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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