Under the Canadian Thalidomide Survivors Support Program (“CTSSP”), one million dollars (indexed at 2% per year) is set aside annually in the EMAF. The EMAF is a shared fund intended to provide some additional assistance to Canadian Thalidomide Survivors in a fair, accessible manner.  The EMAF is replenished annually on April 1st.

There are 2 portions to the EMAF:

1. Automatic EMAF Annual Lump Sum Payment
2. EMAF Reserve

The Automatic EMAF Annual Lump Sum Payment is to assist Confirmed Survivors with some health-related costs, such as personal care supports, rehabilitation and health services, and assistive devices.  The items and services purchased with the Automatic EMAF Annual Lump Sum can be purchased without the need to submit an EMAF application or provide an explanation to the Administrator.

The Automatic EMAF Annual Lump Sum Payment is a portion of the fund that is shared equally among all Confirmed Survivors.  It is automatically shared to all living Confirmed Survivors in the month of April each year.  The exact amount of the Automatic EMAF Annual Lump Sum Payment will be confirmed after the start of the new fiscal year, based on the number of Confirmed Survivors.

All Confirmed Survivors will receive the Automatic EMAF Annual Lump Sum Payment to use at their discretion. It is intended to assist Confirmed Survivors with some health-related costs, such as personal care supports, rehabilitation and health services, and assistive devices.

No, you do not need to return the balance if you do not spend the entire Automatic EMAF Lump Sum Payment.

The EMAF is a shared fund intended to provide some additional assistance to Survivors in a fair, accessible and sustainable manner. The EMAF has a set limit of $1 million dollars (indexed at 2%) each year and is replenished annually on April 1st. An annual cap per Survivor is in place to ensure fair access to the fund. Not every survivor will reach their cap in a given year. Each Survivor can request reimbursements for eligible expenses, up to their individual annual cap when needed, as long as funds remain available. The cap may need to be adjusted year to year in response to the evolving needs of Survivors and to ensure fair and equitable distribution among all Survivors.

The “Yearly Cap” status on the payment letter indicates the total cap for that fiscal year and the “Amount Claimed” represents any EMAF payments you have received including the Automatic EMAF Annual Lump Sum Payment.

The EMAF Reserve is the portion of the EMAF to assist with eligible costs related to specialized treatments and adaptations not otherwise covered by provincial/territorial health care plans, such as surgeries, and home or vehicle adaptations to primary residence or primary vehicle.  To access funding from the Reserve, you must complete and submit an EMAF application to the Administrator.

The EMAF is a shared fund, similar to a community pool of resources. The EMAF fund is replenished at the beginning of each fiscal year.

The individual annual cap is the maximum any one Survivor can be reimbursed, but it doesn’t mean that amount is set aside just for them. There are more than 125 survivors, so not all survivors can use the full cap (as this amount would be over 1 million). The individual annual cap helps ensure fairness so that funding is available to as many survivors as possible.

The EMAF fund was doubled in 2019 to account for new individuals being recognized by the CTSSP, but the annual EMAF fund does not increase with every new Survivor, the total fund increases by 2% each year as per the program requirements. Please see below for more information about the EMAF fund.

• In 2018-2019 the fund was $500,000.00 and was underutilised.
• In 2019-2020 the fund was doubled to $1,000,000.00 (1 million) and was still underutilised.
• In 2021-2022 through 2023-2024 an increase in the use of the fund began. Even with frequent applicants the fund was still underutilized.
• In 2024-2025 increased use of the fund continued. The lump sum was introduced in response to feedback received from Survivors, observations about how the fund was being used, and to ensure that funds set aside for the EMAF would be fully utilized in the fiscal year. This year the fund was fully utilized. Remaining EMAF applications and payments were carried over to 2025-2026.
• The 2025-2026 EMAF statistics will be shared with Survivors in the 2026 spring newsletter.

The EMAF fund for the 2026/2027 fiscal year is $1,148,685.67.

The Automatic EMAF Annual Lump Sum Payment portion is valued at $689,211.40 and the value of the annual lump sum is increasing to approximately $5,100 per confirmed survivor.

The EMAF Reserve portion is valued at $459,474.27 and the individual annual cap is approximately $29,900.

Together, the Automatic EMAF Annual Lump Sum Payment and the EMAF Reserve provide access to up to $35,000 per confirmed survivor.  This represents an increase in total EMAF access compared to the previous fiscal year.

The item or the service is no longer eligible for reimbursement under the EMAF as the guidelines of 2026-2027 have changed.  Some expenses that were previously reimbursed are now expected to be covered through the Automatic EMAF Annual Lump Sum Payment, while the EMAF Reserve is restricted to specific expenses.

Please consult the Comprehensive Guide for more details.

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

Expenses that may be covered under the EMAF Reserve:

• Home adaptations, items or services which improve accessibility, safety and independent living for primary residence only.
• Permanently installed or integrated assistive technologies that support activities of daily living.
• Vehicle adaptations, items or services which improve accessibility, safety and independent living.
• Medical devices, procedures, and related supports that are not otherwise covered by provincial/territorial, or private health plans, and that relate to thalidomide associated birth differences or secondary conditions.

Please consult the Comprehensive Guide for more details.

If you are unsure whether the item or service for which you wish to receive funding is eligible, the Administrator encourages you to submit an EMAF application. Claims that align with the intent and scope of the EMAF, but are not listed, will be considered on a case-by-case basis.

For 2026–2027, the EMAF Reserve individual annual cap is approximately $29,900.

An annual cap per Survivor is in place to ensure fair access to the fund. Not every survivor will reach their cap in a given year. Each Survivor can request reimbursements for eligible expenses, up to their individual annual cap when needed, as long as funds remain available.

The cap is subject to change based on the number of Survivors and includes the Automatic EMAF Annual Lump Sum Payment. Please consult the current year’s Comprehensive Guide for details.

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

•  
• ​Confirmed Survivor’s Total Annual Income*
  
  $0-25000$25,001-$45,000Over $45,000 or unidentifiedPercentage of Eligible Amount to be Received
  
   100% of eligible amount90% of eligible amount80% of eligible amount 

*Your ongoing support payment is not considered income for the purpose of the test

For determining fund availability, your application will be considered part of the fiscal year that the EMAF decision letter and payment are issued - prior to March 31st annually.

Any EMAF decisions and payments issued after March 31st are included in the new fiscal year cap. Survivors are encouraged to submit their EMAF application(s) before March 1st annually to ensure time for processing and payment before March 31st.

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.

No, newly Confirmed Survivors (after April 1st) will receive their Automatic EMAF Annual Lump Sum payment the following fiscal year upon being recognized into the 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.

• 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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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

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.

The Annual Form was introduced to maintain accurate records, improve processes, and deliver Ongoing Support and EMAF payments efficiently. By completing this form, you will no longer need to submit government identification with every application form or complete the witness section/witness signature section in each form starting in the 2025-2026 Fiscal Year.

Please provide your personal information, confirm your contact information, and indicate your preferences for receiving Ongoing Support Payments (if applicable; OSP for TSCP Class Member are disbursed directly to Koskie Minsky) and EMAF payments. If you have a legally appointed personal representative, their information and proof of authority to act on your behalf must also be included.

You can submit the completed Annual Form by mail, email, or fax to the CTSSP Administrator. The contact details are provided in the form.

Accepted forms of government-issued identification include a valid Provincial Driver’s License, a valid Provincial Photo ID Card (must include date of birth), or a valid Canadian Passport.

Please note: if one of the ID’s listed above is not provided, the Administrator will contact you to request an accepted form of ID. Your EMAF lump sum payment cannot be issued until the annual form is completed and returned with valid ID.

If you want to change how you receive your Ongoing Support Payments, please indicate your new preference in the form and provide a void cheque or a direct deposit form from your financial institution.

You can give consent by completing Section 3 of the form, which allows you to name a personal representative to communicate with the CTSSP Administrator on your behalf. This consent remains valid for one year unless you cancel it in writing.

After you submit the Annual Form, the Administrator will review it for completeness and may contact you to request additional information. The information provided will be used to issue your annual Ongoing Support Payment and Extraordinary Medical Assistance Fund payments.

If your contact information changes, you should promptly notify the CTSSP Administrator to ensure uninterrupted service. You can update your contact information in Section 5 of the form.

If the Annual Form cannot be completed and returned to the Administrator by March 1st, 2025, there may be delays in issuing your ongoing support payments and extraordinary medical assistance fund (EMAF) payments. If you foresee any issues with this deadline, please inform the Administrator.

Please note: Your EMAF Annual Lump Sum payment cannot be issued until the annual form is completed and returned with valid ID.

Many Survivors have shared that it can be frustrating to repeatedly explain their situation or speak with someone who doesn’t have a medical background. Starting in September 2025, Administrator’s Healthcare Practitioners Team will be available by email to help with CTSSP-related questions.

Whenever possible, we’ll try to have the same Healthcare Practitioner respond to you for continuity. However, our Healthcare Practitioner Team works closely together and share access to the same notes, so depending on availability, any one of them may reply to ensure you receive timely support without needing to re-explain your situation.

Most support will be provided by email. However, phone calls may be arranged when needed, for example, for reassessment appointments. If you feel a call would be helpful, please let us know.

Please email your request to info@tsspcanada.ca or let the Contact Center Agent know that you have questions for the Health Practitioner team. Your message will be forwarded to the Team, and you’ll receive a reply within 2 business days.

! For urgent health concerns, contact your healthcare provider or emergency services. CTSSP Healthcare Practitioners cannot respond to medical emergencies.