The Disability Tax Credit for Neuropathy Conditions B. Colleen Eggertson, M.Ed., Registered Psychologist (Alberta) Ph. (403) 923-1086

Fax: (403) 225-1086

Email: colleen.eggertson@shaw.ca

website: www.ideascalgary.ca

October 20, 2010

What is the Disability Tax Credit? Canada Revenue Agency recognizes that people with disabilities can have problems in

ordinary tasks of daily life, whether or not they are working. The Disability Tax Credit is

a non-refundable tax credit which gives you a deduction of about $10,000.00 yearly on

both your federal income tax and your provincial income tax. The result is that you pay

less income tax or get a refund.

It does not give you a financial benefit if you owe zero tax.

Who can get the Disability Tax Credit? Children and adults can qualify for the Disability Tax Credit. Many, many people with all

sorts of disabilities can qualify.

Most people think they don't qualify when they read the documentation about

the Disability Tax Credit, so many don't even try to apply. Many doctors and

other professionals are equally confused by what the bureaucrats have written

about the Disability Tax Credit. In fact many people who think they don't

qualify actually do qualify.

For example, when my son was diagnosed with Autism at age 3 ½, I read the tax

information and didn't think my son qualified for the Disability Tax Credit. It was only

because the staff at his specialized preschool insisted that he did qualify that I applied. I

was so surprised when he was approved! He had to have the Certificate filled out again at

around age 13 and he qualified again even though he had improved substantially.

People who are working (or not working) and have Peripheral Neuropathy, Depression,

Attention Deficit Hyperactivity Disorder, Anxiety Disorders, Mobility Impairments,

Hearing Loss, Asperger Syndrome and other disabilities have all qualified for and

received the Disability Tax Credit.

An Example I helped one of your members write up a summary, or “cheat sheet”, for his doctor of all

the ways that his neuropathy and other medical conditions affected his daily life. The

doctor then filled out the Disability Tax Credit Certificate and the person sent it in to the

Canada Revenue Agency. It was approved for the year 2007 and onwards.

The summary included information like:

Hearing Can't benefit from a hearing aid.

Use speech-reading all or part of the time even when talking to just one other

person in a quiet environment.

Safety problem – difficulty hearing emergency sirens when driving.

Walking

On a good day can walk only one block, and am much slower than other people.

Fatigued easily, which makes walking worse and worse.

Safety problem – can't run, even in an emergency.

Great difficulty with stairs, have to pull myself up.

When it snows, can't walk to end of driveway with garbage.

Memory Concentration, short-term memory poor.

If interrupted, have to go back to the beginning of a task, can't pick up where I left

off.

Get mixed up in tasks like following a recipe, e.g. forget the difference between a

teaspoon and a tablespoon.

How Do I Apply for the Disability Tax Credit? Fill out the first page of the “Disability Tax Credit Certificate” with your name, address

and Social Insurance number, sign it, and get a physician and/or other qualified

professional to fill out the rest of the certificate. You can assist your doctor in filling out

the Certificate by writing up a short summary, usually in point form, of how your

disability affects you in daily life. This presentation will help you figure out what to put

in your summary.

You can attach any supporting documents that you want to the Disability Tax Credit

Certificate. You don't have to attach any documents, but some people have found it

helpful to include copies of medical reports, assessments, test results, employer

evaluations, etc. Some people write a letter describing what a typical day is like for them,

and how they deal with their limits. Some people get friends, family or other people who

know them to write letters saying what they have observed. You don't have to supply

receipts. You don't have to have a diagnosis. Be sure to photocopy the form and keep a

copy for yourself before sending it in, just in case it is lost. This will also help if you have

to re-apply.

How Long Can I Get the Disability Tax Credit? The Disability Tax Credit is retroactive for up to ten years, depending on when your

disability started to affect daily life. Some people get a refund of around $30,000.00 for

the past ten years when they first start get it. If your Disability Tax Credit Certificate is

approved, the government will tell you how many years it is valid and when you have to

re-apply. Some people have to re-apply every three years, some every 10 years and for

some it may approved on a permanent basis. If you improve, you have to let them know.

Re-applying is not difficult. You get a new form filled in whenever it is necessary and

mail it to Canada Revenue Agency.

What are the Criteria for Deciding Who Qualifies? People can be working and still get the Disability Tax Credit.

There are three ways to qualify:

1. You are “Markedly Restricted” in at least one of eight areas:

1. Vision

2. Speaking

3. Hearing

4. Walking

5. Elimination (bladder or bowel)

6. Feeding

7. Dressing, and

8. Performing the mental functions necessary for everyday life.

2. You are “Significantly Restricted” in at least two areas in these eight

areas in such a way that the cumulative effect is that you are “markedly

restricted”. (This is retroactive to 2005, not before 2005.)

3. You need Life-sustaining Therapy to support a vital function.

A lot of the rest of this presentation will focus on helping you understand

what the terms “markedly restricted” and “significantly restricted” mean and

how they apply to your situation. That's the information you can put in

your summary for the doctor or other professional(s) whom you choose to

ask to fill out the Disability Tax Credit Certificate.

It is also very important to think back about when your symptoms got worse. You can have had a marked or significant restriction long before you

got a diagnosis. Also, doctors often underestimate how long a patient's

symptoms have been restricting everyday life. Write it down.

What Does “Markedly Restricted” Mean? “Markedly Restricted” is a pretty subjective term. Most of the examples

given in the Disability Tax Credit Certificate are the obvious extremes,

such as for mobility, a person in a wheelchair obviously qualifies. In

actual fact, you don't have to have as severe a problem as that to be

considered “Markedly Restricted”.

Over the years many people who have been refused the Disability Tax

Credit have appealed and gone to court. Court rulings have gradually

modified the definition of “markedly restricted” and often these

changes have not been clearly written into the form.

There are five things taken into account:

1. How does your condition affect your ability to do things? 2. Does it take you significantly longer to do things than it would a typical person your age? 3. Do you need assistance from devices, medication, or other people, and how much assistance do you need? 4. Do devices or medication totally correct the problem or not? 5. Does it affect you all or most of the time? Or could it potentially affect you at any time, fairly randomly, even though it doesn't affect you most of the time?

What Does “Significantly Restricted” Mean? “Significantly Restricted” is also a very subjective term. The reason the

Canadian Government added the category of “Cumulative Effect of

Significant Restrictions” to the Disability Tax Credit Certificate is because

many people really are disabled in several areas of everyday life, but their

doctors didn't think they met the criteria for “markedly restricted” in any one

area.

The same five things are taken into account in order to determine whether a

person is “significantly restricted”. How does the condition affect you, does

it take you longer than other people to do things, do you need assistance from

devices, medication or other people, do either devices or medication totally

correct the problem or not, and are you affected all or most of the time or at

least potentially affected at any time?

Examples: If you wear glasses that correct your vision problems, then you are not

considered disabled. However, if you can drive during the day but can't drive

at night even with glasses, you may be considered “significantly restricted” in

vision.

If you use a cane or walker to help with your walking and with the cane you

are able to walk as well as a typical person your age, then that is not

considered a disability. However, if you use a cane and even with it you fall

down some of the time, or you can only walk fairly short distances even with

a cane, then you may be considered “significantly restricted” in walking.

If you take medication to help you have bowel movements and it works, then

you are not considered disabled. However, if you have difficulty wiping

yourself due to lack of feeling in your hands, you may be disabled.

Most People Underestimate the Extent to Which Their Everyday Life is Affected!

We get used to our difficulties and learn to work around them. We look at the bright side,

at what we can do, not what we can't do.

Difficulties come on gradually and we tend to take them for granted.

No one wants the label of “Disability”.

You may no longer know what “normal” is.

How do your present abilities compare to five years ago, ten years ago, or fifteen

years ago? Is the change just due to being older?

Ask yourself what other people your age are doing. Can you do the same?

Think about what adjustments you've made, such as spreading out your doctor's

appointments over more days, or using a special pen that isn't as difficult to hold?

Other People are often a Better Judge Friends and family can help you do your summary or cheat sheet.

Ask someone who knows you well the five questions. They may be more

objective than you are about how your condition affects you.

Ask people around your age what a typical weekday is like for them and a typical

weekend day.

How long does it take to get ready to leave the house?

How many chores or tasks do they do in a day?

How many different activities are they involved in?

How far can they walk without getting fatigued?

Who can Complete the Disability Tax Credit Certificate? 1. Physicians are the only professionals who can fill out any or all parts of the form.

Any physician can fill it out, family doctor, specialist, a doctor at a clinic, etc. If

one doctor refuses to fill out the Certificate, you can ask a different doctor. If you

do not have a regular family doctor or specialist, you may need to give the doctor

copies of key documents that will give information on your condition, as well as

your summary.

2. Optometrists - Vision 3. Speech-Language Pathologist – Speaking 4. Audiologist – Hearing 5. Occupational Therapist – Walking, Feeding and/or Dressing 6. Physiotherapist – Walking

Physiotherapist (sometimes called Physical Therapist) an only certify for 2005 and

later years.

7. Psychologist – Performing the mental functions necessary for everyday life More than one professional can fill out the form. In that case, each one has to fill

out page nine, giving the Diagnosis (if available), Effects of impairment, uration,

profession, signature and contact information. All of these are attached to the

Certificate.

Peripheral Neuropathy Symptoms By Mayo Clinic staff

http://www.mayoclinic.com/health/peripheral-neuropathy/DS00131/DSECTION=symptoms

Your nervous system is divided into two broad categories.

(1) Your central nervous system consists of your brain and spinal cord.

(2) All the other nerves in your body are part of your peripheral nervous system.

Peripheral Neuropathy affects those nerves, which include:

Sensory nerves to receive feelings such as heat, pain or touch

Motor nerves that control how your muscles move

Autonomic nerves that control such automatic functions as blood pressure, heart

rate, digestion and bladder function. Most commonly, peripheral neuropathy may

start in the longest nerves — the ones that reach to your toes. Specific symptoms

vary, depending on which types of nerves are affected.

Signs and symptoms may include:

Gradual onset of numbness and tingling in your feet or hands, which may spread

upward into your legs and arms

Burning pain

Sharp, jabbing or electric-like pain

Extreme sensitivity to touch, even light touch

Lack of coordination

Muscle weakness or paralysis if motor nerves are affected

Bowel or bladder problems if autonomic nerves are affected

Sleep problems

Depression

The next part of this presentation will look at how these symptoms, and other symptoms, affect the eight areas on the Disability Tax Credit Certificate.

General Questions to Ask Yourself 1. What is your neuropathy like? 2. How does it affect you? 3. Does it affect your safety? If you have numbness, does it mean that you

don't feel pain in that area and can hurt yourself without knowing it? Do you find bruises on yourself, but you don't know what caused them?

Are you at risk of not treating cuts because you don't realize you've got a cut, has

this ever led to an infection? Are you at risk of a majorinfection and possible

gangrene, which could lead to amputation?

4. Do you have muscle weakness that affects your ability to do things, or may cause you to get hurt?

For example, do you get weakness in your arms and burn yourself when

taking things out of the oven?

Do you get weakness in your legs and fall or bump into things?

Does it affect your ability to walk, climb stairs up or down (Walking), lift

things such as pots and pans or ingredients for a recipe (Feeding)?

Do you avoid certain places or activities because of your muscle weakness,

such as you can't go to certain buildings because the doors are too difficult for

you to open?

5. Do you suffer pain? What kind, how often, how long? Is the painunpredictable?

Does your pain make it hard to prepare meals for yourself, or to cut things up on

your plate? (Feeding)

Does it make it hard to walk? (Walking)

Does your pain affect your vision or hearing or sense of touch?

Does pain make it so that it takes you a lot longer to do things? Give examples,

such as, “It takes me three hours to do my stretching exercises, whereas before I

had the neuropathy I could have done the same exercises in twenty minutes.”

Do you get blurred vision when in pain?

6. Do you have difficulty with coordination? Is it particular kinds of coordination, like holding a pen or using your legs? How

often, how long, when?

Does it make it difficult to dress yourself, or to cook, or to cut up food on your

plate, or to walk? Have you had to change the type of clothes you wear, such as

slip-on shoes rather than laces, or the types of recipes you cook, or the places you

go?

Does your problem with coordination cause you to have accidents?

7. Do you have a lot of fatigue? How often, how long, how intense?

When you are fatigued, does it take you longer to do things? For example, how

long does it take to get dressed or make breakfast or wash dishes when you are

fatigued?

Does it make you cancel or postpone things you were going to do?

Do you need other people to help you more when you are fatigued? In what

ways?

8. What shortcuts, devices or services do you use that you didn't need before? For Example:

Frozen meals or Meals on Wheels?

House cleaning? Do you have this service because if you didn't you wouldn't be

able to take care of yourself in other ways?

Do you use modified pens, reaching tools, etc? Are you still limited?

9. Do you have paralysis? If so, where and how much?

What kinds of things are more difficult to do, take longer or are impossible to do

because of it?

How does your paralysis affect your ability to deal with emergencies?

10. Do you have trouble concentrating? How often and for how long?

Does your difficulty concentrating affect your ability to read a recipe and follow

it?

Does it make it hard to focus on finding out what the weather is like and choose

the appropriate clothing?

Does it affect your memory, short-term (several seconds, up to a minute) and/or

long-term?

Do concentration problems affect your ability to follow through on goals you

have set and complete them? This could be small immediate goals and/or

medium-term goals or larger goals.

11. Does your mind seem foggy, or not as sharp as it used to be? Is it hard to think clearly sometimes, most of the time, or all of the time?

Do you find it harder to complete tasks that require thinking than you used to?

Does it take significantly longer than the average person?

Do you need someone else to remind you or keep you on track?

Specific Questions to Ask Yourself Regarding Your Vision Do you have vision problems?

What kind?

Do you have vision problems only under certain circumstances, such as you can't

see well at night, so can't drive at night?

Do you get blurred vision when you are over-tired?

Do glasses correct your vision, or do you still have significant problems even with

glasses?

Regarding Your Speaking Do you have problems with your speech?

In what way?

Do other people ask you to repeat what you've said? Does it take quite a bit longer

than it used to for you to be understood?

Does using aids such as wearing a microphone, or getting speech therapy correct

your problem or not?

Regarding Your Hearing Do you have hearing problems? What kind? How much?

Do you have to ask people to repeat things, so that it takes longer to understand

them than it used to? How much longer?

Do you often give up on trying to understand others?

Are you unable to understand messages left on voice mail, or have great difficulty

understanding them?

Do you use speech reading (also known as lip reading), or rely on written text

(such as the written display on the television)?

Does a hearing aid, cochlear implant or other device correct the problem? Are

you unable to benefit from these devices?

Regarding Your Walking Can you walk? How far can you walk? How long does it take?

Is your walking made worse by factors like fatigue or sudden muscle weakness?

Do you have significant difficulty going up or down stairs? All or almost all of

the time, or some of the time?

Are there any safety issues with your walking, such as numbness in your feet and

legs making you more likely to stumble or fall, or being unable to run in an

emergency?

Can your walking problems be corrected with the use of a cane or walker or

similar device or do you still have problems even with those to help you?

Do you need to have someone with you when you are walking?

Regarding Your Elimination Do you have bowel or bladder problems? What kind, how often, is it constant or intermittent?

Do you have to use medication for elimination? If it works, then you are not

considered markedly restricted. If it only works partially, or intermittently, then

you may be considered markedly or significantly restricted.

Have you cut down on going out in public because you are afraid of embarrassing

accidents?

Do you have to use incontinence products such as Attends or Depends?

Are you able to urinate or have a bowel movement, but have significant difficulty

getting in position on the toilet or wiping yourself?

Do you need to use devices to help with elimination, such as a catheter or ostomy

or other device?

Does it take you an inordinate amount of time to use the toilet or manage your

devices?

Regarding Your Feeding Note: Feeding is considered to include preparing food and cooking it, except

for extra time spent preparing a special diet. It does not include shopping for

food.

Do you have difficulty making meals and/or feeding yourself?

Are you unable to prepare meals and feed yourself all of the time, almost all of

the time or some of the time? How come? Is it because of pain, lack of

coordination, muscle weakness, fatigue or paralysis?

Do you require assistance from another person, for example, to cut up your meat,

or a service like Meals on Wheels?

Does it take you significantly longer than other people to prepare food and/or eat

it?

Do you frequently skip meals because it is too difficult and timeconsuming for

you to prepare and eat them? Are you underweight because of this?

Regarding Your Dressing Do you have a lot of difficulty getting dressed without anyone helping you?

Do you still have difficulty even when you use devices like long-handled

shoehorns, safety pulls, specialized button hooks, etc.

How long does it take you to get dressed? If it takes longer than the average

person, how come? Is it due to pain, stiffness, fatigue, etc.?

Do you need another person to help you, perhaps with specific things like getting

your arms in sleeves, or doing up your shoes?

Regarding Performing the Mental Functions Necessary for Everyday Life Mental functions necessary for everyday life includes three areas:

Adaptive functioning

Memory

Problem-solving, goal-setting, and judgement.

An individual can be affected in only one of these areas and still be considered markedly

restricted in mental functions.

1. Is your mental interest and ability to do self-care, take care of your health and safety, interact with others and do common, simple transactions worse than a typical person in your age group?

Have you lost interest in getting up in the morning, in bathing or showering,

brushing your teeth and other routines of hygiene and selfcare?

Do you have difficulty making phones calls to schedule doctor and/or dentist

appointments, which normally you would be able to focus on and do routinely?

Are there safety problems due to your mental state? For example, does your mind

become so foggy from fatigue that you become more accident-prone or make

unsafe decisions?

Do you need others to help you decide what must be done?

Are your social skills worse than they used to be?

Do you have difficulty making transactions such as buying something, ordinary

banking, paying bills, etc.?

2. Are you suffering from depression? (Other people can often answer this better than the person who has depression.)

Have you lost interest in things you normally care about?

Do you experience little pleasure in things you would normally enjoy?

Do you have difficulty making decisions?

Are you pessimistic?

Are your emotions flat? Or mostly down? Or do they go up temporarily when

with other people or getting some stimulation but go back to flat or down shortly

afterwards?

Are you fearful?

Do you have mood swings?

3. Is your memory affected by fatigue, pain, concentration problems, or lack of sleep, etc., due to your neuropathy or other conditions?

Do you have problems with short-term memory and/or long-term memory?

Do you have difficulty remembering and following instructions?

Do you have significant difficulty keeping one thing in mind while you do

something else?

If you are interrupted, do you have difficulty remembering where you were in a

task? For example, if you were part-way through a recipe, do you have difficulty

remembering what step you were on? Do you have to start over? - Are your

memory problems worse or more frequent than the normal forgetting you

sometimes experienced before you had neuropathy? Does your memory seem

worse than for others your age?

4. Do you have significant trouble problem-solving, goal-setting and/or making judgements? Are you vulnerable to abuse or exploitation?

Do you feel confused a significant amount of the time?

Are you able to think of more than one solution to a problem, and change your

strategy if it is not working?

Are you able to set realistic goals, figure out the steps to get there, take action,

correct your actions if things don't go according to plan, re-evaluate and take

different steps if unanticipated obstacles come up, determine when you have

reached the goal or if the goal has become impossible or no longer important and

evaluate your degree of success?

Is your judgement trustworthy? Do you find yourself getting into dangerous

situations? Do you trust people too easily and then find out they were using you?

Do other people have concerns about your judgement?

Remember, People with Disabilities also have Abilities. Identifying areas that you are restricted doesn't mean you are useless.

For the purposes of getting the Disability Tax Credit, you have to identify your

weaknesses and this can seem overly negative.

Don't worry. You can have lots of strengths & still qualify.

When and Where do You Send the Disability Tax Credit Certificate?

You can mail the Certificate at any time of the year.

You send it to the same Canada Revenue Agency office where you submit your

tax returns. For everyone in Alberta, you send it to the Winnipeg Tax Office. The

address is on the third page of the pages before the Certificate itself starts.

Remember to photocopy the form and keep a copy for yourself before you send it

in. If your doctor or other professional is going to mail it in, make sure you get a

photocopy of the completed Disability Tax Credit Certificate.

Remember to attach any supporting documents that you want to include.

What Happens Next?

Wait. It can take three or four months to get a reply. Canada Revenue Agency

(CRA) will send you a letter. It will say whether or not they have determined that

you are eligible. If they have decided you are eligible, they will also say for what

years.

The CRA will automatically apply the Disability Tax Credit to your most recent

Tax Return and re-process it (2009 return). If this results in a refund, they will do

the same thing that they normally do when you qualify for a refund, send you a

cheque or deposit it directly in your bank account.

CRA will not automatically process any other years. You have to write and tell

them which tax years you want reevaluated from the past. Be sure to claim the

Disability Tax Credit on every tax return in future years, on both the federal part

and the provincial part.

If they decide you are not eligible, I urge you to appeal. Many people

have won appeals and paved the way for others not to be refused.