Caregiver Benefits Application Template

FOR PEOPLE CARING FOR A SICK, DISABLED OR DYING FAMILY MEMBER OR FRIEND

Use this to (1) apply for EI caregiving benefits and (2) track the tax credits you can claim at tax time.

📋 INSTRUCTIONS: Fill in the [BRACKETS]. Delete what does not apply. Keep every receipt and letter.

PART 1 — WHICH EI CAREGIVING BENEFIT?

You do not need to be related or live with the person — only “like family,” with a medical certificate.

Benefit I am applying for: [choose one] Person cared for: [name], relationship: [like-family relationship] Medical certificate completed by: Dr. [name], dated [date]

PART 2 — EI APPLICATION COVER LETTER (attach to MSCA application)

TO: Service Canada — EI Caregiving Benefits FROM: [Your name], [address], SIN [--___]

I am applying for the [Family caregiver benefit for children / adults / Compassionate care benefit] because I am away from work to care for [name], who is [critically ill/injured / needing end-of-life care], certified by Dr. [name] on [date].

My last day of work was [date]; I expect to be off work until [date]. I have attached the medical certificate and my Record of Employment.

Signature: ______ **Date:** ______

Apply through My Service Canada Account. Keep the confirmation number: [__].

PART 3 — TAX CREDITS TO CLAIM (keep for tax time)

Canada caregiver credit (line 30425)

• Infirm spouse/partner or eligible dependant 18+? Yes / No
• Dependant net income: $[__] (credit reduced as this rises; max $8,601, 2025 tax year)

Medical Expense Tax Credit (lines 33099 / 33199)

Track every eligible expense you paid in the year:

• Total eligible: $[__]
• Subtract the lesser of 3% of net income or $2,834 (2025): claim the rest.
• Keep all receipts and the medical practitioner certification where required.

PART 4 — FREE ONTARIO SUPPORT

• Ontario Caregiver Organization helpline: 1-833-416-2273 (live chat too) — counselling, peer support, e-learning, toolkits. Free, confidential.
• ontariocaregiver.ca

Appeal note (if EI refuses)

Request reconsideration within 30 days (form INS5210), no fee. Since April 1, 2026 EI appeals go to the EI Benefits Appeal Tribunal (BOA), not the SST.

Sources (verified 2026-10-07)

• EI caregiving — Canada.ca
• Canada caregiver credit — Canada.ca
• METC (lines 33099/33199) — Canada.ca
• Ontario Caregiver Organization

Not legal or tax advice. Confirm current amounts, forms and deadlines with the source before filing.