18 January 1996 External T.I. 9528975 - 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.

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the Department.

Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle du ministère.

Principal Issues:

Paragraph 118.2(2)(a)

1.whether a payment made to an electrologist for electrolysis services rendered in a province is a qualifying medical expense
2.whether a payment made to a dental hygienist (who satisfies the medical practitioner requirement) for electrolysis services is a qualifying medical expense
3.whether a payment made to a nurse (who satisfies the medical practitioner requirement) for electrolysis services is a qualifying medical expense
4.whether a payment in respect of electrolysis made to a physician is a qualifying medical expense where the service is performed by an employee (an electrologist) of the physician

Position:

1.no
2.no
3.it might not
4.Yes - provided all the necessary requirements are satisfied

Reasons:

1.relevant provincial legislation indicates that the electrologist is not a medical practitioner
2.electrolysis is not within the health discipline of a dental hygienist
3.electrolysis may not be within the health discipline of a nurse
4.The health discipline of a physician could include electrolysis

									952897
XXXXXXXXXX							M. Eisner

Attention: XXXXXXXXXX

January 18, 1996

Dear Sirs:

Re: Medical Expenses

This is in reply to your letter of October 27, 1995 concerning electrolysis and the medical expense tax credit. Your letter is further to our letter of October 23, 1995 (file 952295).

In our letter of October 23, 1995, we indicated that where an individual made a payment to an electrologist for electrolysis services rendered in Ontario, the payment would not be regarded as having been made to a "medical practitioner" for the purposes of paragraph 118.2(2)(a) of the Income Tax Act. Accordingly, the payment was not a qualifying medical expense for the purposes of computing the individual's medical expense tax credit.

You have now asked a number of additional questions. You have asked us whether electrologists in provinces other than Ontario are medical practitioners. In addition, you have asked us whether a payment made to an electrologist who is a registered nurse or a dental hygienist would be a qualifying medical expense as well as whether a payment made to a medical practitioner would be a qualifying medical expense where the service is actually performed by a member of the staff (i.e., an electrologist) of the medical practitioner.

At the outset, we wish to mention that the general requirements which must be satisfied before medical expenses of an individual qualify for the medical expense tax credit are set out in paragraphs 13 and 14 of Interpretation Bulletin IT-519R which has been enclosed. The comments set out below on expenses that are considered to qualify for the medical expense tax credit have been made on the assumption that these requirements have been satisfied.

In the case of your first query, it is necessary to refer to the relevant provincial legislation to determine whether a particular health professional is authorized to practice as such in the relevant jurisdiction and regulated by statute. In relation to this question, we have carried out a cursory review of the relevant provincial legislation which indicated that an electrologist would not be considered to be a medical practitioner. It is, accordingly, our view that fees paid to an electrologist for electrolysis services would not be regarded as being a qualifying medical expense for purposes of paragraph subsection 118.2(2)(a) of the Income Tax Act (the Act).

In order for a payment made to a dental hygienist to be a qualifying medical expense under paragraph 118.2(2)(a) of the Act, the payment needs to be regarded as having been made in respect of medical services to a medical practitioner authorized to practice as such pursuant to the laws of the jurisdiction in which the service was rendered. As a consequence, it is the Department's view that if a payment in respect of electrolysis is made to a dental hygienist who satisfies the medical practitioner requirement, the payment would only be a qualifying medical expense if the electrolysis could be considered to be within the health discipline of the dental hygienist. As the health discipline of a dental hygienist involves care of the mouth and teeth, it seems to us that the payment would not be a qualifying medical expense.

Whether the payment made to a nurse (who is authorized to practice as such pursuant to the laws of the jurisdiction in which the service is rendered) is a qualifying medical expense would be determined in a similar manner. However, as the determination of whether electrolysis is within the health discipline of a nurse is not so clear, it would seem to us that the nurse could contact the relevant regulatory body. For example, in Ontario, this would be the College of Nurses of Ontario. In the absence of establishing that the service is within the health discipline of a nurse, it would be our view that the payment would not be a qualifying medical expense.

Where a payment is made to a medical practitioner (i.e., a physician) for electrolysis that can be regarded as being in the nature of medical services, it is our view that the payment would be a qualifying medical expense even though the service is carried out by an electrologist who is employed by the physician.

As a final comment, we wish to mention that, as indicated to you in our telephone conversation, we are unable to provide you with a copy of the Act. However, we have proceeded to provide you with copies of section 118.2 and subsection 118.4(2) of the Act which are relevant to the questions you have raised.

We trust our comments will be of assistance to you.

Yours truly,

P.D. Fuoco
for Director
Business and General Division
Income Tax Rulings and
Interpretations Directorate
Policy and Legislation Branch

cc: Client Assistance Directorate