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Updated January 2009 |
Special Diet
This section is an excerpt from the Ontario Works Act, 1997 prescribed by the Province of Ontario.
OW Reg.
Medical Conditions Re: Special Diets
1. (1)
For the purposes of paragraph 4 of subsection 41 (1), paragraph 3 of subsection 44 (1), paragraph 5 of subsection 44 (2), paragraph 3 of subsection 44 (3) and clause 57 (5) (c) of Ontario Regulation 134/98 (General) made under the Act, the following is the policy for interpreting and applying those provisions:
1.
The only medical conditions requiring special diets are those set out in Column A of Schedule 1, subject to subsections (2) and (3).
2.
The amount to be included in a recipients' budgetary requirements if a member of the recipients' benefit unit has a medical condition requiring a special diet shall be determined in accordance with section 2.
(2)
If an approved health professional confirms that a member of a recipients' benefit unit has gestational diabetes, the administrator shall include in the recipients' budgetary requirements the amount for that condition determined in accordance with section 2 for the remainder of the member's pregnancy and for a period of up to three months after the end of the pregnancy.
(3)
If an approved health professional confirms that a member of a recipients' benefit unit has the medical condition referred to in item 27 of Schedule 1 relating to breast-feedings, the administrator shall not include the special diet allowance for that condition in the recipients' budgetary requirements after the first birthday of the infant in question.
Budgetary requirements re: special diets
2. (1)
For the purposes of subparagraph 4 i of subsection 41 (1), subparagraph 3 i of subsection 44 (1), subparagraph 5 i of subsection 44 (2), subparagraph 3 i of subsection 44 (3) and subclause 57 (5) (c) (i) of Ontario Regulation 134/98 (General) made under the Act, the amount determined in accordance with Schedule 1 that the administrator shall include in the recipients' budgetary requirements shall be, for each medical condition requiring a special diet that a member of the recipients' benefit unit has, as confirmed by an approved health professional,
(a)
the amount set out in Column C of Schedule 1; or
(b)
if Column B of Schedule 1 indicates that the medical condition is a condition that may cause weight loss, the amount determined in accordance with subsections (2), (3), (4) and (5).
If a member of a recipients' benefit unit has a medical condition that may cause weight loss, as indicated in Column B of Schedule 1, the amount that shall be included in the recipients' budgetary requirements shall be, subject to subsections (3), (4) and (5),
(a)
if the approved health professional confirms that the member has not lost any weight or has lost 2 per cent or less of his or her usual body weight, the amount set out in Column C of Schedule 1;
(b)
if the approved health professional confirms that the member has lost more than 2 per cent but no more than 5 per cent of his or her usual body weight, $150;
(c)
if the approved health professional confirms that the member has lost more than 5 per cent but no more than 10 per cent of his or her usual body weight, $180; or
(d)
if the approved health professional confirms that the member has lost more than 10 per cent of his or her usual body weight, $240.
(3)
If the medical condition that may cause weight loss is one of the following conditions, the amount that shall be included in a recipients' budgetary requirements is the amount determined in accordance with subsection (4):
1
Anorexia Nervosa
2
Cystic fibrosis
3
Kwashiorkor
4
Marasmus
The amount to be included in a recipients' budgetary requirements if a member of a recipients' benefit unit has a medical condition referred to in subsection (3) shall be,
(a)
if the approved health professional confirms that the member has not lost any weight or has lost 2 per cent or less of his or her usual body weight, the amount set out in Column C of Schedule 1; and
(b)
if the approved health professional confirms that the member has lost more than 2 per cent of his or her usual body weight, $150.
(5)
If an approved health professional confirms that a member of a recipients' benefit unit has more than one medical condition that may cause weight loss, as indicated in Column B of Schedule 1, the amount to be included in the recipients' budgetary requirements shall be determined as if the member only had one such condition.
If an approved health professional confirms that a member of a recipients' benefit unit has a medical condition referred to in item 14 of Schedule 1, the administrator shall include in the recipients' budgetary requirements for the first month after the confirmation is received an amount of $75 to compensate for the cost of purchasing a blender, in addition to the monthly amount set out in Column C of Schedule 1.
More than one medical condition
3.
Despite section 2, if a member of a recipients' benefit unit has more than one medical condition that requires a special diet, as confirmed by an approved health professional, the maximum amount that may be included in the recipients' budgetary requirements with respect to all the medical conditions that the member has is $250.
Definition
4.
In this Regulation,
"approved health professional" means a person who is an approved health professional under subsection 2 (4) of Ontario Regulation 134/98 (General) made under the Act.
5. (1)
If, in determining the amount of assistance paid or payable to a recipient for the period between September 1, 2006 and the day section 2 of Ontario Regulation 486/06 comes into force, an amount is or was required to be included in the recipients' budgetary requirements for a special diet required for a member of the recipients' benefit unit who has a medical condition known as amyotrophic lateral sclerosis, the administrator shall adjust the amount of assistance paid or payable in accordance with subsection (2).
(2)
The amount of an adjustment under subsection (1) shall be the difference between the amount to be included in the recipients' budgetary requirements for the special diet referred to in subsection (1) based on Schedule 1 as it read before the day section 2 of Ontario Regulation 486/06 comes into force and the amount to be included for the special diet based on Schedule 1 as it reads after that day.
(3)
The administrator shall pay the amount of the adjustment as soon as practicable.
The following health professionals can certify that Special Diet Allowance is required due to a medical condition:
- Physician who is registered with the College of Physicians and Surgeons of Ontario;
- Registered Nurse in the Extended Class - RN(EC) who is registered with the College of Nurses of Ontario;
- Registered Dietician who is registered with the College of Dieticians of Ontario.
- Registered Midwife who is registered with the College of Midwives of Ontario (a Midwife may only confirm that a special diet is required for medical conditions Inadequate lactation to sustain breast feeding diet or breast-feeding is contraindicated and for the Pregnancy Nutritional Allowance) and
- Traditional Aboriginal Midwife recognized and accredited by his or her Aboriginal community (a Traditional Aboriginal Midwife may only confirm that a special diet is required for medical conditions Inadequate lactation to sustain breast feeding diet or breast-feeding is contraindicated and for the Pregnancy Nutritional Allowance).
The Prescribed Policy Statements set out medical conditions that require Special Diet Allowance(s) and the amounts to be paid.
The approved health professional will complete an Application for Special Diet Allowance/Pregnancy/Breast-feeding Nutritional Allowance indicating the medical condition and length of time a special diet is required for the medical condition. Eligibility will be reviewed at least once every twelve months.
Only the ministry-approved form (Application for Special Diet Allowance/Pregnancy/Breast-feeding Nutritional Allowance) is used. The participant can obtain the form by contacting his or her caseworker.
Administrative Guidelines
On receipt of an Application for Special Diet Allowance/Pregnancy/Breast-feeding Nutritional Allowance, the caseworker will:
- compare the confirmed medical condition(s) with Special Diets Schedule and calculate the allowable amount;
- add the approved amount with an expiry or renewal date; and,
- advise the participant of the approved amount and review date.
When an approved health professional confirms more than one medical condition which requires a special diet for the same member of the benefit unit, the cumulative total of the Special Diet Allowance cannot exceed the maximum of $250 per month.
The Special Diet Allowance is to be issued on a monthly basis, therefore no lump sum or retroactive payments will be issued.
Eligibility for Special Diet Allowance should be reviewed at least once every 12 months, unless the approved health professional specifies a shorter review period. To continue the Special Diet Allowance, the participant will be required to have an approved health professional complete an Application for Special Diet Allowance/Pregnancy/Breast-feeding Nutritional Allowance. If the Application for Special Diet Allowance/Pregnancy/Breast-feeding Nutritional Allowance is not received or the participant no longer has a medical condition that requires a special diet, the Special Diet Allowance will not be renewed and will be removed from the participant's assistance.
If the approved health professional indicates at any point that the special diet is no longer required, the Special Diet Allowance will end.
Item |
Column A |
Column B |
Column C |
|
Medical Conditions That Require a Special Diet |
Medical Conditions That May Cause Weight Loss |
Monthly Amount for Special Diet Unless Otherwise Specified |
1. |
Amyotrophic Lateral Sclerosis |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
2. |
Anorexia Nervosa |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (4) |
3. |
Cardiovascular Disease |
|
$10 |
4. |
Celiac Disease
less than 2 years of age |
|
$58 |
|
2-10 years of age |
|
$115 |
|
11-18 years of age |
|
$147 |
|
19 years of age or older |
|
$131 |
5. |
Chronic Constipation |
|
$10 |
6. |
Chronic wounds requiring protein |
|
$10 |
7. |
Congenital Abnormalities of the Metabolic Type — Adults |
|
$10 |
8. |
Congenital Abnormalities of the Metabolic Type — Infants & Children |
|
$10 |
9. |
Congestive Heart Failure |
|
$44 |
10. |
Crohn’s Disease |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
11. |
Cystic Fibrosis |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (4) |
12. |
Diabetes |
|
$42 |
13. |
Diverticulum/Diverticulitis |
|
$10 |
14. |
Dysphagia/Swallowing or Mastication Difficulties |
|
$25 and, when appropriate, the one-time amount referred to in subsection 2 (6) |
15. |
Extreme Obesity: Class III BMI > 40 |
|
$20 |
16. |
Food Allergy — Eggs |
|
$10 |
17. |
Food Allergy — Milk/Dairy or Lactose Intolerance
less than 2 years of age |
|
$95 |
|
2-10 years of age |
|
$97 |
|
11-18 years of age |
|
$55 |
|
19 years of age or older |
|
$35 |
18. |
Food Allergy — Soya |
|
$83 |
19. |
Food Allergy — Wheat
less than 2 years of age |
|
$38 |
|
2-10 years of age |
|
$77 |
|
11-18 years of age |
|
$98 |
|
19 years of age or older |
|
$57 |
20. |
Gestational Diabetes |
|
$44 |
21. |
Gout |
|
$32 |
22. |
HIV/AIDS |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
23. |
Hyperlipidemia |
|
$10 |
24. |
Hypertension |
|
$10 |
25. |
Hypertension and Congestive Heart Failure and Grade 1 to 2 left ventricular function |
|
$44 |
26. |
Hypercholesterolemia |
|
$22 |
27. |
Inadequate lactation to sustain breast-feeding or breast-feeding is contraindicated during the first 12 months of infant’s life
lactose tolerant |
|
$75 |
|
lactose intolerant |
|
$83 |
28. |
Kwashiorkor |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (4) |
29. |
Liver Failure / Hepatic Disorders |
|
$10 |
29.1 |
Lupus |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
30. |
Macrocytic Anaemia |
|
$10 |
31. |
Malabsorption |
|
$20 |
32. |
Malignancy |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
33. |
Marasmus |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (4) |
34. |
Microcytic Anaemia |
|
$30 |
34.1 |
Multiple Sclerosis |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
35. |
Osteoporosis/Osteomalacia/Osteopenia |
|
$10 |
36. |
Ostomies [e.g., jejunostomy, ileostomy] |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
37. |
Pancreatic Insufficiency |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
38. |
Post-gastric surgery |
|
$10 |
39. |
Prediabetes: Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG) |
|
$42 |
40. |
Renal Failure — Dialysis |
|
$44 |
41. |
Renal Failure — Pre-Dialysis |
|
$44 |
42. |
Short Bowel Syndrome |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
43. |
Ulcerative Colitis |
Yes |
$75 or such higher amount as may be permitted in accordance with subsection 2 (2) |
