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 2 0 N o v 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 d e s i g n a t i o n ( P W D ) b e c a u s e s h e h a d n o t m e t a l l o f t h e l e 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 li t i e s A c 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 h a d d e m o n s t r 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 m e d i c a l p r a c t i t i o n e r o r n u T h e m i n i s t r y f u rt h e r 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 h a d n o i m p a i r m e n t ; t h a t h e r 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 s i g n i f i c a n t l y r e s t r i c t s h e r 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 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 d i r e c t a n d s i g n i f i c a n 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 il i t i 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 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 p e r s o n s w i t h d i s a b i l i t i e s 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 2 t h e E m p l o y m e n t a n d a t e d t h a t s h e h a s r e a c h e d 1 8 y e a r s o f a g e a n d t h a t h e r 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 . t d e m o n s t r a t e d t h a t s h e 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 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 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 l y o r p e r i o d i c a l l y fo r t r e s t r i c t i o n s , s h e 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 t i v i t i e s . 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
PART E -SUMMARY OF FACTS Evidence before the ministry at reconsideration consisted of the following: 1. The appellant's PWD Application The Application contained: • A Self Report (SR) dated 30 May 2018, completed and signed by the appellant. • A Medical Report (MR) dated 05 June 2018, completed by a general practitioner (GP) who indicates she has known the appellant for 1 year and seen her 11 + times in the past 12 months • An Assessor Report (AR) dated 03 August 2018, completed by a chiropractor (DC) who indicates she has seen the appellant 2-10 times in the past 12 months and known the appellant for approximately 2 months. The panel will first summarize the evidence from the PWD Application as it relates to the PWD criteria at issue in this appeal. Diagnoses In the MR, the GP provides the following diagnosis: • A musculoskeletal shoulder injury-onset October 2017 Severity of mental impairment MR: The GP has ticked 'no' in response to whether there are difficulties with communication. The GP indicates that it is unknown whether the appellant has significant deficits with cognitive and emotional functioning. AR: In the AR, the DC has indicated that the appellant reports depression and low motivation The DC indicates that the appellant's ability to communicate is good in all listed areas -speaking, reading, writing (difficulties writing with R [right]) and hearing. The DC comments: and Able to communicate. Emotional during appointment. She reports discomfort when writing with R [right] (dominant). The DC assesses the appellant's cognitive and emotional functioning as having major impacts on daily functioning in the area of emotion; moderate impacts to bodily functions; minimal impacts to consciousness, insight and judgement, attention/concentration, memory and other emotional or mental problems. No impacts are reported in the areas of impulse control, executive, motor activity, psychotic symptoms and other neuropsychological problems. The DC reports that the appellant would benefit from counselling as she is in chronic pain and will require assistance to overcome barriers to recovery, as she presents with "yellow flags". SR: The appellant reports that she is getting depressed because she can't live her normal life and has to ask for help. She reports decreased motivation due to pain that causes her to want to lie in bed all day and sleep or watch a movie. Severity of physical impairment MR: Under Heath History, the GP writes: patient describes subjective neck pain [and] shoulder pain on the right side. Reports difficulty with lifting and ROM [range of motion]. MRI of R shoulder-no internal derangement. Ultrasound of R [right] shoulder-normal. A small amount of bursa/ fluid is present. For functional skills, the GP indicates that the appellant can walk 4+ blocks unaided, climb 5+ steps unaided and
r e m a i n s e a t e d w i t h o u t l i m i t a t i o n . T h e G P i n d i c a t e s t h a t t h 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 d o e s n o t r e q u i r e a n y A R : T h e D C s t a t e s t h a t t h e a p p e l l a n t r e p o rt s a r i g h t s h o u l d e r r e p o rt s d e p r e s s i o n a n d l o w m o t i v a t i o n t h a t i s i m p a c t i n g h T h e D C 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 i s i n d e p e n d e n t w i t h w T h e D C 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 r e q u i r e s p e r i o d i c a s s wi t h a n y t h i n g h e a vi e r t h a n a g l a s s o f w a t e r ) . T h e D C p r o s h o u l d e r R O M , a l l o r t h o p a e d i c te s t i n g n o r m a l . T h e D C r e p o r t s t h a t t h e p h y s i c a l e x a m c o n c l u d e d f u l l r a n t h a t t h e a p p e l l a n t w o u l d b e n e f i t f r o m a n a c t i v e c a r e p l a n . S R : T h e a p p e l l a n t i n d i c a t e s t h a t s h e i s i n c o n s t a n t p a i n f r o m l b s . , u n a b l e t o c o m p l e t e p e r s o n a l a n d h o u s e h o l d t a s k s a a p p e l l a n t s t a t e s t h a t s h e r e q u i r e s a s s i s t a n c e w i t h m a n y t h e l p . A b il i t y t o p e rf o r m D a il v L i v i n g A c t i v i t i e s (D L A ) M 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 h a s n o t b e e n p r e s c r i D L A . 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 i m p a i r m e n t d o e s n A R : T h e D C 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 r e q u i r e s p e r i o d i c a s s g r o o m i n g ( b r u s h i n g h a i r) ; t h e b a s i c h o u s e k e e p i n g t a s k s c a r r y i n g p u r c h a s e s h o m e ( l a r g e r s h o p s r e q u i r e a s s i s t a n c c h o p p i n g v e g g i e s ) . T h e D C r e p o r t s t h a t t h e a p p e l l a n t i s i r e m a i n i n g 4 s h o p p i n g t a s k s ; t h e r e m a i n i n g 2 m e a l s t a s k s T h e D C h a s n o t a s s e s s e d m e d i c a t i o n s t a s k s ( p a ti e n t r e p T h e D C p r o v i d e s t h e f o l l o w i n g a d d i t i o n a l c o m m e n t s : • P a t i e n t r e p o rt s r e q u i r i n g a s s i s t a n c e w i t h g e t t i n g h a ir) . • V a c u u m i n g a n d s w e e p i n g s h e f i n d s d i ff i c u l t d u e • L a rg e g ro c e ry s h o p s s h e r e p o rt s r e q u irin g a s s i s t • P a t i e n t re p o rt s d i ff i c u l t i e s c h o p p i n g a n d p r e p a r i n w e l l a s m i x i n g / s t i r r i n g . S e c t i o n 2 ( 1 )( b ) o f t h e E A P W D R T h e f o l l o w i n g D L A a r e a p p l i c a b l e t o a p e r s o n w h o h a s a M a k e d e c i s i o n s a b o u t p e rs o n a l a c t i v i t i e s , c a r e o r fin a n c e M R : T h e G P m a k e s n o i n d i c a t i o n a s t o w h e t h e r t h e a p p e l l a n t m e a l p r e p a r a t i o n , m e d i c a t i o n s , f i n a n c e s a n d t r a n s p o r t a t i A R : T h e D C 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 i s i n d e p e n d e n t w i t h a e a p p e l l a n t ' s l i ft i n g c a p a c i t y i s u n k n o w n . a i d s o r p r o s t h e s e s f o r h e r i m p a i r m e n t . i n j u r y i n S e p t e m b e r 2 0 1 7 , i s n o w i n c h r o n i c p a i n a n d e r a b i l i t y t o r e c o v e r . a l k i n g i n d o o r s a n d o u t d o o r s , c l i m b i n g s t a i r s a n d s t a n d i n g . i s t a n c e w i t h l i f t i n g a n d c a r r y i n g a n d h o l d i n g ( R e p o rt s p a i n v i d e s t h e a d d i t i o n a l c o m m e n t s : P h y s i c a l e x a m s h o w e d f u ll g e o f m o t i o n a n d n o l o s s o f s t r e n g t h . T h e D C i n d i c a t e s a s h o u l d e r i n j u r y . S h e r e p o r t s b e i n g u n a b l e t o l i f t o v e r 1 O n d u n a b l e w o r k m o r e t h a n a f e w d a y s p e r m o n t h . T h e a s k s a n d i s g e t t i n g d e p r e s s e d b e c a u s e s h e h a s t o a s k fo r b e d m e d i c a t i o n t h a t i n t e r f e r e s w i t h h e r a b i l i t y t o p e rf o r m o t r e s t r i c t h e r a b i l i t y t o p e r f o r m D LA . i s t a n c e w i t h t h e p e r s o n a l c a r e t a s k s o f d r e s s i n g a n d o f l a u n d r y a n d b a s i c h o u s e k e e p i n g ; t h e s h o p p i n g t a s k o f e ) ; a n d t h e m e a l s t a s k s o f f o o d p r e p a r a t i o n ( p a i n w h e n n d e p e n d e n t w i t h t h e r e m a i n i n g 6 p e r s o n a l c a r e t a s k s ; t h e ; a l l p a y r e n t a n d b i l l s t a s k s ; a n d a l l t r a n s p o rt a t i o n t a s k s . o rt s n o m e d i c a t i o n s ) . d r e s s e d ( i . e . b r a ) a n d g ro o m i n g ( i . e . b r u s h i n g h a i r, wa s h in g t o p a i n w i t h R a r m . a n c e c a r ry i n g b a g s i n t o h o u s e a n d c a r . g v e g g i e s . S h e re q u i r e s a s s i s t a n c e l i ft i n g f u ll p o t s/p a n s a s s e v e r e m e n t a l i m p a i r m e n t : s i s r e s t r i c t e d i n h e r a b i l i t y t o m a n a g e p e r s o n a l s e l f c a r e , o n . l l d e c i s i o n m a k i n g t a s k s .
T h e D C h a s n o t c o m p l e t e d t h e s o c i a l f u n c t i o n i n g p o rt i o n 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 ff e c t i v e l y M 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 h a s n o d i ff i c u l t i e s w i A R : T h e D C a s s e s s e s t h e a p p e l l a n t ' s a b i l i t y t o c o m m u n i c a t e s p e a k i n g ) . T h e D C h a s n o t c o m p l e t e d t h e s o c i a l f u n c t i o n i n g p o r t i o n H e l p r e q u i r e d M 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 d o e s n o t r e q u i r e a n y A R : T h e D C 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 r e c e i v e s a s s i s t a n c e p o s s i b l e , i f t h e y a r e n ' t a v a il a b l e s h e w i /1 f i n d a w a y t o d o T h e D C 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 u s e s a s l i n g o n b a d s li n g t o r R a r m o n b a d d a y s . 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 d o e s n o t r e c e i v e a s s 2 . 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 T h e a p p e l l a n t s u b m i tt e d a s i g n e d R e q u e s t f o r R e c o n s i d e h e r d o c t o r d o e s n ' t l i s t e n t o h e r a n d d i d n ' t k n o w h o w t o f i l 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 , t h e a p p e l l a n t r e p o r t e d t h a t c o n t i n u e w o r k i n g t o p a y h e r b i l l s . S h e s t a t e s t h a t i t i s g e t i s i n t e a r s e v e r y d a y a ft e r w o r k . T h e a p p e l l a n t a r g u e s t h a s y m p t o m s s h e e x p e r i e n c e s . S h e a r g u e s t h a t n o t h i n g h e l A d d i t i o n a l i n f o r m a t i o n b e f o r e t h e p a n e l o n a p p e a l c o 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 2 9 N o v e m b e r 2 0 1 8 , t h e a p t h e y a r e s a y i n g m y d o c t o r a n d c h i r o p r a c t o r a s s t a t i n g t h a h o u s e , t h e y d o n ' t l i v e w i t h m e . I a m i n p a i n e v e ry d a y a n 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 a r g u e d t h a t s h e s u ff e r s f r o m b o t h a s e v e r e s h e s u ff e r s f r o m c h r o n i c p a i n a n d i s u n a b l e t o w o r k f o r m u n a b l e t o p e rf o r m m a n y d a i l y t a s k s a n d h a s d i ff i c u l t y w i t h f a m i l y o n a d a i l y b a s i 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 a p p e n o t r e q u i r e a n a d m i s s i b i l i t 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 A c t . 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 b y t h e a n d s o m e e l a b o r a t i o n o f d e t a i l a n d i s , t h e r e f o r e , a d m i s s i a n d A s s i s t a n c e A c t b e c a u s e i t i s i n s u p p o r t o f i n f o r m a t i o n o f t h e A R . t h c o m m u n i c a t i o n . a s g o o d i n a l l l i s t e d a r e a s ( r e a d i n g , w r i t i n g , h e a r i n g a n d o f t h e A R . a i d s o r p r o s t h e s e s . f r o m f r i e n d s a n d f a m i l y ( s h e u t il i z e s fa m i l y /f r i e n d s w h e n t h e t a s k h e r s e l f , o r n o t d o i t . ) d a y s a n d c o m m e n t s : s h e f i n d s re li e f & c o m fo rt u s i n g a i s t a n c e f r o m a s s i s t a n c e a n i m a l s . r a t i o n d a t e d 6 N o v e m b e r 2 0 1 8 , t h e a p p e l l a n t s t a t e d t h a t l o u t t h e f o r m s . I n a 1 p a g e t y p e d l e t t e r s u b m i tt e d w i t h t h e s h e w a s i n j u r e d a t w o r k m o r e t h a n 1 y e a r a g o a n d h a d t o t i n g m o r e d i ff i c u l t t o d r e s s a n d d o c h o r e s a t h o m e , a n d s h e t h e r i n j u r y d o e s q u a l i f y a n d p r o v i d e s d e t a i l s o f t h e p s , a n d s h e w i l l l o s e t h e u s e o f h e r a r m . n s i s t e d o f t h e f o l l o w i n g : p e l l a n t p r o v i d e d t h e f o l l o w i n g r e a s o n s f o r a p p e a l : B e c a u s e t s h e s a i d . H o w e l s e w o u l d t h e y k n o w h o w i t g o e s i n t h e d i n t e a r s a ft e r w o r k a n d m o s t d a y s e v e n i f I d o n ' t w o r k . m e n t a l a n d p h y s i c a l i m p a i r m e n t . H e r s u b m i s s i o n w a s t h a t o r e t h a n 2 h o u r s w i t h o u t s u ff e r i n g . S h e s t a t e d t h a t s h e i s o t h e r s . T h e a p p e l l a n t s t a t e d t h a t s h e g e t s h e l p f r o m l l a n t ' s N o t i c 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 , w h i c h d o e s w i t h s e c t i o n 2 2 ( 4 ) ( b ) o f t h e E m p lo y m e n t a n d A s s i s t a n c e a p p e l l a n t a t t h e h e a r i n g c o n s i s t e d o f a r g u m e n t , r e i t e r a t i o n b l e 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 ) o f t h e E m p l o y m e n t 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 a t r e c o n s i d e r a t i o n .
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 i n t h i s a p p e a l i s w h e t h e r t h e m i n i s t ry 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 a t 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 i d n o t m e e t t h r e e o f t h e f i v e s t a t u t o ry r e q u i r e m e n t s o f S e c t i o n 2 o f t h e EA P W D A f o r 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 i s 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 . S p e c i f i c a l l y , t h e m i n i s t ry d e t e r m i n 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 d i d 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 t 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 e a p p e l l a n t ' s 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 , 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 e r a b i l i t y 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 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 t h o s e r e s t r i c t i o n s , s h e r e q u i r e s 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 t o p e r f o r m t h o s e a c t i v i t i e s . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D A a p p l i e s t o t h i s a p p e a l : P e r s o n s w i t h d i s a b i l i t i e s 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 f o 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 rf 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 ) . T h e f o l l o w i n g s e c t i o n o f t h e E A P W D R a p p l i e s t o t h i s a p p e a l : 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 f o 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 r f 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 r f 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 ff e c t i v e l v .
(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, or (b)acting in the course of the person's employment as a school psychologist by (i)an authority, as that term is defined in section 1 (1 ) of the Independent School Act, or (ii)a board or a francophone education authority, as those terms are defined in section 1 (1) of the Schoo/ Act, if qualifications in psychology are a condition of such employment. Severity of impairment The legislation requires that for PWD designation, the minister must be "satisfied" that the person has a severe mental or physical impairment. The legislation makes it clear that the determination of severity is at the discretion of the minister, considering all the evidence, including that of the appellant. Diagnosis of a serious medical condition or the identification of mental or physical deficits does not in itself determine severity of impairment. Severitv of physical impairment In the reconsideration decision, the ministry determined that a severe impairment of physical functioning had not been established. In making this determination, the ministry noted that the GP has indicated that the appellant does not require aids or prosthesis. The ministry considered the functional skills assessment by the GP noting that the appellant is able to walk 4+ blocks unaided, climb 5+ steps unaided, has unknown lifting ability and can remain seated without limitation. The ministry argued that these assessments provided by the GP are not indicative of a severe physical impairment. The ministry also considered the results of the appellant's MRI and ultrasound, noting no internal derangement and normal results. The ministry argued that the DC's assessments indicate that the appellant is independent with a majority of mobility and physical ability areas. The ministry noted that both the GP and DC use language that indicates that the information provided is based on the appellant's self-assessments rather than medical assessments. The ministry concluded that the assessments provided by the GP and the DC did not establish a severe physical impairment. The panel finds that the ministry's determination was reasonable. The panel notes the ministry's approach to assessing severity in light of the nature of the impairment and the extent of impacts, as evidenced by restrictions/limitations to functioning, ability to perform DLA and help required. Given the focus on restrictions and help required in the legislation, the panel finds this approach and the conclusions flowing therefrom to be reasonable. The panel notes that the GP's and DC's assessments of the appellant's functional capacity and mobility and physical ability assessments in the MR and AR indicate that the appellant is able to function independently for the most part, with some patient-reported difficulty with lifting despite normal orthopaedic and medical imaging test results. The panel finds the appellant's abilities and limitations with lifting to be unclear. The panel also notes that the appellant takes issue with the ministry's finding that the language used by the GP and DC in their reports indicates that the information provided is based on the appellant's self-assessment rather than medical assessments. The appellant argued that, because the GP and DC do not live with her, there is no other way for the medical professionals to know about her limitations. While the panel accepts that the appellant would be expected to report her symptoms and limitations to her medical practitioners, the portions of the MR and AR that use 'patient reports'-type language are not consistent with the portions of the AR and MR that do not use this language and seem to more clearly reflect medical assessments. The panel notes that the medical imaging referred to by the GP indicate "normal" result and "no internal derangement"; furthermore, the GP has indicated that the appellant's impairment does not restrict her ability to perform DLA. Similarly, the DC indicates in the AR that the appellant has full range of motion in her shoulder, no decreased strength, and orthopaedic testing was negative. The panel finds that the ministry's determination, that a severe physical impairment has not been established, is reasonably supported by the evidence. As well, the panel notes that the appellant has emphasized her inability to work. However, the nanel notes that emnlovabilitv or vocational abilitv is not a criterion for PWD desianation nor is it
a D L A s e t o u t i n t h e r e g u l a t i o n . T h e a p p e l l a n t ' s a b i l i t y t o i m p a i r m e n t o f p h y s i c a l o r m e n t a l f u n c t i o n i n g . S e v e ri t y o f m e n t a l i m p a i r m e n 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 , t h e m i n i s t ry d e t e r m i n e d 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 n o t e d t h e a b s e n c e o f a t h e G P ' s a s s e s s m e n t . T h e m i n i s t ry a l s o c o n s i d e r e d t h a t h a v e a n y d i f f i 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 h e r a b i l i t i e s m i n i s t r y c o n s i d e r e d t h a t t h e G P i n d i c a t e s t h a t i t i s u n k n o 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 m i n i s t r y n o t e d g o o d a b i l i t y i n a l l l i s t e d a r e a o f c o m m u n i c a t i o n a n d r e p o r i n d i c a t i n g t h a t t h e r e a r e a n y d i a g n o s e s o f m e n t a l i m p a i r m t h e A R i n d i c a t i n g 2 m aj o r i m p a c t s t o t h e a p p e l l a n t ' s c o g n m i n i m a l i m p a c t s a n d n o i m p a c t s i n t h e o t h e r 6 l i s t e d a r e a i n d i c a t e s t h a t t h e i n f o r m a t i o n i n s e c t i o n 3 B a n d a c c o m p a a s s e s s m e n t r a t h e r t h a n m e d i c a l a s s e s s m e n t . T h e m i n i s t f u n c t i o n . T h e m i n i s t r y c o n c l u d e d t h a t t h e i n f o r m a t i o n p r o f u n c t i o n i n g . 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 a s r e a s o n a b l e . T h e p a n e l f i n d s t h a t a s s e s s m e n t s i n t h e M R i m p a i r m e n t o r b r a i n i n j u ry . F u r t h e r , t h e M R a n d A R a s s e t o f u n c t i o n e ff e c t i v e l y o r i n d e p e n d e n t l y a s a r e s u l t o f a m r e s t r i c t i o n i n t h e a p p e l l a n t ' s s o c i a l f u n c t i o n i n g a b i l i t y . T h e m a k i n g i n d i c a t e t h a t 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 i n a l l a r e p o r t s s u ff e r i n g f r o m d e p r e s s i o n a n d l o w m o t i v a t i o n a n d b a r r i e r s t o h e r r e c o v e r y . T h e p a n e l a l s o n o t e s t h e a s s e r t a p p l i c a t i o n , b u t f i n d s t h a t t h e a s s e s s m e n t s p r o v i d e d d o n 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 p a n e l f i n d s t h a t t h e m i n i s n o t b e e n e s t a b l i s h e d , 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 v 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 a b i l i t y t o p e rf T h e l e g i s l a t i o n s p e c i f i e s t h a t t h e m i n i s t e r a s s e s s d i r e c t a c o n s i d e r a t i o n o f 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 o t h e r e v i d e n c e s h o u l d n o t b e c o n s i d e r e d , b u t i t i s c l e a r t i s s u e i n t h i s a s s e s s m e n t i s t h e d e g r e e o f r e s t r i c t i o n i n t h 2 ( 1 ) ( a ) a n d ( b ) o f t h e E A P W D R . T h e p a n e l n o t e s t h a t , a c r e s t r i c t i o n i n t h e a b i l i t y t o p e r f o r m D L A m u s t b e d u e t o a T h e m i n i s t r y w a s n o t s a t i s f i e d t h a t t h e a p p e l l a n t h a s a s e 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 fi 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 n o t e d 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 m e d i c a n o t e d t h a t t h e G P ' s M R a s s e s s m e n t i n d i c a t e s t h a t t h e a p t h e D C ' s A R r e p o rt 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 i s p e r i o d i f r e q u e n c y o r d u r a t i o n o f a s s i s t a n c e r e q u i r e d . F u rt h e r , t h e w a s b a s e d o n t h e a p p e l l a n t ' s s e l f a s s e s s m e n t r a t h e r t h a i n f o r m a t i o n i n t h e a s s e s s m e n t s a n d s e l f r e p o rt s d o e s n o t h e a p p e l l a n t ' s D L A 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 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 e i m p a i r m e n t 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 a p p e l l a n t ' s a b i l i t y t o p e r i o d s w a s r e a s o n a b l e . 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 m u s t b e 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 . T h e c o m p l e t e t h i s s e c t i o n o f t h e r e p o r t a n d d i d n ' t k n o w h o w t G P c l e a r l y d i d c o m p l e t e t h i s s e c t i o n o f t h e r e p o r t b y i n d i c a b i l i t v t o p e rf o r m D L A . T h e p a n e l n o t e s t h a t t h e M R i n s t r I w o r k i s n o t a c o n s i d e r a t i o n i n d e t e r m i n i n g a s e v e r e 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 d o e s n o t e s t a b l i s h a s e v e r e d e s c r i p t i o n o r d i a g n o s i s r e l a t i n g t o a m e n t a l i m p a i r m e n t i n t h e G P ' s a s s e s s m e n t s i n d i c a t e t h a t t h e a p p e l l a n t d o e s n o t w i t h s p e a k i n g , r e a d i n g , h e a r i n g a n d w r i t i n g a r e g o o d . T h e w n w h e t h e r 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 d e f i c i t s w i t h t h a t t h e D C i n d i c a t e d , i n t h e A R , t h a t t h e a p p e l l a n t h a s t s d e p r e s s i o n a n d l o w m o t i v a t i o n . D e s p i t e t h e G P n o t e n t o r b r a i n i n j u r y , t h e D C h a s c o m p l e t e d s e c t i o n 3 C o f 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 , 1 m o d e r a t e i m p a c t , 5 s . T h e m i n i s t r y a r g u e d t h a t t h e l a n g u a g e u s e d b y t h e D C n y i n g c o m m e n t a r y a r e b a s e d o n t h e a p p e l l a n t ' s s e l f r y n o t e d t h a t t h e D C d i d n o t a s s e s s t h e a p p e l l a n t ' s s o c i a l v i d e d h a d n o t e s t a b l i s h e d a s e v e r e i m p a i r m e n t i n m e n t a l e v e r e m e n t a l i m p a i r m e n t h a s n o t b e e n e s t a b l i s h e d i s a n d A R d o n o t p r o v i d e a n y d i a g n o s i s r e l a t i n g t o a m e n t a l s s m e n t s d o n o t r e f l e c t r e s t r i c t i o n s i n t h e a p p e l l a n t ' s a b i l i t y e n t a l h e a l t h c o n d i t i o n a n d t h e r e i s n o s u g g e s t i o n o f p a n e l n o t e s t h e D C ' s a s s e s s m e n t s r e l a t i n g t o d e c i s i o n r e a s . H o w e v e r , t h e D C 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 t h a t s h e w o u l d b e n e f i t f r o m c o u n s e l l i n g t o a s s i s t w i t h i o n b y t h e a p p e l l a n t o f a m e n i a l b a s i s f o r h e r P W D o t s u p p o rt a c o n c l u s i o n t h a t t h e a p p e l l a n t s u ff e r s f r o m a t r y ' s d e t e r m i n a t i o n , 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 h a s i d e n c e . o r m D L 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 a b i l i t y t o p e rf o r m D L A i n , i n t h i s c a s e t h e G P a n d D C . T h i s d o e s n o t m e a n t h a t h a t a p r e s c r i b e d p r o f e s s i o n a l ' s e v i d e n c e i s f u n d a m e n t a l . A t e a p p e l l a n t ' s a b i l i t y t o p e r f o r m t h e D L A l i s t e d i n s e c t i o n c o r d i n g t o t h e l e g i s l a t i o n , t h e d i r e c t a n d s i g n i f i c a n t 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 . v e r e i m p a i r m e n t 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 o p e r f o r m D L A . I n 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 m i n i s t r y t i o n t h a t i m p a c t s h e r a b i l i t y t o p e r f o r m D L A . T h e m i n i s t r y p e l l a n t i s n o t r e s t r i c t e d w i t h D L A . T h e m i n i s t r y ' n o t e d t h a t c a l l y r e s t r i c t e d w i t h s o m e t a s k s b u t d o e s n o t i n d i c a t e t h e m i n i s t r y a r g u e d 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 C n m e d i c a l a s s e s s m e n t . T h e m i n i s t r y c o n c l u d e d t h a t t h e t e s t a b l i s h t h a t a s e v e r e i m p a i r m e n t s i g n i f i c a n t l y r e s t r i c t s d e d p e r i o d s . a s s e s s m e n t s p r o v i d e d d o n o t e s t a b l i s h t h a t a s e v e r e p e rf o r m D L A 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 t i o n s p e c i f i e s t h a t 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 t o D L A p a n e l n o t e s t h a t t h e a p p e l l a n t a r g u e d t h a t t h e G P d i d n ' t o c o m p l e t e t h e r e p o rt . T h e p a n e l f i n d s , h o w e v e r , t h a t t h e a t i n g t h a t t h e a p p e l l a n t ' s i m p a i r m e n t d o e s n o t r e s t r i c t h e r u c t i o n s s t a t e , " I f v e s , □ l e a s e c o m n l e t e t h e f o l l o w i n q t a b l e : .
T h e p a n e l f i n d s , t h e r e fo r e , t h a t b e c a u s e t h e G P i n d i c a t e c o m p l e t e t h e t a b l e i n d i c a t i n g w h i c h D L A w e r e r e s t r i c t e d . t h e a p p e l l a n t a s b e i n g l a r g e l y i n d e p e n d e n t w i t h D L A . T h p e r i o d i c r e s t r i c t i o n i s a s s e s s e d i n t h e A R , t h e r e i s n o i n f o i n fo r m a t i o n p r o v i d e d i s i n s u ff i c i e n t t o d e t e r m i n e w h e t h e r l e g i s l a t e d l a n g u a g e o f " 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 e d F u r t h e 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 a p p e l l a n t ' s s e l f r e p h e a r i n g a r e c o n s i s t e n t w i t h t h e A R . T h e p a n e l c o n c l u d e s i n s u f f i c i e n t t o s h o w t h a t t h e a p p e l l a n t ' s o v e r a l l a b i l i t y t o p 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 s r e a s o H e l p r e q u i r e d T h e l e g i s l a t i o n r e q u i r e s t h a t , a s a r e s u l t o f b e i n g d i r e c t l y 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 T h i s m e a n s t h a t t h e e s t a b l i s h m e n t o f d i r e c t a n d s i g n i f i c a m e e t i n g t h e n e e d f o r h e l p 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 i g n i f i c a n t h e l p 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 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 , t h e m i n i s t ry d e t e r m i n e d a b i l i t y t o p e rf o r m D L A w e 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 i c a n a p p e l l a n t a r g u 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 b y t h e D C r e c e i v e h e l p a n d t h e m i n i s t ry i s w r o n g i n i t s c o n c l u s i o n o a p p e l l a n t a n d D C d e m o n s t r a t e s t h a t t h e a p p e l l a n t d o e s i u s e a s l i n g o n b a d d a y s , t h e p a n e l n o t e s t h a t i n o r d e r t o m u s t a l s o b e m e t . T h e n e e d f o r h e l p m u s t b e a s a r e s u l t h a s f o u n d t h a t t h e m i n i s t r y ' s c o n c l u s i o n t h a t s i g n i f i c a n t r e B e c a u s e t h e p a n e l h a s a l r e a d y c o n c l u d e d t h a t t h e m i n i s r e s t r i c t i o n s i n t h e 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 r e a s o n a b l y c o n c l u d e d t h a t u n d e r s e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e r e q u i r e s h e l p t o p e rf o r m D LA . 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 i l e g i s l a t e d c r i t e r i a f o r P W D d e s i g n a t i o n , w a s a r e a s o n a b l a p p e l l a n t a n d w a 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 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 .d n o r e s t r i c t i o n s t o D L A i t w a s n o t n e c e s s a r y f o r h e r t o T h e p a n e l a l s o n o t e s t h a t i n t h e A R t h e D C h a s a s s e s s e d e p a n e l f i n d s t h a t , i n r e l a t i o n t o t h e o n l y a r e a s w h e r e s o m e r m a t i o n a s t o p e r i o d i c i t y . T h e p a n e l f i n d s t h a t t h e t h e a p p e l l a n t ' s r e s t r i c t i o n s w i t h t h e s e t a s k s w o u l d m e e t t h 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 f o r e x t e n d e d p e r i o d s . " o rt i n g , i n t h e S R , 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 a n d a t t h e 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 e e v i d e n c e i s e r f o r m h e r D L A i s 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 n a b l e . a n d s i g n i f i c a n t l y r e s t r i c t e d i n t h e a b i l i t y t o p e rf o r m D L A p e r s o n m u s t a l s o r e q u i r e 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 . 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 ) { b ) ( i ) i s a p r e c o n d i t i o n o f s e c t i o n ( 3 ) a s t h e 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 , 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 i n o r d e r t o p e rf o r m a D L A . t h a t a s i t h a d n o t b e e n e s t a b l i s h e d t h a t t h e a p p e l l a n t ' s n o t b e 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 . T h e a n d t h e a p p e l l a n t h e r s e l f c l e a r l y s t a t e t h a t s h e d o e s n t h i s c r i t e r i o n . W h i l e t h e i n f o r m a t i o n p r o v i d e d b y t h e n f a c t r e c e i v e a s s i s t a n c e f r o m f r i e n d s a n d f a m i l y a n d d o e s m e e t t h i s c r i t e r i o n , t h e D L A c r i t e r i o n i n t h e p r e v i o u s s e c t i o n o f 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 . I n t h i s a p p e a l , t h e p a n e l s t r i c t i o n s t o D L A h a v e n o t b e e n e s t a b l i s h e d i s r e a s o n a b l e . 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 a t d i r e c t a n d s i g n i f i c a n t n o t b e e n e s t a b l i s h e d , t h e p a n e l a l s o f i n d s t h a t t h e m i n i s t r y E A P W D A 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 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 h a d n o t m e t a l l o f t h e 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 . 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: (Check one) i:g]UNANIMOUS □BY MAJORITY THE PANEL i:g]CONFIRMS THE MINISTRY DECISION □RESCINDS THE MINISTRY DECISION If the ministry decision is rescinded, is the panel decision referred back to the Minister for a decision as to amount? □Yes □No LEGISLATIVE AUTHORITY FOR THE DECISION: Employment and Assistance Act Section 24(1)(a) i:g] or Section 24(1)(b) i:g] and Section 24(2)(a) i:g] or Section 24(2)(b) D PART H -SIGNATURES PRINT NAME Jennifer Smith SIGNATURE OF CHAIR DATE(YEAR/MONTH/DAY) 2018/12/20 PRINT NAME Jane Nielsen SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2018/12/20 � " • Vl. _,, � PedJTNAME Anne Richmond SIGNATURE OF MEMBER DATE(YEAR!MONTH/DAY) 2018/12/20
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.