Tuesday, 6 January 2009

Canada: family's success in funding appeal

Congratulations, and thanks for the information

The document below, written by two Canadian parents who have sucessfully appealed against a negative funding decision, has been released for wider public benefit. Strict confidentiality has been requested. Nevertheless other families in similar situations might still find this 'sanitised' version of events a rich source of inspiration.

The document is reproduced in its entirety.

Medical Expense Appeal

RE: SIN:

FACTS:

Disabled Child (date of birth, 199_), biological daughter of parent and parent, was diagnosed with Cerebral Palsy at birth. She died while in uterus and was revived after being removed via C-Section. She has extensive and severe brain damage. She is hearing impaired, speech impaired, physically impaired, mentally impaired learning impaired and visually impaired. There is no doubt that she qualifies for the Disability Tax Credit and this has been claimed from 199_ onward. So there is no question that she is a disabled person.

In 2006, Disabled Child was enrolled into a 4 week Conductive Education program at the Movement Centre of Manitoba. The cost of the program and the costs involved with traveling to the program were claimed as a medical expense on parent’s 2006 T1 Personal Income Tax Return.

On ___, 2007, CRA’s Processing Review Section sent a letter requesting further detailed information on the medical expense claim. On ___, 2007 the requested information was sent in and included a detailed spreadsheet showing how travel expenses were calculated (based on CRA’s set meal and mileage rates), physician’s letter, detailed list of medical receipts and copies of the receipts.

On ____, 2008 the Processing Review Section returned the information. That letter indicated the claim for Massage and Acupuncture would not be allowed as they are not medial practioners in Saskatchewan. We are not disputing this disallowance. However, they also disallowed all claims related to Disabled Child’s attendance at the Movement Centre of Manitoba. The letter states “-There is no indication in the documents you submitted that the institution provides special equipment, facilities or personnel for the care or care and training of a person suffering from a physical or mental handicap. We have therefore disallowed your claim for expenses paid to Movement Centre of Manitoba. We have also disallowed the travel expenses incurred for these treatments.” In the original request for information, there was absolutely NO request for this specific information. No telephone or mail contact was ever made to request this additional information. I contacted the Processing Review Section to see if this could be resolved without going through the Notice of Objection appeal and was told that they would not review any further information and a T400A Notice of Objection was my only option. So I am appealing this decision.

According to the ____, 2008 letter, “There is no indication in the documents you submitted that the institution provides special equipment, facilities or personnel for the care or care and training of a person suffering from a physical or mental handicap”. The government of Canada has already acknowledged the special training skills of the individuals that provide the Conductive Education program at the Movement Centre of Manitoba. The term Conductive Education is a registered trademark owned by the Canada March of Dimes. In order to use the term Conductive Education, the instructors (Conductors) must be properly certified and have a 4 year degree specializing in Conductive Education. Human Resources and Social Development Canada (HRSDC), Service Canada (SC) and Citizenship and Immigration Canada (CIC) all acknowledge that Conductive Education providers have specialized training. HRCSD, SC and CIC regularly issues working visas to these individuals to work in Canada. There are a very limited number of Canadian Conductive Education providers working in Canada, so the majority of specially trained workers must obtain working visas and meet ALL of the federal requirements to work in Canada. HRDC, SC and CIC will not issue a working visa to a foreign worker unless these requirements are met and the employer receives a positive Labour Market Opinion. The Ontario March of Dimes has documented to CIC that Conductive Education requires specially trained staff and there are a very limited number of individuals in Canada who are qualified to provide this program. The Movement Centre of Manitoba also has to follow the same process to hire their highly trained and properly certified staff. So without a doubt, the Movement Centre of Manitoba does meet the requirement of having special personnel for the care and training of a person suffering from a physical or mental handicap. Conductors are trained in neurology, disability, physiology, psychology, rehabilitation and motor learning and they work together, with the participant, to build on their skills and help them develop ways of controlling the effects of the condition.

As for the use of specialized equipment, the Movement Centre has custom built equipment that is required for the facilitation of the program. This equipment is an integral part of the program as the children use the polyvalent equipment to assist with mobility and strengthening exercises. The specialized tables, chairs and walking ladders are not available in traditional therapeutic programs (such as Occupational or Physical Therapy) and should meet the requirement for specialized equipment as you can not purchase these items from any special needs equipment store.

There doesn’t appear to be any question as to whether this type of therapy or a similar therapy can be obtained within 40 kms from the home community. But, just to set your mind at ease, we are allocated 45 minutes of Physical Therapy every 30 – 90 days and can not obtain a therapeutic intervention that lasts 6 hours a day 5 days a week. We also can not obtain Occupational Therapy through the hospital system as our daughter is over the age of 5. Private Occupational Therapists are also unwilling to provide 6 hours of service per day. So the Conductive Education program offered by the Movement Centre of Manitoba is a very unique and intensive therapeutic program.

What is Conductive Education?

The Conductive Education program provided by the Movement Centre is an intensive therapeutic training program that is offered in Canada to physically and mentally disabled children and adults who have suffered from stroke or other brain injury. This program is offered in several provinces, however not in Saskatchewan. The closest available centre that operates during the summer months is in Winnipeg Manitoba. The next closest centre is offered by the March of Dimes of Canada in Ontario.

Conductive education is a unique system of teaching and learning for children with motor disorders such as cerebral palsy. It is designed to improve motor skills and increase independence of many aspects of common living. It is not a cure, but a method of exercises which are broken down into basic functional movements. The exercises are performed intensively (6 hours per day, 5 days per week) in small groups which promotes interactivity.

Conductive Education is a repetitive teaching program where basic skills are taught over and over until the child can master the basic skill. Conductive Education was developed by Dr. Andras Peto at the Petö Institute in Hungary over 40 years ago and has now been widely established in Hungary, United Kingdom, United States, Canada, Germany, Australia, Israel, and many other countries.

Conductive Education as the name suggests, is an educational approach to therapy. Its aim is to help children and adults with motor disorders learn to overcome problems of movement as a way of enabling them to live more active and independent lives. They teach children the movements required to sit, crawl, stand, walk, use stairs, feed, dress, toilet, etc. These are basic living skills required for a person to become independent.

Conductive Education is a form of special education rehabilitation for children and adults with motor disorders. It is appropriate for conditions where disease or damage to the central nervous system affects a person's ability to control movement. In childhood these conditions include cerebral palsy and dyspraxia, and in adulthood, Parkinson's, multiple sclerosis, cerebral palsy and those who have had a stroke or head injury.

Conductive Education (more properly conductive pedagogy) has been chiefly directed towards what it terms ‘motor disorders’, that is problems of coordinating and controlling movements, resulting from disease or damage to the central nervous system. It may be provided, in age-appropriate adaptations, for people of all ages and whatever the age at which the condition began, from the first years of life right across the age-span to the frailty of old age.

The fundamental tenet of conductive pedagogy for motor disorders is to address problems that may arise from motor disorders as problems of learning, coupled with an underlying assumption that everyone is capable of learning if appropriately taught; problems of learning are therefore construed as problems of teaching. There may be potentially many pedagogies through which to address such problems: conductive pedagogy has currently gained a small foothold in most of the advanced economies, part of a worldwide conductive movement.

In adulthood Conductive Education is provided for people who have experienced a range of conditions, including Parkinson’s, multiple sclerosis and the after-effects of head injuries and strokes. In childhood, the most commonly served conditions are the cerebral palsies.

Precedents

Mr Gordon and Dr. Valerie Hildebrand

  • In 1999 the taxpayers appealed a decision to disallow a medical expense claim for Conductive Education at the Movement Centre of Manitoba. This appeal was allowed, the original decision overturned, and they were allowed to claim the therapy as a medical expense. Mr. Gordon and Dr. Hildebrand were successful in proving that Conductive Education is indeed a therapeutic intervention.
Similar to this case:
  • Disabled Child also attended the Movement Centre of Manitoba and the expenses incurred for this therapy were also claimed as a medical expense.
Tax Court Case Docket 2005-437(IT)
Erin P. Patton vs. Her Majesty the Queen
October 5, 2005

Similar to this case,

  • Disabled Child also has learning disabilities along with physical disabilities. Disabled Child attended the Movement Centre of Manitoba’s Conductive Education program in 2006 to assist her in overcoming her disabilities.
  • As in this case, parent claimed a medical expense tax credit for the fees paid for her daughter to attend the program and the cost associated with travel to obtain the program benefits.
  • Disabled Child’s doctor also recommended Disabled Child would benefit by attending the Movement Centre of Manitoba and considered it to be a legitimate medical expense. Doctor said participation in the program was NECESSARY and REQUIRED.
  • Conductive Education is also based on a therapeutic teaching model designed to treat medical conditions. Each participant is assessed prior to being approved/denied access to the program by a qualified Conductor.
  • Conductive Education is an intensive program used to develop new movement patterns and problem solving approaches so each participant can learn how to develop solutions to their individual movement challenges.
  • Conductive Education is based on the ongoing need for intervention with a neurologically impaired person. It takes into consideration the plasticity of the brain and the rehabilitation of neuromotor dysfunction.
  • As with this case, we also would expect CRA to apply a ‘large and liberal interpretation and that the services should not be restricted simply to those provided by a medical practitioner”

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