7 May 2007 External T.I. 2007-0224311E5 - Medical Expense - Therapist

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the CRA.
Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'ARC.

Principal Issues: Is a therapist providing a combination of Christian and native healing processes considered a medical practitioner for purposes of the medical expense tax credit?

Position: No.

Reasons: Payments for native and Christian healing would not qualify as a medical expense unless the services were performed by a medical practitioner authorized to practice as such according to the laws of the jurisdiction in which the service is rendered.

									2007-022431
XXXXXXXXXX 								J. Eckler
(416) 952-8930
May 7, 2007

Dear XXXXXXXXXX:

Re: Medical Expense Tax Credit - Therapist

We are writing in reply to your letter of February 5, 2007, wherein you asked whether payments to a therapist employing a combination of Christian and native healing processes would be eligible for the medical expense tax credit.

The situation outlined in your letter appears to relate to a factual one, involving a specific taxpayer. It is not this Directorate's practice to comment on proposed transactions involving specific taxpayers other than in the form of an advanced income tax ruling. For more information about how to obtain a ruling, please refer to Information Circular 70-6R5, "Advanced Income Tax Rulings, dated May 17, 2002. This Information Circular and other CRA publications can be accessed on the internet at http://www.cra-arc.gc.ca. Should your situation involve a specific taxpayer and a completed transaction, you should submit all relevant facts and documentation to the appropriate Tax Services Office ("TSO") for their views. A list of TSOs is available on the "Contact Us" page of the CRA website. Although we cannot comment on your specific situation, we are prepared to provide the following general comments, which may be of assistance.

Our Comments

Subsection 118.2(2) of the Income Tax Act (the "Act") provides a list of the types of expenditures, which qualify as medical expenses for the purposes of the medical expense tax credit. Paragraph 118.2(2)(a) of the Act states that a medical expense of an individual includes an amount paid "to a medical practitioner, dentist or nurse or a public or licensed private hospital in respect of medical or dental services." Paragraph 118.4(2)(a) of the Act provides that, for the purposes of section 118.2 of the Act, a reference to a medical practitioner, dentist, pharmacist, nurse or optometrist is a reference to a person authorized to practice as such, according to the laws of the jurisdiction in which the service is rendered. To the extent that expenditures meet the requirements of the Act, as described above, they would be regarded as medical expenses.

We refer you to paragraphs 2 and 3 of Interpretation Bulletin IT-519R2 (Consolidated), Medical Expense and Disability Tax Credits and Attendant Care Expense Deduction. As noted, a medical practitioner may, depending upon the laws of the jurisdiction in which the service is provided, include a therapeutist (also referred to as a therapist). The reference in paragraph 3 of IT-519R2 (Consolidated) to a therapeutist, or therapist, is a general reference to a number of different health professionals, to whom payments may be considered to be amounts paid to a medical practitioner for medical services. For example, in the province of Ontario, a "therapist" includes those therapists governed by the Regulated Health Professions Act, 1991. These therapists include speech-language pathologists (a protected title under the Audiology and Speech-Language Pathology Act, 1991, as is the title "speech therapist"), denture therapists (a restricted title under the Denturism Act, 1991), massage therapists (a restricted title under the Massage Therapy Act, 1991), an occupational therapist (protected title under the Occupational Therapy Act, 1991), a respiratory therapist (protected title under the Respiratory Therapy Act, 1991) and a physiotherapist(protected title under the Physiotherapy Act, 1991). Each of these health professionals is authorized to practice in the province of Ontario in accordance with the provisions of the Regulated Health Professions Act, 1991, and the relevant Act respecting the regulation of the specific health profession.

The post-amble in paragraph 3 of IT-519R2 (Consolidated) provides that a "nurse" includes a practical nurse whose full-time occupation is nursing as well as a Christian Science nurse authorized to practice according to the relevant laws referred to in subsection 118.4(2). However, this does not mean that all Christian Science practitioners and nurses automatically qualify. Whether a Christian Science practitioner or nurse will qualify as a medical practitioner or nurse will depend upon whether there is legislation in the relevant province or other jurisdiction that authorizes Christian Science practitioners or nurses to practice as "medical practitioners" or "nurses". Your correspondence indicates that your client was a Registered Nurse, and so it appears that she is no longer a Registered Nurse. Our comments will therefore be confined to the issue of a non-registered nurse or a therapist practicing a combination of Christian and native healing.

It is our understanding that native and Christian healing therapists are not authorized under the laws of Ontario as medical practitioners. Therefore, a fee paid to such a therapist in Ontario is not considered to be an expenditure, which qualifies as a medical expense for purposes of the medical expense tax credit. If you have a question as to whether a particular province or other jurisdiction authorizes a person or class of persons to act as medical practitioners or nurses, you should contact the relevant province or jurisdiction responsible for such matters.

We trust our comments will be of some assistance.

Yours truly,

Gwen Moore
for Director
Business and Partnerships Division
Income Tax Rulings Directorate
Legislative Policy and Regulatory Affairs Branch