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Diabetes
Advocacy
Le 25 janvier 2004
In recent correspondence
with the Honourable Minister John Efford, I was told of the existence
of your committee. I would therefore like to take this opportunity
to submit to you some of the concerns we have regarding the current
Disability Tax Credit as it relates to those living with Type One
Diabetes.
Our main concern of course
is the inconsistency of the decisions being made by the CCRA. The
credit is being given to a child in Quebec and denied a child requiring
the same care in Nova Scotia. As this is a federal credit, one would
expect that a condition that qualifies as valid for the DTC in one
part of the country would also qualify in another part of the country.
Those people refused
the tax credit are sent a form letter stating that they may appeal
the decision. The form letter does not go into any specifics regarding
their case. If these people then decide to make an appeal and are
again denied, another form letter is again sent. The reason this
time may be far different than in the original letter. How are the
applicants to adequately defend their position if they are not properly
informed as to what they have to further explain?
People who apply for
this credit all must have a medical doctor certify that the patient
meets the criteria outlined in Form T2201 for the DTC. One is left
to wonder why the certification of one doctor seems to take precedent
over another? Why is it that a doctor in Manitoba who signs the
DTC for a patient is agreed with and a doctor in British Columbia
who has also certified their patient eligible for the DTC is not?
There must be specific
standards either in care required or in diseases that qualify. Currently
the DTC has two criteria in which people living with Type One Diabetes
meet. They do have a physical impairment, which causes them to be
markedly restricted in any of the basic activities of daily living.
These people have a pancreas that no longer produces insulin. Without
insulin, the body can no longer convert glucose into energy to be
used by the cells. Without insulin, as seen in the criminal case
of R vs Tutton (1989), a person dies. The task of figuring out how
much insulin a body needs to survive is extremely difficult and
dependent on a variety of factors including stress, food composition,
illness, growth, and more. Trying to maintain "normal"
blood glucose control in a person with Type One Diabetes is like
trying to drive a car down a windy road from the backseat using
two elastic bands.
When too much insulin
is given, the person becomes hypoglycaemic. They are shaky. They
become weak. They cannot properly think. They are in danger of losing
consciousness, having a seizure, or even dying if left unattended.
Too much insulin can be given if one is not aware how slowly food
will be absorbed or if there is unanticipated physical activity
for example.
When too little insulin
is given, the person is said to be hyperglycaemic. In this case,
they experience headaches and nausea. They may have to use the washroom
more often. If this happens at night, they may be incontinent. They
may also be disoriented and not be able to perform simple tasks.
People living with Type
One Diabetes also meet the criteria of requiring over 14 hours per
week to perform life-sustaining therapy. The American Pediatric
Association lists insulin therapy as life- sustaining therapy. In
order to attempt to mimic the normal functioning of a pancreas,
multiple doses of insulin must be prepared each day, the blood glucose
level must be monitored from 7-12 times per day, food must be weighed,
and all of this data must be logged and examined daily to spot trends
and adjustments that must be made to the insulin regimen. A person
with Type One Diabetes or their caregiver must be prepared to do
these tasks 24 hours per day as hyper- and hypoglycaemic episodes
do not only occur during waking hours.
Again, despite meeting
at least two of the three listed criteria on Form T2201 and despite
the testimony of qualified physicians many applicants are left frustrated
by the process. There have been cases of people with Type One Diabetes
applying, appealing, and having to take their application to Tax
Court, winning their case one year and being denied their application
the following year. Where is the consistency in dealing even with
the same person?
As your committee is
proof, tax credits for those with disabilities must be reformed.
It is unfair to ask that along with fighting to stay healthy, they
must fight to help pay for the medical supplies that they need.
If they do not receive the tax credit initially, they must be prepared
to obtain a lawyer and find willing witnesses to further their case
before the courts. This must be changed.
Thank you for your time.
Sincerely,
Barbra Marche
Mother to Liam 6 years old diagnosed with Type One Diabetes at 2
www.diabetesadvocacy.com
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