P A R T C D E C I S I O N U N D E R A P P E A L T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t r y o f S o c i a l r e c o n s i d e ra t i o n d e c i s i o n d a t e d J a n u a r y 3 0 , 2 0 1 9 i n e l i g i b l e f o r a h e a l t h s u p p l e m e n t f o r m e d i c a l t r a n s p o P e r s o n s w i t h D i s a b i l i t i e s R e g u l a t i o n ( " E A W D R " ) . T h t r a n s p o r t a t i o n t o a t t e n d a n a p p o i n t m e n t f o r p a i n t r e n o t m e e t t h e l e g i s l a t i v e c r i t e r i a b e c a u s e t h e p h y s i c i a s r e q u i r e d b y s e c t i o n s 1 a n d 2 o f S c h e d u l e C . 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 oym e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b S c h e d u l e C s e c t i o n s 1 a n d 2I D e v e l o p m e n t a n d P o v e r t y R e d u c t i o n ' s ( " m i n i s t r y " ) w h i c h t h e m i n i s t r y f o u n d t h a t t h e a p p e l l a n t w a s n o t r t a t i o n u n d e r 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 f o r e m i n i s t r y f o u n d t h a t t h e a p p e l l a n t ' s r e q u e s t f o r a t m e n t i n a n o t h e r c o m m u n i t y ( " C o m m u n i t y B " ) d o e s a n i n C o m m u n i t y B i s n o t r e c o g n i z e d a s a s p e c i a l i s t il i t i e s A c t E A P W D A s e c t i o n 5 i l i t i e s R e g u l a t i o n E A W D R s e c t i o n 6 2 a n d
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 a n d d o c u m e n t a t i o n b e f o r e t h e m i n i s t 1 . I n f o r m a t i o n f r o m t h e m i n i s t r y ' s r e c o r d o f d e c i s i o n • T h e m i n i s t r y a d v i s e d t h e a p p e l l a n t o n J a n u a s u p p l e m e n t fo r t r a n s p o rt a t i o n t o a t t e n d a n a ( " D r . T . " ) . O n J a n u a r y 2 3 , 2 0 1 9 , t h e a p p e l l a w i t h a r e f e r r a l n o t e f r o m h e r g e n e r a l p r a c t i t i o m i n i s t r y c o m p l e t e d i t s r e v i e w o f t h e R F R . • T h e a p p e l l a n t i s a s i n g l e p e r s o n i n r e c e i p t o • O n J a n u a r y 3 , 2 0 1 9 , t h e a p p e l l a n t s u b m i t t e d D r . T . o n J a n u a r y 8 , 2 0 1 9 . • I n a s s e s s i n g t h e a p p e l l a n t ' s r e q u e s t f o r t h e s e e k i n g t r a n s p o rt a t i o n " o u t s i d e ( h e r ) l o c a l a S c h e d u l e C . 2 . A p r e s c r i p t i o n p a d n o t e f r o m D r . S . d a t e d J a n u a r T . i n C o m m u n i t y B . T h e n o t e s t a t e s t h a t D r . T . i s a t o t r a v e l t o C o m m u n i t y B o n a r e g u l a r b a s i s a s t h e 3 . A p r e s c r i p t i o n p a d n o t e f r o m D r . S . d a t e d D e c e m a p p o i n t m e n t w i t h D r . T . o n J a n u a r y 8 , 2 0 1 9 a n d t h e c o m m u n i t y . 4 . A n R F R s i g n e d b y t h e a p p e l l a n t o n J a n u a r y 1 7 , 2 A d d i t i o n a l i n f o r m a t i o n T h e a p p e l l a n t f i l e d a N o ti c e o f A p p e a l , r e c e i v e d b y s u b m i s s i o n d a t e d F e b r u a r y 7 , 2 0 1 9 , t h e a p p e l l a n t p f o l l o w s : • S h e h a s p i n c h e d n e r v e s i n h e r l o w e r b a c k a h a s d o n e a l l h e c a n t o a l l e v i a t e h e r p a i n " w i s u p p r e s s n e rv e p a i n s o t h e a p p e l l a n t h a s t o o ft e n i f s h e h a s a f a l l . • T h e h o s p i t a l i n t h e a p p e l l a n t ' s h o m e c o m m u a v a i l a b l e p a i n s p e c i a l i s t i n h e r h o m e c o m m u u l t r a s o u n d m a c h i n e i n h i s o ff i c e s o h e c a n s T h e r e i s n o o n e w i t h t h i s t e c h n o l o g y i n t h e a • T h e a p p e l l a n t h a s a n a p p o i n t m e n t w i t h D r . T h i g h e r r e n t s h e h a s n o t b e e n a b l e t o p a y t h e T h e a p p e l l a n t a l s o s u b m i t t e d a c o p y o f D r . T . ' s b u s m e d i c i n e . "e r a t t h e r e c o n s i d e r a t i o n c o n s i s t e d o f : w h i c h i n d i c a t e s : r y 4 , 2 0 1 9 t h a t s h e w a s n o t e l i g i b l e f o r a h e a l t h p p o i n t m e n t C o m m u n i t y B w i t h a m e d i c a l p r a c t i t i o n e r n t s u b m i t t e d a R e q u e s t f o r R e c o n s i d e r a t i o n ( " R F R " ) n e r ( " G P " , " D r . S . " ) . O n J a n u a r y 3 0 , 2 0 1 9 , t h e f d i s a b i l i t y a s s i s t a n c e . a n o t e f r o m D r . S , c o n f i r m i n g a n a p p o i n t m e n t w i t h s u p p l e m e n t , t h e m i n i s t r y f o u n d t h a t t h e a p p e l l a n t w a s r e a " u n d e r s u b s e c t i o n 2 ( 1 ) ( f) ( i i ) o f E A P W D R y 9 , 2 0 1 9 , c o n f i r m i n g t h a t t h e a p p e l l a n t i s s e e i n g D r . n " i n t e r v e n t i o n a l p a i n s p e c i a l i s t " a n d t h e a p p e l l a n t h a s s e rv i c e i s n o t p r o v i d e d i n h e r h o m e c o m m u n i t y . b e r 2 0 , 2 0 1 8 , c o n f i r m i n g t h a t t h e a p p e l l a n t h a s a n s e r v i c e i s n o t p r o v i d e d i n t h e a p p e l l a n t ' s h o m e 0 1 9 . t h e T r i b u n a l o n F e b r u a r y 1 3 , 2 0 1 9 I n a n a t t a c h e d r o v i d e s h e r a r g u m e n t a n d e x p l a i n s h e r s i t u a t i o n a s n d r i g h t s h o u l d e r . S h e a l s o h a s o s t e o a r t h r i t i s . D r . S . t h c o r t i s o n e s h o t s " . T h e r e a r e n o p a i n r e l i e v e r s t h a t h a v e c o r t i s o n e s h o t s e v e r y t h r e e m o n t h s , a n d m o r e n i t y d o e s n o t p r o v i d e c o r t i s o n e s h o t s , n o r i s t h e r e a n n i t y . D r . T . i s f a m i l i a r w i t h h e r s i t u a t i o n a n d h a s a n e e t h e p r o b l e m a n d p r o v i d e i m m e d i a t e t r e a t m e n t . p p e l l a n t ' s h o m e c o m m u n i t y . . o n M a r c h 6 , 2 0 1 9 a n d d u e t o h e r r e c e n t m o v e a n d o u t s t a n d i n g c o s t o f h e r l a s t t r i p t o s e e D r . T . i n e s s c a r d w h i c h i n d i c a t e s t h a t h e p r a c t i c e s " p a i n
T h e m i n i s t ry h a d n o o b j e c t i o n s t o t h e a d d i t i o n a l i n f o i n f o r m a t i o n " ; i n p a r t i c u l a r , t h a t n o s p e c i a l i z e d p a i n t c o m m u n i t y . T h e p a n e l f i n d s t h a t t h e s u p p l e m e n t a l r e c o r d s t h a t w e r e b e f o r e t h e m i n i s t e r a t t h e r e c o n s i w e r e n o t b e f o r e t h e m i n i s t e r , t h e m i n i s t r y h a d n o o b f i n d s t h e n e w i n f o r m a t i o n p r o v i d e s a d d i t i o n a l d e t a i l t r a n s p o r t a t i o n t o C o m m u n i t y B . T h e p a n e l a d m i t s t E m p l o y m e n t a n d A s s i s t a n c e A c t a s e v i d e n c e i n s u p t h e m i n i s t e r w h e n t h e d e c i s i o n b e i n g a p p e a l e d w a s T h e a p p e l l a n t d i d n o t a t t e n d t h e h e a r i n g . U p o n c o n p a n e l c o n s i d e r e d t h e a p p e a l i n a p a r t y ' s a b s e n c e a E m p l o y m e n t a n d A s s i s t a n c e R e g u l a t i o n . T h e m i n i s s u b m i t a n y n e w e v i d e n c e .r m a t i o n b u t " c a n n o t c o m m e n t o n t h e a c c u r a c y o f t h e r e a t m e n t i s a v a i l a b l e i n t h e a p p e l l a n t ' s h o m e i n f o r m a t i o n 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 n d d e r a t i o n . W h i l e t h e a p p e l l a n t ' s m e d i c a l c o n d i t i o n s j e c t i o n s t o a d m i t t i n g t h e i n f o r m a t i o n a n d t h e p a n e l i n s u p p o r t o f t h e a p p e l l a n t ' s r e q u e s t f o r m e d i c a l h e s u b m i s s i o n u n d e r s e c t i o n 2 2 ( 4 ) o f t h e p o rt o f t h e i n f o r m a t i o n a n d r e c o r d s t h a t w e r e b e f o r e m a d e . f i r m i n g t h a t s h e w a s n o t i f i e d o f t h e d a t e a n d t i m e , t h e s i t i s a u t h o r i z e d t o d o u n d e r s e c t i o n 8 6 ( b ) o f t h e t r y p r o v i d e d a r g u m e n t a t t h e h e a r i n g a n d d i d n o t
P A R T F R E A S O N S F O R P A N E L D E C I S I O N T h e i s s u e 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 r e a s o n a h e a l t h s u p p l e m e n t f o r m e d i c a l t r a n s p o r t a t i o n u n d t h a t t h e r e q u e s t fo r t r a n s p o r t a t i o n d o e s n o t m e e t t h r e a s o n a b l y s u p p o rt e d b y t h e e v i d e n c e o r a r e a s o n a T h e m i n i s t ry b a s e d 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 o n P u r s u a n t t o t h e E A P W D A : D i s a b i l i t y a s s i s t a n c e a n d s u p p l e m e n t s 5 S u bj e c t t o t h e r e g u l a t i o n s , t h e m i n i s t e r m a y p r o v i d f a m i l y u n i t t h a t i s e l i g i b l e f o r i i . P u r s u a n t t o t h e E A P WD R : G e n e r a l h e a l t h s u p p l e m e n t s 6 2 T h e m i n i s t e r m a y p r o v i d e a n y h e a l t h s u p p l e m e n 3 [ m e d i c a l e q u i p m e n t a n d d e v i c e s ] o f S c h e d u l e C t ( a ) a f a m i l y u n i t i n r e c e i p t o f d i s a b i l i t y a S c h e d u l e C H e a l t h S u p p l e m e n t s D e f i n i t i o n s 1 I n t h i s S c h e d u l e : " s p e c i a l i s t " m e a n s a m e d i c a l p r a c t i t i o n e r r e s u r g e r y i n a c c o r d a n c e w i t h t h e b y l a w s m a d e S u r g e o n s o f B r i t i s h C o l u m b i a u n d e r s e c t i o n 1 G e n e r a l h e a l t h s u p p l e m e n t s 2 ( 1 ) T h e f o l l o w i n g a r e t h e h e a l t h s u p p l e m e n t s t h a t fa m i l y u n i t t h a t i s e l i g i b l e u n d e r s e c t i o n 6 2 [ g e n e ra l ( f ) t h e l e a s t e x p e n s i v e a p p r o p r i a t e m o d ( i ) a n o ff i c e , i n t h e l o c a l a r e a , o f a m e d a b l y c o n c l u d e d t h a t t h e a p p e l l a n t w a s n o t e l i g i b l e f o r e r t h e E A P W D R . W a s 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 l e g i s l a t i v e c r i t e r i a i n s e c t i o n s 1 a n d 2 o f S c h e d u l e C b l e a p p l i c a t i o n o f t h e l e g i s l a t i o n ? t h e f o l l o w i n g l e g i s l a t i o n : e d i s a b i l i t y a s s i s t a n c e o r a s u p p l e m e n t t o o r f o r a t s e t o u t i n s e c t i o n 2 [ g e n e r a l h e a l t h s u p p l e m e n t s ] o r o o r f o r s s i s t a n c e , c o g n i z e d a s a s p e c i a l i s t i n a f i e l d o f m e d i c i n e o r b y t h e b o a r d f o r t h e C o l l e g e o f P h y s i c i a n s a n d 9 ( 1 ) ( k . 3 ) a n d ( k . 4 ) o f t h e H e a l t h P ro f e s s io n s A c t . m a y b e p a i d f o r b y t h e m i n i s t e r i f p r o v i d e d t o a h e a l t h s u p p l e m e n t s ] o f t h i s r e g u l a t i o n : e o f t r a n s p o r t a t i o n t o o r f r o m i c a l p r a c t i t i o n e r o r n u r s e p r a c t i t i o n e r ,
(ii)the office of the nearest available specialist in a field of medicine or surgery if the person has been referred to a specialist in that field by a local medical practitioner or nurse practitioner, (iii) the nearest suitable general hospital or rehabilitation hospital, as those facilities are defined in section 1.1 of the Hospital Insurance Act Regulations, or (iv)the nearest suitable hospital as defined in paragraph (e) of the definition of "hospital" in section 1 of the Hospital Insurance Act, provided that (v) the transportation is to enable the person to receive a benefit under the Medicare Protection Act or a general hospital service under the Hospital Insurance Act, and (vi) there are no resources available to the person's family unit to cover the cost. *** Analysis and panel's decision Section 5 of the EAPWDA authorizes the minister to provide a health supplement to a family unit that meets the eligibility requirements under the Regulations. Under section 62 of the EAPWDR, the minister has the discretion to provide the health supplements set out in section 2 of Schedule C to or for a family unit in receipt of disability assistance. The appellant is a recipient of disability assistance and may therefore be eligible for medical transportation under section 2(1 )(f) of Schedule C if her request meets specific eligibility requirements set out in clauses (i) to (vi). The specifics of the request determine which clause applies in the person's circumstances. The ministry assessed the appellant's request for a transportation supplement under subsection 2(1)(f)(ii) of Schedule C. This subsection authorizes the minister to pay for the least expensive appropriate mode of transportation to or from the office of the nearest available specialist in a field of medicine or surgery if the person has been referred to a specialist in that field by a local medical practitioner or nurse practitioner. The ministry is not disputing that the appellant has been referred to Dr. T. for pain treatment but argues that Dr. T. is not a "specialist" as defined in section 1 of Schedule C which indicates that a specialist is a medical practitioner who is recognized as a specialist in a field of medicine or surgery in accordance with the bylaws made by the board for the College of Physicians and Surgeons of British Columbia. The ministry notes that Dr. T. is not registered as a specialist with the College of Physicians and Surgeons of BC and argues that Dr. T. is therefore not considered a specialist under the EAPWDR. The appellant argues that she does not have the option for severe pain relief in her home community as confirmed by Dr. S. in his notes of January 9, 2019 and December 20, 2018. These notes state that the appellant "is seeing Dr. T. in Community B since the service is not provided in (appellant's home community)". The appellant states that there is no pain specialist in her home community, that cortisone injections are not available at her local hospital, and that the technology employed by Dr. T. ("ultrasound machine in his office") is not available in her home community. The appellant argues that the legislation does not take into consideration the shortage of pain specialists in her home community and Dr. T. should be accepted as a specialist because Dr. S. has referred her there and Dr. T. 's business card "speaks for itself' with the words "pain medicine."
The panel considered whether the ministry reasonably applied the legislation by assessing the appellant's request under subsection 2(1)(f)(ii), rather than 2(1)(f)(i) Of Schedule C. Under clause (i), the minister may provide the least expensive appropriate mode of transportation to or from an office, in the local area, of a medical practitioner or nurse practitioner. Therefore, under subsection 2(1 )(f)(i), the ministry may provide transportation to the office of medical practitioner who is not registered as a specialist with the BC College of Physicians and Surgeons as long as the office is located within the requestor's local area. However, the record indicates that the appellant was requesting a transportation supplement to attend the office of a medical practitioner whom she considers to be a specialist. The appellant indicates that she is already seeing a regular physician (Dr. S.) but he has done all he can for her and she requires pain treatment from Dr. T. who uses specialized technology that is not available in her home community. As well, Dr. S. refers to Dr. T. as an "interventional pain specialist" and Dr. T.'s business card indicates that he practices pain medicine. As the appellant was requesting transportation to attend an appointment with a "pain specialist", the panel finds that the ministry reasonably considered the appellant's request under subsection 2(i)(f)(ii) of EAPWDR Schedule C. The panel finds that the ministry reasonably concluded the appellant is not eligible for a medical transportation supplement under subsection 2(1 )(f)(ii) because Dr. T. is not a specialist in accordance with section 1 of Schedule C. The appellant argues that Dr. T. should be considered a pain specialist under a less restrictive reading of the Regulations but under subsection 2(1)(f)(ii), the minister does not have the discretion to provide transportation to the office of a "specialist" who is not registered as such. Conclusion In order to be eligible for a medical transportation supplement to the office of the nearest available specialist, the criteria in subsection 2(1 )(f)(ii) of Schedule C must be met. As Dr. T. is not a specialist as defined in the Regulation, the panel finds that the ministry reasonably applied the legislation in the circumstances of the appellant. The panel confirms the reconsideration decision and the appellant is not successful on appeal.
PART G -ORDER THE PANEL DECISION IS: (Check one) iSIUNANIMOUS □BY MAJORITY THE PANEL !SI 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) D or Section 24(1)(b} ISi and Section 24(2)(a) ISi or Section 24(2}(b) D PART H -SIGNATURES PRINT NAME Margaret Koren SIGNATURE OF CHAIR DATE (YEAR/MONTH/DAY) 2019/03/07 PRINT NAME Vivienne Chin DATE (YEAR/MONTH/DAY) 2019/03/07 SIGNATURE OF MEMBER � PRINT NAME David Roberts SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2019/03/07
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.