I APPEAL NUMBER PART C -DECISION UNDER APPEAL The decision under appeal is the Ministry of Social Development and Poverty Reduction (the "Ministry") reconsideration decision dated August 19, 2019 which denied the appellant's request for a diet supplement by reason that the appellant did not meet the legislative requirements set out in s.66(1)(2) and Schedule C, section 6 of the Employment and Assistance for Persons With Disabilities Regulation ("EAPWDR") to qualify for the supplement. PART D -RELEVANT LEGISLATION Employment and Assistance Act ("EAA") Employment and Assistance for Persons with Disabilities Regulation ("EAPWDR")
I APPEAL NUMBER PART E -SUMMARY OF FACTS The evidence before the Ministry at reconsideration was: The appellant was in receipt of a diet supplement from May 16, 2007 until June 4, 2019 at which time the appellant's eligibility f o r the diet supplement was reviewed by the Ministry. Previously the Ministry provided the appellant a diet supplement because they relied on information from the appellant's various physicians that the appellant was at risk of diabetes. This information includes: o A May 16, 2007 letter from a physician stating that the appellant would benefit from a diabetes diet and should receive a diabetes diet allowance for 12 months; o A May 11, 2009 letter from the same physician stating that the appellant would benefit from a diabetes diet and should receive a diabetes diet allowance for 12 months; o A May 5, 2011 letter from a second physician stating the appellant requires continuation of her diet supplement as she is at risk of hypercholesterolemia and diabetes due to her antip sychotic medications. She will require the diet on an ongoing basis. o A May 7, 2013 letter from a second physician stating that the appellant has been diagnosed with Schizoaffective Disorder, Asthma, Focal Segmental Glomerulosclerosis and Hypercholesterolmeia and she requires a special diet f o r her multiple health issues on an indefinite basis. On June 4, 2019 the Ministry asked the appellant to provide them with information from a medical practitioner confirming that the appellant still required the diet supplement. On June 10, 2019 the Ministry received a note from the appellant's physician which stated: "needs high protein diet supplement". The Ministry requested a diagnosis from the appellant's physician. On June 26, 2019 the Ministry received a fax from a specialist (the "Specialist") stating: "the appellant has been under my care for 1 O years for kidney disease (focal segmental glomerulosclerosis). She has requested my help with a letter stating her diagnosis in order to renew her meal allowance supplements. Note that her kidney disease does not necessitate any specific dietary restrictions or supplements. On July 16, 2019 the Ministry denied the appellant's request for a renewal of her diet supplement. The Ministry relied on the opinion of the Specialist. The appellant's request for reconsideration provided: o She has been receiving the diet allowance since about 1999; o She leaks a lot of protein in her urine. The disease is called Focal Sclerosis; and o She is also applying f o r the nutritional supplement because the disease is lifelong. The Notice of appeal states: "it is not diabetes. Its renal. I leak protein in my urine. Disease called focal sclerosis". Prior to the hearing the appellant provided new evidence from a doctor which was a prescription pad indicating "the appellant required a diabetic diet for diabetes. 2 years repeats". The Ministry representative did not object to the entry of the new evidence. The additional prescription is in support of prior medical information indicating that the appellant was at risk of diabetes. The panel determined the additional documentary evidence was admissible pursuant to s.22(4) of the EAA as it was in support of the medical records before the minister at reconsideration. At the hearing, the appellant provided the following evidence that: She has been on the diet allowance for over 20 years; Her medication leads to diabetes; and She needs a high protein diets because she leaks protein in her urine. The kidney specialist doesn't think she requires it. At the hearing, the appellant provided the following new evidence: She orders from a meal company so she needs financial help from the meals. The physician that indicated that she has diabetes has been her family doctor for 20 years. She switched to her in 2001. Her familv doctor determined that the annellant was diabetic 3 weeks aao.
T h e S p e c i a l i s t d o e s n o t t e s t h e r f o r d i a b e t e s . H e T h e p a n e l f i n d s t h a t t h e a p p e l l a n t ' s o r a l t e s t i m o n y i s i n s a p p e l l a n t w a s a t r i s k o f d i a b e t e s . T h e p a n e l d e t e r m i n e d t p u r s u a n t t o s . 2 2 ( 4 ) o f t h e E A A a s i t w a s i n s u p p o rt o f t h e A t t h e h e a r i n g t h e M i n i s t r y r e l i e d o n t h e i r r e c o n s i d e r a t i o n a p p e l l a n t o r i g i n a l l y s u p p l i e d f r o m t h e S p e c i a l i s t s t a t e d t h i n d i c a t e d t h a t b a s e d o n t h e n e w i n f o r m a t i o n o f S e p t e m b e f o r t h e d i e t s u p p l e m e n t g o i n g f o rw a r d .I A P P E A L N U M B E R t r a c k s o t h e r t h i n g s f o r t h e K i d n e y s . u p p o r t o f p r i o r m e d i c a l i n f o r m a t i o n i n d i c a t i n g t h a t t h e h e a d d i t i o n a l d o c u m e n t a r y e v i d e n c e w a s a d m i s s i b l e m e d i c a l r e c o r d s b e f o r e t h e m i n i s t e r a t 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 o n f i r m e d t h a t t h e 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 t s h e d i d n ' t n e e d r e q u i r e a s p e c i a l d i e t . T h e M i n i s t r y r 1 2 , 2 0 1 9 t h e M i n i s t r y w i l l b e a b l e t o s u p p o r t a n d p r o v i d e
I A P P E A L N U M B E R PA R T F R E A S O N S F O R P A N E L D E C I S I O N I s s u e o n a p p e a l : T h e i s s u e o n a p p e a l i s w h e t h e r t h e M i n i s t r y ' s d e c i s i o n t o d e n y t h e a p p e l l a n t ' s r e q u e s t f o r a d i e t s u p p l e m e n t i s r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e o r a r e a s o n a b l e a p p l i c a t i o n o f t h e a p p l i c a b l e l e g i s l a t i o n i n t h e c i r c u m s t a n c e s o f t h e a p p e l l a n t . T h e l e g i s l a t i o n p r o v i d e s : E A P W D R D i e t s u p p l e m e n t 6 6 ( 1 ) S u b j e c t t o s u b s e c t i o n ( 2 ) , t h e m i n i s t e r m a y p a y fo r a d i e t s u p p l e m e n t i n a c c o r d a n c e w i t h s e c t i o n 6 [ d i e t s u p p l e m e n t s ] o f S c h e d u l e C t h a t i s p r o v i d e d t o o r f o r 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 s i s t a n c e , i f t h e s u p p l e m e n t i s p r o v i d e d t o o r f o r a p e r s o n i n t h e f a m i l y u n i t w h o ( a ) i s d e s c r i b e d i n s e c t i o n 6 ( 1 ) o f S c h e d u l e C , a n d ( b ) i s n o t d e s c r i b e d i n s e c t i o n 8 ( 1 ) [ p e o p l e r e c e i v i n g s p e c i a l c a r e ] o f S c h e d u l e A . ( 2 ) A p e r s o n i s n o t e l i g i b l e t o r e c e i v e a s u p p l e m e n t u n d e r s u b s e c t i o n ( 1 ) u n l e s s ( a ) t h e p e r s o n i s n o t r e c e i v i n g a n o t h e r n u t r i t i o n r e l a t e d s u p p l e m e n t , a n d ( b ) a m e d i c a l p r a c t i t i o n e r , n u r s e p r a c t i t i o n e r o r d i e t i t i a n c o n fi r m s i n w r i t i n g t h e n e e d f o r t h e s p e c i a l d i e t . [ e n . B . C . R e g . 1 4 5 / 2 0 1 5 , S c h . 2 , s . 6 ; a m . B . C . R e g . 1 2 3 / 2 0 1 9 , A p p . 2 , s . 2 . ] F o r t h e s e r e a s o n s , t h e p a n e l f i n d s t h e M i n i s t r y ' s d e c i s i o n w a s ( o r w a s n o t ) r e a s o n a b l y s u p p o r t e d b y t h e e v i d e n c e ( o r a r e a s o n a b l e a p p l i c a t i o n o f t h e a p p l i c a b l e e n a c t m e n t i n t h e c i r c u m s t a n c e s o f t h e a p p e l l a n t ) a n d c o n f i r m s ( o r r e s c i n d s ) t h e d e c i s i o n . S C H E D U L E C D i e t s u p p l e m e n t s 6 ( 1 ) T h e a m o u n t o f a d i e t s u p p l e m e n t t h a t m a y b e p r o v i d e d u n d e r s e c t i o n 6 6 [ d i e t 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 i s a s fo l l o w s : ( a ) $ 1 0 f o r e a c h c a l e n d a r m o n t h f o r a p e r s o n w h o r e q u i r e s a r e s t r i c t e d s o d i u m d i e t ; ( b ) $ 3 5 f o r e a c h c a l e n d a r m o n t h f o r a p e r s o n w h o h a s d i a b e t e s ; ( c ) $ 3 0 f o r e a c h c a l e n d a r m o n t h fo r a p e r s o n w h o r e q u i r e s k i d n e y d i a l y s i s i f t h e p e r s o n i s n o t e l i g i b l e u n d e r t h e k i d n e y d i a l y s i s s e rv i c e p r o v i d e d b y t h e M i n i s t r y o f H e a l t h S e r v i c e s ; ( d ) $ 4 0 f o r e a c h c a l e n d a r m o n t h f o r a p e r s o n w h o r e q u i r e s a h i g h p r o t e i n d i e t ; ( e ) $ 4 0 f o r e a c h c a l e n d a r m o n t h f o r a p e r s o n w h o r e q u i r e s a g l u t e n f r e e d i e t ; ( f ) $ 4 0 f o r e a c h c a l e n d a r m o n t h fo r a p e r s o n w h o h a s d y s p h a g i a ; ( g ) $ 5 0 f o r e a c h c a l e n d a r m o n t h f o r a p e r s o n w h o h a s c y s t i c f i b r o s i s ; ( h ) $ 4 0 f o r e a c h c a l e n d a r m o n t h f o r w h i c h a p e r s o n r e q u i r e s a k e t o g e n i c d i e t ;
I APPEAL NUMBER (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, nurse practitioner or dietitian as being necessary 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; U)osteoporosis; (k)hepatitis B; (l)hepatitis C. (3)A person who is eligible for a supplement under subsection (1) (d) or (f) is also eligible for a $30 payment towards the purchase of a blender. (4)If a person has more than one of the medical conditions set out in subsection (1), the person may receive only the amount of the highest diet supplement for which the person is eligible. SCHEDULE A -People receiving special care 8 (1)For a person with disabilities who receives accommodation and care in a special care facility (other than a special care facility described in subsection (3)) or a private hospital or who is admitted to a hospital because he or she requires extended care, the amount referred to in section 24 (a) [amount of disability assistance] of this regulation is the sum of (a)the actual cost, if any, to the applicant or recipient of the accommodation and care at the rate approved by the minister for the type of facility, plus (b)a comforts allowance of $222 for each person for each calendar month. lc\Renealed. rs.c. Ren. 193/2017, s. 12.l
E A A s . 2 2 ( 4 ! P a n e l s o f t h e t r i b u n a l t o c o n d u c t a p p e a l s 2 2 ( 1 ) I f a p e r s o n c o m m e n c e s a n a p p e a l i n a c c o r d a n c e c o n s i s t i n g o f u p t o 3 m e m b e r s o f t h e t r i b u n a l t o h e a r a n d ( 2 ) I f a p a n e l c o n s i s t s o f m o r e t h a n o n e m e m b e r , t h e c h a i m e m b e r s o f t h e p a n e l , a n d i f a p a n e l c o n s i s t s o f o n e m e ( 3 ) A p a n e l m u s t c o n d u c t a h e a r i n g i n t o t h e d e c i s i o n b e i n ( a ) o r a l l y , o r ( b ) w i t h t h e c o n s e n t o f t h e p a r t i e s , i n w r i t i n g . ( 4 ) I n a h e a r i n g r e f e r r e d t o i n s u b s e c t i o n ( 3 ) , a p a n e l m a y ( a ) 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 t h e m i n i s ( b ) o r a l o r w r i t t e n t e s t i m o n y i n s u p p o rt o f t h e i n f o r m a t i o n a ( 5 ) E v i d e n c e r e f e r r e d t o i n s u b s e c t i o n ( 4 ) m a y b e a d m i t t e c o u rt o f l a w . ( 6 ) T h e p a n e l c h a i r i s r e s p o n s i b l e fo r d e c i d i n g a n y q u e s t i o a n d i s n o t p r o v i d e d f o r i n t h e r e g u l a t i o n s o r i n t h e p r a c t i c [ p o w e r s a n d d u t i e s o f t h e c h a i r ] . T h e p a n e l f i n d s : T h e p a n e l f i n d s t h a t a t t h e t i m e t h e r e c o n s i d e r a t i o n d e c i s i n f o r m a t i o n b e f o r e t h e m , w h i c h w a s i n f o r m a t i o n f r o m t h e s u p p l e m e n t s " a n d f r o m t h e S p e c i a l i s t i n d i c a t i n g t h a t " k i d n r e s t r i c t i o n o r s u p p l e m e n t s " . A s s u c h t h e p a n e l f i n d s t h a t a p p e l l a n t d i d n o t q u a l i f y f o r a d i e t s u p p l e m e n t b e c a u s e t h w i t h i n a n y o f t h e o t h e r c r i t e r i a i n S c h e d u l e C , s e c t i o n 6 ( 1 T h e n e w i n f o r m a t i o n o f S e p t e m b e r 1 2 , 2 0 1 9 i s a c c e p t e d d i a b e t i c i s d a t e d a s o f S e p t e m b e r 1 2 , 2 0 1 9 . T h a t d i a g n o p h y s i c i a n s . A c c o r d i n g t o t h e r e c o r d s b e f o r e t h e M i n i s t r y S e p t e m b e r 1 2 , 2 0 1 9 . T h e a p p e l l a n t ' s e v i d e n c e s e t o u t i n p a n e l t h e r e f o r e f i n d s t h a t t h e a d d i t i o n a l p r e s c r i p t i o n f r o m o n a s o f S e p t e m b e r 1 2 , 2 0 1 9 a n d t h a t t h e c o n f i r m a t i o n o t h a t t h e a p p e l l a n t w a s d e n i e d t h e d i e t s u p p l e m e n t . T h e p a n e l f i n d s i t r e a s o n a b l e f o r t h e M i n i s t r y t o d e t e r m i n a d i a g n o s i s o f d i a b e t e s . T h i s i s s e t o u t i n S c h e d u l e C , s e o t h e r c o n d i t i o n s a p p l i e d t o e n t i t l e h e r t o t h e d i e t s u p p l e m w a s n o t a b l e t o p r o v i d e t h e d i e t s u p p l e m e n t u n d e r a n y o f E A P W D R a s o f A u g u s t 1 9 , 2 0 1 9 . T h e p a n e l t h e r e f o r e f i n d s o n t h e p r e v i o u s e v i d e n c e b e f o r 1 2 , 2 0 1 9 , t h e M i n i s t r y d e c i s i o n i s r e a s o n a b l y s u p p o r t e d b a n n l i c a b l e e n a c t m e n t i n t h e c i r c u m s t a n c e s o f t h e a n n e l l a I A P P E A L N U M B E R w i t h s e c t i o n 2 1 ( 1 ) , t h e c h a i r m u s t a p p o i n t a p a n e l d e t e r m i n e t h e a p p e a l . r m u s t d e s i g n a t e a c h a i r o f t h e p a n e l fr o m a m o n g t h e m b e r , t h a t m e m b e r i s t h e c h a i r o f t h e p a n e l . g a p p e a l e d w i t h i n t h e p r e s c r i b e d p e r i o d e i t h e r a d m i t a s e v i d e n c e o n l y 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 n d r e c o r d s r e f e r r e d t o i n p a r a g r a p h ( a ) . d w h e t h e r o r n o t i t w o u l d b e a d m i s s i b l e a s e v i d e n c e i n a n o f p r a c t i c e o r p r o c e d u r e t h a t a r i s e s d u r i n g a h e a r i n g e s a n d p r o c e d u r e s o f t h e c h a i r u n d e r s e c t i o n 2 0 ( 2 ) ( a ) i o n w a s m a d e t h e M i n i s t r y r e l i e d o n t h e m e d i c a l a p p e l l a n t ' s p h y s i c i a n i n d i c a t i n g " n e e d s h i g h p r o t e i n d i e t e y d i s e a s e d o e s n o t n e c e s s i t a t e a n y s p e c i fi c d i e t a r y i t w a s r e a s o n a b l e f o r t h e M i n i s t r y t o c o n c l u d e t h a t t h e e a p p e l l a n t d i d n o t h a v e a d i a g n o s i s o f d i a b e t e s o r f i t ) E A P W D R . b y t h e p a n e l . T h e n e w i n fo r m a t i o n t h a t t h e a p p e l l a n t i s s i s w a s n e v e r m a d e f r o m a n y o f t h e a p p e l l a n t ' s p r e v i o u s a n d t h e n e w e v i d e n c e , t h e e a r l i e s t d i a g n o s i s o f d i a b e t e s i s h e r n o t i c e o f a p p e a l i s a l s o t h a t " i t i s n o t d i a b e t e s " . T h e t h e p h y s i c i a n o n S e p t e m b e r 1 2 , 2 0 1 9 c a n o n l y b e r e l i e d f d i a b e t e s , w h i l e a c c e p t e d a s e v i d e n c e , i s a ft e r t h e d a t e e t h a t a r e q u i r e m e n t o f t h e l e g i s l a t i o n i s t h a t t h e r e m u s t b e c t i o n 6 ( 1 ) ( b ) . T h e a p p e l l a n t d i d n o t s u b m i t t h a t a n y o f h e r e n t . T h e p a n e l a l s o f i n d s i t r e a s o n a b l e t h a t t h e M i n i s t r y t h e o t h e r c a t e g o r i e s i n S c h e d u l e C , s e c t i o n 6 ( 1 ) o f e t h e M i n i s t r y a n d a l s o o n t h e n e w e v i d e n c e o f S e p t e m b e r y t h e e v i d e n c e , a n d a r e a s o n a b l e a p p l i c a t i o n o f t h e n t .
I APPEAL NUMBER The Ministry decision is therefore confirmed.
f APPEAL NUMBER PART G -ORDER THE PANEL DECISION IS: (Check one) [gjUNANIMOUS □BY MAJORITY THE PANEL [gjCONFIRMS 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) [gj or Section 24(1 )(b) [gj and Section 24(2)(a) [gj or Section 24(2)(b) D PART H -SIGNATURES PRJNTNAME MEGHAN WALLACE SIGNATURE OF CHAIR DATE (YEAR/MONTH/DAY) 2019/09/18 PRINT NAME LINDA SMERYCHYNSKI SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2019/09/18 PRINT NAME KENT ASHBY SIGNATURE OF MEMBER DATE (YEAR/MONTH/DAY) 2019/09/18
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.