Health benefits are a critical part of the Ontario Disability Support Program. Appropriate access to and funding for health benefits is crucial to make sure that ODSP recipients have access to necessary health-related items like medications, diabetic supplies, wheelchairs, and dentures. The ODSP needs to approach its discretion broadly to ensure that individuals on the program get the health services they need.
The Income Security Advocacy Centre and the Clinic Resource Office are working with a recipient who requires lower denture implants. She has no teeth and only upper dentures. She has a lot of trouble eating, and her weight has fallen to dangerously low levels. But ODSP has refused to fund the dentures that she needs in order to be healthy, saying it does not have the authority to do so.
We are arguing that ODSP is wrong. The legislation says that the Director has the authority to approve dental services without any limitations. Given that an expert hired by ODSP has said she needs these dentures in order to maintain a healthy weight, the evidence is clear that ODSP should approve the request.
Her appeal is scheduled to be heard at the Social Benefits Tribunal in October 2016.