Is refractive surgery tax deductible?

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Probably yes, but policy is not clear. The following is a letter one individual received. This letter is the opinion of one IRS representative and is not necessarily consistent with all IRS investigators. We recommend you contact your local IRS office and ask for a written determination. You may want to provide a copy of this letter as a point of reference..

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Date: March 27, 1996

Refer Reply to: CC:DOM:IT&A:2 - TR-31-2707-95LEGEND:A = XXX

Dear XXX:

This letter is in response to your correspondence dated November 28, 1995, in which you requested a ruling regarding the deductibility of radial keratotomy expenses under section 213 of the Internal Revenue Code. A, an adult individual, has an optical disorder known as myopia (nearsightedness) and is considering undergoing a radial keratotomy procedure in the near future to correct this condition. Myopia occurs when the eyeball becomes elongated, causing incoming light rays to be refracted by the cornea and the lens of the eye to a focal point short of the retina. As a result, distant images are perceived as blurry.

Radial keratotomy is a surgical procedure and involves making small incisions in the cornea radiating outward from the central area of the cornea. These incisions cause the cornea to flatten and change the angle of refraction, with the result that incoming light rays focus on, or closer to, the retina. Acuity of vision is thereby improved.

Section 213(a) of the Internal Revenue Code allows a deduction for medical care expenses for which the taxpayer is not compensated by insurance or otherwise to the extent the expenses exceed 7.5 percent of adjusted gross income. "Medical care" is defined in section 213(d)(1)(A) to include amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body. Under section 213(d)(9)(A), medical care does not include cosmetic- surgery unless the surgery is necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. "Cosmetic surgery" is defined in section 213(d)(9)(B) as any procedure that has as its objective the improvement of the patient's appearance without also meaningfully promoting the proper function of the body or preventing or treating illness or disease. Sec. 1.213-1(e)(1)(ii) of the Income Tax Regulations states that medical care includes operations or treatments, including surgery, that affect a portion of the body and that are deemed to be for the purpose of affecting any structure or function of the body. Deductions will be confined to expenses incurred primarily for prevention or alleviation of a physical or mental defect or illness. Section 1.213-1(e)(1)(iii) specifically states that expenditures for eyeglasses and for the acquisition of a seeing eye dog qualify as expenditures for medical care. Rev. Rul. 55-261, 1955-1 C.B. 307, and Rev. Rul. 68-295, 1968-1 C.B. 92, add that even maintenance expenses associated with a seeing eye dog are deductible. Expenses for contact lenses and contact lens insurance have been determined to be payments for medical care. Rev. Rul. 74-429, 1974-2 C.B. 83.

Under the facts presented, A will be undergoing a surgical procedure that will affect a structure or function of the body and whose purpose is to correct a physical defect. We conclude that the radial keratotomy procedure will constitute medical care to A. To the extent not compensated for by insurance or otherwise, the expenses of the procedure that exceed 7.5 percent of A's adjusted gross income will be deductible. This ruling is directed only to the taxpayer who requested it. Section 6110(j)(3) of the Code provides that it may not be used or cited as precedent. No opinion is expressed as to the federal tax consequences of the transaction described above under any other provision of the Code. A should attach a copy of this ruling to A's tax return for the taxable year in which the transaction covered by this ruling is consummated. In accordance with the power of attorney submitted, we are sending this ruling to an authorized representative.

Sincerely,
Assistant Chief Counsel
(Income Tax & Accounting)

By: Robert A. Berkovsky
Chief, Branch 2