Medical Expenses

OK, you have taken care of the first few steps. You have:

  • Submitted the T2201 to have your child declared disabled
  • Claimed the Disability Tax Credit on your tax form
  • You have applied for the Canada Child Benefits
  • Claimed Child Care expenses if eligible

Now what?

Claim your therapy costs as a medical expense

First, you can expect to claim your therapy costs as a medical expense. Please note that this doesn’t include the administrative costs of your program, such as materials and training. This is why you should claim these costs from the BC government Autism Funding Program. Any medical costs should be claimed by the spouse with the lower income.

Medical expenses will granted by the government as a non-refundable tax credit. In other words, you will receive back about 20% of your costs.

A refundable credit of $1,187 may be claimed by eligible working people with low incomes and high medical expenses.  This is not as beneficial as the non-refundable tax credit, but certainly worth applying for. Refer to the CRA webpage Refundable medical expense supplement for more information.

Therapy or Tutoring?

The problem with claiming “ABA Therapy” is that an ABA Therapist is not a recognized medical practitioner in the province of BC. The CRA workers will not be able to match the medical receipts you have submitted with a claimable medical expense.  Many parents have been turned down for this reason.

The government seems to prefer the term “tutoring” as opposed to “therapy”. Here is the CRA definition of tutoring:

Tutoring services used by, and which are supplementary to the primary education of, a person with a learning disability or impairment in mental functions, and paid to someone in the business of providing such services who is not related to the person being tutored. A medical practitioner must certify in writing that these services are necessary.

I have heard different stories from parents. Most have had success calling it “tutoring” and others have had done OK with “therapy”.

To claim for tutoring, your child must qualify for the Disability Tax Certificate and it must be prescribed by a doctor. You may have to attach a letter from your doctor along with your tax return.

When you are dealing with CRA, you may be talking with an individual who has never heard of autism and you may have to enlighten them.

You can also claim therapy costs for a therapist who is 18 years old, instead of the BC Autism Funds requirement of 19.

What information needs to be on the receipts and invoices?

CRA requires that the following information be provided in order to claim treatment costs as a medical expense:

  • Name of the tutor
  • SIN number
  • Dates of service
  • Service rendered i.e. “ABA Tutoring”
  • Signature of the tutor
  • Receipts indicate “Paid”

Refer to my Files page for an example of an invoice that can be submitted to the Federal Government. My suggestion would be to fill out the receipts and invoices on behalf of your therapists. If you leave it for the therapists to fill out the final paperwork, I guarantee that it will be incomplete.

Do not put anything under Description of Services other than what is required. It should read “Tutoring” or “ABA Tutoring” or “Attendant Care”. Extra items like Team Meeting, overlaps, training etc. will confuse the issue and cause the medical expense to be denied.

What about Behaviour Consultant costs?

A medical expense category created in 2014 is the “Personalized Therapy Plan”. In a nutshell, this is what you can use to claim expenses paid to your Behaviour Consultant (BC).

In years past, I recommended that you tailor invoices for your Behaviour Interventionists (BIs) and call the service rendered as “tutoring”. This advice still holds true, but for your BCs (who always write their own invoices) you can now file your medical expenses using this category.

There are a few conditions to claim expenses as a “Personalized Therapy Plan”:

  • The plan has to be designed for someone who is eligible for the disability tax credit
  • The payment is made to someone who is in the business of providing such services to unrelated persons
  • The therapy has to be prescribed and supervised (in the case of a mental impairment) by a medical doctor or a psychologist
  • The plan has to be needed to access public funding for a specialized therapy (as in BC Autism Funding )

Does the SIN number of your BC need to be on the receipt?

No

Does the invoice need to say “Personalized Therapy Plan”?

No

Don’t make this more complicated than it needs to be.  Simply add your BC invoices to your other medical receipts. That’s it! If CRA reviews your medical expenses and questions these costs, you may remind them that this constitutes a “personalized therapy plan”.

Attendant Care

You may also claim for attendant care if you have hired someone (i.e. a domestic helper) to care for your child. You can claim up to $10,000 (if the child qualifies for the DTC) and still claim the disability amount. Please note that this limit applies to each paying individual. Therefore each spouse can claim $10,000 if this arrangement is supported by receipts.

Attendant care is lumped in with medical expenses as a tax credit, so don’t bother trying to claim ABA expenses as attendant care.

Refer to TaxTips.ca for more information

What if I hire someone for respite or babysitting?

That sounds like attendant care to me (or Child Care. See my page Child Care for more information). I see no reason this can’t be claimed. Ensure that you have proper receipts for this service. You can use the invoice/receipt sample on my Files page. Ensure that the service rendered is “Attendant Care”. Refer to  CRA – Attendant Care for more information.

What items are not covered as a medical expense?

  • Vitamins, Supplements and over the counter medications, even if prescribed by a medical practitioner
  • Organic Foods and special diets
  • Materials and equipment used in ABA programs
  • Administration costs
  • Travel Expenses for therapists

Travel Expenses

Some consultants bill for travel expenses on their monthly invoice. The federal government may have an issue claiming this as a medical expense. One way around this, is to claim these costs from the BC Autism Funds program. They have no such issues with travel expenses.  Alternatively you may request that your consultant revise their billing procedures such that travel expenses are incorporated into their hourly rates.

If you have to travel more than 40km to access medical care, you may be able to claim travel expenses. If you travel over 80km, you may be able to claim meals and accommodation. Refer to the guide RC4065 for more information.

Organization

One final note: You must be organized!!!! To claim anything from the government you must be prepared to back it up with invoices and receipts. If you can’t organize your files, then don’t claim them. Please refer to my page Organize your files.