23 December 2009 External T.I. 2009-0332141E5 - Various medical expenses

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the CRA.
Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'ARC.

Principal Issues: Whether various expenditures qualify as medical expenses

Position: Some

Reasons: CRA views

XXXXXXXXXX 								2009-033214
									Rob Ferrari
December 23, 2009

Dear XXXXXXXXXX :

Re: Various expenditures as medical expenses

We are writing in reply to your fax of July 13, wherein you provided a list of expenditures you have made and asked whether they are eligible medical expenses for the purposes of the medical expense tax credit ("METC").

You indicate that your spouse is a long-term diabetic, has had a stroke and is in end-stage kidney failure. Your son (your dependant born in XXXXXXXXXX ) has cerebral palsy, sleep apnea and profound hearing loss. He also suffers from severe reflux and vomiting and as a result, must sleep in a specific position for his safety and requires care from a nurse. We understand that the form T2201, Disability Tax Credit Certificate, has been certified by a medical doctor for your spouse and your son and have been filed with the Canada Revenue Agency (the "CRA").

Our comments

Since your enquiry concerns an actual situation involving questions of fact, it should be dealt with by your local Tax Services Office. Nonetheless, we have provided our general views regarding the application of the relevant income tax legislation. If you wish to have the CRA review your actual situation, you should submit all of the relevant information and documentation to the particular Tax Services Office serving your area, a list of which is available on the "Contact Us" page of the Canada Revenue Agency website, which may be accessed on the internet at http://www.cra-arc.gc.ca.

Medical expenses which are eligible for the METC are limited to those described in subsection 118.2(2) of the Income Tax Act (the "Act"). If a particular expenditure is not described as an eligible medical expense in subsection 118.2(2) of the Act, or if the conditions under which the expenditure would qualify are not met, the expenditure does not qualify for purposes of the METC, even though the expenditure was incurred for medical reasons. Additionally, in order to claim an amount as a medical expense, there must be no reason that would preclude its deduction, which would happen, for example, if a private or public health insurance plan reimburses you for the particular expense.

Private Nursing Care

Amounts paid to a medical practitioner for medical services provided to a patient qualify as medical expenses for the purposes of paragraph 118.2(2)(a) of the Act. A medical practitioner includes, among others, a nurse provided that he or she is authorized to practice in the stated profession according to the laws of the jurisdiction in which the service is rendered. Accordingly, if the amounts are paid to qualified medical practitioners to provide medical services, these amounts may qualify as medical expenses under paragraph 118.2(a) of the Act for the purposes of the METC.

Wheelchair and hearing aid (including maintenance, repairs and supplies)

Paragraph 118.2(2)(i) of the Act allows as a medical expense, amounts paid "for, or in respect of," various items, including a wheelchair and an aid to hearing for a patient. As outlined in paragraph 35 of IT-519R2 (Consolidated) - "Medical Expense and Disability Tax Credits and Attendant Care Expense Deduction", costs in respect of these devices also include rental charges and related expenses such as maintenance, repairs and supplies. This bulletin can be found on the CRA's website. The expenditures you have made for the wheel chair and hearing aid, as well as the costs in respect of the moulds and creams for the hearing aid, appear to meet the requirements in paragraph 118.2(2)(i) of the Act.

Paragraph 118.2(2)(m) - "Various devices or equipment prescribed in regulations"

Paragraph 118.2(2)(m) of the Act also provides for various devices or equipment as medical expenses if prescribed in section 5700 of the Income Tax Regulation (the "Regulations"). Generally, the device or equipment must be prescribed by a medical practitioner and meet such conditions as are applicable to its use or as to the reason for its acquisition. Your letter did not provide sufficient detail to confirm whether the conditions under paragraph 118.2(2)(m) have been met. However, we provide the following comments with respect to certain devices and equipment you have purchased and section 5700 of the Regulations.

Raised toilet seat, superpole and extender

Paragraph 5700(g) of the Regulations provides 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. Based on the information you have provided, the raised toilet seat, superpole and extender appear to be the type of devices or equipment described in paragraph 5700(g) of the Regulations.

Commodes

We understand some commodes may be designed for the purpose of assisting individuals to get on or off a toilet (or enter or leave a bathtub or shower), in which case, a commode could be considered as a type of device or equipment described in paragraph 5700(g) of the Regulations. However, we have not been provided with sufficient information as to the particular design of commodes you purchased to determine if the requirements of paragraph 5700(g) have been met.

Electric adjustable hospital bed, rails and mattress for the hospital bed

Paragraph 5700(h) of the Regulations describes a "hospital bed including such attachments thereto as may have been included in a prescription thereto". There is no definition of a hospital bed for this purpose, but we are of the view that this term refers to the type of bed usually found in hospitals. If the bed is of the type usually found in hospitals, the bed, rails and mattress would fall within the meaning of paragraph 5700(h) of the Regulations.

Other expenditures

We have reviewed the remaining services and items included in your list of expenditures. Based on the information provided, we are of the view that the following expenditures would not qualify as eligible medical expenses under subsection 118.2(2) of the Act for the purposes of the METC:

- memory foam mattress (not for a hospital bed),
- over-bed rolling table,
- oximeter and probes,
- second stairway hall hand railing,
- bite-activated nipples for sippy-cup,
- dressings, tape liquid bandage and antiseptic,
- lawn care services, and
- house cleaning services.

Further information on medical expenses may be found in IT-519R2 (Consolidated) and the CRA publication RC4064(E) Rev. 08, "Medical and Disability-Related Information - 2008", which are posted on the CRA website.

We trust that our comments will be of assistance.

Yours truly,

G. Moore
for Director
Business and Partnerships Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch