Getting approved for the Disability Tax Credit is the key to unlocking additional benefits such as qualifying for a Registered Disability Savings Plan (RDSP) along with receiving the new Canada Disability Benefit. However, the approval process has been reported as notoriously difficult by many applicants because the T2201 form focuses on how disease affects their life rather than the diagnosis of a medical condition. More specifically, the form asks a medical professional to certify that the candidate’s impairment is present “all or substantially all of the time”, defined by the Canada Revenue Agency (CRA) as at least 90% of the time. This can be a challenge for individuals with irregular disabilities where symptoms flare up and then subside as the amount of time they are affected may be less than 90% despite having a life altering disability that ultimately prevents them from earning income.
How does approval for the DTC compare to approval for provincial disability?
Typically, applications for provincial disability supports require a medical practitioner to verify that a patients impairment substantially limits their ability to work or participate in the workforce. The Disability Adjudication Unit may look at not just the diagnosis but also the education, past work history, and skills to see if the disability prevents the individual from earning a living.
Approval for the DTC ignores the capacity of the person to work, instead relying on a rigid mathematical approach to determine eligibility. Benchmarks such as the 90% rule and the 3 times longer rule can be challenging for medical practitioners to quantify without doing a functional assessment. In a typical clinical appointment, most family doctors do not perform a formal functional evaluation; Their focus is on medical management, that is, checking vitals, adjusting medications, reviewing test results, or treating new symptoms. This is one of the primary reasons why so many DTC applications are denied.
Why normal doctor appointments may not be enough
A major barrier to approval for the DTC is that most physicians focus on diagnosis rather than functionality. The family doctor may not know if the patient is restricted by a symptom of their disease 90% of the time or if it takes them 3 times longer to walk down a flight of stairs.
A specialized functionality appointment may be helpful
To bridge the gap between diagnosis and functionality, it may be helpful to ask the doctor for a functional assessment to assist with them completing the T2201 form necessary to be approved for the DTC. If they are uncooperative, a patient can ask for a referral to see an appropriate specialist, namely a Nurse Practitioner, Optometrist, Audiologist, Occupational Therapist, Physiotherapist, Psychologist, or Speech language pathologist to assist in filling out DTC forms.
How can Occupational Therapy play a role?
An Occupational therapy assessment is a comprehensive evaluation that looks at an individual’s physical, mental, or emotional challenges to determine how that impacts their daily life. It documents how specific difficulties limit their ability to manage the essential activities of daily living required for independence. It is a functional audit of the patient.
Occupational Therapists are experts at explaining how cognitive issues like forgetting how to button up a shirt or how to hold a spoon lead to physical delays that meet the 90% rule. An OT will often use a stopwatch or a standardized test for proof and have data to compare against others in the same age group.
Can more than one medical professional assist in filling out the T2201 form?
Absolutely! if an individual has a complex medical situation involving different parts of their body or mind, having more than one medical professional can significantly strengthen the DTC application. For paper applications, you can submit multiple versions of Part B of the form filled out by a doctor or specialist with a single version of Part A, filled out by the patient. For digital forms, the patient can give their reference number to multiple practitioners.
What are cumulative effects?
If a patient doesn’t meet the 90% threshold in one category, they might still qualify under the cumulative effect of significant limitations. If they have significant limitations in two or more categories, the T2201 forms allows them to be combined; And if their combined impact is equivalent to a marked restriction that affects the patient at least 90% of the time, it is treated it as a single qualifying disability.
For example, take the case of a person that has arthritis and a mild cognitive impairment. They can walk 100 meters, but it takes them twice as long as someone else their age because of joint pain, so they would not qualify under walking since they are not taking 3 times longer. In addition, the patient also has memory issues, and it takes them twice as long to get dressed in the morning. Again, taking twice as long as someone else their age would not qualify them under the rules. However, utilizing the cumulative effect of significant limitations, the time and effort they spend on walking and dressing is equivalent to a single marked restriction, and they would now be eligible for the DTC.