(2021) What is the significance of the medical officer's certificate?

It is difficult for tax officials to assess whether expenses are for the treatment or alleviation of an illness and thus tax-deductible, or whether they are for general prevention and health maintenance and therefore cannot be deducted for tax purposes.

In any case, tax officials do not have the expertise to objectively assess the medical indication. Therefore, in certain cases, they require a certificate from the public health officer or the medical service of the health insurance companies, clearly indicating the illness and the medical indication. This certificate must be obtained before the start of treatment. Many honest citizens have already failed at these two hurdles and have been left with often high medical costs.

Since 2012, the cases in which a certificate from the public health officer or the medical service of the health insurance companies must be obtained and submitted to the tax office are explicitly stated in the law (§ 64 Abs. 1 Nr. 2 EStDV):

• Bath or health cure; in the case of a preventive cure, the risk of an illness to be averted by the cure must also be certified, in the case of a climate cure, the medically indicated spa location and the expected duration of the cure must be certified,
• psychotherapeutic treatment,
• medically necessary accommodation away from home for a child of the taxpayer suffering from dyslexia or another disability,
• necessity of care for the taxpayer by an accompanying person, unless this is already evident from the severely disabled person's pass,
• medical aids considered to be general everyday items,
• scientifically unrecognised treatment methods, such as fresh and dry cell treatments, oxygen, chelation, and autologous blood therapy.

In other cases, the tax office must accept the submitted costs and may not require a public health officer's certificate. For example, expenses for curative eurythmy treatments are deductible as extraordinary expenses in accordance with § 33 EStG. It is not necessary to present a public health officer's certificate; a prescription from the GP is sufficient. Curative eurythmy is not a scientifically unrecognised method but is recognised as a special therapy direction in the law of statutory health insurance (BFH ruling of 26.02.2014, VI R 27/13).