(Canada) Disability Tax Credit

Anyone apply for this tax credit?

I work and pay (a LOT of) taxes. I understand that the requirement for the disability tax credit is 14 hrs/week on “life sustaining therapy”. Many weeks I’m spending two hours and more a day on managing diabetes, not including exercise, meal prep, etc. So possibly it’s worthwhile to apply for this tax credit assuming that the endo will sign off. On the other hand, I’ve long resisted the idea that diabetes is a “disability. . .”

Anyone else?

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I think if you are disabled, meaning you are unable to work because of diabetes, or that you can’t get around, or if you mental capability is has suffered, then yes.

Otherwise you are not disabled. You are inconvenienced.

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Yes, I get it - was encouraged by my GP & endocrinologist to take advantage of it when I pointed out I couldn’t afford to use a CGM. People managing their diabetes with pumps and sensors and studying how to alter their life to ensure their ongoing health for a substantial part of their lives (14h/wk) are exactly who qualify, and it will help offset the costs you have that others without diabetes don’t pay.

Having said that, I would never tick off “disabled” on forms or the like.

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“Disabled” is SUCH a loaded term.

I don’t feel disabled! I mean, yes, I spend a lot of time and money on things that people who don’t have diabetes don’t ever have to think about. I am constantly counting carbs, considering the additional longer bolus if there’s protein, how fats impact glucose, etc. I can’t just “go for a hike” and must have supplies with me for any extended outing. I can’t go to bed without checking and adjusting for my current sugar.

So what does “disability” really mean? Now I’m getting philosophical. . . :grinning:

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I’m not a proponent of cheating the system in any way, but if the regulations are written in such a way that you qualify legally, then by all means take advantage of a social service that was intended for you. It doesn’t matter what the general public thinks disability looks like.

I’m not Canadian, but in the US diabetics (I don’t remember if it’s limited to Type 1 or includes Type 2) qualify for a disability Access Pass that gets you free entry to all the national park, half price camping, and other discounts. I certainly don’t feel disabled, but I’m sure happy to flash my disabled pass at the park entrances. I didn’t even have to fill out the paperwork (there’s a formal application requiring a doctor’s signature) or anything. Just went my local forest service office and told them I was diabetic, and the lady had me sign a book and handed me the pass.

Maybe it’s not the same thing as a monetary payment, but the sentiment is similar.

My retina specialist also asked if I wanted to sign up for the National Library Service for the Blind and Print Disabled (NLS). It’s not just for the legally blind, it’s a “free braille and talking book library service for people with temporary or permanent low vision, blindness, or a physical, perceptual, or reading disability that prevents them from using regular print materials.”. The retina center submitted the application for me and someone called me to set up the service. I’ve only used it once, to try it out. They mailed me an audiobook on this weird old-fashioned Play along device that you plug headphones into. Other things can be downloaded or picked up at my local library. I have a slight audiobook addiction, as the noise keeps me company throughout the day. One of my local libraries subscribes to the Hoopla service with what feels like unlimited audiobooks available and let’s us check out 50 titles a month (up from the original 5 during the pandemic), so I just haven’t had much need for the NLS, but it’s really nice to have it as an option.

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Personally I wouldn’t worry too much about the definition of “disability,” since the tax credit is available to those who have a mental or physical impairment OR spend at least 14 hours a week on their life-sustaining treatment. That is, you don’t have to call yourself disabled to qualify. If you can do with the tax credit – such as if you don’t have private insurance – by all means apply. From what I’ve heard, though, it can be hard to get approved.

Let us know how it turns out for you.

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Who qualifies?

A person who requires “Life Sustaining Therapy” may be eligible under the 2 following conditions:

• Therapy is required to support a vital organ

• Therapy is needed at least 3 times a week for an average of at least 14 hours per week.

The Canada Revenue Agency (CRA) must receive confirmation that the applicant spends at least 14 hours per week on the activities specified by the CRA that are related to administering insulin. These activities include :

• Monitoring blood sugar

• Preparing and administering insulin

(loading, injecting and assessing the amount of insulin to deliver)

• Calibrating/preparing necessary equipment, including changing

infusion sites for the insulin pump

• Adjustment of insulin dosage-blood glucose results recording and

other activities to help adjust the dosage of insulin

• Treating (administering glucose or insulin for) hypoglycemia or

hyperglycemia

There are certain activities that the CRA does not recognize, it is very important to exclude the following when applying for the DTC:

• Counting carbohydrates

• Exercising

• Recovering from hypoglycemia or hyperglycemia

• Meal preparation

• The time the insulin pump takes to deliver insulin

• Attending medical appointments

• Shopping for medication

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I note that there was an earlier post on this same topic, perhaps moderators could combine the two discussions?

Longish essay here: how much time is spent actively treating T1DM a week?

Your thoughts are welcome!

———-

Diabetes takes a lot of time and effort to manage well. I’m not asserting that I do it perfectly, but I do commit time to my health, wanting to be around and healthy for as long as I can.

Anyway, you may not be aware or keep track of the amount of time and energy that you dedicate to ACTIVE diabetes management. But I decided to review.

If I include awakening at night and treating, following up on Dexcom alerts (high OR low) reviewing diabetes supplies, ensuring that I’ve got documentation to maintain capacity directly related to diabetes management (this doesn’t include time spent exercising), reviewing glucose response to medication and to dietary intake, (excluding the counting of carbs of course) and assuring that adequate treatments are available for exercise such as cycling, hiking, and the like. — suffice to say it adds up to the 14 hours a week! I won’t say that none of this is multi-tasking but a substantial amount of my attention is goal-directed to management of diabetes that I believe it qualifies. As noted, I’ve done some tracking, and what I found may be surprising.

Where shall we start? Let’s consider a “standard week”. Starting with Monday morning.

Upon awakening, altogether each morning I spend 20 minutes on direct diabetes management, starting with checking overnight sugar tracing, reviewing response to insulin. I almost always wake up to 6.1 mmol/L. Which is thanks to Control IQ.

What else does this 20 minutes entail?

Part of my daily routing includes checking date and time for replacing glucose monitor or infusion set, and checking both sites for inflammation. I remove the infusion set for a shower, ensuring that insulin flow is stopped (and restarted again after it’s been reconnected), I program a breakfast bolus (depending on carb:protein ratios, for longer or shorter duration etc). Not to forget as part of your morning life-sustaining regimen: to check feet for blistering, cracks, infection etc. during or after the morning shower. Anyone who regards this as inappropriate care for a person with diabetes is missing the point.

During the morning I add another 10 minutes altogether, incurred during the five hours between breakfast and lunch, reviewing glucose tracing and intervening as appropriate (including treating lows or highs but EXCLUDING the actual time spent for example climbing/ descending stairs in order to treat a high. I think you MIGHT be able to count that time as it isn’t exercise per se, but treatment for hyperglycemia. But out of an abundance of caution, I’m not counting that time).

Then 10 minutes at lunch, preparing for injecting insulin via pump appropriate to the amount I’ll be eating after reviewing how the morning insulin has affected my glucose tracing and what I’ll be eating.

Review / treatment in afternoon, similar to the morning, considering another 10 minutes between 1PM and 5 PM.

After considering and counting evening meal carbs, I dedicate 10 minutes reviewing what my evening meal will require in terms of treatment — how many units, all at once, or delayed infusion? Similar to my breakfast calculations. Telling the pump to do it. Later, after evening meal, five minutes checking that glucose tracing is where it should be.

Later on in the evening: 15 minutes that includes reviewing my past 24, 48 hour, and past week time in range, average glucose, and considering factors that may have caused less than 100% of my time at 5.8 mmol/L. Considering pump programming changes to address that, do I need more basal? Should I change I:C ratio? How are my correction factors? I don’t change this every day, but I’m always aware. During this time I have my pump plugged into my computer so that the battery remains adequately charged for the next day.

Evenings: taking pump from pocket, adjusting and putting it in/on a belt so that I don’t strangle myself with the tubing. 5 Minutes.

That’s 80 minutes a day! Maybe not quite exact every day, some days more and some less, but often enough. So if you follow me, I’m dedicating over nine hours a week for just regular / routine management. 9 hours and 20 minutes to be exact, per week.

One or two nights a week I’m awoken, sometimes low, sometimes high, and I need to address. Carbs or insulin? How much? I figure it’s 20 minutes each time. Additionally, three or four days a week, on average, similarly, I need to address an out of bounds glucose, usually because it’s trending low. That adds 10 minutes “additional time” reviewing and treating my out of bounds glucose. An hour and ten minutes a week added here. So now 10 ½ hrs a week.

Preparing the pump: every three days, 30 minutes involves getting out the insulin, drawing it up into a syringe, measuring out how much I’m getting in the syringe, ejecting the bubbles, putting the insulin back in the fridge, checking my insulin supply and remembering to reorder when I’m getting low. Cleaning the area on my body where the infusion site will go. Drying said area. Preparing the injector, unwinding the tube, peeling off the protective tape, removing the needle protector, selecting site and firing it into place. Checking that it’s a good site. (Occasionally, having to go the whole thing over again because it didn’t go in properly). Then: loading up the new cartridge with insulin, switching out the old one, waiting for the pump to recognize the cartridge and all that jazz, filling the tubing with insulin, attaching the tubes, etc. and finally turning on and securing the pump where it needs to go.

This adds another 1 ¼ hours a week so we are at 11 ¾ hours per week on approved diabetes management time.

Changing the CGM: every ten days. 15-20 minutes that involves cleaning and preparing the site, getting the CGM ready, inserting, removing the old one and disposing of it; I’m including a single glucose finger stick during the two hours that your not getting readings. So that’s another hour a month, or 15 minutes a week, getting us to 12 hours. Occasionally, I need to calibrate or check my glucose on a finger stick, say three times a week at 5 minutes each time, so now we’re at 12 ¼ hours a week.

Exercise: I don’t count time spent actually exercising! I exercise more on the weekends than during the week and in general I’m active 10-12 hours a week. (Hiking, paddling, biking, skiing, etc). If I’m going to exercise, I need to prepare for the consequences so have adequate fast acting glucose to treat the downward trends that often occur. I also need to secure the pump and make sure that it and the tubing is adequately protected from the elements and the cold. If I spend 10 minutes addressing pump issues and preparing for treating hypoglycemia that occurs while exercising, and I do this four or five days a week, that’s another 45 minutes a week altogether. 13 hours.

If I treat hypoglycemia (while exercising) it can be a five minute process and sometimes I need to do so twice in an hour, other times not at all. But even if it’s only half the time that I need to treat, I’ve got 60 minutes actively treating a hypoglycemic event that occurs while exercising!

OK, this all adds up to 14 hours.

I’m applying for the credit.

I’ll let you know what they say.

I definitely think we can spend more time on managing diabetes than a casual outside observer would think.

What is this tax credit worth? As a non-Canadian, I am curious.

It’s a lot.

According to my diabetes nurse educator, who has encouraged me to apply, everyone on a pump who reasonably manages their diabetes actively should qualify.

One - time payment (a partial refund on federal taxes paid for the past ten years) of $10,000-15,000 CDN if you are in a higher tax bracket and pay a lot of taxes (which I do).

Then $1,000-$1,500 annually as long as one qualifies!!

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I didn’t quite get that large a lump @MBW when I’d originally applied, of course, it’s based on the taxes you’ve paid out. When I’d originally applied, my endo was totally against it. He said, you’re not “disabled”, but working in the medical field (I could retire, but need to work to be able to pay for my insulin, prescription meds, CGM/FGM) this is a word that can be taken in so many forms. In order to get any “refund”, you have to be paying income taxes.

I did try to reapply for DTC since it had run out, but was denied. Nothing had changed (you have to spend 14 hours or more to be accepted). The other thing, the CRA agents aren’t diabetic … they have a strict protocol to go by and mine was denied due to putting in a few incorrect procedures that they don’t accept. The Liberal’s who are currently the donkey’s in the manger of our country, said they’d make it easier … but they havent. So, the Conservative MPP in town, is going to help me reapply since they are amazed at how difficult it is to get this tax relief, that in the past has helped me so much with paying out of pocket for living as a diabetic.

What’s happened to me, is moving to a new province in Canada, for pump coverage (my other province didn’t offer that for above 18 and I only started pumping in my late 40’s after already being diabetic for the same time). So, moving to province next door, I gave up a great Pharmacare in one province, to the new one, that is crap BUT … the monies I receive for the pump program to pay for infusion sets, etc. helps A LOT (it’s $2,400 paid in $600 x 4 installments). I go between MDI / pump depending on what my rice krispies tell me, and to be able to pay out of pocket for Libre2.

Previous election to the last one we held in October, I was advocating along side of gentleman whose worked the ropes within the federal offices and due to health issues/costs decided to start the project link you see below. He also lives in Nova Scotia (they don’t have great pump/CGM coverage there sad to say but it’s a beautiful province to live in) - the site is still up - but we got the wind taken out of our sails for Faces of Pharmacare … to have coverage for everyone similar to say Denmark, UK, New Zealand. Yes, taxes go up, but everyone is paying into the kitty and eventually some of us will need help with Pharmacare costs. I’m lucky that my out of pocket medical expenses are about $5-7K a year, I’m lucky to be able to still be working in my 60’s (been working since I was 16, when I left home after driving my parents batty for first 11 years as a T1D) … so it would be nice to be able to get a break from medical costs … and buy more wine and chocolate.

Alright, getting off my soap box . Oh Canada … sometimes I wonder as an immigrant , should I go back to the UK … or wait … Denmark?

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Good news for the new year.
Well as an update: I just received a letter stating that my application for the tax credit was approved. No word yet on how much I’ll be getting back but it looks like they automatically calculate the past ten years so it’ll be a good amount! Thank goodness because for years it was all out-of-pocket for me. Now I have a job with benefits but will be retiring and will have to pay to continue my benefit plan (which I will do, because now I’m on some pretty pricy meds!!)

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Congratulations! It’s good to hear success stories like yours. It motivates me to start filling out the application I keep ignoring year after year.

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:slight_smile: you need to be comfortable that you are spending 14 hours a week doing diabetes stuff that a person without diabetes would not have to do. And you just need to make sure you are only claiming time to manage your diabetes (take the time to do it correctly). It took me about 2 hours altogether to complete the paperwork.
Then I brought it with me to my endocrinologist’s appointment and he signed it.
If I think of it as a “job”, completing the forms will be the best paying job I’ve ever had, by a big margin!

If you are a Canadian and get the disability tax credit, note you can also apply to get an RDSP… you can contribute up to $200 000 over your lifetime and the government contributes a substantial amount (based on income) making it a GREAT investment. You can talk to a bank about how to set it up, but essentially you can only pay into it until you are 50 (set it up ASAP), and can’t withdraw from it until you’re 60, but it is SO worth it!!