16 July 2013 External T.I. 2013-0477051E5 - medical expense - endovenous laser treatment

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: Is the procedure for endovenous laser treatment ("ELVT") an eligible medical expense for purposes of the medical expense tax credit ("METC") under section 118.2 of the Income Tax Act (the "Act")?

Position: It is a question of fact.

Reasons: It depends on whether it is done purely for cosmetic purposes.

XXXXXXXXXX
2013-047705
N. Shea-Farrow

July 16, 2013

Dear XXXXXXXXXX:

Re: Technical Interpretation Request – Endovenous Laser Treatment

We are writing in response to your letter of January 28, 2013 on whether the procedure for endovenous laser treatment ("ELVT") is an eligible medical expense for purposes of the medical expense tax credit ("METC") under section 118.2 of the Income Tax Act (the "Act").

You state that you will have a referral from your family doctor, to another doctor that is registered with the XXXXXXXXXX who will perform the ELVT procedure. According to you the procedure is not cosmetic but medically necessary. You also state that it is your understanding that the procedure is not currently covered by the XXXXXXXXXX.

Our Comments

Written confirmations of the tax implications inherent in particular transactions are only provided by this Directorate where the transactions are proposed and are the subject matter of an advance income tax ruling submitted in the manner set out in Information Circular 70-6R5, "Advance Income Tax Rulings", dated May 17, 2002.  This Information Circular and other Canada Revenue Agency (CRA) publications can be accessed on the internet at http://www.cra-arc.gc.ca/formspubs/menu-e.html. This Directorate generally cannot confirm if an individual is eligible for the METC with respect to a particular medical expense. Such a determination would usually be made only in the course of an income tax audit which, if undertaken, would be carried out after the particular taxpayer has prepared and filed an income tax return for the year.  Notwithstanding the foregoing, we are prepared to provide the following comments that may be of assistance.

The CRA's general views regarding the medical expense tax credit are contained in the Folio S1-F1-C1, Medical Expense Tax Credit (S1-F1-C1) which is on the CRA website at 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 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 may have been incurred for medical reasons.

Pursuant to paragraph 118.2(2)(a) of the Act, an amount paid by an individual to a medical practitioner, a dentist or a nurse (a "medical practitioner") or to a public or private licensed hospital for medical services is a qualifying medical expense for the METC. A medical practitioner must be authorized to practice their particular profession according to the laws of the jurisdiction in which the service is rendered, whereas a licensed private hospital must be licensed by the jurisdiction in which the hospital operates. A list of authorized medical practitioners by province is listed on our website at http://www.cra-arc.gc.ca/tx/ndvdls/tpcs/ncm-tx/rtrn/cmpltng/ddctns/lns300-350/330/ampp-eng.html. A "medical service" means a service relating to the diagnosis, treatment or prevention of a disease or disorder performed by a medical practitioner acting within the scope of his or her professional training.

An amount otherwise qualifying under paragraph 118.2(2)(a) of the Act may be denied pursuant to subsection 118.2(2.1) of the Act if the service was provided purely for cosmetic purposes. In particular, this latter provision excludes from eligible medical expenses, an amount paid for a medical or dental service, including any related expenses, which has been provided purely for cosmetic purposes unless it is necessary for medical or reconstructive purposes.

Thus, where a particular medical procedure or service is cosmetic in nature but medically necessary, a taxpayer may wish to obtain a detailed description of the nature and purpose of the medical service from the authorized medical practitioner performing the service as a means of establishing that subsection 118.2(2.1) of the Act does not apply. It is a question of fact whether a particular cosmetic service or procedure was necessary for medical purposes. In such a case the onus is on the taxpayer to substantiate that fact.

As explained at the beginning of our comments, we cannot confirm whether in your particular case the procedure is eligible for the METC. However, it is our view that generally the cost of the EVLT procedure paid to a medical practitioner, or to a public or licensed private hospital, for a patient with symptomatic varicose veins would qualify as an eligible medical expense under paragraph 118.2(2)(a) of the Act.

We trust our comments will be of assistance to you.

Yours truly,

Sharmini Ratnasingham
For Director
Business and Employment Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch