Information Notice - PWD Adjudication Guidelines
Effective September 30, 2002
Introduction
The Ministry of Social Development has developed Adjudication Guidelines to guide adjudicators in the Health Assistance Branch as they determine eligibility for the Persons with Disabilities (PWD) designation as outlined in the Employment and Assistance for Persons with Disabilities Act.
The purpose of the Adjudication Guidelines is to ensure consistency in the interpretation of the evidenced-based information provided in the PWD Designation Application, as well as to ensure the decision-making process is reliable, transparent and effective.
Principles
The Adjudication Guidelines are based on the following principles:
- Decisions are based on the information provided in the application as it relates to the "test" of the criteria outlined in legislation;
- Knowledge and acquired expertise is applied only to determine when more information is required of the referring professionals;
- Guidelines support objective assessment and provide an accumulative basis for assumptions; and,
- Summary of findings supporting the results of the adjudication process are clear and have integrity.
Content Of Guidelines
- Outlines the five basic criteria (as noted below);
- Directs how information will be used from each section of the Application in relation to the test of the criteria;
- Provides a definition framework for critical adjectives (severe, significantly restricts, periodic, etc.);
- Gives instruction on the written summary of findings (meets designation or does not meet designation) as it relates to each of the 5 basic criteria; and,
- Gives instruction on the setting of future review dates.
Five Basic Criteria
All of the following requirements must be met in order for a person to be found eligible for the PWD designation:
- 18 years of age;
- Severe physical or mental impairment (the application collects information
to allow the adjudicator to make the determination whether the
criterion of 'severe' impairment is met);
- Impairment
duration of at least 2 years (unless palliative);
- Impairment
directly and significantly restricts applicant's ability to perform
Daily Living Activities; and,
- Applicant
requires help with Daily Living Activities (again application
collects information and the adjudicator makes the determination
of whether the help required meets the requirement in the Act).
