P A R T C D E C I S I O N U N D E R A P P E A L T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t r y o f S o c i a l D e v e r e c o n s i d e r a t i o n d e c i s i o n d a t e d O c t o b e r 3 0 , 2 0 1 8 , i n w h i d e s i g n a t i o n a s a P e r s o n w i t h D i s a b i l i t i e s ( " P W D " ) u n d e r w i t h D i s a b il i t i e s A c t ( " E A P W D A " ) . T h e m i n i s t r y f o u n d t h a a n d h a s a s e v e r e p h y s i c a l i m p a i r m e n t , b u t w a s n o t s a t i s • t h e a p p e l l a n t h a s a s e v e r e m e n t a l i m p a i r m e n t ; • t h e a p p e l l a n t ' s i m p a i r m e n t , i n t h e o p i n i o n o f a p r e s c r i b e t o p e r f o r m d a i l y l i v i n g a c t i v i t i e s ( " D L A " ) e i t h e r c o n t i n u o u s • a s a r e s u l t o f r e s t r i c t i o n s c a u s e d b y t h e i m p a i r m e n t , t h e o r s u p e r v i s i o n o f a n o t h e r p e r s o n , o r t h e s e rv i c e s o f a n a P A R T D R E L E V A N T L E G I S L A T I O N Emp l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b il i ti e s E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b i l i t i e s I l o p m e n t a n d P o v e r t y R e d u c t i o n ' s ( " m i n i s t ry " ) c h t h e m i n i s t r y f o u n d t h a t t h e a p p e l l a n t i s n o t e l i g i b l e fo r s e c t i o n 2 o f t h e E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s t t h e a p p e l l a n t m e e t s t h e a g e a n d d u r a t i o n r e q u i r e m e n t s f i e d t h a t : d p r o f e s s i o n a l , d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t s h i s a b i l i t y l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s ; a n d a p p e l l a n t r e q u i r e s a n a s s i s t i v e d e v i c e , t h e s i g n i f i c a n t h e l p s s i s t a n c e a n i m a l t o p e rf o r m D L A . A c t ( E A P W D A ) , s e c t i o n 2 R e g u l a t i o n ( E A P W D R ) , s e c t i o n 2
I PART E -SUMMARY OF FACTS The evidence and documentation before the minister at the reconsideration consisted of: 1. Information from the ministry's record of decision indicating the PWD application was received on July 18, 2018 and denied on September 20, 2018. The appellant submitted a Request for Reconsideration ("RFR") on October 18, 2018. The ministry reviewed the RFR on October 30, 2018. 2. The RFR, signed by the appellant on October 21, 2018, describing his physical and mental impairments, and associated restrictions. 3. Chart Summary (2 pages) from the appellant's General Practitioner ("GP"), noting investigations and x-rays of the appellant's left leg injury, performed between March 6 and August 30, 2018. The appellant is to remain non weight bearing for the time being. 4. An orthopedic consult report created on March 29, 2018, indicating a two-week follow-up post-surgery. The appellant's left tibial fracture that was treated by internal fixation. 5. An orthopedic consult report created on April 19, 2018, confirming a complex fracture and vascular injury. The appellant is on a good pain management regimen for his knee. He is working with physiotherapy for his "foot drop." He has no peroneal nerve function and may require a referral for nerve conduction studies and plastic surgery. 6. An orthopedic consult report created on May 19, 2018, indicating the appellant has regained 90% motion in his knee but continues to have "foot drop" for which he is using a splint. The appellant has no motor function of his peroneal nerve and is being referred to plastic surgery to consider surgical intervention as required. 7. An Operative Documentation report ("OR report") created on August 20, 2018, describing surgical intervention for left peroneal neuropathy relative to the appellant's complex tibial plateau fracture. 8.An orthopedic consult report created on September 6, 2018, indicating successful nerve decompression surgery. The appellant was able to weight bear as tolerated, and is on track for reasonable healing of the tibial plateau. The appellant may need further treatment over the years due to degeneration. 9. A letter from a mental health counsellor dated October 18, 2018, indicating the appellant has been receiving counselling since March 2018 for his long standing struggles with anxiety (particularly social anxiety), depression, and anger. These mental health struggles have a significant impact on the appellant's daily life and make it difficult for him to find and hold employment, especially as he recovers from a significant injury. 10. The appellant's PWD application comprised of: • a self-report ("SR") dated June 25, 2018; • a Medical report ("MR") dated July 10, 2018, signed by the appellant's GP who has known the appellant for more than 10 years, and has seen him 11 or more times in the past 12 months; and • an Assessor Report ("AR") dated June 28, 2018, completed by a physiotherapist who has known the appellant since March 2018, and has seen him 11 or more times in the past 12 months. The physiotherapist based the assessment on an office interview with the appellant, file/chart information, and direct observation. 11.The ministry's Denial Decision Summary with attached letter, dated September 20, 2018.
S u m m a ry o f r e l e v a n t e v i d e n c e f ro m t h e a p p li c a ti o n : D i a g n o s e s I n t h e M R , t h e G P i n d i c a t e s " c o m p l e x c o m p o u n d f r a c t u r C o m m e n t s , t h e G P w r i t e s , " v e r y s e v e r e i n j u r y w i t h m u l t i p s y s t e m . S u r g e r i e s o n g o i n g . " F u n c t i o n a l s k ill s I n t h e S R , t h e a p p e l l a n t s t a t e s t h a t s i n c e f a l l i n g 2 0 f e e t a e l e c t r i c a l s e n s a t i o n s i n h i s l e g . H i s n o r m a l r o u t i n e o f w o a s h e c a n n o t k e e p u p a n o r m a l p a c e . D u e t o t h e d i s c o m m i n u t e s w h e n s i t t i n g o r s t a n d i n g . D u e t o h i s " b a d l e g " , h t i m e s l o n g e r t o g e t o u t o f b e d . G o i n g d o w n s t a i r s c a n b e B e n d i n g o v e r t o p i c k t h i n g s u p o ff t h e f l o o r i s v e r y d i ff i c u T h e a p p e l l a n t d e s c r i b e s s l e e p d i s t u r b a n c e s d u e t o p a i n f e e l s h i g h l y u n m o t i v a t e d d u e l o d e p r e s s i o n a n d p a i n . T h a g i t a t i o n , s t r e s s , a n d p a n i c a t t a c k s ; h e c a n n o t p l a n a h e a m e m o r y . T h e a p p e l l a n t r e p o r t s s o c i a l i s o l a t i o n d u e t o b e a p p e l l a n t s t a t e s t h a t h e h a s a n g e r i s s u e s a n d f e e l s s o c i a a n d b a d d a y s . I n t h e M R u n d e r H e a l t h His t o ry , t h e G P r e p o r t s t h a t t h e i n j u ry , p o s t t r a u m a t i c p a i n w i t h " f o o t d r o p " , a n d l i m i t e d u s a p p e l l a n t c a n w a l k 1 t o 2 b l o c k s u n a i d e d o n a f l a t s u rf a c s e a t e d f o r l e s s t h a n o n e h o u r . T h e a p p e l l a n t h a s n o d i f f i c o g n i t i v e a n d e m o t i o n a l f u n c t i o n . U n d e r A d d i ti o n a l C o m i m p a i r e d m o b i l i t y a n d s t r u g g l e s w i t h p o s t t r a u m a t i c p a i n . a b i l i t y t o w a l k a n d w o r k , a n d h a s t a k e n a s i g n i f i c a n t e m o I n t h e A R , t h e a p p e l l a n t ' s A b il i t y t o C o m m u n i c a t e i s r a t e h e a r i n g ) . F o r t h e 6 a c t i v i t i e s l i s t e d u n d e r M o b i l i t y a n d P ( c r u t c h ) f o r W a l k i n g I n d o o r s , W a lk i n g O u t d o o r s , C l i m b i n w i t h o n l y o n e h a n d w h i l e h o l d i n g h i s c r u t c h w i t h t h e o t h e L i ft i n g b u t c a n s t a n d f o r l e s s t h a n 2 0 m i n u t e s , a n d i s a w k a p p e l l a n t w o u l d n o t b e a b l e t o p i c k u p o b j e c t s e a s i l y w i t h F o r C o g n i t i v e a n d E m o t i o n a l F u n c t i o n i n g , t h e p h y s i o t h e r o r i m p a c t s h i s f u n c t i o n i n g a s f o l l o w s : • N o i m p a c t f o r 6 o u t o f 1 3 a r e a s : C o n s c i o u s n e s s , I m p u l P s y c h o t i c s y m p t o m s , a n d O t h e r n e u ro p s y c h o l o g i c a l p ro • M i n i m a l i m p a c t : f o r 4 a r e a s : A t t e n ti o n ( u n a b l e t o m a i n t a • M o d e r a t e i m p a c t fo r 2 a r e a s : B o d i l y f u n c t i o n s ( t o i l e t i n g r a g e " ) ; • M a j o r i m p a c t f o r 2 a r e a s : E m o t i o n ( e x c e s s i v e o r i n a p p r e m o t i o n a l o r m e n t a l p ro b l e m s ( " s o c i a l a n x i e t y , p o s s i b l e P • U n d e r C o m m e n ts , t h e p h y s i o t h e r a p i s t w r i t e s , " n o i d e n t O c t o b e r 1 1 , 2 0 1 8 , t h e p h y s i o t h e r a p i s t w r i t e s , " h a v e r e e h e a l t h . . . N o w c o m p l e t e d p r e a n d p o s t i n j u r y s t a t u s ( e . g . , a n x i e t y , p o s s i b l e P T S D , r e s u l t s i n s l e e p d i s t u r b a n c e s , a e l e f t t i b u l a l f i b u l a " [ o n s e t F e b r u a r y 2 0 1 8 ] . U n d e r l e c o m p l e x s u r g e r i e s t o r e c o n s t r u c t v a s c u l a r , s k e l e t a l n d h a v i n g h i s l e g r e b u i l t , h e d e a l s w i t h c o n s t a n t p a i n a n d r k , t r a i n i n g , a n d o u t d o o r a c t i v i t i e s h a s s e v e r e l y d i m i n i s h e d f o rt i n h i s l e g , h e h a s t o r e p o s i t i o n h i m s e l f e v e r y c o u p l e o f e h a s g r e a t d i f f i c u l t y w i t h b a l a n c i n g a n d i t t a k e s h i m 2 t o 3 v e ry d i ff i c u l t d u e t o h i s " b a d k n e e w i t h p l a t e s a n d s c r e w s . " l t ; t h e a p p e l l a n t r e p o r t s t h a t h e c a n n o t k n e e l a t a l l . a n d t r a u m a . O n b a d d a y s , h e c a n n o t g e t o u t o f b e d a n d e a p p e l l a n t r e p o r t s l o n g s t a n d i n g i s s u e s w i t h a n x i e t y , d o r f i n i s h t a s k s , a n d h e h a s b r a i n f o g a n d p o o r s h o rt t e r m i n g u n a b l e t o e x p r e s s f e e l i n g s o r a s k f o r h e l p . T h e l l y a w k w a r d , a n d h e h a s a n e q u a l n u m b e r o f g o o d d a y s a p p e l l a n t h a s c o m p o r t m e n t s y n d r o m e , p e r o n e a l n e r v e e o f h i s l o w e r l e g . T h e i n f o r m a t i o n i n t h e M R i n d i c a t e s t h e e ; c l i m b 2 t o 5 s t e p s u n a i d e d ; l i ft 5 -1 5 p o u n d s , a n d r e m a i n c u l t i e s w i t h c o m m u n i c a t i o n a n d n o s i g n i f i c a n t d e fi c i t s w i t h m e n t s , t h e G P s t a t e s t h a t t h e a p p e l l a n t h a s s i g n i f i c a n t l y T h e i n j u r y s i g n i f i c a n t l y i n t e rf e r e s w i t h t h e a p p e l l a n t ' s t i o n a l t o l l o n t h e n o r m a l l y a c t i v e a p p e l l a n t . d a s g o o d i n a l l a r e a s ( s p e a k i n g , r e a d i n g , w r i t i n g , a n d h y s i c a l A b il i t y , t h e a p p e l l a n t u s e s a n a s s i s t i v e d e v i c e g S t a i r s , a n d C a r ry i n g a n d h o l d i n g . T h e a p p e l l a n t c a n c a r ry r h a n d . T h e a p p e l l a n t i s i n d e p e n d e n t w i t h S t a n d i n g a n d w a r d w i t h l i ft i n g . T h e p h y s i o t h e r a p i s t s t a t e s t h a t t h e tw o h a n d s . a p i s t i n d i c a t e s t h e a p p e l l a n t ' s m e n t a l i m p a i r m e n t r e s t r i c t s s e c o n t ro l , I n s i g h t a n d j u d g m e n t , M o t o r a c t i v i t y , L a n g u a g e , b l e m s ; i n c o n c e n t r a t i o n ) , E x e c u ti v e , M e m o ry , a n d M o t i v a ti o n ; " a t n i g h t t i m e " , a n d i n s o m n i a ) , a n d I m p u ls e c o n t ro l ( " r o a d o p r i a t e a n x i e t y , " f e e l s s t r e s s e d c o n s t a n t l y " ) , a n d O t h e r T S D f r o m t r a u m a t i c e x p e r i e n c e s " ) . i f i e d m e n t a l o r b r a i n i n j u r y " . I n h e r a p p e n d e d n o t e d a t e d v a l u a t e d c l i e n t i n t e r m s o f m e n t a l / p h y s i c a l / e m o t i o n a l o n g o i n g a n x i e t y i s s u e s ) . M a j o r p r o b l e m s a r e : s t r e s s , t t e n t i o n , a n d m e m o r y d i s t u r b a n c e s . "
DLA In the SR, the appellant reports restrictions with employment, and personal self-care. Bathing/showering and shaving take him 3 to 4 times longer because it is difficult to stand and balance and he needs breaks to rest his leg. The appellant states that he needs to be told to shower and change his clothes and he cannot cook or prepare meals because he cannot stand at the kitchen counter for more than a couple of minutes. It is also hard to reach the lower cupboards. The appellant reports stress symptoms including ulcers and vomiting; he needs to be persuaded to eat a healthy diet. Due to high anxiety and stress from being in a busy public place, the appellant reports that he is unable to pick up/manage his prescriptions and he is unable to grocery shop as there are "too many people in the stores." The appellant states that he is unable to organize himself enough to clean his home and his leg pain and discomfort also restricts this activity. While he is able to drive short distances, his leg gets sore and stiff quickly and he cannot use public transportation due to extreme social anxiety. The appellant states that he also needs constant reminders to pay bills. Due to anxiety and anger issues, the appellant reports that he does not socialize much or have many friends. In the MR, the GP indicates the appellant's pain, "foot drop", and limited use of his lower leg significantly interfere with DLA. The appellant has been prescribed pain medications that interfere with his ability to perform DLA. His need for these medications will vary depending on the progress of his recovery. For the specific DLA listed in section 2 of the MR, the GP checks that 5 out of 1 D activities are restricted: • Personal self-care (the appellant is continuously restricted); • Basic housework (the GP does not indicate whether the restriction is continuous periodic); • Daily shopping (does not indicate whether continuously or periodically restricted); • Mobility inside the home (does not indicate whether continuously or periodically restricted);and • Mobility outside the home ( does not indicate whether continuously or periodically restricted); • Comment: "takes him significantly longer to perform AOL's [DLA] household tasks, etc." In the MR, the GP indicates that 4 out of 10 DLA are not restricted: • Meal preparation; • Management of medications; • Use of transportation; and • Management of finances. • The GP indicates that restrictions to Social functioning are "unknown" ( comment: "emotionally difficult time" for the appellant). In the AR, the physiotherapist states that the appellant's left leg injury with resultant nerve damage and "drop foot" {diminished strength in his leg and severe weakness in his left ankle) are the impairments that impact his ability to manage DLA. In section C of the form, the physiotherapist indicates the appellant is independent with all DLA (comment for Carrying purchases home: "drives car"). Under Additional comments, the physiotherapist writes: "he can put purchases from cart to car, but would not carry bags very far. .. able to drive"). For the Social Functioning DLA, the physiotherapist does not describe how the appellant's mental impairment impacts his relationship with his social networks (this section is left blank). The physiotherapist does not describe any support/supervision required to maintain the appellant in the community, or identify any safety issues (these sections are also left blank). Need for help In the SR, the appellant indicates that due to his injury, anxiety, and depressed mood, he needs help from his family to manage DLA. The appellant reports that his family helps him with personal care and financial transactions (reminders to shower, change clothes, and pay bills), cooking/meal preparation, housecleaning, shopping, and picking up prescriptions. The appellant reports that he also uses a cane or crutch to help with pain and relieve the stress to his knee.
I In the MR, the GP states that the appellant requires mobility aids for his impairment ("crutches, AFO, brace"). The GP reports that family members assist the appellant with numerous activities during his recovery. In the AR, the physiotherapist indicates the appellant uses a crutch for walking and climbing stairs, and while lifting and carrying/holding (the appellant lifts/carries with one hand and holds the crutch with his other hand). In the AR, Part D (Assistance Provided for Applicant), the physiotherapist states that the appellant is living with family "but is independent in AOL's" [DLA]. The physiotherapist indicates the appellant uses crutches, splints, and braces for his impairment (comment: "has a knee brace and ankle splint for left leg, and uses crutch for all walking"). The appellant does not have an assistance animal. Additional information With the consent of both parties, the appeal proceeded as a written hearing pursuant to section 22(3)(b) of the Employment and Assistance Act ("EAA"). Subsequent to the reconsideration decision neither party filed any new evidence requiring an admissibility determination in accordance with section 22(4) of the EAA. The appellant filed a Notice of Appeal with hand-written statement which the panel accepts as argument. In an email to the Tribunal, the ministry states that its submission on appeal will be the reconsideration summary.
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 r y ' s d e c i s i o n t o d e n y t h e a p p e l l a n t P W D d e s i g n a t i o n i s r e a s o n a b l y s u p p o r t e d 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 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 . W a s t h e m i n i s t ry r e a s o n a b l e i n f i n d i n g t h a t t h e f o l l o w i n g e l i g i b i l i t y c r i t e r i a i n s e c t i o n 2 o f t h e E A P W D A w e r e n o t m e t ? • t h e a p p e l l a n t h a s a s e v e r e m e n t a l i m p a i r m e n t ; • t h e a p p e l l a n t ' s i m p a i r m e n t , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t s h i s a b i l i t y t o p e r f o r m D L A e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s ; a n d • a s a r e s u l t o f r e s t r i c t i o n s c a u s e d b y t h e i m p a i r m e n t , t h e a p p e l l a n t r e q u i r e s a n a s s i s t i v e d e v i c e , t h e s i g n i fi c a n t h e l p o r s u p e rv i s i o n o f a n o t h e r p e r s o n , o r t h e s e r v i c e s o f a n a s s i s t a n c e a n i m a l t o p e rf o r m D L A . T h e m i n i s t ry b a s e d i t s 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 t h e fo l l o w i n g l e g i s l a t i o n : E A P W D A 2 ( 1 ) I n t h i s s e c t i o n : " a s s i s t i v e d e v i c e " m e a n s a d e v i c e d e s i g n e d t o e n a b l e a p e r s o n t o p e r f o r m a d a i l y l i v i n g a c t i v i t y t h a t , b e c a u s e o f a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t , t h e p e r s o n i s u n a b l e t o p e r f o r m ; " d a i l y l i v i n g a c t i v i t y " h a s t h e p r e s c r i b e d m e a n i n g ; " p r e s c r i b e d p r o f e s s i o n a l " h a s t h e p r e s c r i b e d m e a n i n g . ( 2 ) T h e m i n i s t e r m a y d e s i g n a t e a p e r s o n w h o h a s r e a c h e d 1 8 y e a r s o f a g e a s a p e r s o n w i t h d i s a b i l i t i e s f o r t h e p u r p o s e s o f t h i s A c t i f t h e m i n i s t e r i s s a t i s f i e d t h a t t h e p e r s o n i s i n a p r e s c r i b e d c l a s s o f p e r s o n s o r t h a t t h e p e r s o n h a s a s e v e r e m e n t a l o r p h y s i c a l i m p a i r m e n t t h a t ( a ) i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r o r n u r s e p r a c t i t i o n e r i s l i k e l y t o c o n t i n u e f o r a t l e a s t 2 y e a r s , a n d ( b ) i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l ( i ) d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t s t h e p e r s o n ' s a b i l i t y t o p e rf o r m d a i l y l i v i n g a c t i v i t i e s e i t h e r ( A ) c o n t i n u o u s l y , o r ( B ) p e r i o d i c a l l y fo r e x t e n d e d p e r i o d s , a n d ( i i ) a s a r e s u l t o f t h o s e r e s t r i c t i o n s , t h e p e r s o n r e q u i r e s h e l p t o p e r f o r m t h o s e a c t i v i t i e s . ( 3 ) F o r t h e p u r p o s e s o f s u b s e c t i o n ( 2 ) , ( a ) a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a i r m e n t i n c l u d e s a p e r s o n w i t h a m e n t a l d i s o r d e r , a n d ( b ) a p e r s o n r e q u i r e s h e l p i n r e l a t i o n t o a d a i l y l i v i n g a c t i v i t y i f , i n o r d e r t o p e rf o r m i t , t h e p e r s o n r e q u i r e s ( i ) a n a s s i s t i v e d e v i c e , ( i i ) t h e s i g n i f i c a n t h e l p o r s u p e rv i s i o n o f a n o t h e r p e r s o n , o r ( i i i ) t h e s e rv i c e s o f a n a s s i s t a n c e a n i m a l . ( 4 ) T h e m i n i s t e r m a y r e s c i n d a d e s i g n a t i o n u n d e r s u b s e c t i o n ( 2 ) . E A P W D R D e f i n i t i o n s f o r A c t 2 ( 1 ) F o r t h e p u r p o s e s o f t h e A c t a n d t h i s r e g u l a t i o n , " d a i l y l i v i n g a c t i v i t i e s " , ( a ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e p h y s i c a l i m p a i r m e n t o r a s e v e r e m e n t a l i m p a i r m e n t , m e a n s t h e fo l l o w i n g a c t i v i t i e s : ( i ) p r e p a r e o w n m e a l s ; ( i i ) m a n a g e p e r s o n a l f i n a n c e s ; ( i i i ) s h o p f o r p e r s o n a l n e e d s ; ( i v ) u s e p u b l i c o r p e r s o n a l t r a n s p o r t a t i o n f a c i l i t i e s ; ( v ) p e rf o r m h o u s e w o r k t o m a i n t a i n t h e p e r s o n ' s p l a c e o f r e s i d e n c e i n a c c e p t a b l e s a n i t a r y c o n d i t i o n ; ( v i ) m o v e a b o u t i n d o o r s a n d o u t d o o r s ; ( v i i ) p e rf o r m p e r s o n a l h y g i e n e a n d s e l f c a r e ; ( v i i i ) m a n a g e p e r s o n a l m e d i c a t i o n , a n d ( b ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e m e n t a l i m p a i r m e n t , i n c l u d e s t h e f o l l o w i n g a c t i v i t i e s : ( i ) m a k e d e c i s i o n s a b o u t p e r s o n a l a c t i v i t i e s , c a r e o r f i n a n c e s ; ( i i ) r e l a t e t o , c o m m u n i c a t e o r i n t e r a c t w i t h o t h e r s e f f e c t i v e l y .
A n a l y s i s a n d p a n e l ' s d e c i s i o n S e v e re m e n t a l o r p h y s i c a l i m p a i r m e n t T o b e e l i g i b l e f o r t h e P W D d e s i g n a t i o n , t h e l e g i s l a t i o n r e b e i n g s a t i s f i e d t h a t t h e a p p l i c a n t h a s a s e v e r e m e n t a l o r s a t i s f i e d t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l i m p a i r m e n t m e t . 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 d o e s n o t h a v p r o v i d e d i n t h e P W D a p p l i c a t i o n a n d R F R . " S e v e r e " i s m e d i c a l c o n d i t i o n d o e s n o t i n i t s e l f e s t a b l i s h a s e v e r e i m m e n t a l i m p a i r m e n t , t h e m i n i s t r y m u s t c o n s i d e r t h e e x t e n l i m i t a t i o n s / r e s t r i c t i o n s i n m e n t a l f u n c t i o n s ; r e s t r i c t i o n s w i s i g n i f i c a n t h e l p i s r e q u i r e d t o m a n a g e D L A . T h e m i n i s t r y a r g u e s t h a t a s e v e r e m e n t a l i m p a i r m e n t i s n d e f i c i t s w i t h c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g a n d t h e i m p a i r m e n t ( d e s p i t e r e p o r t i n g t h a t t h e a p p e l l a n t h a s " m a A s w e l l , n e i t h e r p r e s c r i b e d p r o f e s s i o n a l r e p o r t s a n y d i ff i c a p p e l l a n t e x p e r i e n c e s s o m e i m p a c t s t o h i s c o g n i t i v e a n d a s s e s s m e n t o f h i s m e n t a l s t a t u s d e m o n s t r a t e s a s e v e r e B a s e d o n t h e e v i d e n c e p r o v i d e d , t h e p a n e l f i n d s t h a t t h e i m p a i r m e n t i s n o t e s t a b l i s h e d . T h e a p p e l l a n t r e p o r t s a s a n g e r i s s u e s , a n d t r a u m a t i c e x p e r i e n c e s . T h e a p p e l l a n t h i n d e r s h i m f r o m g o i n g t o s t o r e s , s o c i a l i z i n g , a n d u s i n g p a n d p h y s i o t h e r a p i s t d o e s n o t r e f l e c t t h e d e g r e e o f s e v e r T h e G P a c k n o w l e d g e s t h a t t h e a p p e l l a n t i s g o i n g t h r o u g a p p e l l a n t w i t h a n x i e t y o r d e p r e s s i o n ; o r d e s c r i b e a n y f u n T h e G P c h e c k m a r k s , N o , w h e n a s k e d i f t h e a p p e l l a n t h f u n c t i o n . T h e p h y s i o t h e r a p i s t ' s e v i d e n c e c o m e s c l o s e r t o i d e n t i fy i p r o b l e m s a r e s t r e s s , a n x i e t y , p o s s i b l e P T S D r e s u l t s i n T h e p h y s i o t h e r a p i s t i n d i c a t e s t h e a p p e l l a n t ' s m e n t a l i m p c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g . H o w e v e r , t h e p r o b l m o t i v a t i o n ) a r e a s s e s s e d b y t h e p h y s i o t h e r a p i s t a s m i n i m T h e a p p e l l a n t p r o v i d e s a l e t t e r f r o m h i s c o u n s e l l o r t h a t c d e p r e s s i o n , a n d a n g e r . W h i l e t h e c o u n s e l l o r s t a t e s t h a t d a i l y l i f e , t h e o n l y s p e c i f i c f u n c t i o n a l r e s t r i c t i o n t h e c o u n s t h e m i n i s t ry , e m p l o y a b i l i t y o r t h e a b i l i t y t o w o r k i s n o t a f l e g i s l a t i o n d o e s n o t i n c l u d e t h e i n a b i l i t y t o h o l d e m p l o y m e n t i r e t y , t h e p a n e l fi n d s t h a t t h e m i n i s t r y r e a s o n a b l y d e t e u n d e r s e c t i o n 2 ( 2 ) o f t h e E A P W D A . R e s t r i c t i o n s i n t h e a b il i t y t o p e rf o rm D LA S u b s e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A r e q u i r e s t h e m i n i s p r o f e s s i o n a l , a s e v e r e i m p a i r m e n t d i r e c t l y a n d s i g n i f i c a n c o n t i n u o u s l y , o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s . I n t h i p h y s i o t h e r a p i s t w h o c o m p l e t e d t h e P W D m e d i c a l r e p o rt s a d d i t i o n a l r e p o rt s / l e t t e r s . T h e t e r m " d i r e c t l y " m e a n s t h e r a n d t h e r e s t r i c t i o n t o D L A . T h e d i r e c t r e s t r i c t i o n m u s t a l s I q u i r e s s e v e r a l c r i t e r i a t o b e m e t i n c l u d i n g t h e m i n i s t e r p h y s i c a l i m p a i r m e n t . O n r e c o n s i d e r a t i o n , t h e m i n i s t r y w a s . T h e r e f o r e , t h e c r i t e r i a i n s e c t i o n 2 ( 2 ) o f t h e E A P W D A a r e e a s e v e r e m e n t a l i m p a i r m e n t b a s e d o n t h e i n f o r m a t i o n n o t d e f i n e d i n t h e l e g i s l a t i o n b u t t h e d i a g n o s i s o f a s e r i o u s p a i r m e n t o f m e n t a l f u n c t i o n i n g . T o a s s e s s t h e s e v e r i t y o f a t o f a n y i m p a c t o n d a i l y f u n c t i o n i n g a s e v i d e n c e d b y t h D L A r e q u i r i n g m e n t a l / s o c i a l f u n c t i o n i n g ; a n d w h e t h e r o t e s t a b l i s h e d o n t h e e v i d e n c e b e c a u s e t h e G P r e p o r t s n o a s s e s s o r fi n d s o n l y tw o m a j o r i m p a c t s d u e t o a m e n t a l j o r p r o b l e m s " d u e t o s t r e s s , a n x i e t y , a n d p o s s i b l e P T S D ) . u l t i e s w i t h c o m m u n i c a t i o n . T h e m i n i s t ry a c k n o w l e d g e s t h e e m o t i o n a l f u n c t i o n i n g b u t i s n o t s a t i s f i e d t h a t t h e o v e r a l l d e g r e e o f m e n t a l i m p a i r m e n t . m i n i s t ry r e a s o n a b l y d e t e r m i n e d t h a t a s e v e r e m e n t a l e v e r e d e g r e e o f i m p a i r m e n t d u e t o h i s a n x i e t y , d e p r e s s i o n , r e p o rt s t h a t h e i s e s p e c i a l l y i m p a i r e d b y h i s a n x i e t y , w h i c h u b l i c t r a n s i t . U n f o r t u n a t e l y , t h e i n f o r m a t i o n f r o m t h e G P i t y d e s c r i b e d i n t h e a p p e l l a n t ' s s e l f r e p o r t s . h a d i ff i c u l t t i m e e m o t i o n a l l y , b u t d o e s n o t d i a g n o s e t h e c t i o n a l r e s t r i c t i o n s t h a t r e s u l t f r o m t h e a p p e l l a n t ' s a n x i e t y . a s a n y s i g n i f i c a n t d e f i c i t s w i t h c o g n i t i v e o r e m o t i o n a l n g a s e v e r e i m p a i r m e n t o f m e n t a l f u n c t i o n i n g ( " m a j o r s l e e p d i s t u r b a n c e s , a t t e n t i o n a n d m e m o r y d i s t u r b a n c e s " ) . a i r m e n t h a s a m o d e r a t e o r m a j o r i m p a c t i n f o u r a r e a s o f e m s i d e n t i f i e d b y t h e a p p e l l a n t ( p l a n n i n g , m e m o ry , a n d a l i m p a c t . o n f i r m s h i s l o n g s t a n d i n g s t r u g g l e s w i t h a n x i e t y , t h e s e f e e l i n g s h a v e a s i g n i f i c a n t i m p a c t o n t h e a p p e l l a n t ' s e l l o r d e s c r i b e s i s d i ff i c u l ty w i t h e m p l o y m e n t . A s n o t e d b y a c t o r i n d e t e r m i n i n g e l i g i b i l i t y f o r P W D d e s i g n a t i o n . T h e e n t a s a c r i t e r i o n f o r P W D . B a s e d o n t h e e v i d e n c e i n i t s r m i n e d t h a t a s e v e r e m e n t a l i m p a i r m e n t i s n o t e s t a b l i s h e d t r y t o b e s a t i s f i e d t h a t , i n t h e o p i n i o n o f a p r e s c r i b e d t l y r e s t r i c t s a p e r s o n ' s a b i l i t y t o p e rf o r m D L A e i t h e r s c a s e , t h e p r e s c r i b e d p r o f e s s i o n a l s a r e t h e G P a n d t h e , a n d t h e s p e c i a l i s t s a n d c o u n s e l l o r w h o p r o v i d e d e m u s t b e a c a u s a l l i n k b e t w e e n t h e s e v e r e i m p a i r m e n t o b e s i o n i f i c a n t .
F i n a l l y , t h e r e i s a c o m p o n e n t r e l a t e d t o t i m e o r d u r a t i o n : c o n t i n u o u s o r p e r i o d i c . I f p e r i o d i c , t h e r e s t r i c t i o n m u s t b e r e s t r i c t i o n s m u s t a l s o i n c l u d e h o w f r e q u e n t l y t h e a c t i v i t y a r i s e s o n c e a y e a r i s l e s s l i k e l y t o b e s i g n i f i c a n t t h a n o n e c i r c u m s t a n c e s w h e r e t h e e v i d e n c e i n d i c a t e s t h a t a r e s t r i r e q u i r e e v i d e n c e o n t h e d u r a t i o n a n d f r e q u e n c y o f t h e r e D L A a r e d e f i n e d i n s e c t i o n 2 ( 1 ) o f t h e E A P W D R a n d a r e T h e r e f o r e , a p r a c t i t i o n e r c o m p l e t i n g t h e s e f o r m s h a s t h e r e s t r i c t e d b y t h e a p p l i c a n t ' s i m p a i r m e n t s e i t h e r c o n t i n u o a d d i t i o n a l n a r r a t i v e . D L A , a s d e f i n e d i n t h e l e g i s l a t i o n , d T h e m i n i s t r y a r g u e s t h e r e i s n o t e n o u g h e v i d e n c e f r o m t s i g n i f i c a n t l y r e s t r i c t e d e i t h e r c o n t i n u o u s l y , o r p e r i o d i c a l l y a s r e s t r i c t e d b u t w i t h t h e e x c e p t i o n o f P e r s o n a l s e l f c a r e t h e a c t i v i t i e s a r e c o n t i n u o u s l y o r p e r i o d i c a l l y r e s t r i c t e d o D L A . T h e a p p e l l a n t p r o v i d e s a g r e a t e r d e g r e e o f d e t a i l i n h i s s t o s h o w e r a n d s h a v e ; h e i s u n a b l e t o p e rf o r m h o u s e w o r k d a y s " h a l f o f t h e t i m e . T h e G P d o e s n o t c o n f i r m t h i s i n f o f i n d s t h a t t h e m i n i s t r y r e a s o n a b l y d e t e r m i n e d t h e r e i s i n s r e s t r i c t e d e i t h e r c o n t i n u o u s l y , o r p e r i o d i c a l l y f o r e x t e n d e I n t h e A R , t h e p h y s i o t h e r a p i s t a s s e s s e s a l l D L A a s i n d e p a r e a s o f m o b i l i t y i n c l u d i n g l i ft i n g a n d c a r r y i n g ( t h e a p p e l l h i s c r u t c h w i t h t h e o t h e r h a n d ) . L o g i c a l l y , i t i s u n c l e a r h p h y s i c a l D L A g i v e n h i s s e v e r e p h y s i c a l i m p a i r m e n t f o r w o n e h a n d . E v e n i f t h e p a n e l g i v e s l i t t l e w e i g h t t o t h e p h y e v i d e n c e f r o m t h e G P t o c o n f i r m t h a t m o s t o f t h e a p p e l l a p e r i o d s a s r e q u i r e d b y t h e l e g i s l a t i o n . W h i l e t h e a p p e l l a n t p r o v i d e s a d e t a i l e d d e s c r i p t i o n o f t h e a r g u e s t h a t t h e G P d o e s n o t d e s c r i b e t h e n a t u r e a n d f r e p h y s i o t h e r a p i s t c o n f i r m t h e a p p e l l a n t ' s r e p o rt s o f r e s t r i c t a n d f i n a n c e s , u s e o f t r a n s p o rt a t i o n , a n d s o c i a l f u n c t i o n i n t h a t r e s t r i c t i o n s t o s o c i a l f u n c t i o n i n g a r e u n k n o w n . T h e o rt h o p e d i c c o n s u l t r e p o rt s a n d t h e l e tt e r f r o m t h e a p p e r f o r m t h e D L A l i s t e d i n t h e E A P W D R . A s n o t e d , e m p l f i n d s t h a t t h e m i n i s t ry r e a s o n a b l y d e t e r m i n e d t h e r e i s n o e s t a b l i s h t h a t D L A a r e s i g n i f i c a n t l y r e s t r i c t e d a s r e q u i r e d p r e s c r i b e d p r o f e s s i o n a l s , t h e p a n e l fi n d s t h a t t h e m i n i s t r t h e E A P W D A a r e n o t m e t .I t h e d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n m a y b e e i t h e r f o r e x t e n d e d p e r i o d s . I n h e r e n t l y , a n a n a l y s i s o f p e r i o d i c i s r e s t r i c t e d . A l l o t h e r t h i n g s b e i n g e q u a l , a r e s t r i c t i o n t h a t t h a t o c c u r s s e v e r a l t i m e s a w e e k . A c c o r d i n g l y , i n c t i o n a r i s e s p e r i o d i c a l l y , i t i s a p p r o p r i a t e f o r t h e m i n i s t r y t o s t r i c t i o n i n o r d e r t o b e s a t i s f i e d t h a t t h i s c r i t e r i o n i s m e t . a l s o l i s t e d i n t h e M R , w i t h a d d i t i o n a l d e t a i l s i n t h e A R . o p p o r t u n i t y t o i n d i c a t e w h i c h , i f a n y , D L A a r e s i g n i f i c a n t l y u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s , a n d t o p r o v i d e o e s n o t i n c l u d e t h e a b i l i t y t o w o r k . h e p r e s c r i b e d p r o f e s s i o n a l s t o c o n f i r m t h a t D L A a r e fo r e x t e n d e d p e r i o d s . I n t h e M R , s e v e r a l D L A a r e m a r k e d ( c o n t i n u o u s l y r e s t r i c t e d ) , t h e G P d o e s n o t i n d i c a t e w h e t h e r r h o w m u c h l o n g e r i t t a k e s t h e a p p e l l a n t t o p e rf o r m t h e s e e l f r e p o r t s . H e s t a t e s t h a t i t t a k e s h i m 3 t o 4 t i m e s l o n g e r o r s h o p d u e t o h i s l e g i n j u r y a n d a n x i e t y ; a n d h e h a s " b a d r m a t i o n a s r e q u i r e d b y t h e l e g i s l a t i o n . T h e p a n e l t h e r e fo r e u ff i c i e n t i n fo r m a t i o n t o e s t a b l i s h t h a t D L A a r e s i g n i f i c a n t l y d p e r i o d s . e n d e n t d e s p i t e r e p o r t i n g f u n c t i o n a l r e s t r i c t i o n s w i t h m o s t a n t p e r f o r m s t h e s e a c t i v i t i e s w i t h o n e h a n d w h i l e h e h o l d s o w t h e a p p e l l a n t c a n b e i n d e p e n d e n t w i t h a l l o f t h e h i c h h e e m p l o y s s e v e r a l a s s i s t i v e d e v i c e s a n d u s e s o n l y s i o t h e r a p i s t ' s a s s e s s m e n t o f D L A , t h e r e i s i n s u ff i c i e n t n t ' s r e s t r i c t i o n s a r e c o n t i n u o u s o r p e r i o d i c fo r e x t e n d e d h e l p h e n e e d s f r o m h i s fa m i l y t o p e rf o r m D L A , t h e m i n i s t r y q u e n c y o f t h e h e l p p r o v i d e d . N e i t h e r t h e G P n o r t h e i o n s w i t h m e a l p r e p a r a t i o n , m a n a g e m e n t o f m e d i c a t i o n s g . T h e G P i n d i c a t e s t h a t t h e s e D LA a r e n o t r e s t r i c t e d a n d p e l l a n t ' s c o u n s e l l o r d o n o t a d d r e s s t h e a p p e l l a n t ' s a b i l i t y t o o y m e n t i s n o t l i s t e d a s a D L A i n t h e l e g i s l a t i o n . T h e p a n e l t e n o u g h i n f o r m a t i o n i n t h e P W D a p p l i c a t i o n a n d R F R t o b y t h e l e g i s l a t i o n . B a s e d o n t h e i n f o r m a t i o n f r o m y r e a s o n a b l y d e t e r m i n e d t h e c r i t e r i a i n s e c t i o n 2 ( 2 ) ( b ) ( i ) o f
H e l p t o p e r f o r m D LA S e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A r e q u i r e s t h a t , a s a r e s p e rf o rm D LA , a p e r s o n r e q u i r e s h e l p t o p e rf o r m t h o s e a c r e q u i r e m e n t f o r a n a s s i s t i v e d e v i c e , t h e s i g n i f i c a n t h e l p o a s s i s t a n c e a n i m a l i n o r d e r t o p e rf o r m D L A . T h e M R a n d A R i n d i c a t e t h e a p p e l l a n t u s e s a s s i s t i v e d e T h e m i n i s t ry ' s p o s i t i o n i s t h a t b e c a u s e i t h a s n o t b e e n e s d e t e r m i n e d t h a t s i g n i f i c a n t h e l p i s r e q u i r e d . U n d e r t h e l e t o D L A i s a p r e c o n d i t i o n . f o r n e e d i n g h e l p t o p e rf o r m D L A d e t e r m i n e d t h a t s i g n i f i c a n t r e s t r i c t i o n s t o D L A w e r e n o t e t h a t t h e m i n i s t r y r e a s o n a b l y c o n c l u d e d t h a t t h e c r i t e r i a f o m e t . C o n c l u s i o n B a s e d o n t h e D L A a s s e s s m e n t o f t h e G P a n d p h y s i o t h e p a n e l f i n d s t h a t t h e m i n i s t r y ' 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 P W D d e s i g n a t i o n , i s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n s u c c e s s f u l o n a p p e a l .I u l t o f d i r e c t a n d s i g n i f i c a n t r e s t r i c ti o n s i n t h e a b il i t y t o t i v i t i e s . H e l p i s d e f i n e d i n s u b s e c t i o n ( 3 ) a s t h e r s u p e r v i s i o n o f a n o t h e r p e r s o n , o r t h e s e rv i c e s o f a n v i c e s t o p e rf o r m D L A , a n d h e r e c e i v e s h e l p f r o m h i s fa m i l y . t a b l i s h e d t h a t D L A a r e s i g n i f i c a n t l y r e s t r i c t e d , i t c a n n o t b e g i s l a t i o n , c o n f i r m a t i o n o f d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n s . A s t h e p a n e l f o u n d t h a t t h e m i n i s t ry r e a s o n a b l y s t a b l i s h e d b y t h e i n f o r m a t i o n p r o v i d e d , t h e p a n e l a l s o f i n d s r h e l p u n d e r s e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A a r e n o t r a p i s t , a n d c o n s i d e r i n g t h e e v i d e n c e i n i t s e n t i r e t y , t h e h i c h 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 w a s n o t e l i g i b l e f o r c e . T h e p a n e l c o n f i r m s t h e d e c i s i o n . T h e a p p e l l a n t i s n o t
PART G -ORDER THE PANEL DECISION IS: (Check one) [8]UNANIMOUS □BY MAJORITY THE PANEL □CONFIRMS THE MINISTRY DECISION [8]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) D or Section 24(1)(b) D and Section 24(2)(a) D or Section 24(2)(b) [81 PART H -SIGNATURES PRINT NAME Margaret Koren SIGNATURE OF CHAIR DATE (YEAR/MONTH/DAY) 2018-10-10 PRINT NAME Stephanie Korour SIGNATURE OF MEMBER DATE{YEAR/MONTH/DAY) /?, -j, 2018-10-10 PRINT NAME Nancy Eidsvik SIGNATURE OF MEMBER DATE(YEAR/MONTH/DAY) 2018-10-10 .
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.