8 April 1997 Internal T.I. 9700607 - MEDICAL EXPENSE - SOCIAL WORKER

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.

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the Department.

Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle du ministère.

Principal Issues:

Whether payment to a Certified Social Worker in Ontario can be considered as a payment to a medical practitioner.

Position:

No

Reasons:

To qualify as a medical practitioner in a jurisdiction, that particular jurisdiction must authorize a person to practice. There is no such authority in Ontario

		April 8, 1997

	Ms Doris Atkinson                	Technical Review and
	Client Services Division         	Remissions Section
	Hamilton Tax Services Office     	Jacques E. Grisé
	                                 	957-2059

		970060

Medical Expenses - Social Worker

This is in reply to your memorandum of January 6, 1997 in which you recommend that payments to a Certified Social Worker in Ontario should be considered a medical expense pursuant to paragraph 118.2(2)(a) of the Income Tax Act for the purpose of the medical expense credit in subsection 118.2(1) of the Act.

Paragraph 118.2(2)(a) of the Act states that a medical expense of an individual is 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 states, inter alia, that for the purposes of 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, "where the reference is used in respect of a service rendered to a taxpayer, pursuant to the laws of the jurisdiction in which the service is rendered." To the extent that expenditures are described within the above comments, they would be regarded as medical expenses.

In order for the fees paid to a Certified Social Worker of Ontario to be eligible medical expenses, the social worker must be considered a "medical practitioner" and the fees must be in respect of medical services. Pursuant to subsection 118.4(2) of the Act, to be considered a medical practitioner, the social worker must be authorized to practice as such pursuant to the laws of the jurisdiction in which the service is provided. The jurisdiction in this case is the province of Ontario. It is our understanding that a Certified Social Worker of Ontario is not currently recognized under the Regulated Health Professions Act, 1991 or any other Act of Ontario governing the practice of health care generally. As a result, it is our view that Certified Social Workers of Ontario do not fit within the definition of a medical practitioner for purposes of the Income Tax Act.

We previously dealt with a request to classify, as medical expenses, payments to social workers who are members of la Corporation professionnelle des travailleurs sociaux du Québec. The Professional Code of Quebec sets out the professional activities that may be engaged by the member of la Corporation professionnelle des travailleurs sociaux du Québec. The activities are: "assist persons, families, groups or communities with a view to improving their social activity." We opined that such activities would not be similar to those undertaken by a medical practitioner.

The Ontario College of Certified Social Workers' Code of Ethics sets out the purpose of social work as:

"Social work is a profession committed to the goal of effecting social changes in society and the ways in which individuals develop within their society for the benefit of both. Advancement toward this purpose is achieved through the complementarity of social reform and therapeutic approaches premised in the belief that social conditions of humanity can be bettered.

The practice of social work has a primary focus on patterns of psychosocial relationships between people and the socioeconomic resources, services and opportunities of their respective societies. The functions of social work include helping people to develop individual and collective social problem-solving skills; enhancing self-determination and the adaptive and developmental capacities of people; advocating, promoting and acting to obtain socially just distribution of societal resources and facilitating social connections between people and their societal resources."

In our view, the above activities would not be similar to those carried on by a medical practitioner.

On the basis of the above, we are not prepared to allow the payment to social workers as medical expenses except where the social workers are working in a recognized mental health clinic, community agency or hospital and they are members of the association governing their particular profession and the treatment is at the request of or in association with a medical practitioner.

Please call Jacques Grisé should you wish to discuss the above.

John F. Oulton
Section Chief
Business and Publications Division
Income Tax Rulings and
Interpretations Directorate
Policy and Legislation Branch

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