P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t r y o f S o c i a l r e c o n s i d e r a t i o n d e c i s i o n d a t e d O c t o b e r 9 , 2 0 1 4 w h t h e 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 E D i s a b i l i t i e s A c t f o r d e s i g n a t i o n a s a p e r s o n w i t h d i s a 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 a n d t h a t h i s i m p H o w e v e 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 t h e e v i d • t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l o r m e n t 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 e 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 • a s a r e s u l t o f t h e 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 a n o t h e r p e r s o n , t h e u s e o f a n a s s i s t i v e d e v i c p e rf o r m D L A . P A R T 0 R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e fo r P e r s o n s w i t h D i s a b 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 A P P E A L # I D e v e l o p m e n t a n d S o c i a l I n n o v a t i o n ( t h e m i n i s t r y ) 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 t h r e e o f 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 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 t h a t t h e a i r m e n t i s l i k e l y t o 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 . e n c e e s t a b l i s h e s t h a t : l i m p a i r m e n t ; , 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 , t 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 e , o r t h e s e rv i c e s o f a n a s s i s t a n c e a n i m a l t o i l i t i e s A c t ( E A P W D A ) , S e c t i o n 2 i l i t i e s R e g u l a t i o n ( E A P W D R ) , S e c t i o n 2
P ART E Summary of Facts The eviden ce bef o re the m inistry at the time of the reconsideration decis With Dis abilities (P W D) Application co mpr ised of th 8, 2014, a physic ian r e port ( PR ) a n d an assessor report by a gene r al p r actitio ner who has known th e appe l lant f that th ere have be en 7 consulta tions in th e past 7 months due inf o rmatio n s o u rces used to complete the AR consiste phone inte rvi e w , fi l e / cha rt i n formation from p revious T he evidence a lso incl uded the appe l la nt' s Requ est w ith a ttached writte n explanation by the app el lant to queri Diagnoses In the PR, the general practitioner d i ag nosed the appellant with degenerati back pain, face t j oi n t a rthritis and s p o ndylos is. No date practitioner did not d ia gnose a mental health c onditio Phys ica l I mpairmen t In the PR, the gen eral practiti oner reported that: • In te r ms of h eal th h i st o ry, th e ap pell a nt h a s had low app ell ant r e ported th at te n ye ars prior to consult severi ty to 6/1 0 , sh arp an d r adiating t o th e righ w hich g a v e h i m relief f o r 2 weeks an d th e p a 1 0/10, s h a rp, c on t inuous, radiatin g t o the right kn needl es a nd electr icity d own h is righ t le g t o the 201 2 showing multi-level dege n e r ative d isc disease wit fa c et j oint arth ritis throughout the lumba r spine. • T h e ap pell a nt does not re qu i re any p ros t hesis • In term s of fu n c ti ona l s ki lls, the appe llant can he can c li mb 2 to 5 ste ps, lift und e r 2 kg (u nd In the AR the general practitioner indicated that: • The appe llant is assessed as being independen standing. He requires periodic assistance from another person with climbing stairs and lifti He r eq u ires continuous assistanc e from another person with carrying and holding, with a com ment add ed: ' The pa tient c a n wa lk les s than 1 block lift l i g ht ob jects bu t not in a pr ol o n ged time sp • For assi stive devices , the general practit ion e shopping cart as a walker wh en shopping." • The a ppellant w as referred due to c hr o nic l ow injection to the L5-S1 facet and right sacroiliac area. prolotherapy injections to L4-S1. In his se lf-re p o rt, th e appe l lant in dica ted that: • His lower back and right leg tingles hip to knee. When he walks, he gets pain in his hips which goes into his back and lots of muscle spasms in APP E A L # I ion incl uded the Per sons e applicant information and s e lf-report dated May (AR) both dated May 9, 2 0 14, and completed o r 7 months. The general pra ctitioner n ote d to low back pa in . Th e ap proaches and d of an off i ce int er view with the appella n t, a vis i t s and information from the appellant's sister . f o r Reconsidera t ion dated Septembe r 2 9, 2014 es as outlined i n th e d enial letter. ve d i sc disease and low s of ons e t we r e prov ide d. The genera l n . bac k p a in since the early 1980's. The , t he b ack p ai n had grad u a l ly inc rease d in t butto ck s area. He tried mass a ge therapy in e ven t ually retu r ned . The pain increased to ee . T his was c haracte r ize d a s pins a nd knee area. A plai n f ilm x r ay was done in May h spon d y losi s L 2-L3. The re i s als o or a id f o r his i mpai rment. wa l k l e ss th an 1 block u na ided on a f lat surface, er 5 lbs. ) and remain se a t ed l e ss t h an 1 hour. t with walking indoo rs and outdoo rs , and ng. a nd can tolerate a few s teps. He ca n an ." r indicated a walker, with the commen t: "uses back pa in. He h as had 1 hydro cort i s o n e He has also had 3 sess ions of His stomaGh gets ups et when he is i n pai n.
h i s l e g , a r m a n d c h e s t . H e i s i n p a i n f r o m t h i s " 2 4 / 7 . " • I t u s u a l l y t a k e s a b o u t a n h o u r b e f o r e t h e p a i a b o u t a n d g e t s t a rt e d w i t h t h e d a y . • S t a n d i n g i n o n e p l a c e c a u s e s e x t r e m e p a i n i • H e c a n o n l y w a l k a b o u t 1 b l o c k a n d b a c k b e • H e t a k e s p a i n m e d i c a t i o n r e g u l a r l y t o t r y t o c t a k e s t h e p a i n d o w n t o 3 / 1 0 . H e h a s f o u n d v d a i l y t h a t h e l p s b r i n g t h e p a i n d o w n t o 8 / 1 0 . I n h i s R e q u e s t f o r R e c o n s i d e r a t i o n , t h e a p p e l l a n t w • F o r c l i m b i n g s t a i r s , p e r i o d i c a s s i s t a n c e o n l y l e g s t o g o u p s t a i r s m a k e s h i m h a v e t o s t o p b e f o r e h e n e e d s t o s t o p a n d r e s t s o t h e p a i n a n d t r y a g a i n a n o t h e r d a y . • H e c a n l i f t 2 0 l b s . f o r a v e r y b r i e f t i m e a f e w M e n t a l I m p a i r m e n t I n t h e P R , t h e g e n e r a l p r a c t i t i o n e r r e p o r t e d : • T h e a p p e l l a n t h a s n o d i ff i c u l t y w i t h c o m m u n i • T h e a p p e l l a n t h a s 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 m o t i v a t i o n a n d m o t o r a c t i v i t y , w i t h a c o m m e d a i l y a c t i v i t i e s d u e t o p a i n . H e c a n n o t d o t h i I n t h e A R , t h e g e n e r a l p r a c t i t i o n e r 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 h a s a g o o d a b i l i t y t o c o m m u n i • T h e s e c t i o n o f t h e A R a s s e s s i n g i m p a c t t o c o a n i d e n t i f i e d m e n t a l i m p a i r m e n t o r b r a i n i n j u • W i t h r e s p e c t t o s o c i a l f u n c t i o n i n g , t h e a p p e l l a n a m e l y : w i t h m a k i n g a p p r o p r i a t e s o c i a l d e c i i n t e r a c t i n g a p p r o p r i a t e l y w i t h o t h e r s , d e a l i n g s e c u r i n g a s s i s t a n c e f r o m o t h e r s . • T h e a p p e l l a n t h a s g o o d f u n c t i o n i n g i n b o t h h • A s k e d t o d e s c r i b e t h e s u p p o r t / s u p e r v i s i o n t h c o m m u n i t y , t h e g e n e r a l p r a c t i t i o n e r w r o t e : " t o t h e p a i n . L y i n g d o w n w o u l d h e l p r e l i e v e i D a i l y L i v i n g A c t i v i t i e s ( D L A ) I n t h e P R , t h e g e n e r a l p r a c t i t i o n e r i n d i c a t e d t h a t : • I n t e r m s o f h e a l t h h i s t o r y , t h e a p p e l l a n t f i n d s p a i n w o r s e . • T h e a p p e l l a n t h a s n o t b e e n p r e s c r i b e d a n y m D L A . I n t h e A R , t h e g e n e r a l p r a c t i t i o n e r r e p o r t e d t h a t • T h e a p p e l l a n t i s i n d e p e n d e n t w i t h m o v i n g a b • T h e a p p e l l a n t i s i n d e p e n d e n t w i t h a l l t a s k s o f A P P E A L # I e t i m e h e w a k e s u p u n t i l h e g o e s t o b e d . T h e p a i n n k i l l e r s s t a r t t o w o r k a n d h e f e e l s a b l e t o m o v e n h i s l o w e r b a c k . f o r e i t c a u s e s e x t r e m e b a c k p a i n . o n t r o l t h e p a i n a n d h e h a s n o t f o u n d a n y t h i n g t h a t e r y l i t t l e r e l i e f . H e t a k e s a n a r c o t i c m e d i c a t i o n r o t e : h e l p s w i t h b a l a n c e . E x t r e m e p a i n f r o m l i f t i n g h i s f r e q u e n t l y a n d h e c a n u s u a l l y m a n a g e 5 s t a i r s s u b s i d e s . H e h a s h a d t o t u r n a n d g o b a c k d o w n s e c o n d s t o m o v e a n i t e m o n l y . c a t i o n . 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 n t h e a r e a s o f n t a d d e d : " t h e p a t i e n t h a s l o s t i n t e r e s t i n d o i n g n g s h e u s e d t o d o a n d e n j o y . " c a t e i n a l l a r e a s . 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 n g f o r t h o s e w i t h r y i s m a r k e d " N / A " , o r n o t a p p l i c a b l e . n t i s a s s e s s e d a s b e i n g i n d e p e n d e n t i n a l l a r e a s , s i o n s , d e v e l o p i n g a n d m a i n t a i n i n g r e l a t i o n s h i p s , a p p r o p r i a t e l y w i t h u n e x p e c t e d d e m a n d s , a n d i s i m m e d i a t e a n d e x t e n d e d s o c i a l n e t w o r k s . a t w o u l d h e l p t o m a i n t a i n t h e a p p e l l a n t i n t h e p a t i e n t w o u l d n e e d t o l i e d o w n o n t h e s t r e e t d u e t . " p r e t t y m u c h e v e r y a c t i v i t y o f d a i l y l i v i n g m a k e s h i s e d i c a t i o n a n d / o r t r e a t m e n t s t h a t i n t e r f e r e w i t h h i s o u t i n d o o r s a n d o u t d o o r s . t h e D L A p e r s o n a l c a r e , b a s i c h o u s e k e e p i n Q ,
p r e p a r e o w n m e a l s , m a n a g e p e r s o n a l f i n a n c m e d i c a t i o n s . • F o r s h o p p i n g , t h e a p p e l l a n t i s i n d e p e n d e n t w l a b e l s , m a k i n g a p p r o p r i a t e c h o i c e s a n d p a y i f r o m a n o t h e r p e r s o n w i t h c a r r y i n g p u r c h a s e s p r o v i d e d b y t h e g e n e r a l p r a c t i t i o n e r . • R e g a r d i n g u s e o f t r a n s p o r t a t i o n , t h e a p p e l l a v e h i c l e a n d r e q u i r e s p e r i o d i c a s s i s t a n c e f r o m u s i n g t r a n s i t s c h e d u l e s a n d a r r a n g i n g t r a n s p • A n y p r o l o n g e d a c t i v i t y i s n o t p o s s i b l e d u e t o I n h i s s e l f r e p o r t , t h e a p p e l l a n t i n d i c a t e d t h a t : • H i s b a c k p a i n a f f e c t s h i s d a i l y r o u t i n e a n d l i v t h e m o r n i n g . • D r i v i n g t h e c a r f o r m o r e t h a n a h a l f h o u r i s v e p e r i o d s l o n g e r t h a n a h a l f h o u r . G e t t i n g i n a b a c k p a i n . • C o n s t a n t b e n d i n g a n d m o v e m e n t f o r h o u s e w t h e f l o o r s . • H e c a n n o t w a l k i n a n y s t o r e w i t h c e m e n t f l o o I n h i s R e q u e s t f o r R e c o n s i d e r a t i o n , t h e a p p e l l a n t w • U s i n g t h e b u s s y s t e m i n h i s c o m m u n i t y i s n o w a l k t o w h e r e h e n e e d s t o g o . W a l k i n g m o r e i n h i s b a c k a n d h i s l e g g o i n g n u m b . A l m o s t a b u s i n e s s e s . • T h e l a s t t i m e h e t r i e d t o w a l k f r o m h i s c a r t o t o t h e s t o r e b u t c o u l d n o t w a l k t o g e t g r o c e r i e l i e i n t h e p a r k i n g l o t , b e t w e e n t w o c a r s , t o t a k b e f o r e h e c o u l d d r i v e h o m e . N e e d fo r H e l p • I n t h e A R , t h e g e n e r a l p r a c t i t i o n e r r e p o r t e d t h o t h e r p e o p l e , t h e a p p e l l a n t ' s f a m i l y a n d f r i e n " L y i n g d o w n w o u l d h e l p h i s b a c k p a i n . " T h e p r o v i d e d t h r o u g h t h e u s e o f a s s i s t i v e d e v i c e s h o p p i n g c a rt a s a w a l k e r w h e n s h o p p i n g . " I n h i s N o t i c e o f A p p e a l d a t e d O c t o b e r 9 , 2 0 1 4 , t h e a m i n i s t ry ' 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 e m i n i s t r y ' s i n t e r p r e t a t i o n o f t h e d o c t o r ' s r e t h a t t h e a p p e l l a n t c a n i n d e p e n d e n t l y m a n a g e t i m e . T h e r e p o rt m a k e s i t s e e m l i k e h e i s a b t h e c a s e a t a l l . T h e w e a t h e r c h a n g e s l i m i t h A t t h e h e a r i n g , t h e a p p e l l a n t a n d h i s a d v o c a t e s t a t e • R e q u e s t s w e r e m a d e o f t h e g e n e r a l p r a c t i t i o n A P P E A L # I e ( p a y r e n t a n d b i l l s ) , a n d m a n a g e p e r s o n a l i t h g o i n g t o a n d f r o m s t o r e s , r e a d i n g p r i c e s a n d n g f o r p u r c h a s e s a n d r e q u i r e s p e r i o d i c a s s i s t a n c e h o m e , w i t h n o f u r t h e r e x p l a n a t i o n o r d e s c r i p t i o n n t i s i n d e p e n d e n t w i t h g e t t i n g i n a n d o u t o f a a n o t h e r p e r s o n w i t h u s i n g p u b l i c t r a n s i t a n d o rt a t i o n . p a i n . i n g . T h e p a i n m a k e s i t d i f f i c u l t t o g e t o u t o f b e d i n ry p a i n f u l . H e n e e d s s o m e o n e t o d r i v e h i m f o r n d o u t o f a v e h i c l e c a u s e s a g r e a t i n c r e a s e i n h i s o r k i s v e r y p a i n f u l . H e c a n n o t v a c u u m o r w a s h r s . H e h a s t o l e a v e . r o t e : t a p o s s i b i l i t y . T h e b u s s t o p s a r e t o o fa r f o r h i m t o t h a n a b l o c k i s n o t p o s s i b l e w i t h o u t e x t r e m e p a i n l l t h e b u s s t o p s a r e m a n y b l o c k s a w a y f r o m t h e g r o c e r y s t o r e , i n t h e s u m m e r o f 2 0 1 3 , h e g o t s . H e m a d e i t p a r t w a y b a c k t o h i s c a r a n d h a d t o e t h e p r e s s u r e o f f h i s b a c k a n d r e d u c e t h e p a i n a t , w i t h r e s p e c t t o t h e a s s i s t a n c e p r o v i d e d b y d s a s s i s t h i m . T h e g e n e r a l p r a c t i t i o n e r w r o t e : s e c t i o n o f t h e r e p o r t i n d i c a t i n g a s s i s t a n c e s i d e n t i f i e s a w a l k e r , w i t h t h e n o t e : " u s e s 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 p o r t i s n o t a c c u r a t e . W h i l e t h e d o c t o r i n d i c a t e s t h e l i s t o f D L A , h e c a n o n l y m a n a g e a f e w a t a l e t o d o a l l o f t h e m o n a d a i l y b a s i s , w h i c h i s n o t i m e v e n m o r e . d t h a t : e r t o p r o v i d e a d d i t i o n a l i n f o r m a t i o n i n s u p p o r t o f
the ap pellan t's a pp ea l and t h e heari ng wa s prev in fo rmati on t o be pro v id ed. D es pite t hes e eff gene ral practiti o n er t o rev iew and sign, nothing practitioner, w hich is frus tra ting. • T he Req ues t fo r Rec onsi derati on sets ou t s ome c t h a t is requi red and what it would be l i ke for the ap sy ste m i n his com mun ity. T h e s y stem c o v ers long t ime t o g et anywhe re an d re qu iri ng long • T he appellant h as h ad to li e dow n in a parking • For sho ppi ng, he ca nno t walk on c onc rete flo s tore and t hen he has to le ave. • F o r h ou seke epin g, h e c an not get all hi s ch ores bi t of swe epi ng , for example, and be done for the da him 3 d ay s to d o th e chore s that should ta ke • H e ha s h ad 7 t o 8 cons ul t ations i n a peri od o give n 3 shots in his b ack t o relie v e the pain . befo r e the pain from the ne edle is g one an d he gets som in jec ti ons i f they prov ided lasting reli ef fr o m the • It h a s been about 3 m o nt h s s i n c e h is last shot, 201 4. • Hi s brother will pro vide ass ista nce if h e ne eds n eeds to be r e paire d on h is ro of, f or examp le. we ek to see if the r e is som eth i n g h e need s d • He does his ow n laundr y . He has to walk about • For meals, he m akes mea ls t hat he can have the following day h e at up and h e so meti m e s u se s paper p lates so that h • H e ha s 4 s teps t o g et into h i s re sidence. • Fo r sho pp ing he use s a s h op pi ng c a rt t o le an h i m . • His doct or i s not aware of the restrictions h e experi Admissibility of N e w Information The min istry did not raise a n ob j ection t o the a ppellant's o his Notice of Appeal. The appellant's testimo ny regarding his physical im pact his ability to fu nction is consistent with and tends ministry h a d at reconsideration. The panel admitted this addition information and records that were before the ministry at the time of reconsideratio withs. 22(4)(b) of the Employment and Assistance Act. The mini stry r e l ie d on its reconsiderati o n de cision. APP EAL # I io usly ad journed to al low mo re time for thi s o rts, and h aving p r o vided a sum ma r y to the has been forthc omin g fr om the gener al larific atio ns r e ga r di ng the p eriodi c a ss is ta nc e pella nt t o try t o u se the public tran sp or t at ion a large are a and is ve ry sp r e ad o ut, t aki n g a walks from b u s sto ps. lot to ge t rel ie f from the pa in in h is b ack . ors an d h e is g ood for o n e roun d of t h e groce ry d one i n one d ay. He m ight do the dishes and a y a nd h ave t o s it on the c ouc h. It takes one d ay . f 7 mo n ths for the p ain in h is back. He has been A l on g n eedle is used a nd it t akes two day s e reli ef. H e wa s w i ll i ng t o have the pa in , but th ey d i d n ot. whi ch h e beli ev e s he recei v ed in Septemb er somet hing done in his h o use , i f s o m ething Hi s broth er an d sis ter-in -law wi ll chec k in e very one s uch as vacuum in g or tidyin g u p. 50 feet t o the Laundromat to do his l au n dry . or b uys ite ms t hat he can jus t e will h a v e f e we r d i shes to w ash. on. His do c tor ha s not prescri b e d a wal ker for enc es a t home. r al t estimony or t h e in formation p ro vided i n im pairments and how they to corroborate the in formation that the al in formation as be i ng in support o f n, in accordance
PART F R e asons fo r Panel Decision Th e i ssu e on the appe al is whether the ministr y's r econsider ap pel lan t is no t eligible fo r d esi gnation a s a pers on by t h e evidenc e or was a r easo nable appl icat i o n of the ap the app ell ant. The mi nistry fo u nd that the a pp ell a nt impai r ment b a s e d o n th e i nf or m ation pr o vid ed an d tha o pin io n o f a prescr ibed pr of ession al, di rec t ly and signifi p eriodical ly for extended pe r iods. A ls o, a s a r e s ul t tha t t he a ppel lant requir e s th e sig n i fi can t he lp or sup as sistiv e d ev ice, or the servi ce s of an ass i st ance ani Th e crit er ia for being desi gnat ed as a perso n w i th d EAP WD A as f ollow s: Per sons wit h disabiliti es 2 (1) In thi s s ect i on: "assist ive dev i c e" mea n s a d evice d esi gne d to en a bl e a pe sever e me ntal o r phy sic al i mpair ment , t he p erson i s un able "da il y living activity" has the pre scrib ed mea ning ; "presc r ibed pro fes sio nal" h as th e prescribed meaning. ( 2 ) The min ister m ay designate a p erson who has reached 18 years of this Act if the mini st e r is satis f i e d that the pe rson has a s ( a) in the opi nion of a m edi ca l prac titione r is likely to conti (b) i n the opinion of a prescribed p r ofe ssional (i) dir ect ly a nd signi fic antl y res t ricts the pe r s on's a bi lity (A) con t i nuousl y, or (B ) pe r io dic ally for extend ed p eriods , and ( ii) as a r esul t of t hose res t rictions, t he person r e quires help (3 ) For the purpo ses of s ubs ection (2) , (a) a person who h as a seve re me ntal impa irment inclu de ( b ) a person requi res hel p in rel at ion to a daily livi ng ac tivity (i) an assistive device, (ii) the significant help or supervision of another person, or (iii) the services of an assist a n ce animal. (4) Th e minis ter m ay rescind a designation under subsection (2). Section 2(1)( a) of the EAPWDR defines DLA for a person who has a severe physical or mental impairment as follows: Definiti ons for Act 2 (1) For the purposes of th e Act an d this regulation, " da ily li v (a) in relation to a person who has a severe physical impairment or a severe menta activities: (i) prepare own meals; (ii) mana g e personal finances; A P PEAL# I a t i o n de cision, wh i ch fo u nd that the w ith d isa bilities (P WD) , was re ason ably su ppo r t ed plic ab le ena ctme nt in the circu mst ance s o f · d oes no t h ave a se v e re men tal or p hysic a l t his daily l iving a ctivities (D LA) are no t, i n the c antly restrict e d either c onti nuo usly or of t h o se restrictions, i t c ould no t be determ i ne d ervi s i on o f anot h e r p erson, the use o f a n m al to perf orm D LA. isa bili t ies (PWD) are s e t ou t i n Se ction 2 of the rson to per form a daily li v i n g ac tivi ty th at, becaus e of a to perform; of age as a per son with di sabili t ies for the purpos es eve re men t a l or ph ysic al impairme nt t h at n ue for at le ast 2 y e a rs, and to p erfor m daily living act ivities eithe r to per for m those a cti v itie s. s a person with a men t al disorder, and if, in order to p erform it , th e p erson requires i n g ac tivities" , l impairmen t, means the following
( i i i ) s h o p f o r p e r s o n a l n e e d s ; ( i v ) u s e p u b l i c o r p e r s o n a l t r a n s p o r t a t i o n f a c i l i t i e s ; ( v ) p e r f o r m h o u s e w o r k t o m a i n t a i n t h e p e r s o n ' s p l a c e ( v i ) m o v e a b o u t i n d o o r s a n d o u t d o o r s ; ( v i i ) p e r f o r m p e r s o n a l h y g i e n e a n d s e l f c a r e ; ( v i i i ) m a n a g e p e r s o n a l m e d i c a t i o n , a n d ( b ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a ( i ) m a k e d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e o r f ( i i ) r e l a t e t o , c o m m u n i c a t e o r i n t e r a c t w i t h o t h e r s e f f e S e v e r e P h y s i c a l I m p a i r m e n t 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 e v i d e n c e o f h i s c d i s e a s e , f a c e t j o i n t a r t h r i t i s a n d s p o n d y l o s i s e s t a b l i s 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 w h e n h e w a l k s , h e g m u s c l e s p a s m s i n h i s l e g , a r m a n d c h e s t . H e i s i n p b e d . T h e a p p e l l a n t a r g u e d t h a t h e c a n o n l y w a l k a b b a c k p a i n . H e t a k e s a n a r c o t i c m e d i c a t i o n d a i l y t h a s t a t e d t h a t h e t r i e d i n j e c t i o n s i n h i s b a c k b u t t h a t t h i 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 r e i s n o t e n o u g h i n e s t a b l i s h t h a t t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l i m a p p e l l a n t h a s a s i g n i f i c a n t p h y s i c a l i m p a i r m e n t b u t a t h e s e v e r i t y o f t h e i m p a i r m e n t g i v e n t h e a s s e s s m e n a p p e l l a n t c a n i n d e p e n d e n t l y m a n a g e a l m o s t a l l o f h P a n e l D e c i s i o n A d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n d o e s n o t s e v e r e i m p a i r m e n t . A n " i m p a i r m e n t " i s a m e d i c a l c o a b i l i t y t o f u n c t i o n i n d e p e n d e n t l y o r e f f e c t i v e l y . T o a s s e s s t h e s e v e r i t y o f a n i m p a i r m e n t t h e m i n i s t r y t h e e x t e n t o f i t s i m p a c t o n d a i l y f u n c t i o n i n g a s e v i d e t o w h i c h p e r f o r m i n g D LA i s r e s t r i c t e d . I n m a k i n g i t s r e l e v a n t e v i d e n c e , i n c l u d i n g t h a t o f t h e a p p e l l a n t . H f u n d a m e n t a l b a s i s f o r t h e a n a l y s i s i s t h e e v i d e n c e f r a p p e l l a n t ' s g e n e r a l p r a c t i t i o n e r . T h e g e n e r a l p r a c t i t i o n e r , w h o h a d k n o w n t h e a p p e l l a d e g e n e r a t i v e d i s c d i s e a s e a n d l o w b a c k p a i n , f a c e t p r a c t i t i o n e r r e p o r t e d t h a t t h e a p p e l l a n t d e s c r i b e d h i s t h e r i g h t k n e e . A n x r a y w a s d o n e i n M a y 2 0 1 2 s h o s p o n d y l o s i s L 2 L 3 a n d f a c e t j o i n t a r t h r i t i s t h r o u g h o u t h e a p p e l l a n t c a n w a l k l e s s t h a n 1 b l o c k u n a i d e d o n 5 l b s . a n d r e m a i n s e a t e d l e s s t h a n 1 h o u r . D e s p i t e i n d i c a t e d i n t h e P R t h a t t h e a p p e l l a n t d o e s n o t r e q u i A l t h o u h a w a l k e r w a s i d e n t i f i e d i n t h e A R a s a n a s s A P P E A L # I o f r e s i d e n c e i n a c c e p t a b l e s a n i t a r y c o n d i t i o n ; i r m e n t , i n c l u d e s t h e f o l l o w i n g a c t i v i t i e s : i n a n c e s ; c t i v e l y . h r o n i c l o w b a c k p a i n d u e t o d e g e n e r a t i v e d i s c h e 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 . I n h i s s e l f  e t s p a i n i n h i s h i p s a n d i n t o h i s b a c k a s w e l l a s a i n f r o m t h e t i m e h e w a k e s u p u n t i l h e g o e s t o o u t 1 b l o c k a n d b a c k b e f o r e i t c a u s e s e x t r e m e t h e l p s b r i n g t h e p a i n d o w n t o 8 / 1 0 . T h e a p p e l l a n t s d i d n o t p r o v i d e d l a s t i n g r e l i e f f r o m t h e p a i n . f o r m a t i o n f r o m t h e g e n e r a l p r a c t i t i o n e r t o 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 t h a t t h e r g u e d t h a t i t i s d i ff i c u l t f o r t h e m i n i s t ry t o c o n f i r m t b y t h e g e n e r a l p r a c t i t i o n e r i n d i c a t e d t h a t t h e i s D L A . i n i t s e l f d e t e r m i n e P W D e l i g i b i l i t y o r e s t a b l i s h a n d i t i o n t h a t r e s u l t s i n r e s t r i c t i o n s t o a p e r s o n ' s m u s t c o n s i d e r t h e n a t u r e o f t h e i m p a i r m e n t a n d n c e d b y f u n c t i o n a l s k i l l l i m i t a t i o n s a n d t h e d e g r e e d e t e r m i n a t i o n t h e m i n i s t r y m u s t c o n s i d e r a l l t h e o w e v e r , t h e l e g i s l a t i o n i s c l e a r t h a t t h e o m 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 c a s e , t h e n t f o r 7 m o n t h s , d i a g n o s e d t h e a p p e l l a n t w i t h j o i n t a r t h r i t i s a n d s p o n d y l o s i s . T h e g e n e r a l p a i n a s 1 0 / 1 0 , s h a r p , c o n t i n u o u s , r a d i a t i n g t o w i n g m u l t i l e v e l d e g e n e r a t i v e d i s c d i s e a s e w i t h t t h e l u m b a r s p i n e . 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 , a f l a t s u r f a c e , h e c a n c l i m b 2 t o 5 s t e p s , l i f t u n d e r t h e s e l i m i t a t i o n s , t h e g e n e r a l p r a c t i t i o n e r r e a n y p r o s t h e s i s o r a i d f o r h i s i m p a i r m e n t . i s t i v e d e v i c e t h a t t h e a e l l a n t r o u t i n e ! u s e s ,
APPEAL# I the comment by the general practitioner is that a shopping cart is used as a walker when the appellant is shopping. The appellant stated at the hearing that a walker has not been prescribed for him. In the AR, the general practitioner assessed the appellant as being independent with walking indoors and outdoors, and standing. He requires periodic assistance from another person with climbing stairs and lifting. He requires continuous assistance from another person with carrying and holding, with a comment added: "The patient can walk less than 1 block and can tolerate a few steps. He can lift light objects but not in a prolonged time span." In his Request for Reconsideration, the appellant clarified that when climbing stairs he experiences extreme pain from lifting his legs to go up stairs and he can usually manage 5 stairs before he needs to stop and rest so the pain subsides. The appellant wrote that he can lift 20 lbs. for a very brief time-a few seconds to move an item only. The panel finds that the evidence demonstrates that while the appellant experiences significant pain in his lower back which impacts his mobility, according to the general practitioner he remains independent with mobility and with most of his DLA, including those that require considerable physical effort as set out in more detail under "restrictions in the ability to perform DLA." Although the appellant provided information in his self-report, Request for Reconsideration and at the hearing that he requires assistance from another person with some of the DLA assessed as independent by the general practitioner, there was no further information provided by the prescribed professional to indicate an update or correction to the initial assessment. Considering all of the evidence, the panel finds that the ministry reasonably determined that there is not sufficient evidence to establish that the appellant has a severe physical impairment under Section 2(2) of the EAPWDA. Severe Mental Impairment The appellant did not maintain a position that he has a severe mental impairment. The ministry's position is that there is insufficient evidence to establish that the appellant has a severe mental impairment. Panel Decision The general practitioner did not diagnose a mental health condition but indicated in the PR that the appellant has significant deficits with cognitive and emotional function in the areas of motivation and motor activity, with an explanation that the appellant "has lost interest in doing daily activities due to pain. He cannot do things he used to do and enjoy." The general practitioner marked the section of the AR for assessing the degree of impact to cognitive and emotional functioning for those with an identified mental impairment as not applicable to the appellant. The appellant is assessed as independent in all areas of social functioning and with a good ability to communicate in all areas. Given the absence of a mental health diagnosis or evidence of impacts assessed to the appellant's mental or social functioning, the panel finds that the ministry .reasonably determined that a severe mental impairment was not established under Section 2(2) of the EAPWDA. Restrictions in the ability to perform DLA The appellant's position is that his physical impairment directly and significantly restricts his ability to perform DLA on an ongoing basis to the point that he requires the significant assistance of another person, namely his family. In his Notice of Appeal, the appellant wrote that the ministry's interpretation of the doctor's report is not accurate. While the doctor indicated that the appellant can inde endentl mana e the list of DLA and makes it seem like he is able to do all of them on a dail
b a s i s , h e c a n o n l y m a n a g e a f e w a t a t i m e . T h e a p w i t h t a s k s o f D L A d u e t o h i s l o w e r b a c k p a i n , a s s e R e c o n s i d e r a t i o n , a n d a t t h e h e a r i n g . 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 i n f o r m a t i o n f r o m t t h e a p p e l l a n t ' s i m p a i r m e n t s s i g n i f i c a n t l y r e s t r i c t h i s e x t e n d e d p e r i o d s o f t i m e . T h e m i n i s t r y a r g u e d t h a t a p p e l l a n t r e q u i r e s p e r i o d i c a s s i s t a n c e w i t h s o m e t a p r o v i d e a n y e x p l a n a t i o n o r d e s c r i p t i o n o f t h e f r e q u e e s t a b l i s h t h a t t h e a s s i s t a n c e i s r e q u i r e d f o r e x t e n d e P a n e l D e c i s i o n S e c t i o n 2 ( 2 ) ( b ) o f t h e E A P W D A r e q u i r e s t h a t a p r e s a p p l i c a n t ' s s e v e r e i m p a i r m e n t d i r e c t l y a n d s i g n i f i c a f o r e x t e n d e d p e r i o d s . I n t h i s c a s e , t h e g e n e r a l p r a c d e f i n e d i n S e c t i o n 2 ( 1 ) o f t h e E A P W D R a n d a r e a l s t h e A R . T h e r e f o r e , t h e p r e s c r i b e d p r o f e s s i o n a l c o m i n d i c a t e w h i c h , i f a n y , D L A a r e s i g n i f i c a n t l y r e s t r i c t e 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 . 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 , t h e g e n e r a l p r a c t i b e e n p r e s c r i b e d a n y p a i n m e d i c a t i o n o r t r e a t m e n t t A l t h o u g h t h e g e n e r a l p r a c t i t i o n e r w r o t e i n t h e P R t h d a i l y l i v i n g m a k e s h i s p a i n w o r s e , i n t h e A R t h e g e n i n d e p e n d e n t l y p e r f o r m s a l l t a s k s o f e a c h D L A i n c l u d e x c e p t i o n o f a r e q u i r e m e n t f o r p e r i o d i c a s s i s t a n c e w 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 p e r i o d i c a s s i s t a h o m e w h e n s h o p p i n g a n d u s i n g p u b l i c t r a n s i t a n d u t r a n s p o rt a t i o n . T h e g e n e r a l p r a c t i t i o n e r n o t e d t h a t a a p p e l l a n t d u e t o p a i n , w i t h n o f u r t h e r e x p l a n a t i o n s o d u r a t i o n o f t h e a s s i s t a n c e r e q u i r e d i n o r d e r t o a l l o w r e q u i r e d f o r e x t e n d e d p e r i o d s . T h e a p p e l l a n t r e p o rt e d i n h i s s e l f r e p o r t , h i s R e q u e e x p e r i e n c e s a n i n c r e a s e i n p a i n a n d l i m i t a t i o n s w i t h h i s 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 h i s b a c k p a i m a k e s i t d i ff i c u l t t o g e t o u t o f b e d i n t h e m o r n i n g . T v e h i c l e c a u s e s a g r e a t i n c r e a s e i n h i s b a c k p a i n . I n p o i n t e d o u t t h a t u s i n g t h e b u s s y s t e m i n h i s c o m m u f a r f o r h i m t o w a l k t o w h e r e h e n e e d s t o g o . W a l k i n e x t r e m e p a i n i n h i s b a c k a n d h i s l e g g o i n g n u m b . T s h o p p i n g , h e c a n n o t w a l k o n c o n c r e t e f l o o r s a n d h e t h e n h e h a s t o l e a v e a n d h e u s e s t h e s h o p p i n g c a r t a l l h i s c h o r e s d o n e i n o n e d a y a n d i t t a k e s h i m 3 d a m e a l s , h e m a k e s m e a l s t h a t h e c a n h a v e t h e f o l l o w T h e a p p e l l a n t e x p r e s s e d h i s f r u s t r a t i o n t h a t t h e s e r e g e n e r a l p r a c t i t i o n e r , a s t h e p r e s c r i b e d p r o f e s s i o n a l , t h e i n i t i a l a s s e s s m e n t m a d e i n t h e A R .A P P E A L # I p e l l a n t d e s c r i b e d t h e l i m i t a t i o n s h e e x p e r i e n c e s t o u t i n h i s s e l f r e p o r t , R e q u e s t f o r h e p r e s c r i b e d p r o f e s s i o n a l d o e s n o t e s t a b l i s h t h a t D LA e i t h e r 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 r a l t h o u g h t h e g e n e r a l p r a c t i t i o n e r r e p o r t e d t h a t t h e s k s o f D L A , t h e g e n e r a l p r a c t i t i o n e r d i d n o t n c y o r d u r a t i o n o f t h e a s s i s t a n c e r e q u i r e d t o d p e r i o d s . c r i b e d p r o f e s s i o n a l p r o v i d e a n o p i n i o n t h a t a n n t l y r e s t r i c t s h i s 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 t i t i o n e r i s t h e p r e s c r i b e d p r o f e s s i o n a l . D L A a r e o l i s t e d i n t h e P R a n d , w i t h a d d i t i o n a l d e t a i l s , i n p l e t i n g t h e s e f o r m s h a s t h e o p p o rt u n i t y t o d b y t h e a p p e l l a n t ' s i m p a i r m e n t s c o n t i n u o u s l y o r t i o n e r r e p o r t e d i n t h e P R t h a t t h e a p p e l l a n t h a s n o t h a t i n t e rf e r e s w i t h h i s a b i l i t y t o p e rf o r m D L A . a t t h e a p p e l l a n t f i n d s p r e t t y m u c h e v e r y a c t i v i t y o f e r a l p r a c t i t i o n e r r e p o r t e d t h a t t h e a p p e l l a n t i n g m o v i n g a b o u t i n d o o r s a n d o u t d o o r s , w i t h t h e i t h 3 t a s k s o f D L A . T h e g e n e r a l p r a c t i t i o n e r n c e f r o m a n o t h e r p e r s o n w i t h c a r r y i n g p u r c h a s e s s i n g t r a n s i t s c h e d u l e s a n d a r r a n g i n g n y p r o l o n g e d a c t i v i t y i s n o t a p o s s i b i l i t y fo r t h e r d e s c r i p t i o n s a d d e d r e g a r d i n g t h e f r e q u e n c y o r t h e m i n i s t r y t o d e t e r m i n e t h a t t h e a s s i s t a n c e i s s t f o r R e c o n s i d e r a t i o n , a n d a t t h e h e a r i n g t h a t h e h i s a b i l i t y t o c o m p l e t e v a r i o u s t a s k s o f D L A . I n n a ff e c t s h i s d a i l y r o u t i n e a n d l i v i n g a n d t h e p a i n h e a p p e l l a n t a l s o w r o t e t h a t g e t t i n g i n a n d o u t o f a h i s R e q u e s t f o r R e c o n s i d e r a t i o n , t h e a p p e l l a n t n i t y i s n o t a p o s s i b i l i t y s i n c e t h e b u s s t o p s a r e t o o g m o r e t h a n a b l o c k i s n o t p o s s i b l e w i t h o u t h e a p p e l l a n t s t a t e d a t t h e h e a r i n g t h a t f o r i s g o o d f o r o n e r o u n d o f t h e g r o c e r y s t o r e a n d l i k e a w a l k e r . F o r h o u s e k e e p i n g , h e c a n n o t g e t y s t o d o t h e c h o r e s t h a t s h o u l d t a k e o n e d a y . F o r i n g d a y o r b u y s i t e m s t h a t h e c a n j u s t h e a t u p . s t r i c t i o n s t o D L A h a v e n o t b e e n c o n f i r m e d b y t h e d e s p i t e b e i n g p r o v i d e d a n o p p o r t u n i t y t o u p d a t e
Given the lack of evidence from a prescribed professional regarding the nature restrictions to the appel l a nt's DLA, the panel finds tha evidence is insu ff i cient to show tha t the appell ant' s a e i th er continu o usly or per iod i cal ly f o r ex tended periods, thereby not satisfying the legislative cr of Se c t ion 2(2)(b )(i) of the EAPWDA. Help to perform DLA T h e appellant's po s iti on is that hi s physic a l impairm a s e vere enough extent tha t si gnificant assistance is required from his fa a n d s ister-in -law. T h e ministry 's position is that because it has not been established that DLA ar restrict e d , i t c a n not be determined that s ignificant h P a nel D eci sion S ectio n 2(2 )(b)(ii) of the E APWDA r equires that, as a b il it y t o pe rf or m DLA , a pers on r e quires help to per subsecti on (3) as the requirement for a n assist i v e devic a nother p erson, o r t he servi c es of a n assis tan ce animal in order I n the A R, the g eneral p ractiti oner re port ed t hat, wit p eo ple, the a ppella nt ' s f ami l y a nd friends as sist him. wo ul d h el p his ba c k pain . " While the gen eral pr act i t u sed by the a ppell an t , he n oted that th e appe llant "us and th e ap pellant stated at the h eari ng t ha t a wal ker tha t t he minist ry r easonab ly de termin ed that a s d i rect and a bility to perform D L A have not bee n e stablis h e d, it ca h elp to pe rform DLA as a r esult of those re str ictio ns, as define Conc l u sion Having r e v iewed and cons idered al l of the ev id ence a ministry's reconsideration dec ision which determined t designation was reaso nably supported by the evidence, and t APPEAL# I a nd extent of t the ministry reasonably c o nc lude d that the b i l it y to perform his DLA is signi ficant ly restricted it er ion ent significantly restrict his daily living fun cti ons to mily , specifically his broth er e significantly elp is required. a r esul t of di r ec t an d si gnifi c ant restri c ti o ns i n t he f o rm thos e activitie s. Help is defi n ed in e, the sig nific ant help or s up ervision o f to p e rform a DLA . h res p e ct to the a ss i s tance p rovided by oth e r The gene ral practiti o ner wr ote : " Lying do wn i oner i dentifie d a w a lk e r as an a ssis t ive dev i ce es shop ping cart a s a walker wh en sh o ppin g" has not be en presc r ibed to him. The p an el finds s ignifi cant restrictio ns in the appellant' s nnot be deter min ed that the appell a nt requi r e s d b y section 2(3)(b) of the EAPW D A. nd re levan t legi s l a ti on, the p a ne l fi nds that t he ha t t he appel l ant was not eligible for PWD h erefore confirms t he decision .
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