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 m i n i s t r y } r e c o n s i d e r a t i o n d e c i s i o n d a t e d D e c e m 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 r y r e q u i r e m e n t f o r P e rs o n s w i t h D i s a b ili t i e s A c t f o r d e s i g n a t i o n m i n i s t r y fo u n d t h a t t h e a p p e l l a n t m e t t h e a g e r e c o n t i n u e f o r a t l e a s t t w o y e a r s . H o w e v e r , t h e m e s t a b l i s h e s t h a t : • t h e a p p e l l a n t h a s a s e v e r e p h y s i c a l o r m • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( D L A 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 e i t h e r p e r i o d s ; a n d , • a s a r e s u l t o f t h e s e r e s t r i c t i o n s , t h e a p p e o f a n o t h e r p e r s o n , t h e u s e o f a n a s s i s t i v t o p e r f o r m D L A . P A R T D R E L E V A N T L E G I S L A T I O N E m p l o y m e n t a n d A s s i s t a n c e fo r P e r s o n s w i t h D 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 a n d 2 . 1c i a l D e v 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 ( t h e b e r 3 , 2 0 1 8 w h i c h fo u n d t h a t t h e a p p e l l a n t d i d s o f S e c t i o n 2 o f t h e E m p l o y m e n t a n d A s s i s t a n c e a s a p e r s o n w i t h d i s a b i l i t i e s ( P W D } . T h e q u i r e m e n t a n d t h a t h e r i m p a i r m e n t i s l i k e l y t o i n i s t r y w a s n o t s a t i s f i e d t h e e v i d e n c e e n t a l i m p a i r m e n t ; } a r 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 fe s s i o n a l , 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 e x t e n d e d l l a n t r e q u i r e s t h e 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 e d e v i c e , o r 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 i s a b il i tie s A c t ( E A P W D A } , S e c t i o n 2 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 } , S e c t i o n s 2
P A R T E S U M M A R Y O F F A C T S T h e e v i d e n c e b e f o r e t h e m i n i s t r y a t t h e t i m e o f P e r s o n s W i t h D i s a b i l i t i e s ( P W D ) A p p l i c a t i o n c o r e p o r t d a t e d J u l y 1 6 , 2 0 1 8 , a m e d i c a l r e p o r t ( M 2 4 , 2 0 1 8 a n d 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 a n d h a s m e t w i t h h e r 1 1 o r m o r e t i m e s i n t h e p T h e e v i d e n c e a l s o i n c l u d e d t h e fo l l o w i n g d o c u m 1 ) T w o u n d a t e d p h o t o g r a p h s ; 2 ) C o p y o f G l o b a l N e w s a rt i c l e d a t e d A p r i l ( M V A ) i n w h i c h t h e a p p e l l a n t w a s i n j u r e d 3 ) O p e r a t i v e R e p o rt d a t e d A p r i l 5 , 2 0 1 8 ; 4 ) C o l l i s i o n R e p o rt f r o m a n o t h e r p r o v i n c e d 5 ) K i n e s i o l o g y a s s e s s m e n t r e p o rt f o r A u g u 6 ) P o r t i o n s o f a r e p o rt b y a n O c c u p a t i o n a l a n d , 7 ) 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 D e c e D i a g n o s e s I n t h e M R , t h e G P d i a g n o s e d t h e a p p e l l a n t w i t h p o l y t r a u m a , w i t h n o d a t e s o f o n s e t p r o v i d e d . A p h y s i c a l i m p a i r m e n t s t h a t i m p a c t h e r a b i l i t y t o m w r o t e i n t h e A R : " p a t i e n t h a s s e v e r e d e p r e s s i o n t r a u m a . " P h ys i c a l I m p a i r m e n t I n t h e M R a n d t h e A R , t h e G P r e p o rt e d : • I n t e r m s o f t h e a p p e l l a n t ' s h e a l t h h i s t o r y a n d " p o l y t r a u m a v e rt e b r a l f r a c t u r e s , r i b • T h e a p p e l l a n t r e q u i r e s a n a i d fo r h e r i m p " n e e d s t o u s e c r u t c h e s t o a m b u l a t e d u e c h r o n i c p a i n . " • I n t e r m s o f f u n c t i o n a l s k i l l s , t h e G P r e p o u n a i d e d o n a f l a t s u rf a c e , c l i m b 5 o r m o r r e m a i n s e a t e d l e s s t h a n 1 h o u r . F o r r e m " n e e d s t o t a k e m i c r o b r e a k s t o c o p e . " • I n t h e a d d i t i o n a l c o m m e n t s t o t h e M R , t h M V A a n d s h e s u s t a i n e d s e v e r e i n j u r i e s . • T h e a p p e l l a n t i s a s s e s s e d a s u s i n g a n a " u s e s c a n e d u r i n g e x a c e r b a t i o n s " ) . T h e w a l k i n g o u t d o o r s a n d t h e G P c o m m e n t e F o r c l i m b i n g s t a i r s , t h e a p p e l l a n t r e q u i r e u s e s a n a s s i s t i v e d e v i c e . T h e G P w r o t e b r e a k s . " T h e a n n e l l a n t i s i n d e p e n d e n t w 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 i n c l u d e d t h e m p r i s e d o f t h e a p p e l l a n t ' s i n fo r m a t i o n a n d s e l f R ) a n d a n a s s e s s o r r e p o rt ( A R ) b o t h d a t e d J u n e e r ( G P ) w h o h a s 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 0 a s t 1 2 m o n t h s . e n t s : 4 , 2 0 1 8 r e g a r d i n g t h e m o t o r v e h i c l e a c c i d e n t ; a t e d A p r i l 7 , 2 0 1 8 ; s t 2 7 , 2 0 1 8 ; T h e r a p i s t ( O T ) p r e p a r e d o n A u g u s t 2 8 , 2 0 1 8 ; m b e r 1 9 , 2 0 1 8 . m a j o r d e p r e s s i o n , c h r o n i c k n e e p a i n , a n d M V A s k e d t o d e s c r i b e t h e a p p e l l a n t ' s m e n t a l o r a n a g e h e r d a i l y l i v i n g a c t i v i t i e s ( D L A ) , t h e G P a n d l i m i t e d p h y s i c a l c a p a c i t y d u e t o M V A p o l y , t h e a p p e l l a n t " h a s c h r o n i c p o s t s e p t i c a r t h r i t i s " f r a c t u r e s , e t c . " a i r m e n t a n d t h e G P w r o t e t h a t t h e a p p e l l a n t t o t h e n u m e r o u s M V A r e l a t e d i n j u r i e s a n d r t e d t h a t t h e a p p e l l a n t c a n w a l k 1 t o 2 b l o c k s e s t e p s u n a i d e d , l i f t 2 t o 7 k g . ( 5 t o 1 5 l b s . ) a n d a i n i n g s e a t e d , t h e G P n o t e d t h a t t h e a p p e l l a n t e G P w r o t e t h a t t h e a p p e l l a n t w a s i n v o l v e d i n a s s i s t i v e d e v i c e f o r w a l k i n g i n d o o r s ( G P n o t e : a p p e l l a n t 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 w i t h d t h a t s h e " c a n n o t w a l k fo r m o r e t h a n 2 b l o c k s . " s p e r i o d i c 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 a n d t h a t t h e a p p e l l a n t " u s e s h a n d r a i l s , n e e d s t o t a k e i t h s t a n d i n o a n d r e a 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
f r o m a n o t h e r p e r s o n f o r l i ft i n g ( G P n o t e : a n d h o l d i n g ( G P n o t e : " u n a b l e t o c a r r y h • I n t h e s e c t i o n o f t h e A R r e l a t i n g t o a s s i s b a t h i n g a i d s ( G P n o t e : " u s e s s t o o l o c c a s t h e a p p e l l a n t t o h e l p c o m p e n s a t e f o r h e u s e a c a n e t o h e l p a m b u l a t e d u e t o i n c r e f r e q u e n t l y b u t n o t a t a l l t i m e s . " I n t h e K i n e s i o l o g y a s s e s s m e n t r e p o r t f o r A u g u s • T h e a p p e l l a n t r e p o r t e d t h a t s h e c a n n o t w l e ft f o o t a n d r i g h t a n k l e , s h e n e e d s t o h o b r e a k s t o w a l k u p a f u l l s e t d u e t o p a i n i • T h e a p p e l l a n t r e p o rt e d t h a t s h e c a n s i t i w e i g h t d u e t o d i s c o m f o rt i n h e r l o w e r b a • T h e a p p e l l a n t r e p o r t e d t h a t s h e c a n s t a n h e r w e i g h t o r s i t d o w n d u e t o p a i n i n h e r • T h e a p p e l l a n t r e p o rt e d f e a r o f p a i n , r e i n t h a t c a r r y i n g s m a l l e r b a g s o f g r o c e r i e s a I n t h e p o r t i o n s o f r e p o r t p r e p a r e d o n A u g u s t 2 8 • T h e a p p e l l a n t i s w a l k i n g v e r y s l o w l y w i t h m i n u t e s o f w a l k i n g . S h e i s w a l k i n g w i t h o a s n e e d e d w h e n p a i n l e v e l s a r e h i g h . S • S h e c l i m b s s t a i r s v e r y s l o w l y a s t h i s i n c r I n h e r s e l f r e p o rt , t h e a p p e l l a n t i n d i c a t e d : • S h e h a s s u s t a i n e d m a n y i n j u r i e s t h r o u g h • I n t h e s p r i n g o f 2 0 1 8 s h e w a s i n a m a j o r s u s t a i n e d m a j o r a n d m u l t i p l e i n j u r i e s : 3 s u r g e ry , l e f t h a n d r e q u i r e d t w o s u r g e r i e s r i g h t l u n g c o l l a p s e d , h e r r i g h t a n k l e w a s w a s c r u s h e d a n d r e q u i r e d s u r g e r y . S h e • S h e c a n n o t w a l k m o r e t h a n a b l o c k a n d t i m e . • S h e c a n n o t s i t , l i e d o w n , o r s t a n d f o r a s • S h e i s t a k i n g p a i n k i l l e r s w h i c h m a k e t h e I n h e 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 , t h e a p p e l l a • H e r p r i m a ry c o n c e r n a n d b a r r i e r t o f u n c t m e d i c a t i o n d a i l y , s h e i s n o t a b l e t o w a l k w o u l d l i k e l y r e q u i r e a w a l k i n g a i d o r w h e u n a s s i s t e d , b u t o c c a s i o n a l l y , w h e n s h e c a n e . S h e u s e s a c a n e i n t h e m o r n i n g s m e d i c a t i o n b e q i n s t o w o r k ." u n a b l e t o l i ft m o r e t h a n 1 5 l b s . " ) a n d fo r c a r r y i n g e a v y o b j e c t s " ) . t a n c e p r o v i d e d , t h e G P i n d i c a t e d t h a t a c a n e a n d i o n a l l y " ) a r e a s s i s t i v e d e v i c e s r o u t i n e l y u s e d b y r i m p a i r m e n t . T h e G P w r o t e : " p a t i e n t n e e d s t o a s e d p a i n i n k n e e . S h e n e e d s t h e c a n e q u i t e t 2 7 , 2 0 1 8 , t h e p h y s i c a l t h e r a p i s t i n d i c a t e d : a l k a f u l l c i t y b l o c k a l l a t o n c e d u e t o p a i n i n h e r l d o n t o r a i l i n g s fo r c l i m b i n g s t a i r s a n d t a k e s n h e r l e ft fo o t , r i g h t a n k l e a n d l e ft k n e e . n a c h a i r f o r 5 m i n u t e s a n d t h e n h a s t o s h i ft h e r c k . d fo r l e s s t h a n 5 m i n u t e s a n d t h e n n e e d s t o s h i ft l e ft f o o t a n d r i g h t a n k l e . j u r y o r d r o p p i n g i t e m s u p o n l i ft i n g . S h e r e p o r t e d r e o k a y b u t " n o m o r e t h a n 5 l b s . " , 2 0 1 8 , t h e O T i n d i c a t e d : l o w s t a m i n a . S h e r e q u i r e s a r e s t a ft e r a b o u t 5 u t a w a l k i n g a i d a t t h i s t i m e a n d m a y u s e a c a n e h e r e q u i r e s m e d i c a t i o n . e a s e s h e r p a i n a n d s h e r e q u i r e s m e d i c a t i o n . o u t h e r l i f e t h a t n o w a ff e c t h e r a c t i v i t i e s . M VA i n w h i c h s h e l o s t b o t h o f h e r p a r e n t s a n d v e r t e b r a e i n h e r n e c k , r i g h t w r i s t r e q u i r e d , h e r c h e s t b o n e w a s b r o k e n a n d s i x r i b s , h e r b r o k e n a n d r e q u i r e d s u r g e r y , a n d h e r l e ft f o o t w a s h o s p i t a l i z e d f o r s e v e n w e e k s . s h e u s e s a w a l k e r a t h o m e t h e m a j o r i t y o f t h e i g n i f i c a n t a m o u n t o f t i m e . p a i n " t o l e r a b l e t o j u s t l i v e . " n t w r o t e : i o n i s f o o t , a n k l e a n d k n e e p a i n . W i t h o u t m o r e t h a n 5 0 s t e p s w i t h o u t d e b i l i t a t i n g p a i n , a n d e l c h a i r . M o s t o ft e n , s h e i s a b l e t o w a l k i s i n " h i g h l e v e l s o f p a i n o r f a t i g u e , " s h e u s e s a w h e n h e r fe e t a r e m o r e p a i n f u l a n d u n t i l t h e
• T o m a n a g e t h e a c u t e i n j u r i e s s u s t a i n e d a n d i s a c t i v e l y i n v o l v e d i n a r e h a b i l i t a t i o n • T h e G P m e n t i o n e d a r t h r i t i s i n h e r l e f t k n i s n o t h e r p r i m a r y c o n c e r n . M e n t a l I m p a irm e n t I n t h e M R a n d t h e A R , t h e G P r e p o rt e d : • I n t e r m s o f t h e a p p e l l a n t ' s h e a l t h h i s t o ry e x a c e r b a t e d b y a m a j o r M V A . " • 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 t h c o m • 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 a r e a s o f e m o t i o n a l d i s t u r b a n c e a n d m o t • T h e a p p e l l a n t h a s a g o o d a b i l i t y t o c o m m r e a d i n g , w r i t i n g a n d h e a r i n g . • W i t h r e s p e c t t o t h e s e c t i o n o f t h e A R r e l 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 G P a s s e f u n c t i o n s ( t h e G P c o m m e n t e d t h a t h e r s m o d e r a t e i m p a c t s i n t h e a r e a s o f m o t i v a i m p a c t i n t h e a r e a o f a t t e n t i o n / c o n c e n t r l i s t e d a r e a s o f f u n c t i o n i n g . T h e G P d i d • F o r s o c i a l f u n c t i o n i n g , t h e a p p e l l a n t i s i n d e c i s i o n s , a n d r e q u i r e s p e r i o d i c s u p p o rt/ a p p r o p r i a t e l y w i t h o t h e r s a n d s e c u r i n g a h e l p f r o m fa m i l y " ) . T h e a p p e l l a n t r e q u i r p e r s o n w i t h d e v e l o p i n g a n d m a i n t a i n i n g w i t h d e a l i n g a p p r o p r i a t e l y w i t h u n e x p e c • T h e a p p e l l a n t h a s g o o d f u n c t i o n i n g i n h e f u n c t i o n i n g i n h e r e x t e n d e d s o c i a l n e t w o • A s k e d t o d e s c r i b e t h e s u p p o r t / s u p e rv i s i o c o m m u n i t y , t h e G P l e ft t h i s s e c t i o n i n c o • I n t h e a d d i t i o n a l c o m m e n t s t o t h e A R , t h w h i c h b o t h o f h e r p a r e n t s d i e d a n d t h e a n d a n e x a c e r b a t i o n o f h e r d e p r e s s i o n . I n t h e p o rt i o n s o f t h e r e p o rt p r e p a r e d o n A u g u s • O n t h e p a t i e n t h e a l t h q u e s t i o n n a i r e , t h e h e r a b i l i t y t o w o r k , t a k e c a r e o f t h i n g s a t d i ff i c u l t " a s a r e s u l t o f t h e i d e n t i f i e d i s s u e i s s u e s w e r e h a v i n g t r o u b l e f a l l i n g a s l e e p f e e l i n g b a d a b o u t h e r s e l f . • T h e O T w r o t e t h a t t h i s s c o r e i n d i c a t e d " m r e q u i r e d . "i n t h e M V A , s h e s p e n t s e v e n w e e k s i n h o s p i t a l p r o g r a m i n t h e c o m m u n i t y . e e a n d t h e c h r o n i c a r t h r i t i s b o t h e r s h e r d a i l y b u t , t h e a p p e l l a n t " h a s m a j o r d e p r e s s i o n t h a t w a s m u n i c a t i o n . h h e r c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g i n t h e i v a t i o n . T h e G P d i d n o t p r o v i d e a n y c o m m e n t s . u n i c a t e i n a l l a r e a s , s p e c i f i c a l l y : s p e a k i n g , a t i n g t o d a i l y 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 i t i v e s s e d m a j o r i m p a c t s i n t h e a r e a s o f b o d i l y l e e p i s " i n t e r r u p t e d " ) a n d m o t i v a t i o n . T h e r e a r e t i o n , i m p u l s e c o n t r o l a n d m e m o r y , w i t h m i n i m a l a t i o n . T h e r e a r e n o i m p a c t s t o t h e r e m a i n i n g 8 n o t p r o v i d e a n y c o m m e n t s . d e p e n d e n t w i t h m a k i n g a p p r o p r i a t e s o c i a l s u p e r v i s i o n f r o m a n o t h e r p e r s o n w i t h i n t e r a c t i n g s s i s t a n c e f r o m o t h e r s ( G P n o t e : " o ft e n n e e d s e s c o n t i n u o u s s u p p o rt/ s u p e r v i s i o n f r o m a n o t h e r r e l a t i o n s h i p s ( G P n o t e : " n e e d s f a m i l y h e l p " ) a n d t e d d e m a n d s ( G P n o t e : " n e e d s f a m i l y h e l p " ) . r i m m e d i a t e s o c i a l n e t w o r k a n d m a r g i n a l r k s . n r e q u i r e d t o m a i n t a i n t h e a p p e l l a n t i n t h e m p l e t e . e G P w r o t e t h a t t h e a p p e l l a n t w a s i n a M V A i n a p p e l l a n t s u ff e r e d s e v e r e p o l y t r a u m a i n j u r i e s t 2 8 , 2 0 1 8 , t h e O T i n d i c a t e d : a p p e l l a n t s c o r e d 1 5 o u t o f 2 7 a n d r e p o r t e d t h a t h o m e a n d g e t a l o n g w i t h o t h e r s i s " s o m e w h a t s . T h e m a i n a r e a s t h e a p p e l l a n t i d e n t i f i e d a s , f e e l i n g t i r e d a n d h a v i n g l i t t l e e n e r g y , a n d a j o r d e p r e s s i o n , m o d e r a t e l y s e v e r e s u p p o rt
In her self-report, the appellant wrote: • She has taken anti-depressant medications "on and off' since she was a teen and that she suffered abandonment and abuse issues while growing up. • She has major insomnia due to nightmares of the accident and debilitating pain. • She has memory loss at times due to stress and anxiety. In her Request for Reconsideration, the appellant wrote that: • She was diagnosed with depression as a teen and she has been managing with medication most of her life. • She has a history of abuse in her family and led a very independent childhood/adolescent life that came with many challenges regarding her mental health. • There are days that she does not leave her home or her bed because of sadness and depressive symptoms. Daily Living Activities (DLA) In the MR and the AR, the GP reported: • The appellant has not been prescribed medication and/or treatment that interfere with her ability to perform DLA. • For the personal care DLA, the appellant is independent with performing all of the tasks, specifically dressing, grooming, bathing, toileting, feeding self, regulating diet, transfers in/out of bed, and transfers on/off chair. • Regarding the DLA of basic housekeeping, the appellant requires periodic assistance with doing laundry and basic housekeeping, with a note by the GP that she "takes help from friend/kids." • For the shopping DLA, the appellant is independent with all tasks with the exception of carrying purchases home, for which she requires continuous assistance from another person and the GP wrote that she "takes help from son." Specifically, she is independent with the tasks of going to and from stores, reading prices and labels, making appropriate choices and paying for purchases. The appellant uses an assistive device for going to and from stores, which the GP described as "needs to use car for mobility." • Regarding the meals DLA, the appellant is independent with all of the listed tasks, specifically, meal planning, food preparation, cooking and safe storage of food. • For the pay rent and bills DLA, the appellant is independent with all tasks, including banking and budgeting. • Regarding the medications DLA, the appellant is independent with all of the tasks, specifically: filling/refilling prescriptions, taking as directed, with safe handling and storage. • For the transportation DLA, the appellant is independent with performing all of the tasks, specifically getting in and out of a vehicle, using public transit and using transit schedules and arranging transportation. In the Kinesiology assessment report for August 27, 2018, the physical therapist indicated: • The appellant expressed that she has learned how to adapt a lot of her movements durinn manual tasks but is still unable to comolete manv of her ADLs (activities of dailv
l i v i n g ) w i t h o u t d i ff i c u l t y a n d o ft e n n e e d s I n t h e p o rt i o n s o f t h e r e p o rt p r e p a r e d o n A u g u s • I n t e r m s o f f u n c t i o n a l s t a t u s , t h e a p p e l l a b o w e l m a n a g e m e n t , m e d i c a t i o n m a n a g e m a n a g e m e n t . • T h e a p p e l l a n t r e q u i r e s e q u i p m e n t o r a d d s w a l l o w i n g , g r o o m i n g , b a t h i n g / s h o w e r i n t r a n s f e r s t o t h e t o i l e t , t r a n s fe r s t o t h e b a p r e p a r a t i o n . • T h e a p p e l l a n t r e q u i r e s s u p e r v i s i o n o r s e • 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 w i t h s d o a s m u c h a s s h e c a n , b u t w i l l a s k c h i l d ( n o t e : " T r i e s t o d o t h e fo l d i n g , b u t c a n n o ( n o t e : " N o t a b l e t o d o m a n y d u t i e s b e c a u l i g h t d u t i e s . R e p o rt s i t i s j u s t n o t g e t t i n g a b l e . " ) • 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 w i t h c s t a y i n g w i t h t h e i r f a t h e r d u e t o t h e i r h i g h i n j u ry f r o m t h e M V A . I n h e r s e l f r e p o r t , t h e a p p e l l a n t i n d i c a t e d : • S h e n e e d s h e l p t o c o o k , t o c l e a n , s o m e t • S i n c e h e r l a s t M V A , s h e h a s n o t b e e n a I n h e 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 , t h e a p p e l l a p a s t n u m b e r o f y e a r s w i l l b e p e r m a n e n t d i s a b i l a n d h e r c h i l d r e n . N e e d fo r H e l p T h e G P r e p o rt 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 r e a p p e l l a n t " i s i n n e e d o f a s s i s t a n c e w i t h m o b i l i t y g r o c e r i e s , e t c . a n d d a i l y a c t i v i t i e s i . e . c l e a n i n g r o u t i n e l y u s e s a c a n e a n d b a t h i n g a i d s ( n o t e : " u h e r i m p a i r m e n t . T h e G P a d d e d c o m m e n t s t h a a m b u l a t e d u e t o i n c r e a s e d p a i n i n k n e e . S h e n t i m e s . " A d d i t i o n a l i n fo r m a t i o n I n h e r N o t i c e o f A p p e a l d a t e d D e c e m b e r 1 0 , 2 0 w i t h t h e m i n i s t r y ' s r e c o n s i d e r a t i o n d e c i s i o n a n d c r i t e r i a o f h a v i n g a s e v e r e i m p a i r m e n t w h i c h d i r d a i l y l i v i n g a n d r e q u i r e s a s s i s t a n c e a s a r e s u l t . 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 : • S h e h a s a s e v e r e m e n t a l i m o a i r m e n t . A a s s i s t a n c e fo r e v e n s i m p l e t a s k s . t 2 8 , 2 0 1 8 , t h e O T i n d i c a t e d : n t i s a b l e t o p e rf o r m e a t i n g / f e e d i n g , b l a d d e r a n d m e n t , t r a n s f e r s t o a v e h i c l e , a n d m o n e y i t i o n a l t i m e t o c o m p l e t e s o m e t a s k s , s p e c i f i c a l l y , g , d r e s s i n g h e r l o w e r b o d y , b e d m o b i l i t y , t h t u b / s h o w e r , t r a n s p o rt a t i o n , a n d m e a l t u p w i t h d r e s s i n g h e r u p p e r b o d y , a n d s l e e p . o m e t a s k s , s p e c i f i c a l l y : s h o p p i n g ( n o t e : " t r y i n g t o r e n t o c o m p l e t e s h o p p i n g i f n e e d e d . " ) , l a u n d r y t c o m p l e t e t h e h e a v y l a u n d r y t a s k s " ) , c l e a n i n g s e o f p h y s i c a l i n j u r y a n d p a i n . T r i e s t o c o m p l e t e d o n e , o r s h e a s k s h e r k i d s t o c o m p l e t e w h e n h i l d / p a r e n t c a r e w i t h h e r t w o y o u n g e r c h i l d r e n e r c a r e n e e d s t h a t s h e c a n n o t c o m p l e t e d u e t o i m e s t o s h o w e r . b l e t o c a r e f o r h e r c h i l d r e n o n h e r o w n . n t w r o t e t h a t t h e i n j u r i e s s h e s u s t a i n e d i n t h e i t i e s a n d i m p a c t h e r f u n c t i o n i n c a r i n g f o r h e r s e l f c e i v e s h e l p f r o m f a m i l y a n d w r o t e t h a t t h e a n d w i t h e x t e n d e d d a i l y a c t i v i t i e s i . e . c a r r y i n g h o u s e , e t c . " T h e G P i n d i c a t e d t h a t t h e a p p e l l a n t s e s s t o o l s o c c a s i o n a l l y " ) t o h e l p c o m p e n s a t e fo r t t h e a p p e l l a n t " n e e d s t o u s e a c a n e t o h e l p e e d s t h e c a n e q u i t e f r e q u e n t l y b u t n o t a t a l l 1 8 , t h e a p p e l l a n t e x p r e s s e d h e r d i s a g r e e m e n t w r o t e t h a t s h e b e l i e v e s t h a t s h e m e e t s t h e 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 c t i v i t i e s o f s d e t a i l e d i n h e r n o t e s , s h e h a s s u ff e r e d a b u s e
most of her life. It started when she was a child and is a significant part of the reason for her depression. • In the spring of last year, her depression got much worse. She can go f o r weeks without getting out of bed. • Her depression is taking her away from her children. Her children have missed school or are late. • Sometimes she does not shower. Sometimes she does not bathe f o r days. • She has lost a lot of weight in the last couple of months. • She does not cook for her children. • ICBC had to get a housekeeper for her because she does not clean her own house. • She has not seen her doctor in 3 months. He continues to refill her prescriptions but she has not physically seen him. • Her ankle swells up periodically. She is losing the feeling in her thumb and she cannot feel her pinky finger. Her left knee swells up as well. • She is getting physical rehabilitation therapy and she tries to get to as many sessions as possible but it hurts to go. She has started chiropractic treatments and massage therapy. • She does not wear a bra most of the time because it hurts. Her ribs were broken in the MVA and sometimes it is hard to breathe and she does not sleep well. • Her biggest concern is that she cannot get in to see her doctor. From the time he completed the application, a lot of the information has changed. She did not want to take the application back to the doctor and that is why she submitted the other reports. • She has lumps in her breasts that need to have biopsies. She is always dealing with something, it is never-ending. • She used to be able to jog 6 miles and now she can barely walk a block. • She cannot take her children to the park anymore, or take them swimming. • She has a hard time putting on her own socks. She has no feeling in her pinky and her thumb so it is difficult to pick things up. • For grooming, she does not comb her hair. Grab bars were put in her bathroom and were funded by ICBC. • She is okay with toileting and feeding herself. Regulating her diet is a problem since she lost so much weight. • Her children have to help her get out of bed some mornings. Both of her feet hurt so badly when she first gets up. • She uses the arms of a chair to get up out of the chair and she has a high stool that she uses as well. • She does not do her laundry. • She can drive to and from the store and use a scooter in the store but she does not carry her own groceries. • For meals, she does not do a lot of cooking as she cannot stand for very long. • The bottles for her medications are hard to open if she cannot get blister packs. Her roommate helps her. • Getting in and out of her vehicle is difficult. • She was addicted to drugs for over a decade so the ability to make appropriate social decisions was obviously impacted. • She does not ao anywhere to interact with other oeonle. She needs help all around. She
d o e s n o t h a v e a " s o c i a l n e t w o r k " a s s h e • S h e i s s u p p o s e d t o b e u s i n g a c a n e b u t S h e h a d a c a n e b e f o r e t h a t w a s m i s p l a c h a v e r e a l l y u s e d t h e c a n e . S h e u s e d a i n t h e s p r i n g o f 2 0 1 8 b u t n o l o n g e r u s e s • S h e a g r e e s t h a t t h e m i n i s t r y d i d n o t h a v w e r e c o n s i d e r e d . T h a t i s w h y s h e s u b m t h e O T . S h e d o e s n o t k n o w w h y t h e G P w h e n h e s i g n e d t h e M R a n d t h e A R i n J • S h e a n d h e r l a w y e r h a v e t r i e d t o r e a c h t n e w f a m i l y d o c t o r . S h e h a s s e e n t h e G P fo r 3 d a y s e v e r y 6 w e e k s . • I t t o o k t h e G P 6 m o n t h s t o c o m p l e t e t h e c o m p l e t e d t h e A R . • A l t h o u g h s h e u s e d t h e w o r d " s o m e t i m e s d i ff i c u l t fo r h e r t o g e t o u t o f b e d e v e r y m b e f o r e s h e g e t s o u t o f b e d a n d s h e w a i t s • T h e k i n e s i o l o g y r e p o r t w a s c o m p l e t e d a 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 h e a r i n g , t h e m i n i s t r y c l a r i f i e d t h a t t h e a p p e l l a n t p a rt i c u l a r l y s i n c e s h e s t a t e d t h a t h e r c o n d i t i o n h A d m i s s ib ili ty o f A d d i t i o n a l I n f o r m a ti o n T h e m i n i s t r y d i d n o t r a i s e a n o b j e c t i o n t o t h e a p h e r t e s t i m o n y , w i t h o n e e x c e p t i o n , a s b e i n g i n s f r o m m e d i c a l c o n d i t i o n s r e f e r r e d t o i n t h e P W D r e c o n s i d e r a t i o n . T h e r e f o r e , t h e p a n e l a d m i tt e d 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 A s s i s t H o w e v e r , t h e p a n e l d i d n o t a d m i t t h e r e f e r e n c e a r e s u l t o f l u m p s fo u n d i n h e r b r e a s t s , a s t h e i n r e c o n s i d e r a t i o n a n d w a s n o t i n s u p p o rt o f i n f o r m t h e r e fo r e , d o e s n o t m e e t t h e r e q u i r e m e n t s o f S A s s i s t a n c e A c t . T h e a r g u m e n t s m a d e b y t h e a p p e l l a n t i n h e r R e P a r t F R e a s o n s fo r P a n e l D e c i s i o n , b e l o w .h a s n o f r i e n d s . S h e d o e s n o t d o a n yt h i n g . s h e h a s n o t r e c e i v e d a p p r o v a l f r o m I C B C y e t . e d . H e r a n k l e i s s w o l l e n t o d a y a n d s h e c o u l d w a l k e r i n d o o r s f o r a p e r i o d o f t i m e a ft e r t h e M V A t h e w a l k e r . e m u c h i n f r o n t o f t h e m w h e n t h e d o c t o r ' s r e p o r t s i t t e d t h e o t h e r r e p o r t s b y t h e k i n e s i o l o g i s t a n d w o u l d r e p o r t h e r f u n c t i o n i n g p r i o r t o t h e M V A u n e 2 0 1 8 , a ft e r t h e d a t e o f t h e M V A . h e G P w i t h n o r e s p o n s e a n d s h e c a n n o t g e t a f o r a b o u t 1 4 y e a r s a n d n o w h e i s o n l y a v a i l a b l e a p p l i c a t i o n . S h e w a s w i t h t h e G P w h e n h e " i n h e r s e l f r e p o r t , s h e s a i d t h a t , i n f a c t , i t i s o r n i n g . S h e h a s t o t a k e h e r p a i n m e d i c a t i o n s fo r t h e m t o s t a rt t o w o r k b e f o r e s h e c a n m o v e . t a c l i n i c b y a k i n e s i o l o g i s t . i o n a s s u m m a r i z e d a t t h e h e a r i n g . A t t h e i s a b l e t o a p p l y a g a i n f o r P W D d e s i g n a t i o n , a s g o t t e n w o r s e , i f h e r a p p e a l i s n o t s u c c e s s f u l . p e l l a n t ' s o r a l t e s t i m o n y . T h e p a n e l c o n s i d e r e d u p p o r t o f , a n d t e n d i n g t o c o r r o b o r a t e , t h e i m p a c t a p p l i c a t i o n w h i c h w a s b e fo r e t h e m i n i s t r y a t t h i s a d d i t i o n a l i n f o r m a t i o n i n a c c o r d a n c e w i t h a n c e A c t . b y t h e a p p e l l a n t t o t h e n e c e s s i t y f o r b i o p s i e s a s f o r m a t i o n w a s n o t b e fo r e t h e m i n i s t ry a t a t i o n b e fo r e t h e m i n i s t ry a t r e c o n s i d e r a t i o n a n d , 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 q u e s t f o r R e c o n s i d e r a t i o n w i l l b e a d d r e s s e d i n
PART F -REASONS FOR PANEL DECISION The issue on appeal is whether the ministry's reconsideration decision, which found that the appellant is not eligible for PWD designation, was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. The ministry found that the evidence does not establish that the appellant has a severe mental or physical impairment and that her DLA are, in the opinion of a prescribed professional, directly and significantly restricted either continuously or periodically for extended periods. Also, it could not be determined that, as a result of those restrictions, the appellant requires the significant help or supervision of another person, the use of an assislive device, or the services of an assistance animal to perform DLA. The criteria for being designated as a PWD are set out in Section 2 of the EAPWDA as follows: Persons with disabilities 2 (1) In this section: "assistive device 11 means a device designed to enable a person to perform a daily living activity that, because of a severe mental or physical impairment, the person is unable to perform; "daily living activity" has the prescribed meaning; "prescribed professional" has the prescribed meaning. (2) The minister may designate a person who has reached 18 years of age as a person with disabilities for the purposes of this Act if the minister is satisfied that the person is in a prescribed class of persons or that the person has a severe mental or physical impairment that (a) in the opinion of a medical practitioner or nurse practitioner is likely to continue for at least 2 years, and (b) in the opinion of a prescribed professional (i)directly and significantly restricts the person's ability to perform daily living activities either (A)continuously, or (B)periodically for extended periods, and (ii)as a result of those restrictions, the person requires help to perform those activities. (3)For the purposes of subsection (2), (a) a person who has a severe mental impairment includes a person with a mental disorder, and (b)a person requires help in relation to a daily living activity if, in order to perform it, the person requires (i) an assistive device, (ii) the significant help or supervision of another person, or (iii)the services of an assistance animal. (4) The minister may rescind a designation under subsection (2).
T h e E A P W D R p r o v i d e s a s f o l l o w s : D e f i n i t i o n s f o r A c t 2 ( 1 ) F o r t h e p u r p o s e s o f t h e A c t a n d t h i s r e g u l a t i o n , " d a i l y l i v i n g a c t i v i t i e s " , ( a ) i n r e l a t i o n t o a p e r s o n w h o h a s a s e v e r e p h y s i c a l i m p a i r m e n t o r a s e v e r e m e n t a l i m p a i r m e n t , m e a n s t h e 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 f f e c t i v e l y . ( 2 ) F o r t h e p u r p o s e s o f t h e A c t , " p r e s c r i b e d p r o fe s s i o n a l " m e a n s a p e r s o n w h o i s ( a ) a u t h o r i z e d u n d e r a n e n a c t m e n t t o p r a c t i s e t h e p r o f e s s i o n o f ( i ) m e d i c a l p r a c t i t i o n e r , ( i i ) r e g i s t e r e d p s y c h o l o g i s t , { i i i ) r e g i s t e r e d n u r s e o r r e g i s t e r e d p s y c h i a t r i c n u r s e , ( i v ) o c c u p a t i o n a l t h e r a p i s t , ( v ) p h y s i c a l t h e r a p i s t , ( v i ) s o c i a l w o r k e r , ( v i i ) c h i r o p r a c t o r , o r ( v i i i ) n u r s e p r a c t i t i o n e r , o r ( b ) a c t i n g i n t h e c o u r s e o f t h e p e r s o n ' s e m p l o y m e n t a s a s c h o o l p s y c h o l o g i s t b y ( i ) a n a u t h o r i t y , a s t h a t t e r m i s d e f i n e d i n s e c t i o n 1 ( 1 ) o f t h e I n d e p e n d e n t S c h o o l A c t , o r ( i i ) a b o a r d o r a f r a n c o p h o n e e d u c a t i o n a u t h o r i t y , a s t h o s e t e r m s a r e d e f i n e d i n s e c t i o n 1 ( 1 ) o f t h e S c h o o l A c t , i f q u a l i f i c a t i o n s i n p s y c h o l o g y a r e a c o n d i t i o n o f s u c h e m p l o y m e n t .
P a r t 1 . 1 P e r s o n s w i t h D i s a b i l i t i e s A l t e r n a t i v e g r o u n d s f o r d e s i g n a t i o n u n d e r s e c t i o n 2 o f A c t 2 . 1 T h e f o l l o w i n g c l a s s e s o f p e r s o n s a r e p r e s c r i b e d f o r t h e p u ( a ) a p e r s o n w h o i s e n r o l l e d i n P l a n P ( P a l l i a t i v e C a r e ) u n d ( b ) a p e r s o n w h o h a s a t a n y t i m e b e e n d e t e r m i n e d t o b e M i n i s t r y o f C h i l d r e n a n d F a m i l y D e v e l o p m e n t ' s A t H o m ( c ) a p e r s o n w h o h a s a t a n y t i m e b e e n d e t e r m i n e d b y C o m c o m m u n i t y l i v i n g s u p p o r t u n d e r t h e C o m m u n i t y L i v i n g ( d ) a p e r s o n w h o s e f a m i l y h a s a t a n y t i m e b e e n d e t e r m i r e c e i v e c o m m u n i t y l i v i n g s u p p o r t u n d e r t h e C o m m u n i t p e r s o n ; ( e ) a p e r s o n w h o i s c o n s i d e r e d t o b e d i s a b l e d u n d e r s e c S e v e r e P h y s i c a l I m p a i rm 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 r y w a e s t a b l i s h e s a s e v e r e p h y s i c a l i m p a i r m e n t . T h e d i a g n o s e d b y t h e G P w i t h c h r o n i c k n e e p a i n a n t h a t t h e a p p e l l a n t " h a s c h r o n i c p a i n a n d p o s t s e v e r t e b r a l f r a c t u r e s , r i b f r a c t u r e s , e t c . " I n t h e a d t h e a p p e l l a n t w a s i n v o l v e d i n a M V A a n d s h e s 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 w r o t e t h a t t h e G a l t h o u g h t h e c h r o n i c a rt h r i t i s b o t h e r s h e r d a i l y , w r o t e t h a t h e r p r i m a r y c o n c e r n a n d b a r r i e r t o f u I n h e r s e l f r e p o rt , t h e a p p e l l a n t w r o t e t h a t s h e s a f f e c t h e r a c t i v i t i e s . I n t h e s p r i n g o f 2 0 1 8 , s h e p a r e n t s a n d s u s t a i n e d m a j o r a n d m u l t i p l e i n j u r i w r i s t w h i c h r e q u i r e d s u r g e r y , h e r l e f t h a n d t h a t b r o k e n a n d s i x r i b s , h e r r i g h t l u n g c o l l a p s e d , h e a n d h e r l e f t f o o t w a s c r u s h e d a n d r e q u i r e d s u r g p a i n k i l l e r s t o m a k e t h e p a i n " t o l e r a b l e t o j u s t l i v c o n d i t i o n h a s d e t e r i o r a t e d s i n c e t h e t i m e t h e M t o r e q u i r e p a i n m e d i c a t i o n . A d i a g n o s i s o f a s e r i o u s m e d i c a l c o n d i t i o n o r c o e l i g i b i l i t y o r e s t a b l i s h a s e v e r e i m p a i r m e n t . A n p s y c h o l o g i c a l , a n a t o m i c a l , o r p h y s i o l o g i c a l s t r u a b i l i t y t o f u n c t i o n i n d e p e n d e n t l y , e ff e c t i v e l y , a p p 2 ( 2 ) 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 t r y r p o s e s o f s e c t i o n 2 ( 2 ) [ p e r s o n s w i t h d i s a b i l i t i e s ] o f t h e A c t : e r t h e D r u g P l a n s R e g u l a t i o n , B . C . R e g . 7 3 / 2 0 1 5 ; e l i g i b l e t o b e t h e s u b j e c t o f p a y m e n t s m a d e t h r o u g h t h e e P r o g r a m ; m u n i t y L i v i n g B r i t i s h C o l u m b i a t o b e e l i g i b l e t o r e c e i v e A u t h o r i t y A c t ; n e d b y C o m m u n i t y L i v i n g B r i t i s h C o l u m b i a t o b e e l i g i b l e t o y L i v i n g A u t h o r i t y A c t t o a s s i s t t h a t f a m i l y i n c a r i n g fo r t h e t i o n 4 2 ( 2 ) o f t h e C a n a d a P e n s i o n P l a n ( C a n a d a ) . s n o t s a t i s f i 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 m i n i s t ry a c k n o w l e d g e d t h a t t h e a p p e l l a n t w a s d M V A p o l y t r a u m a . T h e G P w r o t e i n t h e M R p t i c a rt h r i t i s " a n d s h e " s u s t a i n e d p o l y t r a u m a ; d i t i o n a l c o m m e n t s t o t h e M R , t h e G P w r o t e t h a t u s t a i n e d s e v e r e i n j u r i e s . I n h e r R e q u e s t f o r P m e n t i o n e d a rt h r i t i s i n h e r l e ft k n e e a n d , t h i s i s n o t h e r p r i m a ry c o n c e r n . T h e a p p e l l a n t n c t i o n i s f o o t , a n k l e a n d k n e e p a i n . u s t a i n e d m a n y i n j u r i e s t h r o u g h o u t h e r l i f e t h a t w a s i n a m a j o r M VA i n w h i c h s h e l o s t b o t h o f h e r e s , i n c l u d i n g t o 3 v e rt e b r a e i n h e r n e c k , h e r r i g h t r e q u i r e d tw o s u r g e r i e s , h e r c h e s t b o n e w a s r r i g h t a n k l e w a s b r o k e n a n d r e q u i r e d s u r g e ry , e ry . T h e a p p e l l a n t a l s o w r o t e t h a t s h e i s t a k i n g e . " T h e a p p e l l a n t s t a t e d a t t h e h e a r i n g t h a t h e r R a n d t h e A R w e r e c o m p l e t e d a n d s h e c o n t i n u e s n d i t i o n s d o e s n o t i n i t s e l f d e t e r m i n e P W D " i m p a i r m e n t " i n v o l v e s a l o s s o r a b n o r m a l i t y o f c t u r e o r f u n c t i o n i n g c a u s i n g a r e s t r i c t i o n i n t h e r o p r i a t e l y , o r fo r a r e a s o n a b l e d u r a t i o n . S e c t i o n b e s a t i s f i e d t h a t t h e i m p a i r m e n t i s s e v e r e b e fo r e
t h e m i n i s t r y m a y d e s i g n a t e a n a p p l i c a n t a s a P t h e m i n i s t r y m u s t c o n s i d e r t h e n a t u r e o f t h e i m p f u n c t i o n i n g . T h e m i n i s t r y c o n s i d e r e d t h e i m p a c t s o f t h e a p p d a i l y f u n c t i o n i n g , r e v i e w i n g t h e a s s e s s m e n t s p r e p o r t b y t h e O T . T h e m i n i s t r y w r o t e t h a t t h e G w a l k 1 t o 2 b l o c k s u n a i d e d o n a f l a t s u r f a c e , c l i r e m a i n s e a t e d l e s s t h a n 1 h o u r . I n h e r R e q u e s t h e f u n c t i o n a l s k i l l s d e s c r i b e d b y t h e G P w e r e o 2 0 1 8 a n d a r e n o t r e l e v a n t a s h e r p h y s i c a l f u n c t 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 d o e s n o t k n o w w h M V A w h e n h e s i g n e d t h e M R a n d t h e A R i n J u T h e m i n i s t r y a l s o c o n s i d e r e d t h a t t h e G P a s s e s d e v i c e fo r w a l k i n g i n d o o r s a n d t h e G P n o t e d t h s e c t i o n o f t h e A R r e l a t i n g t o a s s i s t a n c e p r o v i d e a r e a s s i s t i v e d e v i c e s r o u t i n e l y u s e d b y t h e a p p t h e G P w r o t e : " p a t i e n t n e e d s t o u s e a c a n e t o h " s h e n e e d s t h e c a n e q u i t e f r e q u e n t l y b u t n o t a t i n d i c a t 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 s c o n t i n u o u s w a l k f o r m o r e t h a n 2 b l o c k s . " T h e m i n i s t r y a l s o c o n s i d e r e d t h e r e p o r t p r e p a r e t h a t t h e a p p e l l a n t i s w a l k i n g v e r y s l o w l y w i t h l o m i n u t e s o f w a l k i n g . T h e m i n i s t r y c o n s i d e r e d t h w i t h o u t a w a l k i n g a i d a n d s h e m a y u s e a c a n e K i n e s i o l o g y a s s e s s m e n t r e p o r t f o r A u g u s t 2 7 , 2 r e p o rt e d t h a t s h e c a n n o t w a l k a f u l l c i t y b l o c k a a n k l e . T h e a p p e l l a n t w r o t e i n h e r s e l f r e p o r t t h u s e s a w a l k e r a t h o m e t h e m a j o r i t y o f t h e t i m e . u s e d t h e w a l k e r fo r a p e r i o d o f t i m e a f t e r t h e a c r e q u i r e s a c a n e a t t i m e s . I n h e r R e q u e s t fo 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 a b l e t o w a l k m o r e t h a n 5 0 s t e p s w i t h o u t d e b i l i t a s h e i s a b l e t o w a l k u n a s s i s t e d b u t o c c a s i o n a l l y s h e u s e s a c a n e . A t t h e h e a r i n g , t h e a p p e l l a n t m i s p l a c e d b u t s h e i s c u r r e n t l y w a i t i n g t h e a p p r o p a n e l f i n d s t h a t t h e m i n i s t r y r e a s o n a b l y c o n s i d e a p p e l l a n t ' s m o b i l i t y i s t h a t , w i t h u s e o f p a i n m e d u n a i d e d a n d s h e r e q u i r e s a c a n e " d u r i n g e x a c e W D . T o a s s e s s t h e s e v e r i t y o f t h e i m p a i r m e n t , a i r m e n t a n d t h e e x t e n t o f i t s i m p a c t o n d a i l y e l l a n t ' s d i a g n o s e d m e d i c a l c o n d i t i o n s o n h e r r o v i d e d i n t h e M R a n d t h e A R a s w e l l a s i n t h e P r e p o r t e d i n t h e M R t h a t t h e a p p e l l a n t i s a b l e t o m b 5 o r m o r e s t e p s u n a i d e d , l i ft 5 t o 1 5 l b s . a n d 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 a r g u e d t h a t b j e c t i v e s f r o m b e f o r e t h e M V A i n t h e s p r i n g o f i o n h a s d e c r e a s e d s i g n i f i c a n t l y . A t t h e h e a r i n g , y t h e G P w o u l d r e p o rt h e r f u n c t i o n i n g p r i o r t o t h e n e 2 0 1 8 , a ft e r t h e d a t e o f t h e M V A . s e d t h e a p p e l l a n t i n t h e A R a s u s i n g a n a s s i s t i v e a t s h e " u s e s c a n e d u r i n g e x a c e r b a t i o n s . " I n t h e d , t h e G P i n d i c a t e d t h a t a c a n e a n d b a t h i n g a i d s e l l a n t t o h e l p c o m p e n s a t e fo r h e r i m p a i r m e n t a n d e l p a m b u l a t e d u e t o i n c r e a s e d p a i n i n k n e e " a n d a l l t i m e s . " F o r w a l k i n g o u t d o o r s , t h e G P a s s i s t a n c e a n d c o m m e n t e d t h a t s h e " c a n n o t d o n A u g u s t 2 8 , 2 0 1 8 i n w h i c h t h e O T i n d i c a t e d w s t a m i n a a n d s h e r e q u i r e s a r e s t a f t e r a b o u t 5 a t t h e O T w r o t e t h a t t h e a p p e l l a n t i s w a l k i n g a s n e e d e d w h e n p a i n l e v e l s a r e h i g h . I n t h e 0 1 8 , t h e k i n e s i o l o g i s t i n d i c a t e d t h a t t h e a p p e l l a n t l l a t o n c e d u e t o p a i n i n h e r l e ft f o o t a n d r i g h t a t s h e c a n n o t w a l k m o r e t h a n a b l o c k a n d s h e A t t h e h e a r i n g , t h e a p p e l l a n t c l a r i f i e d t h a t s h e c i d e n t a n d s h e n o l o n g e r u s e s a w a l k e r b u t n t w r o t e t h a t w i t h o u t m e d i c a t i o n d a i l y , s h e i s n o t t i n g p a i n . T h e a p p e l l a n t w r o t e t h a t m o s t o ft e n , w h e n s h e i s i n " h i g h l e v e l s o f p a i n o r f a t i g u e , " c l a r i f i e d t h a t s h e h a d a c a n e w h i c h w a s v a l f o r f u n d i n g o f a c a n e t h r o u g h I C B C . T h e r e d t h a t t h e c o n s i s t e n t e v i d e n c e r e g a r d i n g t h e i c a t i o n , s h e c a n w a l k o u t d o o r s u p t o o n e b l o c k r b a t i o n s " o r " w h e n p a i n l e v e l s a r e h i g h . "
T h e 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 r e p o rt e d t h f r o m a n o t h e r p e r s o n a n d u s e s a n a s s i s t i v e d e v t h e a p p e l l a n t " u s e s h a n d r a i l s " a n d t h e a p p e l l a n m i n i s t r y r e a s o n a b l y c o n s i d e r e d t h a t h a n d r a i l s d d e v i c e a 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 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 t h e a p p e l l a n t c l i m b s s t a i r s v e r y s l o w l y a s t h i s i 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 r e a s o n a b l y c o t h e u s e o f p a i n m e d i c a t i o n , t h e a p p e l l a n t c a n c T h e G P r e p o r t e d 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 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 fo r l i ft i n g ( G P n c a r r y i n g a n d h o l d i n g ( G P n o t e : " u n a b l e t o c a r r y A u g u s t 2 7 , 2 0 1 8 , t h e k i n e s i o l o g i s t i n d i c a t e d t h a d r o p p i n g i t e m s u p o n l i f t i n g a n d s h e c a n c a r r y s T h e p a n e l f i n d s t h a t t h e m i n i s t r y r e a s o n a b l y c o a p p e l l a n t c a n l i ft u p t o 1 5 l b s . a n d c a n c a r ry l i g F o r t h e m i n i s t ry t o b e " s a t i s f i e d " t h a t a n i m p a i r m f o r t h e m i n i s t ry t o e x p e c t t h a t t h e i n f o r m a t i o n p p r e s c r i b e d p r o f e s s i o n a l p r e s e n t s a c o m p r e h e n i m p a c t s o f t h e m e d i c a l c o n d i t i o n s o n d a i l y f u n c e x a m p l e s i n t h e s p a c e s p r o v i d e d i n t h e M R a n d G i v e n t h e G P ' s a s s e s s m e n t o f p h y s i c a l f u n c t i o l i m i t a t i o n s , w i t h t h e e x c e p t i o n o f w a l k i n g o u t d o o t h e a p p e l l a n t e x p e r i e n c e s e x a c e r b a t i o n s i n h e r t h a t t h e m i n i s t ry r e a s o n a b l y d e t e r m i n e d t h a t t h a p p e l l a n t h a s a s e v e r e p h y s i c a l i m p a i r m e n t u n S e v e r e M e n ta 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 r y w a s u f f i c i e n t e v i d e n c e o f a s e v e r e m e n t a l i m p a i r m e t h e M R t h a t 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 t h a t t h e a p p e l l a n t " h a s m a j o r d e p r e s s i o n t h a t w r e a s o n a b l y c o n s i d e r e d t h a t t h e G P r e p o rt e d i n w i t h h e r c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g i n m o t i v a t i o n . I n a s s e s s i n g d a i l y i m p a c t s t o t h e a t h e G P a s s e s s e d m a j o r i m p a c t s i n t h e a r e a o f m a n d n o t e d t h a t t h e a p p e l l a n t h a s " i n t e r r u p t e d " s a r e a o f e m o t i o n , a s w e l l a s i n t h e a r e a s o f i m p u I 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 i s t a n c e i c e f o r c l i m b i n g s t a i r s . W h i l e t h e G P w r o t e t h a t t " n e e d s t o t a k e b r e a k s , " t h e p a n e l f i n d s t h a t t h e o n o t fa l l w i t h i n t h e d e f i n i t i o n o f a n a s s i s t i v e 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 p e r s o n i s u n a b l e t o p e r f o r m . " T h e O T w r o t e t h a t c r e a s e s h e r p a i n a n d s h e r e q u i r e s m e d i c a t i o n . n s i d e r e d t h a t t h e c o n s i s t e n t e v i d e n c e i s t h a t , w i t h l i m b 5 o r m o r e s t a i r s u n a i d e d . e n t w i t h s t a n d i n g a n d r e q u i r e s c o n t i n u o u s o t e : " u n a b l e t o l i f t m o r e t h a n 1 5 l b s . " ) a n d f o r h e a v y o b j e c t s " ) . I n t h e a s s e s s m e n t r e p o rt f o r t t h e a p p e l l a n t r e p o rt e d fe a r o f p a i n , r e i n j u r y o r m a l l e r b a g s o f g r o c e r i e s b u t " n o m o r e t h a n 5 l b s . " n s i d e r e d t h e c o n s i s t e n t e v i d e n c e i s t h a t t h e h t e r o b j e c t s , u p t o 5 l b s . i n w e i g h t . e n t i s s e v e r e , t h e p a n e l c o n s i d e r s i t r e a s o n a b l e r o v i d e d b y t h e m e d i c a l p r a c t i t i o n e r a n d s i v e o v e r v i e w o f t h e n a t u r e a n d e x t e n t o f t h e t i o n i n g , i n c l u d i n g e x p l a n a t i o n s , d e s c r i p t i o n s o r i n t h e A R f o r m s . n i n g i n t h e m o d e r a t e r a n g e o f f u n c t i o n a l s k i l l s r s , a n d w i t h i n s u ff i c i e n t e v i d e n c e o f h o w o ft e n p a i n a n d r e q u i r e s a s s i s t a n c e , t h e p a n e l f i n d s e e v i d e n c e i s n o t s u ff i c i e n t t o e s t a b l i s h t h a t t h e d e r S e c t i o n 2 ( 2 ) o f t h e E A P W D A . s n o t s a t i s f i 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 w a s n t . T h e m i n i s t r y w r o t e t h a t t h e G P r e p o r t e d i n w i t h m a j o r d e p r e s s i o n a n d t h e G P c o m m e n t e d a s e x a c e r b a t e d b y a m a j o r M V A . " T h e m i n i s t r y t h e M R t h a t t h e a p p e l l a n t h a s s i g n i f i c a n t d e f i c i t s t h e a r e a s o f e m o t i o n a l d i s t u r b a n c e a n d p p e l l a n t ' s 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 , o t i v a t i o n a s w e l l a s t h e a r e a o f b o d i l y f u n c t i o n s l e e p . T h e G P i n d i c a t e d a m o d e r a t e i m p a c t i n t h e l s e c o n t r o l a n d m e m o r y . T h e G P d i d n o t p r o v i d e
further comments regarding the appellant's cognitive and emotional functioning. In her self-report, the appellant clarified that she has major insomnia due to nightmares of the accident and due to debilitating pain, and she has memory loss at times due to stress and anxiety. In the report prepared on August 28, 2018, the OT indicated that the main areas the appellant identified as issues were having trouble falling asleep, feeling tired and having little energy, and feeling bad about herself. In her Request for Reconsideration, the appellant wrote that she was diagnosed with depression as a teen and she has been managing with medication most of her life. She wrote that she has a history of abuse in her family and there are days that she does not leave her home or her bed because of sadness and depressive symptoms. At the hearing, the appellant also emphasized the severity of her mental impairment and stated that since the MVA in the spring of last year, her depression has gotten much worse and she can "go for weeks" without getting out of bed. While the appellant's evidence suggested marked impacts to her functioning due to her mental impairment, this was not reflected in the evidence from the GP or from the OT, or from a mental health specialist. Considering the two "social functioning" DLA, as set out in Section 2(1)(b) of the EAPWDR, that are specific to mental impairment -make decisions about personal activities, care or finances (decision making), and relate to, communicate or interact with others effectively (relate effectively), the panel finds that the ministry reasonably concluded that there is insufficient evidence to establish that the appellant is significantly restricted in either. Regarding the 'decision making' DLA, the GP reported in the AR that the appellant independently manages all of the decision-making components of DLA, specifically: personal care (regulating diet), shopping (making appropriate choices and paying for purchases), meals (meal planning and safe storage of food), pay rent and bills (including budgeting), medications (taking as directed and safe handling and storage), and transportation (using transit schedules and arranging transportation). While the appellant stated at the hearing that she struggles with regulating her diet and with making appropriate social decisions as she has lost a lot of weight in the last couple of months and was addicted to drugs for many years, this information was not confirmed in the opinion of a prescribed professional such as the GP, the OT, or a mental health specialist. Regarding the DLA of 'relating effectively', the GP reported in the AR, that the appellant requires continuous support/supervision with developing and maintaining relationships and periodic support/supervision with interacting appropriately with others. The GP commented with respect to both areas that the appellant "needs family help" and, when asked to describe the support/supervision required to maintain the appellant in the community, the GP left this section incomplete. The GP assessed the appellant with good functioning in her immediate social network and marginal functioning in her extended social networks. In the portions of the report prepared on August 28, 2018, the OT indicated that the appellant scored 15 out of 27 on the patient health questionnaire and reported that her ability to work, take care of things at home and get along with others is "somewhat difficult" as a result of the identified issues. The OT wrote that this score indicated "major depression, moderately severe-support required."
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 s h e d o a n d s h e n e e d s h e l p " a l l a r o u n d . " T h e a p p e l l a n a s s h e h a s n o f r i e n d s a n d s h e d o e s n o t d o a n y G P d e s c r i b i n g t h e d e g r e e a n d d u r a t i o n o f t h e s p r o v i d e d b y a m e n t a l h e a l t h s p e c i a l i s t , . a n d w i t h p a n e l f i n d s t h a t t h e m i n i s t r y r e a s o n a b l y c o n s i d e e s t a b l i s h a s i g n i f i c a n t 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 a p p e l l a n t i n t h e M R a s h a v i n g n o d i ff i c u l t i e s w i t g o o d a b i l i t y t o c o m m u n i c a t e i n a l l a r e a s , s p e c i f G i v e n t h e a b s e n c e o f e v i d e n c e o f s i g n i f i c a n t i m f u n c t i o n i n g , a s w e l l a s t h e i n s u ff i c i e n t e v i d e n c e f u n c t i o n i n g D L A t h a t a r e s p e c i f i c t o a m e n t a l i m r e a s o n a b l y d e t e r m i n e d t h a t a s e v e r e m e n t a l i m o f t h e E A P W D A . R e s tri 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 S e c t i o n 2 ( 2 ) o f t h e E A P W D A r e q u i r e s t h a t a s e 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 f o r m t h e D L e x t e n d e d p e r i o d s . 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 t h e r e s t r i c t i o n i s p e r i o d i c , i t m u s t b e fo r a n e x t e 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 f r e q u e n c e v i d e n c e i n d i c a t e s t h a t a r e s t r i c t i o n a r i s e s p e r i o r e q u i r e e v i d e n c e f r o m t h e p r e s c r i b e d p r o f e s s i o 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 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 a d d i t i o n a l d e t a i l s , i n t h e A R . T h e r e fo r e , a p r e s t h e o p p o r t u n i t y t o i n d i c a t e w h i c h , i f a n y , D L A a r i m p a i r m e n t 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 a r e t h e p r e s c r i b e d p r o f e s s i o n a l s a n d a k i n e s i o l p r o f e s s i o n a l s a s s e t o u t i n S e c t i o n 2 ( 2 ) o f t h e E 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 r y w a 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 t h a t , i n t h e o p i n i o s i g n i f i c a n t l y r e s t r i c t s D L A e i t h e r c o n t i n u o u s l y o 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 , t h e a p p e l l a n t w r o n u m b e r o f y e a r s w i l l b e p e r m a n e n t d i s a b i l i t i e s a h e r c h i l d r e n . T h e m i n i s t r y r e v i e w e d t h e i n f o r m a a s s e s s m e n t i n d i c a t e d t h a t t h e a p p e l l a n t i s i n d e m i n i s t r y c o n s i d e r e d t h a t , f o r t h e p e r s o n a l c a r e D e s n o t g o a n y w h e r e t o i n t e r a c t w i t h o t h e r p e o p l e t s t a t e d t h a t s h e d o e s n o t h a v e a " s o c i a l n e tw o r k " t h i n g . I n t h e a b s e n c e o f f u rt h e r n a r r a t i v e b y t h e u p p o rt/ s u p e rv i s i o n r e q u i r e d o r f u rt h e r i n fo r m a t i o n t h e O T ' s d e s c r i p t i o n o f " m o d e r a t e " s e v e r i t y , t h e r e d t h a t t h e r e w a s i n s u f f i c i e n t i n f o r m a t i o n t o r e l a t e e ff e c t i v e l y . T h e G P a l s o a s s e s s e d t h e h c o m m u n i c a t i o n a n d , i n t h e A R , a s h a v i n g a i c a l l y : s p e a k i n g , r e a d i n g , w r i t i n g a n d h e a r i n g . p a c t s t o t h e a p p e l l a n t ' s c o g n i t i v e a n d e m o t i o n a l o f s i g n i f i c a n t i m p a c t s t o t h e t w o s o c i a l 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 t r y p a i r m e n t w a s n o t e s t a b l i s h e d u n d e r S e c t i o n 2 ( 2 ) v e r e i m p a i r m e n t d i r e c t l y a n d s i g n i f i c a n t l y 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 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 n d e d t i m e . I n h e r e n t l y , a n y a n a l y s i s o f p e r i o d i c i t y y . A c c o r d i n g l y , i n c i r c u m s t a n c e s w h e r e t h e d i c a l l y , i t i s a p p r o p r i a t e f o r t h e m i n i s t ry t o n a l 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 o f t h e s l a t i v e c r i t e r i o n i s m e t . R a n d a r e a l s o l i s t e d i n t h e M R a n d , w i t h c r i b e d p r o f e s s i o n a l c o m p l e t i n g t h e s e fo r m s h a s e s i g n i f i c a n t l y r e s t r i c t e d b y t h e a p p e l l a n t ' s n d e d p e r i o d s . I n t h i s c a s e , t h e G P a n d t h e O T o g i s t i s n o t i n c l u d e d i n t h e l i s t o f p r e s c r i b e d A P W D R . 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 v e r e n o f t h e p r e s c r i b e d p r o f e s s i o n a l , d i r e c t l y a n d 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 f t i m e . I n h e r t e t h a t t h e i n j u r i e s s h e s u s t a i n e d i n t h e p a s t n d i m p a c t h e r f u n c t i o n i n c a r i n g f o r h e r s e l f a n d t i o n i n t h e A R a n d w r o t e t h a t t h e G P ' s p e n d e n t i n a l m o s t a l l o f h e r [ t a s k s o f] D L A . T h e L A , t h e G P r e p o r t e d 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 p e rf o r m i n g a l l o f t h e t a s k s . A h a r d t i m e p u t t i n g o n h e r o w n s o c k s a s s h e h a s a p p e l l a n t s t a t e d t h a t s o m e t i m e s s h e d o e s n o t s a p p e l l a n t s t a t e d t h a t w h i l e s h e i s o k a y w i t h t o i l e p r o b l e m s i n c e s h e l o s t s o m u c h w e i g h t . T h e a p g e t o u t o f b e d s o m e m o r n i n g s s i n c e b o t h o f h e a p p e l l a n t s t a t e d t h a t s h e u s e s t h e a r m s o f a c h 2 0 1 8 r e p o rt , t h e O T i n d i c a t e d t h a t t h e a p p e l l a n c o m p l e t e t h e t a s k s o f g r o o m i n g , b a t h i n g / s h o w e t r a n s f e r s t o t h e t o i l e t , a n d t r a n s fe r s t o t h e b a t h t w h e t h e r e q u i p m e n t o r a d d i t i o n a l t i m e w a s n e e d w i t h e a c h t a s k i n o r d e r t o a l l o w t h e m i n i s t r y t o d T h e m i n i s t r y c o n s i d e r e d t h e G P ' s a s s e s s m e n t 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 i s t a n c e f r o m a n o h o u s e k e e p i n g a n d t h e G P n o t e d t h a t t h e a p p e l 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 d o e s n o t c l e a n h e h e r , a n d s h e d o e s n o t d o h e r l a u n d r y . I n t h e A 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 w i t h t h e t a s k s o f c o m m e n t s t h a t t h e a p p e l l a n t " t r i e s t o d o t h e fo l t a s k s , " a n d s h e i s " n o t a b l e t o d o m a n y d u t i e s b c o m p l e t e l i g h t d u t i e s ; r e p o rt s i t i s j u s t n o t g e tt i n a b l e " d o e s n o t c l a r i f y w h e t h e r t h e a s s i s t a n c e r e 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 . T h e m i n i s t r y a l s o c o n s i d e r e d t h a t , f o r t h e s h o p p b e i n g i n d e p e n d e n t w i t h t h e t a s k s o f g o i n g t o a n m a k i n g a p p r o p r i a t e c h o i c e s a n d p a y i n g f o r p u r c a p p e l l a n t u s e s a c a r a s a n a s s i s t i v e d e v i c e " fo r f i n d s t h a t a c a r d o e s n o t f a l l w i t h i n t h e d e f i n i t i o n 2 ( 1 ) o f t h e E A P W D A . T h e G P i n d i c a t e d t h a t t h a n o t h e r p e r s o n w i t h c a r r y i n g h e r p u r c h a s e s h o s o n . " 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 s s c o o t e r i n t h e s t o r e b u t s h e d o e s n o t c a r r y h e r t h e O T i n d i c a t 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 s a s s a p p e l l a n t i s " t r y i n g t o d o a s m u c h a s s h e c a n , b n e e d e d . " T h e k i n e s i o l o g i s t w r o t e t h a t t h e a p p e g r o c e r i e s a r e o k a y b u t " n o m o r e t h a n 5 l b s . " T h e G P a s s e s s e d t h e a p p e l l a n t a s b e i n g i n d e p ( m e a l p l a n n i n g , f o o d p r e p a r a t i o n , c o o k i n g , a n d ( i n c l u d i n g b a n k i n g a n d b u d g e t i n g ) , t h e m e d i c a t 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 s h e h a s a n o f e e l i n g i n h e r p i n k y f i n g e r a n d h e r t h u m b . T h e h o w e r o r b a t h e fo r d a y s o r c o m b h e r h a i r . T h e t i n g a n d fe e d i n g h e r s e l f , r e g u l a t i n g h e r d i e t i s a p e l l a n t s t a t e d t h a t h e r c h i l d r e n h a v e t o h e l p h e r r f e e t h u r t s o b a d l y w h e n s h e f i r s t g e t s u p . T h e a i r t o g e t u p o u t o f t h e c h a i r . I n t h e A u g u s t 2 8 , t r e q u i r e s e q u i p m e n t o r a d d i t i o n a l t i m e t o r i n g , d r e s s i n g h e r l o w e r b o d y , b e d m o b i l i t y , u b / s h o w e r . T h e O T d i d n o t i n d i c a t e s p e c i f i c a l l y e d a n d h o w m u c h a d d i t i o n a l t i m e i s r e q u i r e d e t e r m i n e t h a t t h e r e i s a s i g n i f i c a n t r e s t r i c t i o n . r e g a r d i n g t h e b a s i c h o u s e k e e p i n g D L A t h a t t h e t h e r p e r s o n w i t h b o t h d o i n g l a u n d r y a n d l a n t " t a k e s h e l p f r o m f r i e n d / k i d s . " A t t h e h e a r i n g , r o w n h o u s e , I C B C f u n d e d a h o u s e k e e p e r f o r u g u s t 2 8 , 2 0 1 8 r e p o rt , t h e O T i n d i c a t e d t h a t t h e l a u n d r y a n d c l e a n i n g ; h o w e v e r , t h e O T ' s d i n g , b u t c a n n o t c o m p l e t e t h e h e a v y l a u n d r y e c a u s e o f p h y s i c a l i n j u r y a n d p a i n ; t r i e s t o g d o n e , o r s h e a s k s h e r k i d s t o c o m p l e t e w h e n q u i r e d i s c o n t i n u o u s o r p e r i o d i c a n d h o w o ft e n i n g D L A , t h e G P a s s e s s e d t h e a p p e l l a n t a s d f r o m t h e s t o r e s , r e a d i n g p r i c e s a n d l a b e l s , h a s e s . W h i l e t h e G P i n d i c a t e d t h a t t h e m o b i l i t y " g o i n g t o a n d f r o m s t o r e s , t h e p a n e l o f a n " a s s i s t i v e d e v i c e " a s s e t o u t i n S e c t i o n e a p p e l l a n t 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 f r o m m e a n d t h e G P w r o t e t h a t s h e " t a k e s h e l p f r o m h e c a n d r i v e t o a n d f r o m t h e s t o r e a n d u s e s a o w n g r o c e r i e s . I n t h e A u g u s t 2 8 , 2 0 1 8 r e p o r t , i s t a n c e w i t h s h o p p i n g a n d n o t e d t h a t t h e u t w i l l a s k c h i l d r e n t o c o m p l e t e s h o p p i n g i f l l a n t r e p o r t e d t h a t c a r r y i n g s m a l l e r b a g s o f e n d e n t w i t h a l l o f t h e t a s k s f o r t h e m e a l s D L A s a f e s t o r a g e o f fo o d ) , t h e p a y r e n t a n d b i l l s D LA i o n s D L A ( f i l l i n g / r e f i l l i n g p r e s c r i p t i o n s , t a k i n g a s
d i r e c t e d , w i t h s a f e h a n d l i n g a n d s t o r a g e ) a n d t h v e h i c l e , u s i n g p u b l i c t r a n s i t , a n d u s i n g t r a n s i t s 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 s h e d o e s n o t l o n g . S h e s t a t e d t h a t t h e b o t t l e s f o r h e r m e d i c a p a c k s a n d h e r r o o m m a t e w i l l h e l p h e r . T h e a p v e h i c l e i s d i ff i c u l t . T h e O T r e p o r t e d o n A u g u s t i n d e p e n d e n t l y p e r f o r m m e d i c a t i o n a n d m o n e y G i v e n t h e G P ' s a s s e s s m e n t o f i n d e p e n d e n c e w f u n c t i o n a l s k i l l s a s s e s s m e n t i n t h e m o d e r a t e r a d e t e r m i n e t h a t p e r i o d i c a s s i s t a n c e i s r e q u i r e d f s i g n i f i c a n t i m p a c t s t o t h e t w o s o c i a l 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 r e a s o n a b l y c o n 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 e r f o r m 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 H e l p t o p e rf o r m D L A 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 r y h e a r e s i g n i f i c a n t l y r e s t r i c t e d , i t c a n n o t b e d e t e r m i 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A r e q u i r e s t h a t , a s a r e i n t h e a b i l i t y t o p e r f o r m D L A e i t h e r c o n t i n u o u s l y m u s t a l s o r e q u i r e 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 i g n i f i c a n t r e s t r i c t i o n s u n d e r s e c t i o n 2 ( 2 ) ( b ) ( i ) i s c r i t e r i o n . H e l p i s d e f i n e d i n s u b s e c t i o n ( 3 ) a s t h 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 o r d e r t o p e rf o r m a D LA . T h e G P r e p o r 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 r e f r e q u e n t l y " a s w e l l a s a b a t h i n g a i d " o c c a s i o n a l 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 p p e l l a n e s t a b l i s h e d , 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 a l s 2 ( 2 ) ( b ) ( i i ) o f t h e E A P W D A , i t c a n n o t b e d e t e r m D L 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 ry ' s r e c o n s i d e r a t w a s n o t e l i g i b l e f o r P W D d e s i g n a t i o n p u r s u a n t 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 c o n f i r m s t h e r e f o r e , i s n o t s u c c e s s f u l .e t r a n s p o r t a t i o n D L A ( g e t t i n g i n a n d o u t o f a c h e d u l e s a n d a r r a n g i n g t r a n s p o rt a t i o n ) . A t t h e d o a l o t o f c o o k i n g a s s h e c a n n o t s t a n d fo r v e r y t i o n s a r e h a r d t o o p e n i f s h e c a n n o t g e t b l i s t e r p e l l a n t s t a t e d t h a t g e tt i n g i n a n d o u t o f h e r 2 8 , 2 0 1 8 t h a t t h e a p p e l l a n t i s a b l e t o m a n a g e m e n t a s w e l l a s t r a n s fe r s t o a v e h i c l e . i t h a l l b u t t h r e e o f t h e t a s k s o f D L A a n d t h e n g e , a n a b s e n c e o f s u f f i c i e n t i n f o r m a t i o n t o o r e x t e n d e d p e r i o d s , a n d i n s u ff i c i e n t e v i d e n c e o f D LA t h a t a r e s p e c i f i c t o a m e n t a l i m p a i r m e n t , c l u d e d t h a t t h e e v i d e n c e i s i n s u ff i c i e n t t o s h o w 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 s , p u r s u a n t t o S e c t i o n 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A . l d t h a t , a s i t h a s n o t b e e n e s t a b l i s h e d t h a t D L A 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 . S e c t i o n s u l t o f b e i n g 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 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 p e r s o n s . T h a t i s , t h e e s t a b l i s h m e n t o f d i r e c t a n d a p r e c o n d i t i o n o f m e e t i n g t h e n e e d f o r h e l p 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 , t h e n , o r t h e s e r v i c e s o f a n a s s i s t a n c e a n i m a l i n c e i v e s h e l p f r o m f a m i l y a n d u s e s a c a n e " q u i t e l y . " A s t h e m i n i s t r y r e a s o n a b l y d e t e r m i n e d t h a t t ' s a b i l i t y t o p e rf o r m D LA h a v e n o t b e e n o 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 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 s h e l p t o p e rf o r m i o n d e c i s 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 t o S e c t i o n 2 ( 2 ) o f t h e E A P W D A , w a s r e a s o n a b l y t h e m i n i s t ry ' s d e c i s i o n . T h e a p p e l l a n t ' s a p p e a l ,
PART G -ORDER THE PANEL DECISION IS: (Check one) IXJUNANIMOUS □BY MAJORITY THE PANEL ix!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) Ii{! or Section 24(1)(b) D and Section 24(2)(a) IRJ or Section 24(2)(b) D PART H -SIGNATURES PRINT NAME S. Walters SIGNATIJREOF CHAIRl DATE {YEARJMONTH!DAY) 2019-01-03 PRINT NAME Vivienne Chin DAT E (YEAR/MONTH/DAY) 2019-01-03 PRINT NAME Sanjay Gulati DATE (YEAR/MONTH/DAY) 2019-01-03
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.