Surgery For Treatment of Acne Scarring

[Guest Laura Browne]

I am looking for some direction for a claim received for Reimbursement. The claimant is receiving treatment for Acne Scarring - would this be considered cosmetic?

[JanetM]

Since it doesn't treat, mitigate or prevent a medical condition I would call it cosmetic.

[Alf]

Yes. Just say no.

[Lori Friedman]

I can't make up my mind about this one.

Under I.R.C. Sec. 213(d)(9)(A), a cosmetic procedure is deductible if it ameliorates a deformity arising from:

(1) congenital abnormality

(2) injury resulting from an accident or trauma, or

(3) disfiguring disease.

Isn't severe acne a disfiguring disease? If so, a procedure to remove the resulting scars should be tax deductible.

I haven't been able to find any PLRs that address this question. It might be fair to compare the procedure to breast reconstruction after a mastectomy, which is certainly deductible. The reconstruction, itself, doesn't cure a medical condition, but it does correct a disfigurement caused by an illness or disease.

[JanetM]

This could be dangerous area, but who decides what is disfiguring? Do some minor acne scars count if the person is really bothered by them?

This is one I hope I don't have to make the call on.

[Kirk Maldonado]

JanetM is right that in that this issue can draw you into some pretty ugly situations (no pun intended) where it is very difficult to decide. However, I have seen some people with acne scars so severe that I would have no trouble classifying them as disfiguring.

Why don't you ask the participant to get his or her doctor to write something that would support the participant's position? It would seem that you should be pretty safe if you have something in writing from the attending physician. (While you should be protected by the letter, the IRS may still try to tax the participant on the amount of the reimbursement.)

Does anybody else have a better idea on how to deal with this?

[JanetM]

Kirk, I like your method. Getting letter from the doctor will give employer gounds to allow under the plan. And of course if IRS disallows then they have some thing to fight it with.

[Lori Friedman]

I'd like to argue that the normal aging process is a disfiguring disease. That way, a Georgetown Lobotomy, which I'll probably want to have someday, would be deductible.

[Kirk Maldonado]

Lori:

Could you explain what a "Georgetown Lobotomy" is? I hope it isn't caused by attending Georgetown University, because it does, then I'm in big trouble since I have a degree from there. That makes me wonder--does the fact that I have to ask what one is, is that conclusive proof that one was performed on me? That would certainly explain a lot of things in my life.

[JanetM]

My guess Kirk is that Lori is referring to a face lift.

[Lori Friedman]

Hi, Kirk. It's nice to hear from you. Janet's right...a facelift. I thought that the term was widespread, but it might be common just in D.C. and vicinity.

Not that you need one, but maybe your alumnus status would give you a special discount?

[Kirk Maldonado]

I think that some people might argue that it would be better for the world if I had a lobotomy rather than a facelift.

[JanetM]

Oh Kirk, how could you think that? We would miss you at the WP lunches if you did. ;-)

[Kirk Maldonado]

Maybe so, but the meetings would probably be a lot shorter if the speakers didn't get so many questions and comments from me.

[JanetM]

And the sooner we would all have head back to work. LOL

[Kirk Maldonado]

Well, I'm somewhat gratified to learn that you would rather listen to my pontificating than to return to work.

I think that's what they mean when they say you are "Damned by faint praise."