PART C -DECISION UNDER APPEAL The decision under appeal is the Ministry of Social Development and Poverty Reduction (the Ministry) Reconsideration Decision dated November 14, 2018, which found that the Appellant did not meet four of the five statutory requirements of Section 2 of the Employment and Assistance for Persons with Disabilities Act (EAPWDA) for designation as a person with disabilities (PWD). While the Ministry found that the Appellant met the age requirement, it was not satisfied that the evidence establishes that: • the Appellant's impairment is likely to continue for at least two years; • the Appellant has a severe physical or mental impairment; • the Appellant's daily living activities (DLA) are, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods; and, • as a result of these restrictions, the Appellant requires the significant help or supervision of another person, the use of an assistive device, or the services of an assistance animal to perform DLA. The Ministry also found that the Appellant is not one of the prescribed classes of persons who may be eligible for PWD designation on the alternative grounds set out in Section 2.1 of the EAPWDA and the Appellant did not appeal the decision on this basis. PART D -RELEVANT LEGISLATION EAPWDA, Section 2 Employment and Assistance for Persons with Disabilities Regulation (EAPWDR), Section 2
P A R T E S U M M A R Y O F F A C T S T h e e v i d e n c e b e f o r e t h e M i n i s t ry a t t h e t i m e o f t h e A p p l i c a t i o n c o m p r i s e d o f t h e a p p l i c a n t i n f o r m a t i o n a R e p o r t ( M R ) d a t e d J u l y 2 , 2 0 1 8 a n d c o m p l e t e d b y t k n o w n t h e A p p e l l a n t s i n c e 1 9 9 9 a n d w h o h a s s e e n A s s e s s o r R e p o r t ( A R ) d a t e d J u l y 2 , 2 0 1 8 c o m p l e t e T h e e v i d e n c e a l s o i n c l u d e d t h e f o l l o w i n g d o c u m e n t 1 . R e q u e s t f o r R e c o n s i d e r a t i o n ( R F R ) s i g n e d o t h a t : • h e h a s b e e n w o r k i n g w i t h a c o m m u n i t y p r o g r a m f o r w h i c h h e h a s c o m p l e t e d a t o e n t e r t h e p r o g r a m s o o n ; a n d , • h e i s d e s p e r a t e f o r h e l p b e c a u s e h e h a o u t b u r s t s w h i c h h e i s n o t b e e n a b l e t o c 2 . P s y c h i a t r i c R e p o rt f r o m a r e g i o n a l h e a l t h a u o f t h e A p p e l l a n t ( t h e H A P s y c h i a t r i c S u m m a p r e s e n t i n g i l l n e s s , h i s p a s t p s y c h i a t r i c h i s t o r s u b s t a n c e u s e s , a n d t h e c o n s u l t a n t ' s i m p r e r e c o m m e n d a t i o n s ; 3 . H A D i s c h a r g e S u m m a r y R e p o rt i n t h e n a m e s u m m a r i z i n g t h e t o p i c s c o v e r e d i n fo u r g r o u t h e A p p e l l a n t a t t e n d e d t h r e e o f t h e f o u r s e s s c h e d u l e d t o s t a r t a d e p r e s s i o n g r o u p t h e r a n o t s t a rt t h e ( d e p r e s s i o n g ro up t h e r a p y s e s s 4 . H A C o n s u l t a t i o n R e p o rt i n t h e n a m e o f t h e A C o n s u l t a t i o n R e p o r t ) p r o v i d i n g d e t a i l s o f t h e a n d a p e r s o n a l i t y d i s o r d e r w i t h n a r c i s s i s t i c f F u n c t i o n i n g ( G A F ) s c o r e o f 6 5 , a n d p r e s c r i b 5 . H A C o n s u l t a t i o n R e p o r t i n t h e n a m e o f t h e A C o n s u l t a t i o n R e p o rt ) , c o m p l e t e d b y t h e s a m C o n s u l t a t i o n R e p o rt , s t a t i n g t h a t t h e A p p e l l a p s y c h o t h e r a p y t re a t m e n t p re s c r i b e d i n t h e Firs c o n s u l t a n t p r o v i d e d t h e s a m e d i a g n o s i s t h a " ( T h e A p p e ll a n t ) f e e l s h e n o w n e e d s t o g e t i a g o . H e w i ll s t a rt p ro c e s s g ro u p w h e n t h e r e I R e c o n s i d e r a t i o n D e c i s i o n i n c l u d e d t h e P W D n d S e l f R e p o r t ( S R ) d a t e d J u n e 2 9 , 2 0 1 8 , a M e d i c a l h e A p p e l l a n t ' s G e n e r a l P r a c t i t i o n e r ( G P ) w h o h a s t h e A p p e l l a n t 2 -1 O t i m e s i n t h e p a s t y e a r , a n d a n d b y t h e G P . s : n O c t o b e r 1 6 , 2 0 1 8 i n w h i c h t h e A p p e l l a n t s t a t e s t r e a t m e n t c e n t e r t o g e t i n t o a 5 w e e k t r e a t m e n t f o r m a l r e q u e s t a n d t h a t h e i s h o p e f u l h e w i l l b e a b l e s h a d m a n y y e a r s o f d e p r e s s i o n , a n x i e t y a n d v i o l e n t o n t r o l a n d t h a t h e h a s l o s t m a n y j o b s a s a r e s u l t ; t h o r i t y ( t h e H A ) d a t e d F e b r u a r y 1 7 , 2 0 1 7 i n t h e n a m e r y R e p o r t ) p r o v i d i n g a h i s t o r y o f t h e A p p e l l a n t ' s y , m e d i c a t i o n s , p a s t m e d i c a l a n d s o c i a l h i s t o r y , s s i o n s o f a m e n t a l s t a t u s e x a m a n d o f t h e A p p e l l a n t p r i n t e d o n S e p t e m b e r 2 8 , 2 0 1 7 , p t h e r a p y s e s s i o n s h e l d i n A p r i l 2 0 1 7 , i n d i c a t i n g t h a t s i o n s , a n d s t a t i n g t h a t t h e A p p e l l a n t h a d b e e n p y s e s s i o n o n J u n e 8 , 2 0 1 7 w i t h t h e n o t e " C l i e n t d i d i o n ) " ; p p e l l a n t d a t e d M a r c h 2 3 , 2 0 1 2 ( t h e F i r s t A p p e l l a n t ' s s o c i a l h i s t o r y , a d i a g n o s i s o f d e p r e s s i o n e a t u r e s , i n d i c a t i n g a G l o b a l A s s e s s m e n t o f i n g g r o u p p s y c h o t h e r a p y t r e a t m e n t ; a n d p p e l l a n t d a t e d A p r i l 1 5 , 2 0 1 3 ( t h e S e c o n d e c o n s u l t a n t w h o h a d c o m p l e t e d t h e F i r s t n t h a d b e e n " k e e n t o a t t e n d ( t h e g ro u p t C o n s u l t a ti o n R e p o rt ) b u t d i d n o t fo ll o w u p " . T h e t a p p e a r e d i n t h e F i r s t C o n s u l t a t i o n R e p o rt a n d s t a t e d n v o l v e d i n t h e (t h e r a p y) r e c o m m e n d e d t o h i m a y e a r i s a n o p e n i n g " .
Duration In the MR, the GP does not indicate whether the Appellant's impairment is likely to continue for two years or more from today by ticking either of the boxes ("Yes" or "No") in the space provided, but does state that the estimated duration of the Appellant's impairment is unknown. The GP adds "(The Appellant) is encouraged to attend treatment for his anxiety ... depression and substance use". In the Section of the MR which asks for additional comments the GP writes "(The Appellant) has (had) behaviour problems since childhood ... He has (a ) history of substance use ... the extent and duration of impairment in mental functions is prolonged and persistent. Diagnoses In the MR, the GP diagnosed the Appellant with mood disorders, anxiety disorders and a personality disorder with narcissistic features, all present since childhood, and a substance use disorder since he was a teenager. Physical Impairment The GP did not identify any physical impairments. In the MR, the GP reports that the Appellant can walk more than 4 blocks unaided on a flat surface, can climb more than 5 steps unaided and has no limitations with respect to lifting and remaining seated. In the AR, the GP indicates that the Appellant is independent with respect to all aspects of mobility and physical ability (walking indoors and outdoors, climbing stairs, standing, lifting and carrying and holding), with the added comment "no impairment. In the section of the HA Psychiatric Summary Report headed "Past Medical History" the consultant has written "Gout". In the SR, the Appellant wrote that he has Gout and arthritis resulting from a build-up of uric acid in his thigh and extreme physical exertion. He explained that he has moved furniture all of his life and likes to lift heavy things. He states that, while his Gout attacks are minor at the moment, when he does suffer an attack he is unable to do physical work for up to 3 to 4 weeks. Regarding his Arthritis, he explains that his feet ache continually in the winter months and that when he's working the pain is worse and persistent. In addition, he states that he has had traumatic injuries from "(punching two) windows a week aparf' when he was 18, resulting in a severed artery in his arm and a 4 inch gash in his wrist and inner arm. The Appellant also writes that he suffered a bike accident as a child and he hit his head on a cement culvert and believes that he damaged his prefrontal cortex as a result. Mental Impairment In the MR, the GP states that the Appellant "has persistent mental disorders of depression, anxiety, (and) anger outbursts. He is unable to keep employment due to his behaviour at work. He has been seen by various psychiatrists and he has been off work since January 2018. ... He used to be a heavy drinker, and (has a) history of substance use". The GP also refers to attached psychiatric consultations completed in 2012, 2013 and 2017 (the HA Discharge Summary Report, the First Consultation Report and the Second Consultation Report). The GP also reports that the Appellant has difficulties with communication due to cognitive influences,
a d d i n g t h e c o m m e n t " H e h a s p ro b l e m s w i t h f o c u s G P l i s t s t h e f o l l o w i n g a r e a s w h e r e c o g n i t i v e a n d e m m o t i v a t i o n a n d i m p u l s e c o n t r o l , a n d a d d s " a n g e r p ro p ro b l e m s w i t h f o c u s , i m p u l s e c o n t ro l a n d a n x i e t y " . W h e r e a s k e d i n t h e M R t o p r o v i d e a d d i t i o n a l c o m m p r o b l e m s s i n c e c h il d h o o d . . . H e d e m o n s t ra t e d p ro a n g e r a n d h i t t i n g o u t/ a s s a u l t . H e h a s a h is t o ry o f s i m p a i r m e n t i n m e n t a l f u n c t i o n s i s p ro l o n g e d a n d p e f u n c t i o n i n g " . I n t h e A R , t h e G P i n d i c a t e s t h a t t h e A p p e l l a n t ' s l e v c o m m u n i c a t i o n ( 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 e a " s a t i s f a c t o r y " , " p o o r " a n d " u n a b l e " ) . W h e r e a s k e d t " ( A p p e ll a n t) s u ff e r s f ro m a n x i e t y a n d d e p r e s s i o n . T H e u s u a ll y s p e n d s t i m e a l o n e a t h o m e a n d t e n d s t o W h e r e a s k e d i n t h e A R t o i d e n t i f y t h e d e g r e e t o w h i m p a c t s h i s d a i l y f u n c t i o n , t h e G P i n d i c a t e s a m a j o r i m p a c t o n i n s i g h t a n d j u d g m e n t , a t t e n t i o n / c o n c e n t r a a n d n o i m p a c t o n t h e o t h e r f u n c t i o n s ( b o d i l y f u n c t i o p s y c h o t i c s y m p t o m s , o r o t h e r n e u r o p s y c h o l o g i c a l , e I n t h e S R , t h e A p p e l l a n t w r i t e s t h a t h e g e t s d e p r e s s c h i l d a n d a f a i l e d r e l a t i o n s h i p w h i c h r e s u l t e d i n h i s y e a r s o l d . H e s t a t e s t h a t h e h a s b e e n p r o n e t o v i o l e Z o l o ft ( S e r t r a l i n e ) . H e a l s o w r i t e s t h a t h e h a s a n x i e s l e e p i n g ( a n d t h a t ) s o m e t i m e s ( h e i s ) up f o r d a y s " . f o r h i s a n x i e t y . T h e A p p e l l a n t w r i t e s t h a t i f h e f e e l s b li n d r a g e " , b u t t h a t h e h a s a l w a y s f o u n d a w a y t o w s t a t e s t h a t h e b e l i e v e s h e h a s P o s t T r a u m a t i c S t r e s n e v e r b e e n d i a g n o s e d w i t h i t . R e s tri c t i o n s i n t h e A b ili ty t o P e rf o r m D L A T h e G P h a s n o t p r o v i d e d a n y i n f o r m a t i o n w h e r e a s a n d p h y s i c a l i m p a i r m e n t s t h a t i m p a c t t h e A p p e l l a n t t h a t t h e A p p e l l a n t h a s n o t b e e n p r e s c r i b e d a n y m e d p e rf o r m D LA a n d i n d i c a t e s t h a t " h e i s o n m e d i c a ti o t h e G P a l s o i n d i c a t e s t h a t t h e A p p e l l a n t h a s n o i m p ( p e r s o n a l s e l f c a r e , 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 m o b i l i t y i n s i d e a n d o u t s i d e t h e h o m e , u s e o f t r a n s p G P h a s n o t i n d i c a t e d w h e t h e r t h e A p p e l l a n t ' s i m p a i I n t h e A R , 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 i s i n d e p p e r s o n a l c a r e , b a s i c h o u s e k e e p i n g , s h o p p i n g , m e a a n d c a n h a v e a n g e r o u t b u r s t s w h e n t r i g g e r e d ' . T h e o t i o n a l d e f i c i t s a r e e v i d e n t : e m o t i o n a l d i s t u r b a n c e , b l e m , d e p r e s s i o n , h e J a c k s m o t i v a t i o n a n d h e h a s e n t s , t h e G P s t a t e s " ( T h e A p p e ll a n t ) h a s b e h a v i o u r b l e m s w i t h i m p u l s e c o n t r o l a n d h a s b e e n i n j a i l f o r u b s t a n c e u s e . . . T h e e x t e n t a n d d u r a t i o n o f h is r s i s t e n t . Th i s h a s s i g n ifi c a n t im p a c t o n h i s d a il y e l o f a b i l i t y w i t h r e s p e c t t o a l l l i s t e d c o m p o n e n t s o f r i n g ) a s " g o o d " ( t h e o t h e r c h o i c e s b e i n g o p r o v i d e a d d i t i o n a l c o m m e n t s , t h e G P s t a t e s h e ( il l e g i b l e ) o f m e n t a l i m p a i r m e n t a ff e c t s h is ( D L A ) . b e s o c i a l l y is o l a t e d ' . i c h 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 o r i m p a c t o n e m o t i o n a n d i m p u l s e c o n t r o l , a m o d e r a t e t i o n , e x e c u t i v e f u n c t i o n i n g , m e m o r y a n d m o t i v a t i o n , n s , c o n s c i o u s n e s s , m o t o r a c t i v i t y , l a n g u a g e , m o t i o n a l o r m e n t a l p r o b l e m s ) . e d f o r l o t s o f r e a s o n s , i n c l u d i n g s u ff e r i n g a b u s e a s a s o n ' s m o t h e r l e a v i n g t h e m w h e n t h e i r s o n w a s 3 n t o u t b u r s t s a s a n a d u l t f o r w h i c h h e w a s p r e s c r i b e d t y a n d t h a t " o v e rt h i n k i n g l a t e r i n ( h i s ) life J e d t o n o t H e a l s o s t a t e s t h a t h e h a d b e e n p r e s c r i b e d S e r o q u e l h e i s b e i n g t a l k e d d o w n t o a t w o r k h e " ( g o e s ) i n t o a a l k a w a y w i t h o u t a s s a u l t i n g s o m e o n e . H e a l s o s D i s o r d e r ( P T S D ) b u t a c k n o w l e d g e s t h a t h e h a s k e d i n t h e A R t o p r o v i d e a b r i e f s u m m a r y o f m e n t a l ' s a b i l i t y t o m a n a g e D L A . I n t h e M R , t h e G P i n d i c a t e s i c a t i o n s o r t r e a t m e n t s t h a t i n t e rf e r e w i t h h i s a b i l i t y t o n s t h a t w i ll f a c il i t a t e h i s p e rf o r m in g D L A " . I n t h e M R , a i r m e n t t h a t d i r e c t l y r e s t r i c t s a n y o f t h e l i s t e d D L A o f m e d i c a t i o n s , b a s i c h o u s e w o r k , d a i l y s h o p p i n g , o r t a t i o n a n d m a n a g e m e n t o f f i n a n c e s ) . H o w e v e r , t h e r m e n t r e s t r i c t s t h e s o c i a l a s p e c t s o f d a i l y f u n c t i o n i n g . e n d e n t w i t h r e s p e c t t o a l l l i s t e d D L A i n t h e a r e a s o f l s , p a y m e n t o f r e n t a n d b i l l s , m e d i c a t i o n s a n d
transportation, ad ding "no impairmenf' in the section provided for additional commentary. With respect to social functioning, the GP indicates that the Appellant is independent in making appropriate social decisions, but requires periodic support or supervision in developing and maintaining relationships, in interacting appropriately with others, in dealing appropriately with unexpected demands, and in ability to secure assistance fr om others. A description of the degree and duration of periodic support or supervision is not provided. The GP indicates that the Appellant has marginal functioning with respect to his immediate and extended social networks, and adds the comment "(The Appellant) will attend group t herapy re: social functioning skills" and that there are no safety issues. The App ellant did not identify any physical restrictions he has in performing DLA, but indicated that he sometimes goes for extended periods without being able to leave the house or get out of bed. Need for Help In the AR, the GP indicates that the Appellant does not have an assistance animal and does not require any prosthesis or aids for his impairment. The GP states that the Appellant lives alone and that he "requires no assistance related to (his) impairmenf', "no assistance for DLA" and "independent living''. The Appellant did not identify any help he required in performing DLA. Additional Information submitted after reconsideration In his Notice of Appeal (NOA) dated November 20, 2018, the Appellant stated that he believes that his GP does not have his best interests in mind and that he is currently awaiting treatment at a treatment centre. Prior to the Appeal Hearing, the Appellant submitted the following additional written evidence: 1. Appendix A, submitted on December 5, 2018, comprising a memo from the Appellant's HA dated November 30, 2018 (the first HA Memo) in which the HA confirms that the Appellant had been attending an HA Treatment Centre "but was discharged early and was transferred to a hospital due to mental health concerns"; and, 2. Appendix B, submitted on December 6 and 7, 2018, comprising: o a memo from the Appellant's HA dated December 5, 2018 (the second HA Memo) in which the HA confirms that the Appellant had been admitted to the HA Treatment Centre on November 14, 2018 and had departed the HA Treatment Centre on November 26, 2018; o a copy of a prescription dated July 30, 2018 signed by the GP for Seroquel, Sertraline and Allopurinol; and, o an email from the Appellant to the Employment and Assistance Appeal Tribunal dated December 6, 2018 stating that Allopurinol is a medication which reduces the production of uric acid in the body and is used to treat kidney stones and gout. The Appellant was supported by his sister and his sister's partner at the hearing. The Ministry did not attend the first hour of the hearing. The Appellant's oral testimony, which had been partially delivered when the Ministry arrived and which follows, was briefly summarized for the Ministry's benefit after it
j o i n e d t h e h e a r i n g . A t t h e h e a r i n g , t h e A p p e l l a n t e m p h a s i z e d t h a t h e d i m i n d w h e n s h e c o m p l e t e d t h e M R a n d t h e A R . T h e s i s t e r ' s a n d h i s f a t h e r ' s d o c t o r . H e s t a t e d t h a t h i s fa t r e a t m e n t b y h i s f a t h e r w a s t h e m a i n c a u s e o f h i s m s i s t e r a t t h e h e a r i n g , t h a t h e w a s c e rt a i n t h a t h i s f a t u n d e r s t a t e d t h e A p p e l l a n t ' s i m p a i r m e n t s a n d t h e i r i c o m p l e t e d t h e M R a n d t h e A R . T h e A p p e l l a n t p o i n G P ' s c o m m e n t s i n t h e M R a n d t h e A R w e r e c o n t r a d t h a t t h e A p p e l l a n t a p o l o g i z e t o h i s f a t h e r , a n d t h a t t c a u s e d h i m t o s e e k o u t a n e w d o c t o r . W i t h r e f e r e n c e t o t h e A p p e l l a n t ' s G o u t , w h i c h h e d e A p p e l l a n t s t a t e d t h a t , w h i l e i t w a s n o t i d e n t i f i e d a s a f r o m i t f o r o v e r 1 0 y e a r s a n d t h a t i t r u n s i n h i s f a m i l n o t b e e n d i a g n o s e d b y a p r e s c r i b e d p r o f e s s i o n a l , h c e r e b r a l c o r t e x i n a c y c l i n g a c c i d e n t h e h a d e x p e r i e P o s t T r a u m a t i c S t r e s s D i s o r d e r ( P T S D ) f r o m c h i l d h R e g a r d i n g h i s m e n t a l i m p a i r m e n t s , t h e A p p e l l a n t s a p r o p e r h e l p , a n d t h a t h e s o m e t i m e s u s e s s u b s t a n c a n d h e i s n ' t s u r e t h a t t h e G P h a s p r e s c r i b e d t h e r i g s e s s i o n s h e h a s a t t e n d e d r e c e n t l y , h e s a i d t h a t s o m t o 3 0 p a r t i c i p a n t s , a n d t h a t h e d o e s m u c h b e t t e r i n t h e d e p r e s s i o n g r o u p t h e r a p y s e s s i o n t h a t h a d b e e n o t b e e n t o l d w h e r e t o g o a n d w h e n t o b e t h e r e . I n t e r m s o f t h e i m p a c t o f h i s i m p a i r m e n t s o n h i s D L h a d b e e n o u t o f h i s h o m e i n t w o w e e k s . H e c o n f i r m a b l e t o d o w h a t b a s i c h o u s e k e e p i n g i s n e c e s s a r y o e x p e r i e n c i n g a n x i e t y o n a d a i l y b a s i s . W i t h r e g a r d w e a t h e r a n d c a n b e d e b i l i t a t i n g f o r d a y s a t a t i m e , m T h e A p p e l l a n t a l s o p r o v i d e d a d d i t i o n a l i n f o r m a t i o n b e t w e e n N o v e m b e r 1 4 a n d N o v e m b e r 2 6 , 2 0 1 8 . H e n d o f h i s t r e a t m e n t t e r m o n N o v e m b e r 2 6 , 2 0 1 8 , h D e p a rt m e n t o f a l o c a l h o s p i t a l a n d w a s t h e r e f o r s i x h e a s s u m e s h e w a s s e n t h o m e b e c a u s e t h e y h a d n t h a t t h e H A T r e a t m e n t C e n t r e o n l y o ff e r s a 4 2 d a y e n o u g h t o e ff e c t i v e l y t r e a t h i m , a n d t h a t a n o t h e r p u c o m m u n i t y h a s a m o r e s u i t a b l e , 9 0 d a y p r o g r a m , t h h i m , a n d t h a t h e e x p e c t s t h a t c o n f i r m a t i o n i n t h e n e W i t h r e g a r d t o t h e G P ' s s t a t e m e n t i n t h e M R t h a t t h o u tl a s s a u / f ' , t h e A p p e l l a n t s t a t e d t h a t h e h a s n e v e r d n o t b e l i e v e t h a t t h e G P h a d h i s b e s t i n t e r e s t s i n A p p e l l a n t e x p l a i n e d t h a t t h e s a m e G P s e rv e d a s h i s t h e r h a d v e r b a l l y a b u s e d h i m a s a c h i l d , a n d t h a t t h i s o o d d i s o r d e r . H e e x p l a i n e d , a s a l s o a r g u e d b y h i s h e r h a d d i r e c t l y i n f l u e n c e d t h e G P t o e n s u r e t h a t s h e m p a c t o n h i s D LA , a n d t h a t s h e h a d n o t a c c u r a t e l y t e d o u t s e v e r a l i n s t a n c e s w h e r e h e t h o u g h t t h a t t h e i c t o r y . H e a l s o s t a t e d t h a t t h e G P h a d s u g g e s t e d h e A p p e l l a n t ' s l a c k o f c o n f i d e n c e i n t h e G P h a d s c r i b e d a s h i s p r i n c i p a l p h y s i c a l i m p a i r m e n t , t h e s e v e r e i m p a i r m e n t b y h i s G P , h e h a d b e e n s u ff e r i n g y . H e a l s o s t a t e d t h a t , w h i l e h e r e c o g n i z e d t h a t i t h a d e w a s q u i t e s u r e t h a t h e h a d s u ff e r e d d a m a g e t o h i s n c e d a t t h e a g e o f 3 o r 4 , a n d t h a t h e m i g h t h a v e o o d t r a u m a . i d t h a t h e w a s s u r e t h e y w o u l d c o n t i n u e w i t h o u t e s t o m e d i c a t e h i m s e l f b e c a u s e h e w a n t s t o b e h a p p y h t m e d i c a t i o n s . R e g a r d i n g t h e g r o u p t h e r a p y e o f t h e m a r e n o t e ff e c t i v e b e c a u s e t h e y i n v o l v e u p s m a l l e r g r o u p s . H e s t a t e d t h a t h e h a d n o t a t t e n d e d n s c h e d u l e d t o s t a rt o n J u n e 8 , 2 0 1 7 b e c a u s e h e h a d A , t h e A p p e l l a n t s a i d t h a t t h i s w a s t h e f i r s t t i m e h e e d t h a t h e l i v e s a l o n e , a n d s t a t e d t h a t h e h a s b e e n v e r t h e p a s t t w o w e e k s , b u t h e h a s b e e n t o h i s G o u t , h e s a i d t h a t i t i s i n f l u e n c e d b y t h e a k i n g i t d i ff i c u l t f o r h i m t o w a l k t o t h e s t o r e . r e g a r d i n g h i s r e c e n t s t a y a t t h e H A T r e a t m e n t C e n t r e e e x p l a i n e d t h a t , u p o n b e i n g d i s c h a r g e d b e f o r e t h e e w a s t r a n s p o r t e d t o t h e E m e r g e n c y S e r v i c e s h o u r s b e f o r e b e i n g s e n t h o m e o n t h e b u s , a n d t h a t e i t h e r s p a r e b e d s n o r a p s y c h i a t r i c w a r d . H e s t a t e d t r e a t m e n t p r o g r a m , w h i c h h e d o e s n o t t h i n k i s l o n g b l i c r e h a b i l i t a t i o n f a c i l i t y l o c a t e d i n a n a d j a c e n t a t h e i s w a i t i n g f o r c o n f i r m a t i o n t h a t t h e y c a n t r e a t a r f u t u r e . e A p p e l l a n t " h a s b e e n i n j a i l fo r a n g e r a n d h i tt i n g b e e n i n j a i l , t h a t h e h a s n e v e r p h y s i c a l l y h a r m e d
a n y o n e , a n d t h a t w i t h r e s p e c t t o a r e f e r e n c e i n t h e h e g o t a n g r y a t a n e m p l o y e e i n a f a s t f o o d r e s t a u r a n o t p h y s i c a l l y a s s a u l t e d a n y o n e o n t h a t o c c a s i o n a 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 i t s R e c o n s i d e r a p r e s c r i b e d p r o f e s s i o n a l g i v e s t o s p e c i f i c q u e s t i o n M i n i s t r y i n d e t e r m i n i n g w h e t h e r t h e l e g i s l a t i v e c r i t e r t h a t a p a r t i c u l a r c o n d i t i o n i s n o t s a t i s f i e d , t h e M i n i s t t h e m e d i c a l p r o f e s s i o n a l d o e s n o t p r o v i d e s p e c i f i c a M i n i s t r y g i v e s t h e i r b e s t e s t i m a t i o n b a s e d o n t h e a n p r o v i d e d t h e A p p e l l a n t w i t h i n f o r m a t i o n c o n c e r n i n g d e s i g n a t i o n , w h i c h t h e M i n i s t r y i n d i c a t e d t h e A p p e l l u n s u c c e s s f u l . A d m i s s i b i l i t y o f A ddi t i o n a l I n fo r m a t i o n S e c t i o n 2 2 ( 4 ) 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 A ( i . e . t a k e i n t o a c c o u n t i n m a k i n g i t s d e c i s i o n ) t h e i n f w h e n t h e d e c i s i o n b e i n g a p p e a l e d w a s m a d e a n d " i n f o r m a t i o n a n d r e c o r d s " b e f o r e t h e M i n i s t r y w h e n t i n f o r m a t i o n t h a t s u b s t a n t i a t e s o r c o r r o b o r a t e s t h e i n r e c o n s i d e r a t i o n . T h e s e l i m i t a t i o n s r e f l e c t t h e j u r i s d i c E AA : t o d e t e r m i n e w h e t h e r t h e M i n i s t r y ' s r e c o n s i d 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 e n a c t m p a n e l s a r e l i m i t e d t o d e t e r m i n i n g i f t h e M i n i s t r y ' s d e o f d e c i s i o n m a k e r s o f t h e f i r s t i n s t a n c e . A c c o r d i n g l y t h e m i n t h a t r o l e . T h e M i n i s t r y d i d n o t o b j e c t t o t h e a d m i s s i b i l i t y o f t h e i n A p p e n d i c e s A a n d B . T h e P a n e l c o n s i d e r e d t h e i n f o r m a t i o n i n t h e N o t i c e a d d i t i o n a l i n f o r m a t i o n i n A p p e n d i c e s A a n d B a n d t h e v i d e n c e i n s u p p o r t o f t h e i n f o r m a t i o n a n d r e c o r d s a d m i t t e d t h e a d d i t i o n a l i n f o r m a t i o n i n a c c o r d a n c e w H A P s y c h i a t r i c S u m m a r y R e p o r t t o a n i n c i d e n t w h e r e n t a n d t h e p o l i c e w e r e c a l l e d , h e s t a t e d t h a t h e h a d n d t h a t h e h a d b e e n a r r e s t e d b u t n o t j a i l e d . a t i o n D e c i s i o n a n d e m p h a s i z e d t h a t t h e a n s w e r s t h a t s p o s e d i n t h e M R a n d t h e A R g i v e g u i d a n c e t o t h e i a h a v e b e e n m e t : i f a p r e s c r i b e d p r o f e s s i o n a l s a y s r y c o n s i d e r s t h a t t h a t c r i t e r i o n h a s n o t b e e n m e t . I f n s w e r s t o a p a rt i c u l a r q u e s t i o n i n t h e M R o r A R , t h e s w e r s t o o t h e r , r e l a t e d q u e s t i o n s . T h e M i n i s t r y a l s o t h e P e r s o n s w i t h P e r s i s t e n t M u l t i p l e B a r r i e r s ( P P M B ) a n t m i g h t w i s h t o a p p l y f o r s h o u l d h i s a p p e a l b e c t ( E AA ) p r o v i d e s t h a t p a n e l s m a y a d m i t a s e v i d e n c e o r m a t i o n a n d r e c o r d s t h a t w e r e b e f o r e t h e M i n i s t r y o r a l a n d w r i t t e n t e s t i m o n y i n s u p p o r t o f t h e h e d e c i s i o n b e i n g a p p e a l e d w a s m a d e i . e . f o r m a t i o n t h a t w a s b e f o r e t h e M i n i s t r y a t t i o n o f a p a n e l e s t a b l i s h e d u n d e r s e c t i o n 2 4 o f t h e r a t i o n d e c i s i o n i s r e a s o n a b l y s u p p o rt e d b y t h e e n t i n t h e c i r c u m s t a n c e s o f a n a p p e l l a n t . T h a t i s , c i s i o n i s r e a s o n a b l e a n d a r e n o t t o a s s u m e t h e r o l e , p a n e l s c a n n o t a d m i t i n f o r m a t i o n t h a t w o u l d p l a c e A p p e l l a n t ' s a d d i t i o n a l w r i t t e n s u b m i s s i o n s c o n t a i n e d o f A p p e a l t o b e a r g u m e n t . T h e P a n e l c o n s i d e r e d t h e e v e r b a l e v i d e n c e s u b m i t t e d a t t h e h e a r i n g t o b e 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 a n d t h e r e f o r e i t h S e c t i o n 2 2 ( 4 ) ( b ) o f t h e E AA .
I PART F -REASONS FOR PANEL DECISION The issue on appeal is whether the Ministry's Reconsideration Decision, which found that the Appellant is not eligible for designation as a PWD, was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the Appellant. The Ministry found that the evidence does not establish that the Appellant has a severe mental or physical impairment that, in the opinion of a prescribed professional, is likely to continue for at least 2 years, and that his DLA are not, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods. Also, the Ministry found that as a result of those restrictions, it could not be determined that the Appellant requires the significant help or supervision of another person, the use of an assistive device, or the services of an assistance animal to perform DLA. The criteria for being designated as a PWD are set out in Section 2 of the EAPWDA as follows: Persons with disabilities 2 (1) In this section: "assistive device" means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "prescribed professional" has the prescribed meaning. (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person is in a prescribed class of persons or that the person has a severe mental or physical impairment that (a)in the opinion of a medical practitioner or nurse practitioner is likely to continue for at least 2 years, and (b)in the opinion of a prescribed professional (i)directly and significantly restricts the person's ability to perform daily living activities either (A) continuously, or (B} periodically for extended periods, and (ii} as a result of those restrictions, the person requires help to perform those activities. (3)For the purposes of subsection (2), (a} a person who has a severe mental impairment includes a person with a mental disorder, and (b} a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, (ii} the significant help or supervision of another person, or (iii) the services of an assistance animal. (4) The minister may rescind a designation under subsection (2). The EAPWDR provides as follows:
Definitions for Act 2 (1) For the purposes of the Act and this regulation, "daily living activities", (a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities: (i) prepare own meals; (ii) manage personal finances; (iii)shop for personal needs; (iv)use public or personal transportation facilities; (v)perform housework to maintain the person's place of residence in acceptable sanitary condition; (vi) move about indoors and outdoors; (vii)perform personal hygiene and self care; (viii) manage personal medication, and (b) in relation to a person who has a severe mental impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. (2) For the purposes of the Act, "prescribed professional" means a person who is (a)authorized under an enactment to practise the profession of (i) medical practitioner, (ii) registered psychologist, (iii) registered nurse or registered psychiatric nurse, (iv) occupational therapist, (v) physical therapist, (vi) social worker, (vii) chiropractor, or (viii) nurse practitioner ... Part 1.1 -Persons with Disabilities Alternative grounds for designation under section 2 of Act 2.1 The following classes of persons are prescribed for the purposes of section 2 (2) [persons with disabilities) of the Act: (a) a person who is enrolled in Plan P (Palliative Care) under the Drug Plans Regulation, B.C. Reg. 73/2015; (b) a person who has at any time been determined to be eligible to be the subject of payments made through the Ministry of Children and Family Development's At Home Program; (c) a person who has at any time been determined by Community Living British Columbia to be eligible to receive
c o m m u n i t y l i v i n g s u p p o r t u n d e r t h e C o m m u n i t y l i v i n ( d ) a p e r s o n w h o s e fa m i l y h a s a t a n y t i m e b e e n d e t e r m i n e c o m m u n i t y l i v i n g s u p p o r t u n d e r t h e C o m m u n i t y l i v i n ( e ) a p e r s o n w h o i s c o n s i d e r e d t o b e d i s a b l e d u n d e r s e c * D u r a t i o n o f I m p a i r m e n t T h e A p p e l l a n t ' s p o s i t i o n i s t h a t t h e G P d e s c r i b e s h i " p e r s i s t e n t " a n d t h a t s h e a l s o i n d i c a t e s t h a t h i s m e n I n 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 , t h e M i n i s t r y w a s n o a n i m p a i r m e n t w h i c h w a s l i k e l y t o c o n t i n u e f o r t w o y u n k n o w n i f y o u r i m p a i r m e n t w i ll c o n t i n u e fo r t w o y e P a n e l D e c i s i o n D e s p i t e t h e M i n i s t r y ' s f i n d i n g t h a t t h e G P h a s i n d i c a w i l l c o n t i n u e f o r t w o y e a r s o r m o r e , t h e P a n e l n o t e s t h e A p p e l l a n t ' s i m p a i r m e n t w i l l c o n t i n u e f o r t w o y e a t h a t t h e d u r a t i o n o f t h e A p p e l l a n t ' s i m p a i r m e n t i s u n l i g h t o f t h e o t h e r e v i d e n c e o n d u r a t i o n p r o v i d e d b y t i n d i c a t e s t h a t " t h e e x t e n t a n d d u r a t i o n o f i m p a i r m e n t h a t 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 s h a v e b e e n d e f i n e s " p ro l o n g e d ' a s " c o n t i n u i n g f o r a l o n g tim e " a g e t rid o f ' . G i v e n t h a t t h e e v i d e n c e c l e a r l y s h o w s t h p r e s e n t s i n c e c h i l d h o o d a n d a r e d e s c r i b e d b y a p r e p e r s i s t e n t , 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 w a s n o t i m p a i r m e n t s w i l l n o t l a s t f o r a t l e a s t a n o t h e r t w o y e a d i r e c t a n s w e r t o t h a t q u e s t i o n . 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 t h e M i n i s t r y ' s d e t e r m e s t a b l i s h t h a t t h e A p p e l l a n t h a d a n i m p a i r m e n t t h a t 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 b e f o r e t h e M S e v e r i t y o f I m p a i r m e n t A d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n d o e s n o t " s e v e r e " i m p a i r m e n t . S e c t i o n 2 ( 2 ) o f t h e E A P W D A b e d e s i g n a t e d a s a P W D t h e M i n i s t r y m u s t b e s a t i s m e n t a l i m p a i r m e n t . A n " i m p a i r m e n t " i s a m e d i c a l c o a b i l i t y t o f u n c t i o n i n d e p e n d e n t l y o r e ff e c t i v e l y . W i t h S e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D R r e q u i r e s t h a t a m r e s t r i c t t h e p e r s o n ' 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 T h e r e f o r e , t o a s s e s s t h e s e v e r i t y o f a n i m p a i r m e n t , i m p a i r m e n t a n d t h e e x t e n t t o w h i c h i t i m p a c t s d a i l y g A u t h o r i t y A c t ; d b y C o m m u n i t y l i v i n g B r i t i s h C o l u m b i a t o b e e l i g i b l e t o r e c e i v e g A u t h o r i t y A c t t o a s s i s t t h a t f a m i l y i n c a r i n g f o r t h e p e r s o n ; t i o n 4 2 ( 2 ) o f t h e C a n a d a P e n s i o n P l a n ( C a n a d a ) . * * * * s m e n t a l i m p a i r m e n t s a s b e i n g " p r o l o n g e d " a n d t a l i m p a i r m e n t s h a v e b e e n p r e s e n t s i n c e c h i l d h o o d . t s a t i s f i e d t h a t t h e i n f o r m a t i o n p r o v i d e d e s t a b l i s h e s e a r s , n o t i n g t h a t t h e G P h a s i n d i c a t e d t h a t " i t is a r s o r m o r e . " t e d t h a t i t i s u n k n o w n i f t h e A p p e l l a n t ' s i m p a i r m e n t t h a t , i n f a c t , t h e G P n e g l e c t e d t o i n d i c a t e w h e t h e r r s o r m o r e . T h e P a n e l n o t e s t h a t t h e G P d i d i n d i c a t e k n o w n , w h i c h i s n o t t h e s a m e t h i n g , p a rt i c u l a r l y i n h e G P . S p e c i f i c a l l y , t h e P a n e l n o t e s t h a t t h e G P t i n m e n t a l f u n c t i o n s i s p ro l o n g e d a n d p e r s is t e n f ' a n d p r e s e n t s i n c e c h i l d h o o d . T h e C a m b r i d g e D i c t i o n a r y n d " p e r s i s t e n f ' a s " l a s t i n g f o r a l o n g t i m e o r d i ff i c u l t t o a t 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 s h a v e b e e n s c r i b e d p r o f e s s i o n a l a s b e i n g b o t h p r o l o n g e d a n d r e a s o n a b l e i n a s s u m i n g t h a t t h e A p p e l l a n t ' s r s s i m p l y b e c a u s e t h e G P n e g l e c t e d t o p r o v i d e a i n a t i o n t h a t t h e r e i s n o t s u ff i c i e n t e v i d e n c e t o w a s l i k e l y t o c o n t i n u e f o r t w o y e a r s o r m o r e w a s n o t i n i s t r y a t r e c o n s i d e r a t i o n . i n i t s e l f d e t e r m i n e P W D e l i g i b i l i t y o r e s t a b l i s h a r e q u i r e s t h a t i n d e t e r m i n i n g w h e t h e r a p e r s o n m a y f i e d t h a t t h e i n d i v i d u a l h a s a s e v e r e p h y s i c a l o r n d i t i o n w h i c h r e s u l t s i n r e s t r i c t i o n s t o a p e r s o n ' s r e s p e c t t o a s s e s s i n g t h e s e v e r i t y o f a n i m p a i r m e n t , 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 d ire c t l y a n d s i g n i f i c a n tl y n t i n u o u s l y , o r p e ri o d i c a ll y f o r e x t e n d e d p e r i o d s . t h e M i n i s t r y m u s t c o n s i d e r b o t h t h e n a t u r e o f t h e f u n c t i o n i n g a s e v i d e n c e d b y f u n c t i o n a l s k i l l l i m i t a t i o n s
a n d t h e d e g r e e t o w h i c h t h e a b i l i t y t o p e rf o r m D L A m u s t c o n s i d e r a l l t h e r e l e v a n t e v i d e n c e , i n c l u d i n g t h t h a t t h e f u n d a m e n t a l b a s i s f o r t h e a n a l y s i s i s t h e e v t h e A p p e l l a n t ' s G P . P h y s i c a l F u n c t i o n i n g T h e A p p e l l a n t ' s p o s i t i o n i s t h a t h e h a s s e v e r a l p h y s G o u t f o r w h i c h h e t a k e s m e d i c a t i o n , a n d t h a t h e i s s w e e k s f o l l o w i n g a n o u t b r e a k . H e a l s o a r g u e s t h a t h h i s c e r e b r a l c o rt e x r e s u l t i n g f r o m a c h i l d h o o d a c c i d h a s n o t b e e n p r o f e s s i o n a l l y d i a g n o s e d w i t h a n y p h y p o s i t i o n , a s s e t o u t i n 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 p r o v i d e d e s t a b l i s h e 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 . P a n e l D e c i s i o n T h e P a n e l n o t e s t h a t , w h e r e a s k e d t o i n d i c a t e t h e s M R , t h e G P d o e s n o t i d e n t i f y a n y p h y s i c a l i m p a i r m 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 r e s p e c t t o a l l a s p e c t s c o m m e n t " n o i m p a i rm e n f ' . W h i l e t h e A p p e l l a n t ' s p o i m p a i r m e n t , t h e P a n e l n o t e s t h a t t h e l e g i s l a t i o n m a k i s t h e e v i d e n c e f r o m t h e G P , a s e x p l a i n e d a b o v e . T D e c i s i o n t h a t i t w i l l r e l y o n t h e d i a g n o s e s p r o v i d e d b a p p l i c a t i o n . 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 l i a n c e o n t h e d d e s i g n a t i o n a p p l i c a t i o n i s r e a s o n a b l e , a n d t h a t i t s c e s t a b l i s h t h a t 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 A p p e l l a n t ' 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 c o n t i n u o u s S e c t i o n 2 ( 2 ) o f t h e E A P W D A , w a s r e a s o n a b l y s u p p r e c o n s i d e r a t i o n . M e n t a l F u n c t i o n i n g I n 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 , a ft e r s u m m a r i z i n g f u n c t i o n i n g f r o m t h e M R , t h e M i n i s t r y s t a t e s ' ' T h e M c o n d i t i o n d o e s n o t i n i t s e l f d e t e r m i n e P W D e l i g i b il i t y M i n i s t r y i m p l i c i t l y a c k n o w l e d g e s t h a t t h e G P h a s d e b u t a r g u e s t h a t a s e v e r e i m p a i r m e n t o f t h e A p p e l l a n b e c a u s e t h e G P h a s n o t p r o v i d e d d e t a i l s a s t o t h e n 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 l i m i t a t i o n s / r e s t T h e M i n i s t r y f u r t h e r n o t e s t h a t , i n t h e M R , t h e G P i n c o m m u n i c a t i o n , n o t i n g t h a t " h e h a s p ro b l e m s w i t h fo w h e r e a s i n t h e A R t h e G P d e s c r i b e s t h e A p p e l l a n t ' s d r a w a c o n c l u s i o n i n 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 , i s r e s t r i c t e d . I n m a k i n g i t s d e t e r m i n a t i o n t h e M i n i s t r y a t o f t h e A p p e l l a n t . H o w e v e r , t h e l e g i s l a t i o n i s c l e a r i d e n c e f r o m a p r e s c r i b e d p r o f e s s i o n a l i n t h i s c a s e i c a l i m p a i r m e n t s , t h e m o s t s i g n i f i c a n t o f w h i c h i s o m e t i m e s u n a b l e t o d o p h y s i c a l w o r k f o r u p t o 3 t o 4 e h a s A rt h r i t i s a n d m i g h t h a v e s u ff e r e d d a m a g e t o e n t a n d p o s s i b l y P T S D , w h i l e a c k n o w l e d g i n g t h a t h e s i c a l a i l m e n t s o t h e r t h a n G o u t . T h e M i n i s t r y ' s , i s t h a t i t w a s n o t s a t i s f i e d t h a t t h e i n f o r m a t i o n e v e r i t y o f t h e A p p e l l a n t ' s m e d i c a l c o n d i t i o n s i n t h e n t s , a n d t h a t i n t h e A R , t h e G P i n d i c a t e s t h a t t h e o f m o b i l i t y a n d p h y s i c a l a b i l i t y , w i t h t h e a d d e d s i t i o n i s t h a t h i s G o u t r e p r e s e n t s a s e v e r e p h y s i c a l e s i t c l e a r t h a t t h e f u n d a m e n t a l b a s i s f o r t h e a n a l y s i s h e M i n i s t r y h a s i n d i c a t e d i n i t s R e c o n s i d e r a t i o n y t h e G P i n t h e A p p e l l a n t ' s P W D d e s i g n a t i o n i a g n o s e s p r o v i d e d b y t h e G P i n t h e A p p e l l a n t ' s P W D o n c l u s i o n t h a t t h e r e i s n o t s u ff i c i e n t e v i d e n c e t o p a i r m e n t w h i c h 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 l y o r p e r i o d i c a ll y f o r e x t e n d e d p e r i o d s p u r s u a n t t o o rt e d b y t h e e v i d e n c e b e f o r e t h e M i n i s t r y a t t h e G P ' s d i a g n o s i s o f t h e A p p e l l a n t ' s m e n t a l i n i s t ry n o t e s t h a t a d i a g n o s i s o f a s e r i o u s m e d i c a l o r e s t a b l i s h a s e v e r e im p a i r m e n f ' . T h e r e f o r e t h e s c r i b e d a d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n , t ' s m e n t a l f u n c t i o n i n g h a s n o t b e e n e s t a b l i s h e d a t u r e o f t h e i m p a i r m e n t a n d t h e e x t e n t o f i t s i m p a c t r i c t i o n s i n e m o t i o n a l , c o g n i t i v e a n d s o c i a l f u n c t i o n i n g . d i c a t e s t h a t t h e A p p e l l a n t h a d d i ff i c u l t y w i t h c u s a n d c a n h a v e a n g e r o u t b u r s t s w h e n t r i g g e r e d ' , a b i l i t y t o c o m m u n i c a t e a s g o o d . W h i l e i t d o e s n o t t h e M i n i s t r y a p p e a r s t o c o n s i d e r t h i s e v i d e n c e t o b e
contradictory and to be an example of an inconsistent assessment by the GP. In its Reconsideration Decision, the Ministry also finds that the GP's assessments in the MR provided evidence of significant deficits with respect to cognitive and emotional functioning in the areas of emotion, motivation and impulse control. In the AR, the Ministry notes that the GP describes emotion and impulse control as having a major impact on the Appellant's daily functioning and describes insight and judgment, attention/concentration, executive memory, and motivation as having moderate impacts on his daily functioning. The Ministry concludes that "the assessment of the deficits to you (sic) cognitive and emotional functioning as well as impacts they have on your daily functioning to be notable particularly when considered cumulatively", but that it was unable to determine why this level of impact on daily functioning is as indicated because in the AR, where asked to indicate the assistance required to perform DLA, the GP indicates that the Appellant does not require assistance. In the "Mental Functioning" section of its Reconsideration Decision the Ministry also weighs assessments relating to required support and supervision which are more appropriately addressed in the "Help Required with DLA" section of the Reconsideration Decision. Panel Decision The Panel notes that having a "good' ability to speak, hear, read and write, as the GP has indicated is the case for the Appellant in the AR, does not mean that an individual could not also have periodic difficulties with communication as a result of having occasional problems with focus and anger outbursts, as the GP states is the case for the Appellant in the MR. The two assessments are not mutually exclus ive. Therefore the Panel finds that there is no apparent contradiction with respect to the GP's observations in that regard and that it is not reasonable for the Ministry to conclude that there is an inconsistency in these assessments, had it intended to do so. The Panel also notes that one of the reasons the Appellant is not considered by the Ministry to have a severe impairment is that the GP has indicated that the Appellant does not require assistance with DLA, which is a separate criterion under the legislation and which is addressed in the section below. Regarding severe impairment, the Panel notes that the legislation does not identify the number of areas of cognitive and emotional functioning in which an applicant must demonstrate a sever e impact, or the number of impacts that must be found to be major or moderate, or even that a majority of areas must be impacted in order for an impairment to be severe. The Panel notes that the GP indicates that the Appellant has significant deficits to cognitive and emotional functioning in the MR, several major and moderate impacts to daily cognitive and emotional functioning in the AR, and has written "The extent and duration of his impairment in mental functions is prolonged and persistent. This has significant impact on his daily functioning" in the "Additional Comments" section of the MR. Therefore the Panel finds that the GP has provided abundant evidence of a severe mental impairment and that the Ministry was not reasonable in determining that a severe menta l impairment was not established pursuant to Section 2(2) of the EAPWDA. Restrictions in the ability to perform DLA
The Appellant's position is that the GP did not provide an accurate assessment of his abilities with respect to performing DLA The Ministry's position is that the evidence provided with the Appellant's application is not sufficient to confirm that his impairment significantly restricts his ability to perform his DLA either continuously or periodically for extended periods, and that therefore the legislative criteria have not been met. Panel Decision Section 2(2)(b) of the EAPWDA requires that the Ministry be satisfied that a prescribed professional has provided an opinion that an applicant's severe impairment directly and significantly restricts his or her DLA, continuously or periodically for extended periods. In this case, the GP is the prescribed professional. DLA are defined in Section 2(1) of the EAPWDR and are also listed in the MR and, with additional details, in the AR. Therefore, the prescribed professionals completing these forms have the opportunity to indicate which, if any, DLA are significantly restricted by the Appellant's impairments either continuously or periodically for extended periods, and to further elaborate so that the nature and extent of the restrictions to DLA are clear. Prescribed professionals are further encouraged to elaborate on the nature and extent of the limitations or restrictions in the instructions provided in those sections of the forms. For example, in Part C of the AR the assessor is instructed to identify whether assistance is required in each case with respect to the full range of DLA, and if the applicant is not independent, to describe the type and amount of assistance required. The Panel notes that the GP does not provide any information where asked in the AR to give a brief summary of mental and physical impairments that impact the Appellant's ability to manage DLA. In addition, the Panel notes that the GP states in the MR that the Appellant has not been prescribed any medications or treatments that interfere with his ability to perform DLA, indicating to the contrary that "he is on medications that will facilitate his performing DLA", and that he has no impairment that directly restricts any of the DLA. The Panel further notes that the GP indicates in the AR that the Appellant is independent with respect to all DLA, adding "no impairment in the section provided for additional commentary. With respect to social functioning, the Panel notes that the GP indicates that the Appellant is independent in making appropriate social decisions, but requires periodic support or supervision in developing and maintaining relationships, in interacting appropriately with others, in dealing appropriately with unexpected demands, and in his ability to secure assistance from others. However, the Panel notes that a description of the degree and duration of periodic support or supervision is not provided. The Panel finds that the Ministry reasonably concluded that there is not enough evidence from the prescribed professional to establish that the Appellant's impairment significantly restricts his ability to manage his DLA either continuously or periodically for extended periods, thereby not satisfying the legislative criterion of Section 2(2)(b)(i) of the EAPWDA. Help with DLA While indicating at the hearing that he had not left his home for two weeks and was only able to perform basic housework, the Appellant did not identify any help he required in performing DLA. The Ministry's position, as set out in its Reconsideration Decision, is that it cannot be determined that significant help is
r e q u i r e d b e c a u s e i t h a s n o t b e e n e s t a b l i s h e d t h a t D P a n e l D e c i s i o n 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 b i l i t y t o p e r f o r m D L A , a p e r s o n r e q u i r e s h e l p t o p 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 s u n d e r s e c t i o n 2 ( 2 ) c r i t e r i o n . 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 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 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 r e a s o n a b l y d e t e r m A p p e l l a n t ' s a b i l i t y t o p e rf o r m D L A h a v e n o t b e e n e s r e q u i r e s h e l p t o p e r f o r m D L A a s a r e s u l t o f t h o s e r e E A P W D A . C o n c l u s i o n H a v i n g r e v i e w e d a n d c o n s i d e r e d a l l o f t h e e v i d e n c 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 h i c h d e t e r m i n d e s i g n a t i o n u n d e r S e c t i o n 2 o f t h e E A P W D A , w a s r 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 E A P W D A i n t h e c i r c u m d e c i s i o n . T h e A p p e l l a n t ' s a p p e a l , t h e r e f o r e , i s n o t s 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 r e s u l t o f dire c t a n d s i g n i f i c a n t re s t r i c t i o n s i n t h e r f o r m t h o s e a c t i v i t i e s . T h a t i s , t h e e s t a b l i s h m e n t o f ( b ) ( i ) i s a p r e c o n d i t i o n o f m e e t i n g t h e n e e d fo r h e l p 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 a n 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 a D L A . i n e d t h a t , a s 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 i n t h e t a b l i s h e d , i t c a n n o t b e 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 t r i c t i o n s , a s d e f i n e d b y S e c t i o n 2 ( 3 ) ( b ) o f t h e a n d r e l e v a n t l e g i s l a t i o n , t h e P a n e l f i n d s t h a t t h e 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 P W D 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 a n d w a s a s t a n c e s o f t h e A p p e l l a n t , a n d t h e r e f o r e c o n f i r m s t h e u c c e s s f u l .
PART G -ORDER THE PANEL DECISION IS: (Check one) 12!:JUNANIMOUS □BY MAJORITY . THE PANEL 121CONFIRMS 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) 121 or Section 24(1 )(b) 121 and Section 24(2)(a) 12!:1 or Section <! 4(2)(b) D • PART H -SIGNATURES • PRINTNAME Simon Clews SIGNATURE OF CHAIR ' DATE{YEAR/MONTH/DAY) ,,/ --< 2018/12/12 b ( '1•1 , > , fJ, ,,::, 'l/,1 ' PRlNTNAME Kulwant Bal SIGNATURE OF MEMBER DATE(YEAR/MONTH/DAY) PRINT NAME Carla Tibbo DATE (YEAR/MONTH/DAY)
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.