Canadian Thalidomide Survivors Support Program

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. For more information, we refer you to the Guiding Principles which the Administrator uses for assessing EMAF claims. You may request a copy of the Guiding Principles by contacting the Administrator or clicking here.

  • Are there important dates that I should know about in regard to the Extraordinary Medical Assistance Fund (“EMAF”)?

    You may submit your application anytime between April 1, 2019 and March 31, 2020. EMAF applications will be reviewed and payment will be issued (if assessed to be eligible) at time of submission on a first come first served basis. If there is more need in a given year then available funds, a Survivor’s application will automatically be carried over to the following fiscal year and that Survivor’s application will be processed first in the next fiscal year. The maximum number of times an EMAF application will be carried over is one fiscal year. Please note that if there is greater need than available funds in a given fiscal year, extraordinary health claims (e.g. surgeries) will be given priority over other types of claims. To date, lack of funding has not been a concern.

     

    To have your application considered for the 2019-2020 FY, your completed EMAF application and supporting documents must be RECEIVED by March 31, 2020. Otherwise, your EMAF request will be reviewed in the following fiscal year.

  • How many times may I apply to the EMAF?

    Survivors may submit a maximum of two EMAF applications per fiscal year unless there is urgent need, which will be evaluated on a case by case basis.

  • 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.

     

    All EMAF claims and payments are subject to the application of the Guiding Principles. You may request a copy of the Guiding Principles by contacting the Administrator or clicking here.

  • What expenses are eligible under the EMAF?

    Click here for a list of potential eligible expenses or call the Administrator. While the Administrator has attempted to create a comprehensive list, there may be additional eligible expenses not contemplated. Subsequently, if you do not see your expense specifically listed, please submit an application anyway and that expense will be assessed for eligibility. If your expense is found to be eligible, that expense will be added to the list.

     

    Expenses must have been purchased or quotations must have been acquired within 1 year of the submission date of your EMAF application. For example, if you submit your application on June 5, 2019, then expenses/quotes acquired between June 5, 2018 and June 5, 2019 will be considered for the 2019-2020 FY. Each receipt/quotation should contain a clear description of the expense incurred or to be incurred.

  • 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.

     

    Ongoing expenses such as medications needed on a continual basis and ongoing/regular treatments or assistance are not eligible costs under EMAF. Examples would include:

     

    • The cost of medically necessary insured hospital or physician services;
    • Medications used on a recurring basis;
    • Ongoing/regular treatments (e.g. massage or chiropractic treatments),
    • Ongoing/regular services (e.g. home or garden maintenance);
    • Ongoing/regular assistance (e.g. attendant care, cleaning services);
    • Routine eye exams or annual eye glass prescription renewals;
    • Routine dental check-ups

     

    Requests for funding for the same home or vehicle adaptation expense will not be permitted within 5 years of the previous request. For example, if funding is provided for fully adapting the main floor bathroom in your home, you may not request funding to make the same changes to that same bathroom within the next 5 years unless there is an urgent need.

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

    Yes. The cap for the 2019-2020 FY will be $41,616 CDN. Because the cost of services continues to increase each year, this amount will increase by 2% each year.

  • How does the Administrator decide who receives EMAF funding?

    EMAF applications will be reviewed and payment will be issued (if assessed to be eligible) at time of submission on a first come first served basis. If there is more need in a given year then available funds, a Survivor’s application will automatically be carried over to the following fiscal year and that Survivor’s application will be processed first in the next fiscal year. The maximum number of times an EMAF application will be carried over is one fiscal year. Please note that if there is greater need than available funds in a given fiscal year, extraordinary health claims (e.g. surgeries) will be given priority over other types of claims. To date, lack of funding has not been a concern.

     

    To ensure equal access to the EMAF for all Survivors, 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 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 (e.g. motion sensing appliance with on/off feature), please include supporting documents (e.g. a report from a medical professional) citing the reasons for that specific installation.

     

    Depending upon a Survivor’s total income as identified in an income tax document (e.g. Notice of Assessment) that he or she submits with his or her EMAF application, the Survivor may receive the full amount or a partial amount of the eligible expenses requested subject to fund availability. If the Survivor chooses not to submit an income tax document, then he or she will be assessed at the highest income level for the purposes of this principle. The following table will be used to calculate the potential amount of funding to be received.

     

    •  
    • Survivor’s Total Annual Income$0-10,000$10,001-$20,000$20,001-$30,000$30,001-$40,000Over $40,000Potential Amount Of Funding Received100% of amount requested90% of amount requested80% of amount requested70% of amount requested60% of amount requested
    • *Please note that your Ongoing Support Payment is not considered part of your total income for the purposes of this calculation.
  • 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 of the website at www.tsspcanada.ca.

     

    You must then submit the completed EMAF application by the application deadline specified in the form for your claim to be reviewed within that fiscal year.

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

    You must complete the EMAF application in full and you may either submit photocopies of receipts for expenses already incurred or a quotation for expenses that you would like covered by the EMAF.

     

    Obtaining a quotation/estimate may be preferable because there is a fixed amount of money in the EMAF per year so there is a chance that not everyone who submits a request for EMAF funding will receive it.

     

    When obtaining quotations, the quotation must be from a licensed professional (e.g. licensed contractor, automobile service garage, or professional medical facility etc.). The 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 that should also be indicated. Only expenses from qualified/licensed professionals will be considered. Once the work is completed, you will be required to submit a final invoice or receipt before payment will be issued.

     

    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 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. The list will be updated as new expenses are identified.

  • What happens after I submit my EMAF application?

    EMAF applications will be reviewed and payment will be issued (if assessed to be eligible) at time of submission on a first come first served basis. If there is more need in a given year then available funds, a Survivor’s application will automatically be carried over to the following fiscal year and that Survivor’s application will be processed first in the next fiscal year. The maximum number of times an EMAF application will be carried over is one fiscal year. Please note that if there is greater need than available funds in a given fiscal year, extraordinary health claims (e.g. surgeries) will be given priority over other types of claims. To date, lack of funding has not been a concern.

     

    Each applicant who requested EMAF funding will be notified in writing if they will be receiving EMAF funding within 30 calendar days of submitting the application unless there are extenuating circumstances.

  • 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 on the website at www.tsspcanada.ca.

  • 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.

     

  • Are there important dates I should know about in regard to the CTSSP for the 2019-2020 fiscal year?

    Yes.

     

    Emergency Medical Assistance Fund (“EMAF”) DeadlineOngoing Support Payment Change Request DeadlineOutreach Survey Response DeadlineReassessment Application DeadlinePostmarked by March 31, 2020Postmarked by March 15, 2020Postmarked by March 15, 2020Postmarked by March 31, 2020

  • 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.

     

    The 2020-2021 FY Ongoing Support Payment will be issued around April 30, 2020.

  • 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. You may request reassessment once per year between April 1st of the current year and March 31st of the next year unless there is an urgent need. Urgent requests will be reviewed on a case by case basis to decide if the request will be granted. 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.

     

    Any increase to a Survivor’s Ongoing Support Payment amount as a result of a change in disability level as a result of a Reassessment would take effect April 1st of the next Fiscal Year.

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

    You may request a health status reassessment once per year between April 1st of the current year and March 31st of the next year unless there is an urgent need. Urgent requests will be reviewed on a case by case basis to decide if the request will be granted. 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.

  • My medical records won’t be ready until after the reassessment deadline. What do I do?

    Please send in your Reassessment Application now and the medical records may follow when they are available.

  • 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

 

 

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 for the 2019-2020 FY anytime between April 1, 2019 and March 31, 2020. Click here to download the application.

 

EMAF:

EMAF applications are now being accepted for the 2019-2020 FY. Confirmed Survivors may submit up to a maximum of two applications per year anytime between April 1, 2019 and March 31, 2020. 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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