Who can sign the form.

The government has proposed allowing occupational therapists to certify the bowel and bladder section, for certifications issued after 2026. That change is not law yet. Public comment closed on 4 September 2026.

None of this is law. It was announced in the Spring Economic Update on 28 April 2026, draft wording followed on 23 July, and public comment closed on 4 September 2026. We publish it because somebody deciding who to book an appointment with should know what is coming — not because it can be relied on yet.

• An occupational therapist could certify bowel and bladder function, and count it towards the cumulative route.
• A physiotherapist could certify feeding and dressing, and the cumulative route across walking, feeding and dressing.
• A speech-language pathologist could certify feeding and hearing, and the cumulative route across speaking, feeding and hearing.
• A podiatrist could certify walking — where assessing it is within their provincial scope of practice.
• A public guardian, trustee or curator could certify that an adult in their care holds a certificate of incapacity.

Those five would apply to certifications issued after 2026, for the 2027 tax year onwards.

This is the change that would matter most. For any of the 43 conditions below, a practitioner would certify the diagnosis and would not have to fill in the section describing how it affects an ordinary day — the section this site spends most of its time helping people get right. It is proposed for certifications issued for the 2026 tax year onwards.

Being off this list is not a refusal. Finance says it plainly: any condition that meets the legislated requirements can still be certified by a medical practitioner exactly as before.

And being on it is not automatic approval. The proposal does not change who qualifies — it changes how much paperwork the practitioner fills in. The Canada Revenue Agency keeps the power to ask for more information, and the impairment still has to be severe and prolonged.

Where a condition below carries a description — a stage, a severity, a threshold — that wording is part of it. The diagnosis alone is not enough.

• Alzheimer’s disease
• Amyotrophic lateral sclerosis/Lou Gehrig’s disease
• Angelman syndrome
• Autism spectrum disorder level 3
• Bilateral blindness (legally blind)
• Bilateral hearing loss (severe or profound)
• Cardiac functional class of 4/IV or an ejection fraction of 20% or less
• Cerebral palsy (severe)
• Chronic obstructive pulmonary disease, stage III or higher
• Colostomy (permanent)
• Cystic fibrosis
• Dementia
• Down Syndrome/Trisomy 21
• Duchenne muscular dystrophy (advanced or severe)
• Edwards syndrome/Trisomy 18
• Hemipelvectomy
• Hemophilia A (severe)
• Hip disarticulation
• Huntington disease
• Ileostomy (permanent)
• Intellectual disability (severe, profound or IQ of 70 or below)
• Lower limb amputation (leg or foot)
• Microcephaly
• Paraplegia
• Parkinson’s disease (advanced or severe)
• Patau syndrome/Trisomy 13
• Phenylketonuria
• Prader-Willi syndrome
• Profound hearing loss in one ear and severe hearing loss in the other ear
• Progeria
• Quadriplegia or tetraplegia
• Relies only on lip-reading and/or use sign language to understand conversations or communicate
• Renal (kidney) failure requiring lifelong hemodialysis or peritoneal dialysis
• Requires lifelong continuous supplemental oxygen (O2)
• Schizophrenia
• Sickle cell disease (severe) requiring transfusions
• Sign language is primary means of communicating due to profound hearing loss or expressive aphasia
• Spinal muscular atrophy of type 1 and 2
• Stroke (severe) no functional recovery
• Tay-Sachs disease (infantile/juvenile)
• Total mutism
• Traumatic brain injury (severe)
• Upper limb amputations (transcarpal or higher)

Table 3, Spring Economic Update 2026 — read on 26 August 2026.

There is a second route: several limitations that are each short of a marked restriction but together amount to one. An occupational therapist can certify that route only where the limitations are among feeding, dressing and walking. Anything else is a medical doctor or nurse practitioner.