Clinical letter

A clinical letter is a short letter from the diagnosing physician that names the celiac diagnosis and the medical instruction to follow a gluten-free diet. A chart note from the same physician saying the same thing works too. Either one is the document a CPA or tax professional will ask for when the gluten-free premium shows up on Schedule A.

The letter does not need to be long. A clinically appropriate version names the patient, the date of diagnosis (or the date the diet was prescribed), the condition (celiac disease), and the instruction (lifelong gluten-free diet). One paragraph. A few sentences. Some physicians use a template; some write a fresh one.

What the letter does inside the substantiation chain is hold up the middle link. The three documents a CPA or tax professional expects on a celiac medical-expense claim are: the diagnosis (often a pathology report from the biopsy), the prescribed-diet instruction (the clinical letter or chart note), and the receipts (Gluten Hero's year-end report). Without the middle link, the first and third do not connect.

Most diagnosing physicians will write the letter on request. Some charge a small administrative fee, some do not. The letter is a one-time document for tax purposes; it does not need to be re-issued every year. Keep a copy filed.

If the diagnosis is years old and the original chart note is missing or thin, the request goes to whoever holds the records today: the current gastroenterologist, the primary-care physician with access to the original notes, or the records department of the diagnosing facility.

For the full walk-through of what to ask for, read Asking your doctor for a clinical letter.