Social Policy in Ontario

Disability tax credit not extended to those with mental illness

Posted on January 13, 2017 in Social Security Policy Context

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TheStar.com – News/GTA – There are many Canadians with serious mental illness who, experts say, are missing out on benefits and tax breaks because too few doctors understand what constitutes a disability.
Jan. 13, 2017.   By PETER GOFFIN, Staff Reporter

Delusions, depression, reckless behaviour.

The symptoms of Patti Gardner’s bipolar disorder make it nearly impossible for her to perform many simple functions of daily life.

She can’t work, she can’t socialize with people, she struggles to make financial decisions or big purchases, she says. She just can’t trust herself.

“I think of bipolar disorder as trying to ride a bucking bronco all the time,” she says. “You have to be careful because it’s going to try to get away from you whenever it has a chance.”

Gardner says the impediments caused by her mental illness could qualify her for the Canada Revenue Agency’s Disability Tax Credit — potentially worth thousands of dollars per year.

But Gardner, who already receives a disability pension from the federal government, says she can’t find a doctor who will approve her application.

There are many Canadians with serious mental illness who, experts say, are missing out on benefits and tax breaks because of the way doctors interpret CRA requirements, which can seem to favour the physical over the psychological.

Dr. Ariel Shafro, a psychiatrist who has treated Gardner, says the criteria for the Disability Tax Credit does not reflect the way in which people with severe mental illness experience impairments.

“This (tax credit) form is one of the many examples in which stigma and a lack of understanding about mental illness acts as a barrier to patients who are unable to access services that would help them in their recovery,” Shafro says in a written statement. “It is my hope that this antiquated criteria can be improved to reflect the real experience of those suffering from mental illness, to validate their experiences, and support them in their recovery.”

CRA language aside, there can be problems when it comes to defining what constitutes a “disability.”

Dr. Vicky Stergiopoulos, physician-in-chief at the Centre for Addiction and Mental Health, says there is a misperception that disability benefits are for people with physical, not mental health issues.

“It’s how we’ve constructed the term ‘disability’ in our minds, both amongst lay people but also clinicians,” she says. “Many physicians are not comfortable (approving) disability benefits … for people with mental health conditions.”

The Disability Tax Credit is available to Canadians with a physical or mental condition that severely impedes their ability to perform basic activities.

CRA spokesperson David Walters says a mental illness could qualify someone for the tax credit. Eligibility is based on the degree to which a person’s condition affects their life, not the type of condition they have.

But, to apply for the credit, a person must have a doctor certify that they have “one or more severe and prolonged impairments in physical or mental functions,” Walters adds.

“In my experience, at least, it’s been a little bit more difficult for individuals with mental illness to qualify,” says lawyer Brendon Pooran, who consults clients on applying for the Disability Tax Credit.

“Usually the biggest barriers are related to knowledge and process. Understanding the qualification criteria, educating the medical practitioner with respect to the criteria as it relates to the person’s restrictions, and the actual filing process to the CRA.”

The effects of a mental illness on a person’s daily life may not be as clear-cut as those of a physical impairment or developmental disability, Pooran says. But he has seen people qualify for the credit based on a mental illness.

The Canadian Medical Association says the government should provide patients and health care professionals with a “comprehensive information package,” describing the eligibility criteria for government programs, benefits and compensation.

“Additional efforts are required to ensure that forms, such as the Disability Tax Credit Form, provide clearer information and are, most of all, user-friendly for patients,” says Canadian Medical Association spokesperson Ziad Saab.

After reviewing the CRA’s criteria, Stergiopoulos, a psychiatrist, said “adults with mental health conditions would definitely qualify for disability tax credits.”

But, she added, some of the criteria are “overly-restrictive” and could disqualify many people with mental illness disabilities.

The CRA’s requirements state that a person’s condition must restrict their abilities at least 90 percent of the time.

Mental disorders can have a “more variable course” than that, but still cause profound disability, Stergiopoulos says.

Gardner, for instance, says she does not suffer the debilitating symptoms of bipolar disorder every minute of the day. But, because she never knows when mania or depression might strike, she cannot engage in many simple activities, for fear her illness may take control.

Shafro says the tax credit criteria may fit patients with neurocognitive disorders like Alzheimer’s disease, but excludes many people with anxiety, depression or psychosis.

“(Their) overall impairment can meet or exceed those with physical impairments deemed sufficient to receive approval for the disability tax credit,” he says.

“Many patients still face severe impairments to ‘daily living’ including ability to work, maintain personal relationships and ability to care for themselves, however they do not have the more overt physical impairments required for the disability tax credit, which is clearly designed around those with physical illness, rather than considering the nature of impairment in mental illness and its impact on function.”

Canadians applying to the Disability Tax Credit for 2016 can claim up to $8,001.

But recipients can be reimbursed for past years in which they qualified, but did not claim, the credit, dating back a decade.

A person who qualified in every year since 2007 could claim up to $66,000 of previously paid tax, and see at least a portion of it returned to them, in addition to this year’s credit.

And, once a person with a disability has been approved, they can claim the credit for a dependant, spouse or common-law partner.

The Disability Tax Credit also opens the door for other highly desirable benefits.

It is the main prerequisite for the federal government’s Registered Disability Savings Plan. The government matches contributions to these plans, up to $3,500 per year, and up to $70,000 over the course of a person’s lifetime.

“It’s a very powerful certificate to have in place,” says Pooran.

Stergiopoulos says doctors have a role to play in guiding patients towards these types of financial resources.

“In my experience, most of my patients wouldn’t even know to apply (for the Credit),” Stergiopoulos says.

“One of my hopes for (CAMH) this year is to increase financial literacy among our clinicians when it comes to how best to support our patients’ access to a full cadre of benefits.”

Read more about the challenges facing people with mental illness:

Patients suffer over gap between physical and mental health care:  < https://www.thestar.com/news/gta/2016/12/28/patients-suffer-over-gap-between-physical-and-mental-health-care.html >

Timely, affordable mental health care out of reach for many:  < https://www.thestar.com/news/gta/2016/12/29/timely-affordable-mental-health-therapy-out-of-reach-for-many.html >

Many Ontarians with mental health issues must choose between food and meds:  < https://www.thestar.com/news/gta/2016/12/30/many-ontarians-with-mental-health-issues-must-choose-between-food-and-meds.html >

< https://www.thestar.com/news/gta/2017/01/13/disability-tax-credit-not-extended-to-those-with-mental-illness.html >

Tags: disabilities, featured, ideology, mental Health

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