I APPEAL# PART C Decision unde Appeal The Ministry of Social Deve opment and Social Innovation (the ministry) reconsideration decision dated 8 January 2015 deter r 1 ined that the appellant was not eligible for the monthly nutritional supplement (MNS) for vitan ,in/mineral supplementation under section 67(1) of the Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) because it was not established that the requested vitamins and m 1 inerals would alleviate the symptoms of a chronic, progressive deterioration of health and f 1 revent imminent danger to life under s. 67(1.1)(c) and (d) of the EAPWDR. The ministry however deten 1ined the appellant was eligible for a monthly nutritional supplement (MNS) for nutritional items c ,s part 6f a caloric supplementation to a regular dietary intake to alleviate the symptoms of his chronic progressive deterioration of health and to prevent an imminent danger to his life as set out ins. 67(1. ) and $chedule C, subsection 7(a) of the EAPWDR. I I PART D Relevant Legis ation I Employment and AssistancE for Persons with Disabilities Regulation (EAPWDR), section 67; EAPWDR, Schedule C, s. 7 EMT003(10/06/01)
I APPEAL# PART E -Summa The following evidence was ~efore the ministry at the time of reconsideration: • The appellant is a perso with disabilities who receives disability assistance and persons with disabilities (PWD) benefi 1 s. • An Application for Month~ Nutritional Supplement dated 15 November 2014 completed and signed by the appellant' physician indicating that: o The appellant su rs from chronic low back and neck pain and depression. o As a result of the . 1 evere medical condition of the appellant, he is being treated with "physic" and anal 1 esics. o Section 3 of the f tmt itled "As a direct result of the chronic, progressive deterioration of health noted abo f ! , doe5i the applicant display two or more of the following symptoms? If so, please descri in detail" and there is a list of 7 symptoms but the section was not completed and le I blank. o The physician rec mmends Vitamin D for bone support and to prevent fractures. I o The nutritional ite s would alleviate symptoms related to anorexia and depression and would prevent furt er weight loss. • In his request for reconsi, eration dated 10 December 2014, the appellant indicates that his physician wrote that the ,: roblems were associated with malnutrition and weight loss for both of which he added "looks u I derweight, poor dietary intake", significant weight loss of 10 lbs in less than 1 year and significa t muscle mass loss -"was very lean before; lost 10 lbs muscle mass". Both the appellant and h physipian signed the document. • Along with the request fo I reconsideration, the appellant submitted a copy of the Application for MNS dated 15 Novembe II 2014 in which the originally blank section 3 had been filled as follows: o Malnutrition and u derweight status: "looks and is malnourished" o Significant weight o Significant muscl I os s: "10 lb in one year" mass loss: "Over 18 [months] weakened ++" In his Notice of Appeal date I 2 January 2015, the appellant wrote that his physician misunderstood and that he bought his own alcium with vitamin D and that the physician supports his need for a vitamin supplement. Further he stated that his physician told him he did not complete those forms often and that he had made :. mistake. Along with his Notice of Appeal, the appellant provided a prescription dated 13 Janua 1 2015 signed by his physician to the effect that he needed multivitamins 50+, daily for 1 year. I The ministry did not object t the admissibility of the prescription and the panel determined the additional documentary evid: nee was admissible under s. 22(4) of the EAA as it was in support of the I records before the minister t reconsideration, specifying exactly what vitamins the physician intended to prescribe, the d se and for how long. EAAT 003(10/06/01)
I APPEAL#. PART F Reasons for P nel Decision The issue under appeal is w I ether the ministry's decision that the appellant was not eligible for the monthly nutritional supplem nt for vitamin/mineral supplementation under section 67(1) of the EAPWDR because it was n 1 t estab/ished that the requested vitamins and minerals would alleviate the symptom of a chronic, p gressjve deterioration of health and prevent imminent danger to life I under s. 67(1.1)(c) and (d) 01· the EAPWDR, was a reasonable application of the legislation or reasonably supported by th evidence. The applicable legislation is I ection 67 of the EAPWDR that states: 67 (1) The minister may pro ide a nutritional supplement in accordance with section 7 [monthly 1 nutritional supplement] of S edule C to or for a person with disabilities in a family unit who receives disability assistance under (a) section 2 [monthly supp I alloWjance], 4 [monthly shelter allowance], 6 [people receiving room and board] or 9 [people in e I ergenby shelters and transition houses] of Schedule A, or ... if the minister is satisfied tha ( c) based on the information pontained in the form required under subsection (1.1) , the requirements set out in subsection (1.1) ( 1 to (d) are met in respect of the person with disabilities, (d) the person is not receivin a supplement under section 2 (3) [general health supplement] of Schedule C, (e) the person is not receivin. a suRplement under subsection (3) or section 66 [diet supplements], (f) the person complies with : ny reqluirement of the minister under subsection (2), and (g) the person's family unit d, es no( have any resources available to pay the cost of or to obtain the items for which the supplem 1 nt may be provided. (1.1) In order for a person wi h disabilities to receive a nutritional supplement under this section, the I minister must receive a requ st, in the form specified by the minister, completed by a medical practitioner or nurse practiti er, in which the practitioner has confirmed all of the following: I (a) the person with disabiliti to whom the request relates is being treated by the practitioner for a chronic, progressive deterio . tion o~ health on account of a severe medical condition; (b) as a direct result of the c 11 ronic, progressive deterioration of health, the person displays two or 1 more of the following sympt s: (i) malnutrition; (ii) underweight sta (iii significant weigh loss; (iv) significant mus e mass loss; (v) significant neur ogical degeneration; (vi) significant dete bration of a vital organ; (vii) moderate to se 1 ere immune suppression; 1 (c) for the purpose of alleviatng a s~mptom referred to in paragraph (b), the person requires one or more of the items set out in 1 ction 7 of Schedule C and specified in the request; (d) failure to obtain the items referred to in paragraph (c) will result in imminent danger to the person's life. (2) In order to determine or c, nfirm the need or continuing need of a person for whom a supplement is rovided under subsection 1 , the minister ma at an time re uire that the erson obtain an EAAT 003(10/06/01)
I APPEAL# opinion from a medical prac iltioner or nurse practitioner other than the practitioner referred to in subsection (1) (c). Also applicable is s. 7 (Mon I ly Nutritional Supplements), Schedule C of the EAPWDR: 7 The amount of a nutrition suppl~ment that may be provided under section 67 [nutritional supplement] of this regulati is the sum of the amounts for those of the following items specified as required in the request und section 67 (1) (c): (a) for additional nutritional i ms that are part of a caloric supplementation to a regular dietary intake, up to $165 each month; (b) Repealed (B.C. Reg. 68/ 1 • 010) (c) for vitamins and mineral I up to $40 each month. The ministry argued that the 'evidence did not demonstrate the relationship between the vitamins and the symptoms that the appe ant ex~erienced as a result of a chronic deterioration of health and did not provide an explanation to why he needed bone support or that failure to obtain those vitamins would result in imminent da ~er to his life. The appellant argued that th · doctor misunderstood the issue and was not keen in completing those forms for the ministry and th t resulted in the ministry being misinformed. He argued that his physician wanted him to ha I the best care possible and that vitamins were necessary in this respect. He indicated the pr .s cription dated 13 January 2015 completed the evidence he wanted to provide and that it confirme 1 the need for the vitamins. The panel notes that the ap rllant's physician prescribed multivitamins in order to provide bone support to the appellant to p rvent fractures. According to the evidence the symptoms were malnutrition, underweight st tus, significant weight loss of 10 lbs in 1 year and significant muscle loss, "weakened ++" over 1 months. The ministry accepted this evidence to confirm the appellant needed nutritional items as art of a caloric supplementation to a regular dietary intake but did not find a relationship between 1 o 1 ne support and alleviating any of the symptoms the physician had 1 identified. The panel finds th• evidence is far from convincing that any of the symptoms described by the physician are related to bne support and that the new evidence, the prescription dated 13 January 2015, while specifyi I g what vitamins are prescribed and for how long, does not address the issue of the relationship be een bone support and such vitamins. The panel finds the ministry reasonably determined it wa • 1 not satisfied this nutritional supplement, vitamins, would alleviate any of the symptoms described by he medical practitioner. Further, while the physician II entioned the vitamins could prevent fractures, there is no evidence of whether failure to obtain the I itamins would result in imminent danger to the appellant's life. The panel cannot speculate on I at the consequences of "preventing fractures" could be and acknowledges that the appel ant should get the best care possible but must look at the reasonableness of the minis 1 's decision under the legislation and based on the evidence provided. Thus, the panel comes to th conclusion that the ministry could reasonably determine that the evidence provided by the m ical practitioner did not demonstrate that failure to obtain those vitamins would result in imminent dan '· er to the appellant's life. Consequently, the panel finds the ministry reasonably determined the a ,1 pellant was not eligible for vitamin/mineral supplementation under s. 67 1 . 1 of the EAPWDR. EAAT 003(10/06/01)
I APPEAL# In conclusion, the panel find~ the ministry's decision was reasonably supported by the evidence and confirms the decision. EAAT 003(10/06/01)
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