Section 118.4

Subsection 118.4(1) - Nature of impairment

Cases

The Queen v. Marceau, 2008 DTC 6511, 2007 FCA 352

Substantial time was spent in preparing anallergic foods for the taxpayer's daughter, who had 38 food allergies. The taxpayer did not in light of s. 118.4(1)(e) qualify for the disability tax credit given that the significant meal preparation time related to a dietary restriction.

Andrasik v. CCRA, 2003 FCA 252

The Tax Court had not erred in finding that the taxpayer, whose nose was crushed in an accident leaving him with a permanent loss of the sense of smell, was not entitled to the disability tax credit. "The discretion to decide these matters resides primarily in the Minister, not this Court (p. 5418)".

The Queen v. Hamilton, 2002 DTC 6836, 2002 FCA 118

The inordinate amount of time required by the taxpayer to find and procure foods that were gluten-free qualified him for the credit on the basis that this effort was part of the process of feeding himself.

Johnston v. The Queen, 98 DTC 6169, Docket: A-347-97 (FCA)

The taxpayer, who suffered from spinal epiphyseal dysplasia was found to have a markedly restricted ability to walk given that even on his best days, he could walk only short distances of 50 feet (which took him five minutes). He also had a marked restriction in his ability to feed and dress himself that, given that he could not prepare food generally (let alone food that was medically required by his state of health) and that before dressing himself, had to exercise up to 20 minutes because his limbs were numb.

See Also

Benoit v. The Queen, 2014 DTC 1141 [at 3384], 2014 TCC 95

physician's reports were constrained by forms; not definitive basis for denying disability credit

The taxpayer was a professional musician who developed biopolar disorder, essential tremors (a neurotransmitter problem in which each muscle command is followed immediately by an echo), and a subarachnoid cyst that put pressure on his brain, causing further tremors as well as memory loss. Consequently, he had to judiciously avoid stressful situations, could barely drive, and had great difficulty completing simple tasks (e.g. tying his shoes).

Masse DJ found that the taxpayer's conditions meant that he was markedly restricted in his ability to perform activities of daily living, all or substantially all of the time. A T2201 certificate, an additional medical report, and a "Certificate Respecting Impairment" prepared by the taxpayer's physician appeared not to support the taxpayer's disability tax credit claim. Massed DJ noted, however (at para. 31):

These reports are only forms that contain questions the doctor must answer by checking the appropriate box, not for the purpose of providing a complete, detailed and well-formulated medical opinion for each case, but only for the purpose of providing the most appropriate answer from among two or three possible answers. These forms do not leave the doctor much freedom to express himself. By the way they are presented and worded, these forms do not seem to inspire much confidence in the medical opinions found therein.

Arciresi v. The Queen, 2014 DTC 1037 [at 2714], 2013 TCC 331

symptoms contemporaneous with broken vertibrae did not rise to the level of s. 118.4

The taxpayer's wife had fainting spells, and a related fall caused her to break two vertibrae. She was subsequently diagnosed with asthma, sleep apnea, nocturnal hyperventilation, and exercise-induced hypoxemia, and later with obesity. Favreau found that the taxpayer's claim for mental or physical impairment tax credits should be denied for lack of a medical certificate. He also noted that "the effects of the disability are limitations on exercise tolerance" (para 10) and that his wife "could still dress herself, feed herself, and walk by herself," and the impairment was of limited duration (para. 13), so she did not have a prolonged mental or physical impairment under s. 118.4(1) in any event.

Wiley v. The Queen, 2013 DTC 1198 [at 1056], 2013 TCC 237

contrary physician's letter

The taxpayer suffered from fibromyalgia. After it worsened in 2011, she applied for the disability tax credit, but her physician's letter stated that her impairment did not markedly restrict her ability to perform basic activities. VA Miller J confirmed that the taxpayer's credit should be denied - the Tax Court cannot use its own medical opinion in place of a qualified practitioner's (para. 16).

Islam v. The Queen, 2013 DTC 1143 [at 762], 2013 TCC 175

Lamarre J found that the taxpayer was unable to demonstrate that permanent blindness in one eye markedly restricted any basic activities of daily living. On the contrary, the taxpayer had 20/20 vision in his left eye, a normal field of vision, an unrestricted driver's licence, and could read without difficulty.

Pakarinen v. The Queen, 2010 DTC 1319 [at 4212], 2010 TCC 456

The taxpayer suffered from seizures, but this was found not to markedly restrict any basic daily activities. The taxpayer's physician opined that he could live without supervision, and without spending an inordinate amount of time on basic daily activities.

Drouin v. The Queen, 2008 DTC 2636, 2005 TCC 793

In finding that the taxpayer, who could not use his upper left limb, was entitled to the credit, Lamarre Proulx, J. stated (at para. 2638):

"The Appellant could perhaps choose clothes without zippers, shoes without laces, eat food that is already cut up, or buy frozen vegetables. This would, however, imply a very marked divergence from what is considered normal."

McNaughton v. The Queen, 2005 DTC 1681, 2005 TCC 714,

The taxpayer was entitled to the disability tax credit under ss.118.3 and 118.4 in respect of her son whose attention deficit hyperactivity disorder was characterized by Bowman C.J. as "severe".

Radage v. The Queen, 96 DTC 1615 (TCC)

Before concluding that the severe intellectual limitations of the taxpayer's son rendered him incapable of performing such mental tasks as would enable him to function independently and with reasonable competence in everyday life, Bowman TCJ. found that the "and" in s. 118.4(1)(c)(ii) should be treated as disjunctive, and engaged in an extensive discussion of the meaning of the terms "thinking", "perceiving" and "remembering".

Words and Phrases
and thinking

Murphy v. The Queen, 95 DTC 415 (TCC)

The taxpayer, who suffered from chronic fatigue syndrome and myalgia was required to spend an inordinate amount of time in performing a basic activity of daily living, i.e., walking. In particular, she could not walk at a normal pace, had to stop periodically and rest, had to monitor her fatigue level so that she did not injure herself physically and undergo considerable pain and, at best, she could not walk further that a block.

Paragraph 118.4(1)(c)

See Also

Girard v. The Queen, 2006 DTC 2394, 2005 TCC 104, briefly aff'd 2006 DTC 6129, 2006 CAF 65

The taxpayer, who suffered from sleep apnea and who used nightly a continuous positive airway pressure device, was not entitled to the credit.

Watkin v. The Queen, 2002 DTC 2132, Docket: 2002-2166-IT-I (TCC)

In finding that the taxpayer, who suffered from chronic fatigue syndrome, was eligible for the credit under s. 118.3(1), Rip T.C.J. referred to s. 33(2) of the Interpretation Act ("words in singular include the plural") and accepted a submission that the cumulative effect of restrictions imposed on the taxpayer's ability to perform more than one basic activity of daily living could be taken into account.

Administrative Policy

27 March 2013 Folio S1-F1-C2

Qualifying for a CPP disability benefit does not necessarily mean qualifying for a disability tax credit, because they use different standards of disability (CPP depends on ability to pursue any substantially gainful occupation, while DTC depends on ability to perform basic activities of daily living).

Subsection 118.4(2) - Reference to medical practitioners, etc.

Cases

Murphy v. The Queen, 2010 TCC 434, 2010 DTC 1293 at 4034

McArthur J. held that the passing of the Traditional Chinese Medicine Act, 2006 (S.O. 2006 c. 27) meant that acupuncturists became "authorized" medical practitioners in Ontario, for the purposes of s. 118.4(2).

The Queen v. Couture, 2009 DTC 5675, 2008 FCA 412

The Trial Judge erred in finding that, because the practice of acupuncture was no longer prohibited under the Controlled Acts Regulations (Ontario), an acupuncturist was an authorized person under s. 118.4(2). To "authorize" meant to give formal approval to or to formally approve, and the mere fact that an action is no longer prohibited does not lead to the conclusion that such action has been formally approved.

See Also

Power v. The Queen, 2012 DTC 1137 [at 3211], 2012 TCC 113

Webb J. denied the taxpayer's claimed medical expense tax credit on acupuncture expenses. He stated (at para. 12):

The reason that Ermin Zhu could perform acupuncture was because Ermin Zhu was not prohibited from performing acupuncture. Since the provisions of the [Ontario] Traditional Chinese Medicine Act that would provide specific authority for a person to perform acupuncture were not proclaimed, they are of no legal effect and in 2009 there was still no formal approval for a person to perform acupuncture. Therefore Ermin Zhu was not authorized to perform the acupuncture treatments in 2009.

Davar v. The Queen, 2005 DTC 1671, 2005 TCC 715

The taxpayer spend approximately $1,200 on the services of two naturopaths who had certificates under the Drugless Practitioners Act (Ontario) as naturopathic doctors. Miller J. noted that although Ontario had legislation dealing with professionals in alternative treatment, here the services had been received in New Brunswick and did not qualify.

Administrative Policy

7 August 2015 Memorandum 2015-0585011I7 - Osteopaths & naturopaths in Quebec

Quebec osteopaths and naturopaths excluded in contrast to their eligibility for Quebec purposes

Are osteopaths and naturopaths are authorized medical practitioners in the province of Quebec for purposes of the federal medical expense tax credit (METC)? The Directorate responded:

[T]here does not appear to be specific legislation in Quebec which authorizes the practice of osteopathy or naturopathy and which provides for a regulatory body for osteopaths or naturopaths. Therefore… osteopaths and naturopaths in the province of Quebec are not medical practitioners within the meaning of subsection 118.4(2)… .

The Income Tax Act does not have a provision that is similar to paragraph 752.0.18.(b) of the Quebec Taxation Act… .

25 November 2014 Ministerial Correspondence 2014-0551781M4 - 118.2(4)-Pulse electromagnetic technician

certified pulse electromagnetic technician

Ontario "certified pulse electromagnetic technicians… are not currently considered to be medical practitioners for the purposes of the medical expense tax credit."

30 September 2013 T.I. 2013-0490121E5 - Medical Practitioner - Doulas in Alberta

doulas

"it appears that doulas are not currently authorized to practise as medical practitioners in the province of Alberta and therefore, the amounts paid for services provided by such doulas in Alberta do not qualify as eligible medical expenses for the purposes of the medical expense tax credit.

27 March 2013 Folio S1-F1-C1

In accordance with the decision of the Federal Court of Appeal in Canada v Couture, ... it is the CRA's view that an individual is authorized by the laws of the jurisdiction to act as a medical practitioner if there is specific legislation that enables, permits or empowers that individual to perform medical services. Generally, such specific legislation would provide for the licensing or certification of the practitioner as well as for the establishment of a governing body (for example, a college or board) with the authority to determine competency, enforce discipline and set basic standards of conduct.

Medical practitioners authorized to practice in accordance with the above laws can include the following (depending on the applicable province or jurisdiction, as the case may be): chiropractors, dental hygienists, dieticians, midwives, optometrists and naturopaths. A current list of Authorized medical practitioners by province or territory for the purposes of claiming medical expenses is available on the CRA Web site.

21 September 2012 T.I. 2012-0462011E5 - medical expenses - drugs

In response to a question as to whether products purchased from a naturopath would be eligible for the medical expense tax credit, CRA stated:

The Canada Revenue Agency Web site provides a summary chart identifying those health care professionals authorized to practice as medical practitioners by province or territory for the purposes of claiming medical expenses. It appears that naturopaths are authorized as medical practitioners in the province of Ontario and the cost of services they provide would qualify for the METC if they are medical services.

However, CRA went on to note that:

Natural health products that are available for self-selection as over-the-counter products would not generally meet the requirements of [s. 118.2(2)(n)].

28 January 1994 T.I. 933242 (C.T.O. "Medical Expenses-Fees to Dietician or Nutritionist")

A dietician who is qualified under s. 7 of the Dietetics Act (Ontario) will be considered to be a medical practitioner. However, a nutritionist will not be considered to be a medical practitioner except to the extent that she qualifies as a dietician.