Mental functions necessary for everyday life
A person is considered markedly restricted in performing the mental functions necessary for everyday life (described below) if, even with appropriate therapy, medication, and devices (for example, memory aids and adaptive aids):
- he or she is unable or takes an inordinate amount of time to perform them by himself or herself and
- this is the case all or substantially all the time (at least 90% of the time)
Mental functions necessary for everyday life include:
- adaptive functioning (for example, abilities related to self-care, health and safety, abilities to initiate and respond to social interactions, and common simple transactions)
- memory (for example, the ability to remember simple instructions, basic personal information such as name and address, or material of importance and interest) and
- problem-solving, goal-setting, and judgment, taken together (for example, the ability to solve problems, set and keep goals, and make the appropriate decisions and judgments)
A restriction in problem-solving, goal-setting, or judgment that markedly restricts adaptive functioning all or substantially all the time (at least 90% of the time) would qualify.
It is important to address what occurs at home or out in the community, not only what occurs in a work or school environment.
Agnes is unable to leave the house due to anxiety, at least 90% of the time, despite medication and therapy.
Gerald is independent in some aspects of everyday living; however, despite medication and therapy, he needs daily support and supervision due to an inability to accurately interpret his environment.
Terry cannot make a common, simple transaction without help, such as a purchase at the grocery store, at least 90% of the time.
Bridget experiences psychotic episodes several times a year. Given the unpredictability of the psychotic episodes and the other defining symptoms of her impairment (for example, lack of initiative or motivation, disorganized behaviour and speech), she continues to need daily supervision
Richard is unable to express needs or anticipate consequences of behaviour when interacting with others.
Alternative formats and transcript
For some people, performing the mental functions necessary for everyday life may pose a challenge.
In the first example, an individual is making their third follow-up visit to the doctor with respect to being in a clinical depression for the past three months.
Doctor: "Since your last visit, has the medication that I prescribed, made any difference?"
Patient: "I feel a little more emotionally steady now, and I'm crying less than I did before. However, I'm still having significant problems with sleeping. During the day, I still have difficulty concentrating. I also find it difficult to remember to do the day-to-day essentials. When I go outside my home, I feel uncomfortable."
Doctor: "Are you still living alone?"
Patient: "Yes, but a family member and several friends will stop by or phone me a couple of times a week to chat."
Doctor: "Have you experienced any unacceptable side effects from taking the medication?"
Doctor: "Fine. Continue to take the medication and come back to see me in about a month. Of course, if any of the symptoms get worse, come back sooner."
While this individual is clearly having difficulty with some mental functions, they are still able to live alone and cannot be viewed as being markedly restricted at this point in time. The medical condition is not yet prolonged in that it hasn't lasted, nor is it expected to last, for a continuous period of at least 12 months. Therefore, this individual would not qualify for the disability tax credit.
In the second example, a parent and a small child are at a follow-up visit to the doctor to discuss the child's ongoing behavioural problems.
The child is fidgety and is looking around almost continuously.
Doctor: "It's been a couple of months since I last saw you and your child. I believe it was near the end of the school year. Have the medication and therapy that I prescribed made any difference in your child's behaviour?"
Parent: "Well, there were a few less problems at school but the biggest difference has been at home."
Doctor: "How are you feeling?"
The child is not paying attention, and is looking at different posters on the wall.
Child: "Sorry, what did you say?"
Doctor: "How are you feeling?"
Child: "Okay, I guess."
Doctor: "Are you enjoying your summer vacation and having fun playing with the other kids?"
The child looks to the parent for approval, and receives it with a nod of the head, before replying to the doctor.
Child: "Yes. I really like going to the park and playing baseball with the other kids."
Doctor: "Okay. Let's continue with the medication and therapy. Come back to see me in a couple of months."
The doctor updates his file.
Although the child's condition has been present for over a year and is likely to continue into the near future, it is improving as a result of the medication and therapy. Since there is clearly a difference between school and home, the impairment cannot be seen to exist all or substantially all of the time. Therefore, this child would not qualify for the disability tax credit.
In the third example, a patient with Type 1 diabetes is accompanied by a friend during a winter follow-up visit to the doctor.
Doctor: "It's been about a month since I last saw you. How are you feeling today?"
Patient: "Fine, thank you. I just came back from playing a round of golf."
Doctor (a bit puzzled) asks: "Were you playing at one of the indoor golf ranges?"
Patient: "No, I played 18 holes at the new golf course on the other side of town."
The doctor looks to the patient's friend for confirmation; the friend twice shakes their head from left to right. The doctor makes a note in his file and then asks the patient: "May I take a look at your diabetes logbook that you use to record your glucose levels and insulin usage?"
The patient looks towards the friend.
Friend: "I've had to do the testing, maintain the log, and give the shots."
Doctor: "Your readings have been quite high for the past few mornings. What are you typically having for breakfast?"
Patient: "I haven't eaten since yesterday."
Friend interjects, and replies to the doctor: "Today, I served a small glass of orange juice, a small bowl of oatmeal, a slice of toast, and a cup of tea."
Doctor asks the friend: "Have you noticed any improvement in your friend's short-term memory loss since she began taking the medication?"
Friend: "No, not really."
The doctor updates his file.
In the third example, the patient is suffering from a severe and prolonged impairment that affects both their adaptive functioning and their memory all or substantially all of the time. In addition, the patient is unable to live independently. Therefore, the patient would qualify for the disability tax credit.
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