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🇨🇦 2026 CRA Form T2201 Medical Certification & Practitioner Workflow

DTC Medical Report (Form T2201) Practitioner Guide 2026

Current CRA guide for applicants and medical practitioners completing Form T2201, covering the digital application, practitioner eligibility, functional restrictions, cumulative effects, life-sustaining therapy and CRA review.

1. What Form T2201 Part B Does

Form T2201, Disability Tax Credit Certificate, is the CRA application used to establish DTC eligibility. Part A contains the applicant's personal information and Part B records information about the effects of the impairment and must be completed and certified by an authorized medical practitioner.

Key Framework Highlights:
  • Part B is completed by a medical practitioner authorized under the Income Tax Act for the relevant impairment category.
  • CRA determines eligibility from the information provided by the medical practitioner; a diagnosis alone does not establish entitlement.
  • For a marked restriction, CRA generally requires the applicant to be unable to perform the activity or to take 3 times longer than a person of similar age without the impairment.
  • The marked restriction must generally be present all or almost all of the time, interpreted as at least 90%, and must have lasted or be expected to last at least 12 continuous months.
  • The DTC can also be available through the cumulative effect of significant limitations in 2 or more categories, or through qualifying life-sustaining therapy.
  • The applicant and practitioner can use the DTC digital application, and a paper process remains available.
Action Checklist:
  • Applicant completes Part A or begins the digital application.
  • Applicant provides the practitioner with the reference number when using the digital workflow.
  • Practitioner opens the CRA Digital Application for Medical Practitioners.
  • Practitioner documents the functional effects, frequency, duration and applicable category.
  • Both parts are submitted to CRA using the appropriate workflow.
  • Keep a complete copy of the submitted information.

2. Current DTC Practitioner Matrix

CRA authorizes different medical practitioners to certify different impairment categories. Medical doctors and nurse practitioners can certify all categories; other authorized practitioners are limited to specified categories.

PractitionerCategories They Can Certify
Medical doctorAll DTC impairment categories
Nurse practitionerAll DTC impairment categories
OptometristVision
AudiologistHearing
Occupational therapistWalking, feeding and dressing
PhysiotherapistWalking
PsychologistMental functions
Speech-language pathologistSpeaking

3. The Marked-Restriction Standard

For a marked restriction, the practitioner should address whether the person is unable to perform the activity or takes 3 times longer than a person of similar age without the impairment, even with appropriate therapy, medication and devices. The restriction must generally be present all or almost all of the time, interpreted as at least 90%, and the impairment must last or be expected to last for at least 12 continuous months.

RequirementWhat the Practitioner Should Address
Functional effectDescribe exactly what the person cannot do or what takes substantially longer
ComparisonFor the 3-times test, compare the time required with a person of similar age without the impairment
Treatment and devicesConsider the person's functioning even with appropriate therapy, medication and assistive devices
FrequencyExplain whether the restriction is present all or almost all of the time, generally 90% or more
DurationState whether the impairment has lasted or is expected to last at least 12 continuous months

4. DTC Impairment Categories and What to Document

The current CRA framework includes walking, mental functions, dressing, feeding, eliminating, hearing, speaking, vision and life-sustaining therapy. The practitioner should provide category-specific information rather than a diagnosis-only statement.

CategoryCore CRA TestKey Documentation
WalkingUnable or takes 3 times longer than a similar-age personWalking ability, timing, need for devices, frequency and duration
Mental functionsUnable or takes 3 times longer to perform mental functions necessary for everyday lifeFunctional examples involving memory, problem-solving, behaviour/emotions and comprehension
DressingUnable or takes 3 times longer to dressActual dressing tasks, timing, assistance and frequency
FeedingUnable or takes 3 times longer to prepare food or feed oneselfFood preparation/feeding impact, timing and frequency
EliminatingUnable to personally manage bowel or bladder functions or takes 3 times longerActual functional restriction, timing and frequency
HearingUnable to hear and understand spoken conversation with a familiar person in a quiet setting or takes 3 times longerHearing function with appropriate treatment/devices and everyday impact
SpeakingUnable to speak so as to be understood by a familiar person in a quiet setting or takes 3 times longerSpeech intelligibility, communication impact and frequency
VisionSpecific visual-acuity or visual-field test in both eyes after correctionCorrected acuity/field-of-vision information and duration
Life-sustaining therapyTherapy supporting a vital function, at least 2 times per week and average 14 hours per week, with required durationTherapy type, frequency, time calculation and qualifying activities

5. Cumulative Effect of Significant Limitations

A person can qualify through the cumulative effect of 2 or more significant limitations when neither limitation alone meets the marked-restriction test. The limitations must exist together all or almost all of the time, generally at least 90%, and their combined effect must be equivalent to being unable or taking 3 times longer to perform an activity in one qualifying category. The cumulative-effect route does not apply to life-sustaining therapy.

Key Framework Highlights:
  • The test is based on the combined functional impact, not simply the number of diagnoses.
  • The limitations must generally exist together at least 90% of the time.
  • The combined effect must be equivalent to the marked-restriction standard in one qualifying category.
  • The person must meet the duration requirement of at least 12 continuous months.
  • Life-sustaining therapy is not combined under the cumulative-effect category.

6. Life-Sustaining Therapy: The 14-Hour Rule

Qualifying life-sustaining therapy can establish DTC eligibility when all of CRA's conditions are met. Current CRA guidance requires therapy to support a vital function, to be needed at least 2 times per week, to average at least 14 hours per week of qualifying time, and for the impairment to last or be expected to last at least 12 continuous months.

RequirementCurrent CRA Standard
PurposeTherapy must be needed to support a vital function
FrequencyTherapy is needed at least 2 times per week
TimeAverage of at least 14 hours per week, taking time away from everyday activities
DurationImpairment has lasted or is expected to last at least 12 continuous months

7. Vision, Mental Functions and Category-Specific Evidence

Some DTC categories have specialized objective or functional criteria. The practitioner should document the information that CRA needs to apply the appropriate category rather than using a generic statement of severity.

8. Documenting the Onset and Eligibility Period

The practitioner should provide sufficient information for CRA to determine when the applicant first met the DTC criteria. This is particularly important when the applicant may qualify for prior years. CRA's current process can use the information in the T2201 to determine the applicable eligibility years.

Action Checklist:
  • Identify when the relevant functional restriction began.
  • Distinguish the diagnosis date from the date the DTC functional criteria were first met.
  • Explain if the severity or functional restriction changed over time.
  • Identify an end date when the restriction is temporary or expected to improve.
  • Provide enough clinical and functional information for CRA to assess the requested historical period.
  • Do not invent an onset date merely to obtain a longer reassessment period.

9. The CRA Digital Application for Medical Practitioners

CRA provides a DTC Digital Application for Medical Practitioners. Under the standard digital workflow, the applicant starts the DTC application and provides the practitioner with a reference number. The practitioner then enters the reference number and completes Part B online.

10. CRA Review and Requests for More Information

CRA reviews DTC applications before allowing or denying the credit and bases its decision on the information provided by the medical practitioner. CRA can contact the applicant or medical practitioner when additional information is needed.

Key Framework Highlights:
  • The review is case-specific rather than an automatic approval based on diagnosis.
  • CRA may request clarification or supporting medical information.
  • The practitioner should respond using the instructions and reference information supplied by CRA.
  • The application should be supported by clinical information that explains the functional effects relevant to the DTC test.
  • A fixed universal 45-day response deadline should not be stated unless that specific CRA communication provides it.

11. Medical Practitioner Fees for Completing T2201

The applicant is responsible for fees charged by the medical practitioner for completing Form T2201 or providing additional information. CRA states that these fees may be claimable as eligible medical expenses.

ExpenseCRA Treatment
Medical practitioner fee for completing T2201May be claimed as a medical expense on line 33099 or 33199, subject to the normal medical-expense rules
Medical practitioner fee for providing additional DTC informationMay also be an eligible medical expense under CRA's medical-expense guidance
Promoter or consultant feeDifferent rules can apply; do not automatically treat every third-party DTC-related fee as a medical practitioner expense

12. Practitioner Documentation Checklist

A strong T2201 Part B response focuses on the functional effects that CRA's test actually measures.

Action Checklist:
  • Identify the impairment or condition relevant to the functional restriction.
  • Identify the specific DTC category being certified.
  • Describe what the person cannot do or what takes 3 times longer.
  • Explain how the person functions with appropriate therapy, medication and devices.
  • State how often the restriction is present.
  • State how long the restriction has lasted or is expected to last.
  • Distinguish diagnosis date from the date the DTC criteria were met.
  • Provide objective measurements where the category requires them.
  • Describe concrete daily-life examples when the category uses functional criteria.
  • For cumulative effect, describe both significant limitations and their combined impact.
  • For life-sustaining therapy, calculate qualifying weekly hours using CRA's inclusion and exclusion rules.
  • Retain the clinical records supporting the certification.
  • Answer any CRA clarification request using the exact information requested.

13. Common Form T2201 Errors

Incomplete functional descriptions can make it difficult for CRA to determine whether the statutory DTC test is met.

Action Checklist:
  • Writing only the diagnosis without describing functional limitations
  • Using 'markedly restricted' without explaining what the person can or cannot do
  • Using the old '100 metres' wording as though it were the general walking test
  • Failing to address therapy, medication or assistive devices
  • Ignoring the 90% frequency requirement
  • Ignoring the 12-month duration requirement
  • Using a practitioner who is not authorized for the category
  • Listing two diagnoses and assuming that cumulative effect automatically applies
  • Including non-qualifying activities in the 14-hour life-sustaining-therapy calculation
  • Confusing diagnosis onset with DTC eligibility onset
  • Inventing an onset date not supported by the clinical record
  • Treating CRA clarification requests as having one universal 45-day deadline
  • Submitting DTC documents through the ordinary CRA Submit documents feature after the July 14, 2026 change
  • Using a paper T2201 version older than CRA's accepted version after the September 8, 2026 cutoff

14. Complete 2026 Practitioner Filing Roadmap

Use this workflow to prepare a complete and defensible T2201 certification.

Frequently Asked Questions

Yes. CRA lists nurse practitioners as authorized to certify all DTC impairment categories. Other authorized practitioners have category-specific authority, such as optometrists for vision, audiologists for hearing, occupational therapists for walking, feeding and dressing, physiotherapists for walking, psychologists for mental functions and speech-language pathologists for speaking.

The applicant starts the DTC application and provides the practitioner with a reference number. The practitioner enters that number in the CRA Digital Application for Medical Practitioners and completes Part B online. If the practitioner does not have the reference number, CRA allows Part B to be completed online and then printed and signed for the patient to submit with Part A.

The practitioner should describe the functional effect of the impairment, whether the person is unable to perform the activity or takes 3 times longer than a similar-age person, how the person functions with appropriate therapy, medication and devices, how often the restriction occurs and whether it has lasted or is expected to last at least 12 continuous months.

Two or more significant limitations can qualify through cumulative effect when they exist together generally at least 90% of the time and their combined impact is equivalent to being unable or taking 3 times longer to perform an activity in one qualifying category. Life-sustaining therapy is excluded from the cumulative-effect route.

CRA's current criteria generally require therapy at least 2 times per week and an average of at least 14 hours per week of qualifying time, plus the 12-month duration requirement and the other statutory conditions. CRA specifies which activities count toward the 14 hours and which do not. Type 1 diabetes has a special rule for 2021 and later years.

No universal 45-day rule should be stated. CRA may request additional information from the applicant or medical practitioner, and the actual response instructions and deadline should be taken from the CRA communication. Older CRA materials referenced a 45-day response period, but that historical figure should not be presented as the universal 2026 rule.

2026 T2201 Metrics

  • Form
    Form T2201 — Disability Tax Credit Certificate
  • Digital Practitioner Filing
    CRA Digital Application for Medical Practitioners
  • Duration Requirement
    At least 12 continuous months
  • Marked Restriction Test
    Unable or 3× longer, generally 90%+ of the time

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