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Barriers and confusion for people with disabilities accessing the Disability Tax Credit

January 11, 2018

  • A 48-year-old disabled man was approved for the Disability Tax Credit (DTC) for 10 years, denied for 10 years, approved for 2 years, then denied, pending additional information from a doctor.

  • An application for an 8-year-old with permanent spinal cord injury since birth was approved for 5 years because a doctor answered ‘unsure’ in response to ‘duration of disability.’

  • 41-year-old woman was approved for 5 years but denied on renewal application, only because the doctor failed to submit requested, follow-up information.

  • A woman was told by a doctor he wouldn’t fill out the form because she didn’t qualify and it didn’t matter because she had no income. She subsequently qualified for the DTC and an Registered Disability Savings Plan (RDSP).

These stories are examples of confusing and challenging barriers keeping eligible people from accessing the Disability Tax Credit. Connections is an advocate for families in which a parent has a disability and in our role of providing support, we identified and communicated these experiences to Canada Revenue Agency.
 
We offered simple solutions to make the process easier for applicants and improve the success of eligible Canadians accessing entitlements that were designed for them. While Connections has had no response to its recommendations, there appears to be increasing pressure on CRA to address the unnecessary complexity and inconsistency of the DTC program.
 
Connections families’ experience:
At Connections, where individuals we support have cognitive challenges and often limited literacy skills, we’re concerned for the impact of these challenges on families.
 
Connections’ families are all below or very near the poverty line and live in fear of child intervention. Parents with cognitive challenges have their children removed from their custody at a significantly higher rate than typical parents, even though the rate of neglect or abuse is lower than for typical parents.
 
Connections’ experience over 27 years and the international research show that while a disability may be a reason for child intervention, it is more likely to be poverty that results in the decision to question the parent’s capacity.
 
Connections’ mandate is to provide support and advocate for adults with cognitive challenges so that they have the opportunity to parent if they choose. These parents love their children like anyone else and they are highly motivated to be the best parent they can be. They learn the parenting skills they need, when taught in a way that works for them, and when that support is offered consistently, over the long term. These families are also more likely to be successful if we can help them maintain a stable home, with enough income to cover their family’s basic needs.
 
As an agency that advocates for more than 100 families in a year, we question all policy and system processes that make it harder for our families to be successful. The Disability Tax Credit is one such process.
 
The Disability Tax Credit offers no direct benefit for most of the families we support. It is only valuable because of its link to other benefits. This is difficult for people to comprehend and appreciate the importance to them of going through the difficult DTC application process.
 
Qualifying for the DTC opens doors to receive a child disability benefit. The DTC is also required to open a Registered Disability Savings Plan. The families Connections support depend on Alberta’s Assured Income for the Severely Handicapped (AISH) program which ends at age 65 and leaves individuals with a loss in income of approximately $160 per month. An RDSP is needed to mitigate the loss in income.
 
The DTC requires a form filled out by a doctor or, added recently in Alberta, a nurse practitioner. Alberta allows doctors to charge a fee for the form and that fee is negotiated but can be as high as $250. A family living on AISH cannot be out of pocket $250 in a month and still put food on the table. Nor is a person with a developmental disability or other cognitive challenge likely to be able to negotiate fees with a doctor.
 
Individuals we support have been intimidated and shamed by doctors who told them they don’t qualify for the DTC. It is not the doctor’s role to approve the DTC, but to support the application process for CRA to then make the decision.
 
Most of our families have qualified for and participate in two, Alberta Government, direct support programs: Assured Income for the Severely Handicapped (AISH) for financial support and Persons with Developmental Disabilities (PDD) for long-term, living supports. These programs both require proving the existence and extent of disability, which means that the DTC application is duplication.
 
Once submitted, CRA can ask the doctor for follow-up information or confirmation. However, the applicant is not aware that this request has taken place. If the doctor does not respond, the application is denied without the applicant ever understanding the gap in information.
 
Finally, Connections sees many individuals having to re-qualify even though their disability, as indicated on the application form, is a lifelong disability that was present from birth. Further, the re-application process has led to individuals being turned down which puts their RDSP in question.
 
It seems contradictory to have governments at the Federal and Provincial levels make commitments to inclusive communities and full participation for all citizens, and then create programs with processes that have substantial barriers.
 
For the parents that Connections supports, the opportunity for something as simple and basic as being a parent and part of a family needs to be better supported. Most Canadians take this opportunity for granted whereas people with cognitive challenges have a very different experience.
 
For more information, contact:
Erin Waite, Agency Director, Connections
erinw@connectionscounselling.ab.ca or cell: 403 804-6100


Solutions recommended to CRA and to the Alberta Government:

Provincial:

 

AMA / Alberta Government Ministry of Health

Add the T2201 Form to Insured Services so that the cost can be recovered from the Alberta Government, rather than from the individual.

 

Follow Ontario’s lead by setting a $46 flat fee for doctors to charge for the form. It is not reasonable to expect a person with cognitive challenges to negotiate with a doctor’s fee.

PDD and AISH in-take

Both AISH and PDD intake services could proactively and automatically fill in the T2201 form for the individual at the time that they are approved for those disability support programs. This would be minimal time for PDD and AISH intake processes and go a long way to improve the lives of the individuals they are approving for supports.

Federal solution:

 

CRA – Form adjustment

Adjust the form for each province, allowing the applicant to check a box indicating enrollment in the AISH and/or PDD programs. Checking that box would preclude the need for the remainder of the form or medical practitioner signature. AISH and PDD require assessment and proof of disability. The file number for either program could be added so that CRA can verify enrollment.


Real situations and examples of barriers and process issues for the Disability Tax Credit:

  • 8 yr. old boy born with spinal cord injury called myelomeningocele, the most serious form of spina bifida. Doctor checked “unsure” to answer ‘duration of disability’ question. CRA approved DTC until 2020 only.

  • Adult male with AISH and PDD since age 18 had support to request DTC application form filled in by doctor. Doctor refused because individual did not work. After correcting this misunderstanding, form returned to doctor’s office. Doctor did not fill out reason for qualification (nature of disability) even though the same doctor had filled in AISH/PDD forms. AISH and PDD could not provide original assessments, but recommended filing a FOIP request. FOIP filing led to obtaining assessments; DTC application successful, with a doctor’s fee of $65.

  • Female, age 40, has had a DTC since age 18, in addition to AISH and PDD. RDSP in place.

  • In 2015, the DTC ended and she had to reapply for 2016 and 2017. CRA denied application; Doctor did not provide enough information to the effects of impairment. CRA approved for 20 years, then at age 40, disallows? New application sent in stating impairment is permanent/lifelong.  CRA appeals officer is reviewing.

  • 30 yr. old female with IQ of 66 and unable to read/write, with both PDD and AISH funding.  DTC application led to CRA sending follow-up questions to her doctor without her knowledge. Only by calling CRA on the phone was it known that the doctor had a questionnaire to be completed. Follow-up has occurred on numerous occasions so that form will be completed.

  • 31 yr. old female has had epilepsy since 18 months old; AISH and PDD since age 18 years. An RDSP is in place. Pharmacotherapy failed and she endured two brain surgeries. DTC denied. Reapplication with doctor fee of $195 successful but CRA only approved from 2015 to 2022. Approval should be retroactive to onset of epilepsy.

  • 24 yr. old female with IQ of 53. Two applications for DTC were denied. Approved on 3rd try when cover letter with school records and assessments sent along with application form.

  • 41 yr. old female with PDD and AISH had DTC from 2010-2015. Reapplied for 2016 and 2017. CRA response letter stated a delay in processing. Follow-up was sent to doctor but not fulfilled by doctor. Finally, form submitted, but CRA did not approve. RDSP already set up.

  • 51 yr. old female has 3 sons with DTC only until 2017.  Why do all 3 expire in 2017? There could be substantial doctor fees for three DTC renewal applications for family of 5 on AISH.

  • 48 yr. old male has neurofibromatosis since birth causing significant cognitive impairment. AISH and CPP disability income in place. DTC application delayed by follow-up letter sent to doctor for more information. CRA account shows confusing DTC approval/non-approval dates:  1988-1998 eligible; 1999-2011 not eligible; 2012 eligible; 2013-2017 still pending CRA approval.


Disability Tax Credit Facts

  • Government of Canada made a committment to ‘full participation for persons with disabilities' and the creation of the Disability Tax Credit (DTC) is a key component of that goal.

  • Efforts to improve tax treatment for people with disabilities has occurred beginning in 1996 and continuing with a task force in 1996 and again in 2002 and 2004. Some recommendations have been followed, but structural barriers remain.

  • The Disability Tax Credit, in and of itself, may not result in increased income for people who qualify. But it is a gateway to other credits and supports that can be meaningful.

  • DTC is a requirement for the Registered Disability Savings Plan.

  • Albertans who live on Assured Income for the Severely Handicapped (AISH) ($1,588 per month) will see that income end at age 65. If no savings are in place, then the individual is left with Old Age Security (OAS) plus a Guaranteed Income Supplement (GIS) top-up.

  • Combined OAS and GIS for an individual results in maximum income of $1,455 per month.

  • The reduction at 65 from AISH to OAS/GIS by $133 or more per month is significant. This is an 8% reduction at an age when costs and needs will likely increase.

  • The Disability Tax Credit is difficult to understand:  the facts, implications for other benefits and tax credits, as well as the process to apply are all challenging, whether or not a person has cognitive challenges.

The complexity of the DTC and the forms required to apply for it are a barrier to access the program. Reducing this complexity is the responsibility of the authority providing the programs.