Ministry of Social Development and Poverty Reduction

Decision Information

Decision Content

I PART C -DECISION UNDER APPEAL The decision under appeal is the Ministry of Social Development and Poverty Reduction (the "Ministry") reconsideration decision dated August 21, 2018 where the Ministry denied the Appellant's request for non-local medical transportation by reason that the appellant did not meet all of the criteria in s.2(1 )(f) of Schedule C of the Employment and Assistance for Persons with Disabilities Regulation ("EAPWDR"). Specifically, the Appellant was not visiting a specialist pursuant to s.2(1 )(f)(ii) Schedule C EAPWDR and as defined in Section 1 of Schedule C EAPWDR. The Ministry determined that the Appellant's travel requirement also did not fit into any of the remaining criteria set out in s.2(1 )(f) EAPWDR. PART D -RELEVANT LEGISLATION Sections 1, 2, 2(1)f Schedule C Employment and Assistance for Persons with Disabilities Regulation ("EAPWDR") s.24 Employment and Assistance Act ("EAA")
P A R T E S U M M A R Y O F F A C T S T h e i n f o r m a t i o n b e f o r e t h e M i n i s t r y a t r e c o n s i d e r a t i o n w a T h e A p p e l l a n t i s fo u r y e a r o l d a n d i s t h e d e p e n d a s s i s t a n c e . T h e A p p e l l a n t i s e l i g i b l e f o r g e n e r a l E A P W D R . O n J u l y 1 9 , 2 0 1 8 t h e a p p e l l a n t ' s g r a n d m o t h e r a n r e q u e s t f o r n o n l o c a l m e d i c a l t r a n s p o rt a t i o n fo r t t o a t t e n d a v a r i e t y o f a p p o i n t m e n t s . T h e a p p o i n t m e n t s w e r e w i t h a n o p t o m e t r i s t , s p e t h e r a p i s t . T h e R e p r e s e n t a t i v e a n d t h e A p p e l l a n t w o u l d b e a c c o m m o d a t i o n , a n d t h e A p p e l l a n t r e q u i r e d t h e T h e o p t o m e t r i s t , s p e e c h t h e r a p i s t , o c c u p a t i o n a l A p p e l l a n t s o u g h t w e r e n o t a v a i l a b l e l o c a l l y a n d n T h e A p p e l l a n t a n d t h e R e p r e s e n t a t i v e w o u l d b e s c h e d u l e d a p p o i n t m e n t s . T h e A p p e l l a n t ' s r e q u e s t fo r r e c o n s i d e r a t i o n p r o v i d e s t h e C o n c e r n t h a t s h e w a s n o t i n f o r m e d o f t h e r e c o n s r e l y i n g o n i n m a k i n g t h e i r d e c i s i o n . C o n f i r m a t i o n t h a t t h e A p p e l l a n t c o u l d n o t a c c e s s t o t h e a p p o i n t m e n t s . C o n f i r m a t i o n t h a t h e r d o c t o r w a s s u p p o rt i v e o f t h T h e d o c u m e n t a r y e v i d e n c e a v a i l a b l e a t r e c o n s i d e r a t i o n R e q u e s t f o r n o n l o c a l m e d i c a l t r a n s p o rt a t i o n a s s R e p r e s e n t a t i v e s t a t i n g t h e d a t e s a n d t i m e s t o m s p e e c h t h e r a p i s t a n d o p t o m e t r i s t . P r e s c r i p t i o n f o r m d a t e d J u l y 1 3 , 2 0 1 8 f r o m t h e A l o c a t i o n s t h a t t h e A p p e l l a n t r e q u i r e s f o r o c c u p a t i o p t o m e t r y . P r e s c r i p t i o n f o r m d a t e d A u g u s t 3 , 2 0 1 8 f r o m t h e t o a t t e n d t h e a p p o i n t m e n t s . L e t t e r d a t e d A u g u s t 7 , 2 0 1 8 f r o m a S u p p o rt e d C s e e n b y p h y s i o , o c c u p a t i o n a l a n d s p e e c h t h e r a p S p e e c h l a n g u a g e p a t h o l o g y d i s c h a r g e n o t i c e s e f r o m s p e e c h l a n g u a g e p a t h o l o g y . T h e n o t i c e o f a p p e a l ( " N O A " ) f i l l e d i n b y t h e R e p r e s e n t a t t h e M i n i s t ry ' s d e f i n i t i o n o f a s p e c i a l i s t s h o u l d b e t h e i r e x p e rt i s e d i s c o u n t e d s i m p l y b e c a u s e t h e y c S u r g e o n s . 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 R e p r e s e n t a t i v e a n d h e r A d t h e A p p e l l a n t r e q u i r e s t h e m e d i c a l c a r e . O n D e c e m b e r 1 7 , 2 0 1 7 t h e A p p e l l a n t ' s R e p r e s e w i t h m a n y i s s u e s . T h e c l o s e s t p l a c e f o r t h e A p p e l l a n t t o r e c e i v e t h i A t t h e h e a r i n g t h e M i n i s t r y r e l i e d o n t h e i r r e c o n s i d e r a t i o n I s t h e f o l l o w i n g : a n t o f h i s g r a n d m o t h e r w h o i s i n r e c e i p t o f d i s a b i l i t y h e a l t h s u p p l e m e n t s u n d e r S c h e d u l e C , S e c t i o n 2 d r e p r e s e n t a t i v e ( t h e " R e p r e s e n t a t i v e " ) s u b m i t t e d a h e A p p e l l a n t t o v i s i t a C h i l d D e v e l o p m e n t C e n t r e ( " C D C " ) e c h t h e r a p i s t , o c c u p a t i o n a l t h e r a p i s t a n d p h y s i c a l t r a v e l l i n g b y v e h i c l e , d i d n o t r e q u i r e o v e r n i g h t R e p r e s e n t a t i v e a s a n e s c o r t . t h e r a p i s t , a n d p h y s i c a l t h e r a p i s t r e s o u r c e s t h a t t h e o b u s t r a n s p o rt a t i o n w a s a v a i l a b l e . r e q u i r e d t o t r a v e l t o t h e C D C t w i c e i n o r d e r t o a t t e n d a l l t h e f o l l o w i n g i n f o r m a t i o n f r o m t h e R e p r e s e n t a t i v e : i d e r a t i o n d e c i s i o n o r t h e l e g i s l a t i o n t h e M i n i s t r y w a s t h e a p p o i n t m e n t s l o c a l l y a n d t h a t s h e c o u l d n o t t a k e a b u s e a p p o i n t m e n t s . w a s t h e f o l l o w i n g : i s t a n c e f o r m d a t e d J u l y 1 3 , 2 0 1 8 a n d s i g n e d b y t h e e e t w i t h a n o c c u p a t i o n a l t h e r a p i s t , p h y s i c a l t h e r a p i s t , p p e l l a n t ' s d o c t o r s h o w i n g a p p o i n t m e n t d a t e s , t i m e s a n d o n a l t h e r a p y , p h y s i c a l t h e r a p y , s p e e c h t h e r a p y , a n d A p p e l l a n t ' s d o c t o r s t a t i n g t h a t t h e A p p e l l a n t r e q u i r e s t r a v e l h i l d D e v e l o p m e n t C o n s u l t a n t s t a t i n g t h a t t h e a p p e l l a n t w a s i s t s o n J u n e 5 , 2 0 1 8 i n h i s h o m e c o m m u n i t y . n t A u g u s t 1 , 2 0 1 8 i n d i c a t i n g t h e A p p e l l a n t w a s d i s c h a r g e d i v e s t a t e s : r e v i e w e d a s t h e p e o p l e t h e a p p e l l a n t s a w s h o u l d n o t h a v e a n n o t b e r e g i s t e r e d w i t h t h e C o l l e g e o f P h y s i c i a n s a n d v o c a t e s t a t e d : n t a t i v e t o o k c u s t o d y o f h i m a n d t h e A p p e l l a n t s t r u g g l e s s k i n d o f m e d i c a l a t t e n t i o n i s t h r e e h o u r s a w a y . d e c i s i o n .
I P A R T F R E A S O N S F O R P A N E L D E C I S I O N T h e i s s u e o n a p p e a l i s w h e t h e r t h e M i n i s t ry ' s d e c i s i o n t o r e a s o n 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 a l l t h e c r i t e r i a i n s b y t h e e v i d e n c e o r a r e a s o n a b l e a p p l i c a t i o n o f t h e a p p l i c S p e c i f i c a l l y , w a s i t r e a s o n a b l e f o r t h e M i n i s t r y t o d e t e r m s . 2 ( 1 ) ( f) ( i i ) S c h e d u l e C E A P W D R o r a n y o f t h e r e m a i n i n g Th e l e g i s l a t i o n p ro v i d e s : S c h e d u l e C S e c t i o n 1 E A P W D R " s p e c i a l i s t " m e a n s a m e d i c a l p r a c t i t i o n e r r e c o g n i z e d a s a w i t h t h e b y l a w s m a d e b y t h e b o a r d f o r t h e C o l l e g e o f P h 1 9 ( 1 ) ( k . 3 ) a n d ( k . 4 ) o f t h e H e a l t h P r o f e s s i o n s A c t . G e n e r a l h e a l t h s u p p l e m e n t s E A P W D R 2 ( 1 ) T h e fo l l o w i n g a r e t h e h e a l t h s u p p l e m e n t s t h a t m a i s e l i g i b l e u n d e r s e c t i o n 6 7 [ g e n e r a l h e a l t h s u p p l e m e n t s ] ( f ) t h e l e a s t e x p e n s i v e a p p r o p r i a t e m o d e o f t r a n s p o rt a t i o ( i ) a n o ff i c e , i n t h e l o c a l a r e a , o f a m e d i c a l p r a c t i t i o n e r o r ( i i ) t h e o f f i c e o f t h e n e a r e s t a v a i l a b l e s p e c i a l i s t i n a f i e l d s p e c i a l i s t i n t h a t f i e l d b y a l o c a l m e d i c a l p r a c t i t i o n e r o r n ( i i i ) t h e n e a r e s t s u i t a b l e g e n e r a l h o s p i t a l o r r e h a b i l i t a t i o n H o s p i t a l I n s u r a n c e A c t R e g u l a t i o n s , o r ( i v ) t h e n e a r e s t s u i t a b l e h o s p i t a l a s d e f i n e d i n p a r a g r a p h I n s u r a n c e A c t , p r o v i d e d t h a t ( v ) t h e t r a n s p o r t a t i o n i s t o e n a b l e t h e p e r s o n t o r e c e i v e a h o s p i t a l s e r v i c e u n d e r t h e H o s p i t a l I n s u r a n c e A c t , a n d ( v i ) t h e r e a r e n o r e s o u r c e s a v a i l a b l e t o t h e p e r s o n ' s f a m T h e p a n e l f i n d s : T h e M i n i s t r y 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 ' s n e e d f o r t r a r e a s o n t h a t t h e A p p e l l a n t r e q u i r e d n o n l o c a l m e d i c a l t r a n s p e c i a l i s t s d e f i n e d i n t h e E A P W D R . B y v i r t u e o f t h e d e f a s p e c i a l i s t t h a t c a n b e r e g i s t e r e d w i t h t h e C o l l e g e o f P h t h e A p p e l l a n t n e e d e d t o s e e h a d t h e a b i l i t y t o b e r e g i s t e r T h e r e f o r e t h e p a n e l f i n d s t h a t i t w a s r e a s o n a b l e f o r t h e M t r a v e l r e q u i r e m e n t s i n s . 2 ( 1 ) ( f) ( i i ) S c h e d u l e C E A P W D R . T h e M i n i s t r y d i d n o t t h o r o u g h l y r e v i e w i n d e t a i l s e c t i o n 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 i t h r e s p e c t t o t h e s e s e c t i o n s r e n u e s t d o e s n o t f i t i n t o a n v o f t h e r e m a i n d e r , e l l a i b l e c a d e n y t h e a p p e l l a n t n o n l o c a l m e d i c a l t r a n s p o r t a t i o n b y . 2 ( 1 ) ( 1 ) o f S c h e d u l e C E A P W D R i s r e a s o n a b l y s u p p o r t e d a b l e l e g i s l a t i o n i n t h e c i r c u m s t a n c e s o f t h e a p p e l l a n t . i n e t h a t t h e A p p e l l a n t ' s t r a v e l r e q u i r e m e n t d i d n o t f i t i n t o c r i t e r i a s e t o u t i n s . 2 ( 1 ) ( f ) ( i ) -( i v ) S c h e d u l e C E A P W D R ? s p e c i a l i s t i n a f i e l d o f m e d i c i n e o r s u r g e ry i n a c c o r d a n c e y s i c i a n s a n d S u r g e o n s o f B r i t i s h C o l u m b i a u n d e r s e c t i o n y b e p a i d f o r b y t h e m i n i s t e r i f p r o v i d e d t o a f a m i l y u n i t t h a t o f t h i s r e g u l a t i o n : n t o o r f r o m n u r s e p r a c t i t i o n e r , o f m e d i c i n e o r s u r g e r y i f t h e p e r s o n h a s b e e n r e f e r r e d t o a u r s e p r a c t i t i o n e r , h o s p i t a l , a s t h o s e f a c i l i t i e s a r e d e f i n e d i n s e c t i o n 1 . 1 o f t h e ( e ) o f t h e d e fi n i t i o n o f " h o s p i t a l " i n s e c t i o n 1 o f t h e H o s p i t a l b e n e f i t u n d e r t h e M e d i c a r e P r o t e c t i o n A c t o r a g e n e r a l i l y u n i t t o c o v e r t h e c o s t . v e l d i d n o t f i t i n t o s . 2 ( 1 ) ( f) ( i i ) S c h e d u l e C E A P W D R b y s p o r t a t i o n t o v i s i t h e a l t h p r o f e s s i o n a l s w h o w e r e n o t i n i t i o n i n s . 1 S c h e d u l e C E A P W D R , t h e s p e c i a l i s t m u s t b e y s i c i a n s a n d S u r g e o n s o f B C . N o n e o f t h e s p e c i a l i s t s t h a t e d w i t h t h e C o l l e g e o f P h y s i c i a n s a n d S u r g e o n s o f B C . i n i s t r y t o d e t e r m i n e 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 e s . 2 ( 1 ) ( f ) ( i ) , ( i i i ) , o r ( i v ) S c h e d u l e C E A P W D R i n t h e i r , t h e r e c o n s i d e r a t i o n d e c i s i o n o n l y s t a t e s " i n a d d i t i o n , y o u r t e a o ri e s f o r m e d i c a l t r a n s n o rt a t i o n t o a n d f ro m a n o ffi c e , i n
the local area, of a medical practitioner or nurse practitioner, the nearest suitable general hospital or rehabilitation hospital or the nearest suitable hospital as defined in paragraph (e) of the definition of hospital in section 1 of the Hospital Insurance Act." This kind of reasoning by the Ministry is not only difficult to follow, but it is also inadequate. With respect to s.2(1 )(f)(i) the reasons do not tell the Appellant why or how the Ministry determined this is not "transportation ... of a medical practitioner or nurse practitioner." What is the legislation that excludes the types of professionals the Appellant's wanted to see as medical practitioners or nurse practitioners? The reasons do not guide the Appellant on how the Ministry came to its conclusion about if these practitioners were in fact medical practitioners or nurse practitioners. With respect to s.2(1 )(f)(iii) the reasons to not tell the Appellant why the CDC is not a facility as defined in section 1.1 of the Hospital Insurance Act Regulations. With respect to s.2(1)(f)(iv) the reasons do not tell the appellant why the CDC is not a hospital as defined in paragraph (e) of the definition of hospital in section 1 of the Hospital Insurance Act. Paragraph (e) for instance refers to designations made by the Lieutenant Governor in Council in accordance with the act and regulations, but the Ministry does not review those regulations or orders in council to determine if the CDC does or does not qualify as a hospital pursuant to the act, regulations, or orders-in-council, as the case may be. Pursuant to s.24(1)(b) EAA, the panel must determine if the decision being appealed is a reasonable application of the applicable enactment in the circumstances of the person appealing the decision. Without substantive reasons from the Ministry, the panel cannot conduct a reasonableness analysis. The best the panel could do at this point, is conduct their own analysis of the legislation and come up with their own decision. The panel finds that they do not have the authority to do that under the EAA. The panel's authority it to determine if the Ministry's interpretation of their own legislation is a reasonable interpretation. In this case, the Ministry failed to adequately interpret their legislation and so the panel must find that unreasonable. Given the inadequacy of the reasons and the lack of the interpretation of the legislation conducted by the Ministry, the panel finds that this was not a reasonable application of the legislation in the circumstances of the Appellant. The panel therefore rescinds the decision of the Ministry.
PARTG-0RDER THE PANELDECISI0NIS:(Checkone) [SI UNANIMOUS OBYMAJ0RITY THEPANEL OC0NFIRMSTHEMINISTRYDECISION [SIRESCINDSTHEMINISTRYDECISION lftheministry decisionis rescinded,is the paneldecision referredback totheMinisterforadecision as to amount? Yes [SINo LEGISLATIVEAUTH0RITYF0RTHEDECISI0N: EmploymentandAssistanceAct Section 24(1)(a) D or Section 24(1)(b) D and Section 24(2)(a) D or Section 24(2)(b) ISi PARTH-SIGNATURES PRJNTNAME MEGHAN WALLACE (by telephone) S!GNATUREOFC,R DATE(YEAR/MONTJ-VDAY) IA.d_ ----' w 2018/11/26 /J PRINTNAME WENDY MARTEN SIGNATUREOFMEMBER DATE(YEAR/MONTH/DAY) 2018/11/26 PRINTNAME KIM READ DATE{YEAR/MONTHIDAY) 2018/11/26 EAAT003 {17/08f17)Last Page
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