POLIO TIPS AND TECHNIQUES |
By Dr. Richard L. Bruno
It’s that time of year when taxes are due, and, as with the grim reaper, the tax man always gets his way. But, there are ways around the tax man with paths provided by the IRS itself.
For example, when polio survivors travel to The Post-Polio Institute for evaluation, we remind them that the cost of airfare, hotel, food, ground transportation—even the expenses of someone flying with them as their “assistant”—are tax deductible.
This is a surprise to many patients. Everyone knows that payments and co-pays for medical evaluation and treatment and prescription items (i.e., drugs, braces, wheelchairs) are tax deductible as medical expenses. What most folks don’t know is that nonprescription items and services can be considered medical expenses even without prescriptions or letters of medical necessity if they meet the IRS “extra” test. “Extra” means that there’s something “extra” you need that those without disabilities don’t, or that you need “extra” of something that everyone commonly uses.
Many extras don’t need a prescription. An electric can opener and big-grip kitchen utensils; a special computer keyboard, trackball or voice-activated software; vehicle modifications, such as a van’s wheelchair lift—all these are nonprescription items deductible without a physician’s letter. Home modifications are also deductible without a letter: installing a ground floor bathroom; modifications to make a kitchen accessible and building a ramp; repair costs for assistive devices and vehicle accessibility modifications; hiring someone to help you with activities of daily living that you can’t perform, including yard work. Massage therapy and acupuncture are deductible, as is a trip to a place where the climate will improve your medical condition if a change in location is “a medically recognized treatment.” Native American healing rites are also deductible if performed by a real “medicine man.” (A trip to Arizona in February, anyone?)
You should also be aware that the IRS and many states allow a credit or deduction just for having a disability.
Some nonprescription extras require a physician’s letter to be deductible: Stair glides, elevators, and hospital beds; the extra cost of orthopedic shoes over regular shoes; the extra cost of high-protein food (protein drinks or bars) to treat hypoglycemia; the extra cost of electricity or fuel for heating; even the cost of central air conditioning. A window air conditioner or space heaters are deductible since polio survivors need to be in a constant temperature. And, yes, a doctor’s note can get you a deduction on a swimming pool or “whirlpool” (read: Jacuzzi) to reduce your post-polio pain.
If you’re working, you can take some of these items, not as medical deductions, but as “impairment-related work expenses” that are required for you to earn a living (see IRS Publications 502 and 907). Impairment-related work expenses do not have a lower limit before they are allowed, as do medical deductions, that require expenditures to exceed 7.5% of your adjusted gross income before they are deductible.
Regardless of the type of deduction, make sure that all prescriptions and physicians’ letters state that the deducted items are necessary to “mitigate the effect” of your disability. Your tax preparer will need to include in your return prescriptions, doctors’ letters and a statement that you had polio, have PPS, and are taking deductions for items and services that mitigate the effect of your disability. For example, if you’re claiming the cost of “extra” electricity or food, make sure that you have paperwork documenting the difference between what you pay and what a nondisabled neighbor would pay. File these documents with receipts, credit card statements, and canceled checks in case the IRS asks for them.
Unfortunately, most tax preparers don’t know about deductions available to people with disabilities. Your tax preparers may not want to file for these deductions out of fear that an audit will be triggered. If you’re a solid citizen with regard to other aspects of your taxes and can document your disability and the need for necessary “extras,” you shouldn’t fear an audit. If your accountant isn’t familiar with or won’t file for these deductions, call your local post-polio support group or the Muscular Dystrophy Association. They may know of accountants who are knowledgeable about disability and taxes and who will be able to save dollars that should be in your pocket, not Uncle Sam’s.
Dr. Richard L. Bruno is chairperson of the International Post-Polio Task Force and director of The Post-Polio Institute and International Centre for Post-Polio Education and Research at Englewood (NJ) Hospital and Medical Center. His iBook, How to STOP Being Vampire Bait: Your Personal Stress Annihilation Program, is now available. E-mail: PostPolioInfo@aol.com.
