Taxes seem to be involved in almost every aspect of our lives. Therefore, it is not surprising that the person with multiple sclerosis (MS) will want to think carefully about the tax consequences of the changes that may occur in his financial situation. If it becomes necessary for you to buy equipment or to make changes to your house or apartment to cope with your condition, you may be able to deduct their costs. This could be true of such things as crutches, a wheelchair, or a mobility scooter, as well as ramps or guardrails to assist you in getting around.

In the same way, if you are required to modify your car by adding a lift device or special ramp to allow you to get in and out, this cost should also be deductible when it is not reimbursed by insurance.

More expensive improvements also may be deductible, such as an elevator or swimming pool for physical therapy. In the case of major home improvements, you should talk to your doctor to ensure that she will back you up on the medical need for the expense. You also should be aware that the amount you may deduct will be reduced by any increase in the resale value of your home. You should not expect to deduct the cost of making the improvement look good, such as landscaping around a swimming pool or repainting the rest of your house after a modification has been made. To help back up your claim, you might get an appraiser or Realtor to give you a written estimate of any increase in resale value. This often will not mean much reduction in your tax benefit because many modifications, including swimming pools, really do not add substantially to the resale value of the average home. Be aware that some courts have held that buying a house that already has a swimming pool does not allow you to take any deduction because the IRS claims that there was no expenditure in excess of the “market value” of the property.

Timing is important. This is especially true with the kinds of expenses just discussed because they usually may be done or paid for on a more flexible schedule than your regular doctor bills.

Further tax benefits might be available if you or your spouse is self-employed, perhaps in a family business. If you work out of your home or have to modify a vehicle that you use in business, you may be able to take advantage of the provisions of Sections 44 and 190 of the Internal Revenue Code. These provide for a tax deduction (thereby reducing your taxable income) or a tax credit (a direct reduction, dollar-for-dollar in your taxes). These sections might be significant if they apply because they may be taken without regard to whether you meet the itemized deduction limits for a particular year (i.e., the 7.5 percent of income limitation). This possibility might become especially important if you are trying to work in some form of self-employment to be able to qualify for Social Security Disability Insurance  or to meet the requirements for group insurance coverage.

Another area, which often is overlooked, is the cost of nursing care in your home. You may be entitled to deduct this care even if it is not provided by a full-time nurse. Maid service is not deductible, but if the same person who takes care of your house also provides nursing care to you, it is legitimate to deduct a portion of the cost.

As noted above, you can deduct for some long-term care through a long-term care insurance policy. This can include both assistance in a facility, such as a nursing home, as well as home care. To be eligible, you must meet several conditions, such as a chronic illness, like MS, which limits your ability to perform at least two activities of daily living for a period of at least 90 days without substantial assistance from some other individual. The activities of daily living referred to include such things as eating, going to the toilet, transferring, bathing, and dressing. “Substantial assistance” can include standby assistance from somebody else if there is a danger of your injuring yourself while trying to perform these activities.