A person is considered markedly restricted in speaking if, even with appropriate therapy, medication, and devices, they meet both of the following criteria:
- They are unable or take an inordinate amount of time to speak so as to be understood by another person familiar with the patient, in a quiet setting.
- This is the case all or substantially all the time (at least 90% of the time).
Devices for speaking include tracheoesophageal prostheses, vocal amplification devices, and other such devices.
Examples for speaking
Anita must rely on other means of communication, such as sign language or a symbol board, at least 90% of the time.
In the doctor's office, Cedric's doctor must ask him to repeat words and sentences several times, and it takes Cedric an inordinate amount of time to make himself understood.
Alternative formats and transcript
For some people, it may be that speaking poses a significant challenge. For instance, the ability to speak so as to be understood by a familiar person, in a quiet setting, even with appropriate therapy, medication, and devices.
In this example, a person is consulting with a doctor because of a sore throat.
Doctor: "Hello. What can I do for you today?"
Patient replies (in a quiet raspy voice): "My throat is very sore and it hurts to talk."
The doctor starts the examination, and puts his hands out to palpate the patient's throat for swollen glands.
Doctor: "Let me see. Please open your mouth. Yes, you have a throat infection. I will prescribe some medication."
In the first example, while the individual is having some difficulty speaking, it is attributable to a short-term condition. The person would therefore not qualify for the disability tax credit.
In the second example, a person is having a follow-up appointment after receiving a medical device.
Doctor: "How are you coming along with your Duck Bill prosthesis?"
With a thumb, the patient covers a Duck Bill prosthesis in throat stoma. Patient then replies (in a quiet, gravelly, stained voice):"I am able to speak much better than before."
The second example shows an individual with a severe and prolonged speaking impairment. However, with the use of a medical device, they are is able to speak so as to be understood. They therefore would not qualify for the disability tax credit.
In this example, a person is having a follow-up appointment after undergoing a course of therapy.
Doctor: "It's been over a year since your stroke. How are you coming along with your therapy?"
Patient replies (in a slurred, quiet, mumbling voice): "Ieeeeee, tra, tra, tryeeee. Ieee, Ieeee."
The patient is slightly slumped to one side and is taking an inordinate amount of time to formulate a sentence. There are long pauses, and the patient is experiencing difficulty pronouncing the words.
The doctor is having trouble hearing what the patient is saying. The doctor leans toward the patient to listen.
The patient swallows hard, and replies to the doctor, "Ieee, Ieee."
The patient lets out an audible sigh, and stops speaking.
This example shows an individual who despite undergoing appropriate therapy remains markedly restricted in their ability to speak. They would therefore qualify for the disability tax credit.
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