PART C – DECISION UNDER APPEAL The decision under appeal is the ministry’s reconsideration decision dated June 8, 2018. In that decision the ministry decided that the appellant did not meet the eligibility requirements set out in Employment and Assistance for Persons with Disabilities Regulation (EAPWDR) Schedule C, subsection 2(c)(i), (ii) and (iii) to receive the benefit of a naturopath. EAPWDR section 62 states the minister may provide a general health supplement for a family unit in receipt of disability assistance. Schedule C states that health supplement can be the service of naturopathy provided by a naturopath if a medical practitioner or nurse practitioner has confirmed an acute need, if the visits available under the Medical and Health Care Services Regulation for that calendar year have been provided, and if there are no resources available to the family unit to cover the cost. PART D – RELEVANT LEGISLATION Employment and Assistance for Persons with Disabilities Regulation (EAPWDR), section 62 and Schedule C section 2.
PART E – SUMMARY OF FACTS The information before the ministry at reconsideration included the following: • The Request for Reconsideration Section 3, dated May 16, 2018, in which the appellant wrote: o A naturopath intended to treat the appellant for “Persistent Lyme Disease”; o “I again request that you exempt me for treatment, as I have not been ‘acute’ since 1971” • A statement from a Naturopath, dated March 14, 2018, that stated: o That testing should be done “as soon as possible” to “rule out a chronic infection as cause of current health issues” at a cost of 425 Euros and $275; o An estimated cost of care of “$600-900 per month with an additional $600 every 6 months” and o “Our goal of treatment is stabilization of [the appellant’s] health and a gradual improvement…” Information provided on appeal: Notice of Appeal In the Notice of Appeal dated June 22, 2018, the appellant wrote under the heading Reasons for Appeal “Due to physical + mental debilitation of ‘persistent lyme disease’ I’m asking for ‘exemption’ to your ‘acute interpretation’ policy so as to secure Naturopathic Lyme Treatment...” The Panel determined that this was argument and was not new evidence.
PART F – REASONS FOR PANEL DECISION The issue in this appeal is whether the ministry’s determination that the appellant did not meet the eligibility requirements set out in EAPWDAR Schedule C, subsection 2(1)(c)(i) to receive the benefit of a naturopath, is reasonably supported by the evidence or is a reasonable application of the legislation in the circumstances of the appellant. Applicable Legislation EAPWDR General health supplements 62 The minister may provide any health supplement set out in section 2 [general health supplements] or 3 [medical equipment and devices] of Schedule C to or for (a) a family unit in receipt of disability assistance, (b) a family unit in receipt of hardship assistance, if the health supplement is provided to or for a person in the family unit who is under 19 years of age, or Schedule C General Health Supplements 2(c) subject to subsection (2), a service provided by a person described opposite that service in the following table, delivered in not more than 12 visits per calendar year, (i) for which a medical practitioner or nurse practitioner has confirmed an acute need, (ii) if the visits available under the Medical and Health Care Services Regulation, B.C. Reg. 426/97, for that calendar year have been provided and for which payment is not available under the Medicare Protection Act, and (iii) for which there are no resources available to the family unit to cover the cost: Item Service Provided by Registered with 1 acupuncture acupuncturist College of Traditional Chinese Medicine under the Health Professions Act 2 chiropractic chiropractor College of Chiropractors of British Columbia under the Health Professions Act 3 massage therapy massage College of Massage Therapists of British Columbia under the Health therapist Professions Act 4 naturopathy naturopath College of Naturopathic Physicians of British Columbia under the Health Professions Act 5 non-surgical podiatrist College of Podiatric Surgeons of British Columbia under the Health podiatry Professions Act 6 physical therapy physical College of Physical Therapists of British Columbia under the Health therapist Professions Act Appellant’s Submissions The appellant’s submission was that he was aware that he did not meet the legislative criteria to receive the services of a naturopath because neither a medical practitioner nor a nurse practitioner had confirmed an acute need for those services. However, he requested the Panel exercise its power of
“Discernment” to provide an exemption and/or an exception from the statutory requirements. Ministry Submissions The ministry stated that it reaffirmed the reasoning articulated in the Reconsideration Decision. The ministry also highlighted that the appellant did not meet the statutory requirements because his condition was chronic and not acute and that no medical practitioner or nurse practitioner confirmed there was an acute need. The ministry highlighted that although a naturopath can provide a service, a naturopath is not a medical practitioner or nurse practitioner as defined in the legislation. The Panels’ Decision The Employment and Assistance Act, section 24 provides legislative authority for the Panel to determine whether the decision being appealed is reasonably supported by the evidence and if it is a reasonable application of the legislation in the circumstances of the appellant. The Panel has no legislative authority to exercise any power of discernment or discretion to exempt or except an appellant from the legislative requirements. EAPWDR Schedule C section 2(c)(i) requires a medical practitioner or nurse practitioner to confirm an acute need for the service of a naturopath as a prerequisite for the ministry providing a health supplement. The Panel finds that no medical practitioner or nurse practitioner has identified that acute need. Conclusion The Panel finds that the ministry’s determination that the appellant did not meet the eligibility requirements set out in EAPWDR Schedule C, subsection 2(1)(c)(i) to receive the benefit of a naturopath, is reasonably supported by the evidence and a reasonable application of the enactment in the circumstances of the person appealing the decision. The Panel confirms the ministry’s reconsideration decision. The appellant is not successful on appeal.
PART G – ORDER THE PANEL DECISION IS: (Check one) UNANIMOUS BY MAJORITY THE PANEL CONFIRMS THE MINISTRY DECISION RESCINDS THE MINISTRY DECISION If the ministry decision is rescinded, is the panel decision referred back to the Minister for a decision as to amount? Yes No LEGISLATIVE AUTHORITY FOR THE DECISION: Employment and Assistance Act Section 24(1)(a) or Section 24(1)(b) and Section 24(2)(a) or Section 24(2)(b) PART H – SIGNATURES PRINT NAME Trevor Morley SIGNATURE OF CHAIR DATE (YEAR/MONTH/DAY) 2018/07/17 PRINT NAME Carl Gorham SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2018/07/17 PRINT NAME Wesley Nelson SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2018/07/17
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