Definitions for the disability tax credit

Basic activities of daily living

The basic activities of daily living are:

• speaking;
• hearing;
• walking;
• elimination (bowel or bladder functions);
• feeding;
• dressing; and
• performing the mental functions necessary for everyday life.

Blind

See vision.

Certified in writing

Certified in writing means that a qualified practitioner must write a prescription or a note that states the requirement for the patient.

Cumulative effect of significant restrictions (for 2005 and later years)

Cumulative effect of significant restrictions means that :

• a person is significantly restricted in two or more basic activities of daily living or in vision and at least one of the basic activities of daily living even with appropriate therapy, medication, and devices;
• these significant restrictions exist together all or substantially all the time; and
• the cumulative effect of these significant restrictions is equivalent to being markedly restricted in a single basic activity of daily living.

Note
Life-sustaining therapy cannot be combined with any of the basic activities of daily living.

Examples of cumulative effects equivalent to being markedly restricted in a basic activity of daily living (examples are not exhaustive):

• A person can walk for 100 metres, but then must take time to recuperate. He or she can perform mental functions necessary for everyday life, but can concentrate on any topic for only a short period of time.
• A person always takes a long time for walking, dressing, and feeding.

Dressing

A person is considered markedly restricted in dressing if, all or substantially all the time, he or she is unable or requires an inordinate amount of time to dress himself or herself, even with appropriate therapy, medication, and devices.

 

Notes
Dressing oneself does not include identifying, finding, shopping for or otherwise procuring clothing.

Devices for dressing include specialized buttonhooks, long-handled shoehorns, grab rails, safety pulls, and other such devices.

Examples of markedly restricted in dressing (examples are not exhaustive):

• The person cannot dress without daily assistance from another person.
• Due to pain, stiffness, and decreased dexterity, the person requires an inordinate amount of time to dress on a daily basis.

Elimination (bowel or bladder functions)

A person is considered markedly restricted in elimination if, all or substantially all the time, he or she is unable or requires an inordinate amount of time to personally manage bowel or bladder functions, even with appropriate therapy, medication, and devices.

 

Note
Devices for elimination include catheters, ostomy appliances, and other such devices.

Examples of markedly restricted in elimination (examples are not exhaustive):

• The person needs the assistance of another person to empty and tend to his or her ostomy appliance on a daily basis.
• The person is incontinent of bladder functions all or substantially all the time, and requires an inordinate amount of time to manage and tend to his or her incontinence pads on a daily basis.

Feeding

A person is considered markedly restricted in feeding if, all or substantially all the time, he or she is unable or requires an inordinate amount of time to feed himself or herself, even with appropriate therapy, medication, and devices.

 

Notes
Feeding oneself does not include identifying, finding, shopping for or otherwise procuring food.

Feeding oneself does include preparing food, except when the time associated is related to a dietary restriction or regime, even if the restriction or regime is required due to an illness or health condition.

Devices for feeding include modified utensils, and other such devices.

Examples of markedly restricted in feeding (examples are not exhaustive):

• A person requires tube feedings, all or substantially all of the time.
• A person requires an inordinate amount of time to prepare meals or to feed himself or herself on a daily basis, due to significant pain and decreased strength and dexterity of upper limbs.

Hearing

A person is considered markedly restricted in hearing if, all or substantially all the time, he or she is unable or takes an inordinate amount of time to hear so as to understand another person familiar with the patient, in a quiet setting, even with the use of appropriate devices.

 

Note
Devices for hearing include hearing aids, cochlear implants, and other such devices.

Examples of markedly restricted in hearing (examples are not exhaustive):

• A person must rely completely on lip reading or sign language, despite using a hearing aid, to understand a spoken conversation all or substantially all of the time.
• To be understood, it is necessary for the speaker to raise his or her voice and repeat words and sentences several times, and it takes an inordinate amount of time for the person to understand, despite the use of a hearing aid.

Inordinate amount of time

An inordinate amount of time means that an activity takes significantly longer than for an average person who does not have the impairment.

Life-sustaining therapy

Life-sustaining therapy must meet both of the following conditions:

• The therapy is required to support a vital function, even if it alleviates the symptoms.
• The therapy is needed at least 3 times per week, for an average of at least 14 hours a week.
  

Notes
A person must dedicate the time for the therapy-that is, the person has to take time away from normal, everyday activities to receive it. If the person receives therapy by a portable device, such as an insulin pump, or an implanted device, such as a pacemaker, the time the device takes to deliver the therapy does not count towards the 14-hour per week requirement. However, the time he or she spends setting up a portable device does count.

Do not include activities such as following a dietary restriction or regime, exercising, travelling to receive the therapy, attending medical appointments (other than appointments where the therapy is received), shopping for medication, or recuperating after therapy.

 

For 2005 and later years, life-sustaining therapy includes a regular dosage of medication that needs to be adjusted on a daily basis. The activities directly related to determining dosage are considered part of the therapy, except activities related to exercise, or following a dietary regime such as carbohydrate calculation.

The time spent by a primary caregiver performing and supervising activities related to the therapy of a child because of his or her age can be counted toward the 14-hour per week requirement.

Examples of life-sustaining therapy (examples are not exhaustive):

• Chest physiotherapy to facilitate breathing
• Kidney dialysis to filter blood

Markedly restricted

A person is markedly restricted if, all or substantially all the time, they are unable (or it takes them an inordinate amount of time) to perform one or more of the basic activities of daily living, even with therapy (other than life-sustaining therapy) and the use of appropriate devices and medication.

Mental functions necessary for everyday life

A person is considered markedly restricted in performing the mental functions necessary for everyday life (described below) if, all or substantially all the time, he or she is unable or requires an inordinate amount of time to perform them by himself or herself, even with appropriate therapy, medication, and devices (for example, memory aids and adaptive aids).

Mental functions necessary for everyday life include:

• adaptive functioning (for example, abilities related to self-care, health and safety, abilities to initiate and respond to social interaction, and common simple transactions);
• memory (for example, the ability to remember simple instructions, basic personal information such as name and address, or material of importance and interest); and
• problem-solving, goal-setting, and judgment, taken together (for example, the ability to solve problems, set and keep goals, and make appropriate decisions and judgments).

Note
A restriction in problem-solving, goal-setting, or judgement that markedly restricts adaptive functioning all or substantially all the time would qualify.

Examples of markedly restricted in mental functions necessary for everyday life (examples are not exhaustive):

• A person is unable to leave the house all or substantially all the time due to anxiety, despite medication and therapy.
• A person is independent in some aspects of everyday living. However, despite medication and therapy, he or she needs daily support and supervision due to an inability to accurately interpret his or her environment.
• A person is incapable of making a common simple transaction, such as a purchase at the grocery store, without assistance all or substantially all the time.
• A person experiences psychotic episodes several times a year. Given the unpredictability of the psychotic episodes and the other defining symptoms of his or her impairment (for example, avolition, disorganized behaviour and speech), the person continues to require daily supervision.
• A person is unable to express needs or anticipate consequences of behaviour when interacting with others.

Prolonged

An impairment is prolonged if it has lasted, or is expected to last, for a continuous period of at least 12 months.

Qualified practitioner

The table below lists the qualified practitioners and which type of impairment each can certify.

Qualified practitioner	Can certify:
Medical doctor	all impairments
Optometrist	vision
Audiologist	hearing
Occupational therapist	walking, feeding, dressing, and the cumulative effect for these activities
Physiotherapist	walking
Psychologist	mental functions necessary for everyday life
Speech-language pathologist	speaking

Significantly restricted

Significantly restricted means that although the person does not quite meet the criteria for markedly restricted, his or her vision or ability to perform a basic activity of daily living is still substantially restricted.

Speaking

A person is considered markedly restricted in speaking if, all or substantially all the time, he or she is unable or takes an inordinate amount of time to speak so as to be understood by another person familiar with the patient, in a quiet setting, even with appropriate therapy, medication, and devices.

Note
Devices for speaking include tracheoesophageal prostheses, vocal amplification devices, and other such devices.

Examples of markedly restricted in speaking (examples are not exhaustive):

• A person must rely on other means of communication, such as sign language or a symbol board, all or substantially all of the time.
• A person must be asked to repeat words and sentences several times, and it takes a significant amount of time to make himself or herself understood.

Vision

A person is considered blind if, even with the use of corrective lenses or medication:

• visual acuity in both eyes is 20/200 or (6/60) or less, with the Snellen Chart (or an equivalent); or
• the greatest diameter of the field of vision in both eyes is 20 degrees or less.

Walking

A person is considered markedly restricted in walking if, all or substantially all the time, he or she is unable or requires an inordinate amount of time to walk even with appropriate therapy, medication, and devices.

 

Note
Devices for walking include canes, walkers, and other such devices.

Examples of markedly restricted in walking (examples are not exhaustive):

• A person must always rely on a wheelchair outside the home, even for short distances.
• A person can walk 100 metres (or approximately one city block), but only by taking an inordinate amount of time, stopping because of shortness of breath or because of pain, all or substantially all of the time.
• A person experiences severe episodes of fatigue, ataxia, lack of co-ordination, and problems with balance. These episodes cause the person to be incapacitated for several days at a time, in that he or she becomes unable to walk more than a few steps. Between episodes, the person continues to experience the above symptoms, but to a lesser degree. Nevertheless, these symptoms cause him or her to require an inordinate amount of time to walk all or substantially all of the time.