The Federal Disability Tax Credit (DTC) is a nonrefundable tax credit used to reduce the amount of tax payable on an individual's income.1 Clinical experience suggests that the DTC is not well understood by both patients and healthcare professionals and is often overlooked. Additionally, there have been recent changes to the application process.
The DTC has evolved over time. Prior to 1986, the Canada Revenue Agency (CRA), the federal organization that oversees Canadian tax law, maintained a standard deduction reserved for individuals who used wheelchairs or were blind. Since that time, eligibility criteria have evolved and in 2005 the definition was expanded to include all persons who struggle with "severe and prolonged impairments in mental or physical functions." This change opened the door for people who faced challenges with common activities of daily living to receive disability benefits through the DTC. The Canadian Government's correct assumption is that people with disabilities will have unavoidable, additional expenses that put them and their families at a financial disadvantage. There have been recent changes to the DTC application form (Form T2201). Prior to 2017, the signature portion of the form required a physician's signature, but this has recently been changed to include the option of having a nurse practitioner's signature. In 2017, the CRA also shortened the application form, from 12 to 6 pages, thus streamlining the process for completing this form.
Many Canadians who live with an ostomy are unaware of their eligibility for this credit, and those who embark on completing the application process often encounter difficulties. In addition, the physicians and nurse practitioners who are involved in signing the form, often do not have background knowledge in ostomy management.
ADDRESSING THE CHALLENGES
In 2016, the Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC) and the Ostomy Canada Society (OCS) formed the DTC Joint Committee (Box 1). The goal of the committee was to find ways to improve things for Canadians living with an ostomy by explaining the process involved in application for the DTC. The first unanimous decision reached by this committee was creation of a brochure to effectively communicate essential information for DTC application. The purpose of the brochure was to provide information in a clear and simple format. The goal was to outline who is eligible for DTC assistance, how to apply, and where to access the form from the CRA (approval from the CRA is required before those living with an ostomy become entitled to the DTC benefit). Within 6 meetings, a draft had been created and it was then fine-tuned. The productivity of this committee speaks to the benefits of collaboration among all those with a vested interest in a solution. Through the hard work of all on the committee, both English and French brochures are now available and are titled "Disability Tax Credit for People Living With an Ostomy" (Figure 1, Supplemental Digital Content 1, http://links.lww.com/JWOCN/A45) and "Credit d'impot pour personne handicapee (CIPH) pour les personnes stomisees" (Figure 2, Supplemental Digital Content 2, http://links.lww.com/JWOCN/A46).
These brochures summarize key information about tax credit eligibility and application in an easy-to-understand format. They include national contact information as well as a space for OCS chapters to provide local contact information. Brochures have been shared with all OCS chapters and with NSWOCC members across the country.
Both NSWOCC and OCS hope this brochure will help increase understanding about eligibility and the application process in a clear way that helps more people living with an ostomy to avail from this nonrefundable CRA tax credit. The committee is encouraging all nurses specialized in wound, ostomy, and continence (NSWOC), and particularly those with an outpatient clinic, to access copies of the brochure. It can be accessed at http://www.nswoc.ca or free hardcopies can be ordered via http://www.ostomycanada.ca or by calling 1.888.969.9698; NSWOCC and OCS are sharing the cost of preparing and printing the brochures.
ONGOING ADVOCACY
The DTC Joint Committee has also been advocating for future inclusion of NSWOC specialty practice nurses to be considered as one of the professions that can sign Form T2201. Advocacy has included written letters, requesting this change, to both the Honourable Bill Morneau, Minister of Finance, and the Honourable Diane Lebouthillier, Minister of National Revenue. In response to the written communication, the Canadian Office of the Minister of National Revenue requested a meeting with core members of the DTC Joint Committee to learn more about this proposal. The core members, including both associations' presidents, leader, and the Executive Director of NSWOCC, met April 26, 2018. This meeting provided information and a growing understanding of the complexities of those living with an ostomy, and a request from the government office was made for our core group to present our information to the Canadian Federal Disability Advisory Committee. We have initiated correspondence with this committee; key points for our argument are summarized in Box 2.
Additional efforts of the DTC Joint Committee members are focused on arranging to have DTC information in the journals and Web sites of various professional associations including physicians, pharmacists, and nurse practitioners. An image, highlighting the key points, has been developed for use on these Web sites, thus providing a link to the brochure. The Ostomy Canada Society will also be further promoting the committee's activities in a feature article in its next Ostomy Canada magazine.
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