Revenue Canada Self-Assessment Questionnaire
This questionnaire is provided by Revenue Canada to help you assess whether individuals may be eligible for the disability tax credit. We have modified it for you to use as a guide to determine whether your child may be eligible. Please contact Revenue Canada directly if you have any questions.
- Has your impairment in physical or mental functions lasted, or is it expected to last, for a continuous period of at least 12 months?
If you answered yes, answer Questions 2 to 5 below.
If you answered no, you are probably not eligible for the disability amount. For you to claim the disability amount, the impairment has to be prolonged (see the definition on the next page).
- Are you blind? ________ yes _______ no
- Do you receive life-sustaining therapy (see the definition below)?
- Do the effects of your impairment cause you to be markedly restricted (see the definition on the next page) in one of the following basic activities of daily living? _______yes _______no
- Speaking - hearing - walking - elimination (bowel or
- Feeding - dressing - mental functions
necessary for everyday life
- Do you meet all the following conditions?
- because of your impairment, you are significantly restricted (see the definition on the next page) in two or more basic activities of daily living mentioned in question 4, or you are significantly restricted in vision and at least one of the basic activities of daily living mentioned in question 4, even with appropriate therapy, medication, and devices;
- these significant restrictions exist together, all or substantially all the time; and
- the cumulative effect of these significant restrictions is equivalent to being markedly restricted (see the definition of "markedly restricted" on the next page) in a single basic activity of daily living.
Are you eligible for the disability amount?
If you answered yes to Question 1 and to any one of Questions 2 to 5, you may be eligible for the disability amount. To apply for the disability amount, please contact Revenue Canada.
If you answered no to all of Questions 2 to 5, you are probably not eligible for the disability amount. For you to be eligible for the disability amount, you have to answer yes to at least one of these questions. Even if you cannot claim the disability amount, you may have expenses you can claim on your income tax return. For more information, see Guide RC4064, Medical and Disability-Related Information.
Life-sustaining therapy (for 2000 and later years) – Life-sustaining therapy must meet the following conditions:
- You receive the therapy to support life, even if it alleviates the symptoms. Examples of this therapy are chest physiotherapy to facilitate breathing and kidney dialysis to filter blood. However, implanted devices such as a pacemaker, or special programs of diet, exercise, or hygiene do not qualify.
- You have to dedicate time for this therapy—at least 3 times a week, for an average of at least 14 hours a week (do not include time needed to recuperate after therapy, for travel, medical appointments, or shopping for medication). Time dedicated to therapy means that you must be required to take time away from normal, everyday activities in order to receive the therapy. The time it takes for a portable or implanted device to deliver therapy is not considered to be time dedicated to therapy.
Note: For 2005 and later years, where the life-sustaining therapy requires a regular dosage of medication that needs to be adjusted on a daily basis:
- the activities directly related to determining the dosage are considered part of the therapy, except for those activities related to exercise or following a dietary regime, such as carbohydrate calculation; and
- the time spent by primary caregivers performing and supervising the activities related to the therapy of a child because of his or her age is considered to be time dedicated to this therapy.
Markedly restricted –You are markedly restricted if, all or substantially all the time, you are unable (or it takes you an inordinate amount of time) to perform one or more of the basic activities of daily living (see list in Question 4 on previous page), even with therapy (other than life-sustaining therapy) and the use of appropriate devices and medication.
Prolonged – An impairment is prolonged if it has lasted, or is expected to last, for a continuous period of at least 12 months.
Qualified practitioner – Qualified practitioners are medical doctors, optometrists, audiologists, occupational therapists, physiotherapists, psychologists, and speech-language pathologists.
Significantly restricted – means that although you do not quite meet the criteria for markedly restricted, your ability to perform a basic activity of daily living is still substantially restricted.
Where to get more information
For more information on the Disability Tax Credit, as for the pamphlet, Information Concerning People With Disabilities [RC4064(E) Rev.00] available at Canada Customs and Revenue Office or at www.ccra.adrc.gc.ca. You can also reach the Canada Customs and Revenue Office by calling their toll free number:
ENGLISH: 1-800-959-8281 8:15 am – 5 pm (ON) Monday – Friday
FRENCH: 1-800-959-7383 8:15am – 5 pm (ON) Monday – Friday
Child Disability Benefit
Families with children who qualify for the disability amount are eligible to receive a Child Disability Benefit (CDB). A child qualifies for the disability amount when we have approved Form T2201, Disability Tax Credit Certificate, for that child. For more information on the disability amount, visit our Web site at www.cra.gc.ca/disability.
The CDB, which is based on family net income, provides up to a maximum of $191.66 per month to families with an eligible child who has a qualifying disability. The CDB starts being reduced when family net income is more than $36,378. For more information about the CDB, visit our Web site at www.cra.gc.ca/benefits or call 1-800-387-1193.