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 d e c i s i o n d a t e d 7 S e p t e m b e r 2 0 1 8 , w h i c h d e t e r m i n e d t h a S u p p l e m e n t ( M N S ) f o r n u t r i t i o n a l i t e m s b e c a u s e h e h a d s e c t i o n 7 , S c h e d u l e C 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 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 h a d d e m o n s t r a t e d h e a l t h , a s s e t o u t i n s e c t i o n 6 7 ( 1 . 1 ) ( a ) . T h e m i n i s t ry a l s p r o g r e s s i v e d e t e r i o r a t i o n o f h e a l t h , s u ff e r s f r o m t w o o r m 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 i i w a s n o t s a t i s f i e d t h a t t h e s u p p l e m e n t a t i o n t o a r e g u l a r d i e t a r y i n t a k e t o a l l e v i a t e s a c c o r d a n c e w i t h s e c t i o n 6 7 ( 1 . 1 ) ( c ) a n d s e c t i o n 7 , S c h e d i n s e c t i o n 6 7 ( 1 . 1 ) ( d ) . P A R T D R E L E V A N T L E G I S L A T I O N 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 ili t i e l o p m e n t a n d P o v e rt y R e d u c t i o n ( m i n i s t r y ) r e c o n s i d e r a t i o n 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 a M o n t h l y N u t r i t i o n a l n o t m e t t h e l e g i s l a t e d c r i t e r i a u n d e r s e c t i o n 6 7 ( 1 . 1 ) a n d 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 R e g u l a t i o n ( E A P W D R ) . t h a t h e s u f f e r s f r o m a c h r o n i c p r o g r e s s i v e d e t e r i o r a t i o n o f o f o u n d t h a t t h e a p p e l l a n t , a s a r e s u l t o f h i s c h r o n i c o r e o f t h e s y m p t o m s l i s t e d i n s e c t i o n 6 7 ( 1 . 1 ) ( b ) . H o w e v e r , a p p e l l a n t r e q u i r e s n u t r i t i o n a l i t e m s a s p a rt o f a c a l o r i c y m p t o m s o f a c h r o n i c p r o g r e s s i v e d e t e r i o r a t i o n o f h e a l t h , i n u l e C , a n d t o p r e v e n t a n i m m i n e n t d a n g e r t o l i f e , a s s e t o u t s R e g u l a t i o n s e c t i o n 6 7 a n d S c h e d u l e C s e c t i o n 7 .
P A R T E S U M M A R Y O F F A C T S I n f o r m a t i o n b e f o r e t h e m i n i s t r y a t r e c o n s i d e r a t i o n c o n s i s • T h e a p p e l l a n t i 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 ) a n d • T h e a p p e l l a n t a p p l i e d f o r m o n t h l y n u t r i t i o n a l s u p p l e m • A M N S A p p l i c a t i o n , d a t e d 1 3 J u l y 2 0 1 8 , c o n t a i n i n g n u t r i t i o n a l i t e m s : • T h e a p p e l l a n t h a s b e e n d i a g n o s e d w i t h • T h e a p p e l l a n t ' s p h y s i c i a n i n d i c a t e s t h a t d e t e r i o r a t i o n o f h e a l t h . • T h e p h y s i c i a n i n d i c a t e s t h a t t h e a p p e l l a d e g e n e r a t i o n ( a u t o i m m u n e e n c e p h a l i t i s ) m e d i c a t i o n u s a g e ) . • I n r e s p o n s e t o a p r o m p t t o s p e c i f y t h e a d u r a t i o n o f t r e a t m e n t , t h e p h y s i c i a n i n O n g o i n g . • T h e p h y s i c i a n c o n f i r m s t h a t t h e a p p e l l a n a b s o r b s u ff i c i e n t c a l o r i e s t h r o u g h a r e g u • T h e p h y s i c i a n r e s p o n d s t o t h e p r o m p t t o a l l e v i a t e o n e o r m o r e o f t h e s y m p t o m r e g u l a r d i e t : w i l l a i d i n b e t t e r a b s o r p ti o n • T h e p h y s i c i a n r e s p o n d s t o t h e p r o m p t t o p r e v e n t i m m i n e n t d a n g e r t o t h e a p p l i c n e e d e d t o p re v e n t i m m i n e n t d a n g e r . H e w i l l h e l p a i d w i t h b e t t e r a b s o r p t i o n . • T h e a p p e l l a n t ' s r e q u e s t f o r M N S f o r v i t a m i n s a n d m i • A 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 d a t e d 2 8 A u g u s t 2 d o c u m e n t e n t i t l e d A p p e n d i x 1 R e a s o n s f o r R e c o n s i d n o t i n d i c a t e d . T h e a u t h o r o f A p p e n d i x 1 a r g u e s t h a t t a u t h o r d e s c r i b e s t h e a p p e l l a n t ' s C r o h n ' s c o n d i t i o n a a r g u e s t h a t t h e a p p e l l a n t i s r e l i a n t o n E n s u r e a s r e g u e x p e n s i v e v i t a m i n s t o m a i n t a i n h e a l t h a n d p r e v e n t d e n u t r i t i o n a l a n d v i t a m i n s u p p l e m e n t a t i o n w i l l r e s u l t i n d a u t h o r a r g u e s t h a t t h e a p p e l l a n t ' s c o n d i t i o n i s c o m p l i n t e r f e r e s w i t h t h e n a t u r a l a b s o r p t i o n o f n u t r i e n t s a n d N o t i c e o f A p p e a l I n t h e N o t i c e o f A p p e a l d a t e d t h e 1 5 S e p t e m b e r 2 0 1 8 , t h n u tri t i o n a l s u p p l e m e n t d u e t o [ e } ff e c t s o f C h ro h n ' s d i s e a s A p p e a l S u b m i s s i o n s T h e a p p e l l a n t d i d n o t m a k e a p p e a l s u b m i s s i o n s . H e a r i n g S u b m i s s i o n s T h e m i n i s t r y r e l i e d o 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 . A d m i s s i b i l i t y T h e p a n e l f i n d s 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 i n t h e N o t i c t h a t t h e r e i s n o i n f o r m a t i o n b e f o r e i t t h a t r e q u i r e s a n a d m 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 c t .t e d o f t h e f o l l o w i n g : i s a r e c i p i e n t o f P W D b e n e f i t s , e n t ( M N S ) f o r v i t a m i n s a n d m i n e r a l s a n d n u t r i t i o n a l i t e m s . t h e f o l l o w i n g i n f o r m a t i o n p e r t a i n i n g t o t h e r e q u e s t fo r C r o h n ' s D i s e a s e ( A c t i v e ) a n d E n c e p h a l i t i s ( I n r e m i s s i o n ) t h e a p p e l l a n t i s b e i n g t r e a t e d f o r a c h r o n i c p r o g r e s s i v e n t d i s p l a y s t h e f o l l o w i n g s y m p t o m s : s i g n i f i c a n t n e u r o l o g i c a l a n d m o d e r a t e t o s e v e r e i m m u n e s u p p r e s s i o n ( y e s , f ro m d d i t i o n a l n u t r i t i o n a l i t e m s r e q u i r e d a n d e x p e c t e d d i c a t e s : E n s u r e , F i s h O i l , V i t a m i n s ( m u l t i v i t a m i n s ) . t h a s a m e d i c a l c o n d i t i o n t h a t r e s u l t s i n t h e i n a b i l i t y t o l a r d i e t a r y i n t a k e ( Y e s , C ro h n ' s D i s e a s e ) , d e s c r i b e h o w t h e n u t r i t i o n a l i t e m s r e q u i r e d w i l l s s p e c i f i e d a n d p r o v i d e c a l o r i c s u p p l e m e n t a t i o n t o t h e o f n u t ri e n t s . d e s c r i b e h o w t h e n u t r i t i o n a l i t e m s r e q u e s t e d w i l l a n t ' s l i f e : T h e s e n u t r i e n t s ( E n s u r e , V i t a m i n s ) a r e n o t c a n s t il l r e c e i v e n u t r i t i o n f r o m d i e t . T h e s e n u tri t i o n a l i t e m s n e r a l s a n d n u t r i t i o n a l i t e m s w a s d e n i e d o n 1 6 A u g u s t 2 0 1 8 . 0 1 8 . W i t h t h e 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 i s a 1 p a g e t y p e d e r a t i o n R e q u e s t . A p p e n d i x 1 i s u n d a t e d , a n d i t s a u t h o r i s h e a d j u d i c a t o r ' s d e c i s i o n i s w r o n g a n d c o n t r a r y t o l a w . T h e s s e v e r e a n d h e s u ff e r s f r o m c o n s t a n t p a i n . T h e a u t h o r l a r f o o d c a n n o t b e t o l e r a t e d a n d a l s o m u s t u s e s e v e r a l t e r i o r a t i o n . T h e a u t h o r a r g u e s t h a t f a i l u r e t o u s e e t e r i o r a t i o n o f h e a l t h a n d r i s k t o t h e a p p e l l a n t ' s l i f e . T h e i c a t e d b y e n c e p h a l i t i s , w h i c h r e q u i r e s m e d i c a t i o n t h a t c a u s e s s e v e r e w e i g h t g a i n . e s t a t e d r e a s o n s f o r a p p e a l a r e : s h o u l d b e e l i g i b l e f o r e . e o f A p p e a l c o n s i s t s o f a r g u m e n t . A s s u c h , t h e p a n e l f i n d s i s s i b l y d e t e r m i n a t i o n i n a c c o r d a n c e w i t h s e c t i o n 2 2 ( 4 ) ( b )
PART F -REASONS FOR PANEL DECISION The issue in this appeal is whether the ministry decision determining that the appellant did not meet the statutory requirements of Section 67 and section 7, Schedule C of the EAPWDR for MNS eligibility for nutritional items is reasonably supported by the evidence or is a reasonable application of the legislation in the circumstances of the appellant. The following sections of the EAPWDR apply to this appeal: Nutritional supplement 67 (1) The minister may provide a nutritional supplement in accordance with section 7 [monthly nutritional supplement] of Schedule C to or for a family unit in receipt of disability assistance, if the supplement is provided to or for a person in the family unit who (a) is a person with disabilities, and (b) is not described in section 8 (1) [people receiving special care} of Schedule A, unless the person is in an alcohol or drug treatment centre as described in section 8 (2) of Schedule A, if the minister is satisfied that (c)based on the information contained in the form required under subsection (1.1 ), the requirements set outin subsection (1.1) (a) to (d) are met in respect of the person with disabilities, (d)the person is not receiving another nutrition-related supplement, (e)Repealed. [B.C. Reg. 14512015, Sch. 2, s. 7 (c).] (I)the person complies with any requirement of the minister under subsection (2), and (g)the person's family unit does not have any resources available to pay the cost of or to obtain the items for which the supplement may be provided. (1.1) In order for a person with disabilities to receive a nutritional supplement under this section, the minister must receive a request, in the form specified by the minister, completed by a medical practitioner or nurse practitioner, in which the practitioner has confirmed all of the following: (a) the person with disabilities to whom the request relates is being treated by the practitioner for a chronic, progressive deterioration of health on account of a severe medical condition; (b) as a direct result of the chronic, progressive deterioration of health, the person displays two or more of the following symptoms: (i) malnutrition; (ii)underweight status; (iii) significant weight loss; (iv)significant muscle mass loss; (v) significant neurological degeneration; (vi)significant deterioration of a vital organ; (vii)moderate to severe immune suppression; (c)for the purpose of alleviating a symptom referred to in paragraph (b), the person requires one or more of the items set out in section 7 of Schedule C and specified in the request; (d)failure to obtain the items referred to in paragraph (c) will result in imminent danger to the person's life. (2)In order to determine or confirm the need or continuing need of a person for whom a supplement is provided under subsection (1), the minister may at any time require that the person obtain an opinion from a medical practitioner or nurse practitioner other than the practitioner referred to in subsection (1) (c). (3) Repealed. [B.C. Reg. 145/2015, Sch. 2, s. 8.] [am. B.C. Regs. 31712008, s. 8; 6812010, ss. 1 and 2; 145/2015, Sch. 2, ss. 7 and 8.] Schedule C Monthly nutritional supplement 7 The amount of a nutritional supplement that may be provided under section 67 [nutritional supplement] of this regulation is the sum of the amounts for those of the following items specified as required in the request under section 67 (1) (c): (a} for additional nutritional items that are part of a caloric supplementation to a regular dietarv intake, uo to $165 each month;
I (b) Repealed. [B.C. Reg. 68/2010, s. 3 (b).] (c) for vitamins and minerals, up to $40 each month. In order to receive a monthly nutritional supplement, a person must demonstrate that: they suffer from a chronic progressive deterioration of health, as set out in section 67 (1.1 )(a); as a result of the chronic progressive deterioration of health, they suffer from two or more of the symptoms listed in section 67(1.1)(b); for the purpose of alleviating a symptom, the person requires one or more of the items set out in section 7 of Schedule C and specified in the request; and failure to obtain the items referred to in paragraph will result in imminent danger to the person's life. Section 7(a), Schedule C provides for additional nutritional items that are part of a caloric supplementation to a regular dietary intake. In this appeal, the ministry is satisfied that the appellant suffers from a chronic progressive deterioration of health, as set out in section 67 (1.1 )(a) and suffers from two or more of the symptoms listed in section 67(1.1)(b). Therefore, the last two criteria are at issue in this appeal; namely, whether the ministry was reasonable in determining that the appellant had not demonstrated that he requires vitamin/mineral supplement and nutritional items as a part of caloric supplementation to a regular dietary intake to alleviate a symptom(s) set out in section 67(1.1 )(b) due to a chronic progressive deterioration ofhealth and to prevent imminent danger to life. In the reconsideration decision the ministry determined that the appellant is not eligible for MNS because, it was not satisfied that the appellant requires nutritional items as part of a caloric supplementation to a regular dietary intake to alleviate symptoms of a chronic progressive deterioration of health and to prevent an imminent danger to his life. In reaching this conclusion the ministry found that the doctor had not provided enough information to establish that the appellant is displaying a symptom that would indicate a need for caloric supplementation, such as underweight status, significant weight loss or significant muscle mass loss. The ministry noted that the appellant's BMI is in the obesity range. The ministry found that the information provided by the doctor does not establish how caloric supplementation would alleviate a symptom(s) listed in the MNS application. In the reconsideration decision the ministry determined that the appellant is not eligible for MNS because, it was not satisfied that the appellant requires vitamin/mineral supplementation to alleviate a symptom set out in section 67(1.1)(b). In reaching this conclusion the ministry found that the doctor had not provided evidence to establish that the appellant is suffering from malnutrition, which would indicate a need for vitamin/mineral supplementation. As well, the ministry found that the doctor's statement (helps with Crohn's disease [symptoms]) had not specified how vitamin/mineral supplementation would alleviate a symptom(s) listed in the MNS application. The ministry also noted that the doctor has explicitly stated that the nutritional items will not prevent imminent danger to the appellant's life. The panel notes that the ministry has conducted a combined analysis of section 67(1.1)(c) and (d) for vitamin/mineral supplements and for nutritional items. The panel finds that the ministry's determination that the evidence provided does not establish that appellant requires caloric supplementation to be reasonable. The panel notes that the doctor has indicated in the MNS application that the appellant is unable to absorb sufficient calories through a regular dietary intake as required by section 67(1.1 )(c) and section 7(a) in Schedule C of the EAPWDR. The panel notes the doctor has indicated that the appellant requires Ensure. However, the panel finds that while the doctor has indicated that the nutritional items will aid in better absorption of nutrients, the doctor has not described how the nutritionals items will alleviate one or more symptoms in the MNS Application. The panel notes that Appendix A does address the appellant's inability to absorb nutrients despite his BMI and does explain that medications are interfering with nutrient absorption. However, the information in Appendix A does has not been provided by a medical practitioner as required in the legislation, nor ii is endorsed by the appellant's medical practitioner. Therefore, the panel finds that the ministry reasonably determined that the appellant's need caloric supplementation under section 67(1.1)(c) and section 7(a) in Schedule C of the EAPWDR has not been established. The panel notes that the doctor has explicitly stated in the MNS application that the nutritional items are not required to prevent imminent danger to the appellant's life. Thus, the panel also finds that the ministry's conclusion regarding imminent danger under section 67(1.1 )(d) is reasonably supported by the evidence.
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 i n a t i o n , t h a t t h r e q u i r e s v i t a m i n / m i n e r a l s u p p l e m e n t a s a p a r t o f c a l o r i c s y m p t o m ( s ) s e t o u t i n s e c t i o n 6 7 ( 1 . 1 ) ( b ) d u e t o a c h r o n i r e a c h i n g t h i s c o n c l u s i o n , t h e p a n e l n o t e s t h a t t h e i n f o r m m e d i c a l p r a c t i t i o n e r a s r e q u i r e d i n t h e l e g i s l a t i o n , n o r i t i t h e i n f o r m a t i o n i n A p p e n d i x A c o n t r a d i c t s t h e i n f o r m a t i o n f i n d s t h a t t h e i n fo r m a t i o n p r o v i d e d b y t h e d o c t o r d o e s n o i t e m s t o a l l e v i a t i o n o f a s y m p t o m i n s e c t i o n 6 7 ( 1 . 1 ) ( b ) . A c r i t e r i o n t o b e 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 . T h s e c t i o n 6 7 ( 1 . 1 ) ( d ) r e l i e s o n i t s c o n c l u s i o n t h a t v i t a m i n / m s y m p t o m i s n o t r e q u i r e d , w h i c h t h e p a n e l h a s f o u n d t o b m i n i s t r y ' s c o n c l u s i o n r e g a r d i n g v i t a m i n / m i n e r a l s u p p l e m C 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 , t h e p a n e l a l r e g a r d i n g i m m i n e n t d a n g e r i s r e a s o n a b l y s u p p o rt e d b y t C o n c l u s 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 c o n s i d e r a t i o n d e c i s f o r n u t r i t i o n a l i t e m s 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 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 s u c c e s s f u l o n a p p e a l .I e e v i d e n c e p r o v i d e d d o e s n o t e s t a b l i s h t h a t t h e a p p e l l a n s u p p l e m e n t a t i o n t o a r e g u l a r d i e t a ry i n t a k e t o a l l e v i a t e a c p r o g r e s s i v e d e t e r i o r a t i o n o f h e a l t h t o b e r e a s o n a b l e . I n a t i o n p r o v i d e d i n A p p e n d i x A h a s n o t b e e n p r o v i d e d b y a s e n d o r s e d b y t h e a p p e l l a n t ' s m e d i c a l p r a c t i t i o n e r . R a t h e r , p r o v i d e d b y t h e d o c t o r i n t h e M N S a p p l i c a t i o n . T h e p a n e l t l i n k t h e v i t a m i n / m i n e r a l s u p p l e m e n t a t i o n o r n u t r i t i o n a l s s u c h , t h e p a n e l f i n d s t h e m i n i s t r y ' s c o n c l u s i o n o n t h i s e m i n i s t r y ' s c o n c l u s i o n r e g a r d i n g i m m i n e n t d a n g e r u n d e r i n e r a l s u p p l e m e n t a t i o n f o r t h e p u r p o s e o f a l l e v i a t i n g a e r e a s o n a b l e . A s t h e p a n e l h a s d e t e r m i n e d t h a t t h e e n t a t i o n u n d e r s e c t i o n 6 7 ( 1 . 1 ) ( c ) a n d s e c t i o n 7 , S c h e d u l e s o f i n d s t h a t i t s c o n c l u s i o n u n d e r s e c t i o n 6 7 ( 1 . 1 ) ( d ) h e e v i d e n c e . i o n , d e t e r m i n i n g 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 f o r M N S n c e . T h e p a n e l c o n f i r m s t h e m i n i s t ry ' s r e c o n s i d e r a t i o n
PART G -ORDER THE PANEL DECISION IS:(Checkone) kZ)UNANIMOUS THE PANEL kZ)CONFIRMS 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) kZ1 or Section 24(1 )(b) D and Section 24(2)(a) kZI or Section 24(2)(b) D PART H -SIGNATURES PRINT NAME Jennifer Smith SIGNATURE OF CHAIR /'i ' l u'f /) J� ,<'-/ 4 1,.,, , PRJNTNAME Angie Blake SIGNATURE OF -C, r>/J Ji , ( a- � ) � _ _M E _ sM RE _ _ _ PRINT NAME Marlene Russo SIGNATURE OF� □BY MAJORITY □ RESCINDS THE MINISTRY DECISION DATE (YEAR/MONTH/DAY) 2018/10/22 DATE (YEAR/MONlH/DAY) L_ _ o 1 _ 8 _ 1 _ 0 _ 2, 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , DATE {YEAR/MONTH/DAY) 2018/10/22
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.