Thalidomide Survivors Contribution Program

I got a payment from the Extraordinary Assistance Plan in 1991

 

I did not get a payment from the Extraordinary Assistance Plan in 1991

I did not get a payment from the Extraordinary Assistance Plan in 1991 but have since been qualified by the Administrator

 

Extraordinary Medical Assistance Fund FAQs

Reassessment Application FAQs

 

 

Q. 1 Are there important dates I should know about in regard to the program?

 

Yes.

 

Reassessment deadline dateDate to return ongoing support payment formPostmarked by March 31, 2018Postmarked by March 15, 2018

Q. 2 What did the financial support for Thalidomide Survivors announced by the Government of Canada in 2015 include?

 

 

Q. 3 When will the next ongoing support payment be sent out?

 

The 2018-2019 FY Ongoing Support Payment will be issued in April of 2018 as one lump sum or in monthly installments as per your expressed preference.

 

Q. 4 How will I receive my ongoing support payments?

 

All ongoing support payments will be sent by cheque by registered mail unless you tell us otherwise. 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 form from the website at www.tscp-pcst.ca. 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 monthly installments throughout the year.

 

Q. 5 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 chose to receive payments monthly. Thereafter Survivor payments would stop to the Estate. If a Survivor chose 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 a form by contacting the Administrator or you may download a copy of the form from the website at www.tscp-pcst.ca.

 

Q. 6 May I get a higher ongoing support payment if my condition has declined since 1991?

 

If you believe your health has declined since 1991 as a result of your Thalidomide-related condition, you may ask to be 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. You may obtain a form by contacting the Administrator or you may download the application from the website at www.tscp-pcst.ca.

 

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

 

Q. 7. What if my health status gets worse in the future?

 

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. You may obtain a form by contacting the Administrator or you may download the application from the website at www.tscp-pcst.ca.

 

When requesting reassessment, providing complete information and detailed responses to the question in the Health Assessment section of the 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 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.  The photographs may be helpful to the medical assessor to better understand the nature and extent of your physical injuries when information contained within the medical documentation is minimal or absent.

 

Q. 8 What will be required of me to receive my annual benefits?

 

You will need to:

 

 

This is to make sure that you receive your annual payments.

 

Q. 9 Why do you require that I provide medical documentation when I request reassessment?

 

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

 

Q. 10. 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 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 a form by contacting the Administrator or you may download the form from the website at www.tscp-pcst.ca.

 

Q. 11 My medical records won’t be ready until after the reassessment deadline. What do I do?

 

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

 

Q. 12 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 has two parts. The first part asks you to talk about your physical disabilities as a result of Thalidomide. The second part asks you to describe how you have been affected by your condition since the 1991 assessment or since your last reassessment.

 

Q. 13 What can I claim as part of the Extraordinary Medical Assistance Fund and when?

 

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.

 

Only expenses incurred between April 1, 2017 and March 31 2018 may be submitted for consideration for the 2017-2018 FY EMAF.

 

For a general list of potentially eligible expenses, please visit www.tscp-pcst.ca.

 

Q. 14 Will the financial support payments be tax free?

 

Yes. Canada Revenue Agency Tax Ruling indicates that the annual tax-free support payments and any monies received through the Extraordinary Medical Assistance Fund are tax free.

 

Q. 15. 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.

 

Q. 16 What happens after I submit my Reassessment application?

 

Requests for reassessment will be evaluated on an individual basis, independent of one another. Under the Thalidomide Survivors Contribution Program, 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. 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.

 

Q. 17 Can I get help in completing these forms?

 

Yes. 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 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, who may possibly be a Crawford Healthcare provider, assist you.

 

 

Qualification Application FAQs

 

The deadline to submit the proof and a completed application to the Administrator has passed. No further applications are being accepted.

 

 

 

Extraordinary Medical Assistance Fund FAQs

 

Q. 1 Are there important dates that I should know about in regard to the Extraordinary Medical Assistance Fund (“EMAF”)?

 

NEW: For the 2018-2019 fiscal  year,  you  may  submit  your  application anytime  between  April 1, 2018 and March 31, 2019. 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 that 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.

 

NEW: To have your application considered for the 2018-2019 FY, your completed EMAF application and supporting documents must be RECEIVED by March 31, 2019. Otherwise, your EMAF request will be reviewed in the following fiscal year.

 

NEW: 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, 2018, then expenses/quotes acquired between June 5, 2017 and June 5, 2018 will be considered for the 2018-2019 FY. Each receipt/quotation should contain a clear description of the expense incurred or to be incurred.

 

 

Q. 2 How many EMAF applications may I submit per fiscal year?

 

Survivors may continue to 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.

 

 

Q. 3 What is the Extraordinary Medical Assistance Fund (“EMAF”)?

 

Confirmed Canadian Thalidomide Survivors have access to the EMAF which is intended to help cover the cost of extraordinary health support costs of Canadian Thalidomide Survivors with needs such as specialized surgeries or home or vehicle adaptations.

 

 

Q. 4 What expenses may be eligible under the EMAF?

 

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. A schedule of possible expenses is available on the website at www.tscp-pcst.ca or by calling the Administrator. If you are unsure if an expense may be eligible, submit an application anyway for consideration.

 

Q. 5 What expenses are not eligible under the EMAF?

 

Expenses which are not eligible under the EMAF include, but are not limited to:

 

 

Q. 6 How does the Administrator decide who receives EMAF funding?

 

Because there is a fixed amount of money in the EMAF per fiscal year, there is a chance that not everyone who submits a request for EMAF funding will receive his or her funding in the fiscal year that the Survivor submits his or her application. As a result, it is suggested that you submit your request for EMAF funding first and receive approval of that request before incurring the expense.

 

Upon receipt of your application, the Administrator will review and make a determination on your application by applying the principles below to determine the distribution of funds in as fair a manner as possible. 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 that 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.

 

 

 

Q. 7 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(s) 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 in the fiscal year in which they submit their application.

 

NEW: 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, 2018, then expenses/quotes acquired between June 5, 2017 and June 5, 2018 will be considered for the 2018-2019 FY. Each receipt/quotation should contain a clear description of the expense incurred or to be incurred.

 

NEW: Requests for funding for the same 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.

 

NEW: 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. Having said that, there may be a justifiable need for a high end finish. If that is the case, please include supporting documents (e.g. a report from a medical professional) citing the reasons for that specific installation.

 

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. 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. When a Survivor is unable to obtain two quotes, the Administrator may elect to obtain a second quotation using a Crawford & Company (Canada) Inc. associated vendor for comparison purposes only.

 

Q. 8 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 and supporting documents anyway because if you are approved for EMAF funding, the Administrator can issue payment as a co-payable cheque to you and the service provider.

 

Q. 9 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.

 

Q. 10 What happens after I submit my EMAF application?

 

Upon receipt of your application, the Administrator will review it for completeness. If additional information is needed, the Administrator will contact you. EMAF applications will be reviewed and payment will be issued (if 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.

 

Depending upon the volume of applications received at a given time, you should expect to receive a decision in regard to your application within 30 calendar days of submission. If there is insufficient funds available when you submit your application, the Administrator will notify you within 30 calendar days that your application is being carried over to the next fiscal year.

 

Upon receipt of the Administrator’s decision, you will then have 45 calendar days from the date of the decision letter to either accept or appeal the Administrator’s decision.

 

Q. 11 What must I do once I receive the Administrator’s decision?

 

If you agree with the Administrator’s decision, you must contact the Administrator to advise that you agree with the decision so that payment may be issued promptly. Otherwise, the Administrator will wait until the 45 day appeal period expires before issuing payment. Payments will be issued as co- payable cheques to the Survivor and the vendor when the work is still in progress. If a Survivor produces an invoice verifying the work/expense has been paid for in full by the Survivor, then payment will be issued to the Survivor solely.

 

If you disagree with the Administrator’s decision, you must contact the Administrator to request an appeal form be sent to you or you may download a blank Appeal form from the Forms page at www.tscp-pcst.ca. If you appeal the decision, no payments will be issued until the Appeal Assessor renders his/her decision.

 

Q. 12 How do I appeal the Administrator’s Decision?

 

Appeals are in writing only.

 

You must contact the Administrator to request an Appeal form be sent to you or you may download a blank Appeal form from the Forms page at www.tscp-pcst.ca.

 

Complete and submit the Appeal form along with any supporting documentation to the Administrator within 45 days of the date of the Decision letter from the Administrator.

 

The Administrator will then forward your Appeal form and supporting documentation along with the original EMAF application submission to the Appeal Assessor for independent review.

 

The Appeal Assessor will then complete his/her review of the Administrator’s Decision promptly and you will receive the Appeal Assessor’s Decision in writing. Any outstanding payments in regard to your application and appeal will be issued shortly thereafter.

 

The Appeal Assessor’s decision is final.

 

Q. 13 When will EMAF payments be issued?

 

EMAF payments will be issued within 30 calendar days following the expiration of the 45 day appeal period.

 

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. If the work is not completed, the Survivor will be required to repay the payment back to the Administrator upon request.

 

Otherwise, if you already paid for the expense that has been approved for EMAF funding then payment will be issued to you solely.

 

 

Q. 14 What is the purpose of the random review of completed work?

 

NEW: 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 Crawford & Company (Canada) Inc. 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.

 

Q. 15 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.

 

Q. 16 How do I apply to the EMAF?

 

To request funding from the EMAF, you must submit an EMAF application. The application is available for download from the Forms page at www.tscp-pcst.ca or you may call or email the Administrator to request one be sent to you. Our contact information is as follows:

 

Phone: 1-877-507-7706 (1-877-627-7027 TTY), Monday to Friday – 9:00 a.m. to 6:00 p.m. Eastern

Email: tscp-pcst@crawco.ca

 

While there is no specific deadline to submit an EMAF application per se, the Administrator must receive your completed EMAF application by March 31st, 2019 for it to be considered for the 2018-2019 FY.

 

Q. 17 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.