Authorized medical practitioners by province or territory for the purposes of claiming medical expenses

Transcription

1 Canada Revenue Agency Home / Individuals and families / Tax return / Deductions / Medical expenses / List of allowable medical expenses / Authorized medical practitioners by province or territory for the purposes of claiming medical expenses Authorized medical practitioners by province or territory for the purposes of claiming medical expenses The following list summarizes publicly available provincial and territorial information identifying those health care professionals authorized to practice as medical practitioners. This is not an all inclusive list of every profession that is authorized by each province or territory. For the most up to date information, see the provincial or territorial website that applies to you. Medical practitioners: A to E Medical practitioners: H to O Medical practitioners: P to T Medical practitioners: A to E Profession AB BC MB NB NL NS NT NU ON PE QC SK YT Acupuncturist Audiologist Chiropodist Chiropractor Combined lab and x-ray technologist Counselling therapist Dental assistant Dental hygienist

2 Dental nurse Dental technician or technologist Dental therapist Dentist Denturist, dental mechanic, denturologist Dietician Emergency medical technician Medical practitioners: H to O Profession AB BC MB NB NL NS NT NU ON PE QC SK YT Hearing aid practitioner Kinesiologist Licensed or registered practical nurse Marriage and family therapist Medical laboratory technologist Medical radiation technologist Midwife

3 Naturopath Occupational therapist Ophthalmic medical assistant Optician Optometrist Medical practitioners: P to T Profession AB BC MB NB NL NS NT NU ON PE QC SK YT Pharmacist Physician Physiotherapist or physical therapist Podiatrist Professional technologist in orthoses/prostheses Psychological associate Psychologist Registered massage therapist or massage therapist Registered nurse (including nurse practitioner) Registered nursing

4 assistant Registered nutritionist Registered psychiatric nurse Respiratory therapist Sexologist Social worker Speech language pathologist Surgeon Traditional chinese medicine practitioner Date modified:

5 Medical Expense Credit Quick Table M-1 Overview (Medical Expense Credit Quick Table) The Medical Expense Credit Quick Table (M-2) lists and describes over 350 itemized expenses, stating if they do or do not qualify for the medical expense tax credit under section of the Income Tax Act, and identifying the authority, including sections of the Income Tax Act and Income Tax Regulations, case law, CRA Views Documents, Interpretation Bulletins, Folio Views, Guides, and other relevant CRA publications. The table has been updated to include references to every paragraph of new Folio View S1-F1-C1: Medical Expense Tax Credit, which replaced IT-519R2. The table is intended to serve as a guideline only. Section of the Act and the Income Tax Regulations should be consulted for precise wording, exceptions and restrictions. At the end of the Medical Expense Credit Quick Table is a summary of claimable attendant care or care in an establishment expenses reproduced from CRA Guide RC4064 (M-3), and a list of authorized medical practitioners by province or territory, reproduced from the CRA website (M-4). M-2 Itemized Expense List (Medical Expense Credit Quick Table) Last updated: December 2013 Item Qualifies Description of Medical Expense/Conditions for Acne treatment Depends Cosmetic procedures to treat common acne would generally not qualify; however, cosmetic procedures to treat acne that is severe, persistent and disfiguring would be considered to have a medical or reconstructive purpose, and may qualify if the conditions in 118.2(2)(a) are met. See also Cosmetic surgery Acoustic coupler Amount paid for an acoustic coupler (prescription not required) Acupuncturist Amount paid to an acupuncturist licensed to practise under the laws of the province or territory as a medical practitioner. The CRA's view is that a person is authorized by the laws a jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers a person to perform medical services and generally, such specific legislation provides for the licensing or certification of the practitioner as well as for the establishment of a governing body (eg, a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct. In Couture, an acupuncturist in Ontario was held not to be a medical practitioner as authorized to practice 118.2(2)(a), 118.2(2.1), E5, S1-F1- C1 (paras ) 118.2(2)(i), CRA Guide RC (2)(a), S1-F1-C1 (paras , 1.131), E5, Couture, [2009] 2 C.T.C. 80 (FCA, reversing the TCC), Murphy, [2010] 6 C.T.C (TCC), Power, 2012 CarswellNat 977 (TCC), E5

6 means specifically authorized by legislation, not simply permitted. As well, in Power, acupuncture services performed by an unlicensed practitioner in Ontario were not eligible. However, in Murphy, an acupuncturist was held to be a medical practitioner in 2007 because Ontario had passed the Traditional Chinese Medicine Act (Couture was distinguished from Murphy by virtue of the enactment of the TCMA). The CRA looks for specific legislation that enables, permits or empowers a person to perform medical services Air conditioner Air filter, cleaner, or purifier Amount paid for an air conditioner to cope with an individual's severe chronic ailment, disease or disorder qualify if prescribed by a medical practitioner. The claimable portion of the expense is limited to the lesser of: 1) $1,000 and 2) 50% of the amount paid for the air conditioner. The cost of electricity used to operate an air conditioner that qualifies for the medical expense credit is not eligible for the medical expense credit. A central air conditioner may qualify under this provision; E5 (document numbers provided throughout this table refer to CRA Views Documents, available in TaxnetPro and TaxPartner) Amount paid for an air filter, cleaner, or purifier for use by an individual who is suffering from a severe chronic respiratory ailment or a severe chronic immune system disregulation to cope with or overcome that ailment or disregulation qualify (prescription required). If an air exchanger and an air purifier are separate units such that each may be purchased separately (ie, the functions of purifying and exchanging the air are not engineered to work together inextricably as one unit), the CRA's view is that only the cost of the air purifier may qualify as a medical expense under 118.2(2)(m) and 5700(c.1). If the device acts as an air exchanger in addition to an air purifier, this fact will not generally preclude it from qualifying for the medical expense credit 118.2(2)(m), Reg 5700(c.3), I7, S1-F1-C1 (para 1.122) 118.2(2)(m), Reg 5700(c.1), , E5, S1-F1- C1 (para 1.122) Altered auditory feedback device Amount paid for an altered auditory feedback device designed to be used by an individual who has a speech impairment (prescription required) 118.2(2)(m), Reg 5700(z.1), S1-F1-C1 (para 1.122)

7 Alternative medicine The medications for which the medical tax credit is available must be prescribed by a medical practitioner Ambulance service fees Amount claimed under section 64 (disability supports deduction) Anaesthetist fees Animals (specially trained to assist impaired person) Amount paid for ambulance service fees for transportation to or from a public or licensed private hospital An amount claimed under section 64 cannot be deducted under section Section 64 allows a deduction for various eligible expenditures paid in the year by a disabled individual for services, devices, or supports that enable the individual to perform the duties of an office or employment, carry on a business, attend a designated educational institution or secondary school, or carry on research or similar work for which a grant was received. A section 64 deduction is generally limited to the amount of disability support costs paid in the year to enable a disabled individual to earn certain sources of income less reimbursements and other forms of assistance the disabled individual received in respect of the disability support cost. Individuals do not have to be eligible for the disability tax credit to claim a deduction under section 64 (except in the case of the deduction of part-time attendant care costs). Also, the disability tax credit can be claimed in addition to a deduction under section 64 Amount paid in respect of anaesthetist fees not covered by provincial health insurance (prescription required) 118.2(2)(n), Banman v. R., [2001] 2 C.T.C (TCC) 118.2(2)(f), S1-F1-C1 (para 1.64) 64(a)A(iv), S1-F1-C3, S1- F1-C1 (para 1.148) 118.2(2)(o), S1-F1-C1 (para 1.130) The cost of an animal specially trained to assist a 118.2(2)(l), S1-F1-C1 (para patient who is blind or profoundly deaf or has 1.92); E5 severe autism, severe epilepsy or a severe and prolonged impairment that markedly restricts the use of the patient's arms or legs may qualify for the credit. The animal must be provided by a person or organization one of whose main purposes is such training of animals. Eligible expenses include amounts paid for the care and maintenance of such an animal, including food and veterinary care; for reasonable travel expenses of the patient incurred for the purpose of attending a school, institution or other facility that trains, in the handling of such animals, individuals who are so impaired; and for reasonable board and lodging expenses of the patient incurred for the purpose of the patient's

8 full-time attendance at a school, institution or other facility just described. A certificate from a medical practitioner that the animal is required by the patient is not required Antiseptic Amount paid for antiseptic E5 Appointment cancellation fee A fee paid in respect of a missed appointment with a medical practitioner Artecoll injections Depends For expenses incurred after March 4, 2010, expenses incurred for purely cosmetic procedures no longer qualify for the credit (unless required for medical or reconstructive purposes). See also Cosmetic surgery Artificial eye Including expenses in respect of (prescription not required) Artificial kidney machine Amount paid for a kidney machine, including the cost of repairs, maintenance, and supplies; additions, renovations, or alterations to a home (the hospital official who installed the machine must certify in writing that the additions, renovations, or alterations were necessary for installation); the portion of the operating costs of the home that relate to the machine (excluding mortgage interest and CCA); a telephone extension in the dialysis room and all calls to a hospital for advice or to obtain repairs; and necessary and unavoidable costs to transport supplies. A prescription is not required Artificial limbs Amount paid for an artificial limb, including the cost of repairs and parts and other expenses in respect of (prescription not required) Assessment, medical Costs for a medical assessment qualify if the fee is paid to a medical practitioner. If the fee is not paid to a medical practitioner, it may qualify if it is for diagnostic purposes ( E5). Associations Payments made to partnerships, societies and associations for medical services rendered by their employees or partners qualify for the credit as long as the person who provided the service is a medical practitioner, dentist or nurse authorized to practice as a medical practitioner (for example, the Victorian Order of Nurses and The Canadian Red Cross Society Home Maker Services). The CRA has stated that payments qualify only to the extent that they are for the period when the patient is at home. Payments for a period when the nurse is simply looking after a home and 118.2(2)(a), Zaffino, [2007] 5 C.T.C (TCC) 118.2(2.1), CRA I7, S1-F1-C1 (paras ) 118.2(2)(i), S1-F1-C1 (paras ) 118.2(2)(i), CRA Guide RC4064, S1-F1-C1 (paras , ) 118.2(2)(i), S1-F1-C1 (paras ) 118.2(2)(a), (o), E (2)(a), S1-F1-C1 (para 1.28)

9 children when the patient is in hospital or otherwise away from home do not qualify since these would be personal or living expenses. In some instances, such as that of the Canadian Mothercraft Society, the visiting worker instead of the society may give the receipts but, if the worker can be regarded as a practical nurse, those receipts will be accepted. Athletic or fitness club fees Attendant care (patient qualifies for the disability credit) Attendant care at a retirement home, home for seniors, or other institution Amounts paid for athletic or fitness club membership Amount paid as remuneration for one full-time attendant for a patient who qualifies for the disability credit, or the cost of full-time care in a nursing home for such a patient, may qualify for the credit. At the time the remuneration is paid, the full-time attendant cannot be under 18 years of age or be the individual's spouse or commonlaw partner. It is the CRA's view that a taxpayer's private home would not be considered a nursing home for purposes of 118.2(2)(b). The CRA accepts that a particular place need not be a licensed nursing home but is of the view that it must have the equivalent features and characteristics of a nursing home (see E5). If a patient claims the medical expense credit under 118.2(2)(b), the patient cannot claim the disability tax credit. See also under Nursing home (full-time care) and E5, E5, C6, E5. See also the summary of claimable attendant care expenses in Chapter 8 Amounts paid for attendant care at a retirement home, home for seniors, or other institution as remuneration for a full-time attendant may quality. A disability tax credit certificate is required. Also, the CRA requires a detailed statement from the establishment showing the amount paid for staff salaries that apply to attendant care services. Qualifying costs include: food preparation; housekeeping services for a resident's personal living space; laundry services for a resident's personal items; health care (registered nurse, practical nurse, certified health care aide, personal support worker); activities (social programmer); salon services (hairdresser, barber, manicurist, pedicurist), if included in the CRA Guide RC4064, E5, E5, Roberts, 2012 CarswellNat (2)(b), CRA Guide RC4064, S1-F1-C1 (paras ) 118.2(2)(b), CRA Guide RC4064, S1-F1-C1 (paras ), E5

10 monthly fee; transportation (driver); and security for a secured unit. Ineligible costs include: rent; food; cleaning supplies; other operating costs (such as the maintenance of common areas and outside grounds); and salaries and wages paid to the following employees: administrators; receptionists; groundskeepers; and janitors or maintenance staff. If a claim is made under 118.2(2)(b) rather than 118.2(2)(b.1) (limited to $10,000; see below), the disability tax credit cannot be claimed. See also the summary of claimable attendant care expenses in Chapter 8 Attendant care (parttime) Attendant care provided at a group home in Canada Amounts paid as remuneration for part-time attendant care may qualify for the credit, The attendant cannot be the patients spouse or common-law partner and must be over 17 years of age when the amounts were paid. The care must be provided in Canada and a disability tax credit certificate (Form T2201) is required. Where amounts are paid to an establishment, the CRA requires a detailed statement from the establishment showing the amount paid for staff salaries that apply to attendant care services (all amounts paid to a nursing home generally qualify). The claim is limited to $10,000 (or $20,000 if the individual dies in the year). While most claims under 118.2(2)(b.1) will be for a parttime attendant, the CRA acknowledges that expenses for a full-time attendant may also be claimed under 118.2(2)(b.1). The $10,000 limit applies to each person paying for attendant care. A person can claim the disability credit and make a claim under 118.2(2)(b.1); however, where a claim is made under 118.2(2)(b.1), no part of the remuneration can be included in computing a deduction claimed in respect of the patient under section 63 or 64 or 118.2(2)(b), (b.2), (c), (d) or (e) for any taxation year. See under Attendant care at a retirement home, home for seniors, or other institution regarding qualifying costs (see also E5) Amounts paid as remuneration for an individual's care or supervision provided in a group home in Canada maintained and operated exclusively for the benefit of individuals who have a severe and prolonged impairment may qualify. A disability tax credit certificate (Form T2201) is required. Also, the CRA requires a detailed statement from 118.2(2)(b.1), CRA Guide RC4064, S1-F1-C1 (paras , ), I (2)(b.2), CRA Guide RC4064, S1-F1-C1 (paras , )

11 the establishment showing the amount paid for staff salaries that apply to attendant care services. A claim under 118.2(2)(b.2) does not preclude a person from claiming the disability credit; however, where a claim is made under 118.2(2)(b.2), no part of the remuneration can be included in computing a deduction claimed in respect of the patient under section 63 or 64 or 118.2(2)(b), (b.1), (c), (d) or (e) for any taxation year. See also the summary of claimable attendant care expenses in Chapter 8 Attendant care in a self-contained domestic establishment (fulltime) Attendant care (fulltime at a nursing home; patient lacks normal mental capacity) Amounts paid as remuneration for a full-time attendant at a person's personal residence may qualify for the credit. The attendant cannot be the patients spouse or common-law partner and must be over 17 years of age when the amounts were paid. Additionally, ether: 1) a disability tax credit certificate (Form T2201) is required or 2) a letter from a medical practitioner has to certify that the patient is likely to continue to be dependent on others for his or her personal needs and care for the long-term and needs a full-time attendant because of an impairment in mental or physical functions. Fees claimed must be for salaries and wages paid for attendant care services. If an individual issues the receipt for attendant care services, the receipt must include the attendant's social insurance number. Several attendants can qualify as one full-time attendant as long as there is only one attendant for any given period of time ( E5). If a claim is made under 118.2(2)(c) rather than 118.2(2)(b.1) (limited to $10,000), the disability tax credit cannot be claimed. See also the summary of claimable attendant care expenses in Chapter 8 The cost of receiving full-time care in a nursing home is an eligible medical expense not only in respect of a patient with a severe and prolonged mental or physical impairment (see 118.2(2)(b)), but also in respect of a patient who is and will in the foreseeable future continue to be dependent on others for his/her personal needs and care because of a lack of normal mental capacity. Such a condition must be certified by a medical practitioner in either a letter or by completing Form T2201. An individual can generally claim the entire amount paid for full-time care in a nursing home. The care does not have to be 118.2(2)(c), CRA Guide RC4064, S1-F1-C1 (paras , ) 118.2(2)(d), CRA Guide RC4064, S1-F1-C1 (paras , ), E5, E5

12 provided in Canada. Where a claim is made under 118.2(2)(d), the disability tax credit cannot be claimed (see para 118.3(1)(c)). Though the term nursing home in paragraph 118.2(2)(b) does not include a retirement residence even if it provides 24-hour nursing care (see Miles Estate v. R., [2000] 2 C.T.C. 2165), the CRA accepts that where a portion of retirement home costs is identified as being paid for attendant care, it will qualify under paragraph 118.2(2)(b.1) ( E5). A taxpayer's home also does not qualify as a nursing home. See also the summary of claimable attendant care expenses in Chapter 8 Audible signal device Amount paid for an audible signal device (prescription not required) Autistic child day care, school, institution or other place Baby formula Baby wipes/moist wipes Baby's cry signal device Balance disorder (prescribed device) Bathroom aids Bicycle, batterypowered Bicycle, motorized stationary Birth control devices Depends For an institute to qualify, the CRA's view is that certification would need to clearly indicate that the centre has specialized equipment, facilities, or trained personnel to provide care, or care and training, of a person with an autistic disorder Amounts paid for baby formula, even if prescribed by a medical practitioner, do not qualify if it is also available over-the-counter (see also Over-the-counter medications ). It is CRA's view that the reference to other products in 118.2(2)(i.1) is restricted to the same class of products as diapers, disposable briefs, etc. and would not include baby wipes or moist wipes See Infants Amount paid for a pressure pulse therapy device designed to be used by an individual who has a balance disorder (prescription required) See Device or equipment (bathtub or shower) The CRA's view is that a battery powered twowheeled bicycle cannot be considered a wheelchair The CRA s view is that a motorized stationary bicycle (designed for people with medical conditions such as Parkinson s disease, muscular dystrophy and arthritis) cannot be considered a device Depends The CRA has stated that birth control pills which a medical practitioner has prescribed are considered to qualify under 118.2(2)(n) if a 118.2(2)(i), CRA Guide RC4064, S1-F-C1 (paras , 1.80) 118.2(2)(e), E5, E5, S1-F1-C1 (paras , ) 118.2(2)(n), E (2)(i.1), E5, E5, S1-F1-C1 (para 1.87) 118.2(2)(m), Reg 5700(z.4), S1-F1-C1 (para 1.122) E E (2)(n), S1-F1-C1 (para 1.127)

13 pharmacist has recorded the prescription Bite-activated nipples for sippy-cup Blind individuals (braille note-taker; prescribed) Blind individuals (guide dog) Blind individuals (intervening services) Blind individuals (optical scanner; prescribed) Blind individuals (reading software; prescribed) Blind individuals (special computer devices; prescribed) Bliss symbol board or similar device Amount paid for bite-activated nipples for sippycup Amount paid for a braille note-taker designed to be used by a blind individual to allow them to take notes (that can be read back to them or printed or displayed in Braille) with the help of a keyboard and that is for the individual's use as prescribed by a medical practitioner (prescription required) The purchase of a guide dog for a blind individual from an institution that trains such dogs, as well as related expenses (for a list of qualifying expenses, see under Animals ) Amount paid for deaf-blind intervening services used by a person who is both blind and profoundly deaf and paid to someone in the business of providing such services Amount paid for an optical scanner (or similar device) designed to be used by a blind individual to enable him to read print (prescription required) Amount paid for a device or software designed to be used to enable the individual to read print and that is for the individual's use as prescribed by a medical practitioner (prescription required) Amount paid for a device or equipment, including a synthetic speech system, Braille printer and large print-on-screen device, designed exclusively to be used by a person who is blind in the operation of a computer (prescription required) Amount paid for a bliss symbol board or similar device designed to be used to help an individual who has a speech impairment communicate by selecting the symbols or spelling out words (prescription required). The purchase of an ipad to assist certain special needs children would not qualify for the medical expense credit, nor would a digital camera used to make Bliss symbol boards (Henschel, 2010 CarswellNat 1783 (TCC)) Block fees Block fee paid to a medical centre to cover the cost of certain ancillary or incidental uninsured medical services Blood coagulation monitors Prescribed blood coagulation monitor for individuals who require anti-coagulation therapy, including associated disposable peripherals such as pricking devices, lancets and test strips E (2)(m), Reg 5700(y), 118.2(2)(l), S1-F1-C1 (para 1.92) 118.2(2)(l.44), S1-F1-C1 (para 1.106) 118.2(2)(m), Reg 5700(l), 118.2(2)(m), Reg 5700(l.1), 118.2(2)(m), Reg 5700(o), CRA Guide RC4064, S1- F1-C1 (para 1.122) 118.2(2)(m), Reg 5700(x), E5, S1-F1- C1 (para 1.122) 118.2(2)(a), I7, S1-F1-C1 (para 1.29) 118.2(2)(m); Reg 5700(s.1), S1-F1-C1 (para 1.122)

14 Blood pressure monitors Purchase of a blood pressure monitor CRA Guide RC4064 Blood transfusion Bone conduction receiver Bone marrow transplant Boots (Orthopaedic) Amount paid for a blood transfusion (prescription required) Purchase of a bone conduction receiver (prescription not required). See also Hearing aid Reasonable amounts paid to locate a compatible donor, to arrange the transplant including legal fees and insurance premiums, and reasonable travelling costs including board and lodging for the patient, the donor, and their respective companions See Brace (including related costs) and Orthopaedic shoe or boot (and an insert for a shoe or boot) Botox injections Depends For expenses incurred after March 4, 2010, expenses incurred for purely cosmetic procedures no longer qualify for the credit (unless required for medical or reconstructive purposes). See also Cosmetic surgery Brace (for a limb) Amounts paid for braces for a limb, including woven or elasticized stockings made to measure, qualify for the credit (prescription not required). The CRA has stated that a brace for a limb does not necessarily have to be something of a rigid nature, although at least one of the functions of the brace must be to impart some degree of rigidity to the limb which is being braced. Accordingly, that phrase is considered to include woven or elasticized stockings where these are of a kind that are carefully fitted to measurement or are made to measure. When a brace for a limb is necessarily built into a boot or shoe in order to permit a person to walk, the brace will be considered to include the boot or shoe. A rehabilitative splinting system to stretch the tissue in the elbow would likely qualify as a brace for a limb ( E5). Brace (spinal) Amount paid for a spinal brace (prescription not required) Braille note-taker See Blind individuals Braille printer See Blind individuals Breast prosthesis See External breast prosthesis CRA Guide RC4064, 118.2(2)(a) 118.2(2)(i), CRA Guide RC4064, S1-F1-C1 (para 1.80) 118.2(2)(l.1), S1-F1-C1 (paras 1.93, 1.147) 118.2(2.1), I7, S1-F1-C1 (paras ) 118.2(2)(i), CRA Guide RC4064, S1-F1-C1 (paras , 1.77) 118.2(2)(i), S1-F1-C1 (paras ) Breast pump Purchase of a breast pump E5 Buzzer See Hearing aid

15 Canadian Red Cross See Associations Society Home Maker Services Cancellation fee See Appointment cancellation fee Cancer treatment Cost of cancer treatments provided by a medical practitioner, including treatment received outside Canada for drugs not approved in Canada. Car seat An infant car seat, even if specially designed for a disabled child Cardiograph Care or care and training at institutions or other places Care or care and training at special schools Amount paid in respect of cardiograph tests not covered by provincial health insurance (prescription required) Amounts paid for care at an institution or other place may qualify for the credit. An appropriately qualified person (normally a medical practitioner; preferably who does not work for the institution) has to certify in writing that the person has an impairment in mental or physical functions and confirm the person requires the equipment, facilities, or personnel available at the establishment. A private home adapted to the needs of its owner/occupant would not qualify as an other place for purposes of 118.2(2)(e) ( E5). A retirement home was found to qualify in McKinley, [2004] 2 C.T.C (TCC), but not in Lister, [2007] 1 C.T.C. 137 (FCA) or in Shultis, [2007] 1 C.T.C (TCC). The expense of renting an accommodation near the school or institution would not qualify; however, transportation expenses to and from the school may qualify under 118.2(2)(g) ( E5). Amounts paid for care or training at a school may qualify for the credit. An appropriately qualified person (normally a medical practitioner; preferably who does not work for the school) has to certify in writing that the person has an impairment in mental or physical functions and confirm the person requires the equipment, facilities, or personnel available at the establishment. Under former 110(1)(c)(vi), private school fees incurred for a child with behavioral problems were held to be ineligible (see Somers v. MNR, [1979] C.T.C (TRB)) since there was no evidence of mental or physical handicap and the school in question was not an institution of the type specified. Also, in Flower 118.2(2)(a), CRA Guide RC (2)(o), CRA Guide RC (2)(e), CRA Guide RC4064, S1-F1-C1 (paras , ) 118.2(2)(e), CRA Guide RC4064, S1-F1-C1 (paras , ), E5, Scott, [2009] 1 C.T.C. 224 (FCA)

16 v. R., [2005] 2 C.T.C (TCC), fees to an Academy for children with learning disabilities did not qualify. However, in Rannelli v. MNR, [1991] 2 C.T.C. 2040, the Court concluded that fees paid to a school for dyslexic children qualified under former 110(1)(c)(vi). Fees paid to a disciplinary school for children with attention disorders were found to qualify in Marshall, [2003] 4 C.T.C (TCC). Fees paid to the Calgary Academy qualified in Karn, 2013 CarswellNat 1382, since the school was only for students with learning disabilities; however, tuition fees paid did not qualify in Bauskin, 2013 CarswellNat 342, because there was no evidence of special equipment, facilities or personnel in the school s mainstream program. Caregiver training An amount paid for reasonable expenses (other than amounts paid to a person who was at the time of the payment the individual's spouse or common-law partner or a person under 18 years of age) to train the individual (or a person related to the individual) if the training relates to the mental or physical infirmity of a person who is related to the individual and is a member of the individual's household (or is dependent on the individual for support) Catheters and catheter trays Amounts paid for catheters and catheter trays required by the patient by reason of incontinence caused by illness, injury or affliction (including catheter trays, tubing, or other products required for incontinence caused by illness, injury, or affliction); a prescription is not required Certificates Amount paid to a medical practitioner for completing and providing additional information in regard to Form T2201 and other certificates Chair (poweroperated) Chiropodist (or podiatrist) See Power-operated guided chair, wheelchair, and Scooter Amount paid to a chiropodist (or podiatrist) licensed to practise under the laws of the province or territory as a medical practitioner Chiropractor Amount paid to a chiropractor licensed to practise under the laws of the province or territory as a medical practitioner Christian Science practitioner Payments to a Christian Science practitioner where the practitioner is not otherwise a medical doctor or a nurse acting within the scope of his or her profession (none of the provinces or territories 118.2(2)(l.8), S1-F1-C1 (paras ) 118.2(2)(i.1), CRA Guide RC4064, S1-F1-C1 (para 1.87) 118.2(2)(a), CRA Guide RC (2)(a), S1-F1-C1 (paras ) 118.2(2)(a), S1-F1-C1 (paras ) 118.2(2)(a), M4, E5, M4, 2007-

17 license Christian Science practitioners as being medical practitioners). Amounts paid to a Christian Science nurse authorized to practise as a nurse according to the relevant laws referred to in subsection 118.4(2) would qualify. The CRA's view is that a person is authorized by the laws of a jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers a person to perform medical services and generally, such specific legislation provides for the licensing or certification of the practitioner as well as for the establishment of a governing body (eg, a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct Circumcision procedure Clinic or corporation (amount paid for medical services) Depends Cost of infant male circumcision would generally qualify if it can be shown that it is not done purely for cosmetic purposes Amounts paid to a clinic or corporation for medical services provided by or supervised by a medical practitioner Clinical counsellor See Counsellor Cochlear implant Amount paid for a cochlear implant (prescription not required) Colostomy and ileostomy pads Commodes Compression stockings Contact lenses Cosmetic surgery (purely cosmetic procedures) Amount paid for colostomy and ileostomy pads, including pouches and adhesives (prescription not required) See Device or equipment (bathtub, shower or toilet) Depends Cost of compression stockings required to be worn after treatment for varicose veins would qualify if fitted to measurement or made to measure Amount paid for contact lenses (prescription required from a medical practitioner or optometrist) After March 4, 2010, expenses incurred for purely cosmetic procedures no longer qualify for the credit. This generally includes surgical and nonsurgical procedures purely aimed at enhancing one's appearance, such as the following: augmentations (such as chin, cheek, lips); body modifications (such as tongue splits); body E5, E5, S1-F1-C1 (paras ) 118.2(1), 118.2(2.1), E5, S1-F1-C1 (paras ) 118.2(2)(a), Mudry, 2008 CarswellNat 715 (TCC), E5, E5, S1-F1-C1 (para 1.28) 118.2(2)(i), CRA Guide RC4064, S1-F1-C1 (para 1.80) 118.2(2)(i), CRA Guide RC4064, S1-F1-C1 (paras , 1.78) 118.2(2)(i), S1-F1-C1 (para 1.77), E (2)(j), CRA Guide RC4064, S1-F1-C1 (para 1.89) 118.2(2.1) I7, M4, M4, E5, E5, E5, S1-F1-C1

18 shaping, contouring or lifts (such as breasts, buttocks, face and stomach); botulinum injections; chemical peels; implants (such as jewellery implanted into an eye or a tooth, or microdermal, transdermal, and subdermal cosmetic implants); filler injections for removal of wrinkles; hair removal and replacement procedures; laser treatments (such as skin resurfacing and removal of age spots); liposuction; reshaping procedures (such as rhinoplasty and otoplasty); rib removal; tattoo removal; and teeth whitening, contouring or reshaping. A cosmetic procedure will continue to qualify if required for medical or reconstructive purposes (see directly below). The CRA's former position was that an amount paid to a medical practitioner for surgery of any kind, whether cosmetic or elective, generally qualified as a medical expense. Cosmetic surgery (for medical or reconstructive purposes) Counsellor After March 4, 2010, expenses incurred for purely cosmetic procedures no longer qualify for the credit. A cosmetic procedure will continue to qualify if required for medical or reconstructive purposes (for example, those that would ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease), including the following: breast implant and related procedures for reconstructive purposes after a mastectomy; breast reduction to reduce back and shoulder pain; dental braces, if required to correct a misaligned bite; dental veneers to correct decayed or misaligned teeth; gastric bypass surgery, gastric sleeve surgery or gastric stapling; laser eye surgery; removal of excess skin after rapid weight loss due to a risk of infection; and the treatment of melasma that is severe, persistent and disfiguring. The cost of sex reassignment surgery and related surgeries would likely qualify ( E5). The CRA's former position was that and amount paid to a medical practitioner for surgery of any kind, whether cosmetic or elective, generally qualified as a medical expense. Depends The CRA has stated that counselling services are considered to qualify if: 1) the counsellor is working in a recognized mental health clinic, community agency or hospital; 2) the counsellor (paras ) 118.2(2.1) I7, M4, E5, E5, E5, E5, S1-F1-C1 (paras ) , E5, E5

19 is a member of an association governing their profession; and 3) the treatment is at the request of, or in association with, a medical practitioner Courses, pain management Expenses related to pain management courses if incurred for diagnosis, therapy or rehabilitation purposes in relation to a pre-existing medical problem and paid to a certified medical practitioner or public or private hospital. Crutches Amount paid for crutches, including related costs (prescription not required) Cushion (wheelchair or bath Cycle monitoring fees Deaf individual (intervening services) Depends Amount paid for a wheelchair cushion would qualify as a medical expense, but amount paid for a bath cushion would not Amount paid in respect of cycle monitoring fees not covered by provincial health insurance (prescription required), including diagnostic procedures relating to cycle monitoring fees Amount paid for deaf-blind intervening services used by a person who is both blind and profoundly deaf and paid to someone in the business of providing such services E (2)(i), S1-F1-C1 (paras ) 118.2(2)(i), S1-F1-C1 (paras ), E (2)(o), S1-F1-C1 (para 1.130), E (2)(l.44), S1-F1-C1 (para 1.106) Deaf individual (teletypewriter; prescribed) Dental appliance (used to treat sleep apnea) Amount paid for a teletypewriter or similar device, including a telephone ringing indicator, that enables a deaf or mute individual to make and receive telephone calls (prescription required) Amount paid for a dental appliance would qualify as a medical expense if the individual is suffering from a severe chronic respiratory ailment and the dental appliance was designed exclusively for use by the individual for that ailment. Dental crowns Amount paid to a dentist or medical practitioner for dental crowns Dental hygienist Amount paid to a dental hygienist licensed to practise under the laws of the province or territory as a medical practitioner Dental implants Amount paid to a dentist or medical practitioner for dental implants 118.2(2)(m), Reg 5700(k), 118.2(2)(m), Reg 5700(c), E5, S1-F1- C1 (para 1.122) 118.2(2)(a), M (2)(a), S1-F1-C1 (paras ) 118.2(2)(a), E5, E5 Dentist Amount paid for dental services 118.2(2)(a), S1-F1-C1 (paras ) Dentures Amount paid to a person authorized under the laws of a province to carry on the business of a dental mechanic for the making or repairing of an upper or lower denture, or for the taking of 118.2(2)(p), S1-F1-C1 (para 1.132)

20 impressions, bite registrations and insertions in respect of the making, producing, constructing and furnishing of an upper or lower denture (prescription not required) Detoxification clinic for a person addicted to drugs or alcohol Device or equipment (bathtub, shower or toilet; prescribed) Device or equipment (cold therapy; prescribed) Device or equipment (electrotherapy; prescribed) Amount paid to attend a detoxification clinic where a medical practitioner certifies in writing that the person requires the specialized equipment, facilities, or personnel provided. There is no requirement that the detoxification clinic be a public or licensed private hospital Amount paid for a mechanical device or equipment designed to be used to assist an individual to enter or leave a bathtub or shower or to get on or off a toilet (prescription required). Eligible devices would include a raised toilet seat. Commodes designed for the purpose of assisting individuals to get on or off a toilet (or enter or leave a bathtub or shower) may also qualify. Bath cushions would not qualify Cost of a cold therapy device (such as a Cryo- Cuff or Polar Care Cube) prescribed by a doctor to control and reduce knee swelling Amount paid for an electrotherapy device designed to be used by an individual with a medical condition or by an individual who has a severe mobility impairment (prescription required). An electrical muscle stimulation (EMS) device used for muscle stimulation and strengthening is an electrotherapy device ( E5) (2)(a), CRA Guide RC4064, S1-F1-C1 (paras ) 118.2(2)(m), Reg 5700(g), E5, E5, S1-F1-C1 (para 1.122) E E (2)(m), Reg 5700(z.2) E5, S1-F1- C1 (para 1.122) Device or equipment (general) A medical device or equipment that was not prescribed by a medical practitioner and that is not otherwise described in section does not qualify (see list of eligible expenses in this table; for example, see under Altered auditory feedback device, Blind individuals, Bliss symbol board, Diabetics, Drugs, Heart disease, Infants, Mobility impairment, Pressure pulse therapy device, Reading services, Standing device, Teletypewriter (or similar device), Vibratory signalling device, Visual signalling device Amount paid for a device or equipment designed exclusively for use by an individual suffering from a severe chronic respiratory ailment or a severe chronic immune system disregulation 118.2(2), Young, 2009 CarswellNat 4364 (TCC) Device or equipment (respiratory ailment; prescribed) 118.2(2)(m), Reg 5700(c),

21 (prescription required). An air conditioner, humidifier, dehumidifier, heat pump or heat or air exchanger specifically does not qualify under Regulation 5700(c) Diabetics (blood sugar measure; prescribed) Diabetics (infusion pump; prescribed) Amount paid for a device designed to enable individual to measure blood sugar level (prescription required) Infusion pump (including disposable peripherals) for the treatment of diabetes (prescription required) Diabetics (insulin) The cost of insulin or substitutes, as prescribed by a medical practitioner, purchased by a person suffering from diabetes qualifies. The CRA has stated that when such a person has to take sugarcontent tests using test-tapes or test tablets and a medical practitioner has prescribed this diagnostic procedure, the tapes or tablets qualify as devices or equipment under 118.2(2)(m) and Part LVII of the Regulations Diabetics (scales) The cost of various kinds of scales, which diabetics frequently use for weighing themselves or their food Diapers Diapers required by the patient by reason of incontinence caused by illness, injury or affliction qualify; a prescription is not required. Amounts paid to a diaper service do not qualify Diathermy Amount paid to a medical practitioner or a licensed private hospital Dietician Payments to a dietician would not qualify as eligible medical expenses unless the amounts were paid for medical services performed by a medical practitioner authorized to practise as such according to the laws of the jurisdiction in which the service was rendered (the CRA's view is that a person is authorized by the laws of a jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers a person to perform medical services and generally, such specific legislation provides for the licensing or certification of the practitioner as well as for the establishment of a governing body (eg, a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct) Disposable briefs Amounts paid for disposable briefs required by the patient by reason of incontinence caused by 118.2(2)(m), Reg 5700(s), 118.2(2)(m), Reg 5700(s), 118.2(2)(k), (n), S1-F1-C1 (paras ) S1-F1-C1 (paras 1.91, 1.131) 118.2(2)(i.1), CRA Guide RC4064, S1-F1-C1 (para 1.87) 118.2(2)(a), CRA Guide RC (2)(a), E5, S1-F1-C1 (paras ) 118.2(2)(i.1), S1-F1-C1 (para 1.87)

22 illness, injury or affliction; a prescription is not required Doctor Amounts paid to a medical practitioner (meaning discussed in CRA Guide RC4064 and S1-F1-C1 (paras 20-23) for medical services Dogs (guide) See Guide dogs Driveway alterations Reasonable amounts paid to alter the driveway of the main residence of a person who has a severe and prolonged mobility impairment to allow easier access to a bus qualify. Also, the CRA has stated that reasonable expenses relating to alterations to the driveway would also qualify under this provision if they facilitate access to whatever mode of transportation, bus or otherwise, that is ordinarily used by the patient. However, the cost of installing a walkway would generally not qualify as an eligible medical expense (see E5). Driving lessons for disabled person Drugs bought under Health Canada's Special Access Program Drugs, medicaments or other preparations or substances (overthe-counter) Drugs, medicaments or other preparations or substances The cost of tuition fees and exams for driver training for a disabled individual Drugs and medical devices bought under Health Canada's Special Access Program (ie, amounts paid for drugs and medical devices that have not been approved for use in Canada if they were purchased under this program). Visit Health Canada's Web site at Over-the-counter medications, vitamins, and supplements, even if prescribed by a medical practitioner. Subparagraph 118.2(n)(ii) refers to drugs, medicaments or other preparations or substances that can lawfully be acquired for use by the patient only if prescribed by a medical practitioner or dentist. See also E5, M4, E5 and E5 Amounts paid for drugs, medicaments or other preparations or substances that are manufactured, sold or represented for use in the diagnosis, treatment or prevention of a disease, disorder or abnormal physical state, or its symptoms, or in restoring, correcting or modifying an organic function qualify for the credit if a medical practitioner or dentist prescribed the medication and the medication is purchased from a pharmacist who recorded the prescription in a prescription record. Additionally, such amounts also qualify where they are available without a 118.2(2)(a) 118.2(2)(l.6), E5, S1-F1-C1 (para 1.108) E (2)(s), (t), S1-F1-C1 (para 1.137) CRA Guide RC4064, 118.2(2)(n), S1-F1-C1 (paras ) 118.2(2)(n), S1-F1-C1 (paras ), Reg 5701

23 prescription and a medical practitioner or dentist has prescribed the medication for the patient and the medication is only available with the intervention of a medical practitioner (eg a pharmacist) Elastic support hose Elective medical procedures performed by a medical practitioner Amount paid for elastic support hose designed exclusively to relieve swelling caused by chronic lymphedema (prescription required) Depends For expenses incurred after March 4, 2010, expenses incurred for purely cosmetic procedures no longer qualify for the credit (unless required for medical or reconstructive purposes). See also Cosmetic surgery 118.2(2)(m), Reg 5700(u), M4, 118.2(2.1), S1-F1-C1 (paras ) Electric breast pump Purchase of an electric breast pump E5 Electric shock treatments Amount paid for electric shock treatments (prescription required) CRA Guide RC4064, 118.2(2)(a) Electrocardiograms Electrolysis Electronic bone healing device Electronic speech synthesizer Electrotherapy device Elevators or lifts (power-operated) Environmental control system (electronic or computerized) Amount paid in respect of electrocardiogram tests not covered by provincial health insurance (prescription required) Depends Amounts paid to a medical practitioner for electrolysis Amount paid for electronic bone healing device (prescription required) Amount paid for a speech synthesizer (electronic) that enables a mute individual to communicate by use of a portable keyboard (prescription required) Amount paid for an electrotherapy device designed to be used by an individual with a medical condition or by an individual who has a severe mobility impairment (prescription required) Amount paid for elevators or lifts designed exclusively for use by a person with an impairment to allow them to access different levels of a building, enter or leave a vehicle, or place a wheelchair on or in a vehicle (prescription required) Amount paid for environmental control system designed exclusively for the use of an individual with a severe and prolonged mobility restriction (prescription required) (including the basic computer system used by a person with a mobility impairment) 118.2(2)(o), CRA Guide RC4064 CRA Guide RC4064, S1- F1-C1 (paras ) 118.2(2)(m), Reg 5700(z.2), CRA Guide RC4064, S1-F1-C1 (para 1.122) 118.2(2)(m), Reg 5700(p), 118.2(2)(m), Reg 5700(z.2), S1-F1-C1 (para 1.122) 118.2(2)(m), Reg 5700(m), CRA Guide RC4064, S1- F1-C1 (para 1.122) 118.2(2)(m), Reg 5700(t), CRA Guide RC4064, S1- F1-C1 (para 1.122)