A signed waiver almost cost a couple their fertility medication claim

The situation

Shira read the letter twice standing at her kitchen counter before she understood what it was actually saying. The tax authority had denied about half of the medical expense credit she had claimed for fertility medication costs, and the reason given referenced a form she barely remembered signing at the fertility clinic more than a year earlier, something about how the invoice and payment records would be issued and to whom.

She and Rivka had been paying for fertility treatment out of pocket for over a year, medication costs that added up steadily rather than all at once, and had planned to claim the combined total as a medical expense on Shira's return, since she had the higher income of the two and the credit was worth more calculated against her tax owing. Rivka worked as a pharmacy technician, and Shira worked as a call-centre representative for the Canadian arm of a US-based company, a role that came with a small annual grant of stock units in the parent company on top of her regular wages. Neither income was large on its own, but the stock units were part of what widened the gap between them, and the fertility costs represented a real strain on their household budget, which was part of why the credit mattered.

The form in question, it turned out, was a payment and billing consent the clinic had them sign at intake, standard paperwork among a stack of other forms, that Shira now realized had specified the invoices would be issued in Rivka's name for internal billing reasons, even though the couple had always paid from a joint account and had always intended the expenses to be claimed on Shira's return. Neither of them had understood, at the time, that this administrative detail could affect who was allowed to claim the expense for tax purposes.

The amount in dispute was modest in absolute terms, a few thousand dollars, but it represented a meaningful chunk of what they had budgeted to recoup from a difficult and expensive year, and Shira wanted to know whether the form she had signed without reading closely had permanently closed off the claim, or whether there was still a way to fix it.

The legal question

Medical expenses can generally be claimed by either spouse or common-law partner, and the Income Tax Act does not require the person claiming the expense to be the one named on every invoice, provided the expenses were actually paid by the couple and the claim is not duplicated between them. The real question in Shira's case was not whether same-sex couples could combine and split medical expenses this way, which they clearly could, but whether the billing consent form had, in substance, created a record that contradicted who had actually paid.

The tax authority's reviewer had taken the invoices issued in Rivka's name at face value and treated them as evidence that Rivka, not Shira, had incurred those particular costs, which meant they could not be added to Shira's claim without some other proof of who had actually paid. That was a reasonable reading of the paper trail as it stood, even though it did not reflect what had actually happened financially between Shira and Rivka.

The legal question, then, was evidentiary as much as it was about the underlying entitlement: could Shira demonstrate, despite the billing form's language, that the payments had come from the couple's joint funds and that the expense claim on her return was not overlapping with any claim Rivka had made or could make on her own return. If the answer was yes, the credit was available to her regardless of whose name appeared on the clinic's internal invoice.

There was a second, smaller question buried in the same file: whether signing the consent form had, on its own terms, waived any right to reallocate the expense later, since the form's wording was broader than a simple billing preference and touched on language about invoices being 'issued and claimed' in Rivka's name. If that language was read literally, it went further than a billing convenience and came closer to an agreement about the tax treatment itself, something a clinic's administrative form has no real authority to dictate, but something that still had to be addressed directly rather than dismissed.

None of this turned on Shira and Rivka's relationship being same-sex or common-law rather than married. The medical expense rules treat spouses and common-law partners the same way for this purpose, and nothing about the couple's family structure was ever in question. The entire dispute lived in the narrower, more mundane space between what a clinic's billing paperwork said and what the couple's bank records could actually prove, which is exactly the kind of gap that a signature made in a hurry can quietly create.

What we did

1. Obtained the full consent form Shira had signed, rather than relying on her recollection of it, and read every clause describing how invoices would be issued and to whom, because the reassessment's outcome depended entirely on the exact wording of that section, not on the impression Shira had carried away from a rushed clinic appointment more than a year earlier.
2. Confirmed the clause was about billing administration, not tax entitlement, by reading it in the context of the rest of the form, which otherwise dealt with payment processing and insurance coordination, and set out in plain terms why a clinic's internal paperwork has no authority to decide which partner may claim a medical expense credit, regardless of how its wording happened to be drafted.
3. Gathered joint account statements showing the actual source of every payment, matching each fertility medication charge to a specific withdrawal from the account both Shira and Rivka funded, which established who had actually paid for each item independent of whose name sat on the clinic's invoice, organized as a simple chart a reviewer could follow without cross-referencing several months of statements.
4. Confirmed with Rivka, in writing, that she had not claimed any portion of the same expenses on her own return, since a claim could only proceed on Shira's return if there was no overlap between them, and kept that written confirmation in the file so the point could not later be questioned by a reviewer working from an incomplete record.
5. Prepared a written response to the tax authority distinguishing the billing administration language from a tax claim waiver, supported by the joint account records and Rivka's written confirmation that she had made no competing claim, and explained plainly why the clinic's internal invoicing convention did not reflect who had actually borne the cost of the medication, attaching the account statements as the primary evidence rather than leaving the reviewer to take the explanation on faith.
6. Recalculated the claim to include only the portion supported by clear payment records, since a handful of early charges from before the couple had settled into paying strictly from the joint account could not be traced as cleanly, and we advised Shira it was better to concede that smaller, weaker portion than to risk the credibility of the much larger claim by overreaching on all of it.
7. Asked Nikos, the clinic's billing coordinator, to amend the consent form's language for future patients and for Shira and Rivka's ongoing file, replacing the ambiguous 'issued and claimed' wording with language limited strictly to billing administration, and confirmed in writing that the correction had been made to the clinic's standard template, not just noted informally in their file, so no future patient at the same clinic would run into the same avoidable dispute.

The outcome

The tax authority accepted the recalculated claim, restoring most, though not all, of the amount originally denied. The portion tied to the early charges without clean joint-account records stayed disallowed, a concession we recommended rather than a result imposed on Shira, because the paper trail for those specific charges genuinely could not support the claim and pushing further risked the credibility of the stronger part of the file.

Shira and Rivka recovered a majority of what they had originally claimed, but not the full amount, and the difference was not trivial against a household budget already stretched by fertility treatment costs. It was a real loss, contained rather than eliminated, and we were direct with them about that distinction from the outset rather than promising a full reversal.

The corrected consent form now sits in their clinic file, and going forward the billing paperwork will not create the same ambiguity for a future year's claim. Shira said afterward that she now reads every intake form line by line, not because any one form is likely to cause a problem, but because she had learned that an administrative signature, made without much thought at a stressful appointment, can end up shaping a tax outcome months later.

Rivka took a different lesson from the same file. Because the couple had always paid from a joint account without keeping a separate ledger, sorting out exactly which payment went to which charge took longer than either of them expected once the dispute began. She now keeps a simple running note alongside the joint account, matching each medical payment to what it was for as it happens, rather than trying to reconstruct that history from bank statements alone if a future year's claim is ever questioned again.

What you can learn from this