Takeaways from the Senate Committee Report on DTC

This article was originally created for insulinpumps.ca and published on June 19, 2019

Some background

senate review

During the summer of 2017, many Canadian diabetes groups were made aware of an increased number of rejected applications for the Disability Tax Credit (DTC) by people living with diabetes. A public letter was sent to both the media and finance department asking why the Canada Revenue Agency seemed to be implementing a policy change when there had been no change in legislation.

By December of 2017, the Senate Committee on Social Affairs, Science and Technology convened to discuss this issue. They met with various groups in February of 2018.

What the committee was told

The committee heard from a variety of groups and individuals including key players from the Juvenile Diabetes Research Foundation (JDRF) and Diabetes Canada. They were told that both the DTC and the (Registered Disability Savings Plan)RDSP are underutilized despite the potential to offer great assistance to qualifying individuals. The current DTC is only of financial benefit to those who have an income because it is a non-refundable tax credit. Individuals with little or no income are not applying and therefore are not eligible for any further assistance in the form of grants available from the RDSP.

They were told that currently the CRA (Canada Revenue Agency) employees are being given the power to overrule the certification of a medical doctor. This suggests that the employees somehow have greater knowledge of a person’s medical condition and restrictions than that of a physician.

JDRF and Diabetes Canada also requested that the 14 hour minimum for life sustaining therapy be removed. They noted that similar health burdens and financial challenges occur for all people with type one diabetes regardless of the time spent. They all require the same activity restrictions and higher costs associated with administering insulin regardless of whether it takes 10 hours or 14 hours per week.

It was further noted that “these rules can often mean that young adults cease to qualify for the DTC when they turn 18 simply because their parent’s time is no longer included in the amount of time spent administering a therapy. In reality the only thing that has changed is that the person has turned 18. “

Finally, the committee was advised that people with life-long conditions, like diabetes, are being forced to reapply for the disability tax credit. This is a waste of time and resources.

The Recommendations:

On June 27th, 2018 the Senate Committee on Social Affairs, Science and Technology released its recommendation on the Disability Tax Credit and the Registered Disability Savings Program. These are the ones that apply to people living with diabetes.

  • implement legislation that would limit the fees disability services providers can charge to complete the Disability Tax Credit application (this has been tabled but not brought into force yet)
  • Re-examine the arbitrary 14 hours required for life sustaining therapy
  • Eliminate the need to reapply for life long conditions
  • Improved transparency for those who have to appeal their DTC denial
  • Allow people to keep all contributions made to their Registered Disability Savings Plans for periods in which they qualified for the Disability Tax Credit.
  • Work with all levels of government to ensure that all people with qualifying disabilities over the age of 18 can access the Registered Disability Savings Plan program.
  • Change the 10 year wait to access RDSP funds and grants
  • Make this a refundable credit so that it also helps those with lower or no incomes
Senate committee recommendations

Tax Tips for People with Diabetes

Tax tips for people with diabetes

If you are like me, you aren’t overly excited by tax time. The thought of paying in more money is so depressing that you are probably digging through every receipt trying to figure out how you can write off that last Ice-cap from Tim Hortons as a diabetes-related expense. Here are a few tax tips that you may have overlooked.

Diabetes supplies

Keep all of the receipts for your diabetes supplies such as:

  • insulin
  • syringes
  • test strips
  • ketone strips
  • alcohol wipes
  • medical tape
  • Glucagon kit
  • pump supplies including the insulin pump, tape, infusion sets, reservoirs, batteries, and mastisol 
  • Continuous Glucose Monitor, transmitters, and batteries

If you have paid out of pocket for these items or a co-pay after insurance, make sure that you have a prescription for them.

Travel

You can claim the cost of travel to medical appointments.

In Canada you must travel at least 40 km one way to get to your appointment. Make sure that you have a signed letter from the office before you leave stating that you have been there. You will then be able to deduct the cost of public transportation or vehicle expenses.

If you must travel over 80 km one way, you will also be able to claim the cost of meals. You are allowed up to $17 per meal up to a maximum of $51 per day. You can learn more here.

Finally, you can also claim your accommodations and parking fees for travel over 80km. Again, make sure that you have a letter stating that you have traveled for medical appointments.

In the US, you can deduct 23 cents per mile in lieu of gas and oil, plus any parking fees and tolls for travel to medical appointments. If you take a taxi, bus, train, airplane or ambulance you can deduct the actual expense. You can deduct the cost of any accomodations, but unlike Canada, you cannot deduct the cost of meals.

In the US, these expenses must exceed 7.5% of your gross annual income. The amount will rise to 10% in the 2019 tax year. For those living in Canada, medical expenses must be above the lesser of $2,208 or 3 percent of your net income.

HSA/FSA

If you live in the USA, you can also save by contributing to a Health Savings Account (HSA) or a Flexible Spending Account (FSA).

These accounts are managed by financial institutions and accessed in the same way as you access your chequing account.

Both a Health Savings Account and a Flexible Spending Account are made up of tax-deductible contributions with pre-set contribution limits. Contributions can be set up through your employer. Both accounts also share the same list of “qualified expenses”.

The difference, however, is in who is eligible. Anyone can contribute to an FSA but only those with a high deductible ($1,350 or more for an individual or $2,700 or more for a family in 2018) health plan are eligible for the Health Savings Accounts. 

The maximum contribution to an HSA is $3,450 for an individual and $6,900 for families.  The maximum contribution into an FSA is $2,650. (at the time of this writing)

Disability Tax Credit

In Canada, we do not have Health Savings Accounts. We do however have a Registered Disability Savings Plan. To access this plan and the associated government grants, you must first apply for and be approved for the Disability Tax Credit (DTC).

The DTC is a non-refundable tax credit that reduces your taxable income. To qualify, you must be insulin-dependent and spend over 14 hours per week on your care.

See if you might qualify for the DTC here.

To make sure that you have all of the receipts you need, download our checklist before you start your tax return this year!

An Overview of BC’s New Insulin Pump Program

BC insulin pump program expandsThe internet has been abuzz. The provincial government of BC lived up to an election promise by removing the cap on its insulin pump program. There was celebrating in the streets…until the fine print of the new program was read.

You see, this program will be unlike any other program in the country.  It will be a two-tiered program that seems to favour one insulin pump company over the others.

The issue is complex and very emotionally charged. Let’s take a closer look and you can decide for yourself if this is a step in the right direction or a step on a new and slippery path.

No more age cap

This is big news.  Adults no longer have to pay for their insulin pump out of pocket if they don’t have private insurance.  One pumper I spoke with as spent almost $20,000 to purchase insulin pumps over the past 15 years.  That is a lot for an individual to come up with every 5 years.  It is not surprising that she sees this as a welcome relief!

A two-tiered program

This is the news that has some people scratching their heads and wondering if this is such a good program after all.

All residents with diabetes will be eligible for an Omnipod insulin pump and supplies under tier one.  There will be no deductible for this system.

If you do not want this insulin pump system and feel that a Medtronic insulin pump would be better suited for your needs, you will have to convince your doctor of this as well.  Under tier two, a portion of your insulin pump and supplies will be covered if your physician prescribes a tubed (Medtronic) insulin pump.  If you simply want to own a tubed pump but your doctor does not deem it medically necessary, you will have to pay all costs out of pocket.

You can read all of the details on the BC government website here.

A pump is better than no pump

There is a school of thought that any pump is better than no pump and I can agree with that.  If you want to use an insulin pump, then this is a fabulous option if you have no coverage. You can also work with your doctor to attempt to get some relief on a tubed insulin pump if that is your preference.

It’s a win for the little guy

Some people are claiming that this is a huge coup for the little guy.  The small insulin pump company Insulet is the preferred insulin pump for the province.  That is rather significant I will agree.

It’s a start

One thing that I always tell people who ask me for tips on advocacy is to think of their “ask” as a cookie.  Every piece of the cookie that you get is a step forward.  Often you don’t get the entire “ask” (cookie) at one go so you keep asking.  You keep enjoying each bite, knowing that you are working towards having that entire cookie.

Conclusion

For residents of BC, this is another step towards the ultimate cookie. There were pumps for kids. There were pumps for adults up to age 25 and now there are Omnipods for anyone who wants them and assistance on tier two, tubed pumps.  It another step towards the goal of coverage for everyone regardless of age who wishes to use a sensor-augmented insulin pump.

Congratulations BC residents on your new insulin pump program!

Disability Tax Credit…What now?

Disability Tax Credit next steps for people with diabetesLast week, CRA decided to reverse its policy on adults living with Type 1 diabetes and the Disability Tax Credit. This probably has many people wondering..what now?? Here are a few next steps for adults living with type 1.

If you have had your application rejected since May of 2017, CRA has said that they will be re-examining all denied claims for people living with type 1 diabetes.

This means that if you would have previously qualified for the DTC based on pre-May guidelines, your application status will be changed to approved.

If you haven’t made your application yet, you can now do so with some confidence of approval.

If you live with type 1 diabetes and are intensively managing your diabetes, then you could qualify.  As per before May 2017, you will have to show the time you spent.  That time will have to be more than 14 hours per week.  It cannot include time spent on exercise, carb counting or recovering from a low.

Follow the Disability Advisory’s Committee’s actions and calls for action.

The Disability Advisory Committee is made up of professionals and advocates.  They will be working to see the DTC fairly applied to all qualifying individuals.

If you are interested in seeing the credit properly reflect the needs of Canadians and more specifically, Canadians with type 1 diabetes, I would suggest that you follow the activities of this committee. They will be looking for submissions and information from Canadians.  Send in your letters and continue to help them inform Ottawa of why people with diabetes who intensively manage their diabetes qualify for this credit.

Keep the pressure on your MPs.

Make sure that your MP understands that the Liberal government’s recent actions surrounding the Disability Tax Credit are not acceptable.  Let them know that we do not appreciate being lied to.  Ensure that they understand what is involved in diabetes care on a daily basis.  Work to educate them on how people with type 1 diabetes spend over 14 hours on life sustaining therapy.

If you have any more questions or would like someone to review your application before submitting it to CRA for approval, I am always just an email away!

The DTC…We have come a long way. We will win the war!

we will win dtc warThe past few weeks have been incredibly busy and I have never been more proud! I have been battling the Federal government over the Disability Tax Credit since the early 2000s.  There have been victories and most recently there have been setbacks but we have come a long way!!

Let me give you a bit of history.

Back in 2002 or so, a lady named Shelley Tyler took the Canada Revenue Agency to court and won.  She believed that her son was eligible for the Disability Tax Credit because they took an inordinate amount of time to feed him and keep him alive.  Her son had type 1 diabetes.

Mrs. Tyler was kind and shared her experience with others.  I used some of her work in preparing my own application.  Others did as well.

More and more families were applying for the Disability Tax Credit.  They were still being turned down, but even more where refusing to take no for an answer.  They were taking their cases to Tax Court–and winning!

Families like the Chafes were winning the argument that insulin therapy was administered 24 hours a day when using an insulin pump.  This led to a year of qualification for all pumpers.

(The irony of recent comments that the increased use of insulin pump therapy is why applications have been denied is not lost on me. )

Changes were happening.  The diabetes community was roaring.  We were a grassroots group.  The Canadian Diabetes Association was only in the infancy of creating a dedicated Advocacy Office and JDRF was focused on funding research. That was okay because the diabetes community was powerful in its own right.

Together we rallied. We worked on court cases.  Friends and family members contacted their MPs and demanded fairness. The diabetes community was represented at the Federal review of DTC fairness.

The result was legislative change.  Children with diabetes were now given the tax credit based on a certified diagnosis of type 1 diabetes.  Adults were also allowed the credit but their means test was a bit more strict.

Recently there seems to have been a change in how disability tax credit applications are handled for people with diabetes.  We have discussed it before.  One thing hasn’t changed however and that is the power of the diabetes community.

Thanks in part to the power of social media,  the community voice is louder than ever and I couldn’t be more proud!

Diabetes Canada is sending well-spoken, knowledgeable individuals to meet with CRA and voice our concerns.  JDRF has been delving into the issue for months as well.  Together they are creating a powerful voice.  Behind the scenes, there are many more grassroots groups working together.  Everyone is pushing the same  message.  “Diabetes is a 24/7 job.  People living with insulin dependent diabetes take more than 14 hours per week to perform life-sustaining therapy.”

The message is getting out there.  This issue was all over the media.  My Twitter feed has been blown up with articles and Tweets.  I am proud! The diabetes community is coming together.

Some members have voiced their frustration. This should have been finished years ago.  People living with diabetes have enough to deal with.  Fighting their government for a credit that they obviously qualify should not be another stressor. They are right of course.  I totally understand their get their pain.

I have been in this battle since the beginning.  It’s been a long one but please don’t lose hope! This is not a war that is lost.  It is a battle that will see victory.

The diabetes community is a powerful voice.  Canadians with diabetes are coming together in record numbers.  We are using that voice to let CRA and the Minister of Finance know that we are not prepared to back down.

Now is the time to keep the momentum going.  Write your letters to your MPs. Answer the call when one of the diabetes organizations calls looking for your story.  Our voice is strong.  We have come a long way and together we will finally win the war.

How to Fight for the Disability Tax Credit with Type 1 Diabetes

How to fight for the DTC with T1DDiabetes Canada recently released a statement claiming that the Canadian Revenue Agency (CRA) is now declining 80% of applications for the Disability Tax Credit (DTC) submitted by people living with type 1 diabetes.  I cannot confirm or deny these figures. I can state that I am seeing a significant increase in the number of people contacting. They are reaching out because they  or  their clients have been declined for the DTC.

What is going on with the DTC?

No one seems to know.  CRA claims that there has been no change in policy.  Public concern seems to suggest otherwise.

For years, people with diabetes have often received a follow-up letter when they have made their application asking for more details from their doctor.  In the past, that letter was filled out in a similar manner to the initial application and the claim was approved.  This seems to be happening with less frequency now.

People living with diabetes are often receiving a letter stating that “an adult who independently manages insulin therapy on a regular basis generally does not meet the 14 hours per week requirement unless there are exceptional circumstances.”.  In some cases, this is followed by a request for more information but in other cases, it is part of the denial for their claim.

Does this mean that I should not apply?

No.  People living with diabetes usually spend over 14 hours per week to intensively manage their diabetes.  Granted this does not include all people living with diabetes but does include a large majority.

You should continue to send in your detailed applications. Make sure that you are adding tasks that are approved and that your total is over 14 hours.

Get our Disability Tax Credit workbook to ensure you are spending over 14 hours per week on approved tasks. 

What happens after I apply for the DTC?

Once you and your doctor have completed your forms and returned your application, there will be some time before you hear back from CRA.

Odds are high that your doctor will be contacted and asked for more information.  Again, make sure that the follow-up letter is detailed. Take care to clearly show that you spend over 14 hours per week on your diabetes care.

What if I am rejected?

If you are turned down for the Disability Tax Credit, you have a few options.

First, you can ask that your file be reassessed by another officer.  Sometimes fresh eyes will give a fresh perspective and the ruling can be changed.

Second, you can formally appeal their decision within the first 90 days of your rejection letter.  This is a detailed process but does not necessarily require a lawyer.  If you choose to go this route (and I would encourage everyone to do so), be sure to keep careful and detailed records. You must also contact CRA for a copy of your file under the Access to Information Act to better understand what you are fighting against.

Read more tips on appealing the DTC here.

Write your Member of Parliament

Finally, at any stage of the process, I would encourage you to ask for the assistance of your MP.  Whether you are thinking of applying, have applied or have been rejected, it is important for Members of Parliament to be aware of this situation.  Diabetes Canada has written a great template for people to send to their MP.  Download the letter. Be sure to personalize it to your situation and forward it on.  Remember that letters sent to a Member of Parliament in Ottawa do not require postage.

The more MPs that contact the Finance Department and ask them what is going on, the stronger the case for change and fairness.

Together we were able to get access to this credit for some people living with diabetes over 10 years ago.  Working together again, we will create change for even more individuals!

Take our short quiz to see if you might qualify for the Disability Tax Credit.

The Disability Tax Credit for Adults…What you need to know

Disability Tax Credit tipsThe Disability Tax Credit is a non-refundable tax credit available to Canadians who meet a very strict criteria set out by the Canadian Revenue Agency.  One of the criteria is that you must take over 14 hours per week to perform life-sustaining therapy.  This is the section that many people living with diabetes qualify under.  Before you apply there are a few things that you need to know.

Having diabetes doesn’t mean that you qualify.

Not everyone with diabetes will qualify for the Disability Tax Credit (DTC).  The criteria states that children with Type 1 diabetes do qualify. Adults (anyone over 18 years of age) however, must show that they spend over 14 hours per week on their care.

You can take our quick quiz to see if you might qualify.

Why do children get the DTC so easily?

The reason that children qualify for the Disability Tax Credit is because CRA feels that the time that they spend on their care AND the time that their parents spend on their care, together is equal to more than 14 hours per week.  Adults do not require the help of others for the most part. Therefore must prove that they, themselves spend over 14 hours per week on therapy to keeping themselves alive.

Download our workbook to see if you spend over 14 hours per week of eligible tasks. 

Do I really spend 14 hours per week keeping myself alive?

That is a question that only you can answer.  I will say that if you are intensively managing your diabetes, then more than likely, you do take an inordinate amount of time out of your day to manage your diabetes care.

A person who is not reliant on an external source of insulin to live does not have to be concerned about blood glucose readings, anticipated activity levels, impending illness,  or fat contents of meals when planning their day to day activities.  The average person does not have to draw up a syringe, put in an infusion set or calibrate a continuous glucose monitoring sensor.  A person without diabetes does not have to keep track of their insulin requirements, blood glucose levels or activity levels in a journal.

These tasks, while commonplace for a person with diabetes, are all tasks that are recognized by CRA and count towards the 14 hour total required to be certified for the Disability Tax Credit as requiring life-sustaining therapy.

I hear that adults no longer qualify so why should I try?

Some adults are experiencing a harder time getting the tax credit.  There can be many reasons for your application being denied.  You may be including tasks that are not recognized by CRA as being an allowable part of therapy.  Things like grocery shopping, doctors appointments and trips to the pharmacy are not allowed to be included in your total.

Another reason that adults are being turned down is because they are not providing details on their own specific care.  Often people are turning to internet groups that have sample forms filled out. They then simply copy and paste the details that they have found. You should be  using that information as a guide and filling out the application in your own words with your own specific care details.  CRA is noticing a pattern of applications and is now beginning to question their authenticity.

What does that mean?

It means that you need to make your application your own.  Spend one week detailing what you do each day.  It will take you a lot of time to stop and write everything down.  Time each task.  Note how often you perform it. If you have trouble deciding what to document, our workbook might help you.

Take this week’s worth of information and then compare it to your online resources.  Eliminate the tasks that CRA won’t approve.  Add in the tasks that you did but forgot to add in your personal list.  Now total your time spent.  Most likely, you will find that you spend more than 14 hours per week on your care.  This data can also be shared with your doctor at your appointment. It will help he/she understand who much time you do put into your care.  This will further be of use if he/she if they receive a follow up letter from CRA asking for more details on your care.

Adults with insulin dependent diabetes who test regularly (6+ times per week), who inject insulin multiple times per day through injections or an insulin pump, and make their own adjustments to their insulin regimen should apply for the Disability Tax Credit.  If you are turned down, you have the right to ask for your application to be approved by another CRA staff member. Sometimes the second review still does not turn out in your favour but don’t despair. At that point,  you have the right to see all correspondence used in your file and begin a formal appeal process.

If you are unsure of how to fill in your application or you just want someone to review your totals, I can assist you. Email me , check out the Disability Tax Credit page or check out our helpful downloads.

RDSP–What was the catch?

Years ago, when the RDSP first came out I was skeptical.  Free money even from the government sounded too good to be true.  Friends encouraged me to open an account for my son. They emphasized, “the government is going to give YOU money for just putting in a few dollars!”   I still continued to wonder “What was the catch?”

For those who don’t know, an RDSP or  Registered Disability Savings Plan is long term savings plan created by the Canadian government. There can only be  one plan per person.  That person must have an approved Disability Tax Credit application on file with the Canadian Revenue Agency .  Unlike an RRSP, with the RDSP  the government will provide grant money to the investor that can then be invested and earn its own income.

When I first opened the plan for my son, my understanding was that the government portion (the grant money) had to stay in the account for a period of 10 years before it could be withdrawn.  In my mind, this meant that the money that I put in when he was 15 coupled with the grant money would cover a new insulin pump for my son when he turned 25.  I was wrong.

An RDSP is meant for long term savings for an individual who has serious health issues.  You can take the money that you put in out at any point.  When you make that withdrawal however, the government portion must also be returned.

In my case, I didn’t want to take the money out right away, I wanted to leave it for 10 years.  There is however another catch.  According to rdsp.com, “Disability Assistance Payments (DAP) can be made from an RDSP at any time, but grants and bonds may need to be repaid if they have not been in the plan for at least 10 years.” This meant that no one could contribute to my son’s RDSP for a period of 10 years prior to taking any funds out if we did not want to be penalized.  There could be no grant money for that 10 year period or the amount that I contributed had to be more than the government’s grant portion. That was not what I had been aiming for.

“Payments in the early years of a plan are limited by the assistance holdback rule. Since all grants and bonds received in the previous 10 years must be repaid once a disability assistance payment is received, the plan must hold back an amount equal to that amount in case a benefit repayment must be made. In some cases, that can prevent any disability payment at all.” states RDSP.com

What does this mean? 

RDSP are not the short term savings vehicle that some of us had hoped for.  They are a long term savings for those who cannot afford to save for their own long term medical expenses.

They still offer “free” money unlike any other plan but like other retirement plans, require the owner to be in his/her senior years before needing the funds.

It has been suggested that for parents contributing for their children, they should look at it as a safety net in case something happens to the parent.  If parents were to pass early, it would give the child a bit of extra help in their care.

For me, it is an individual choice that should be made with the help of both your accountant and financial advisor. I think that you have to have a clear idea of when and how the funds are to be used.  At that point, you can better decide which of the current savings options are best for your family and your situation.

rdsp blog

Most Frequently Asked Questions regarding the Disability Tax Credit.

dtc basicsIts that time of year again…tax time! Here in Canada it is also the time that many people living with diabetes learn that they could be eligible for the Disability Tax Credit (DTC).

Here are a few frequently asked questions that will hopefully help you as you decide if you or your loved one qualifies…

  1. Does everyone with diabetes qualify?

No.  In order to qualify for the DTC you must use multiple daily injections of insulin via syringe or insulin pump and be intensively managing your diabetes care.

2 What does intensively managing your diabetes care mean?

You must be testing, injecting, logging, and adjusting your insulin doses.  These tasks must take you over 14 hours per week to perform.

3.   Do children with diabetes qualify?

Yes, children under 18 qualify without having to prove the 14 hours.  CRA assumes that the amount spent on diabetes care by both the parent and child would combine to be over 14 hours per week and therefore a diagnosis signed by the doctor on the T2201 is all that is required for their approval.

4. What is the Disabled Child Benefit? 

This is a separate amount that can be given to you for your child if your child is eligible for the DTC and you are receiving a Child Tax Benefit.

5. What is a T2201?

This is the form created by CRA that must be filled out by the person with diabetes and their doctor in order to qualify for the disability tax credit.

6. I am not disabled! I don’t want to be labelled disabled. Why do I want to fill out this credit?

The DTC, when applied to people with diabetes,  is not about being disabled.  A person with diabetes does not qualify based on a disability. They qualify based on the clause for people who require “Life-sustaining therapy”.  This subsection is for people who spend an inordinate amount of time on the therapy that they require to live.

7.  I have read that I can’t use the amount of time that I spend counting carbohydrates. Why not?

CRA feels that over time things like counting carbs become second nature to a person with diabetes and therefore no longer takes an inordinate amount of their time.

8.  I have to exercise because of my diabetes.  Can I count the time I spend at that the gym?

No. Everyone should be exercising and while there is added benefits for a person with diabetes, this is not an activity that will be allowed on your application.

9.  What tasks can I include in my application? The Diabetes Advocacy website includes a comprehensive list of what sort of tasks are allowed and a guide of how much time it takes to perform them each day.

10.  Do I need to send CRA my log book?

There is no need. CRA simply wants to see the tasks that you do each week with a specific breakdown of how much time those tasks take.  You doctor however may ask that you keep track of what you are doing for a period of time and bring it to him/her before they will sign off on the T2201 for you.

11.  Who can sign the T2201?

A medical doctor must sign this form.  This can be your family doctor, pediatrician, internist or endocrinologist.  Choose the person with the most knowledge of your care and understanding of what they are signing.  Their support is vital to a successful application.

12.   Do I need to pay someone to fill out the T2201?

No.  There is no reason to pay a fee or a percentage of your return to have this credit filled for you.  Diabetes Advocacy does offer a service to assist in filling the forms for those who are not comfortable  in doing this themselves.  I also have created a booklet that guides you step by step on how to fill the form that can also be purchased here.

If you have more questions , please email me at

advocacy @diabetesavocacy.com and I will do what I can to help.

 

 

Can I get the DTC if I am an adult insulin pumper?

insulin pumps and the DTC

For a number of months, there has been concern about a video posted on the CRA website.  It suggested that using an insulin pump did not allow a person to be eligible for the Disability Tax Credit.

Many people have written letters to their MP as well as CRA.  Diabetes Canada has also made the issue of easier qualifications for adults with Type 1 diabetes a priority for the upcoming federal election.  What does this really mean to people living with diabetes, however?  Do they no longer qualify for the DTC if they are using an insulin pump?

A member of insulinpumps.ca staff received the following response from CRA….

In receiving a qualifying therapy, the person must dedicate time to the process. This means taking time away from his or her normal everyday activities to receive the therapy. For portable devices, such as an insulin pump or implanted devices like a pacemaker, the time the device takes to deliver the therapy does not count toward the 14‑hour requirement. Activities like following dietary restriction, exercising, travelling to receive therapy, attending medical appointments, shopping for medication, or recuperating after therapy also do not count toward the 14-hour requirement.

Early on in the fight for fairness regarding the Disability Tax Credit, people living with type 1 diabetes, successfully argued that a person using an insulin pump was actually injecting insulin 24/7.  This meant that they easily spent more than 14 hours per week on life-sustaining therapy.

It is not surprising that CRA quickly made an amendment to their policy. They no longer consider the time a machine/device requires to deliver therapy as part of the 14 hour therapy total.

This does not mean that people who use insulin pumps no longer qualify for the DTC. It means that the time the pump spends delivering insulin does not count towards time spent on therapy. The amount of time dedicated to diabetes-related tasks such as bg testing, ketone monitoring, logging, making dosing adjustments, as well as site changes and pump maintenance is still used in the 14 hour calculation of therapy.  The video posted online and the CRA website, unfortunately does not clarify this.  That can be problematic.

Doctors who rely on the CRA website to guide them on what is considered therapy when dealing with Type 1 diabetes may be led to think that insulin pumpers in general do not qualify for the DTC.  Even those living with Type 1 diabetes may wrongly think that they no longer meet the qualifications.

Here are a few key points to remember…

  • Being an adult with Type 1 diabetes does not automatically qualify someone for the the DTC.  Being a child under 18 with Type 1 diabetes does.
  • Using an insulin pump does not automatically qualify you for the DTC–neither does using multiple daily injection therapy.

The key to qualification is to intensively manage your diabetes care. This means that you spend over 14 hours per week on such things as testing your bg levels, monitoring for ketones, changing infusion sites, injecting insulin, logging daily diabetes related activities, and other diabetes related tasks that a person without diabetes does not have to do to maintain life.  Tasks such as carb counting does not count towards therapy nor does the amount time spent recovering from a low blood glucose level but many other tasks do and can quickly add up to spending over 14 hours per week on life sustaining therapy. fairness report