This decision uses a PDF as its source file. To print it properly, please download the source file by clicking the PDF icon located in the bottom-right corner of the decision header.
PART C – DECISION UNDER APPEAL
The decision under appeal is the Ministry of Social Development and Poverty Reduction (the “Ministry”)
reconsideration decision dated July 12, 2018 which denied the appellant funding for Diabetic Test Strips (“DTS”).
Specifically the Ministry found that the DTS were not a medical supply (Schedule C, section 2(1)(a) EAPWDR),
were not medical equipment (Schedule C, section 3 EAPWDR), were not extended therapy (Schedule C, section
2(1)(c) EAPWDR),were not health supplements (Schedule C sections 1 – 9 EAPWDR), that the appellant did not
have a life-threatening health need (s.69 EAPWDR), and that the DTS do not meet the criteria of a crisis
supplement (s.57 EAPWDR)
PART D – R
ELEVANT LEGISLATION
s.57, s.62, s. 69, Schedule C Employment and Assistance for Persons with Disabilities Regulation (“EAPWDR”)
EAAT003 (17/08/17)
2
PART E – SUMMARY OF FACTS
The information before the Ministry at reconsideration was:
On April 23, 2018 the Ministry received a letter completed from the appellant’s physician which states “the
appellant was diagnosed with diabetes January 2017 and this is expected to be life long. Currently is
managed on diet and currently needs no medication.”
On April 30, 2018 the Ministry received another letter date from the Physician which states “the appellant
was diagnosed with diabetes January 2017 and needs funds for a low carb diet”.
The appellant was approved for $35.00 per month for a diabetic diet supplement.
On May 7, 2018 the Ministry received a quote from a drug store dated April 27, 2018 indicating that the
cost of 100 diabetic test strips for 30 days would be $85.99. The appellant’s medication history as of May
7, 2018 was also included. The diabetic test strip prescription was received on January 5, 2018 and again
on April 27, 2018.
On May 9, 2018 the appellant contacted the Ministry to ask if the Ministry would assist with the purchase of
test strips but his request was denied.
On May 10, 2018 an employment and assistance worker (“EAW”) called the drug store to find out why the
test strips were not being covered by PharmaCare and was advised that the appellant had exceeded his
yearly allotment of test strips.
On May 11, 2018 the Ministry received a referral letter dated May 9, 2018 completed by the appellant’s
Physician which states that the appellant is diagnosed with Diabetes Type 2 and he requires testing strips
three times each day.
The appellant appealed to the Health Assistance Branch (“HAB”) for payment of the diabetic test strips. On
May 14, 2018 the HAB denied the appellant’s request for diabetic test strips on the basis that the diabetic
test strips do not fall into any of their legislated categories and are not eligible items, and other resources
may be available to the appellant.
On May 16, 2018 a supervisor from the Ministry spoke with the appellant explaining that he would need
special authorization from PharmaCare as they are responsible for providing diabetic testing strips. The
supervisor provided the appellant with a crisis supplement for $100 to prevent hardship while his request
was being adjudicated.
On June 22, 2018 the Ministry received an official prescription receipt dated February 15, 2018 from a
drugstore. It indicated that the appellant would have to pay $85.99 and that he was no longer covered as
his maximum quantity had been exceeded. His prescription history was also included. The prescription
history notes that prescriptions for DTS were received on January 6 and February 15, 2018.
On June 25, 2018 a note was entered into his electronic records to the effect that the HAB did not take
action on his request to cover DTS because a decision had already been made on May 14, 2018. An EAW
contacted the appellant to suggest that he have his physician submit a request to PharmaCare for an
increase. The appellant said he had done that but was denied because he was not using insulin. On June
25, 2018 a second decision was prepared by the HAB and sent to the appellant.
On June 26, 2018 the appellant called the Ministry to inquire about the status of his decision. An EAW
informed the appellant about the denial and offered the appellant the opportunity to request reconsideration
of the decision.
On June 28, 2018 the appellant completed his request for reconsideration which states: he needs to test
his blood sugar because he has Diabetes Type 2, his doctor says he needs to test 3 times per day, he has
high blood pressure, high cholesterol, anxiety and stress, he has sleep apnea, he falls asleep all the time
and it stressed him out, his blood pressure is high due to worry about getting DTS, he has severe anxiety
for over ten years and has been on medications, he has carpal tunnel syndrome in his wrist.
The appellant’
s notice of appeal dated July 17, 2018, does not provide new evidence but instead re-states the
information he provided at reconsideration. He pays $750 in rent and after that there is no money left. His blood
glucose levels are such that [if not properly monitored] he could die.
At the hearing the appellant states that the Ministry does not know about diabetes. A person can die from diabetes
and you can loose a limb from diabetes. He goes to the hospital to test his diabetes. He doesn’t have money to
buy his test strips. It is approximately $90 for 100 test strips. He has tried to re-use the strips but they are not re
usable strips. If he buys strips he has no money for food. He pays $750 per month for rent and $40 per month for
EAAT003 (17/08/17)
3
hydro. He has diabetes, high cholesterol, and carpal tunnel syndrome. His eye sight is not straight. There are no
other resources, he requires protein and nuts and meat for his diet. He cannot guess what his blood sugar level is.
The appellant believes his physician has already done all he can to obtain Pharma Care. He faxed Pharma Care
and was informed that he cannot get additional testing strips. The appellant says he would rather be in heaven
with his father than live like how he is living. The Ministry states that DTS are not coverable in the Ministry
legislation. The Ministry states that the appellant should have other resources to obtain the DTS.
EAAT003 (17/08/17)
4
PART F – REASONS FOR PANEL DECISION
The issue on appeal is whether the Ministry’s decision to deny the appellant funding for DTS was reasonably
supported by the evidence or a reasonable application of the applicable legislation in the circumstances of the
appellant. Specifically, was it reasonable for the Ministry to determine that the DTS were not a medical supply
(Schedule C, section 2(1)(a) EAPWDR), were not medical equipment (Schedule C, section 3 EAPWDR), were not
extended therapy (Schedule C, section 2(1)(c) EAPWDR),were not health supplements (Schedule C sections 1 – 9
EAPWDR), that the appellant did not have a life-threatening health need (s.69 EAPWDR), and that the DTS do not
meet the criteria of a crisis supplement (s.57 EAPWDR).
The legislation provides:
Crisis supplement – S. 57 EAPWDR
57 (1)The m
inister may provide a crisis supplement to or for a family unit that is eligible for disability assistance or
hardship assistance if
(a)the family unit or a person in the family unit requires the supplement to meet an unexpected expense or obtain
an item unexpectedly needed and is unable to meet the expense or obtain the item because there are no resources
available to the family unit, and
(b)the minister considers that failure to meet the expense or obtain the item will result in
(i)imminent danger to the physical health of any person in the family unit, or
(ii)removal of a child under the Child, Family and Community Service Act.
General health supplements – s.62 EAPWDR
62 The mi
nister 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
(c)a family unit, if the health supplement is provided to or for a person in the family unit who is a continued person.
[en. B.C. Reg. 145/2015, Sch. 2, s. 4; am. B.C. Reg. 161/2017, App. 2, s. 2
.]
Health supplement for persons facing direct and imminent life threatening health need – s.69 EAPWDR
69 The mini
ster may provide to a family unit any health supplement set out in sections 2 (1) (a) and (f) [general
health supplements] and 3 [medical equipment and devices] of Schedule C, if the health supplement is provided to
or for a person in the family unit who is otherwise not eligible for the health supplement under this regulation, and if
the minister is satisfied that
(a)the person faces a direct and imminent life threatening need and there are no resources available to the
person's family unit with which to meet that need,
(b)the health supplement is necessary to meet that need,
(c)a person in the family unit is eligible to receive premium assistance under the Medicare Protection Act, and
(d)the requi
rements specified in the following provisions of Schedule C, as applicable, are met:
(i)paragraph (a) or (f) of section (2) (1);
(ii)sections 3 to 3.12, other than paragraph (a) of section 3 (1).
Schedule C EAPWDR
2 (1)The following are the health supplements that may be paid for by the minister if provided to a family unit that
EAAT003 (17/08/17)
5
is eligible under section 62[general health supplements] of this regulation:
(a)medical or surgical supplies that are, at the minister's discretion, either disposable or reusable, if the minister is
satisfied that all of the following requirements are met:
(i)the supplies are required for one of the following purposes:
(A)wound care;
(B)ongoing bowel care required due to loss of muscle function;
(C)catheterization;
(D)incontinence;
(E)skin parasite care;
(F)limb circulation care;
(ii)the supplies are
(A)prescribed by a medical practitioner or nurse practitioner,
(B)the least expensive supplies appropriate for the purpose, and
(C)necessary to avoid an imminent and substantial danger to health;
(iii)there are no resources available to the family unit to pay the cost of or obtain the supplies;
(a.1
)the following medical or surgical supplies that are, at the minister's discretion, either disposable or reusable, if
the minister is satisfied that all the requirements described in paragraph (a) (ii) and (iii) are met in relation to the
supplies:
(i)lancets;
(ii)needles and syringes;
(iii)ventilator supplies required for the essential operation or sterilization of a ventilator;
(iv)tracheostomy supplies;
(a.2
)consumable medical supplies, if the minister is satisfied that all of the following requirements are met:
(i)the supplies are required to thicken food;
(ii)all the requirements described in paragraph (a) (ii) and (iii) are met in relation to the supplies;
(b)Repealed. [B.C. Reg. 236/2003, Sch. 2, s. 2 (b).]
(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
(d)and (e)Repealed. [B.C. Reg. 75/2008, s. (a).]
(f)the least expensive appropriate mode of transportation to or from
(i)an office, in the local area, of a medical practitioner or nurse practitioner,
(ii)the office of the nearest available specialist in a field of medicine or surgery if the person has been referred to a
specialist in that field by a local medical practitioner or nurse practitioner,
(iii)the nearest suitable general hospital or rehabilitation hospital, as those facilities are defined in section 1.1
of
the Hospital Insurance Act Regulations, or
EAAT003 (17/08/17)
6
(iv)the nearest suitable hospital as defined in paragraph (e) of the definition of "hospital" in section 1 of the Hospital
Insurance Act,
provided that
(v)the transportation is to enable the person to receive a benefit under the Medicare Protection Act
or a general
hospital service under the Hospital Insurance Act, and
(vi)there are no resources available to the person's family unit to cover the cost.
(g)Repealed. [B.C. Reg. 75/2008, s. (a).]
(1.1)For the purposes of subsection (1) (a), medical and surgical supplies do not include nutritional supplements,
food, vitamins, minerals or prescription medications.
(2)No more than 12 visits per calendar year are payable by the minister under this section for any combination of
physical therapy services, chiropractic services, massage therapy services, non-surgical podiatry services,
naturopathy services and acupuncture services.
(2.1)If eligible under subsection (1) (c) and subject to subsection (2), the amount of a general health supplement
under section 62
of this regulation for physical therapy services, chiropractic services, massage therapy services,
non-surgical podiatry services, naturopathy services and acupuncture services is $23 for each visit.
(3)If the minister provided a benefit to or for a person under section 2 (3) of Schedule C of the Disability Benefits
Program Regulation, B.C. Reg. 79/97, the Income Assistance Regulation, B.C. Reg. 75/97 or the Youth Works
Regulation, B.C. Reg. 77/97, as applicable, for the month during which the regulation was repealed, the minister
may continue to provide that benefit to or for that person as a supplement under this regulation on the same terms
and conditions as previously until the earlier of the following dates:
(a)the date the conditions on which the minister paid the benefit are no longer met;
(b)the date the person ceases to receive disability assistance.
Optic
al supplements
2.1 The following are the optical supplements that may be provided under section 62.1 [optical supplements] of
this regulation:
(a)basic eyewear and repairs;
(b)pre-authorized eyewear and repairs.
Eye ex
amination supplements
2.2 The minister may pay a health supplement under section 67.2 [eye examination supplements] of this
regulation for an eye examination that,
(a)if prov
ided by an optometrist, is provided for a fee that does not exceed $44.83, or
(b)if provided by an ophthalmologist, is provided for a fee that does not exceed $48.90.
Medical equipment and devices
3 (1) Subject to subsections (2) to (5) of this section, the medical equipment and devices described in sections 3.1
to 3.12 of this Schedule are the health supplements that may be provided by the minister if
(a)the supplements are provided to a family unit that is eligible under section 62 [general health supplements] of
this regulation, and
(b)all of t
he following requirements are met:
(i)the family unit has received the pre-authorization of the minister for the medical equipment or device requested;
(ii)there are no resources available to the family unit to pay the cost of or obtain the medical equipment or device;
(iii)the medical equipment or device is the least expensive appropriate medical equipment or device.
(2)For medical equipment or devices referred to in sections 3.1 to 3.8 or section 3.12, in addition to the
requirements in those sections and subsection (1) of this section, the family unit must provide to the minister one or
EAAT003 (17/08/17)
7
both of the following, as requested by the minister:
(a)a prescription of a medical practitioner or nurse practitioner for the medical equipment or device;
(b)an assess
ment by an occupational therapist or physical therapist confirming the medical need for the medical
equipment or device.
(2.1) F
or medical equipment or devices referred to in section 3.9 (1) (b) to (g), in addition to the requirements in that
section and subsection (1) of this section, the family unit must provide to the minister one or both of the following,
as requested by the minister:
(a)a prescription of a medical practitioner or nurse practitioner for the medical equipment or device;
(b)an assessment by a respiratory therapist, occupational therapist or physical therapist confirming the medical
need for the medical equipment or device.
(3)Subject
to subsection (6), the minister may provide as a health supplement a replacement of medical equipment
or a medical device, previously provided by the minister under this section, that is damaged, worn out or not
functioning if
(a)it is more economical to replace than to repair the medical equipment or device previously provided by the
minister, and
(b)the peri
od of time, if any, set out in sections 3.1 to 3.12 of this Schedule, as applicable, for the purposes of this
paragraph, has passed.
(4)Subject to subsection (6), the minister may provide as a health supplement repairs of medical equipment or a
medical device that was previously provided by the minister if it is more economical to repair the medical equipment
or device than to replace it.
(5)Subject
to subsection (6), the minister may provide as a health supplement repairs of medical equipment or a
medical device that was not previously provided by the minister if
(a)at the t
ime of the repairs the requirements in this section and sections 3.1 to 3.12 of this Schedule, as
applicable, are met in respect of the medical equipment or device being repaired, and
(b)it is more economical to repair the medical equipment or device than to replace it.
(6)The minister may not provide a replacement of medical equipment or a medical device under subsection (3) or
repairs of medical equipment or a medical device under subsection (4) or (5) if the minister considers that the
medical equipment or device was damaged through misuse.
Dental supplements
4 (1) In this section, "period" means
(a)in respect of a person under 19 years of age, a 2 year period beginning on January 1, 2017, and on each
subsequent January 1 in an odd numbered year, and
(b)in respect of a person not referred to in paragraph (a), a 2 year period beginning on January 1, 2003 and on
each subsequent January 1 in an odd numbered year.
(1.1) T
he health supplements that may be paid under section 63 [dental supplements] of this regulation are basic
dental services to a maximum of
(a)$2 000 each p
eriod, if provided to a person under 19 years of age, and
EAAT003 (17/08/17)
8
(b)$1 000 each period, if provided to a person not referred to in paragraph (a).
(c)Repealed. [B.C. Reg. 163/2005, s. (b).]
(2)Dentures
may be provided as a basic dental service only to a person
(a)who has never worn dentures, or
(b)whose dentures are more than 5 years old.
(3)The lim
its under subsection (1.1) may be exceeded by an amount necessary to provide dentures, taking into
account the amount remaining to the person under those limits at the time the dentures are to be provided, if
(a)a person requires a full upper denture, a full lower denture or both because of extractions made in the previous
6 months to relieve pain,
(b)a person requ
ires a partial denture to replace at least 3 contiguous missing teeth on the same arch, at least one
of which was extracted in the previous 6 months to relieve pain, or
(c)a person who has been a recipient of disability assistance or income assistance for at least 2 years or a
dependant of that person requires replacement dentures.
(4)Subsect
ion (2) (b) does not apply with respect to a person described in subsection (3) (a) who has previously
had a partial denture.
(5)The dental supplements that may be provided to a person described in subsection (3) (b), or to a person
described in subsection (3) (c) who requires a partial denture, are limited to services under
(a)fee numbers
52101 to 52402 in the Schedule of Fee Allowances — Dentist referred to in paragraph (a) of the
definition "basic dental service" in section 1 of this Schedule, or
(b)fee numbers 41610, 41612, 41620 and 41622 in the Schedule of Fee Allowances — Denturist referred to in
paragraph (b) of the definition "basic dental service" in section 1 of this Schedule.
(6)The dental
supplements that may be provided to a person described in subsection (3) (c) who requires the
replacement of a full upper, a full lower denture or both are limited to services under
(a)fee numbers 51101 and 51102 in the Schedule of Fee Allowances — Dentist referred to in paragraph (a) of the
definition "basic dental service" in section 1 of this Schedule, or
(b)fee numbers
31310, 31320 or 31330 in the Schedule of Fee Allowances — Denturist referred to in paragraph
(b)of the definition "basic dental service" in section 1 of this Schedule.
(7)A reline or a rebase of dentures may be provided as a basic dental service only to a person who has not had a
reline or rebase of dentures for at least 2 years.
Crown a
nd bridgework supplement
4.1 (1) In this section, "crown and bridgework" means a dental service
(a)that is provided by a dentist,
(b)that i
s set out in the Schedule of Fee Allowances — Crown and Bridgework, that is effective April 1, 2010 and is
published on the website of the ministry of the minister,
(c)t
hat is provided at the rate set out for the service in that Schedule, and
EAAT003 (17/08/17)
9
(d)for which a person has received the pre-authorization of the minister.
(2)A health supplement may be paid under section 63.1 of this regulation for crown and bridgework but only if the
minister is of the opinion that the person has a dental condition that cannot be corrected through the provision of
basic dental services because
(a)the dental condition precludes the provision of the restorative services set out under the Restorative Services
section of the Schedule of Fee Allowances — Dentist, and
(b)one of the f
ollowing circumstances exists:
(i)the dental condition precludes the use of a removable prosthetic;
(ii)the person has a physical impairment that makes it impossible for him or her to place a removable prosthetic;
(iii
)the person has an allergic reaction or other intolerance to the composition or materials used in a removable
prosthetic;
(iv)the person has a mental condition that makes it impossible for him or her to assume responsibility for a
removable prosthetic.
(3)The mi
nister must also be satisfied that a health supplement for crown and bridgework will be adequate to
correct the dental condition.
(4)A healt
h supplement for crown and bridgework may not be provided in respect of the same tooth more than
once in any period of 60 calendar months.
Emergency dental supplements
5 The health supplements that may be paid for under section 64 [emergency dental and denture supplements] of
this regulation are emergency dental services.
Diet supplements
6 (1) The amount of a diet supplement that may be provided under section 66 [diet supplements] of this regulation
is as follows:
(a)$10 for each c
alendar month for a person who requires a restricted sodium diet;
(b)$35 for each calendar month for a person who has diabetes;
(c)$30 for each calendar month for a person who requires kidney dialysis if the person is not eligible under the
kidney dialysis service provided by the Ministry of Health Services;
(d)$40 for each calendar month for a person who requires a high protein diet;
(e)$40 for each calendar month for a person who requires a gluten-free diet;
(f)$40 f
or each calendar month for a person who has dysphagia;
(g)$50 for each calendar month for a person who has cystic fibrosis;
(h)$40 for each calendar month for which a person requires a ketogenic diet;
(i)$40 f
or each calendar month for which a person requires a low phenylalanine diet.
(2)A diet supplement under subsection (1) (d) may only be provided if the diet is confirmed by a medical
practitioner or nurse practitioner as being necessary for one of the following medical conditions:
EAAT003 (17/08/17)
10
(a)cancer that requires nutritional support during
(i)radiation therapy,
(ii)
chemotherapy,
(iii
)surgical therapy, or
(iv)
ongoing medical treatment;
(b)chronic inflammatory bowel disease;
(c)Crohn's disease;
(d)ulcerat
ive colitis;
(e)HIV p
ositive diagnosis;
(f)AIDS;
(g)chronic
bacterial infection;
(h)tubercu
losis;
(i)hyperthyroidism;
(j)osteoporosis;
(k)hepat
itis B;
(l)hepatitis C.
(3)A perso
n who is eligible for a supplement under subsection (1) (d) or (f) is also eligible for a $30 payment
towards the purchase of a blender.
(4)If a person has more than one of the medical conditions set out in subsection (1), the person may receive only
the amount of the highest diet supplement for which he or she is eligible.
Monthly nutritional supplement
7 The amount of a nutritional supplement that may be provided under section 67 [nutritional supplement] of this
regulation is the sum of the amounts for those of the following items specified as required in the request under
section 67 (1) (c):
(a)for additional nutritional items that are part of a caloric supplementation to a regular dietary intake, up to $165
each month;
(b)Repeale
d. [B.C. Reg. 68/2010, s. 3 (b).]
(c)for vitamins and minerals, up to $40 each month.
Natal
supplement
8 The amount of a natal supplement that may be provided under section 68 [natal supplement] of this regulation is
(a)$45 for each c
alendar month for a period set out in section 68 (2), or
EAAT003 (17/08/17)
11
(b)$90 for each calendar month for a period set out in section 68 (2) if the person
(i)is pregnant with more than one child, as confirmed in writing by a medical practitioner, a nurse practitioner or a
registrant of the College of Midwives of British Columbia, or
(ii)gives
birth to more than one child.
Infant f
ormula
9 The minister may provide infant formula under section 67.1 of this regulation if
(a)a medical
practitioner or nurse practitioner confirms in writing that
(i)t
he dependent child for whom a specialized infant formula is to be provided has a medical condition and the
specialized infant formula is necessary to treat the medical condition, or
(ii)
the dependent child for whom the infant formula is to be provided is at risk of contracting a disease that is
transmissible through the mother's breast milk,
(b)in the case of a dependent child described by paragraph (a) (ii), the dependent child is under 12 months of age,
and
(c)t
he minister is satisfied that the infant formula is medically required to treat the medical condition or respond to
the risk referred to in paragraph (a).
The panel finds:
The Mini
stry reviewed the available sections of the EAPWDR to determine if the DTS fit into one of the legislated
categories.
The Ministry determined that the items were not medical or surgical supplies as defined in Schedule C, Section
2(1)(a) EAPWDR. In order to be a medical or surgical supply the item must be used for a legislated purpose set
out in s.2(1)(a)(i) A - F. Testing is not one of the legislated purposes. Additional medical supplies that may be
provided are described in s.2(1)(a.1)(i) – (iv). The Ministry founds that DTS were not one of the legislated supplies.
The panel finds that it was reasonable for the Ministry to determine that DTS were not a medical or surgical supply
on the basis that they were not in the legislated list and did not meet one of the legislated purposes.
The Min
istry determined that the DTS were not medical equipment as defined in Schedule C, section 3 EAPWDR.
The Ministry reviewed all of the legislated equipment in s.3 and determined that DTS did not fit into any of the
legislated criteria. The panel find that it was reasonable for the Ministry to determine that DTS were not medical
equipment
The Ministry determined that the DTS were not extended therapy as defined in Schedule C, section 2(1)(c))
EAPWDR. The panel finds that it was reasonable for the Ministry to determine that DTS were not a legislated
therapy as they were not used for the legislated therapies in s.2(1)(a.2)(c)(iii) 1 – 6.
The Mini
stry determined that the DTS were not any other health supplements set out Schedule C sections 1 – 9
EAPWDR. They were not optical supplements, eye examination supplements, dental supplements, crown and
bridgework supplements, emergency dental supplements, diet supplements, monthly nutritional supplements, natal
supplements, and infant formula. The panel finds that it was reasonable for the Ministry to determine that DTS did
not fit into any of these legislated criteria.
The Ministry determined that the appellant was not eligible pursuant to s.69 EAPWDR as the item requested was
not needed to address a direct and imminent life-threatening health need s.69 EAPWDR. The panel finds that
since a requirement of s.69 is that the health need must be a medical supply, medical equipment, or medical
transportation and the DTS were already determined as not qualifying as any of those items, it was reasonable for
the Ministry to determine that the appellant did not qualify pursuant to s.69 EAPWDR. The Ministry also
EAAT003 (17/08/17)
12
determined that the appellant in this case did not suffer from an imminent life threatening health need for the DTS.
Although Diabetes is a serious and potentially life threatening illness, there was not evidence that the appellant
would face an imminent life threatening situation without the DTS. The appellant’s physician did not state in his
evidence that a failure to obtain the DTS would be life threatening to the appellant imminently or otherwise. The
appellant provided some evidence about the dangers of diabetes, however did not provide sufficient evidence
about suffering an imminent life threatening illness without the DTS. The panel finds that given that the Ministry
was not provided with information from the appellant’s doctor or adequate information from the appellant himself
that he could suffer an imminent life threatening illness without the DTS it was reasonable for the Ministry to
conclude that the appellant did not meet this requirement of s.69 EAPWDR.
The Mini
stry determined that the DTS would not meet the criteria of a crisis supplement pursuant to s.57 EAPWDR.
The first requirement of s.57 EAPWDR is that the items cannot be a Schedule C item or any other health care
goods or services. The Ministry determined that the DTS were not Schedule C items but were certainly health care
goods as they were used as a diagnostic item to test for a health related illness. The panel finds that this was a
reasonable determination by the Ministry.
For these reasons, the panel finds the ministry’s decision was reasonably supported by the evidence and a
reasonable application of the applicable enactment in the circumstances of the appellant and confirms the decision.
The appellant is not successful on his appeal.
EAAT003 (17/08/17)
13
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 – SI
GNATURES
PRINT NAME
MEGHAN WALLACE (by telephone)
SIGNATURE OF CHAIR
DATE (YEAR/MONTH/DAY)
PRINT NAME
JANE NIELSEN
SIGNATURE OF MEMBER
DATE (YEAR/MONTH/DAY)
PRINT NAME
LINDA SMERYCHYNSKI
DATE (YEAR/MONTH/DAY)
SIGNATURE OF MEMBER
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.