What is the Disability Tax Credit?
The Disability Tax Credit is a credit offered by Revenue Canada to those of who have a severe mental or physical impairment which markedly restricts the basic activities of daily living and/or need and dedicate time for Life-Sustaining Therapy (Therapy that must occur at least 3 times per week for more than 14 hours per week).
They further require that the person eligible have an impairment that has lasted or is expected to last for a period of 12 continuous months. Finally, Revenue Canada notes “For the purposes of the disability amount, Life-Sustaining Therapy is any treatment for a disease or a disorder that, if withheld would prevent the functioning on one or a group of vital organs to sustain human life.”
There are some who do not wish to be labelled as “disabled” or have their child carry such a label. I respect that but, for myself and others, any financial relief provided by the Federal government is accepted and desired.
Who Can Apply?
The Disability Tax Credit is available to those who have a taxable income and who are markedly restricted in the Basic Acts of Daily Living OR require 14 or
more hours per week to administer Life-Sustaining Therapy.
My child or I have Type 1 Diabetes. Do either of us qualify?
Yes! While the qualification criteria for a child under 18 is slightly different from that of an adult, if both of you are intensively managing your diabetes care (you are using MDI or an insulin pump), you most likely will qualify.
Children with type 1 diabetes are deemed to qualify once the doctor certifies that they do in fact have type 1 diabetes. This is because CRA recognizes both the time spent on care by the child and the parent(s) and feels that the total is in excess of 14 hours per week.
Adults must prove that they intensively manage their diabetes for more than 14 hours per week to qualify.
What is an Intensive Insulin Management System?
This means that you are taking more than 1 or 2 injections of insulin per day, you are monitoring your blood glucose levels 6 or more times per day, you are monitoring your carbohydrate income to match your insulin needs, and you are keeping detailed data on trends and patterns for your diabetes care.
I’m on a pump so I automatically qualify right?
WRONG. As of the 2004 tax year, the method of insulin delivery no longer matters. What does matter is the time you spend on Life-Sustaining Therapy. In
previous years, the amount of time spent injecting insulin was the criteria for acceptance. Insulin pumps inject 24/7. With the changes, activities must take away from routine daily living.
What if I have no taxable income?
People with low incomes may still find some relief but the credit is designed to assist in reducing your taxable income. IF you have a child with Type 1 diabetes, there is an added benefit to being approved for the DTC regardless of your income level. If you are receiving a Child Tax Benefit AND you have a child with Type 1 diabetes, you will be entitled to an added Disabled Child Benefit each month.
I already filed my taxes for this year. Do I have to wait until next year to apply?
NO. You can fill out the T2201 at any time. When you are ready to submit it, you simply request that CRA reassess your taxes for the applicable years.
You will first need to obtain a form T2201. This can be downloaded from the Canadian Revenue Agency website.
This form must then be filled out by the applicant and by an attending physician. For details on what may be included in this form, please see our Tips section.
The T2201 is sent in with your income tax return. You will fill out your income tax return as if you have ALREADY been approved for the credit and will fill out line 316 (or line 318 to transfer from a dependent).
What do I need to tell my doctor to have the form signed?
It is important that physicians understand what they are signing.
If you have a child with Type 1 diabetes, make sure that your doctor understands that by signing the T2201, they are certifying ONLY that the child has a diagnosis of Type 1 Diabetes. They are NOT being asked to specify how much time the
child or family spends on diabetes-related care. CRA assumes, based on previous Tax Court cases, that to look after a child (presently defined as someone under 18 years of age) with Type 1 diabetes requires more than 14 hours dedicated to Life Sustaining Therapy on the part of the parent and the child.
For adults (anyone over 18 years of age), the doctor must understand that they WILL most likely be asked to fill out a supplementary form. Provide your doctor with as many details of what you do over a week as possible. They must understand how you spend your time so that they can accurately fill out any supplementary form that they may receive.
Again, our tips page lists what activities are currently recognized as being part of Life-Sustaining Therapy for Type 1 Diabetes. The more information you and your doctor can provide in the original T2201, the less chance that your application will be declined.
Make sure that your doctor indicates that this condition is PERMANENT. It may affect the amount of time you are given the credit for.
How long will I get the DTC for?
The length of time you qualify for the DTC is subject to CRA’s internal policies. They can grant the credit for one year time frames, and you will have to reapply each year, or they can grant it for specific lengths of time (i.e. 5 years), or they
may grant it permanently. The last scenario is unlikely but does seem to occur after repeated applications have been approved.
When you receive your Notice of Assessment stating that you qualify for the DTC, there should be a further statement of exactly how long you have before you need to reapply. You can also go into your online CRA account to verify the date
that you may need to reapply for the Disability Tax Credit.
Go to the CRA site and download the form .
Insert your personal information as required.
Fill out Part A, page one of the Disability Tax Certificate.
Part B is to be filled out by your doctor. The only issue of importance for most people is “life sustaining therapy”.
Your doctor will check off the box “yes” when asked “Does your patient meet the conditions for life sustaining therapy as described above?”
In the section of “year” he/she will put the diagnosis year.
Details would be insulin dependent Type 1 diabetes and then the method of insulin delivery (please remember that method of deliver does NOT change your eligibility for the DTC)
Effects of impairment is the reliance on an external source of insulin to sustain life.
Duration is annoying for those living with diabetes but you must remember that this form is for other diseases/conditions as well. Please note that “yes” the impairment will last for more than 12 months and no there will be no marked
improvement thanks to therapy (there will be no cure).
The physician and the person with diabetes signs off on the form and it is submitted with your tax return or as a separate request for review if you have already sent in your latest tax return.
What do I do if I am sent a second form asking about time spent?
The easy answer is of course to simply tell them all the time it takes you to fill cartridges, adjust basals, and do all of those things that you have probably forgotten take time out out your day. If you sit for one day and every time you do something because you have diabetes, you will quickly be amazed how time adds up.
Below are some examples of how your time can add up.
Please remember that these are only examples. To help to ensure that your
application is accepted, please make sure to personalize your list. You do not want it to look like you simply copied and pasted something that you found online.
Establish the insulin required based on time of day, caloric intake, activity level and wellness; clean the area with alcohol; make sure alcohol is dried; clean insulin vial with alcohol; remove cap on needle; draw up correct amount of insulin; pinch skin; insert needle; inject insulin; relax hold on skin; place swab over injection site and maintain pressure for a few seconds; replace protective cap on needle; and properly dispose of needle. This takes approximately 6 minutes multiplied by the number of injections per day. For a person who uses a
long acting and injects for meals you would count a minimum of 5 needles per day (without corrections) totalling 30 minutes per day, and 210 minutes per week (3.5 hours)
For insulin pumpers:
Establish the insulin required based on time of day, caloric intake, activity level and wellness (2 minutes six times per day for 84 minutes per week), change pump tubing and insulin cartridge (7.5 minutes every other day totalling 70 minutes per week); adjusting pump programming to accommodate for temporary basal rates, exercise, changing bolus ratios or altering basal rates (10 minutes daily, 70 minutes per week), site change and rotation (10 minutes every other day, 35 minutes per week), emergency site changes due to sites falling out or failing (17.5 minutes twice per week, 35 minutes), establishing correction doses (1 minute twelve times per day, 84 minutes per week), changing pump battery (2 minutes every other week).
Logging: I know not everyone logs but reality says that you must look at trends and see if you need adjustments for your exercise routine, pizza supper, or that extra shift at work. All of these things are tasks that a person with a functioning pancreas would not have to do. This is something you do think about. It would total a minimum of 30 minutes per day, equating to three and a half hours per week.
Analyzing trends and making adjustments: every three days, 20 minutes equals one hour per week
Checking meter: this includes coding, using control solution, changing lancet for
approximately fifteen minute procedure
Repeating Blood Glucose Test when meter error occurs: two minutes of your time approximately five times per week (10 minutes)
Treating lows: CDA guidelines state a low is anything under 4. How many lows are normal? This is individual but if you maintain tight control it is more likely to occur. Fourteen lows per week and 5 minutes to treat equals 70 minutes per week.
CRA states in their legislation that recovery time from lows does not count in the calculation of time spent on Life Sustaining Therapy (an extra 15 minutes per low). It has been argued that this is part of therapy and privately they agree but unfortunately there does not seem to be legal precedents backing us at the moment.
Dealing with highs: Again, not to be taken lightly. You need to establish a correction factor. Some people are more insulin resistant at higher bg levels. If
you are pumping, you want to check the tubing and the site. If you are on injections you may wish to look at the insulin and the injected area for hypertrophy. You will need to inject to correct and finally you may also need to test for ketones (three minutes every other week, or 1.5 minutes per week). The amount of time this takes would be approximately 6 minutes and as most people tend to run high more times than low. We found 21 highs per week I would say three highs per day totalling 18 minutes per day, or 2 hour 8 minutes per week.
Checking Blood Glucose levels:
Checking blood glucose levels becomes routine but it still must be done. On average one hopes that there are at least 6-12 finger pokes per day. To check you must wash the area to be tested, ensure that the meter is coded properly, insert the test strip, lance the area, apply the blood, record the reading. 8 times
per day at 3 minutes per test is 24 minutes per day or 3 hours per week
For people using a CGM:
You would most likely have slightly less testing time (6 times per day or 2.1 hours per week) but will have other tasks that must be added into your calculations such as:
Rotating CGM Sensor sites: 10 minutes once per week
Analyzing your CGM Trends: 30 minutes once per week
Emergency Sensor site changes: 10 minutes every other week or 5 minutes per week.
CGM Calibration: 1 minute four times per day or 28 minutes per week)
For a total time spent dealing with the CGMS part of your diabetes care being
73 minutes per week.
So what are the totals?
For someone on injections:
Injecting: 4.5 hours (this includes the time required when you are high and need to calculate a correction dose.)
Logging: 3.5 hour
Analyzing trends and making adjustments: 1.5 hour
Checking meter, coding, changing lancets, etc.: 15 minutes
Blood checks: 4.5 hours (this included the extra time for retesting during lows)
Total: 14.25 hours per week
Dealing with pump: 6.3 hours
Logging: 3.5 hour
Analyzing trends and making adjustments: 1 hour
Checking meter, coding, changing lancets, etc.: 15 minutes
Treating lows: 1 hour 15 minutes (or more)
Dealing with highs: 2 hours 30 minutes
Checking blood glucose: 4 hours (pumpers usually test closer to the 10-12x per day mark)
Total: 18.8 hours per week
If using a CGM: add .5 hr.
Time devoted to the CGM part of therapy is approximately 73 minutes but there
is usually less time spent testing blood glucose levels which would negate the total or increase it only slightly.
Still not sure what to do?
Diabetes Advocacy offers assistance in filling out the T2201.
We will print off the T2201 as well as any requests for reassessment years, fill in the forms and indicate where you and your doctor need to sign, as well as provide you with a detailed letter stating why people with diabetes now qualify for the DTC. We are not tax accountants but are well versed regarding the Disability Tax Credit and those with diabetes. Please make sure that your doctor will support your claim. This fee is for filling out the appropriate forms for you
only. We do not guarantee your success but will assist you with any further issues you may have.
payment of $170.00 ($150 for service and $20 for shipping) can be etransferred via your online banking.
Please send payments to advocacy @ diabetesadvocacy.com
Security question: service requested. Answer: DTC
Please ensure that you also follow up with an email so that we can contact you directly for details on your package.
Want to do it yourself?
Diabetes Advocacy now offers you a step by step guidebook in electronic form or a hardcopy booklet.
Need a second opinion before you send in your application?
I will review your documents and suggest any edits or reviews before your T2201 is submitted.
Any other questions?
Please contact us.
This site does not supply clinical treatment information or medical advice. The
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