PART C -DECISION UNDER APPEAL The decision under appeal is the reconsideration decision of the Ministry of Social Development and Poverty Reduction (the ministry) dated December 12, 2018, which held that the appellant did not meet 3 of the 5 statutory requirements of section 2 of the Employment and Assistance for Persons with Disabilities Act (EAPWDA) for designation as a person with disabilities (PWD). The ministry found that the appellant met the requirements of having reached 18 years of age and of a medical practitioner confirming that the appellant's impairment is likely to continue for at least 2 years. However, the ministry was not satisfied that: • 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 those restrictions, in the opinion of a prescribed professional, the appellant requires an assistive device, the significant help or supervision of another person, or the services of an assistance animal to perform DLA. PART D -RELEVANT LEGISLATION E m ployment and Assistance for Persons with Disabilities Act (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 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 1 ) T h e a p p e l l a n t ' s P W D a p p l i c a t i o n c o m p r i s e d o f : • A M e d i c a l R e p o r t ( M R ) d a t e d A u g u s t 2 0 k n o w n t h e a p p e l l a n t s i n c e 2 0 1 4 , a n d h m o n t h s ; • A n A s s e s s o r R e p o r t ( A R ) a l s o d a t e d A u g • T h e a p p e l l a n t ' s s e l f r e p o r t ( S R ) s e c t i o n 2 ) T h e a p p e l l a n t ' s R e q u e s t fo r R e c o n s i d e r a t i o n , w h 2 9 , 2 0 1 8 b y t h e G P . T h e G P i s a s k e d t o a g r e e o r c o m m e n t s i s a l s o p r o v i d e d , t h o u g h t h e G P h a s p I n f o r m a t i o n p r o v i d e d o n a p p e a l o n d a d m i s s i b i l i t y 1 ) T h e a p p e l l a n t ' s N o t i c e o f A p p e a l ( N O A ) d a t e d D d i s a g r e e s t h e m i n i s t r y ' s d e c i s i o n b e c a u s e h e h a s c o n s i d e r e d . 2 ) A t t h e h e a r i n g , t h e a p p e l l a n t d e s c r i b e d h i s m e d f u n c t i o n i n g . 3 ) 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 s p o n d e d t o q u e s t 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 ) o f t h e E m p l o y m e n t a n d w r i t t e n t e s t i m o n y t h a t i s 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 T h e p a n e l c o n s i d e r e d t h e a p p e l l a n t ' s N O A a s a r g u m e n t a p p e l l a n t w a s a d m i t t e d a s s u p p o r t i n g i n f o r m a t i o n w h i c h i n f o r m a t i o n a v a i l a b l e a t r e c o n s i d e r a t i o n . I n r e a c h i n g t h i i n t r o d u c e d t h e t e r m s a r t h r i t i s a n d s c i a t i c a a t t h e h e a r i n o f f o r a m i n a l n a r r o w i n g i n t h e c e rv i c a l a n d l o w e r b a c k . T h e a r g u m e n t s o f b o t h p a r t i e s a r e s e t o u t i n P a r t F o f t h S u m m a r y o f r e l e v a n t e v i d e n c e D i a g n o s e s o n d H e a l t h H i s t o r y I n t h e P W D a p p l i c a t i o n , t h e G P r e p o r t s : • S p e c i f i c d i a g n o s i s : C h r o n i c P a i n S y n d r o m e a n d D t h e C S + C 6 + L B , a l l w i t h a n o n s e t d a t e o f 2 0 1 4 . • T h e s e v e r i t y o f t h e m e d i c a l c o n d i t i o n s r e l e v a n t c o n d i t i o n . " • T h e a p p e l l a n t c a n ' t l i f t m o r e t h a n 1 5 l b s ., 2 0 1 8 , c o m p l e t e d b y a 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 a s s e e n t h e a p p e l l a n t 1 1 o r m o r e t i m e s i n t h e p a s t 1 2 u s t 2 0 , 2 0 1 8 , c o m p l e t e d b y t h e s a m e G P ; a n d o f t h e P W D a p p l i c a t i o n , d a t e d J u n e 2 4 , 2 0 1 8 . i c h i n c l u d e d a q u e s t i o n n a i r e s i g n e d a n d d a t e d N o v e m b e r d i s a g r e e w i t h p r e p a r e d s t a t e m e n t s . T h e o p t i o n f o r r o v i d e d n o n e . e c e m b e r 1 7 , 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 h a t h e m o b i l i t y i s s u e s a s w e l l a s o t h e r t h i n g s t h a t s h o u l d b e i c a l c o n d i t i o n s a n d t h e i m p a c t t h e y h a v e o n h i s i o n s b u t d i d n o t p r o v i d e a d d i t i o n a l e v i d e n c e . A s s is t a n c e A c t ( E A A ) , t h e p a n e l m a y a d m i t o r a l a n d n d r e c o r d s a v a i l a b l e a t t h e t i m e o f r e c o n s i d e r a t i o n . a n d a c c e p t e d i t o n t h a t b a s i s . T h e o r a l t e s t i m o n y o f t h e o n b a l a n c e e i t h e r r e i t e r a t e d o r a u g m e n t e d t h e s 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 w h i l e t h e a p p e l l a n t g , t h e s e r e f e r e n c e s a r e c o n s i s t e n t w i t h t h e G P ' s d i a g n o s e s i s d e c i s i o n . e g e n e r a t i v e D i s c D i s e a s e / N e u r o f o r a m i n a l N a r r o w i n g o f t o t h e i m p a i r m e n t i s d e s c r i b e d a s " s e v e r e d i s a b l i n g
Physical Impairment • The GP assesses the appellant's physical functional skills as: • able to walk 2 to 4 blocks unaided on a flat surface; • able to climb 2 to 5 steps unaided, "L leg+ back pain+ neural [illegible]+ neck pain+ H/Aches"; • limited to lifting 5 to 15 lbs.; and, • no limitation with remaining seated. • No prostheses or aids are required. • All listed aspects of mobility and physical ability are managed independently, with commentary in brackets: • walking indoors and outdoors (2x longer); • climbing stairs (needs rail); • standing; and, • lifting(< 15 lbs.), and carrying and holding(< 15 lbs. Bending and lifting> 15 lbs. prevented by pain.) In the SR, the appellant reports that arthritis in his neck causes headaches all the time and limited movement in his neck. Degenerative disc disease in his lower back limits his lifting, bending and walking. All of these affect his appetite and sleep, and he is getting depressed. At the hearing, the appellant stated that due to arthritis in his neck, loss of discs in his lower back, and closing of the nerves in his neck and lower back (sciatica), he cannot lift, bend, or lift his leg more than half way, and he has constant headaches. He tries to walk everyday but some days is unable, noting that occasionally there is a disconnect between his brain and leg, and he cannot move his leg. If walking 4 blocks, he hobbles and is not comfortable. If he performs activities that involve bending and lifting, his lower back pops out leaving him laid up for days in bed, which sometimes happens 1-2 times a week. Lifting lSlbs. is not enough for either of the vocations for which he is qualified. Mental Impairment In the MR, the GP reports: • No significant deficits with the 11 listed areas of cognitive and emotional function. • No difficulties with communication. • Social functioning is not restricted. In the AR, the GP reports: • Good ability with all listed forms of communication. • Where asked to assess the impact on daily functioning for 14 listed aspects of cognitive and emotional functioning, the GP drew a line through the page. • A line is also drawn through the page respecting social functioning. The questionnaire does not address mental functioning.
T h e G P r e p o r t s t h e f o l l o w i n g ( i n f o r m a t i o n i n t h e q u e s t i o • T h e a p p e l l a n t h a s b e e n p r e s c r i b e d m e d i c a t i o n a p e r f o r m D L A -" "-' c o g n i t i v e c a p a c i t y w i t h G a b a • D e g e n e r a t i v e d i s c d i s e a s e o f t h e L a n d C S p i n e , w l o w e r b a c k p a i n + d a i l y h e a d a c h e s a r e t h e i m p a i • I n f o r m a t i o n r e s p e c t i n g t h e D L A " m o v e a b o u t i n h e a d i n g P h y s i c o l I m p a i r m e n t . • A l l l i s t e d t a s k s f o r t h e D L A " s h o p p i n g " a r e m a n a l i m i t e d t o < 1 5 l b s . [ i l l e g i b l e ] . • A l l l i s t e d t a s k s o f t h e D L A " m e a l s " a r e m a n a g e d s t a n d i n g " n o t e d f o r f o o d p r e p a r a t i o n a n d c o o k i • A l l l i s t e d t a s k s o f t h e D L A " p a y r e n t a n d b i l l s " a r m e d i c a t i o n s , w i t h t h e G P n o t i n g t h a t t h e a p p e l l a • T h e D L A " t r a n s p o r t a t i o n " i s m a n a g e d i n d e p e n d U s e o f p u b l i c t r a n s i t i s N / A . • R e s p e c t i n g t h e D L A " p e r s o n a l c a r e " : • G r o o m i n g , t o i l e t i n g , f e e d i n g s e l f , r e g u l a i n d e p e n d e n t l y . • D r e s s i n g r e q u i r e s p e r i o d i c a s s i s t a n c e , 2 R e q u i r e s h e l p 3 -4 d a y s p e r w e e k , p a i n l e p u t p a n t s o n i n d e p e n d e n t l y . • B a t h i n g r e q u i r e s c o n t i n u o u s a s s i s t a n c e d a y s , b e i n g u n a b l e t o l i f t h i s l e g i n d e p e n h i s h e a d a n d n e c k b e c a u s e h e i s u n a b l e • T r a n s f e r s i n / o u t o f b e d r e q u i r e p e r i o d i c • R e s p e c t i n g t h e D L A " b a s i c h o u s e k e e p i n g , " b o t h a s s i s t a n c e f r o m a n o t h e r p e r s o n . N e e d s h e l p t o c w a s h fl o o r s , c l e a n t h e t o i l e t a n d b a t h t u b b e c a u s e x a c e r b a t e p a i n , p r e v e n t i n g h i m f r o m m o s t c l e a b e c a u s e h e c a n n o t b e n d o v e r t h e m a c h i n e s t o t r A t t h e h e a r i n g , t h e a p p e l l a n t s t a t e d t h a t t h e i n f o r m a t i o n h i s c o n d i t i o n s i n c e t h e d a t e t h e P W D a p p l i c a t i o n w a s c o h a s i n c r e a s e d t o 3 -4 t i m e s a w e e k . T h e a p p e l l a n t a l s o s t i n / o u t o f b e d b e c a u s e h i s b e d i s h i g h e n o u g h o f f o f t h e g g e t h i m s e l f o u t o f b e d . N e e d fo r H e l p 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 r e q u i r e s a s s i s t a n c e fo a n d c o m m e n t s t h a t t h e a p p e l l a n t ' s s p o u s e h e l p s w i t h h o f o r h e l p w i t h d r e s s i n g , b a t h i n g a n d h o u s e k e e p i n g .I n n a i r e i s i t a l i c i z e d ) : n d / o r t r e a t m e n t s t h a t i n t e r f e r e w i t h t h e a b i l i t y t o p e n t i n . " i t h f o r a m i n a l n a r r o w i n g , c a u s i n g n e c k , s h o u l d e r a n d 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 ' s a b i l i t y t o m a n a g e D L A . d o o r s a n d o u t d o o r s " i s a s d e s c r i b e d a b o v e u n d e r t h e g e d i n d e p e n d e n t l y , w i t h c a r r y i n g p u r c h a s e s h o m e b e i n g i n d e p e n d e n t l y , w i t h " a l t e r n a t i n g b e t w e e n s i t t i n g + n g . e m a n a g e d i n d e p e n d e n t l y a s a r e t h e t a s k s fo r t h e D L A n t " f o r g e t s a t t i m e s " t o t a k e m e d i c a t i o n a s d i r e c t e d . e n t l y , w i t h g e t t i n g i n a n d o u t o f a v e h i c l e t a k i n g 2 x l o n g e r . t i n g d i e t , a n d t r a n s f e r s o n / o f f c h a i r a r e m a n a g e d d a y s a w e e k , f r o m a n o t h e r p e r s o n d u e t o p a i n s e v e r i t y . v e l i s s u c h t h a t h e c a n n o t b e n d a n d l ift l e g f a r e n o u g h t o f r o m a n o t h e r p e r s o n . N e e d s h e l p i n / o u t o f b a t h m o s t d e n t l y . A ls o n e e d s h e l p a c o u p l e d a y s p e r w e e k t o w a s h t o l ift h i s a r m s u p . a s s i s t a n c e , 2 d a y s a w e e k , f r o m a n o t h e r p e r s o n . b a s i c h o u s e k e e p i n g a n d l a u n d r y r e q u i r e c o n t i n u o u s l e a n b a t h r o o m . N e e d s h e l p m o s t o f t h e t im e t o v a c u u m , e r e p e t i t i v e t w i s t i n g / r e a c h i n g m o v e m e n t s a n d b e n d i n g n i n g a c t i v i t i e s . N e e d s h e l p w i t h m o s t o f t h e l a u n d r y a n sfe r c l o t h e s . p r o v i d e d i n t h e q u e s t i o n n a i r e r e f l e c t s t h e w o r s e n i n g o f m p l e t e d . T h i s i s w h y t h e n e e d f o r a s s i s t a n c e w i t h d r e s s i n g a t e d t h a t h e d o e s n o t r e q u i r e a s s i s t a n c e f o r t r a n s f e r s r o u n d t o g e t i n t o b e d a n d h e i s a b l e t o p i v o t a n d r o l l t o r D L A f r o m f a m i l y a n d h e a l t h a u t h o r i t y p r o f e s s i o n a l s , u s e w o r k . I n t h e q u e s t i o n n a i r e , t h e G P r e p o rt s t h e n e e d
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 I s s u e o n A p p e a l T h e i s s u e o n a p p e a l i s w h e t h e r t h e m i n i s t r y ' s d e c i s i o n t o s u p p o r t e d b y t h e e v i d e n c e o r w a s a r e a s o n a b l e a p p l i c a t t h e a p p e l l a n t . T h a t i s , w a s t h e m i n i s t r y r e a s o n a b l e w h e n E A P W D A w e r e n o t m e t b e c a u s e : • a s e v e r e p h y s i c a l o r m e n t a l i m p a i r m e n t w a s n o • t h e a p p e l l a n t ' s D L A a r e n o t , i n t h e o p i n i o n o f a r e s t r i c t e d e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o • 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 , i n t h e o p i n i o n o r e q u i r e 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 s s i s t a n c e a n i m a l t o p e r f o r m D L A ? R e l e v a n t L e g i s l a t i o n E A P W D A 2 ( 1 ) I n t h i s s e c t i o n : " a s s i s t i v e d e v i c e " m e a n s a d e v i c e d e s i g n e d t o e n a b l e a 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 " d a i l y l i v i n g a c t i v i ty " 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 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 ( 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 { 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 ) 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 ( 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 ( 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 ( i ) a n a s s i s t i v e d e v i c e ,d e n y t h e a p p e l l a n t d e s i g n a t i o n a s a P W D w a s r e a s o n a b l y i o n o f t h e a p p l i c a b l e e n a c t m e n t i n t h e c i r c u m s t a n c e s o f d e t e r m i n i n g t h a t t h e r e q u i r e m e n t s o f s e c t i o n 2 ( 2 ) o f t h e t e s t a b l i s h e d ; 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 x t e n d e d p e r i o d s ; a n d 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 a p p e f l a n t d o e s n o t 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 r v i c e s o f a n 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 b l e t o p e r f o r m ; 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 fo r t h e 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 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 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 e i t h e r q u i r e s h e l p t o p e r f o r m t h o s e a c t i v i t i e s . 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 c t i v i t y i f , i n o r d e r t o p e r f o r m i t , t h e p e r s o n r e q u i r e s
(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). EAPWDR 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, 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 In d epen d ent School Act, or (ii) a board or a francophone education authority, as those terms are defined in section 1 (1) of the School Act,
if qualifications in psychology are a condition of such employment. (3)The definition of "parent" in section 1 (1) applies for the purposes of the definition of "dependent child" in section 1 (1) of the Act. Panel Decision Physical Impairment The appellant's position is that arthritis in his neck and degenerative disc disease in his lower back limits his functioning to the point that he is disabled and is unable to work. The appellant argues that the ministry has not taken all of his medical issues into account. The ministry's position is that a diagnosis of a serious medical condition does not in itself determine PWD eligibility or establish a severe impairment and that the information, including the appellant's own information, respecting the appellant's physical functioning does not establish a severe physical impairment. Noting that employability or ability to work is not taken into consideration, the ministry finds that the assessment of physical functional skills, including taking 2x longer with walking, is not considered indicative of a severe impairment of physical functioning. The ministry further notes that handrails are not considered an assistive device and that the appellant is assessed as being independent with all listed areas of mobility and physical ability. Respecting the GP's comment in the questionnaire that the appellant's "medical condition is severe", the ministry notes that the questionnaire speaks largely to restrictions of DLA, not specific impacts on physical functioning upon which severity of physical impairment is assessed. The panel finds that while the appellant is reported as independently managing most aspects of physical functioning, the supporting narrative from the GP, and the limitations within which the appellant independently functions, do not support the ministry's conclusion that a severe physical impairment is not established. While the statement in the questionnaire that the appellant's "medical condition is severe" may not specifically address physical functional abilities, when considered together with the GP's assessment in the MR of "a severe disabling condition" and of limitations to both upper and lower body functioning due to pain, including being limited to independently walking 2 to 4 blocks and climbing 2 to 5 steps and having reduced range of motion of arms and the left leg, and daily headaches, a more complete picture of the severity of impairment is provided. The panel also notes that limitations in the ability to bend, which the GP indicates is prevented by pain are not directly assessed as part of the assessment of physical functional skills in the PWD application. With the exception of the information respecting being bedridden at times, which is not consistent with the information from the GP and on that basis is given little weight, the appellant's own information supports the GP's assessment of limitations to all aspects of his physical functioning due to both mechanical and nerve related problems of his upper back, neck and shoulders as well as his lower back. While the limitations to aspects of physical functioning may be considered less than severe when viewed discretely, when taken together, the panel finds that the ministry was not reasonable in concluding that the information does not establish a severe impairment of physical functioning.
M e n t a l I m p a i r m e n t I n h i s S R t h e a p p e l l a n t c o m m e n t s t h a t h e i s g e t t i n g d e p r T h e m i n i s t r y ' s p o s i t i o n i s t h a t a s e v e r e m e n t a l i m p a i r m e P W D a p p l i c a t i o n a n d t h e q u e s t i o n n a i r e o r t h e a p p e l l a n t c o m m u n i c a t i o n o r s i g n i f i c a n t d e f i c i t s w i t h c o g n i t i v e a n d T h e p a n e l c o n c l u d e 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 i s a n d t h e G P r e p o r t s t h a t t h e r e a r e n o s i g n i f i c a n t d e f i c i t s c o m m u n i c a t i o n . A d d i t i o n a l l y , t h e G P i n d i c a t e s t h a t s o c i a f u n c t i o n i n g s e c t i o n s o f t h e P W D a p p l i c a t i o n . W h i l e t h e G r e l a t i n g t o t h e a b i l i t y t o p e r f o r m D L A , w i t h t h e e x c e p t i o m e d i c a t i o n a s d i r e c t e d " a t t i m e s , " t h e a p p e l l a n t i s r e p o r o t h e r l i s t e d t a s k s o f D L A t h a t r e l a t e t o c o g n i t i v e f u n c t i o n t h a t h e i s g e t t i n g d e p r e s s e d b u t c o n c l u d e s t h a t t h e a s s e w e r e r e a s o n a b l y v i e w e d b y t h e m i n i s t ry a s n o t e s t a b l i s h 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 r f o rm D L A S e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A r e q u i r e s t h a t t h e m i n i s p r o f e s s i o n a l , a s e v e r e 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 d i r p e r f o r m D L A e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e f o r c l a r i f i c a t i o n o r s u p p o r 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 e v i d e n c e f r o m p r e s c r i b e d p r o f e s s i o n a l s . T h e t e r m " d i r e c s e v e r e i m p a i r m e n t a n d t h e r e s t r i c t i o n . T h e d i r e c t r e s t r i c r e l a t e d t o t i m e o r d u r 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 r e i t m u s t b e fo r e x t e n d e d p e r i o d s . I n h e r e n t l y , a n y a n a l y s i s f r e q u e n c y . A l l o t h e r t h i n g s b e i n g e q u a l , a r e s t r i c t i o n t h a o n e t h a t o c c u r s s e v e r a l t i m e s a w e e k . A c c o r d i n g l y , i n c i r r e s t r i c t i o n a r i s e s p e r i o d i c a l l y , i t i s a p p r o p r i a t e f o r t h e m o f t h e r e s t r i c t i o n i n o r d e r t o b e " s a t i s f i e d " t h a t t h i s l e g i s D L A a r e d e f i n e d i n s e c t i o n 2 ( 1 ) o f t h e E A P W D R a n d a r e a p p l i c a t i o n w i t h t h e o p p o r t u n i t y fo r t h e p r e s c r i b e d p r o f n a r r a t i v e . D L A , a s d e f i n e d i n t h e l e g i s l a t i o n , d o n o t i n c l u 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 m i n i s t ry h a s w r o n g l y s i g n i f i c a n t l y r e s t r i c t e d o n a d a i l y b a s i s . T h e m i n i s t r y ' s p o s i t i o n i s t h a t w h i l e t h e a p p e l l a n t e x p e r t h e r e i s n o t e n o u g h e v i d e n c e t o c o n f i r m a s e v e r e i m p a i 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 . R e s p e r e s t r i c t i o n s o c c u r r i n g 2 d a y s p e r w e e k o r t a k i n g t w i c e a s s i g n i f i c a n t r e s t r i c t i o n . T h e m i n i s t ry a l s o f i n d s i t d i ff i c u l t t c o n t i n u o u s r e s t r i c t i o n s w i t h b a s i c h o u s e k e e p i n g g i v e n t h m i n i s t r y a l s o n o 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 e s s e d , b u t o t h e r w i s e d i d n o t a d d r e s s m e n t a l i m p a i r m e n t . n t i s n o t e s t a b l i s h e d b a s e d o n t h e G P ' s i n fo r m a t i o n i n t h e ' s S R b e c a u s e t h e r e a r e n o r e p o r t e d d i f f i c u l t i e s w i t h e m o t i o n a l f u n c t i o n i n g . r e a s o n a b l e . T h e r e i s n o d i a g n o s i s o f a m e n t a l i m p a i r m e n t w i t h c o g n i t i v e a n d e m o t i o n a l f u n c t i o n o r p r o b l e m s w i t h l f u n c t i o n i n g i s n o t a n i s s u e b y s t r i k i n g t h r o u g h t h e s o c i a l P r e p o r t s t h a t m e d i c a t i o n i m p a c t s c o g n i t i v e c a p a c i t y n o f n o t i n g t h a t t h e a p p e l l a n t f o r g e t s t o t a k e h i s t e d a s i n d e p e n d e n t l y m a n a g i n g t h i s D L A t a s k a s w e l l a s a l l i n g . T h e p a n e l a c k n o w l e d g e s t h e a p p e l l a n t ' s c o m m e n t s s m e n t s o f c o g n i t i v e , e m o t i o n a l a n d s o c i a l f u n c t i o n i n g i n g a s e v e r e m e n t a l i m p a i r m e n t . t e r b e s a t i s f i e d t h a t i n t h e o p i n i o n o f a p r e s c r i b e d 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 a p p e l l a n t ' s a b i l i t y t o n d e d p e r i o d s . W h i l e o t h e r e v i d e n c e m a y b e c o n s i d e r e d a s t o w h e t h e r o r n o t i t i s s a t i s f i e d , i s d e p e n d e n t u p o n t h e t l y " m e a n s t h a t t h e r e m u s t b e a c a u s a l l i n k b e t w e e n t h e t i o n m u s t a l s o b e s i g n i f i c a n t . F i n a l l y , t h e r e i s a c o m p o n e n t s t r i c t i o n m a y b e e i t h e r c o n t i n u o u s o r p e r i o d i c . I f p e r i o d i c , o f p e r i o d i c i t y m u s t a l s o i n c l u d e c o n s i d e r a t i o n o f t h e t o n l y a r i s e s o n c e a y e a r i s l e s s l i k e l y t o b e s i g n i f i c a n t t h a n c u m s t a n c e s w h e r e t h e e v i d e n c e i n d i c a t e s t h a t a i n i s t ry t o r e q u i r e e v i d e n c e o f t h e d u r a t i o n a n d f r e q u e n c y l a t i v e c r i t e r i o n i s m e t . l i s t e d i n b o t h t h e M R a n d t h e A R s e c t i o n s o f t h e P W D e s s i o n a l t o c h e c k m a r k e d b o x e s a n d p r o v i d e a d d i t i o n a l d e t h e a b i l i t y t o w o r k . d e t e r m i n e d t h a t h i s a b i l i t y t o p e r f o r m D L A i s n o t i e n c e s r e s t r i c t i o n s t o D L A r e q u i r i n g r e a c h i n g a n d b e n d i n g , m e n t t h a 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 b i l i t y t o p e r f o r m D L A c t i n g t h e P W D a p p l i c a t i o n , t h e m i n i s t ry d o e s n o t c o n s i d e r l o n g a s t y p i c a l i n p e r f o r m i n g a D L A t o b e i n d i c a t i v e o f a o e s t a b l i s h w h y t h e a p p e l l a n t w o u l d e x p e r i e n c e e G P ' s a s s e s s m e n t s o f t h e a b i l i t y t o l i f t a n d w a l k . T h e t h t h e m a j o r i t y o f l i s t e d a r e a s o f D L A a n d t h a t n o
I restrictions are identified for social functioning. The ministry considers the questionnaire as essentially reiteration of the restrictions outlined in the PWD application, with the exception of the frequency of restrictions with dressing, which increased to 3 to 4 days per week. The ministry notes that the questionnaire does not indicate restrictions to shopping, meals, paying rent and bilfs, medications or transportation. The panel notes that while the appellant reports that he is unable to work either in his previous vocation or in another vocation for which he has been trained, section 2(b)(i) of the EAPWDA requires that a person's severe physical or mental impairment directly and significantly restricts the person's ability to perform the DLA defined In the legislation. While there is potentially some crossover between restrictions impacting the ability to work and thos e impacting the ability to perform DLA, only the restriction on the ability to perform the DLA set out in the legislation is considered under section 2(b)(i) of the EAPWDA. And, as noted above, the restriction is to be in the opinion ofa prescribed professional, which in this case, is the GP. In this case, the GP has ass.essed the appellant as independently managing most DLA tasks independently without the need for any assistance, including all listed tasks oft he following DLA· shopping, meals, pay rent and bills, medications, and transportation. Whtie a few of these tasks are reported to take significantly longer to perform, there is either no description of how much longer or the appellant is reported as taking or the appellant takes two times longer than typical, which the panel concludes was reasonably viewed by the ministry as not establishing a significant restriction. DLA tasks that the appellant is not able to manage independently are those that require the appellant to lift his leg and/or involve significant bending. Of those tasks, only three (both tasks ofthe DLA basic housekeeping and one task of the DLA personal care, bathing) require continuous assistance. The ministry questions the need for continuous assistance with the DLA basic housekeeping based on the physical functional skills assessment. The panel finds that the GP's narrative in the PWD application (and the questionnaire) identifies the inability to bend as significantly contributing to the restriction with basic housekeeping. When this aspect of functioning/mobility is considered, given the amount of bending and twisting routinely required for basic housekeeping tasks, it is the finding of the panel that the information is reasonably viewed as establishing. a continuous significant restriction that is directly related to the appellant's physical impairment. Respecting the DLA personal car e , only the activity of bathing is reported as requiring continuous assistance, with the appellant either independently managing the other activities, including transfers In/out of bed, as described by the appellant, or requiring periodic assistance that is not established as being for extended periods. The panel concludes that the frequency and nature of the assistance required for personal care could reasonably be determined not to rise to the point of significantly restricting his ability to perform the DLA. Based on the overall level with which the appellant is assessed as performing the DLA defined in the legislation, with only one DLA, basic housekeeping, directly and significantly restricted continuously, .the panel concludes that the ministry was reasonable to determine that there is not enough evidence to establish that in the opinion of a prescribed professional the appellant's impairment significantly restricts the ability to perform DLA either continuously or periodically for extended periods. Help to perform DLA Section 2(2)(b)(iiJ of the EAPWDA requires that, as a result of direct ond significant restrictions in the ability to perform DLA, a person requires help to perform "those activities." Help is de fined in subsection (3) as the requirement for an assistive device, the significant help or supervision of another person, or the services of an assistance animal in order to perform DLA.
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 n t r e s t r i c t i o n s w " 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 . " I n t h i s c a s e , t h e p a n e e s t a b l i s h e d f o r o n l y o n e d a i l y l i v i n g " a c t i v i t y " , b a s i c h o u 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 r e s t r i c " a c t i v i t i e s " h a v e n o t b e e n e s t a b l i s h e d . A c c o r d i n g l y , t h e t h a t 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 r e q u i r e 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 w i t h d a i l y l i v i n g " a c t i v i t i e s " a 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 P W D d e s i g n a t i o n , 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 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 t h d a i l y l i v i n g " a c t i v i t i e s " i s a p r e c o n d i t i o n o f r e q u i r i n g l c o n c l u d e d t h a t a 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 w a s s e k e e p i n g , a n d t h e r e f o r e f o u n d t h a t t h e m i n i s t ry 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 r f o r m d a i l y l i v i n g 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 ry r e a s o n a b l y c o n c l u d e d s h e l p t o p e r f o r m " t h o s e a c t i v i t i e s " a s a r e s u l t o f d i r e c t s r e q u i r e d b y s e c t i o n 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A . i o n , w h i c h d e t e r m i n e d t h a t t h e a p p e l l a n t w a s n o t e l i g i b l e e v i d e n c e , a n d t h e r e f o r e c o n f i r m s t h e d e c i s i o n . T h e
I PART G -ORDER THE PANEL DECISION IS: (Check one) iz<JUNANIMOUS □BY MAJORITY THE PANEL iz<JCONFIRMS 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) i2<J or Section 24(1 )(b) D and Section 24(2)(a) � or Section 24(2)(b) D PART H -SIGNATURES PRINT NAME Jane Nielsen SIGNATURE OF CHAIR DATE(YEARIMONTH/DAY) 2019/01/09 PRINT NAME Wesley Nelson SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2019/01/09 PRINT NAME Margarita Papenbrock SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2019/01/14
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