Disability tax credit – For medical practitioners

Transcript

Slide 1

Welcome and thank you for joining us for our presentation on the Disability Tax Credit for medical practitioners.

I would like to begin by acknowledging that I am presenting to you from Treaty 1 territory, traditional territory of the Anishinaabeg, Cree, Oji-Cree, Dakota, and Dene Peoples, and the homeland of the Métis Nation.

We recognize that everyone on the line is joining us from different places. We invite you to take a moment to reflect on the territory that you are joining us from.

Slide 3

In today's webinar, we will give an overview of the Disability Tax Credit or as we'll also refer to it – the DTC.

We will be covering how you can help your patients apply for the DTC using the new Form T2201 and digital application.

We will review eligibility periods and what to do if an application is denied.

Finally, we will go over some frequently asked questions relating to the DTC application process.

Slide 4

The purpose of the DTC is to provide some relief for unavoidable, additional expenses that result from living with a disability. It helps to offset these costs that other taxpayers don't have to face.

The DTC is a non-refundable tax credit that helps persons with disabilities or their supporting family members reduce the amount of income tax they may have to pay.

A supporting family member can be a spouse or common-law partner, parent, grand-parent, child, grand-child, brother, sister, uncle, aunt, niece, or nephew of the person with the disability.

A supplement for persons under 18 years of age is available if they are eligible.

Being eligible for the DTC can act as a gatekeeper to allow the individual to access other federal, provincial, and territorial programs such as the registered disability savings plan, the Canada workers benefit, and the child disability benefit.

This aspect of the DTC is particularly important for those with a low income. It is important that all eligible individuals apply for DTC regardless of their taxable income in order to qualify for other disability-related programs, benefits and plans. They cannot access these critical programs without first qualifying for the DTC.

Slide 5

In order to receive the DTC, your patient must apply for it. There are two ways to do this.

They can manually complete Form T2201 on paper. Or, apply using the new digital application.

If your patient receives the Canada Pension Plan or the Quebec Pension Plan disability benefits, workers' compensation benefits, or other types of disability or insurance benefits, it does not necessarily mean they are eligible for the disability tax credit. These programs have other purposes and different criteria.

Slide 6

Whether your patient is completing the paper form or using the app, your role is to provide information in Part B of the T2201 form using your best professional judgement.

Slide 7

Part B of Form T2201 can only be filled out by a medical practitioner.

Use your medical knowledge and judgement to describe and certify the effects of the impairment on your patient.

It is important to note that although medical practitioners are certifying Part B of Form T2201, it is the CRA that determines eligibility.

If further information is required, the CRA may send a clarification letter to you. If this is the situation, the details you previously provided may not have described how your patients impairment met the criteria of a particular category. For example, a diagnosis may have been provided and a category was selected, however, there were no further details specific to the limitations for the person with a disability.

Slide 8

The application process requires a medical practitioner to certify the categories of impairment. The categories of impairment are: life sustaining therapy, vision, hearing, speaking, walking, feeding, dressing, eliminating – so bowel or bladder functions, and performing the mental functions necessary for everyday life.

Here is a list of medical practitioners who can certify these categories.

It is important to note that medical doctors and nurse practitioners are the only practitioners who can certify all categories.

Slide 9

Now, we will take a look at the steps for filling out the paper version of form T2201.

Slide 10

When applying for the DTC on paper, there are 3 steps.

Step 1 – The patient or their authorized/legal representative fills out and signs the sections that apply to them in Part A of Form T2201.

Step 2 – The patient or their authorized/legal representative asks a medical practitioner to fill out and certify Part B of Form T2201.

Step 3 –The patient or authorized/legal representative or the medical practitioner sends the form to the CRA.

Slide 11

Now that we've gone over the steps, let's take a look at how to fill out the application form. Whether you're using a printed form or the app, the questions will be the same. The following slides are screen shots of what Part B looks like.

As you can see, at the top of each page in Part B there is a space for your patient's name. Once you fill that in, please indicate your field of medical practice by initialling the appropriate box.

Questions 2 and 3 ask about medication, devices, and therapy. To be eligible, your patient's impairment must be present even with the appropriate use of devices, medication, and therapy.

In this case, the patient takes medication and uses a cane to walk.

Slide 12

For question 4, you have to provide examples of the factors that limit your patient. To do this, use the scales of severity and frequency on the form.

In this case, the patient has severe pain all of the time even when he walks with his cane.

The more specific the information you provide, the better we can assess the patient's eligibility for DTC.

Slide 13

Question 5 asks you to choose the box that best describes your patient's limitations.

Here, select whether your patient is either unable to perform the activity, or takes an inordinate amount of time to complete the activity.

Time is considered inordinate if the activity takes at least three times longer than it would for an individual of similar age without an impairment in that category.

If your patient has multiple impairments meeting this criteria, they may be eligible under the cumulative effect of significant limitations.

Finally in the third column, provide the year the impairment began to meet the selections you listed.

Questions 6 and 7 ask about the duration and possibility for improvement of the condition.

These must be answered for any sections you complete for the patient.

In this case, the patient's impairment is expected to last at least 12 months and is not likely to improve.

Slide 14

An patient with limitations in more than one category may qualify under the cumulative effect of significant limitations on page 14.

Generally, this would be used when the patient has limitations across two or more categories.

Slide 15

Life-sustaining therapy has a unique set of criteria to qualify for the DTC.

In this section, answer the questions that are applicable to your patient.

Slide 16

Once you've completed all appropriate categories, you will be required to review and confirm the details you provided.

In order to certify the T2201, please print and sign Form T2201 and provide it to your patient to submit to the CRA.

Slide 17

Now, we will take a look at the steps for using the digital application.

Slide 18

There are 3 steps in applying for the credit through the digital application

Step 1 – The patient or their authorized/legal representative asks their medical practitioner to fill out Part B of the digital T2201, via canada.ca/dtc-digital-application.

Step 2 – The medical practitioner prints and certifies Part B of the T2201 and provides it to their patient.

Step 3 – The patient or their authorized/legal representative completes Part A and mails it to their tax center or submits it via My Account.

Slide 19

The digital application is broken down into 5 steps.

1. Provide the medical practitioner information
2. Provide the patient information
3. Select and describe the conditions or diagnoses
4. Review and confirm the information
5. Print the pages

The information entered in this digital application is not stored after you close the browser window or start a new form.

To complete the application, you can visit canada.ca/dtc-digital-application

If it is your first time using the digital application, you may wish to review the information on the landing page.

Slide 20

Step 1 and 2 are pretty straight forward.

Step 1 is to complete the 'medical practitioner information' section.

Step 2 is to complete the 'patient information' section, and select the appropriate categories for your patient. Note: The cumulative category will appear automatically, if applicable.

Slide 21

Step 3 of filling out the digital application is the completion of the selected categories.

Select any conditions or diagnoses applicable to your patient from the pre-populated list, and provide the year of diagnosis.

• If your patient's condition or diagnosis is not listed, use the ‘Other' field to add it.

The following questions will be dynamic based on your initial selections. When effects of your patient's impairment are required, Likert scales are provided for frequency and/or severity assessments.

Slide 22

After providing the details about your patient, you will be asked to offer an assessment about their level of impairment and the level of the limitations your patient experiences, whether they are present all or substantially all of the time. Finally, you should include the year the patient began to experience those limitations.

When providing details about your patients limitations the CRA recognizes the need to consult with your patient as well as the medical information you have on file.

Following the completion of all individual impairments, you may be directed to the Cumulative effect of significant limitations section of the form (if necessary).

Slide 23

Once you've completed all selected categories, Step 4 will ask you to review and confirm the details you provided.

The final step generates the PDF which will populate Form T2201.

In order to certify the T2201, please print and sign the PDF, and provide it to your patient to submit to the CRA.

Its important to note that when the digital application is used, only those pages with input from the medical practitioner will print.

Slide 24

The CRA will assess the application to determine eligibility for the DTC. There are two possible outcomes, approval or denial. Let's take a look at both scenarios.

Slide 25

If the form is approved, the CRA will send a notice of determination stating the length of time for which the patient has been approved.

If your patient's Form T2201 is approved by the CRA, they do not need to send a new form each year, unless we ask for a new one.

We will let your patient know when their eligibility is about to expire on the Notice of Assessment. They will get their Notice of Assessment each year after they do their taxes.

Slide 26

If an application is denied, the patient will receive a Notice of Determination from the CRA explaining why the application was denied.

If your patient disagrees with the CRA's decision and has additional information, they can send it to the CRA. We will review their file again using the new information provided.

The patient also has the right to file a formal objection to appeal the decision. The time limit for filing an objection is 90 days after the CRA mails the Notice of Determination.

Slide 27

We are nearing the end of today's presentation, but before we go, we would like to go through some of the most common questions that we get from medical practitioners.

Slide 28

Do I need to send in additional information with the T2201?

It is not mandatory to send in additional information with the T2201. The CRA may send a clarification letter or request reports if we require more information. If you are asked to submit a report please limit responses to the limitations indicated.

Should I complete a T2201 if I don't know the patient very well?

The CRA requires that a medical practitioner certify the limitations (restrictions) indicated in Form T2201 based on their medical judgement, and knowledge of their patient as per medical information on file. If you don't have medical information on file, consider asking your patient to provide it to you so you are comfortable with what you are certifying. If you feel you cannot certify a limitation (restriction) in a particular category of impairment, let your patient know that and suggest they have a medical practitioner who knows them complete the form.

I have questions about completing the T2201 is there a specific number I can call?

We have a dedicated line where medical advisors who are registered nurses answer calls from medical practitioners. Call 1-800-280-2639 and we will get back to you promptly.

What kind of examples are you looking for in the various categories of impairment?

Examples should be specific to your patient and include details of how they are limited in a particular area.

What are you looking for when you ask for the date the limitations began?

The date should be the year when your patient began to experience severe limitations in that particular category. Severe is defined as unable to or took an inordinate amount of time all or substantially all of the time.

The limitations may be in more than one category of impairment – so there's a cumulative effect based on significant limitations. In this case, the year should be when the limitations combined together, and were considered severe, such that they were unable to or took an inordinate amount of time all or substantially all of the time.

Be aware that life sustaining therapy contains specific criteria.

How can I evaluate if my patient takes an inordinate amount of time?

An inordinate amount of time is described as three times longer than another person of a similar age who does not have the impairment. The evaluation is based on the medical judgement of the medical practitioner.

Which diagnosis are eligible under mental functions?

To be eligible for the DTC under limiting mental functions, a patient must have a severe and prolonged impairment, which meets specific criteria.

DTC eligibility is not solely based on the presence of a medical condition or diagnosis, but rather on the effects of the impairment on a person's ability to perform the mental functions necessary for everyday life.

Given the fact that the severity of the functional limitations may vary from person to person within the same diagnostic category, all DTC applications are examined on a case-by-case basis.

Slide 29

The CRA's website canada.ca/disability-tax-credit provides more information about the disability tax credit, including:

• A self-assessment tool, which helps an individual determine if they or their dependant may be eligible for the DTC.
• The DTC application form
• And a guide to help individuals navigate the DTC process and other related tax credits

The CRA has a dedicated toll-free phone line for medical practitioners who have questions about the DTC or who need help filling out the form: 1-800-280-2639.

Patients, who have DTC questions, may call 1-800-959-8281 or TTY: 1-800-665-0354

Slide 30

That concludes the webinar for medical practitioners on the disability tax credit.

Thank you for joining us today.