i n g t h a t s h n u m b e r o f c o n c e r n s a n d t h a t h e h a d a p e r i o d o f u p a n i c a n d a n x i e t y . H e a l s o h a s a d e p e n d e n c e o n c o g n i t i v e a b i l i t y i n p a r t . H e h a d i n t e r m i t t e n t m o o d i n t e r p e r s o n a l l y a n d t h a t m a y h a v e b e e n i m p a c t e d t h e d i a g n o s i s . S h e i n d i c a t e d h e h a d m a d e a n a t t e y e t p r o v e d h e c a n s u s t a i n t h a t e ff o r t . • A l e t t e r f r o m h i s f a m i l y d o c t o r , t h e p h y s i c i a n w h o 2 0 1 4 i n d i c a t i n g t h e a p p e l l a n t h a s s h o w n s o m e d e p a i n s t o h i s e x t r e m i t i e s l i m i t i n g h i s a b i l i t y t o c a r r y m i n u t e s " d u r i n g a f l a r e u p " ; h e e x p e r i e n c e s p a r e s a b i l i t y t o t y p e o r w r i t e ; h e u s e s a r e c o r d i n g d e v i c e i n f o r m a t i o n c o n f i r m i n g t h e i n f o r m a t i o n i n t h e r e p o • A l e t t e r b y t h e a p p e l l a n t ' s n e u r o l o g i s t s e n t o n 1 4 p a r t i c u l a r l y t h a t t h e a p p e l l a n t ' s s y m p t o m s a r e p e r n e u r o p a t h i c p a i n t h a t i s t y p i c a l i n p a t i e n t s w i t h M S ( d e p r e s s i o n a n d a n x i e t y ) i m p a i r s h i s a b i l i t y t o f u n c a p p l i c a t i o n f o r P W D . • A l e t t e r d a t e d 1 7 N o v e m b e r 2 0 1 4 f r o m a c l i n i c a l c o n 1 6 S e p t e m b e r 2 0 1 3 ( t h e l e t t e r i n d i c a t e s 2 0 1 4 h e a r i n g ) a n d s i n c e t h e n f o r a t o t a l o f 2 2 o n e h o u r s t r u g g l e d w i t h s y m p t o m s c o n s i s t e n t w i t h a n x i e t y a d a y t o d a y f u n c t i o n i n g . H e n e e d s s u p p o r t t o p e r f o a n x i e t y t h a t f e e d o b s e s s i v e t h o u g h t s " a n d t h a t s h h e a l t h s y m p t o m s a l o n e c a n n e g a t i v e l y i m p a c t h i s h i s " d i s a b i l i t y a p p l i c a t i o n a n d t h e a v a i l a b i l i t y o f c o e d u c a t i o n a l s u p p o r t s . " A t t h e h e a r i n g , t h e a p p e l l a n t t e s t i f i e d t h a t t h e R N w h o v e r 2 h o u r s w i t h h i m t o c o m p l e t e i t w h i l e t h e p h y s i c i E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # c o u n s e l o r f o r a y e a r e v e r y 2 w e e k s a n d a m o n t h s . y , f r i e n d s , c o u n s e l o r , p s y c h i a t r i s t , d i s a b i l i t y s a c a r t w h e n s h o p p i n g , w i l l g e t a r e c o r d e r f o r c a l m h i m . s a n d s a w h i m 2 -1 0 t i m e s i n t h e p a s t y e a r . c a t i o n , s u p p o r t , d i a g n o s i s , t r e a t m e n t a n d p p e l l a n t i n d i c a t e d h e f e l t h i s a p p l i c a t i o n f u l l y o t w o r k . H e m e n t i o n e d t h a t t h e a d j u d i c a t o r h a d p a c t e d t h e a p p e l l a n t ' s d e c i s i o n . i n g d o c u m e n t s : ' s f a m i l y d o c t o r , a p s y c h i a t r i s t a c c o r d i n g t o t h e e h a d b e e n t a k i n g c a r e o f t h e a p p e l l a n t f o r a n e m p l o y m e n t a n d l i m i t e d s o c i a l f u n c t i o n s d u e t o p r e s c r i p t i o n d r u g s t h a t h a s r e s t r i c t e d h i s s w i n g s r e l a t e d t o h i s d i s o r d e r a f f e c t i n g h i m b y h i s M S t h a t s e e m s t o h a v e w o r s e n e d s i n c e m p t t o r e t u r n t o s c h o o l r e c e n t l y b u t h e h a s n o t c o m p l e t e d t h e P R a n d A R , d a t e d 1 O N o v e m b e r t e r i o r a t i o n o f h i s M S s y m p t o m s . H e h a s d a i l y o v e r 1 0 l b s ; h e i s u n a b l e t o w a l k m o r e t h a n 5 t h e s i a s t o h i s h a n d s w h i c h i n t e r f e r e s w i t h h i s i n c l a s s t o c a p t u r e i n f o r m a t i o n a n d s i m i l a r rt s s h e a l r e a d y s u b m i t t e d . N o v e m b e r 2 0 1 4 t o t h e T r i b u n a l i n d i c a t i n g s i s t e n t a n d d i s a b l i n g a n d " c o m b i n a t i o n o f h i s , n e u r o g e n i c f a t i g u e w i t h p s y c h i a t r i c i l l n e s s t i o n o n a d a y t o d a y b a s i s . " H e s u p p o r t e d h i s o u n s e l l o r w h o m e t t h e a p p e l l a n t f o r t h e f i r s t t i m e b u t t h e a p p e l l a n t c o r r e c t e d t h e d a t e a t t h e c o u n s e l l i n g s e s s i o n s . S h e s t a t e d t h a t h e n d d e p r e s s i o n a f f e c t i n g , a c c o r d i n g t o h e r , h i s r m h i s d a y t o d a y t a s k s d u e t o " l o w m o o d a n d e b e l i e v e s , f r o m o b s e r v a t i o n , t h a t h i s m e n t a l f u n c t i o n i n g t o a s i g n i f i c a n t d e g r e e . S h e s u p p o r t s n t i n u e d s u p p o r t s , s u c h a s c o u n s e l l i n g a n d o d i d t h e r e p o r t d a t e d 2 9 S e p t e m b e r 2 0 1 4 s p e n t a n w h o c o m p l e t e d t h e A R s p e n t 1 5 m i n u t e s . H e
a d d e d t h a t h e h a d s e e n h i s p h y s i c i a n r e c e n t l y a n d t h N o v e m b e r 2 0 1 4 . H e m e n t i o n e d t h a t t h e r e w a s a t y p o h e r f i r s t o n 1 6 S e p t e m b e r 2 0 1 3 a n d n o t 2 0 1 4 , a n d h a d u r i n g t h a t p e r i o d o f t i m e . H e e s t i m a t e d t h a t o u t o f t h a b o u t 3 w e e k s . T h e a p p e l l a n t a l s o s t a t e d t h a t h e c u r r h i m s l e e p . T h e m i n i s t r y d i d n o t o b j e c t t o t h e a d m i s s i b i l i t y o f t h e n p a n e l d e t e r m i n e d i t w a s a d m i s s i b l e u n d e r s . 2 2 ( 4 ) o f w a s i n s u p p o r t o f t h e r e c o r d s b e f o r e t h e m i n i s t e r a t r e a b o u t 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 . E AA T 0 0 3 ( 1 0 / 0 6 1 0 1 )I A P P E A L # a t p r o m p t e d h e r t o w r i t e t h e l e t t e r d a t e d 1 0 i n t h e c o u n s e l l o r ' s l e t t e r a n d t h a t h e h a d s e e n d h a d m a n y c o u n s e l l i n g s e s s i o n s w i t h h e r e p a s t m o n t h , h e h a d f l a r e u p s o f h i s M S f o r e n t l y o n l y u s e s m e d i c a t i o n f o r p a i n a n d t o h e l p e w o r a l a n d d o c u m e n t a r y e v i d e n c e a n d t h e 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 A c t ( E A A ) a s i t c o n s i d e r a t i o n a n d p r o v i d e d u p d a t e d i n f o r m a t i o n
I APPEAL# PART F -Reasons for Panel Decision The issue under appeal is whether the ministry's determination that the appellant has not met all of the eligibility criteria for designation as a PWD because it was not satisfied that the appellant had a severe physical and/or mental impairment that, in the opinion of a prescribed professional, directly and significantly restricts his ability to perform DLA either continuously or periodically for extended periods resulting in the need for help to perform DLA was either a reasonable application of the legislation or reasonably supported by the evidence. The ministry determined that the age requirement had been met and that the appellant has an impairment that will last for 2 years. The criteria for being designated as a person with disabilities (PWD) are set out in s. 2 of the EAPWDA and s. 2 of the EAPWDR. Section 2 of the EAPWDA states: 2 (1) In this section: "assistive device" means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "health professional" repealed "prescribed professional" has the prescribed meaning; (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i) directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B) periodically for extended periods, and (ii) as a result of those restrictions, the person requires help to perform those activities. (3) For the purposes of subsection (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, (ii) the significant help or supervision of another person, or (iii) the services of an assistance animal. (4) The minister may rescind a designation under subsection (2). Section 2 of the EAPWDR provides further clarification: 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; EAAT003(10/06/01)
(vii) p erform pers o nal hy gi ene and self c are (viii) m an age personal m edication, an d (b) i n relation to a person who has a severe mental impairment, i (i) make decisions about p ers o nal a ct ivities, ca (ii) relat e to, communicate or interact wit h others effec (2) For th e purposes of the A c t, "presc ribed professional" means (a) authorized unde r an enactmen t to p ractise th (i) me dical practit ioner , (ii) registered psychol o gist, (iii ) r egistered nurse or registered psychiatric nurse, (iv) occupational therapist, (v) physical ther apist, (v i) social worker, (vii) chiropractor, or (viii) nurse practi ti oner, or (b) a cting in t he cours e of t he person's employment as a school (i ) an authori ty , as that ter m is defined in section 1 (1) ( i i) a board or a f rancopho n e e duca tion au thority, of th e Schoo l A ct, i f qual ificat i o ns in psycho logy a T he ministry ac know led g ed t h a t th e app e lla nt me et s h e is a t l ea st 1 8 years o f age and h i s impairment is likel th e m i n i stry arg ue d that he does no t m e et the o ther 3 c Seve r e ph ysic al impairme nt: Th e mi n i stry argu ed th at th e evide n ce di d not d emon phys ica l i mp airment because ac cordi n g to the phy si c m obil i t y and ph ysical a bili t y and that he does not n eed The app e llan t refe rred to the medical docume ntation report made b y th e R N d a ted 2 9 September 2014 , ar signi f i cant impairme n t on his daily functioning amoun argu ed that t he minist r y fa iled to properly consi der t hat physical and mental impairments. At t he out se t, t he pa nel agree s with t he appellant that the ministry did not properly consider the report d ate d 2 9 September 2014 by the RN since there i s on considered but t h e r e is no specific reference to th is report when analysing the severity of the impairments and its impact on the appellant's DLA. The conside r that report but only the physician report to determine the severity of the impairment but admitted that it should have been considered when anal conditions set at s. 2(2)(a)(iii) o f t he EAPW DR as a prescribed unreasonable for the minis t ry not to include that report in its analysis of the appellant's PWD application, and will consider this report in our analysis. EAAT 003(10/06/01) I APPEAL# ; ncludes the fol lowing ac t ivities: re o r fi na nces; tiv e ly. a person who is e profession of psyc ho logis t by of th e I n d ependent Sch ool Act, or as th ose term s a r e d efined in section 1 (1) r e a condi tion of such em ployme n t. 2 of th e cond iti ons f or P W D designa tion in t h a t y to contin u e for 2 years or mor e . H ow ever, r iteria. s t rat e the appel lant su ffe re d from a sev ere i a n, he can independentl y manage all ar e as of any pr osth es es or aids. pro v ided to th e mini stry a n d in particular the g uing that th er e was enough evide nc e of tin g to a severe physical impairme n t. He al s o repo rt i n its an alys is of th e s e v e ri ty of his ly a me n tion a t t he bott om of a p age t ha t it was ministry argued th at it did no t ne ed to y si ng DLA since the author met the professional. The panel finds it was
T h e p a n e l n o t e s t h a t t h e r e h a v e b e e n s o m e c h a n g e s l i f t i n g a n d w h i l e t h e p h y s i c i a n i n d i c a t e d t h e a p p e l l a n t l b s a n d t h e m o r e r e c e n t l e t t e r f r o m t h e a p p e l l a n t ' s p h l i m i t a t i o n t o 1 0 l b s . F u r t h e r , t h e m o s t r e c e n t i n f o r m a t i i s u n a b l e t o w a l k m o r e t h a n 5 m i n u t e s d u r i n g f l a r e u p t e r m s o f l i f t i n g a n d w a l k i n g i n d o o r s a n d o u t d o o r s w i t h a c t i v i t i e s i n d e p e n d e n t l y b u t n o t f o r p r o l o n g e d p e r i o d s a t t a c k , b u t w i t h o u t a n y f u r t h e r i n f o r m a t i o n i n t e r m s o f h a v e . W h i l e t h e p a n e l n o t e s t h e a p p e l l a n t ' s c o n d i t i o n l i m i t a t i o n s t o w h a t h e c a n p h y s i c a l l y d o , t h o s e l i m i t a t i n o t s i g n i f i c a n t t o t h e p o i n t o f d e m o n s t r a t i n g a s e v e r e m i n i s t r y r e a s o n a b l y d e t e r m i n e d i t w a s n o t s a t i s f i e d t h i m p a i r m e n t . S e v e r e m e n t a l i m p a i r m e n t : T h e m i n i s t r y a c k n o w l e d g e d d e f i c i t s o f c o g n i t i v e a n d e m a j o r i m p a c t : b o d i l y f u n c t i o n a n d e m o t i o n w h i l e a l l o t f u n c t i o n i n g . T h u s , t h e m i n i s t r y a r g u e d , t h e r e i s n o t e n T h e a p p e l l a n t a r g u e d t h a t t h e e v i d e n c e w a s s u f f i c i e n s a m e r e a s o n s a s e v e r e p h y s i c a l i m p a i r m e n t w a s e s t a I n t e r m s o f c o g n i t i v e a n d e m o t i o n a l f u n c t i o n , t h e R N ' s " b o d i l y f u n c t i o n s " t h a n t h e A R b u t h e i s i n d e p e n d e n t w s a i d f o r " e m o t i o n s " i f h e g e t s t h e p r o p e r s u p p o r t f r o m w r o t e t h a t t h o s e d e f i c i t s ( o n c o g n i t i v e a n d e m o t i o n a l d e g r e e w h i l e i n t h e A R s h e w r o t e t h a t t h e y c a u s e d h i t h a t h e w a s a t t e n d i n g c o u n s e l l i n g a n d w a i t i n g f o r p s y p a n e l n o t e s t h a t t h e a p p e l l a n t ' s m e n t a l c o n d i t i o n a p p i m p a c t o n h i s d a i l y f u n c t i o n i n g i t i s n o t t o t h e p o i n t w h i m p a i r m e n t . R e c e n t e v i d e n c e s e e m s t o s u p p o r t t h i s : p s y c h i a t r i s t m e n t i o n s " m a j o r d e p r e s s i v e d i s o r d e r i n r e m o o d s w i n g s t h a t s e e m s t o h a v e w o r s e n e d a n d i m p a A u g u s t 2 0 1 4 , t h e a p p e l l a n t ' s p h y s i c i a n w a s o f t h e v i e b e c a u s e h e w o u l d b e a t t e n d i n g s c h o o l i n S e p t e m b e r e m p l o y m e n t i n s u r a n c e h a d e x p i r e d t h e p a n e l n o t e s d e t e r m i n a t i v e f o r a P W D d e s i g n a t i o n . I n t h e v o l u m i n o u s d o c u m e n t a t i o n t h a t w a s p r o v i d e d , m e d i c a l r e p o r t s , s o m e o f t h e m s u g g e s t i n g a m e n t a l i m h i s p s y c h i a t r i s t r e p o r t e d o n 2 0 D e c e m b e r 2 0 1 3 t h a t h e x p r e s s e d a b s o l u t e l y n o c o n c e r n s o r r e s e r v a t i o n a b o c o m i n g b a c k f r o m h i s t r i p , t h e p s y c h i a t r i s t w r o t e i n a r r e t u r n e d f r o m h i s t r i p a b r o a d a n d t h a t " f r o m a n e u r o l o w e l l " ; h e s e t s t h e n e x t a p p o i n t m e n t t o 6 m o n t h s . E AA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # s i n c e t h e r e p o r t s w e r e c o m p l e t e d i n t e r m s o f c o u l d l i f t u p t o 3 5 l b s , t h e R N l i m i t e d l i f t i n g t o 2 0 y s i c i a n d a t e d 1 0 N o v e m b e r 2 0 1 4 i n d i c a t e d a o n f r o m t h e a p p e l l a n t ' s p h y s i c i a n s t a t e d t h a t h e s b u t s h e h a d a s s e s s e d h i m a s " i n d e p e n d e n t " i n t h e c a v e a t t h a t h e c o u l d p e rf o r m t h o s e o f t i m e a n d u n a b l e t o p e r f o r m i f h e h a s a n f r e q u e n c y o r t h e d e g r e e o f t h e i m p a c t i t w o u l d o n s o m e a s p e c t s m a y w o r s e n a n d h e h a s s o m e o n s w e r e r e a s o n a b l y v i e w e d b y t h e m i n i s t r y a s p h y s i c a l i m p a i r m e n t a n d t h e p a n e l f i n d s t h e e i n f o r m a t i o n p r o v i d e d w a s e v i d e n c e o f a s e v e r e m o t i o n a l f u n c t i o n i n g b u t o n l y 2 a r e a s s u f f e r a h e r a r e a s h a v e m o d e r a t e t o n o i m p a c t o n d a i l y o u g h e v i d e n c e o f a s e v e r e m e n t a l i m p a i r m e n t . t t o p r o v e a s e v e r e m e n t a l i m p a i r m e n t f o r t h e b l i s h e d . r e p o r t p r o v i d e s m u c h m o r e i n f o r m a t i o n f o r i t h a l l o f t h o s e f u n c t i o n s a n d t h e s a m e c a n b e h i s f a m i l y a n d f r i e n d s . I n t h e P R , t h e p h y s i c i a n f u n c t i o n ) a ff e c t h i s f u n c t i o n t o a s i g n i f i c a n t m t o w i t h d r a w f r o m h i s e d u c a t i o n a l p l a n s a n d c h i a t r i c c o n s u l t a t i o n . F r o m t h e e v i d e n c e , t h e e a r s t o b e u n d e r c o n t r o l a n d w h i l e i t h a s s o m e e r e i t c o u l d b e q u a l i f i e d a s " s e v e r e " m e n t a l I n h e r l e t t e r d a t e d 8 O c t o b e r 2 0 1 4 , a m i s s i o n " b u t t h a t h e s u f f e r s f r o m i n t e r m i t t e n t c t a t t e n d i n g s c h o o l . A s w e l l , i n a l e t t e r d a t e d 1 9 w t h e a p p e l l a n t n e e d e d a P W D d e s i g n a t i o n a n d r e q u i r e d f i n a n c i a l a s s i s t a n c e s i n c e h i s t h a t b e i n g a b l e t o w o r k o r g o i n g t o s c h o o l i s n o t t h e p a n e l a l s o n o t e s t h a t t h e r e a r e m a n y p a i r m e n t f a r f r o m b e i n g s e v e r e . F o r e x a m p l e , e h a s n o t h a d a n y n e u r o l o g i c a l s y m p t o m s a n d u t t h e a p p e l l a n t g o i n g o n a t r i p a b r o a d a n d u p o n e p o r t d a t e d 2 5 A p r i l 2 0 1 4 , t h a t t h e a p p e l l a n t g i c a l s t a n d p o i n t h e h a s d o n e a c t u a l l y q u i t e
In t erms of m e m ory, the panel note s that the AR in dicat me ntione d some of t h o s e difficul ti e s faced b y the appe h e i s more diso rg anized but s h e also indi c a ted t hat h ho mework; in ot he r wor d s, he do e s have t ools to a dd Given t he ev i dence before t h e m inistry at rec onside rat e vidence p r ov i d ed b y the appellan t, th e pan e l fin ds tha info rmat io n provi d ed d i d no t am ount to evidence of sev D aily Living Activiti e s ( D L A): The mini s tr y based its a ss essment fo r D LA exc lusivel in fo rma tio n provided t o e xplain the d egree , f re que n cy o appel la nt t o m anage c leaning an d cookin g, a nd tha t h t h e ministry a rgued tha t when t h e AR ment ioned that so a flare up o f his MS, there was no i nf orm a ti on indica t of th e flare up s and the degree o f assi stanc e requir ed. mentioned t hat some D LA we r e impa cted by medicati fr equency o r du r a tion o f th ose im p acts. S inc e the a ppellant is requires l i t tle h elp f r om o t hers, t he mi nis t ry argued that the imp airment signifi c antly re stric ts DL A e i t her conti n uously or peri Th e ap pellant arg ued that t h e RN 's r e port w as evidence hi s impairme nt an d tha t his c o ndition has wo r s ene d. oth ers and gave as e x amp le t h e hel p h e gets fr om the cou l d discu ss hi s condition e x t ens ively. He a l so argue and som e had sign ifi cant si d e eff e c ts that w ere detriment up s were quite freq ue nt , for i ns tance for the equivalen s ign ifi ca n t impact on his D LA. Th e panel n ote s there was no men tio n w h a t soev er of the DLA e v e n t hough she is a prescr i bed pro fe ssional under the act. There are certain discrepancies b etween th e RN 's re port a nd t he AR bu t the f ormer i s m reaso n s already mentioned. Yet, i n g eneral, the RN's r vast majority of his DLA indepe nd ently as he fou nd ways of addressing his deficiencies. For instanc e, the AR mentioned the appe RN's report explains that t he appellant can cook basic simple me also has the opportu nity of going at his sister's place when he is in her l a undry, whi le th e A R s t a t ed th at he is i nd e pend ent th laundry but also mentioned he did small loads and would like to wash clothes more often. Likewise for basic housekeeping, while the AR mention ed assistan stated that he does not do it as it is too much fo r him housekeep er at his residence; at the hearing, the appellant admitted that there were days when he could do that kind of work but he won't do it since he does have access to EAAT 003(10/06/0 1) I APPE AL # e d a minimal i mpa c t and th at the RN lla nt, i.e. that he f or gets nam es etc. and th at e could c onsult his charts a nd tab les f or re ss t hose defici e n cies . ion including the RN evi denc e as well as n e w t th e m inistr y r e as o na b ly de termin e d the er e me n tal imp airme nt. y on t he AR, arguing t hat there was insu ffic ie nt r dur ati on of t h e a ssistance re q u i re d by the e is indep endent f or al l the o the r DLA. Furt her , me activiti es were i mpac ted whe n ther e w as in g what a ctivi ties w e r e impact ed, t he frequen c y Fi nall y t h e ministry argue d th a t while the AR o n, there wa s no in format ion o n the d egr e e, indep endent f or th e majorit y o f DLA or ap pellant has no t e sta bl i sh ed th at odically f o r extended p e ri ods. that his D LA we re s ignifi c ant ly im pacted by He argue d he nee ded sign ificant h e lp from counse llor that he see s and w ith whom he d that he wa s tr ying m any differe nt medica tions a l to his heal th. He indicate d that his fla re t o f 3 wee ks in th e l as t 4 We eks and that had a RN's re po r t in th e mi n ist r y's ass ess me nt of u ch more elaborate than the la tte r for epo r t shows the appel l ant can ma nage the p hys ic a l and / or mental ll ant gets help from others fo r cooking whi le the a ls with meat and vege t ables but he community. I n terms of e RN's report stated th at his sister d oe s his ce due to pain and fatigue, the RN's report and h e doesn't care and that he has a that serv ice.
I APPEAL# For social functioning, there is a notable discrepancy between the AR and the RN's report for the appellant's functioning with extended networks that the RN assessed as "marginal functioning" with the comment "will interact to take care of business" while the AR assessed as "good functioning positively interacts in community: often participates in activities with others". For' lack of an explanation by the RN, the panel is satisfied that whether it is to interact in the community or to take care of business, it is reasonable to conclude he has good interaction with extended networks -and here the panel must mention that at the hearing, the appellant was very articulate, clear and concise when he spoke, showing no hesitation in making his points, defending his position effectively. The panel also notes that in the AR there is no mention of the help required while in the RN's report, she indicated that he uses the support of his counsellor, family and friends and that he is on the phone often to deal with new crisis and that without this assistance he would stay at home and would not attend school. In terms of medication, the ministry argued that there was no evidence of the impact on the appellant's DLA but the panel notes that in the letter from a psychiatrist dated 8 October 2014 (that the ministry had not received by the time it conducted the reconsideration), she mentioned he had a dependence on a type of drugs "that have restricted his cognitive ability in part" but, again, it did not specify what this impact was. Thus, the panel finds that with the evidence available then and today, the ministry reasonably determined there was not enough information to establish that the appellant's impairment significantly restricted DLA either continuously or periodically for extended periods. As a result of those restrictions, help required to perform DLA: The ministry argued that since DLA are not significantly restricted, it cannot be determined that significant help is required from other persons and that no assistive devices are required nor an assistance animal. The appellant argued that he does need help from friends, family and professionals to deal with his impairments and that he could not go to school or interact with others if he did not have that assistance. From the evidence presented, the appellant has managed to create a network of friends and family with professionals to help him cope with his illness but this help is general, supportive of his endeavours, mostly to encourage him to be active or deal with crisis -little of this assistance is required to perform DLA. Thus, the panel finds the ministry reasonably determined the appellant did not meet the legislative test for the need for help arising from significant restrictions to perform DLA either continuously or periodically for extended periods. Conclusion: The panel realizes that the appellant's medical condition is difficult and that it does have an impact on his daily functioning. However, based on the above analysis and evidence, the panel comes to the conclusion that the ministry reasonably determined the appellant does not have a severe physical or mental impairment and that the prescribed professionals did not establish that an impairment directly and si!'.lnificantly restricted his ability to perform DLA either continuously or periodically for extended EAA T003(10/06/01)
p e r i o d s a n d 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 h e r e 2 ( 2 ) o f t h e E A P W D A . C o n s e q u e n t l y , t h e p a n e l f i n d s t 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 e d e c i s i o n . E M T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L "I/ q u i r e d h e l p t o p e r f o r m t h o s e a c t i v i t i e s u n d e r s . h e m i n i s t r y ' s d e c i s i o n w a s r e a s o n a b l y s u p p o r t e d
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.