27 May 2011 External T.I. 2010-0403181E5 - Medical Expenses for an Autistic Child

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: (1) Whether the incremental cost of gluten-free food products for a child diagnosed with autism qualifies as a medical expense for purposes of the METC. (2) Whether the cost of sending an autistic child to a private school would qualify as a medical expense under paragraph 118.2(2)(e) of the Income tax Act.

Position: (1) No (2) No

Reasons: (1) An individual must have been certified in writing by a medical practitioner to be a person who, because of celiac disease, requires a gluten-free diet. (2) The school in question does not provide the specialized equipment, facilities or personnel for the care, or care and training, for an individual with an autistic disorder.

XXXXXXXXXX
					2011-040318
					Linda Compton
May 27, 2011

Dear XXXXXXXXXX :

Re: Medical Expenses for an Autistic Child

This is in response to your letter of April 14, 2011, in which you requested our opinion on whether the incremental cost of a gluten free diet and tuition fees for a private school for an autistic child are eligible medical expenses for the purposes of the medical expense tax credit ("METC").

You provided documentation signed by a medical practitioner that states that the child's special dietary needs require him to follow a gluten free diet. As well, the documentation indicates that the child is benefitting from the exposure and experience in the environment at the private school he attends.

Written confirmation of the tax implications inherent in particular transactions is given by this Directorate only where the transactions are proposed and are the subject matter of a request for an advance income tax ruling submitted in the manner set out in Information Circular 70-6R5, "Advanced 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. Where the particular transactions are complete, the inquiry should be addressed to the relevant tax services office, a list of which is available on the "Contact Us" page of the CRA website. Although we cannot comment on your specific situation, we are prepared to provide the following comments in respect of the issues that you raised. Please note, however, that these comments are of a general nature only and are not binding on the CRA.

Gluten free diet

Subsection 118.2(2) Income Tax Act (the "Act") describes the types of drugs, medicaments and other preparations that may qualify as medical expenses. Paragraph 118.2(2)(r) of the Act provides that the incremental cost of gluten-free food products, as compared to the cost of comparable non-gluten-free food products, may qualify as a medical expense if a patient has been certified in writing by a medical practitioner to be a person who, because of celiac disease, requires a gluten-free diet. Unless the child has been certified in writing by a medical practitioner to be a person who, because of celiac disease, requires a gluten-free diet, the incremental cost of gluten-free food would not qualify as a medical expense.

Private School fees

There are two requirements that must be met in order for fees paid to a school, institution or other place to qualify as a medical expense under paragraph 118.2(2)(e) of the Act in respect of a student who receives care and training at that place:

(a) the student must be suffering from a physical or mental handicap, the severity of which is such that the student requires the equipment, facilities or personnel specially provided by the school, institution or other place; and,

(b) an appropriately qualified person must certify that the above conditions are met with respect to the individual receiving the care at that place.

This certification is usually carried out by a medical practitioner, but is not restricted to such professionals. Generally, the certificate should include a description of the equipment, facilities or trained professionals required to adequately provide care, or care and training, for the individual. In addition, the CRA must be satisfied that the equipment, facilities or personnel provided by a particular place meet this description.

Based upon the information provided, it is our view that the school in question does not provide the specialized equipment, facilities or personnel for the care, or care and training, for an individual with autism. XXXXXXXXXX 's approach focuses on a low student-to-teacher ratio, beneficial social effects and a stimulating atmosphere. These factors, while beneficial to children in general, are not determinative in deciding whether a school, institution or other place is a qualifying facility for the purposes of paragraph 118.1(2)(e) of the Act.

We trust that these 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