## Facts

- A taxpayer incurred unreimbursed costs for crutches used to assist mobility after a leg injury.
- The taxpayer incurred unreimbursed costs for bandages used to cover torn skin.
- A physician recommended that the taxpayer take over-the-counter aspirin for pain related to the leg injury; the taxpayer purchased aspirin without a prescription and was not reimbursed.
- The taxpayer, who has diabetes, incurred unreimbursed costs for blood-sugar test kits used to monitor blood glucose levels.

## Issues

1. Whether unreimbursed costs of crutches and bandages used to treat injuries are deductible “medical care” expenses under I.R.C. § 213(a) and (d).
2. Whether the cost of physician-recommended over-the-counter aspirin purchased without a prescription is deductible under § 213, given § 213(b)’s limitation for “drugs.”
3. Whether unreimbursed costs of diabetic blood-sugar test kits are deductible “medical care” expenses under § 213(a) and (d).

## Decision

- Crutches: deductible medical care expense under § 213(a) and (d), subject to the applicable adjusted-gross-income threshold and other general limits.
- Bandages: deductible medical care expense under § 213(a) and (d), subject to the applicable threshold and other general limits.
- Over-the-counter aspirin: not deductible under § 213 because § 213(b) disallows amounts paid for a “drug” unless it is a “prescribed drug” (or insulin), and aspirin does not legally require a prescription.
- Blood-sugar test kits: deductible medical care expense under § 213(a) and (d), subject to the applicable threshold and other general limits.

## Legal Principles

- “Medical care” under § 213(d)(1) includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting a structure or function of the body.
- Expenses for medical equipment, supplies, and diagnostic devices used primarily for treating or diagnosing a disease or injury (e.g., crutches, bandages, glucose test kits) generally qualify as § 213(d) medical care.
- Section 213(b) bars a § 213 deduction for amounts paid for a “drug” unless the drug is insulin or is a “prescribed drug,” meaning it legally requires a physician’s prescription for use by the individual.
- A physician’s recommendation does not convert an over-the-counter drug into a “prescribed drug” for § 213(b) purposes.
- Items that are not “drugs” (such as equipment and diagnostic supplies) are not subject to § 213(b)’s prescription-only limitation and are tested under § 213(d)’s medical care standard.

## Conclusion

The ruling permits § 213 deductions for unreimbursed costs of crutches, bandages, and diabetic blood-sugar test kits as medical care, but disallows a deduction for over-the-counter aspirin even when physician-recommended because § 213(b) requires the drug to be prescription-only (or insulin).


Rev. Rul. 2003-58, 2003-22 I.R.B. 959 (2003)