Under the Canadian Thalidomide Survivors Support Program (“CTSSP”), one million dollars (indexed at 2% per year) is set aside annually in the EMAF to help cover the unique health support costs of Canadian Thalidomide Survivors who require specialized surgeries, health support treatments and/or require changes to their primary residence or primary vehicle to better accommodate their needs as Thalidomide Survivors.

The EMAF Annual Lump Sum Payment is a $4,000.00 payment which will be automatically disbursed to all Confirmed Survivors of the CTSSP from the EMAF Fund annually at the start of the fiscal year beginning in April 2025. The Annual Lump Sum Payments are disbursed from the existing EMAF of one million dollars, indexed at 2% per year.

This new component of the EMAF aims to reduce the administrative burden for coverage of eligible expenses under $1000. For example, assistive daily living tools (reaching aid, adaptive utensils, etc.), prescription glasses, fall prevention devices, footwear or “smart” home appliances (automated vacuums, interactive voice assistants, etc.) can be purchased without the need to submit an EMAF application or provide an explanation to the Administrator.

There is no requirement to submit an EMAF application and there is no need to explain to the Administrator how these funds are used. Please note that the EMAF Annual Lump Sum is not paid retroactively. Newly Confirmed Survivors will receive their Annual Lump Sum payment for the current fiscal year upon being recognized into the CTSSP.

All Confirmed Survivors will receive the Annual Lump Sum Payment to use at their discretion. It is intended to assist with less costly medical expenses and does not require justification

The EMAF is a shared fund intended to provide some additional assistance to Survivors in a fair and equitable 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.

In addition, to ensure that critical access to the fund remains available throughout the year, a portion of the EMAF will be reserved for emergency medical needs, such as life-saving surgeries or urgent medical expenses.

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 Annual Lump Sum.

EMAF applications will be considered in 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.

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; however, to avoid potential issues, please do not wait too close to the one-year deadline to submit.

No. Ongoing Support Payments are a separate fund which is not affected when the EMAF fund is fully used.

It is difficult to know how quickly the EMAF fund will be used in the next fiscal year. Approximately half of the EMAF will be distributed to Survivors in April when the Annual Lump Sums are issued. Other factors that impact the available funding include the number of applications that were carried over from the previous fiscal year and any urgent requests received. We are actively tracking applications and reviewing program criteria to best meet your evolving needs.

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 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 EMAF fund for the 2025/2026 fiscal year is $1,126,162.00.

The annual cap per Survivor can be adjusted, as it has been for the 2025-2026 fiscal year. This year the annual cap per is $34,080.00. This amount includes the Annual Lump Sum Payment of $4,080.

For the 2025/2026 fiscal year the EMAF program is undergoing temporary changes to ensure equal and fair access to funding for all survivors.

As the lump sum payment and increased usage fully utilized the fund in the 2024-2025 fiscal year, prioritization of the applications was needed. Lower cost items may no longer be eligible and redirected to the Annual Lump Sum. To ensure critical access to the fund remains available throughout the year, a portion of the EMAF is reserved for emergency medical needs, such as life-saving surgeries or urgent medical expenses.

The list of Potentially Eligible/Non-Eligible items has been updated to prioritize your evolving needs. Please consult the Comprehensive Guide for more details.

EMAF decisions letters will be sent after April 1st.

After you indicate agreement with the decision payment will be requested for the next payment distribution.

There is no limit as to how many applications you may submit. Please submit a new application

whenever you wish; however, the Administrator requests that you accumulate $1000 worth of expenses

before sending in your application unless it creates a financial hardship for you.

Confirmed Survivors cannot be paid from two different sources for the same expense. If you have received full or partial funding from a provincial or territorial program for the same expense, please submit documents showing the amount received. Confirmed Survivors may be reimbursed for the uncovered balance of the expense only, subject to eligibility and availability of funding.

Examples:

• Many provinces and territories have a low-cost prescription drug coverage plan and any uncovered portion is requested from EMAF.
  
  
• You wish to complete a $30,000 adaptation to your primary residence. 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 application 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.

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; however, to avoid potential issues, please do not wait too close to the one-year deadline to submit.

Thalidomide-related expenses that could be covered by the EMAF include:

• Dental reconstructive surgery
• Adaptations to a kitchen or bathroom with accessible cabinetry and appliances
• Adding ramps or an automatic lift to the interior or exterior of a primary residence to facilitate mobility
• Automating curtains, blinds, or faucets to help with mobility or dexterity concerns
• Adaptations to a primary vehicle with steering wheel controls to permit independent operation
• Ongoing health support treatments, such as some prescriptions, physiotherapy, massage, attendant care, etc. Only receipts from a qualified, licensed practitioner will be considered for these types of expenses.

For home adaptations consisting of high-end materials or items, Confirmed Survivors may not be reimbursed the full amount but may receive an amount equal to the cost of standard equipment/material of similar size, quality, and design. For example, the cost of a high-end appliance or a luxury upgrade to an item may not be fully reimbursed. However, if there is a justifiable need for high-end materials or upgrade in any adaptation, please include supporting documentation (e.g., a report from a medical professional) citing the reasons for that specific installation.

For further information about the Guiding Principles for Assessing Applications to the EMAF and the list of potentially eligible expenses, refer to the EMAF Comprehensive Guide, available on the website at https://tsspcanada.ca/documents.html or by contacting the Administrator.

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 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.

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 $4,000 Annual Lump Sum (indexed at 2%). 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

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.

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

Please consult the Comprehensive Guide for examples of items that may not be covered such as costs related to ordinary home or vehicle maintenance, or wear and tear.

Unless otherwise stated, equipment-related expenses are limited to one (1) every five (5) years. All requests are assessed on a case-by-case basis. Exceptions may apply based on fund availability and individual circumstances.

For further information, please review the EMAF Comprehensive Guide found on the Documents page of the website at https://tsspcanada.ca/documents.html or by contacting the Administrator.

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.

The CTSSP Administrator’s team of application evaluators have undergone thalidomide specific training and follow medically informed guidelines when assessing applications in order to determine if the Survivor’s request aligns with the intent of EMAF, for example: confirming that expenses are eligible in addition to supporting a need based on their thalidomide-related birth differences and secondary health conditions.

The application evaluators meet regularly with the healthcare professionals on the team to discuss the applications which are under review which ensures that applications are evaluated with the appropriate level of medical input as needed.

No. EMAF is funding available only to Confirmed Survivors (found eligible under the CTSSP) and it is designed to help cover the unique health support costs of Canadian Thalidomide Survivors who require specialized surgeries, health support treatments and/or require changes to their home or vehicle to better accommodate their needs as Thalidomide Survivors.

https://tsspcanada.ca/faq-confirmed.html#extrablock

There is a separate process for medical oversight for Unconfirmed Survivors (Claimants who are going through the CTSSP application process).  They are assessed by qualified medical staff at Step 2 and by the multidisciplinary committee of medical/legal experts at Step 3 in order to determine their eligibility to the CTSSP as outlined in the Order in Council and in the April 29, 2024, judgement by the Honourable Judge Pamel.

https://tsspcanada.ca/ctssp-application-process.html

Thalidomide Survivors must complete the brief EMAF application form and submit the completed form along with any supporting documentation to the Administrator by email, mail or fax to:

Canadian Thalidomide Survivors Support Program

PO Box 507 Stn B

Ottawa ON K1P 5P6

info@tsspcanada.ca
Fax: 1-866-262-0816

You may download the form from the Forms page of the website at www.tsspcanada.ca or you may request one be sent to you by contacting the Administrator.

If you are submitting multiple documents by email, please contact us to request a file upload link.  We use a secure file system called GoAnywhere that allows multiple documents to be submitted at once. If you would like to try this option, please send an email to info@tsspcanada.ca asking for an upload link to be sent to you.

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.

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 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.

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).

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.

Note: EMAF funding cannot be provided prior to the purchase or the item or service unless it is a co-payable cheque. Prior to issuing funding, a valid invoice is required before a cheque can be issued and payments are only made in Canadian funds.

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

EMAF applications will be reviewed in the order they are received unless extraordinary health applications (i.e. life dependent surgeries) are received. Each application is assessed on a case-by-case basis and takes into account each Survivor’s individual needs.

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.

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/fund availability review.

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.

Please note that if you are approved for EMAF funding and submitted a quotation for services, the payment will be issued co-payable to you and the service provider. Both you and service provider will have to sign off on the cheque before the cheque can be cashed.

Otherwise, if you already paid for the expense that has been approved for EMAF funding then payment will be issued to you solely upon presentation of an invoice confirming the same.

If your EMAF application has been carried forward to the next fiscal year, the payment will be issued after April 1 of the new fiscal year.

For quality assurance purposes, 10% of all EMAF applications, for which payment has been issued, will be randomly selected to undergo a review of the work completed. For home or vehicle adaptations, the review will be completed by a bonded professional associated with the Administrator. The Administrator will contact the Confirmed Survivor to discuss a suitable time and date for the review. The Administrator welcomes Confirmed 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.

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

No. Annual Lump Sums are not paid retroactively. The EMAF lump sum payment begins the fiscal year in which the Survivor is admitted to the CTSSP.

You may contact us if you have questions about the EMAF, or any of the forms used in 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.

You may also choose to complete the EMAF application verbally over the phone with a CTSSP staff member. After the application is completed, a copy will be mailed/emailed to you for your signature. After submitting supporting documents and signing the application please send it to us to be processed.

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.