Total US Centric Question - Tax Deductions

I've had some documentation from my dermatologist, but not much because it seemed pointless once I found out about the lack of insurance coverage. So it definitely seems unlikely that I could declare the expense. But.. I promised Art I'd look into it for him :P

My PS worded my disability forms in a way that it was medically necessary. Forget how it was worded, but I collected Calif disability for 8 weeks and did claim it on my taxes.

Our accountant says that surgery directly related to my weight loss will deductible.

The year I had my plastics I had enough deductions to claim it on my taxes. My plastics were deemed "medically necessary" even the part that wasn't covered by insurance (TT was covered by breast lift was not). That year I was able to claim all medical deductions - including insurance premiums. Worth checking into.

yes you can deduct PS cost after massive weight loss, since ....obesity is a disease

and yes I have deducted it off my taxes

The wording seems a little gray to me. You would only have to prove it if you were audited. I have had medical above 10% in a year several times and you don't itemize it on the return... just have to be willing to present your proof if it raises a red flag.

Before you complete your taxes you should have documentation and photos of limitations caused by your excess skin and a letter of necessity in hand from your bariatric surgeon and your primary. Don't assume your doctors will agree with you or that you will get a letter after the fact.

Breast implants and "mommy make overs" are not a medical necessity. But skin removal, some muscle repair and breast lifts are.

The wording in the tax laws is ambiguous.

Here is how something like that works. You claim the expense and you are prepared to tell an auditor that the disfiguration was 100% percent caused by the disease of obesity. During an audit you never back down from that claim.

You are also prepared to pay back the money if the ruling goes against you.

Your chances of getting audited depend on your income:

"People who earned more than $1 million had the greatest chance of getting audited with the IRS examining 6.4 percent of returns in that income bracket. Those earning between $200,000 and $1 million had a 2.9 percent chance of getting audited, and those with incomes under $200,000 had about a 1 percent chance."

Audits are expensive and the auditors want to earn their keep by getting back big amounts of money from those being audited. If you claim the deductions, put together whatever you might need for an audit and don't worry about it.

The IRS does not have auditors that have much expertise in skin removal. If you can document the issues from the excess skin in the form of a letter or evaluation by a physician, and that letter states that skin removal is needed to improve your health, then that should suffice. I HAVE had numerous patients do this successfully.

Just because you don't meet insurance definition does not mean you fail to meet IRS definitions. My argument has ALWAYS been that problems from excess skin are a deformity resulting from the disease of obesity.

In my mind the removal of pounds of lose and hanging skin that, with 40 pounds still left to lose, already causes chaffing, odor and, in my case, makes shaving my arm pits without help impossible is NOT cosmetic. I think it's BS that my (expensive) insurance policy excludes it. Especially since I work for a high hospital system that covers WLS.