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He suffers from debilitating mental illnesses and traumas that often leave him unable to leave his home more than once a week. At times, he wonders if an expansion of Canada’s contentious medical assistance in dying regime could be his only way out.

But as federal aid finally starts to roll out, Tremblay and others are being left behind.

It’s not because of their income or diagnosis,Ìýbut by the inability to get past a bureaucratic gatekeeper Ottawa has made necessary for eligibility: the disability tax credit (DTC), a certificate requiring a form filled out by a medical practitioner that gives Canadians with long-term impairments tax breaks and access to a slew of federal supports.

For years,Ìýdisability advocates, doctors and tax experts have issued stark warnings about the DTC. Critics have argued eligibility is too vague and restrictive, and that applying for it is too burdensome, time-consuming and costly for people living with severe disabilities. A United Nations committee report has raised alarms about the system, arguing it was full of disparities and leads to “unequal coverage.”

But calls for an overhaul are taking on renewed urgency as the federal government finally rolls out the long-awaited Canada Disability Benefit, a maximum $200 per month income supplement for working-age disabled Canadians living in poverty. Already, frustrated advocates have argued the benefit falls far short of the Trudeau government’s initial promise to close the gap between provincial disability payments and the poverty line.Ìý

“It’s really hard to trust people at this point, especially the government,” Tremblay said in a Zoom interview with the Star. “We’re at the point where we’re dying or we’re losing interest in politics altogether … Canada’s a lie to a lot of us.”

The office of Patty Hajdu, the minister responsible for Employment and Social Development Canada, said in a statement the government is committed to improving the benefit “over time,” but provided no specific details.

“Over time and through feedback, the Government of Canada will improve the Benefit and how to access it where needed,” the statement said, noting the benefit is the first of its kind in Canada and was backed by $6.1 billion investment over six years. “We will get this right; Canada is committed to make the eligibility and the application process for the CDB as barrier free and straightforward as possible.”

For Tremblay, a lack of access to a doctor has left him unable to fill out the DTC form. Even though he receives ODSP payments, he can’t get federal disability supports.

He’s not alone.

Millions of Canadians don’t have access to family doctors or specialists, and doctors in walk-in clinics can be hesitant or unable to sign off on a 16-page form that asks for detailed information to prove the person’s disability is so severe as to impair their ability to perform normal tasks. Getting a doctor to fill out the form can also cost more than $100, and it often requires reapplication after a period of time.

“The last time I had a permanent, stable family doctor was living with my parents when I was a kid, 20-something years ago,” Tremblay said. The process is so tiring, he said, that it’s easier to use his online platform to beg for help.

Margot Burnell, the president of the Canadian Medical Association, described filling out the form as a massive “administrative burden” for doctors. Many of the assessments are subjective, she explained, requiring time and documentation that makes it difficult for all sides.

“Obviously it’s more difficult for a physician if they haven’t been involved in the patient’s journey for a longer period of time,” Burnell said. The federal government promisedÌý$41.5 million per year in 2024 to ease the financial burden of applications, but no money has been doled out yet.

Even those who are able to fill out the form can face delays from an overburdened Canada Revenue Agency, which says it may take up to 15 weeks to process requests.Ìý

And in the first two months of rollout, technical issues have prevented some recipients from getting the Canada Disability Benefit at all (The government says this happened to few people and those who are approved for the benefit after its launch will receive retroactive payments).

“The supports aren’t there,” said Alun Davies, who lives in Ontario with cerebral palsy and diabetes. He was set to receive $400 for the first two months of the benefit in August, and budgeted for it, but nothing arrived in his bank account the day it was supposed to. Efforts to get support through a government call centre left him on hold for hours. Weeks later, the payment finally arrived.Ìý

Out of nearly 900,000 disabled adults Statistics Canada says live in poverty across the country, just over 156,000 have so far have received the Canada Disability Benefit.

The federal government predicted 465,000 adults would be receiving the monthly benefit in its first year, and 40,000 Canadians would be lifted out of poverty because of it at its peak.

Not all eligible applicants were expected to apply at launch, however, and the initial intake of CDB applications is “approximately on par with the estimated forecast,” a spokesperson for Employment and Social Development Canada said.

Burnell said she believes the government should simplify the process by accepting personal attestations. Some advocates have called for a harmonization of eligibility criteria for disability supports across the country, or at the very least, having Ottawa automatically enrol Canadians receiving provincial aid into the Canada Disability Benefit.

The federal government has so far rejected the latter, arguing the DTC is the best way to ensure criteria for eligibility isÌýapplied equally to all Canadians. Provincial systems differ and not all have their own systems, at the same time, making disability supports across the country a complicated patchwork.

Still, Ottawa has long acknowledged the DTC needs reforms, and the Liberal government made several over the years, including digitizing the process and making minor expansions in eligibility. In the April election, the Liberals pledged to reform it once more, but his government has provided no details since. With Prime Minister Mark Carney now looking to cut spending, advocates fear no coming changes would be big enough to fix what they say is a broken system.

In a statement, a spokesperson for Finance Canada said “the federal government will continue working with persons with disabilities as well as health care and tax professionals to find ways to make it easier to apply for the Disability Tax Credit and will provide updates when available.”