General Care for Quadriplegic

[Guest AHayhow]

An employee of a client is a quadriplegic and has to have help getting ready for work in the morning. He has hired people to insert and remove his catheter, get him bathed and dressed and into the van. The hired people are not nurses nor are they certified in anything, they are simply trained by the family to help him get through these morning rituals.

The employee would like to establish an FSA to help offset the cost of this care. I told them that the expense is not eligibile through the dependent care FSA because it isn't a care situation that is required to allow the spouse to work.

I don't believe it would qualify for a medical expense either because 213 disallows reimbursement of medical expenses for general health. Plus, the definition of medical care in section 213 does not include this type of expense.

Has anyone else encountered this? If so, how did you handle it?

[E as in ERISA]

Why do you consider these "general health" expenses? I don't know what the answer to your question is. But I think that you should consider the comments in Publication 502, relating to Medical and Dental Expenses, which indicates that the following are deductible under 213 (and therefore should be reimbursable under an FSA): "Nursing Services. You can include in medical expenses wages and other amounts you pay for nursing services. Services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. This includes services connected with caring for the patient’s condition, such as giving medication or changing dressings, as well as bathing and grooming the patient. These services can be provided in your home or another care facility."

[Lisa Hand]

I concur with Katherine and the section of Pub 502 quoted, these expense are not for general health. They are treating a specific medical condition, the employee's status as a quadriplegic and therefore would be eligible for reimbursement under a Medical FSA under the employer's Section 125 Plan or to be claimed by the employee on his individual taxes to the extent they exceed 7.5% of his gross adjusted income.