Canadian Thalidomide Survivors Support Program

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Extraordinary Medical Assistance Fund

 

Reassessment Application and Ongoing Support Payment

Confirmed Survivors

Extraordinary Medical Assistance Fund FAQs

  • What is the Extraordinary Medical Assistance Fund (“EMAF”)?

    Confirmed Canadian Thalidomide Survivors have access to the Extraordinary Medical Assistance Fund (“EMAF”) which is intended to help cover extraordinary health support costs,  not otherwise provided for through provincial/territorial health coverage, of Canadian Thalidomide Survivors who have needs such as specialized surgeries or home or vehicle adaptations.

     

    Survivors are able to submit requests to the EMAF to help cover the cost of home or vehicle adaptations even if the province or territory in which he or she resides has a similar program to assist with these expenses. As such, if a Survivor has applied to a provincial or territorial program for help with the cost of an extraordinary home or vehicle adaptation and are waiting to learn if it will be covered, the Survivor can choose to submit his or her claim to the EMAF for consideration instead or in tandem; however a Survivor cannot be paid the full cost of the expense from two different sources.

  • How many times may I apply to the EMAF?

    There is no limit as to how many applications you may submit as the Administrator has removed the yearly submission deadline date to make the process easier for you. Please submit a new application whenever you wish; however, the Administrator requests that you accumulate $500 worth of expenses before sending in your application unless it creates a financial hardship for you.

  • Can I apply to the EMAF if I have already applied for funding through another source?

    Confirmed Survivors are able to submit requests to the EMAF to help cover the cost of home or vehicle adaptations even if the province or territory in which they reside has a similar program to assist with these expenses. As such, if a Confirmed Survivor has applied to a provincial or territorial program for help with the cost of an extraordinary home or vehicle adaptation and are waiting to learn if it will be covered, the Confirmed Survivor can choose to submit their claim to the EMAF for consideration instead or in tandem. However, a Confirmed Survivor cannot be paid the full cost of the expense from two different sources.

     

    For example, you wish to complete a $30,000 adaptation to your home. You apply for assistance under a provincial program for $30,000. While waiting to hear back from the provincial program, you also apply for $30,000 of funding for the same expense from the EMAF.  If the provincial program grants you coverage either in full or in part for the expense before you receive a decision from the CTSSP Administrator, you must notify the CTSSP Administrator immediately. The CTSSP Administrator will then take that into account when reviewing your claim under the EMAF. If you are found eligible for funding from the EMAF for that same expense, the CTSSP Administrator will deduct the amount you received from the provincial program from any amount you are eligible to receive from the EMAF before payment is issued, subject to funding availability.  If you receive funding from the EMAF prior to receiving a decision from the provincial program, you must notify the provincial program that you received funding in full or in part from the EMAF so that you are not being paid twice for the full cost of the same expense from two different sources.

     

  • What expenses are eligible under the EMAF?

    The Administrator considers any request to the EMAF that is accompanied by receipts or quotations acquired within one year of the date that the EMAF application is submitted to the Administrator. Funding requests for expenses with receipts more than one year old may be considered on an exceptional basis.

     

    Survivors may request funding from the EMAF even if the province or territory in which they reside has a similar program to assist with these expenses; however, Survivors cannot be paid from two different sources for the same expense.

     

    Click here for a list of potential eligible expenses or call the Administrator.

  • What expenses are not eligible under the EMAF?

    Any expenses covered by provincial or territorial healthcare plans or by another service provider are also not covered because this is prohibited under the Canada Health Act.

     

    Generally, costs related to ordinary home or vehicle maintenance or wear and tear are not covered by the EMAF. Examples of expenses that may not be covered are routine dental check ups, age-related need for reading glasses, and regular household repairs due to age and deterioration. Requests for funding for the same household modification (e.g. redoing your kitchen) may not be allowed within 5 years of the previous request unless there is an urgent need.

  • Is there a cap on the amount of money I can receive?

    To help everyone have equal access to the EMAF fund, the maximum amount of EMAF funding each Survivor may receive per fiscal year is capped at $40,000 (indexed at 2% per year). To find out this year’s cap, please contact the Administrator.

  • How does the Administrator decide who receives EMAF funding?

    For determining fund availability, your application will be considered part of the fiscal year in which the decision is made regarding your application.

     

    To help everyone have equal access to the EMAF fund, the maximum amount of EMAF funding each Survivor may receive per fiscal year is capped at $40,000 (indexed at 2% per year). This fiscal year’s cap is $42,448.32 CDN per Survivor.

     

    All approved funding requests are also subject to the following financial means test:

     

    •  
    • Survivor’s Total Annual Income*

      $0-25000 $25,001-$45,000Over $45,000 or unidentified
      Percentage of Eligible Amount to be Received

      100% of eligible amountof amount requested90% of eligible amount80% of eligible amount 
    • * Your ongoing support payment is not considered income for the purpose of the test

     

    Submission of quotations for home adaptations that contain high end finishes (e.g. granite countertops) may be subject to an individual cap for that expense. In other words, the Confirmed Survivor may not be fully reimbursed for the granite countertop, but instead may receive an amount equal to the cost to install a standard countertop of similar size and design. As there may be a justifiable need for a high-end finish, please include supporting documents (e.g. a report from a medical professional) citing the reasons for that specific installation.

     

    Lastly, please note that if funding remains in the EMAF at the end of the fiscal year, the Administrator will issue top up payments to anyone whose funding in the same fiscal year was reduced due to the financial means test. Top up payments will be subject to the cap and may be pro-rated if necessary.

  • How do I apply to the EMAF?

    You may contact the Administrator to request that an EMAF Application be sent to you or you may download an EMAF Application from Forms page by clicking here.

  • Do I need to submit receipts in regard to the expenses that I want to be covered by the EMAF?

    You may choose to pay for an item first and then submit a request for EMAF funding or you may obtain quotations for the expense(s) and submit those for consideration instead.

     

    When obtaining quotations, the quotations must be from a licensed professional (e.g. licensed contractor, automobile service garage, or professional medical facility etc.). The quotations should itemize in detail the work required and the associated cost of the same. If there is a requirement for a down payment/deposit before the work can be started that should also be indicated. Only expenses from qualified/licensed professionals will be considered.

     

    If you are requesting funding of more than $10,000, please submit two detailed quotations for the expense from two different licensed professionals. If that is not possible, please let us know when you submit your application. The Administrator may elect to obtain a second quotation for comparison purposes only.

     

  • What if I need a surgery or a home/vehicle adaption that I cannot afford to pay for upfront? May I still apply for assistance through the EMAF?

    Yes. Please complete and submit an EMAF application because if you are approved for EMAF funding, the Administrator can issue payment co-payable to you and the service provider. Please provide a quotation/estimate from the licensed/professional service provider that clearly describes the expense(s) and associated cost(s).

     

    When submitting an application for home or vehicle adaptions that exceed $10,000, Survivors must submit two quotations, of comparable detail, from two different professional service providers. If that is not possible, the Survivor must provide an explanation in writing as to why he or she was unable to obtain two quotations. The Administrator may elect to obtain a second quotation using an associated vendor for comparison purposes only. Each quotation should itemize in detail the work required and the associated cost of the same. If there is a requirement for a down payment/deposit before the work can be performed that should also be indicated. Only expenses from qualified/licensed professionals will be considered.

  • What do I do if the expense I wish to have covered is not listed on the schedule of eligible expenses?

    Please complete and submit an EMAF application anyway. While the Administrator has attempted to create a comprehensive list, there may be additional eligible expenses not contemplated.

  • What happens after I submit my EMAF application?

    EMAF applications will be reviewed in the order they are received unless extraordinary health claims (i.e. life dependent surgeries) are received. Payments for eligible items will be issued on a first come first served basis except for life dependent surgeries which will be given priority. If there is more need than available funds in a fiscal year, a Survivor’s application will automatically be carried over to the following fiscal year and that Survivor’s application will be prioritized in the next fiscal year.

  • When will EMAF payments be issued?

    Upon receipt of the Administrator’s decision regarding your EMAF Application, you have 45 calendar days to contact the Administrator to inform them that you either agree or disagree with the Administrator’s decision. If you agree with the Administrator’s decision, payment will then follow promptly. If you disagree with the Administrator’s decision, you have 45 calendar days from the date of the EMAF Application decision letter to complete and submit to the Administrator an EMAF Appeal Form which is available by contacting the Administrator or by download from the Forms page by clicking here.

  • Will the Administrator follow up with me at the conclusion of my EMAF claim?

    To help the Administrator better understand the specialized needs of Thalidomide Survivors and for quality assurance purposes, 10% of all EMAF claims, for which payment has been issued, will be randomly selected to undergo a review of the work completed. In the case of home or vehicle adaptations, the review will be completed by a bonded professional associated with the Administrator. The Administrator will contact the Survivor to discuss a suitable time and date for the review and the Administrator welcomes Survivors to have family member(s) or friend(s) in attendance if they so wish during the review. In the case of medical surgeries, the Administrator will contact the service provider directly.

  • Are the estates of confirmed Thalidomide Survivors no longer living, eligible for this assistance?

    No. Only living Canadian Thalidomide Survivors are eligible for financial support under this program.

  • Where may I get help in filling out the form?

    You may contact the Administrator if you have questions about the forms or the program.

     

    You may also choose to have someone help you fill out the forms such as a family member, friend, healthcare provider (in the case of the need for a specialized surgery), contractor (in the case of the need for home or vehicle adaptions) etc. The Administrator will reimburse reasonable costs incurred to have a professional complete the form. Please submit the receipt with your application.

 

Confirmed Survivors

Reassessment Application and Ongoing Support Payment FAQs

  • What is the purpose of the Canadian Thalidomide Survivors Support Program (“CTSSP”)?

    The CTSSP is intended to contribute to meeting the needs of Thalidomide Survivors for the remainder of their lives so that they may age with dignity.

  • What does the CTSSP include?

    • An increased initial ex gratia lump sum, tax-free payment of $250,000 for Thalidomide Survivors confirmed under the new CTSSP. Survivors already recognized under the former Thalidomide Survivors Contribution program will receive a top up payment of $125,000;

    • Ongoing annual tax-free payments to Thalidomide Survivors indexed at 2% per year for life based on each individual’s assessed level of disability;

    • Access to an annual Extraordinary Medical Assistance Fund (“EMAF”) to help cover the costs of extraordinary health support costs of Thalidomide Survivors with needs such as specialized surgeries and home or vehicle adaptations that are not otherwise provided in provincial/territorial healthcare plans.

    • An increase to the EMAF to $1 M per year, indexed at 2% per year, to account for an anticipated greater number of Confirmed Thalidomide Survivors.

     

  • When are Ongoing Support Payments issued?

    Ongoing Support Payments are issued at the end of April each year as one lump sum or in monthly installments as per your expressed preference.

  • How may I receive my Ongoing Support Payments?

    All ongoing support payments are sent by cheque by registered mail unless you tell us that you would prefer that your payment(s) be issued by direct deposit. To change how you are receiving your payments, please complete an Ongoing Support Payments form. You may request the form by contacting the Administrator or you may download a copy of the Ongoing Support Payment form from the Forms page of the website by clicking here. You may choose to have your ongoing support payments sent to you as one lump sum yearly or the lump sum may be sent to you in twelve monthly installments throughout the year. Monthly installments are typically issued in the last week of each month.

  • Why would I want to change how I am receiving my Ongoing Support Payments?

    When choosing between yearly or monthly payments, please note that in the event of the death of a Survivor after the payment process begins, the Survivor’s Estate will be permitted to keep the payment received in the month that the Survivor passed away if the Survivor chooses to receive payments monthly. Thereafter Survivor payments would stop to the Estate. If a Survivor chooses to receive a lump sum annual amount, the Estate will be permitted to keep the full amount for that year regardless of the date of death of the Survivor. Then Survivor payments would stop. So you must decide what works best for you. To change how you are receiving your payment, please complete an Ongoing Support Payments form. You may request an Ongoing Support Payment form by contacting the Administrator or you may download a copy of the form by clicking here.

  • May I get a higher Ongoing Support Payment if my condition has declined since the 1991 EAP or since my last reassessment?

    If you believe your health has declined since the 1991 EAP or since your last reassessment as a result of your Thalidomide-related injuries, you may ask to have your health status reassessed. Survivors may request reassessment once per fiscal year or more frequently if urgently needed on a case by case basis. Any changes to a person’s disability level will take effect on April 1st of the fiscal year following the year in which the final determination is made on the Survivor’s reassessment application. Please complete a Reassessment Application to have your health status reassessed. You may obtain a form by contacting the Administrator or you may download the Reassessment Application from the Forms page of the website by clicking here.

  • What if my health status gets worse in the future?

    If you believe your health has declined since the 1991 EAP or since your last reassessment as a result of your Thalidomide-related injuries, you may ask to have your health status reassessed. Survivors may request reassessment once per fiscal year or more frequently if urgently needed on a case by case basis. Any changes to a person’s disability level will take effect on April 1st of the fiscal year following the year in which the final determination is made on the Survivor’s reassessment application. Please complete a Reassessment Application to have your health status reassessed. You may obtain a form by contacting the Administrator or you may download the Reassessment Application from the Forms page of the website by clicking here.

     

    When requesting that your health be reassessed, providing detailed responses to the questions in the Health Assessment section of the Reassessment Application is very important.  The information you provide helps the medical assessor, who is reviewing your file, better understand you as a person and how the degeneration of your health as it relates to Thalidomide over time has impacted your quality of life and your ability to live independently as you are aging.

     

    Although optional, we highly recommend submitting photographs with your Reassessment Application and reports from your health care providers.  The reports and photographs may be helpful to the medical assessor to better understand the nature and extent of your physical injuries when information contained within medical documentation is minimal or absent.

  • What will be required of me to receive my annual Ongoing Support Payment?

    Each year you will need to verify your address, payment details and will be required to provide proof of identification to ensure that you receive your annual payments.

  • Why do you require that I provide medical documentation when I request that my health status be reassessed?

    Medical records along with your completed Reassessment Application will help the Administrator assess how your health has changed since your last reassessment.

  • Why should I allow the Administrator to get my medical records on my behalf instead of me getting them?

    Some people may find the process and financial cost to getting the records difficult. Completing a Reassessment Consent to Release Medical Information form allows the Administrator to communicate with your health care professionals and pay them directly for the medical information that you allow us to obtain. If you choose to get the records yourself, you will be reimbursed for that expense. The Administrator will pay the cost to obtain your medical records once per year. If an urgent need arises to request records more than once per year, that request will be reviewed on a case by case basis. You may obtain the Reassessment Consent to Release Medical Information form by contacting the Administrator or you may download the Reassessment Consent to Release Medical Information form from the Forms page by clicking here. Please note that you must submit a separate Reassessment Consent To Release Medical Information form for each Health Practitioner that you would like the Administrator to request records from.

  • When I am completing the Reassessment Application, how do I tell you about my current functionality which has changed since my last reassessment?

    Section 4 of the Reassessment Application has two parts. The first part asks you to talk about your physical injuries as a result of Thalidomide. The second part asks you to describe how you have been affected by your injuries since the 1991 EAP assessment or since your last reassessment under the former TSCP or the current CTSSP.

  • What happens after I submit my Reassessment Application?

    Requests for reassessment will be evaluated on an individual basis, independent of one another. Under the Canadian Thalidomide Survivors Support Program (“CTSSP”), a person’s disability level will be assessed by reviewing identified functional limitations and how the person’s need for assistance has changed as a result of the degeneration of his or her birth or secondary injuries due to Thalidomide since the last assessment. Qualified Health Practitioners associated with the Administrator will also review health records to evaluate an individual’s current physical condition. Decisions will be based on identified functional limitations and need for assistance; however submitting a request for reassessment will not automatically result in an individual moving to a higher Disability Level. Individuals who require moderate levels of assistance for activities of daily living will be assessed as a Level 2. Those individuals with extensive need for assistance will be assessed as a Level 3. The Administrator will contact you if more information is needed to complete the assessment. In some cases, the Administrator may seek input from your healthcare provider. Otherwise, your application will be reviewed and you will be notified in writing of the determination.

  • Will the financial support payments be tax free?

    Yes. Canada Revenue Agency Tax Ruling indicates that the annual support payments and any monies received through the Extraordinary Medical Assistance Fund are not taxable.  They do not need to be declared on your annual tax return.

  • Are the estates of confirmed Thalidomide Survivors no longer living, eligible for this assistance?

    No. Only living Canadian Thalidomide Survivors are eligible for financial support under this program.

  • Where can I get help?

    You may contact the Administrator if you have questions about any of the forms or the program. You may also choose to have someone help you fill out the forms such as a family member, friend or a healthcare provider (e.g. family doctor, occupational therapist, naturopath, personal aide worker etc.). The Administrator will reimburse reasonable costs incurred to have a healthcare professional complete the forms. Please submit the receipt with your application. Alternatively, you may contact the Administrator who will make arrangements to have a healthcare professional assist you.

Important Updates

 

 

The Administrator has a new mailing address:

 

CANADIAN THALIDOMIDE SURVIVORS SUPPORT PROGRAM

PO Box 507 Stn B

Ottawa, ON

K1P 5P6

Thalidomide Survivors Contribution Program Class Proceeding – Notice of Settlement Approval Hearing on February 26-27, 2020. Click
here  for more information.

 

On May 8, 2020, the Federal Court approved the settlement and Class Counsel’s fee request in the class proceeding regarding the 2015 Thalidomide Survivors Contribution Program. The motion for costs was denied.  Copies of these orders and the reasons for the decision can be found at Class Counsels' website at: Thalidomide Survivors Contribution Program Class Proceeding

 

CTSSP Application Deadline:

Step 1 – Preliminary Screening Applications are now available for any living individual who believes that they are a Thalidomide Survivor, including those previously denied under the 1991 EAP or the 2015 TSCP. Click here to download the form or call 1-877-507-7706 (TTY: 1-877-627-7027) to have one sent to you. The CTSSP Application deadline is postmarked by June 3, 2024 to the Administrator.

 

Reassessment:

Confirmed Survivors who are currently at a level 1 or a level 2, may request reassessment of their health status once per fiscal year or more frequently if there is an urgent need. Click here to download the application.

 

EMAF:

There is no limit as to how many applications you may submit as the Administrator has removed the yearly submission deadline date to make the process easier for you. Please submit a new application whenever you wish; however, the Administrator requests that you accumulate $500 worth of expenses before sending in your application unless it creates a financial hardship for you. Click here to download the application.

 

You may also call the Administrator at 1-877-507-7706 (TTY: 1-877-627-7027) or by email to  info@tsspcanada.ca to have any of the forms sent to you by mail or email.

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