Paschal Donohoe (Dublin Central, Fine Gael)
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I am advised by Revenue that section 469 of the Taxes Consolidation Act (“TCA”) 1997 provides for tax relief where an individual proves that he or she has incurred costs in respect of qualifying health expenses. Only “health expenses” incurred in the provision of “health care”, which has been carried out or advised by (in certain circumstances) a “practitioner”, will qualify for tax relief.

Section 469 TCA 1997 provides definitions for the terms above. Health care is defined as the “prevention, diagnosis, alleviation or treatment of an ailment, injury, infirmity, defect or disability”.

Health expenses are defined as “expenses in respect of the provision of health care” and include "expenses representing the cost of maintenance or treatment necessarily incurred in connection with the services of a practitioner". The definition of practitioner includes a number of medical professionals, including a person registered in the register established under section 43 of the Medical Practitioners Act 2007.

In relation to surgical, dental or nursing appliances, Revenue guidance sets out that relief is allowed on the costs incurred on the:

• supply;
• maintenance; or
• repair of any medical, surgical, dental or nursing appliance used on the advice of a practitioner.

In respect of wheelchair users in particular, Revenue guidance sets out that expenses incurred in the provision of a wheelchair or wheelchair lift for a person with a disability, on the advice of a medical practitioner, are allowable. Income tax relief is not available in respect of costs incurred on building alterations to facilitate a lift.

Further guidance on tax relief for qualifying health expenses can be found in Revenue’s Tax and Duty Manual Part 15-01-12, which can be accessed at the following link: www.revenue.ie/en/tax-professionals/tdm/income-tax-capital-gains-tax-corporation-tax/part-15/15-01-12.pdf.

In relation to VAT, the treatment of goods and services is subject to EU VAT law, with which Irish VAT law must comply. In general, the Directive provides that all goods and services are liable to VAT which is paid by the final consumer and that all goods and services are liable to VAT at the standard rate, unless they fall within categories of goods and services specified in Annex III of the VAT Directive, in respect of which Member States may apply a lower rate of VAT. Annex III includes the supply of medical equipment and appliances, and Ireland applies a zero rate of VAT, subject to condition, to these supplies, which includes wheelchairs.

In addition, the Directive also allows for historic VAT treatment to be maintained under certain conditions, and Ireland has retained the application of a refund order, the Value Added Tax (Refund of Tax) (No. 15) Order, 1981 (SI No. 428 of 1981), (Refund Order). Under EU VAT law it is not possible to widen the scope of the VAT Refund Order.

The VAT Refund Order provides that disabled persons, defined as persons who, as a result of an injury, disease, congenital deformity or physical or mental illness, or defect, suffer from a loss of physical or mental faculty resulting in a specified degree of disablement, may apply for a refund of VAT incurred on qualifying goods.

Qualifying goods are defined as goods other than mechanically propelled road vehicles which are aids or appliances, including parts and accessories, specially constructed or adapted for use by a disabled person and includes goods which, although not so specially constructed or adapted, are of such a kind as might reasonably be treated as so constructed or adapted having regard to the particular disablement of that person.

Claims under the refund order are assessed on a case-by-case basis and claims for such goods will be considered when accompanied by specific medical evidence that clearly demonstrates that they are essential in assisting a person with a disability to overcome this disability in performance of their daily functions or in exercise of their vocation.

Claims for refunds should be made on eRepayments through Revenue’s MyAccount. Alternatively, paper applications can be made on Form VAT 61. Further information is available on the Revenue website www.revenue.ie/en/vat/repayments-to-unregistered-persons/disabled-persons/reclaim-vat-aids-appliances.aspx.