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No special diet for Income Assistance recipient

HMC contributor Kendall Worth fights decision all the way to the Nova Scotia Supreme Court

by Rana Encol

Kendall Worth, who lives on social assistance, took his fight for a special diet all the way to the Nova Scotia Supreme Court. He lost.  Photo Halifax Media Co-op
Kendall Worth, who lives on social assistance, took his fight for a special diet all the way to the Nova Scotia Supreme Court. He lost. Photo Halifax Media Co-op

(K'JIPUKTUK) HALIFAX – On Thursday, long-time Halifax Media Co-op contributor Kendall Worth appealed a decision by Nova Scotia Supreme Court upholding the Department of Community Services and Assistance Appeal Board decision that he no longer should be granted his special needs diet.

Justice James L. Chipman upheld the decision.

Worth had been receiving a monthly allowance of $66 for a high-calorie, high-protein diet prescribed to him by his doctors since 2011. This is in addition to the monthly income assistance he receives through the Employment Services and Income Assistance act.

Worth lives with compulsive control disorder, a learning disorder, and a cardiovascular medical condition. His diet is prescribed to him because of his weight loss associated with compulsive behaviour. Worth told the assistance appeal board that “since the high protein portion of his special diet was taken away his symptoms have gotten harder to control.”

The diet was originally prescribed by Dr. Muthu, a psychiatrist in 2011, and again in 2012. The same diet was prescribed by another doctor, Dr. Grada in July 2013, and finally by Dr. Wilson in October 2013 -- although Wilson said the diet was to reduce “cardiac risk factors such as obesity” -- different from the previous prescriptions and so requiring clarification.

The Department of Community Services denied him funding for his special diet in February 2013. Worth appealed this decision April 2013.

In a second appeal in March 2014, a caseworker on behalf of the department told the board that Doctor Wilson, which had made the most recent prescription for Worth, “is of the opinion that after reviewing this [case], that the client is not in need of this diet,” in a conversation dated Dec. 11, 2013.

The hearing Thursday was meant to determine whether the court’s decision was “reasonable” given the circumstances: Tanya Jones, counsel from Nova Scotia Legal Aid representing Worth, argued that it was not reasonable for this final conversation to trump prescriptions from three doctors.

Zoe Roberts countered that it was reasonable because Wilson’s prescription was unclear and had to be verified, and that he ultimately decided that Worth was no longer in need of the diet.

At least one doctor previous to Wilson was fed up with repeated calls from case workers and said they could no longer help Kendall.

North End Community Health Centre workers have signed a letter asking that current ESIA policy be reformed because of such instances of a “vague” medical assessment form and the “discrepancy between workers and offices regarding detail requested and guidelines imposed relating to eligibility for special needs.”

The letter states that it is unclear why medical reports are sometimes rejected and that proper communication from case workers is lacking.

Worth has approached the head of FEED Nova Scotia and various food banks to see if they could help him in purchasing his special diet products, but to no avail.


An earlier version of this story said Tanya Jones works for Dal Legal Aid, when in fact she is with Nova Scotia Legal Aid. The Media Co-op regrets the error.


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Topics: FoodPoverty
494 words


To report a Typo!


I Mr.Kendall Worth wants publicy thank Rana Encol for covering this. Just one correction needs to be made in the article. The correction is:

Tanya Jones, counsel from Dal Legal Aid is not correct. Tanya Jones works for Nova Scotia Legal Aid.


Thank you!

Support from medical community lacking as well

One of the scariest things about ESIA is how we, as clients (isn't is an insult to call us clients, by the way) are 100% reliant on a doctor to not only understand our needs but to be willing to write endless letters about them. If you can't get a doctor interested in your situation, you're out of luck.

The loss of the $66 can be attributed to the apathy of one doctor, compounded by the extreme strictness of ESIA. ESIA won't give you anything unless a doctor says exactly what you need and why. The fact that three previous doctors said it was a need was irrelvant. The government pounced on the useless doctor's word for all it was worth.

What a disaster. Infuriating!

Many years ago, a caseworker said I could get extra money for green leafy vegetables if my doctor wrote a note about it. I told my doctor this. She scribbled a one-sentence note on a prescription form: "...needs to eat vegetables." The note was useless because it did not specify what kind of vegetables. I had to ask her to do it up again. She was very annoyed. More recently, I foolishly trusted my doctor to tell my caseworker that I needed iron supplements. I told him the note was supposed to state the brand name (because of cost), the duration, and the reason/medical condition. His note said: "Needs iron supplementation, 3 months." It was rejected and I had to get him to do up the letter again with all the needed details.

I've had many problems with irritated doctors who just don't get how important these letters are and how precise the details have to be. I have a long-standing policy of typing up the letter exactly as it should read, handing it to them to read, and if they agree, to get an identical or near-identical copy typed up by the receptionist, and have the doctor sign it. As long as the doctor agrees with the entire content of the letter and signs it, this is what all clients of ESIA should do if they have the cognitive skills to compose rock-solid letters. Never trust a doctor to tell ESIA exactly what they need to be told. One still may lose money off one's cheque at the yearly review, but at least you have the best shot at getting every penny you can if you supervise the process every step of the way.

Wrtie down exactly what needs to be said, leaving no detail out, hand it to the doctor, stating that every word of the draft letter must be included. Do not allow letters to be sent directly to ESIA. Check it first, and if anything is not right, insist it be redone.

As for why I lost most of my transportation allowance despite the letter from my doctor stating that there were issues with Access-A-Bus: because he did not explain those issues to the tune of what would have been a three page dissertation on the Access-A-Bus service. I didn't ask him to include several more pages on Access-A-Bus because he has no knowledge of the service, nor is it a medical issue. However, at the appeal, I was told that my doctor should have written a long letter detailing all the issues with Access-A-Bus.

And that's the other scary thing: ESIA wanting documentation from doctors for non-medical issues. When I asked if I could get some money as I was in desperate need of clothing, I was told they would give me $150 if I got a note from my doctor. Ridiculous!

Thanks for your comment!


It is good that you had provided your comment say what you had said. What you had said in your comment is so true. Because of how the caseworkers treat us,expecially when it comes to Medcial needs, we need to continue fighting. Your experinece is good to know.

You comment is evendients that shows that I am not alone in this.



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