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 r e c o n s i d e r a t i o n d e c i s i o R e d u c t i o n ( t h e m i n i s t r y ) d a t e d J u n e 1 0 , 2 0 1 9 , w h i c h h e l b e c a u s e i t w a s n o t r e q u i r e d fo r a n y o f t h e c o n d i t i o n s o r E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b i l i t i e s P A R T D R E L E V A N T L E G I S L A T I O N E m p l o y m e n t a n d A s s i s t a n c e f o r P e rs o n s w i t h D i s a b i l i t i e s E A P W D R , s e c t i o n 6 6 a n d s e c t i o n 6 o f S c h e d u l e CI A P P E A L N U M B E R n o f t h e M i n i s t ry o f S o c i a l D e v e l o p m e n t a n d P o v e r t y 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 a d i e t s u p p l e m e n t d i e t a r y n e e d s d e s c r i b e d i n s e c t i o n 6 o f S c h e d u l e C o f t h e R e g u l a t i o n ( E A P W D R ) . A c t ( E A P W D A } , s e c t i o n 5
P A R T E S U M M A R Y O F F A C T S T h e a p p e l l a n t i s a d e p e n d e n t c h i l d i n a f a m i l y u n i t i n r e c r e q u e s t e d a d i e t s u p p l e m e n t o n t h e a p p e l l a n t ' s b e h a l f a o f a n a d v o c a t e , f o r t h e a p p e a l h e a r i n g . 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 O n M a y 1 , 2 0 1 9 , t h e m i n i s t ry r e c e i v e d a l e t t e r d a t e d A p r e g i s t e r e d d i e t i c i a n w h o p r o v i d e t h e f o l l o w i n g i n fo r m a t i v e r y l o n g c h a i n a c y l C o A d e h y d r o g e n a s e d e f i c i e n c y ( V L C d o w n c e r t a i n f a t s . V L C A D i s m a n a g e d b y f o l l o w i n g a l i f e m e d i u m c h a i n t r i g l y c e r i d e o i l . L i f e l o n g a d h e r e n c e t o t h e c a r d i o m y o p a t h y a n d l i v e r d i s e a s e . I t i s n e c e s s a r y f o r t h e o f f r u i t s a n d v e g e t a b l e s , g r a i n s , a n d s m a l l a m o u n t s o f l e r e q u i r e m e n t f o r i n f a n t f o r m u l a f o r a p p r o x i m a t e l y 6 m o n O n M a y 9 , 2 0 1 9 , t h e m i n i s t r y a p p r o v e d t h e r e q u e s t f o r i O n J u n e 5 , 2 0 1 9 , r e c o n s i d e r a t i o n o f t h e m i n i s t r y ' s d e n i a R e c o n s i d e r a t i o n , t h e a p p e l l a n t ' s p a r e n t w r i t e s t h a t n o t t e r m h o s p i t a l i z a t i o n o r d e a t h . I t i s a l s o n o t e d t h a t m o s t p r o c e s s , t h a t f i n d i n g o r g a n i c l o w f a t o p t i o n s a t t h e f o o d r e q u i r e M e d i u m C h a i n T r i g l y c e r i d e ( M C T ) o i l w h i c h , o n a I n f o r m a t i o n a n d d o c u m e n t a t i o n p r o v i d e d o n a p p e a l a n d 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 J u n e 1 7 , c o n f i r m e d a n d t h e p a r e n t i n d i c a t e s t h e d e s i r e " t o a p p e a 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 p a r e n t e x p l a i n e d t h a t V L a t b i r t h b y a b l o o d t e s t . T h e c o n d i t i o n i s p r e t t y r a r e , w i t f a t a l . T h e a p p e l l a n t c a n n o t e a t f o o d s w i t h h e a v y f a t s , s u a n d o t h e r l o w f a t f o o d s a s w e l l a s a n o i l s u p p l e m e n t t o h a d v o c a t e a d d e d t h a t t h e a p p e l l a n t i s u n d e r t h e r e g u l a r c w h o l e m e d i c a l t e a m s u p e r v i s e s t h e a p p e l l a n t , s e e i n g t h e o r 6 m o n t h i n t e r v a l s ( i n c l u d i n g b l o o d t e s t s , e c h o s c a n s a A t t h e h e a r i n g , t h e m i n i s t ry r e v i e w e d t h e r e c o n s i d e r a t i o t h e l e g i s l a t i o n a s w r i t t e n . T h e m i n i s t r y a l s o n o t e d t h a t s l o w s o d i u m f o o d s , m a y f a l l w i t h i n o n e o f t h e o t h e r l i s t e d t o b e c o n f i r m 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 . 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 o n l y ( a ) 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 t h e m r A P P E A L N U M B E R e i p t o f d i s a b i l i t y a s s i s t a n c e . T h e a p p e l l a n t ' s p a r e n t n d i s a c t i n g o n b e h a l f o f t h e a p p e l l a n t , w i t h t h e a s s i s t a n c e r i l 1 9 , 2 0 1 9 , c o a u t h o r e d b y a m e d i c a l p r a c t i t i o n e r a n d a o n . T h e a p p e l l a n t i s l i v i n g w i t h a m e t a b o l i c d i s o r d e r c a l l e d A D ) w h i c h r e s u l t s i n a n i n a b i l i t y o f t h e b o d y t o b r e a k l o n g d a i l y d i e t t h a t i s l i m i t e d i n l o n g c h a i n f a t s a n d h i g h i n V L C A D d i e t i s n e c e s s a r y t o p r e v e n t c o m p l i c a t i o n s s u c h a s a p p e l l a n t t o f o l l o w a l o w f a t , h e a rt h e a l t h y d i e t c o n s i s t i n g a n m e a t . L o w f a t a l t e r n a t i v e s w i l l a l s o b e n e e d e d . T h e t h s i s a l s o i d e n t i f i e d . n f a n t f o r m u l a b u t d e n i e d t h e d i e t s u p p l e m e n t . l o f t h e d i e t s u p p l e m e n t w a s r e q u e s t e d . I n t h e R e q u e s t f o r f o l l o w i n g t h e r e q u i r e d s p e c i f i c d i e t c o u l d r e s u l t i n l o n g h e a v i l y p r o c e s s e d f o o d s a r e d i f f i c u l t f o r t h e a p p e l l a n t t o b a n k i s d i f f i c u l t , a n d t h a t i n 6 m o n t h s t h e a p p e l l a n t w i l l v e r a g e , c o s t s $ 4 0 p e r b o t t l e . a d m i s s i b i l i t y 2 0 1 9 , i n w h i c h 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 i s l t o c h a n g e t h e l i s t o f a c c e p t e d [ m e d i c a l ] c o n d i t i o n s . " C A D p r e v i o u s l y w e n t u n d i a g n o s e d b u t i s n o w d e t e c t a b l e h a b o u t 4 c a s e s d i a g n o s e d e a c h y e a r i n B C , a n d c a n b e c h a s e g g y o l k s a n d a v o c a d o s , a n d r e q u i r e s l e a n m e a t s e l p b r e a k d o w n h e a v y f a t s i n t o m e d i u m c h a i n f a t s . T h e a r e o f n u r s e p r a c t i t i o n e r , w i t h t h e p a r e n t c l a r i fy i n g t h a t a a p p e l l a n t e v e r y t h r e e m o n t h s w i t h t e s t s c o n d u c t e d a t 3 n d e y e t e s t s ) . n d e c i s i o n , n o t i n g t h a t t h e m i n i s t r y i s l i m i t e d t o a p p l y i n g o m e 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 , s u c h a s t h e n e e d f o r d i e t s u p p l e m e n t s b u t t h a t t h e i n f o r m a t i o n w o u l d n e e d A s s i s 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 a s e v i d e n c e 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 m a d e , a n d
( b ) o r a l o r 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 rt o f t h e i n f r e c o n s i d e r a t i o n . A s t h e i n f o r m a t i o n i n t h e N O A a n d a t h e a r i n g r e i t e r a t e d 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 r e c o n s i d e r a t i o n . 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 I A P P E A L N U M B E R o r m a t i o n a 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 p r i o r s u b m i s s i o n s , i t w a s a d m i t t e d a s t e s t i m o n y i n i s d e c i s i o n .
I APPEAL NUMBER PART F -REASONS FOR PANEL DECISION Issue on Appeal The issue on appeal is whether the ministry's decision to deny the appellant a diet supplement was reasonably supported by the evidence or was a reasonable application of the applicable enactment in the circumstances of the appellant. That is, was the ministry reasonable when determining that the requirement of section 6 of Schedule C of the EAPWDR was not met because the diet supplement is not required for one of the medical conditions or dietary needs listed in that section? Relevant legislation EAPWDA Disability assistance and supplements 5 Subject to the regulations, the minister may provide disability assistance or a supplement to or for a family unit that is eligible for it. EAPWDR Diet supplement 66 (1) Subject to subsection (2), the minister may pay for a diet supplement in accordance with section 6 [diet supplements] of Schedule C that is provided to or for a family unit in receipt of disability assistance, if the supplement is provided to or for a person in the family unit who (a} is described in section 6 (1) of Schedule C, and (b} is not described in section 8 (1} [people receiving special care] of Schedule A. (2)A person is not eligible to receive a supplement under subsection (1) unless (a} the person is not receiving another nutrition-related supplement, and (b} a medical practitioner, nurse practitioner or registrant of the College of Dietitians of British Columbia established under the Health Professions Act confirms in writing the need for the special diet. Diet supplements 6 (1) The amount of a diet supplement that may be provided under section 66 [diet supplements] of this
I APPEAL NUMBER regulation is as follows: (a) $10 for each calendar month for a person who requires a restricted sodium diet; (b) $35 for each calendar month for a person who has diabetes; (c) $30 for each calendar month for a person who requires kidney dialysis if the person is not eligible under the kidney dialysis service provided by the Ministry of Health Services; (d) $40 for each calendar month for a person who requires a high protein diet; (e) $40 for each calendar month for a person who requires a gluten-free diet; (f} $40 for each calendar month for a person who has dysphagia; (g} $50 for each calendar month for a person who has cystic fibrosis; (h} $40 for each calendar month for which a person requires a ketogenic diet; (i) $40 for each calendar month for which a person requires a low phenylalanine diet. (2)A diet supplement under subsection (1) (d} may only be provided if the diet is confirmed by a medical practitioner or nurse practitioner as being necess a ry for one of the following medical conditions: (a} cancer that requires nutritional support during (i) radiation therapy, (ii} chemotherapy, (iii) surgical therapy, or (iv) ongoing medical treatment; (b) chronic inflammatory bowel disease; (c} Crohn's disease; (d} ulcerative colitis; (e} HIV positive diagnosis; (f} AIDS; (g) chronic bacterial infection; (h} tuberculosis; (i} hyperthyroidism;
( j ) o s t e o p o r o s i s ; ( k ) h e p a t i t i s B ; ( I ) h e p a t i t i s C . ( 3 ) A p e r s o n w h o i s e l i g i b l e f o r a s u p p l e m e n t u n d e r s u b s t o w a r d s t h e p u r c h a s e o f a b l e n d e r . ( 4 ) I f a p e r s o n h a s m o r e t h a n o n e o f t h e m e d i c a l c o n d i t i t h e a m o u n t o f t h e h i g h e s t d i e t s u p p l e m e n t f o r w h i c h h e D e c i s i o n P o s i t i o n s o f t h e P a r t i e s O n b e h a l f o f t h e a p p e l l a n t , t h e a d v o c a t e a n d p a r e n t d o i n c l u d e d i n t h o s e f o r w h i c h a d i e t s u p p l e m e n t m a y b e p c o n d i t i o n s f o r w h i c h a d i e t s u p p l e m e n t i s p r o v i d e d s h o u d i a g n o s a b l e f a i r l y r e c e n t l y . W h i l e s y m p a t h i z i n g w i t h 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 r e q u i r e m e n t s a n d m e d i c a l c o n d i t i o n a r e n o t l i s t e d u n d e c a n n o t p r o v i d e a d i e t s u p p l e m e n t . P o n e / A n a l y s i s S e c t i o n 5 o f t h e E A P W D A a l l o w s f o r t h e m i n i s t e r t o p r o v s e c t i o n 6 6 a n d s e c t i o n 6 o f S c h e d u l e C o f t h e E A P W D R . S e c t i o n 6 ( 1 ) o f S c h e d u l e C d e s c r i b e s t h e s p e c i f i c d i e t s u p r o t e i n , g l u t e n f r e e , k e t o g e n i c , o r l o w p h e n y l a l a n i n e ) o ( d i a b e t e s , k i d n e y d i a l y s i s , d y s p h a s i a o r c y s t i c f i b r o s i s ) . N p r o v i d e d . S u b s e c t i o n ( 2 ) s e t s o u t a n a d d i t i o n a l r e q u i r e m h i g h p r o t e i n d i e t : t h e d i e t m u s t b e c o n f i r m e d b y a m e d i m e d i c a l c o n d i t i o n s l i s t e d i n t h a t s u b s e c t i o n c a n c e r , c h u l c e r a t i v e c o l i t i s , H I V p o s i t i v e d i a g n o s i s , A I D S , c h r o n i c b o s t e o p o r o s i s , h e p a t i t i s B , o r h e p a t i t i s C . I n t h i s c a s e , a m e d i c a l p r a c t i t i o n e r h a s i d e n t i f i e d t h e n e m e d i c a l p r a c t i t i o n e r d o e s n o t i d e n t i fy a n y o f t h e o t h e r d ( 2 ) o f S c h e d u l e C . I n t h e r e c o n s i d e r a t i o n s u b m i s s i o n , t h e r e q u i r e d d i e t b u t t h i s i s n o t c o n f i r m e d b y a m e d i c a l o r n a c k n o w l e d g i n g t h a t t h e i n f o r m a t i o n c l e a r l y e s t a b l i s h e s I A P P E A L N U M B E R e c t i o n ( l ) ( d ) o r ( f ) i s a l s o e l i g i b l e f o r a $ 3 0 p a y m e n t o n s s e t o u t i n s u b s e c t i o n ( 1 ) , t h e p e r s o n m a y r e c e i v e o n l y o r s h e i s e l i g i b l e . n o t a r g u e t h a t 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 i s r o v i d e d b u t i n s t e a d a r g u e t h a t t h e l i s t o f d i e t s a n d m e d i c a l l d b e e x p a n d e d t o i n c l u d e V L C A D , w h i c h h a s o n l y b e e n i o n , 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 t h e a p p e l l a n t ' s d i e t a r y r s e c t i o n 6 o f S c h e d u l e C a n d t h e r e f o r e t h e m i n i s t r y i d e s u p p l e m e n t s f o r e l i g i b l e f a m i l y u n i t s a s d e s c r i b e d i n p p l e m e n t s a s e i t h e r a t y p e o f d i e t ( r e s t r i c t e d s o d i u m , h i g h r a s a d i e t r e l a t e d t o a m e d i c a l c o n d i t i o n / t r e a t m e n t o o t h e r b a s e s o f e l i g i b i l i t y f o r d i e t s u p p l e m e n t s a r e e n t f o r t h e p r o v i s i o n o f a d i e t s u p p l e m e n t t h a t i s f o r a c a l o r n u r s e p r a c t i t i o n e r a s b e i n g n e c e s s a r y f o r o n e o f t h e r o n i c i n f l a m m a t o r y b o w e l d i s e a s e , C r o h n ' s d i s e a s e , a c t e r i a l i n f e c t i o n , t u b e r c u l o s i s , h y p e r t h y r o i d i s m , e d f o r a s p e c i a l i z e d V L C A D d i e t fo r t h e a p p e l l a n t . T h e i e t s o r m e d i c a l c o n d i t i o n s d e s c r i b e d i n s e c t i o n s 6 ( 1 ) a n d a p p e l l a n t ' s p a r e n t s t a t e s t h a t " n o s o d i u m " i s p a r t o f t h e u r s e p r a c t i t i o n e r , w h i c h i s a l e g i s l a t e d r e q u i r e m e n t . W h i l e t h e a p p e l l a n t ' s n e e d f o r a s p e c i a l i z e d V L C A D d i e t , g i v e n
I APPEAL NUMBER that this diet is not required for one of the medical conditions or dietary needs set out in section 6 of Schedule C and as none of the other diets/medical conditions for which a diet supplement may be provided are confirmed by a medical or nurse practitioner, the panel concludes that the ministry has reasonably determined that the appellant is not eligible for a diet supplement based on the legislation. Conclusion The panel finds that the ministry's reconsideration decision, which determined that the appellant had not met all requirements set out under section 6 of Schedule C of the EAPWDR for a diet supplement was a reasonable application of the legislation. The ministry's decision is confirmed and the appellant is not successful on appeal.
I APPEAL NUMBER PART G -ORDER THE PANEL DECISION IS: (Check one) ISJUNANIMOUS □BY MAJORITY THE PANEL ISJCONFIRMS 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) D or Section 24(2)(b) ISi PART H -SIGNATURES PRINT NAME Jane Nielsen SIGNATURE OF CHAIR DATE(YEAR/MONTHIDAY) 2019/07/09 PRINT NAME Tina Ahnert SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2019/07/09 PRINT NAME Carlos Garcia S I G NA TIJ R f O f M E M B f R DATE {YEAR/MONTH/DAY) 2019/07/09
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.