Cumulative effect eligibility

Overview

Some people may be limited by mental or physical impairments, but do not meet the eligibility criteria for a marked restriction.

The cumulative effect of significant limitations combines the effects of limitations in 2 or more categories if, together, their effect is as severe as having a marked restriction in 1 category.

For example, if a person always takes a long time to walk and dress, and the extra time it takes to do these 2 activities is equivalent to being unable (or taking 3 times longer) to do just 1 of them, then they may be eligible.

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What marked restriction means

You are unable to do the activity, or it takes 3 times longer than someone of similar age without the impairment, even with the use of appropriate therapy, devices, and medication
The restriction is present all or almost all of the time (generally 90% or more)
The restriction has lasted or is expected to last for a continuous period of at least 12 months

What significant limitation means

The 2 or more limitations exist together all or almost all of the time (generally 90% or more)
If the limitations were combined, their cumulative effect (combined impact) would be both of the following:
- equivalent to being unable, or taking 3 times longer than someone of similar age without the impairment, to do an activity in 1 of the categories
- present all or substantially all of the time (generally interpreted as 90% or more), even with the use of appropriate therapy, devices, and medication

Transcript and alternative formats

Transcript

For some people, the cumulative effect of significant restrictions in two or more basic activities of daily living may pose a significant challenge.

In this first example, a person with arthritis is having a follow-up appointment with the doctor to discuss continuing difficulties.

Doctor: "Have you noticed any improvement in your condition since you've been taking the new medication?"

Patient: "I'm still having difficulties with feeding myself and dressing in the morning. However as the day progresses and the medication starts to work, I can manage much more easily."

In this first example, the individual has an impairment that is not present all or substantially all of the time, and is responding to medication.

Therefore, the individual would not qualify for the disability tax credit.

In the second example, a person has a follow-up appointment after receiving a medical device.

The patient is wearing an electric hook at the elbow due to amputation.

Doctor: "How are you adjusting to your electric hook?"

Patient: "Each week I find my hook getting easier to use."

Doctor: "Do you find your ability to dress and feed yourself is improving?"

Patient: "Most of the time, it really doesn't take extra time to do those activities, but depending on what I'm wearing or trying to eat, it can sometimes take a little longer."

While this individual clearly has a severe and prolonged impairment that affects both feeding and dressing, they are not significantly restricted in these two activities all or substantially all of the time, and therefore would not qualify for the disability tax credit.

In the third example, a person who has suffered from lupus for 10 years is at a regular follow-up visit to the doctor. This person has been treated with high doses of cortisone, which has resulted in hand malformations and the loss of fine motor skills.

The patient is sitting. The patient's hands, held on her lap, are slightly bent at the wrists and turned inward.

Doctor: "How have you been feeling since our last visit?"

Patient: "I'm still able to do some things without help. However, I am having significant problems everyday with getting dressed and undressed, as well as feeding myself. It takes me considerably longer to do these activities than it did last year."

In the third example, the individual is significantly restricted in both dressing and feeding all or substantially all of the time, and therefore would qualify for the disability tax credit.

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What marked restriction means

You are unable to do the activity, or it takes 3 times longer than someone of similar age without the impairment, even with the use of appropriate therapy, devices, and medication
The restriction is present all or almost all of the time (generally 90% or more)
The restriction has lasted or is expected to last for a continuous period of at least 12 months

What significant limitation means

The 2 or more limitations exist together all or almost all of the time (generally 90% or more)
If the limitations were combined, their cumulative effect (combined impact) would be both of the following:
- equivalent to being unable, or taking 3 times longer than someone of similar age without the impairment, to do an activity in 1 of the categories
- present all or substantially all of the time (generally 90% or more), even with the use of appropriate therapy, devices, and medication

Example of someone who may be eligible

Evelyne's mother Joan struggles to walk, dress, and feed herself

Evelyne is the caregiver to her mother, Joan, who lives with her.

For years, Joan was able to manage on her own even though she had a progressive medical condition. But her condition slowly became worse and now she struggles to walk, to dress, and to feed herself.

Evelyne applied for the DTC for her mother. As a result of the information provided by the medical practitioner on the application form, Joan is now eligible for the DTC in the cumulative effect category.

As Joan has little taxable income and her daughter helps with her food, clothing, and shelter throughout the year, Evelyne may claim any unused portion of the tax credit.

Example of someone who may be eligible

Evelyne's mother Joan struggles to walk, dress, and feed herself

Evelyne is the caregiver to her mother, Joan, who lives with her.

For years, Joan was able to manage on her own even though she had a progressive medical condition. But her condition slowly became worse and now she struggles to walk, to dress, and to feed herself.

Evelyne applied for the DTC for her mother. As a result of the information provided by the medical practitioner on the application form, Joan is now eligible for the DTC in the cumulative effect category.

As Joan has little taxable income and her daughter helps with her food, clothing, and shelter throughout the year, Evelyne may claim any unused portion of the tax credit.

Cumulative effect categories

Review the criteria for marked restrictions in the categories below. If you have limitations in 2 or more of these categories, their combined effects may be equivalent to 1 marked restriction.

Included:

Not included:

Category not included in cumulative effect Life-sustaining therapy

Eligibility criteria checklist

You must meet all 4 criteria below. Check the boxes that apply.

checkbox 1 of 4You have limitations in 2 or more of the cumulative effect categories above
checkbox 2 of 4Your limitations exist together all or almost all of the time (generally 90% or more)
checkbox 3 of 4Your limitations have lasted or are expected to last for a continuous period of at least 12 months
checkbox 4 of 4If the limitations were combined, their cumulative effect (combined impact) would be:

Equivalent to being unable or taking 3 times longer than someone of similar age without the impairment to do an activity in 1 of the categories

Present all or substantially all of the time (generally 90% or more), even with the use of appropriate therapy, medication, and devices

If you’re not sure you qualify

You may still apply even if you're not sure. Your eligibility is based on the information given by your medical practitioner.

You may be eligible for the DTC

This does not guarantee eligibility. When you apply, the CRA will base their decision on the information given by your medical practitioner.

Which medical practitioners can certify this

Medical practitioners who can certify impairments
Medical practitioner	Can certify
Medical doctor	All impairments
Nurse practitioner	All impairments
Optometrist	Vision
Audiologist	Hearing
Occupational therapist	Walking, feeding, dressing
Physiotherapist	Walking
Psychologist	Mental functions
Speech-language pathologist	Speaking

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Date modified:: 2023-01-24

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Overview

Video for cumulative effect

Transcript

Alternative formats

Evelyne's mother Joan struggles to walk, dress, and feed herself

Evelyne's mother Joan struggles to walk, dress, and feed herself

Cumulative effect categories

Eligibility criteria checklist

If you’re not sure you qualify

You need all of the above to be eligible

You may be eligible for the DTC

Page details