Ministry of Social Development and Poverty Reduction

PART C – Decision under Appeal The decision under appeal is the reconsideration decision of the Ministry of Social Development and Social Innovation (the ministry) dated August 11, 2016, which held that the appellant did not qualify as a person with persistent multiple barriers to employment (PPMB) under section 2 of the Employment and Assistance Regulation (EAR). The ministry determined that the appellant met the requirement of subsection (2) as he has been in receipt of income assistance for 12 of the immediately preceding 15 calendar months and that his application would be assessed under (4) rather than subsection (3) based on his employability screen score of 14. The ministry was satisfied that the requirement of subsection (4)(a) was met as a medical practitioner has confirmed that the appellant has a medical condition, other than addiction, that has continued for at least one year and is likely to continue for at least 2 more years. However, the ministry determined that the requirement of subsection (4)(b) was not met as it was not satisfied that the appellant’s medical conditions preclude him from searching for, accepting or continuing in employment. PART D – Relevant Legislation EAR, section 2

PART E – Summary of Facts The appellant has been in receipt of income assistance as a PPMB and applied for renewal of his PPMB qualification. The appellant’s employability screen score is 14. In support of his re-application for PPMB, the appellant provided a “Medical Report – Persons with Persistent Multiple Barriers” (Medical Report) dated March 11, 2016, completed by a medical practitioner. The primary medical condition is L2-L3 disc herniation and lumbar spinal stenosis is the secondary medical condition. Treatments are described as “pain relief Tylenol #3” and “mobility” with the respective outcomes described as “to decrease pain to allow mobility” and “to keep mobile ultimately which helps with pain in long term.” The duration of the appellant’s medical conditions are described as “life time.” The medical conditions are reported to be episodic in nature with the frequency of the episodes described as “some days will be worse than others” and that “all days will have pain.” No response is provided where asked to describe the nature of any restrictions specific to the diagnosed medical conditions. At reconsideration, the appellant submitted a July 20, 2016 questionnaire which was prepared and signed by an advocate and was completed by an unidentified person. As the ministry notes, the handwriting is different from that of the medical practitioner who completed the Medical Report. In the questionnaire, the appellant is reported as having restrictions to employment including: no repetitive use of his hands; lifting limit of less than 25 lbs. with no repetition; drops even light items due to lack of grip and strength in both hands; severe arthritis in both hands; carpal tunnel in the right hand; limited to sitting less than 30 minutes and standing less than 60 minutes due to daily back pain; no repetitive bending, reaching, twisting etc. due to daily back pain; and, drowsiness, feeling impaired from daily pain medication. The unknown author adds that “conditions are deemed permanent.” Also before the ministry were medical reports and doctor’s notes submitted in support of the appellant’s previous PPMB applications. These reports and notes are from 2012 through 2014 and provide information from the same medical practitioner who completed the current Medical Report respecting the appellant’s lower back pain. All of the previous medical reports identify restrictions relating to the appellant’s back pain. The most recent medical report dated April 11, 2014, indicates that the medical conditions are not episodic and describes the resulting restrictions as “Back pain, unable to stand, sit, bend, twist, lift, climb, kneel, pull or push without pain.” On appeal, in his Notice of Appeal, the appellant writes that his condition has gotten considerably worse since the initial acceptance for multiple barriers assistance. No additional submissions were provided by the ministry or the appellant on appeal.

PART F – Reasons for Panel Decision Issue under appeal The issue under appeal is whether the ministry’s reconsideration decision which held that the appellant did not qualify for PPMB because he had not met the requirement of section 2(4)(b) of the EAR that his medical condition precludes him from employment is reasonably supported by the evidence or a reasonable application of the legislation in the appellant’s circumstances. Relevant Legislation – section 2 of the EAR Persons who have persistent multiple barriers to employment 2 (1) To qualify as a person who has persistent multiple barriers to employment, a person must meet the requirements set out in (a) subsection (2), and (b) subsection (3) or (4). (2) The person has been a recipient for at least 12 of the immediately preceding 15 calendar months of one or more of the following: (a) income assistance or hardship assistance under the Act; (b) income assistance, hardship assistance or a youth allowance under a former Act; (c) a disability allowance under the Disability Benefits Program Act; (d) disability assistance or hardship assistance under the Employment and Assistance for Persons with Disabilities Act. (3) The following requirements apply (a) the minister (i) has determined that the person scores at least 15 on the employability screen set out in Schedule E, and (ii) based on the result of that employability screen, considers that the person has barriers that seriously impede the person's ability to search for, accept or continue in employment, (b) the person has a medical condition, other than an addiction, that is confirmed by a medical practitioner and that, (i) in the opinion of the medical practitioner,

(A) has continued for at least one year and is likely to continue for at least 2 more years, or (B) has occurred frequently in the past year and is likely to continue for at least 2 more years, and (ii) in the opinion of the minister, is a barrier that seriously impedes the person's ability to search for, accept or continue in employment, and (c) the person has taken all steps that the minister considers reasonable for the person to overcome the barriers referred to in paragraph (a). (4) The person has a medical condition, other than an addiction, that is confirmed by a medical practitioner and that, (a) in the opinion of the medical practitioner, (i) has continued for at least one year and is likely to continue for at least 2 more years, or (ii) has occurred frequently in the past year and is likely to continue for at least 2 more years, and (b) in the opinion of the minister, is a barrier that precludes the person from searching for, accepting or continuing in employment. Appellant’s position The appellant’s position is that he re-qualifies for PPMB as his condition has considerably worsened since he was initially accepted for PPMB and that the doctor cannot feel the appellant’s pain or disability in his daily living. Ministry’s position The ministry notes that when assessing eligibility for PMMB under section 2(4)(b) of the EAR it expands on the common interpretation of “precludes” which is to make impossible or prevent from happening, in keeping with the context of the PPMB program, it considers a medical condition to preclude a person from searching for, accepting or continuing in employment when, as a result of the medical condition, a person is unable to participate in any type of employment for any length of time except in a supported or sheltered type work environment. The ministry notes that while past information from the medical practitioner described restrictions arising from the appellant’s medical conditions, no restrictions are reported in the current Medical Report. Additionally, while restrictions are identified in the questionnaire, the author of the

questionnaire is unknown. Based on the documents submitted, the ministry finds that the appellant’s medical conditions do not preclude him from searching for, accepting or continuing in employment. Panel Decision Section 2 of the EAR sets out the requirements for PPMB qualification. The requirements of subsection (2) must be met as must the requirements of either subsection (3) or (4). The requirements of subsection (3) apply where an applicant has an employability screen score of at least 15, otherwise, the requirements of subsection (4) apply. In the appellant’s case, the ministry determined that the requirements of subsection (2) were met and that the appellant’s application must be assessed under subsection (4) based on his employability screen score of 14. That the appellant’s employability screen score is 14 is not in dispute and accordingly, the requirements of subsection (4) apply in the appellant’s circumstances. The requirements of subsection (4)(a), specifically that the appellant has a medical condition, other than addiction, that in the opinion of a medical practitioner has continued for at least one year and is likely to continue for at least two more years, were found to have been met. The only basis for denial was the requirement of subsection (4)(b) that the ministry be of the opinion that the medical conditions confirmed by the medical practitioner are a barrier that precludes the appellant from searching for, accepting or continuing in employment. Ministry policy with respect to the PPMB qualification is that a qualified individual’s medical condition is to be reviewed every two years, at which time a re-applicant is required to submit a new medical report in which a medical practitioner provides updated information. The current medical information before the ministry in support of the appellant’s re-application for PPMB qualification was the Medical Report dated March 11, 2016, in which the medical practitioner has not provided any information where asked to identify restrictions arising from the appellant’s medical conditions. When describing the prescribed treatment and outcomes, the medical practitioner reports that the appellant has daily pain, with some days being worse than others, and that he requires pain medication to allow mobility, but this information does not describe what impact the appellant’s daily pain has on his daily functioning or ability to work, or how often the days of worse pain occur. Although the medical practitioner indicated that the prognosis is “life time now”, the impact of the medical conditions on the appellant’s functioning may change as various treatments are explored and result in improvements to the associated restrictions. The current treatments, as set out in the Medical Report, include pain relief medication “to allow mobility” as well as “mobility,” to “…keep mobile, ultimately which helps with pain in the long run.” While, as the ministry notes, the same medical practitioner had indicated restrictions in the documents provided in support of the appellant’s previous PPMB applications, given that two years have passed since the last medical assessment, it is reasonable to require current information respecting restrictions even if the diagnosed medical conditions remain the same. It is unknown whether the lack of restrictions represents an oversight on the part of the medical practitioner or reflects a changed assessment. While the appellant reports that his condition has worsened since he was originally approved as a PPMB, he has not elaborated by describing his current restrictions, writing in his Notice of Appeal that the doctor cannot feel his pain and he finds daily living difficult, and the medical practitioner now describes the medical conditions as episodic whereas in 2014 he

indicated they were not episodic. Unfortunately, no additional information from the medical practitioner was provided at reconsideration to provide clarification. While the questionnaire was provided at reconsideration, given that it is unknown who completed the questionnaire and as the questionnaire identifies some restrictions that do not relate to either the primary or secondary medical conditions diagnosed by the medical practitioner, the panel finds that ministry has reasonably placed little weight on the information in the questionnaire. Based on the available information respecting the appellant’s current medical condition, the panel finds that the ministry reasonably concluded that it could not be determined that the appellant’s medical conditions are a barrier that preclude him from searching for, accepting or continuing in employment as required by section 2(2)(b) of the EAR to re-qualify for PPMB status. As the reconsideration decision was reasonably supported by the evidence, the panel confirms the decision. The appellant is not successful on appeal.