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 1 7 , 2 0 1 4 w 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 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 • 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 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 r f o r m D L A . P A R T D R e l e v a n t L e g i s l a t i o n E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a 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 I A P P E A L # 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 ) h i c h f o u n d t h a t t h e a p p e l l a n t d i d n o t m e e t 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 f o r P e r s o n s w i t h a b i l i t i e s ( P W D ) . T h e m i n i s t r y f o u n d 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 . d 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 ; e , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s ; a n d , 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 r v i c e s o f a n a s s i s t a n c e a n i m a l 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
I APPEAL# PART E -Summary of Facts The evidence before the ministry at the time of the reconsideration decision included the Persons With Disabilities (PWD) Application comprised of the applicant information and self-report dated March 25, 2014, a physician report (PR) and an assessor report (AR), both reports completed by a general practitioner who has known the appellant since May 2013. The evidence also included the appellant's Request for Reconsideration dated October 14, 2014. Diagnoses In the PR, the appellant was diagnosed by the general practitioner with previous left elbow compound # [fracture] comminuted and ongoing left elbow pain, with an onset of 2007, low back strain and neck strain, with an onset of August 2013 and query depression since 2007. Physical Impairment In the PR, the general practitioner reported that: • In terms of health history, in 2007 the appellant had an open reduction and internal fixation using tension band wiring for a comminuted fracture. The pins and wires were removed once the fracture healed. • The appellant has constant pain and throbbing in his left elbow that keeps him up at night. The appellant used to work with his hands and has stopped working since the injury because of pain. • In August of 2014, the appellant was in a MVA [motor vehicle accident] which caused neck and back strain. He has tried physiotherapy and medications and active rehabilitation. • The appellant does not require any prosthesis or aid for his impairment. • In terms of functional skills, the appellant can walk 4 or more blocks and climb 5 or more steps unaided, and he can lift 5 to 15 lbs. (2 to 7 kg) and remain seated for less than 1 hour. In the AR the general practitioner indicated that: • The appellant is assessed as independent with walking indoors and outdoors, climbing stairs and standing. He requires periodic assistance from another person with lifting and he requires periodic assistance with carrying and holding, with a comment added: "less than 5 to 15 lbs." • No assistive devices are indicated in the section of the AR relating to assistance provided and this section has been crossed out. • The general practitioner provided no additional comments. In the appellant's self-report, he wrote that: • He has increased pain to his left elbow as well as lower back and neck injury due to the MVA. • He is unable to stand for long periods. His bending and lifting abilities are minimal. • When he coughs, he gets sharp pains in his lower back that can "send [him] to the floor at any time." In his Request for Reconsideration, the appellant wrote that: • He has severe lower back pain at night and in the mornings which is worse in the cold weather. • His shoulder and left elbow are in a lot more pain. His right shoulder seems to have dropped out of the socket. He has been taking pain killers that just put him out of it. Mental Impairment In the PR, the general practitioner reported:
APPEAL# I • The appell a nt's mo od ha s b een low si nc e a fami l y m ember passed away. He has been irr ita ble , wi th de creased concentration and sleep intervals. • The a p pellant ha s no difficu l ty with comm unicatio n. • The appellant has signific ant deficits with cognit i v e and emotion al fun ction in the a reas of exe cutive, m e m or y , emotio nal dis t u rba n ce , motivat ion, and attention or sustained concen tration, with no comments provided . In the AR, the gene ral pr actitioner indicated that : • The appellant ha s a go od a bi lity to communi cate in all areas. • There are no major impacts to the appellant's cognitive an d e m otional functioning , wi th modera te impact s to bodily functions, em o t i on, at tention/concent ration, executive , memory, and motivat ion. There are mi nimal or no impac ts to the remainin g 8 areas of function ing, wi th no commen ts added by the general pract itioner. • With respect to social functioning, the appellant i s a s sessed as requiring pe r iodic supp ort/sup erv ision i n a ll asp e cts, name ly making a ppro priat e social de cisions, develop i n g an d ma i nt aini n g relations hips , i n t eract ing ap pr o p riat e ly wi t h others , de aling a ppropriat ely with unex pec t ed demand s, an d securing ass istance from others. • T he a ppellant "may req uire a s sista n ce" if m oo d decreases, co n c en tration a nd f o cu s are r ed u ce d, an d energ y a nd motivation dec re a se. • T he a p pe l lan t has mar gi n a l fu nctioni ng in bot h hi s im mediat e a nd extende d social netw o rk s . • Asked t o des cr ibe t h e s up port/s upe rvision req uired b y t he app ellan t which would help to maintai n hi m in the co m munity, t he g e ne ral pra ctiti one r w rote : "room m ate. " I n t he a ppell ant's s elf -repor t , he wrote that : • H is situ a tion is "ve ry dep ress ing a n d taki n g a hu g e t oll o n [ his] emot i on al well-b ei ng . V e r y angry an d s tre sse d." • He is awak e 3 to 4 times in an 8 -hour p eriod. He is sl eepin g for 12 t o 13 hour p eriod s. • He h as " ze r o pun ctual ity " a nd cann ot keep appointm ents very we ll. • He is em otionally s t r ess ed. In hi s Re que st for Rec onside rat ion , t he appe ll ant w r ote that: • He i s suffering f r om depr ession b ecause he cann ot work. Daily Living Activ ities (DLA) In the PR, the general practitione r indicated that: • The appellant has not been prescribed any medication and/or treatments that interfere with his daily liv ing act i vities. In the AR, the genera l practitioner reporte d that: • T he appellant is independent with moving about indoors and outdoors. • The appellant is independent with all tasks of the DLA personal care, manage personal finances (paying rent and bills), personal medica tion a nd u se o f t r ansportation. • For basic housekeeping, the appellant requires periodic assistance from another person, and the general practitioner wrote "lifting tolerance 5 to 15 lbs." • For s h o pp ing, t he app el lan t is indepe ndent with going to and from stores, reading prices and labels, making appropriate choices an d p a ying for pu rchases and requires periodic assi stance from another person with carrvinQ purchases home. The Qeneral practitioner aQain referred to
t h e a p p e l l a n t ' s a b i l i t y t o l i f t 5 t o 1 5 l b s . • R e g a r d i n g m e a l s , t h e a p p e l l a n t i s i n d e p e n d 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 a n o t h e g e n e r a l p r a c t i t i o n e r c o m m e n t e d : " s t a n d t o l e r a 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 w r o t e t h a t : • H i s l i v i n g c i r c u m s t a n c e s a r e s u c h t h a t h e c a n t h e m h o m e . • H e n e e d s h e l p d o i n g h i s l a u n d r y b e c a u s e h e b a c k a n d e l b o w p a i n . H e c a n n o t d o d i s h e s a n • H i s r o o m m a t e c o o k s e v e r y t h i n g w h i l e t h e a p e v e r y t h i n g . • H i s r o o m m a t e c l e a n s , t a k e s c a r e o f b i l l s , d o e 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 r • H e i s t a k i n g p a i n k i l l e r s t h a t p u t h i m " o u t o f i t " • H i s r o o m m a t e h e l p s h i m w i t h e v e r y t h i n g . N e e d fo r H e l p 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 i n t h e A R t h a t , w i t p e o p l e , t h e a p p e l l a n t ' s f r i e n d s a s s i s t h i m . T h e s e c t i 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 i s c r o s s e d o u t a 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 2 4 , 2 0 1 4 , t h e 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 h e a n d e l b o w p a i n . T h i s c a u s e s h i m t o b e v e r y d e p r e s h i m s e l f . H e d o e s n o t u n d e r s t a n d w h y h e k e e p s b e i n 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 t a t e d t h a t : • H e e x p e r i e n c e s e l b o w a n d b a c k p a i n a n d h i s • H i s r o o m m a t e h a s t o d o p r e t t y m u c h e v e r y t h • H e h a s b e e n t r y i n g t o g e t a n t i d e p r e s s a n t m e m i s s e d a n a p p o i n t m e n t a t a m e n t a l h e a l t h c o H e h a s n o t b e e n d i a g n o s e d w i t h d e p r e s s i o n . • H e h a s a f a m i l y h i s t o r y o f m e n t a l h e a l t h i s s u e m e n t a l h e a l t h c o n d i t i o n s . H e w o n d e r s i f h e m d o w n . • A s a r e s u l t o f t h e p a i n , h e h a s t r o u b l e d o i n g t • T h e c o l d e r w e a t h e r i n t h e w i n t e r a l s o a f f e c t s • H i s c o n d i t i o n s a r e o v e r w h e l m i n g f o r h i m i n m • H e i s a b l e t o m o v e h i s e l b o w b u t a s s o o n a s h m o r e p a i n . • H e w a s s u p p o s e d t o s e e a n o r t h o p e d i c s u r g e e l b o w , t o s e e i f t h i s w o u l d h e l p , a n d t o c h e c k a p p o i n t m e n t a n d d i d n o t k n o w h e h a d t o p h o n a p p o i n t m e n t w a s c a n c e l l e d . H e h a s t o r e s c h a n q rv t h a t h e m i s s e d t h e a p p o i n t m e n t .A P P E A L # I n t w i t h m e a l p l a n n i n g a n d s a f e s t o r a g e o f f o o d r p e r s o n w i t h f o o d p r e p a r a t i o n a n d c o o k i n g . T h e n c e l e s s t h a n 1 h o u r ; l i f t i n g 5 t o 1 5 l b s . " n o t b u y g r o c e r i e s a l o n e b e c a u s e h e c a n n o t c a r r y c a n n o t l i f t t h e l a u n d r y b a s k e t d u e t o h i s l o w e r d h a s t r o u b l e b r u s h i n g h i s t e e t h s t a n d i n g u p . p e l l a n t c a n n o t s t a n d l o n g s o h e m i c r o w a v e s s l a u n d r y a n d " b a s i c a l l y d o e s e v e r y t h i n g . " o t e t h a t : a n d h e i s u n a b l e t o w o r k n o r m a l l y . 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 o t h e r 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 p r o v i d e d s n o t a p p l i c a b l e t o t h e a p p e l l a n t . 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 h a s a r e c o n s t r u c t e d e l b o w , s e v e r e l o w e r b a c k s e d . H e f e e l s u s e l e s s a n d h e c a n n o t h e l p g d e n i e d . s h o u l d e r i s o u t o f t h e s o c k e t . i n g f o r h i m . d i c a t i o n b u t h e n e e d s t o b e d i a g n o s e d a n d h e u n s e l i n g c e n t r e a n d t h e n t h e o f f i c e c l o s e d t h e f i l e . s w i t h s i b l i n g s w h o h a v e b e e n d i a g n o s e d w i t h i g h t b e b i p o l a r s i n c e h i s m o o d g o e s u p a n d h e d i s h e s o r l a u n d r y . h i s p a i n . a n y w a y s . e p u t s p r e s s u r e o n i t o r u s e s h i s a r m , h e f e e l s o n a b o u t g e t t i n g t h e m e t a l p i n s r e m o v e d f r o m h i s h i s s h o u l d e r . H e w a i t e d 3 m o n t h s f o r t h e e i n a d v a n c e t o c o n f i r m t h e a p p o i n t m e n t a n d t h e e d u l e t h e a p p o i n t m e n t b u t h i s d o c t o r w i l l b e
• H i s d o c t o r h a s n o t s a i d m u c h a b o u t h i s s h o u • H e m a y h a v e t o h a v e f u r t h e r s u r g e r y o n h i s b r a c e b u t s o m e t i m e s h e p u t s h i s a r m i n a s h s l e e p i n g . • H e h a s l o w e r b a c k p a i n i n t h e m o r n i n g a n d u i n c r e a s e d p a i n t o h i s e l b o w a n d s h o u l d e r . • T h e p a i n m e d i c a t i o n h e t a k e s l e a v e s h i m w i t r o o m m a t e h e l p s h i m w i t h e v e r y t h i n g . H e c l e d o e s t h e c o o k i n g . • H e h a s e x p l a i n e d t o h i s d o c t o r h o w t h e m e d i h e b e l i e v e s h i s d o c t o r m a y b e o v e r w o r k e d a h i m h i s s i t u a t i o n . • H i s l i m i t a t i o n s w i t h l i f t i n g a r e f o r b o t h a r m s s i s h o u l d e r . A d m i s s i b i l i t y o f N e w I n fo r m a t i o n T h e m i n i s t r y d i d n o t r a i s e a n o b j e c t i o n t o t h e a p p e l l a d d i t i o n a l i n f o r m a t i o n r e g a r d i n g h i s i m p a i r m e n t a s d i n t h e 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 p a n e l a d m s u p p o r t o f i n f o r m a t i o n a n d r e c o r d s t h a t w e r e b e f o r e a c c o r d a n c e w i t h s . 2 2 ( 4 ) ( b ) o f t h e E m p l o y m e n t a n d T h e m i n i s t r y r e l i e d o n i t 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 A P P E A L # I l d e r e x c e p t t o t r y n o t t o u s e i t . e l b o w . H e d o e s n o t w e a r a n e l b o w , b a c k o r n e c k o u l d e r s l i n g s o h e d o e s n o t r o l l o n t o i t w h e n h e ' s s e s h i s a r m s t o s u p p o r t h i s b a c k , w h i c h r e s u l t s i n h n o s t r e n g t h o r a m b i t i o n t o d o a n y t h i n g . H i s a n s , d o e s t h e d i s h e s , g e t s t h e g r o c e r i e s , a n d c a t i o n s m a k e i t d i f f i c u l t f o r h i m t o d o a n y t h i n g b u t n d d o e s n o t p a y a t t e n t i o n w h e n t h e a p p e l l a n t t e l l s n c e h e h a s p a i n i n h i s l e f t e l b o w a n d h i s r i g h t a n t ' s o r a l t e s t i m o n y . T h e a p p e l l a n t p r o v i d e d i a g n o s e d i n t h e P W D a p p l i c a t i o n a n d d e s c r i b e d i t t e d t h i s a d d i t i o n a l i n f o r m a t i o n a s b e i n g i n t h e m i n i s t r y a t t h e t i m e o f r e c o n s i d e r a t i o n , i n A s s i s t a n c e A c t . s s u m m a r i z e d a t t h e h e a r i n g .
APPEAL# I PART F -Reasons for Panel Decision The issue on the appeal is whether the ministry's reconsideration decision, which found that the appellant is not eligible for designation as a person with disabilities (PWD), was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. The ministry found that the appellant does not have a severe mental or physical impairment based on the information provided and that his daily living activities (DLA) are not, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods. Also, as a result of those restrictions, it could not be determined that the appellant requires the significant help or supervision of another person, the use of an assistive device, or the services of an assistance animal to perform DLA. The criteria for being designated as a person with disabilities (PWD) are set out in Section 2 of the EAPWDA as follows: Persons with disabilities 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; "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(1)(a) of the EAPWDR defines DLA for a person who has a severe physical or mental impairment as follows: Definitions for Act 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;
( 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 ( 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 ( 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 a s e v e r e p h y s i c a l i m o n g o i n g p a i n h e e x p e r i e n c e s d u e t o a p r e v i o u s l e f t s t r a i n a n d n e c k s t r a i n c a u s e d b y a m o t o r v e h i c l e a c h e h a s e x p l a i n e d h i s s i t u a t i o n t o h i s d o c t o r a n d h e a t t e n t i o n . 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 s t a t e d t h a b e n d i n g a n d l i f t i n g a b i l i t i e s a r e m i n i m a l , a n d w h e n h t h a t c a n " s e n d [ h i m ] t o t h e f l o o r a t a n y t i m e . " 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 ' s f u n c t i o a s i d e f r o m t h e n o t e d l i ft i n g t o l e r a n c e o f 5 t o 1 5 l b s . p r o v i d e d d o e s n o t d e m o n s t r a t e a s e v e r e p h y s i c a l i m p r a c t i t i o n e r i n d i c a t e d t h e a p p e l l a n t i s o t h e rw i s e i n d e n a m e l y 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 , c l i m b i n g s t a i 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 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 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 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 L A 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 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 l e f t e l b o w c o m p o u n d f r a c t u r e c o m m i n u t e d a n d o n g o n e c k s t r a i n a s a r e s u l t o f a m o t o r v e h i c l e a c c i d e n t . w r o t e t h a t h i s r i g h t s h o u l d e r a l s o s e e m s t o h a v e d r o a p p e l l a n t s t a t e d t h a t w h e n h e d i s c u s s e d h i s s h o u l d u s i n g h i s s h o u l d e r a n d r e f e r r e d h i m t o a s p e c i a l i s t . a p p o i n t m e n t s c h e d u l e d w i t h t h e o r t h o p e d i c s u r g e o n p o s s i b i l i t y o f f u r t h e r s u r g e r y f o r h i s e l b o w a n d h e n e 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 ; a 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 : f i n a n c e s ; c t i v e l y . p a i r m e n t i s e s t a b l i s h e d b y t h e e v i d e n c e o f t h e e l b o w c o m p o u n d f r a c t u r e a s w e l l a s l o w b a c k c i d e n t . 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 r g u e d t h a t b e l i e v e s h i s d o c t o r i s o v e r w o r k e d a n d d i d n o t p a y t h e i s u n a b l e t o s t a n d f o r l o n g p e r i o d s , h i s e c o u g h s , h e g e t s s h a r p p a i n s i n h i s l o w e r b a c k n a l s k i l l l i m i t a t i o n s a r e n o t s i g n i f i c a n t l y r e s t r i c t e d a n d s i t t i n g l e s s t h a n o n e h o u r a n d t h e i n f o r m a t i o n p a i r m e n t . T h e m i n i s t r y a r g u e d t h a t t h e g e n e r a l p e n d e n t w i t h a l l 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 , r s a n d s t a n d i n g . t 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 o 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 y 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 r 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 a n t f o r a b o u t a y e a r , 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 i n g l e f t e l b o w p a i n , a s w e l l a s l o w b a c k s t r a i n a n d 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 p p e d o u t o f t h e s o c k e t . A t t h e h e a r i n g , t h e e r w i t h h i s d o c t o r , t h e d o c t o r r e c o m m e n d e d n o t T h e a p p e l l a n t s t a t e d t h a t h e m i s s e d t h e t o i n v e s t i g a t e h i s s h o u l d e r i n j u r y a n d r e v i e w t h e e d s t o r e s c h e d u l e t h a t a p p o i n t m e n t .
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 i n t h e P R t h a t t h e l e f t e l b o w t h a t k e e p s h i m u p a t n i g h t a n d t h a t t h e a s t o p p e d w o r k i n g s i n c e t h e i n j u r y b e c a u s e o f p a i n . s e c t i o n 2 ( 2 ) o f t h e E A P W D A r e q u i r e s t h a t t h e m i n i d e m o n s t r a t e s s i g n i f i c a n t r e s t r i c t i o n s i n t h e p e r s o n ' f u n c t i o n i n g ( D L A ) . A s t h e a b i l i t y t o s e a r c h f o r , a c c o f t h e p r e s c r i b e d D L A i n s u b s e c t i o n 2 ( 1 ) ( a ) o f t h e r e a s o n a b l y h e l d t h a t e m p l o y a b i l i t y i s n o t a f a c t o r i n T h e g e n e r a l p r a c t i t i o n e r f u r t h e r r e p o r t e d t h a t t h e a h i s i m p a i r m e n t a n d d o e s n o t r e q u i r e a n a s s i s t i v e d h e w e a r s a s h o u l d e r s l i n g w h e n s l e e p i n g t o p r e v e n f u n c t i o n a l s k i l l 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 p o r t e d t h c l i m b 5 o r m o r e s t e p s u n a i d e d , a n d h e c a n l i f t 5 t o 1 h o u r . T h e a p p e l l a n t i s a s s e s s e d a s i n d e p e n d e n t a n d s t a n d i n g . W h i l e t h e a p p e l l a n t i s a s s e s s e d a s r w i t h l i f t i n g a n d w i t h c a r r y i n g a n d h o l d i n g , t h i s i s d e t o 1 5 l b s . 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 p a i n i n h i s l e f t e l b o w a s w e l l a s h i s r i g h t s h o u l d e r . u n a b l e t o s t a n d f o r l o n g p e r i o d s a n d h i s b e n d i n g a n T h e p a n e l f i n d s t h a t w h i l e t h e e v i d e n c e d e m o n s t r a t o h i s p h y s i c a l a b i l i t i e s d u e t o o n g o i n g p a i n , p a r t i c u h e r e m a i n s i n d e p e n d e n t w i t h h i s m o b i l i t y a n d f u r t h p e n d i n g . I n t h e a b s e n c e o f f u r t h e r d e t a i l f r o m t h e m a p p e l l a n t ' s c u r r e n t f u n c t i o n i n g , t h e p a n e l f i n d s t h a t n o t s u f f i c i e n t e v i d e n c e t o e s t a b l i s h t h a t t h e a p p e l l a 2 ( 2 ) o f t h e E A P W D A . 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 a p p e l l a n t ' s p o s i t i o n , a s e x p r e s s e d i n h i s R e q u h e s u f f e r s f r o m d e p r e s s i o n . I n t h e a p p e l l a n t ' s s e l f d e p r e s s i n g a n d t a k i n g a h u g e t o l l " o n h i s e m o t i o n a d i s t u r b e d s l e e p , h e h a s " z e r o p u n c t u a l i t y " a n d c a n n e m o t i o n a l l y s t r e s s e d . I n h i s R e q u e s t f o r R e c o n s i d e f r o m d e p r e s s i o n b e c a u s e h e c a n n o t w o r k . 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 i n s u f f i c i e n t e v 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 r g u e d t h s i g n i f i c a n t d e f i c i t s t o t h e a p p e l l a n t ' s c o g n i t i v e a n d e a s m o d e r a t e i m p a c t s , w i t h n o m a j o r i m p a c t s t o f u n 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 h a s d e s c r i b e d a r e m o r e i n k e e p i n g w i t h a m o d e r a t e d e g P a n e l D e c i s i o n 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 w r o t e t h a t t h e r e h e a r i n g , t h e a p p e l l a n t a c k n o w l e d g e d t h a t h e h a s n a e l l a n t s t a t e d t h a t h e w a n t e d t o e t a r e s c r i t i o I A P P E A L # a p p e l l a n t h a s c o n s t a n t p a i n a n d t h r o b b i n g i n h i s p p e l l a n t u s e d t o w o r k w i t h h i s h a n d s a n d h a s F o r a n i m p a i r m e n t t o b e a " s e v e r e i m p a i r m e n t , " s t r y m u s t b e s a t i s f i e d t h a t t h e e v i d e n c e s a b i l i t y t o p e r f o r m s p e c i f i e d a r e a s o f d a i l y e p t o r c o n t i n u e i n e m p l o y m e n t i s n o t l i s t e d a s o n e E A P W D R , 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 a s s e s s i n g e l i g i b i l i t y f o r P W D d e s i g n a t i o n . p p e l l a n t d o e s n o t r e q u i r e a n y p r o s t h e s i s o r a i d f o r e v i c e , w h i l e 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 t r o l l i n g o v e r o n h i s i n j u r e d s h o u l d e r . I n t e r m s o f a t t h e a p p e l l a n t c a n w a l k 4 o r m o r e b l o c k s a n d 1 5 l b s . ( 2 t o 7 k g ) a n d r e m a i n s e a t e d f o r l e s s t h a n w i t h 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 , c l i m b i n g s t a i r s e q u i r i n g p e r i o d i c a s s i s t a n c e f r o m a n o t h e r p e r s o n s c r i b e d a s f o r l i f t i n g w e i g h t s o u t s i d e t h e r a n g e o f 5 h i s l i f t i n g l i m i t a t i o n s r e l a t e t o b o t h a r m s b e c a u s e o f 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 w r o t e t h a t h e i s d l i f t i n g a b i l i t i e s a r e m i n i m a l . t e s 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 s s o m e l i m i t a t i o n s l a r l y i n t h e a r e a o f l i f t i n g a n d c a r r y i n g a n d h o l d i n g , e r i n v e s t i g a t i o n o f h i s s h o u l d e r a n d e l b o w i s e d i c a l p r a c t i t i o n e r r e g a r d i n g i m p a c t s t o t h e t h 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 t h a t t h e r e i s n t h a 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 u n d e r S e c t i o n e 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 , i s t h a t r e p o r t , h e w r o t e t h a t h i s s i t u a t i o n i s " v e r y l w e l l b e i n g . T h e a p p e l l a n t s t a t e d t h a t h e h a s o t k e e p a p p o i n t m e n t s v e r y w e l l , a n d h e i s r a t i o n , t h e a p p e l l a n t w r o t e t h a t h e i s s u ff e r i n g i d e n c e t o 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 a 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 r e p o r t e d m o t i o n a l f u n c t i o n i n g , t h e s e w e r e a s s e s s e d l a r g e l y c t i o n i n g i n d i c a t e d . T h e m i n i s t r y a r g u e d t h a t t h e n o d i f f i c u l t i e s w i t h c o m m u n i c a t i o n a n d t h e i m p a c t s r e e o f i m p a i r m e n t . i s a q u e r y r e g a r d i n g d e p r e s s i o n a n d , a t t h e o t y e t b e e n d i a g n o s e d w i t h d e p r e s s i o n . T h e n f o r a n t i d e r e s s a n t m e d i c a t i o n s , h e h a s a f a m i l
APPEAL# I history of mental health conditions, but that he missed an appointment arranged to see a specialist and it is likely that the office closed his file. The general practitioner wrote in the PR that the appellant's mood has been low since a family member passed away and he has been irritable, with decreased concentration and sleep intervals. The general practitioner reported that, while there are significant deficits to the appellant's cognitive and emotional functioning, there are no major impacts to daily functioning. There are moderate impacts reported in the areas of bodily functions, emotion, attention/concentration, executive, memory, and motivation, with minimal or no impacts to the remaining 8 areas of functioning and no comments added by the general practitioner. In the appellant's self-report, he wrote that his situation is "very depressing and taking a huge toll" on his emotional well-being. The appellant stated that he has disturbed sleep, he cannot keep appointments very well, and he is emotionally stressed. In his Request for Reconsideration, the appellant wrote that he is suffering from depression because he cannot work and, at the hearing, the appellant stated that his conditions are overwhelming for him. Considering the two DLA that are specific to mental impairment -make decisions about personal activities, care or finances (decision making), and relate to, communicate or interact with others effectively (social functioning), the available evidence indicates that the appellant is not significantly restricted in either. With respect to decision making, the general practitioner reported in the AR that the appellant independently manages his finances (banking, budgeting, pay rent and bills) and his medications (taking as directed and safe handling). He is also reported as independent in the decision-making components of the DLA of daily shopping (making appropriate choices), meal preparation (meal planning and food storage) and transportation (using transit schedules and arranging transportation). The general practitioner indicated that the appellant requires periodic support/supervision with making appropriate social decisions but wrote that the appellant "may" require assistance if his mood, concentration/ focus, energy and motivation decrease. Regarding the DLA of social functioning, the appellant is assessed as requiring periodic support/supervision with developing and maintaining relationships, interacting appropriately with others and securing assistance from others "if' his condition deteriorates. The appellant has marginal functioning in both his immediate and extended social networks. Asked to describe the support/supervision required by the appellant that would help to maintain him in the community, the general practitioner wrote: "room-mate." The appellant is assessed with a good ability to communicate in all areas. Given the absence of a definitive mental health diagnosis and current impacts 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 and mental impairments directly and significantly restrict his ability to perform DLA on an ongoing basis to the point that he requires the significant assistance of another person, namely his room-mate. The appellant argued in his Request for Reconsideration that he is taking pain killers that put him "out of it," he is unable to work normally, and his room-mate helps him with everything. In his self-report, the appellant wrote that his living circumstances are such that he cannot buy groceries alone because he cannot carry them home, he needs help doing his laundry because he cannot lift the laundry basket, he cannot do dishes and has trouble brushing his teeth standing up, and his room-mate cooks, cleans, takes care of bills, does laundry and "basically does everything."
I APPEAL# The ministry's position is that all DLA are performed independently or require periodic assistance from others but the information is not specific as to the frequency of assistance required. Therefore, the information from the prescribed professional does not establish that his impairment significantly restricts DLA either continuously or periodically for extended periods of time. Panel Decision Section 2(2)(b) of the EAPWDA requires that a prescribed professional provide an opinion that an applicant's severe impairment directly and significantly restricts his DLA, continuously or periodically for extended periods. In this case, the general practitioner is the prescribed professional. DLA are defined in Section 2(1) of the EAPWDR and are also listed in the PR and, with additional details, in the AR. Therefore, a prescribed professional completing these forms has the opportunity to indicate which, if any, DLA are significantly restricted by the appellant's impairments continuously or periodically for extended periods. In the appellant's circumstances, while the appellant stated that the pain medications he is taking leaves him with no strength or ambition to do anything, the general practitioner reported in the PR that the appellant has not been prescribed any medication and/or treatments that interfere with his DLA. At the hearing, the appellant stated that he has explained to his doctor how the medications make it difficult for him to do anything but he believes his doctor may be over-worked and does not pay attention. In his Request for Reconsideration, the appellant wrote that he is taking pain killers that put him "out of it" and he is unable to work normally. As set out above, the panel finds that the ministry reasonably determined that employability is not a factor for evaluating eligibility for PWD designation. In the AR, the general practitioner reported that the appellant is independent with walking indoors and outdoors and with most tasks of all other listed DLA. While the general practitioner assessed some tasks of the DLA housekeeping, shopping and meals to require periodic assistance from another person, the general practitioner tied these restrictions to lifting tolerance of 5 to 15 lbs. and standing tolerance of less than one hour and provided no other comment regarding the frequency of assistance required. Therefore, although this is an indication from a prescribed profession of a need for periodic assistance in some tasks of DLA, namely laundry, basic housekeeping, carrying purchases home when shopping, food preparation and cooking, the general practitioner has not provided sufficient detail to determine whether the need for assistance is periodic for extended periods. The appellant stated at the hearing that his room-mate has to do pretty much everything for him, including cleaning, doing the dishes, getting the groceries, and cooking; however, there was no further information provided from a prescribed professional. The panel finds that the ministry reasonably concluded that there is not enough evidence from the prescribed professional to establish that the appellant's impairment significantly restricts his ability to manage his DLA either continuously or periodically for extended periods, thereby not satisfying the legislative criterion of Section 2(2)(b)(i) of the EAPWDA. Help to perform DLA The appellant's position is that his combined physical and mental impairments affect his daily living functions to a severe enough extent that assistance is required. The minist 's osition is that because it has not been established that DLA are si
r e s t r i c t e d , i t c a n n o t b e d e t e r m i n e d t h a t s i g n i f i c a n t h P a n e l D e c i s i o n S e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A r e q u i r e s t h a t , a s a b i l i t y t o p e rf o r m D L A , a p e r s o n r e q u i r e s h e l p t o p e s u b s e c t i o n ( 3 ) a s t h e r e q u i r e m e n t f o r a n a s s i s t i v e d a n o t h e r p e r s o n , o r t h e s e r v i c e s o f a n a s s i s t a n c e a n 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 i n t h e A R t h a t , w p e o p l e , t h e a p p e l l a n t r e c e i v e s h e l p f r o m h i s f r i e n d s f r o m h i s r o o m m a t e a n d t h a t h e a l s o u s e s a s h o u l d H o w e v e r , t h e s e c t i o n o f t h e A R i n d i c a t i n g a s s i s t a n c h a s b e e n c r o s s e d o u 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 a s t h a t t h 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 t h a t a s d i r e a b i l i t y t o p e r f o r m D L A h a v e n o t b e e n e s t a b l i s h e d , i t h e l p t o p e r f o r m D L A 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 C o n c l u s i o n H a v i n g r e v i e w e d a n d c o n s i d e r e d a l l o f t h e e v i d e n c e 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 w h i c h d e t e r m i n e d e s i g n a t 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 b y t h e e v i d e I A P P E A L # e l p i s r e q u i r e d . a r e s u l t o f d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n s i n t h e r f o r m t h o s e a c t i v i t i e s . H e l p i s d e f i n e d i n e v i c e , 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 i m a l i n o r d e r t o p e r f o r m a D L A 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 o t h e r . T h e a p p e l l a n t c l a r i f i e d t h a t h e r e c e i v e s h e l p e r s l i n g a t n i g h t t o p r o t e c t h i s i n j u r e d s h o u l d e r . 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 n o t a p p l i c a b l e t o t h e a p p e l l a n t . T h e p a n e l f i n d s c t a n d s i g n i f i c a n t r e s t r i c t i o n s i n t h e a p p e l l a n t ' s c a n n o t b e 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 r e q u i r e s , a s d e f i n e d b y s e c t i o n 2 ( 3 ) ( b ) o f t h e E A P W D A . a n d r e l e v a n t l e g i s l a t i o n , t h e p a n e l f i n d s t h a t t h e d t h a t t h e a p p e l l a n t w a s n o t e l i g i b l e f o r P W D n c e , a n d t h e r e f o r e c o n f i r m s t h e d e c i s i o n .
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.