Canada: Disability Tax Credit

I am getting increasingly frustrated by diabetics complaining about the Liberal government’s recent push to deny diabetics the Disability Tax Credit. Now, don’t get me wrong, I am not a Liberal supporter and this is not intended to be a political post. My frustration is hearing that other diabetics are qualifying for the Disability Tax Credit and I am not.

I am a Type 1 diabetic “Accountant”, and I am honest. I had a doctor sign off the T2201 a number of years ago. It lasted for two years when the CRA stepped in and said that I don’t qualify as I don’t meet the 14 hour rule.

In all honesty, I have to agree with them. I cannot justify my claim to investing 14 hours a week in life-sustaining therapy per the requirements of the Income Tax Act.

Here’s my question. For those of you who are claiming the Disability Tax Credit, how do you justify the 14 hour rule?

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I get the DTC for severely impaired vision (unrelated to diabetes), so I’ve never taken the time to add up the hours I spend on diabetes-related tasks. However, if I did I suspect I would be close to 14 hours if not over. I don’t think that everyone would necessarily hit this requirement, since even I myself have experiences changes in how difficult my diabetes is to manage over the years.

I personally think that if the DTC is available to one person with T1D it should be available to everyone with T1D. For myself, my blood sugar is affected so drastically by so many variables that I have to actively manage it all day every day in order to maintain tight control. I can’t go an hour without checking my CGM or my blood sugar can end up way out of range. There are likely many people out there who do not experience such factors and who may not need to pour so much time into managing their blood sugar.

I think that some of the things the government excludes from the 14 hours, in particular carbohydrate counting, is utterly ridiculous since that takes up a significant chunk of time and is absolutely necessary to accurately dose insulin.

Jen … I completely understand how you get to the 14 hours if you have other disability complications. On T1D alone however, I can’t make the math work. Let’s assume that one is on a worst-case scenario of MDI and 10 fingersticks a day. Neither a finger stick nor an injection takes any longer than 5 minutes.

Ten finger sticks and ten injections a day would get you to 100 minutes a day, or 700 minutes a week. That’s still less than 12 hours a week.

That said, given the financial, emotional and time investment one with T1D invests, excluding us from the Disability Tax Credit is ridiculous.

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If you have a disability, then T1D doesn’t even come into play. My vision loss isn’t related to T1D in any way, and when I apply for the DTC I don’t even mention that I have T1D, because it’s irrelevant. My vision loss alone will enable me to qualify. The same would probably be true of anyone who had significant complications of diabetes causing disability (aputations, severe vision loss, on dialysis, etc.).

So the people who are applying for coverage under the 14 hours a week are mostly those who have T1D alone without any significant complications. Otherwise, they would just apply for the DTC without needing to mention the fact that they have T1D (except maybe in passing, if their vision loss were caused by diabetic retinopathy, for example).

I am South of the Border.
But from reading on the subject…
14 hours per week is 120 minutes per day

32 minutes per day - 8 fingersticks per day @ 4 mins each. (Including walking across the house to get the meter, washing hands, …)
45 minutes per day - Treating Hypos. Which includes waiting to come up from a hypo.
24 minutes per day - 3 meals and 1 snack @ 6 mins each. Looking up carb counts via books and internet for each meal.
10 minutes per day - Logging data
10 minutes per day - Analyzing data looking for trends to make adjustments

Or as a non-Canadian have I totally missed the underlying intent or applicability here?

3 meals and 1 snack … Verboten is “activities related to dietary restrictions or regimes, even when these activities are a factor in determining the daily dosage of medication (such as carbohydrate calculation)” (

Treating hypos … Also verboten is “Treating and recovering from hypoglycemia or hyperglycemia” (

Including walking across the house … You obviously (luckily) have never had dealings with Canada Revenue Agency. This would not be taken into consideration.

I calculated my own time once. Maybe I seriously underestimated. Maybe I’m too fast at everything. Elsewhere here I posted:

it takes a minute max to do a fingerstick, so if I do post-prandials and a bedtime (and otherwise use CGM), that’s 7 minutes a day. I probably spend 10 minutes a day looking at my CGM. Delivering insulin via Omnipod – three meals and a correction or two, so 5 minutes a day tops. Changing my pod twice a week, 5 minutes each time. Occasional adjustments to basals and ratios, couple of minutes. All the time I spend thinking about my diabetes and how what I’m doing or eating affects it is constant, unending, but far from quantifiable.

So I’m up to just under 3 hours a week.

It does look like it would be hard to legitimately get to 14 hrs per week based on Type 1 Diabetes alone and not taking into account additional complications that would add extra time.

I would imagine that people simply fudge the number and take the credits whether it is proper or not. Certainly not everybody.

Note that for a young child, it is probably much easier as additional elements are included which legitimately would add up to much more time then when flying solo:
“If a child cannot perform the activities related to the therapy because of his or her age, the time spent by the child’s primary caregivers performing and supervising these activities can be counted toward the 14-hour per week requirement. For example, for a child with Type 1 diabetes, supervision includes having to wake the child at night to test his or her blood glucose level, checking the child to determine the need for additional blood glucose testing (during or after physical activity), or other supervisory activities that can reasonably be considered necessary to adjust the dosage of insulin.”

Would this not also be the same for adults? I mean, I typically wake up once or twice during the night to either check or because my Dexcom is alarming. Sometimes I’m up for hours at night trying to fix a blood sugar issue. I check my blood sugar more frequently before, during, and after physical activity and under other unusual circumstances such as when I’m sick.

I do know it takes some extra time to manage kids’ diabetes just because they are more unstable (although I feel like I’m unstable quite frequently myself!), but I don’t feel as if it’s that much extra time compared to an adult (except perhaps with infants and toddlers who can’t communicate if they feel high or low) such that one would easily qualify while the other wouldn’t. In some ways I feel like I spend more extra time on my diabetes now that I’m an adult, because I’m flying solo and have to do absolutely everything myself, even when I’m feeling like crud, compared to when I was younger and my parents and I all shared the responsibility.

But yeah, overall I think a lot of the exclusionary rules for things like carbohydrate counting or time spend recovering from hypoglycemia are ridiculous. Especially carbohydrate counting, since I don’t see how someone can even dose insulin properly if they’re not engaging in that step.

Can’t include treating hypos, meal preparation, or carb counting.

Like I said, unless there are other circumstances at play, T1Ds don’t qualify for the DTC.

There is at least one website that details how to adjust your numbers to meet or surpass the 14-hour threshold, and there are several outfits that will, for a fee, similarly adjust your application. Perhaps CRA caught on? Not that that would explain the drop to zero approvals.

My daughter is type 1 and we get the disability tax credit, solely on her diabetes alone. I honestly can’t remember how we made the numbers work because it was years ago, but I’m pretty sure it was our social worker at the hospital that filled out the forms for us.

But for me the point is that she has a disability that takes a ton of time and effort on my part and hers, and I think that all people with type 1 should get it, even if they can’t come up with the exact 14 hours per week.

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I am a type 1 receiving the DTC, I am extremely active and have to spend upwards of 20 hours a week monitoring and adjusting doses based on activity etc. I also have gastroparisis which makes dosing more difficult. Did you have your regular GP sign the T2201? I am an accounting technician and have seen many people come in with varying “disabilities” with the T2201 signed by a GP and did not qualify. Once I mentioned to have their specialist sign they did end up qualifying.
My endo signed my form and I was approved rather quickly. Maybe see your endocrinologist try again? Let’s be honest caring for and treating T1 is a 24 hour a day task.

That seems to be the one exception. There is significant precedent in tax law recognizing that parents with T1D children qualify for the 14 hours.

That said, I agree that ALL diabetics should qualify. Not only does it take a significant amount of time, diabetes also chews through a significant amount of money.

I don’t understand why the government covers the cost of insulin syringes for drug addicts, but not for diabetics !!

I can “one-up” your credentials. I am an CPA with 25 years of experience, and I have an MBA specializing Corporate Finance and Financial Accounting. Now that I have the peacock strut out of the way, we can discuss the actual 14-hour requirements.

You couldn’t possibly be spending 20 hours a week (3 hours a day) monitoring and adjusting doses. A typical blood test these days takes about one minute. Let’s say, that it takes 5 minutes to stress my point. That means you are taking 36 tests a day. For any T1D diabetic, that would be excessive.

As for being “extremely active”, I am a road cyclist and mountain biker. In a normal week, I spend six to seven hours on a bike either on the road, on a trail, or on a trainer. Some weeks can get up to ten hours. Blood Glucose management is CRITICAL to not only athletic performance, but also to safety. Although I normally use a CGM with my BG readout on my iWatch, if I am not wearing my CGM, I take one test an hour while cycling, and outside of that only about five or six tests a day.

Besides, if you are spending 20 hours a week (half the time of a full-time job) testing and adjusting doses, when do you have time to be active AT ALL?

By the sounds of it, you have found a GP and an Endocrinologist who are willing to bend the rules and essentially, help you evade taxes. I, myself, find it difficult ethically and morally to take a tax credit that is not permitted by law.

I have a perfect A1C and no complications but I spend every minute of my life thinking about diabetes and how to manage it. I think 14 hours a week is a stupid requirement. It is hard to prove but is the reality for all diabetes patients one way or the other (those who have a perfect control and no complications need to sped time to achieve that and those with complication are losing time on managing complications. That is why we should stick together and make the government change this stupid rule instead of arguing who is eligible and who is not.

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I have been T1 for 40 years and living in Canada most of my life.

I agree that 14 hours is a little silly.

I agree that parents of children with T1 should easily qualify for the credit simply for the mental anguish it must cause.

I don’t receive the DTC . But, neither I or my Endo think I qualify.

I don’t spend 14 hours a week looking after diabetes. (Unless you count posting in a public web site) After 40 years of practice I have learned how to calculate and deliver insulin in a fairly efficient manner. I guess not every one is a quick learner like me.

I certainly don’t think about diabetes 24/7 as some seem to. That would be NO FUN at all. The idea is to deal with managing diabetes first and then enjoy a happy , active life.

If you dwell on TAXES then you will not enjoy your life. In fact spending ANY time thinking about taxes can be quite stressful unless you are a professional and getting good money to think about taxes.

“45 minutes per day - Treating Hypos.” If I had that many hypos I would probably be dead and the deceased do NOT qualify.

Like the OP , I too, am fed up hearing about people complaining about loosing the Credit if they only have diabetes and no other disability or serious complications.

Definitely on top of all the responses here check out the DTC Facebook page. I’ve found that group to be very helpful. And there are lots of documents to view as well.

I’ve read that the government is considering lowering the hour requirement to 10 per week and including carbohydrate counting in that total (which previously has not counted even though it takes significant time). For me personally, I would definitely hit that (though I already receive the DTC for other reasons).

Correct, but don’t hold your breath.

Private Member’s Bill C-399 had first reading on March 21 of this year. It proposes a few amendments to the Income Tax Act, primarily to reduce the required hours from 14 to 10, and to include “time spent on activities that are directly related to the determination of the dosage of the medication” – which obviously would cover carb counting.

Second reading is not yet scheduled. And don’t get overly excited: each year, only about a quarter of private members’ bills are deemed votable, and fewer than 2% receive royal assent.

Canadians may wish to contact their MP to voice their support for Bill C-399, “An Act to Amend the Income Tax Act (Disability Tax Credit).”

In other news, in November of last year Diabetes Canada asked Canada Revenue to revert to previous interpretations of applications, to review all the recently denied applications, and to restore the disbanded Disability Advisory Committee (which had included nurses) to help review applications. CRA agreed to all three requests. One of the new Advisory Committee members is a Type 1 CDE.

Diabetes Canada also asked CRA to “revise eligibility criteria to explicitly allow carbohydrate counting.” CRA asked the Advisory Committee to review that request. The committee meets only three times a year, so don’t sit up at night waiting for its answer.

In February, Diabetes Canada made a submission to the Senate Standing Committee on Social Affairs, Science and Technology, in which it argued for including carbohydrate counting in the 14 hours. Note that Diabetes Canada itself is not advocating for reducing the required number of hours. (The complete submission is available here.)

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After getting a handle on carb counting it only takes a few seconds to size up most meals and come to a carb number. (Not eating out food!)

Admittedly I am a plain eater so it is easier for me to count carbs but I still don’t see carb counting taking a long time.

If we count food prep and carb counting to qualify for a tax credit the all the health food nuts wiil be claiming the credit as well.

DTC should cover a disability. Diabetics should get their drugs and other supplys covered. If they have a disability from D or not then a Credit should be allowed. 10 hours 14 hours Irrelevant!

But taxes should be simple. And that didn’t happen yet.:slight_smile: