Letter from JDRF and Diabetes Canada to the Honourable Diane Lebouthillier regarding joint recommendations aimed at ensuring access to the Disability Tax Credit for Canadians with diabetes

October 31, 2017
The Honourable Diane Lebouthillier, P.C., M.P.
Minister of National Revenue
7th Floor, 555 MacKenzie Avenue
Ottawa ON K1A 0L5

RE: Joint recommendations aimed at ensuring access to the Disability Tax Credit (DTC) for Canadians with diabetes

Dear Minister,

We are writing to you with regard to the ability of people with diabetes to access the Disability Tax Credit. Further to our correspondence of October 4 and our meeting with your staff on October 25, 2017, we trust that the following clarifies our joint position on behalf of all those living with type 1 diabetes.

In our meeting last week, the CRA confirmed that new direction was given to their reviewers at the beginning of May 2017 with respect to insulin therapy. Additional text began appearing in clarification and denial letters after this date asserting that “An adult who independently manages insulin therapy on a regular basis does not generally meet the 14 hour per week criterion unless there are exceptional circumstances. For example, the existence of other chronic conditions that affect the time needed to manage the therapy or affect the ability to independently manage the therapy.” As a result, the CRA has since May 1 been denying nearly every application for the Disability Tax Credit by adults living with type 1 diabetes, despite medical certification.

The CRA has been asserting this despite the fact that the claimants’ doctors and nurses have been certifying that their patients ARE spending the required 14 hours on their therapy. Since that time, the CRA has been denying all adults who have not specified other chronic conditions (as well as some who have) even though there is no requirement in the Income Tax Act that Canadians with diabetes need to have other chronic conditions in order to qualify. These denials are in contradiction of the certifications provided by licensed medical practitioners and do not appear to be based on evidence.

The medical practitioners who certify these applications for the DTC do so based upon their detailed understanding of this disease and its management, as well as based upon a personal knowledge of their patient’s self-management practices. In short, they are best positioned to opine on whether the patient is actually spending the minimum of 14 hours per week on applicable activities, as the clinician is certifying. To question the accuracy of a certification is to question the knowledge and/or integrity of the certifying clinician.

On behalf of all people with diabetes in Canada, JDRF and Diabetes Canada request the following:

1) Recent interpretation of guidelines, the new direction and the language in the clarification letters provided needs to be immediately reversed to pre-May status, and in the interim replaced with a directive using new language to the effect that:

An adult who independently manages insulin therapy on a regular basis and whose claim has been certified by a qualified medical practitioner who has attested to the fact that they meet the 14 hour a week requirement using the eligibility criteria in the Income Tax Act will generally be approved for the DTC unless there are exceptional circumstances that warrant denial.

2) All people with diabetes who have been denied the DTC since May 1st will have their T2201 forms reviewed under the new directive.

3) Eligibility criteria in the Income Tax Act should be clarified to remove the ambiguity around calculating carbohydrates (not allowed) which is in the case of diabetes an essential and inseparable function to calculating insulin dosage (allowed).

4) Eligibility criteria in the Income Tax Act should be modernized and amended such that the language reflects that doctors can certify that their patient has type 1 diabetes and is following their prescribed regimen, but does not require certification of activities performed by the patient in a nonclinical setting. This modernization should include reconsidering the ongoing relevance of the 14 hour per week requirement.

Furthermore, we recommend that:

1) The government should establish an advisory committee comprised of medical professionals, Diabetes Canada, JDRF and patients with type 1 diabetes to provide CRA with advice on policies and practices regarding the interpretation of claims from people with diabetes going forward. Reports and recommendations made by that advisory committee to CRA should be made public. That committee should be established by no later than November 30, 2017.

2) The Disability Advisory Committee, which was dissolved in 2006, should be reinstated with a mandate to act as a liaison between Parliament and the CRA to address systemic problems in the administration of the Disability Tax Credit. We welcome the opportunity to discuss this further at your convenience.​

We welcome the opportunity to discuss this further at your convenience.

Respectfully,

Russell Williams

Vice-President, Government Relations and Public Policy President & CEO

Diabetes Canada

Dave Prowten

President & CEO

JDRF 

Cc: Kamal Khera, Parliamentary Secretary of National Revenue
Pamela Goldsmith-Jones, Chair, Juvenile Diabetes Caucus
Sonia Sidhu, Chair, Diabetes Caucus
Christine Moore, Co-Chair, Diabetes Caucus
Dean Allison, Co-Chair, Diabetes Caucus
Katie Telford, Prime Minister’s Office

Lets turn type one into type none