An online community dedicated to advocacy, education, and assistance for those living with Diabetes
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APPLICATION FOR DISABILITY TAX CREDIT FOR XX XXX
DATE OF BIRTH: MO/DAY/YEAR NATURE OF DISABILITY: TYPE 1 DIABETES DIAGNOSED: MO/DAY/YEAR Dear Sir or Madame; In
________ our son/daughter______ was diagnosed with Type 1 Diabetes.
He/She was placed in the Intensive Care Unit for twenty-four
hours before spending a total of two weeks in __________ Unlike Type 2 Diabetes (or adult onset diabetes), Type 1 Diabetes (formerly known as Juvenile Diabetes) is not preventable. Diet and exercise alone cannot manage it and you do not “grow out of it”. Type 1 Diabetes is an autoimmune disease in which the body attacks and destroys the islet producing cells of the pancreas. Without these cells the body is no longer able to convert food into glucose which is the energy the body uses to function. Again this is a permanent condition for which there is no known cure. A person with Type 1 Diabetes can no more grow a new pancreas than they can grow a new leg. They can only continue to survive with an outside life support system consisting of insulin injections and blood glucose monitoring. This system must be monitored twenty-four hours per day as the balance is precarious and death is a real and constant threat. At nighttime, hypoglycemia (low blood glucose level) is a very real problem in young people with diabetes as changes can occur quickly and without warning. A number of young people have been found “dead in their bed” without previous symptoms of illness, hyper-or hypoglycemia. Such “Dead in Bed” deaths account for approximately 6% of all deaths in persons with diabetes aged less than 40. Not wanting our son/daughter to be a statistic, _____’s mother monitors his/her blood glucose levels numerous times throughout the night. This is exhausting but will continue for as long as he/she lives under our roof. He/She cannot be expected at 5 years old to wake up throughout the night to care for him/herself. When he/she is hypoglycemic he/she rarely wakes up on his/her own. If he/she was left unattended during such a time he/she may have a seizure or even die. On the few occasions where ____ has woken up when hypoglycemic, he/she was extremely disoriented and unable to eat or drink on his/her own. During such hypoglycemic episodes, he/she must have his/her blood glucose levels tested. He/she must have some fast-acting glucose such as juice or icing immediately. These items must be carefully measured and then fed to _____ as he/she cannot feed him/herself. Not measuring the food could result in giving him too little or too much glucose at one time creating further problems. A sandwich of specific content must also be prepared and hand fed to ____. After twenty minutes his/her blood glucose level must be rechecked. If it is not in an acceptable range yet this process must be repeated. The entire procedure can take between 30 minutes to two hours. After diagnosis, we quickly realized that keeping up with the changing insulin and food requirements of a growing child was a full-time job. At breakfast _____ must have a balanced meal that contains both complex carbohydrates and adequate protein. His/her insulin includes a background insulin that lasts him/her throughout the day as well as a short acting insulin that is calculated based on what food was eaten, fat content, protein, previous blood glucose readings, health, time of day, and anticipated activity. At lunch, supper and bedtime this process is repeated—calculate the number of carbohydrates in the meal, ensure that the required food is eaten, establish how many complex and simple carbohydrates were eaten, what the fat content of the food was, how much protein was consumed, what did he/she do over the past 24 hours, what you anticipate he/she will be doing over the next four hours, is he/she ill, is he/she growing, etc. While this is something that ____ will learn over time, at this point the complex issues of food, eating, and insulin are not something_____ can currently manage. _____ must be monitored at all times. He/She can only be left in the care of someone who knows how to look after a hypoglycemic episode and who can give an insulin injection in the case of hyperglycemia (high blood glucose). The caregiver must also know how to administer an emergency glucagon needle incase of hypoglycemia and seizure. Too much or too little insulin or food can be life threatening. Type 1 Diabetes is the leading cause of kidney failure, blindness, amputation, and heart disease in this country. With tight control through multiple daily injection therapy, such as our son/daughter receives these risks go down. ____ still requires a number of appointments to various professionals to keep on top of possible complication. Regular trips to the hospital in ____________ for check-ups, education, and ophthalmology appointments take a day. Trips to _________, a one-hour drive, are also more frequent to see the dentist, family doctor, as well as purchase the large amount of groceries and pharmaceutical supplies required to keep _________ healthy. Our grocery bill went up by at least $100 per month upon diagnosis. _____’s diet is extremely important and we cannot scrimp on our food supply. We need small juice boxes and prepared and packaged sugar supplements in the case of hypoglycemia while at school. Also, the six small meals per day seem to be never ending. More packaged snacks are necessary for trips and to keep up with the demand of having high/low sugar snacks on hand. These are expensive items that we would not normally have purchased in our groceries. We also spend much more at the pharmacy than we would have thought. All of the equipment and supplies we have had to buy cost hundreds of dollars. We have a blood glucose meter (glucometer) at school, one at home, and a back-up meter in case of a meter breaking down or providing false readings. Each meter costs between $50-$100 but it is the best tool we have available to keep ______ healthy. It tells us what _____ can’t—is he/she in range, hypoglycemic or just napping, hyperglycemic or just being a brat? Its results help us to determine if he needs more insulin, less, or if he received just the right amount. While ______ is old enough to perform the 8-10 required blood glucose tests per day; he/she is too young to understand what the corresponding readings mean. This is task is often too overwhelming for many adults. For example, in order for ____ to attend preschool last year his/her mother had to also be present each day for the entire class. Despite the fact that the preschool teacher had been given extensive information on Type 1 Diabetes and _____’s care, she did not feel qualified to care for ______ in class. Now that _____ is in school full-time things are still not “normal” for him/her. When he/she goes to school, his/her first job is to wash his/her hands, test his/her blood glucose level and eat a snack. It does not matter that no one else is eating or that h/she may not be hungry. If he/she does not eat at the predetermined time his/her required snack, ____’s blood glucose level may plummet to dangerous levels. While the other children are getting ready to eat and play on the playground at recess, _____ prepares by lancing his/her finger to obtain more blood for another blood glucose test. This will allow his/her teacher to see if he is in a safe range to play on the playground or not. When lunchtime arrives, _____’s mother must be on hand to ensure that all of his/her lunch is eaten and to inject him with the required amount of insulin. ______ is too young right now to properly prepare the syringe, understand the importance of rotating injection sites, or figuring out his/her carbohydrate to insulin ratio. The school also does not have a full-time nurse to provide this service for him/her. Once _____ is old enough to care for him/herself and understand all that is involved, his/her mother will no longer have to be there to do these tasks for him/her. It is anticipated that he/she will be responsible enough for this by the time he/she reaches 14 years old. Our first priority for now is to ensure the proper care for ____ so that he/she grows up to be a healthy adult. Current research shows that this is most likely achieved through a regimen of tight control. In order to provide this kind of care one of us needs to be with him/her or available to him/her at all times. This is a 24-hour a day job. There is no respite. To date there is no known cure for Type 1 Diabetes. All we can do is hope to mimic the functions of the pancreas through multiple injections of insulin throughout the day and regular blood glucose testing. ______ will have to live with this disease for the rest of his/her life. We want to give him/her the best start possible by taking the time to teach him/her how to care for him/herself and follow his/her diet, testing, and insulin routine diligently. This is a very time consuming process as well as being mentally and physically exhausting. ____ cannot be sent to a birthday part, swimming or even to play at a friend’s house without careful preparation. He/She must bring his glucometer and extra snacks. We may need to plan for an extra insulin injection or have them work around his/her schedule, and an adult trained in his/her care must be present at all times. Life revolves around a clock. Meals must be eaten at specific times and all food must be measured and weighed to obtain its carbohydrate value. Unlike his/her older brother, ____ will not be able to sleepover at friends’ houses until he/she is much older. He/she needs to receive insulin injections and a carefully planned snack at 8:30 at night before he/she goes to bed. He/she then needs to be monitored throughout the night. _____’s lifestyle compared to other children his age is limited because of his condition. The psychological implication on a child with this disability is also a worry to us as parents. This is a difficult disease for parents to cope with but a 5-year-old has his/her own coping to do. When the other kids are buying treats for recess ____ can only bring them home for later because its not the right time for him/her to eat that type of food or too eat period. There is no ice cream on a whim, no going to a friend’s house without Mom or Dad hovering in the background. There is the lancing of fingers repeatedly throughout the day to monitor his/her blood glucose levels. There are the minimum of six injections of insulin per day to keep him/her alive. Currently _____ may not be in a wheelchair or have a physical impairment that can be seen by everyone but he/she does have a lot to deal with on a daily basis just to stay alive and healthy. We cannot let up on his/her routine for even a few hours without dangerous consequences. We hope that the parental support that we give him/her now when he/she is young will help him to cope with the psychological impact of this disease when he/she becomes a teen. We feel that if we have the financial assistance to make ourselves available to ____ at this young age that he/she will become more responsible for his/her own care as he/she gets older. When he/she is old enough to look after him/herself and give him/herself insulin injections we hope that the time we have spent with him/her and our diligent approach will benefit his/her lifetime health. We hope that you consider the Disability Tax Credit for____ and thank you for taking the time to read this application. Sincerely; Parents of __________ Notice of Objection
Name______________________________ A Day in the Life of ___________ Note: All data from the glucose levels and injections must be recorded.______ must be observed during snack and meal times to ensure that everything is consumed. 12 noon ___________ arrives at school, checks glucose level, ______ eats lunch under her/his supervision to ensure that there is no sharing of food with other children, computes carbohydrate to insulin ration, prepares syringe and gives injection. 2:00 p.m. Check glucose level, eat snack
TAX COURT OF CANADA BETWEEN: ____________APPELLANT - and - HER MAJESTY THE QUEEN RESPONDENT NOTICE OF APPEAL PART I - INTRODUCTION 1. XXXXXX (hereinafter the "Appellant"), is an individual residing at or near XXXXXXXXXXXXXX,XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXX, and whose mailing address is XXXXXXXXXX 2. The Appellant appeals to the Tax Court of Canada in respect of a reassessment by the Minister of National Revenue (the "Minister") of the Appellant's 2001 taxation year (the "Subject Taxation Year") under the Income Tax Act, R.S.C. 1985 (5th Supp.) c. 1, as amended (the "Act") as set forth in a Notice of Assessment dated November 4, 2002 (the "Assessment"). 3. The Appellant elects to have the Informal Procedure, provided by sections 18.1 to 18.28 of the Tax Court of Canada Act, applied to this appeal. PART II - FACTS 4. The Appellant states that the following sets forth the material facts relied upon for the purposes of the present appeal: (a) The Appellant is an individual, resident in XXXXXXXXXXXXXXX XXXXXXX XXXXXXXX XXXXXXXXXXXX XXXXXXXX XX XXXXXXXXXXXX (b) The Appellant is the father of XXXXXXXXXXXXXXXX, whose date of birth is XXXXXX, XXXX; (c) XXXXXXXXXXX was diagnosed with Type I (sometimes called Juvenile) Diabetes in 1992 and she/he has been insulin-dependant since that time. (d) Type1 Diabetes is a disease and there is currently no cure other than transplantation, a choice not offered to children or most adults. Insulin injection is the only therapy that reduces the effects and the mortality rate associated with the disease; (e) As with all types of diabetes, the metabolism of carbohydrates (including sugars such as glucose), proteins and fats is altered; (f) In Type I Diabetes, the beta cells no longer produce insulin. Insulin is required to allow glucose to enter blood cells to be used as fuel; (g) Without insulin and monitoring of XXXXX XXXXXXX blood sugars and the assessment of trends and adjustments in her/his insulin dosages, XXXXX will suffer hypoglycemia caused by too much insulin in her system and hyperglycemia caused by too little insulin in her system; (h) Without adequate insulin, glucose builds up in the bloodstream instead of going into the cells causing hyperglycemia; (i) When suffering from hyperglycemia the body is unable to use this glucose for energy, despite high levels in the bloodstream, leading to increased hunger; (j) With hyperglycemia, the high levels of glucose in the diabetic's blood causes the diabetic to urinate more which, in turn, causes excessive thirst; (k) When XXXXX XXXXX has hyperglycemia, it means she/he does not have enough insulin in her/his body and this can result in her/him being very thirsty, tired, have blurred vision, frequent urination and nausea; (l) Hyperglycemia increases the risk for all types of strokes (m) Without intervention and treatment for hyperglycemia caused by too little, or no insulin, XXXXX XXXXX can develop Diabetic ketoacidosis, a life-threatening complication of hyperglycemia; (n) Diabetic ketoacidosis, if untreated, is fatal; (o) With too much insulin in her/his body, XXXXX XXXXXXX blood glucose gets too low causing her/him to suffer from hypoglycemia. (p) When suffering from hypoglycemia, low levels of glucose in the body caused by too much insulin, the body does not have the energy required to function properly; (q) When XXXXX XXXXX suffers from mild – moderate hypoglycemia, or low blood sugar values, she/he feels weak, confused, irritable, hungry and tired; (r) Without intervention and/or treatment for hypoglycemia XXXXX XXXXX can develop severe hypoglycemia; (s) Severe hypoglycemia can cause unconsciousness, coma or convulsions; (t) In order to markedly reduce the frequency of hypoglycemic and hyperglycemic episodes XXXXX has suffered since developing Type 1 diabetes at the age of X XXXXXXXXXXX began insulin pump therapy in 1999. This therapy involves the use of an insulin infusion pump (“Infusion Pump Therapy” or “IPT”). She/He wears the insulin infusion pump seven days a week for more than 23 hours a day; (u) Insulin Pump therapy uses only rapid acting insulin; (v) Insulin Pump Therapy does not use cloudy insulin (NPH) which has drastically reduced the frequency of low to moderate hypoglycemic episodes that XXXXX suffered and to this date has prevented the onset of severe hypoglycemic episodes (w) XXXXX XXXXX has been using Insulin Pump Therapy since March of 1999; (x) The use of Insulin Pump Therapy has alleviated XXXXX XXXXXXX impairment caused by the frequency of hypoglycemic and hyperglycemic events while he/she was on multiple daily injection of multiple insulins. While undergoing insulin pump therapy XXXXX is not markedly restricted in her/his ability to perform basic activities of daily living; (y) The use of the insulin infusion pump, accompanied by frequent monitoring of blood glucose values provides the data required to read trends and make proper adjustments in insulin requirements; (z) The use of Insulin Pump Therapy has given XXXXX XXXXX the ability to maintain healthier blood glucose levels leading to better physical health; (aa) The use of Insulin Pump therapy has given XXXXX XXXXX more control over her disease alleviating the sense of hopelessness and helplessness; (bb) The insulin infusion pump (Insulin Pump Therapy) is attached to XXXXX XXXXXXX body by a length of tubing through which the insulin is delivered from the pump and into an infusion set; (cc) An infusion set consists of the tubing which runs from the reservoir of insulin in the insulin pump, an introducer needle which inserts a cannula under the skin and tape to keep it in place (much like an IV); (dd) A cannula is flexible Teflon tubing, approx 6mm long, which lies under the skin and disperses the insulin which is ‘pumped’ through the tubing which runs from the insulin reservoir contained in the insulin infusion pump. It has to be replaced and moved every 3-4 days; (ee) The insulin infusion pump is a medical device which requires the user to enter pertinent information about the users needs; This requires that the insulin infusion pump is regulated and set each day; (ff) The insulin infusion pump requires maintenance and is battery operated; (gg) Requires knowledge of its technical aspects and supplies which are necessary to use it properly; (hh) Requires knowledge and attention to the insulin requirements of the person with diabetes, which can change daily according to age, growth, illness, activity, stress, and other physiological and environmental effects. (ii) Insulin Pump Therapy is used to deliver insulin, subcutaneously, for three different reasons. Basal or background insulin, bolus insulin to cover carbohydrates which are ingested and correction doses to reduce high levels of glucose in the blood (hyperglycemia); (jj) Insulin Pump Therapy provides a system where XXXXX XXXXX receives minute doses of insulin automatically throughout the day to mimic what a healthy pancreas would provide if she were not diabetic. This is called basal insulin and her basal requirements can change depending on growth, illness, activity, stress, and other physiological and environmental factors; (kk) The amount of basal insulin required for XXXXX XXXXXX background insulin needs over a 24 hour period is manually entered into the insulin infusion pump and unless it is manually changed, will be delivered automatically on a continual 24 hour basis. (ll) Presently XXXXX XXXXX automatically receives minute doses of basal insulin approximately every 4 minutes resulting in approximately 360 doses of basal insulin over a 24 hour period; (mm) Insulin Pump Therapy provides a system where XXXXX XXXXX can receive insulin for carbohydrates she consumes during the day. This is called bolus insulin. Each time XXXXX XXXXX ingests carbohydrates she/he must manually enter, into the insulin pump, the amount of insulin the insulin pump must give her to convert the carbohydrates to glucose which is used as fuel by her blood cells. The requirements for each dose of bolus insulin varies depending on the amount of carbohydrates, the time of day, type of food, illness, activity, stress and other physiological and environmental factors; (nn) Presently XXXXX XXXXX receives, on the average, 10 bolus doses of insulin a day to convert carbohydrates to fuel each time she/he eats and drinks; (oo) Infusion Pump Therapy provides a system whereby XXXXX XXXXX can correct a high blood glucose reading by giving her/himself a correction dose. The amount of insulin required for a correction dose is arrived at by factoring in the glucose level and XXXXX XXXXXXX insulin sensitivity factor which is determined by her/his diabetes healthcare team.. This amount is then manually entered into her insulin pump for delivery. (pp) Presently, on average, XXXXX XXXXX requires 0-3 correction doses a day to maintain tight glucose control; (qq) Form T2201E(01) was filled out and certified by Dr. XXXXXXXXX XXXXXXXX on ___________; (rr) Dr. XXXXXXXX certified that the use of insulin pump therapy was life-sustaining therapy; (ss) For the Subject Taxation Year the Appellant claimed the Disability Tax Credit with respect to XXXXX XXXXXXX impairment; (tt) By Notice of Assessment dated ______________, the Minister disallowed the Appellant's Disability Tax Credit claim; (uu) On or about ___________________, the Appellant duly filed a Notice of Objection with respect to the subject taxation year within the time prescribed by subsection 165(1) of the Income Tax Act; (vv) By way of letter dated ____________, the Minister issued a Notice of Confirmation with respect to the disallowance of the Appellant's claim for the Disability Tax Credit in respect to XXXXX XXXXX, his dependant; (ww) The Appellant appeals to the Tax Court in response to the Minister's Notice of Confirmation and the Notice of Assessment dated ____________; (xx) The Appellant filed his ______ Tax Return and did not claim the Disability Tax Credit in respect to XXXXX XXXXXXX disability as he was advised by representatives of the Minister on the basis that the claim had been disallowed for the subject taxation year. PART III - ISSUES 5. The Minister erred in disallowing the Disability Tax Credit claimed with respect to the Appellant’s dependant’s impairment for the Subject Taxation Year. PART IV - STATUTORY PROVISIONS 6. The Appellant relies upon the following statutory provisions: (a) Subsection 118.3 and, more specifically, 118.3(1)(a.1) of the Act; and (b) Such other statutory provisions as the Appellant may advise. PART V - GROUNDS FOR APPEAL 7. The Appellant intends to rely upon the following reasons for the purposes of the present appeal: (a) The Appellant submits that the claim for the Disability Tax Credit with respect to his dependant's impairment is correct; (b) The Appellant claims under provision of the Act in force for the year 2000 and subsequent on the basis that, in the absence of insulin therapy, his daughter's basic activities of daily living would be markedly restricted; In fact, his daughter would die; (c) That the use of Insulin Pump Therapy is therapy within the meaning of the Act; d) That Insulin Pump Therapy is essential for sustaining vital functions of XXXXX XXXXX. Namely, the therapy when used properly, drastically reduces her chances of severe hypoglycemia and diabetic ketoacidosis; (e) Insulin Pump Therapy requires that the mechanism be physically attached to XXXXX XXXXX for almost 24 hours a day, seven days a week and that, while attached to XXXXX XXXXX, it automatically administers .1 units of basal (background) insulin every 4 minutes equaling ± 360 injections of insulin continuously over each 24 hour period. (f) Insulin Pump Therapy requires that the mechanism be physically attached to XXXXX XXXXX when she/he delivers a bolus dose of insulin to cover any carbohydrates she ingests during the day. This amount of insulin required is manually entered into the pump by pushing the buttons. The pump then delivers the required insulin over a period of time (g) Insulin Pump Therapy requires that the mechanism be physically attached to XXXXX XXXXX when she requires a correction bolus of insulin in order to lower blood glucose levels when they are out of acceptable range. (h) The use of Insulin Pump Therapy cannot reasonably be expected to be of significant benefit to a person without Type I or Type II Diabetes; and (i) Such other grounds as the Appellant may advise and this Honourable Court may allow. PART VI - RELIEF SOUGHT 8. The Appellant seeks the following relief from this Honourable Court: (a) that the Notice of Assessment for the Subject Taxation Year be referred back to the Minister for further reassessment on the basis that: A. The Appellant is entitled to claim the Disability Tax Credit pursuant to subsection 118.3 of the Act with respect to the Appellant's dependant, XXXXX XXXX XXXXX; and B. Such further and other relief as this Honourable Court may allow, including the costs of the Appeal. 9. The Appellant requests that this appeal be heard in XXXXXXX XXXXXXXXXXXXX
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Below
are examples of letters that have been used by other families applying
for the DTC