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Tax Credits, Registered Disability Savings Plans and Grants in Canada

Tuesday, February 14, 2017 2:49:25 PM America/New_York

by Barbara Wagstaff of http://www.diabetesadvocacy.com

Diabetes is a costly disease in so many ways. Trying to fight complications can be a financial burden that often is too much to carry. Sadly it is the poorest in our world who stand the highest chance of experiencing complications. Some  provinces and states in North America offer  help  to cover the costs of such items. That is still not enough. There are those of us in Canada who are and will continue to lobby various government agencies so that one day there is no longer this gap and everyone living with diabetes will have equal access to the best methods of care.

Disability Tax Credit

What is the Disability Tax Credit?

The Disability Tax Credit is a credit offered by Revenue Canada to those of who have a severe mental or physical impairment which markedly restricts the basic activities of daily living and/or need and dedicate time for Life Sustaining Therapy (Therapy that must occur at least 3 times per week for more than 14 hours per week). They further require that the person eligible have an impairment that has lasted or is expected to last for a period of 12 continuous months. Further Revenue Canada notes "For the purposes of the disability amount, Life Sustaining Therapy is any treatment for a disease or a disorder that, if withheld would prevent the functioning on one or a group of vital organs to sustain human life."

There are some who do not wish to be labelled as "disabled" or have their child carry such a label. I respect that but for myself and others, any financial relief provided by the Federal government is accepted and desired.

Who Can Apply?

The Disability Tax Credit is available to those who have a taxable income and who are markedly restricted in the Basic Acts of Daily Living OR require 14 or more hours per week to administer Life Sustaining Therapy.

My child or I have Type 1 Diabetes. Do either of us qualify?

Yes! If you or your child use an intensive insulin management system, you will qualify for the Disability Tax Credit because you require Life Sustaining Therapy.  You require an insulin regime to keep you and/or your child alive.

But what is an Intensive Insulin Management System?

This means that you are taking more than 1 or 2 injections of insulin per day,  you are monitoring your blood glucose levels 6 or more times per day, you are monitoring your carbohydrate income to match your insulin needs, and you are keeping detailed data on trends and patterns for your diabetes care.

I'm on a pump so I automatically qualify right?

WRONG.  As of the 2004 tax year, the method of insulin delivery no longer matters.  What matters is the time you spend on Life Sustaining Therapy.  In previous years, the amount of time spent injecting insulin was the criteria for acceptance.  Insulin pumps inject 24/7.  With the changes, activities must take away from routine daily living.

Please note that if you are using an insulin pump, you can ask to be reassessed for the years 2000-2004 based on pump use.  This will not help you after 2004 BUT you will be given the credit based on the 2000 guidelines for those in between years. Those people who used injections during that time will not qualify.

What if I have no taxable income?

People with low incomes may still find some relief but the credit is designed to assist in reducing your taxable income.  IF you have a child with Type 1 diabetes, there is an added benefit to being approved for the DTC regardless of your income level.  If you are receiving a Child Tax Benefit AND you have a child with Type 1 diabetes, you will be entitled to an added Disabled Child Benefit each month.

But I already filed my taxes for this year. Do I have to wait until next year?

NO.  You can fill out the T2201 at any time.  When you are ready to submit it, you simply request that CRA reassess your taxes for the applicable years (2004 and 2005 for example)

Where do I start?

You will first need to obtain a T2201.  This can be ordered from CRA or found online by clicking on the following link http://www.ccra-adrc.gc.ca/E/pbg/tf/t2201/

This form must then be filled out by the applicant and by an attending physician.  For details on what may be included in this form, please see our Tips section.

The T2201 is sent in with your income tax return. You will fill out your income tax return as if you have ALREADY been approved for the credit and will fill out line 316 (or line 318 to transfer from a  dependent).

What do I need to tell my doctor to have the form signed?

It is important that physicians understand what they are signing. If you have a child with Type 1 diabetes, make sure that your doctor understands that by signing the T2201, they are certifying ONLY that the child has a diagnosis of Type 1 Diabetes.  They are NOT being asked to specify how much time the child or family spends on diabetes related care.  CRA assumes, based on previous Tax Court cases, that to look after a child (presently defined as someone under 18 years of age) with Type 1 diabetes requires more than 14 hours dedicated to Life Sustaining Therapy on the part of the parent and the child.

For adults and older children, the doctor must understand that they WILL be asked to fill out a supplementary form.  Provide your doctor with as many details of what you do over a week as possible.  They must understand how you spend your time so that they can accurately fill out the supplementary form.  Again, our tips page lists what activities are currently recognized as being part of Life Sustaining Therapy for Type 1 Diabetes. The more information you and your doctor can provide in the original T2201, the less room for error.

Make sure that your doctor indicates that this condition is PERMANENT.  It may effect the amount of time you are given the credit for.

How long will I get the DTC for?

The length of time you qualify for the DTC is subject to CRA's internal policies.  They can grant the credit for one year time frames, and you will have to reapply each year, or they can grant it for specific lengths of time (i.e. 5 years), or they may grant it permanently.  The last scenario is unlikely unless there are other underlying conditions that would warrant it.

When you receive your Notice of Assessment stating that you qualify for the DTC, there should be a further statement of exactly how long you have before you need to reapply.

I received the DTC already as a pumper. Will I be disqualified under the new guidelines?

You will not be disqualified, but you may receive a letter stating that the criteria has changed.  This does NOT mean that you don't qualify. It simply means that you need to reapply under the new rules.  If you were given the credit for 5 years for example, you should not receive any letters but will have to reapply under the new rules when your 5 year period ends.

How do I fill out the form?

Go to the above CRA site and download the form.

On the "Self-Assessment page" check off "yes" to question 3 Do you require life sustaining therapy?

Fill out Part A, page one of the Disability Tax Certificate.

Part B is to be filled out by your doctor. The only issue of importance for most people is "life sustaining therapy".

Your doctor will check off the box "yes" when asked "Does your patient meet the conditions for life sustaining therapy as described above?"

In the section of "year" he/she will put the diagnosis year.

Details would be insulin dependent Type 1 diabetes and then the method of insulin delivery (please remember that method of deliver does NOT change your eligibility for the DTC)

Effects of impairment is the reliance on an external source of insulin to sustain life.

Duration is annoying for those living with diabetes but you must remember that this form is for other diseases/conditions as well. Please note that "yes" the impairment will last for more than 12 months and no there will be no marked improvement thanks to therapy (there will be no cure).

The physician signs off on the form and you submit it with your tax return.

What do I do if I am sent a second form asking about time spent?

The easy answer is of course to simply tell them all the time it takes you to fill cartridges, adjust basals, and do all of those things that you have probably forgotten take time out out your day. If you sit for one day and every time you do something because you have diabetes, you will quickly be amazed how time adds up.

Here are examples:

For injections: Establish the insulin required based on time of day, caloric intake, activity level and wellness; clean the area with alcohol; make sure alcohol is dried; clean insulin vial with alcohol; remove cap on needle; draw up correct amount of insulin; pinch skin; insert needle; inject insulin; relax hold on skin; place swab over injection site and maintain pressure for a few seconds; replace protective cap on needle; and properly dispose of needle. This takes approximately 6 minutes multiplied by the number of injections per day. For a person who uses a long acting and injects for meals you would count a minimum of 5 needles per day (without corrections) totalling 30 minutes per day, and 210 minutes per week (3.5 hours)

For insulin pumps: Establish the insulin required based on time of day, caloric intake, activity level and wellness (2 minutes six times per day for 84 minutes per week), change pump tubing and insulin cartridge (7.5 minutes every other day totalling 70 minutes per week); adjusting pump programming to accommodate for temporary basal rates, exercise, changing bolus ratios or altering basal rates (10 minutes daily, 70 minutes per week), site change and rotation (10 minutes every other day, 35 minutes per week), emergency site changes due to sites falling out or failing (17.5 minutes twice per week, 35 minutes), establishing correction doses (1 minute twelve times per day, 84 minutes per week), changing pump battery (2 minutes every other week, Logging: I know not everyone logs but reality says that you must look at trends and see if you need adjustments for your exercise routine, pizza supper, or that extra shift at work.  All of these things are tasks that a person with a functioning pancreas would not have to do. This is something you do think about. It would total a minimum of 30 minutes per day, equating to three and a half hours per week.

Analyzing trends and making adjustments: every three days, 20 minutes equals one hour per week Checking meter: this includes coding, using control solution, changing lancet for approximately fifteen minute procedure

Repeating Blood Glucose Test when meter error occurs:  two minutes of your time approximately five times per week (10 minutes)

Treating lows: CDA guidelines state a low is anything under 4. How many lows are normal? This is individual but if you maintain tight control it is more likely to occur. Fourteen lows per week and 5 minutes to treat equals 70 minutes per week.  CRA states in their legislation that recovery time from lows does not count in the calculation of time spent on Life Sustaining Therapy(an extra 15 minutes per low). It has been argued that this is part of therapy and privately they agree but unfortunately there does not seem to be legal precedents backing us at the moment.

Dealing with highs: Again, not to be taken lightly. You need to establish a correction factor. Some people are more insulin resistant at higher bg levels. If you are pumping, you want to check the tubing and the site. If you are on injections you may wish to look at the insulin and the injected area for hypertrophy. You will need to inject to correct and finally you may also need to test for ketones (three minutes every other week, or 1.5 minutes per week). The amount of time this takes would be approximately 6 minutes and as most people tend to run high more times than low. We found 21 highs per week I would say three highs per day totalling 18 minutes per day, or 2 hour 8 minutes per week

Testing: Testing becomes routine but it still must be done. On average one hopes that there is at least 6-12 tests per day. To test you must wash the area to be tested, ensure that the meter is coded properly, insert the test strip, lance the area, apply the blood, record the reading. 8 times per day at 3 minutes per test is 24 minutes per day or 3 hours per week .

For people using a CGM:  You would most likely have slightly less testing time (6 times per day or 2.1 hours per week) but will have other tasks that must be added into your calculations such as:
Rotating CGM Sensor sites:  10 minutes once per week
Analyzing your CGM Trends:  30 minutes once per week
Emergency Sensor site changes:  10 minutes every other week or 5 minutes per week.
CGM Calibration:  1 minute four times per day or 28 minutes per week)For a total time spent dealing with the CGMS part of your diabetes care being 73 minutes per week.

So what are the totals?

For someone on injections:
Injecting: 4.5 hours (this includes the time required when you are high and need to calculate a correction dose.)
Logging: 3.5 hour
Analyzing trends and making adjustments: 1.5 hour
Checking meter, coding, changing lancets, etc.: 15 minutes
Testing: 4.5 hours (this included the extra time for retesting during lows)
Total: 14.25 hours per week

For pumpers:
Dealing with pump: 6.3 hours
Logging: 3.5 hour
Analyzing trends and making adjustments: 1 hour
Checking meter, coding, changing lancets, etc.: 15 minutes
Treating lows: 1 hour 15 minutes (or more)
Dealing with highs: 2 hours 30 minutes
Testing: 4 hours (pumpers usually test closer to the 10-12x per day mark)

Total: 18.8 hours per week If using a CGM:  add .5 hr.  Time devoted to the CGM part of therapy is approximately 73 minutes but there is usually less time spent testing blood glucose levels which would negate the total or increase it only slightly.

Still not sure?

Diabetes Advocacy offers assistance in filling out the T2201.  We will print off the T2201 as well as any requests for reassessment years, fill in the forms and indicate where you and your doctor need to sign, as well as provide you with a detailed letter stating why people with diabetes now qualify for the DTC.  We are not tax accountants but are well versed regarding the Disability Tax Credit and those with diabetes.  Please make sure that your doctor will support your claim.  This fee is for filling out the appropriate forms for you only. We do not guarantee your success but will assist you with any further issues you may have.

 

Registered Disability Savings Plan

What is the Registered Disability Savings Plan?

RDSP - ITS NOT A MYTH! THERES NO CATCH; AND YES - ITS SO REAL IT WILL CHANGE YOUR LIFE. A Registered Disability Savings Plan (RDSP) was designed to provide long-term financial security for a person with a disability. Tax-deferred investment growth, along with generous government grants and bonds make the RDSP a powerful investment tool. "There must be a catch," is a familiar comment advocates often hear so it comes as a surprise when disabled people learn they can often get thousands and tens of thousands of dollars. Perhaps the most attractive reason to open up an RDSP is to get access to the annual Canada Disability Saving Grants (CDSGs) which can provide 100%, 200% or 300% matching grants, depending both on the beneficiary’s family income and the amount contributed, up to a lifetime maximum CDSG limit of $70,000*

Who Can Apply?

In order to qualify for an RDSP, you must have also qualified for the Disability Tax Credit.

When can I  begin taking money back out?

Money put into a RDSP can be withdrawn at any time but in order to receive the full amount of your grant money, funds must be left in the account for 10 years.  (Grant money received in 2013 are not eligible for use until 2023).

How do I get started?

Contributions for RDSPs can be made through your local financial institution and invested in a way that best suits you and your goals.

The above information has been contributed by Avi Yoffe, a mother of a child with Type 1 diabetes.  She has had the pleasure of educating families with disabled people (adults and children), on how to receive the maximum amount of disability tax credit as well as RDSP Grants and Bonds.  You may contact her with your questions at avi @ rdspforyou.com

How much money will I get from the government?

CRA provides a wonderful breakdown of grant amounts on their website.

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Posted in Living With Diabetes Guides By Tino Montopoli

Dealing with Diabetes during Illness and Hyperglycemia

Monday, July 14, 2014 1:08:26 PM America/New_York

Having an illness or infection can make it particularly difficult to manage blood glucose levels. A little knowledge of how illness affects diabetes can go a long way towards helping you get through it.

An illness like a cold or virus infection is considered a stress to your body resulting in your body releasing stress hormones or counter-regulatory hormones. These hormones will cause a release of glucose from the liver and muscle resulting in blood glucose levels increasing often to very high levels. In addition your body becomes more insulin resistant which means you will often need more insulin than usual.

When there is not enough insulin available, blood sugar levels rise and excess sugar spills into the urine. The body then starts breaking down fat as an alternative supply of energy. The ketones produced by fat breakdown are acidic, causing Diabetic Ketoacidosis (DKA) which may be life threatening requiring an emergency room visit as soon as possible. As the condition worsens, and more and more water is lost in the urine and through vomiting, you may become increasingly dehydrated. DKA can be avoided by careful attention to all aspects of the diabetes treatment plan. DKA usually develops over hours or days.

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Posted in Living With Diabetes Guides By Tino Montopoli

Saving Money on Infusions sets

Friday, March 14, 2014 2:09:00 AM America/New_York

There are a number of ways to stretch your dollars when purchasing your infusion sets. Consider using a combination package. Some sets are available with 10 sites and 5 tubing sets with the idea that the tubing may be used for 6 days while the sites (Teflon) may be changed every 3 days.

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Video Guides

Friday, February 14, 2014 2:04:23 AM America/New_York

We have recently added 2 new videos to our website

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Posted in Guides By Tino Montopoli

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