Deduction for Rhinoplasty

[nycCPA]

Hi all,

So a client's wife had a septorhinoplasty done. Basically this is having the septum fixed, which was covered by insurance, and at the same time having the cosmetic aspect of the nose fixed as well. We asked the doctor does the fixing for the rhinoplasty aspect assist or aid in the natural and proper functioning of the septum and the Doctor said "Yes, it does, because the situation was such that he probably would have had to break certain bones in the nose to achieve the proper functioning of the septoplasty." However, the insurance would not cover the rhinoplasty and the doctor said he would sign something to the above quoted effect. I read Publication 502, with an excerpt below. I was wondering what people's thoughts were to this as the client would be able to exceed enough so the 7.5% AGI floor if the out-of-pocket cost for the rhinoplasty portion of the surgery were deductible. Thoughts please, thanks. As an FYI, this is supposedly an injury from an accident 10+ years ago, though there is no documentation to that effect.

David

Excerpt from Relevant Publication 502:

Cosmetic Surgery
Generally, you cannot include in medical expenses the amount you pay for unnecessary cosmetic surgery. This includes any procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. You generally cannot include in medical expenses the amount you pay for procedures such as face lifts, hair transplants, hair removal (electrolysis), and liposuction.

You can include in medical expenses the amount you pay for cosmetic surgery if it is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease.

Example.

An individual undergoes surgery that removes a breast as part of treatment for cancer. She pays a surgeon to reconstruct the breast. The surgery to reconstruct the breast corrects a deformity directly related to the disease. The cost of the surgery is includible in her medical expenses.

[RLymanC]

Surgery

I had the same proceedure. Doc had to break septum in order to get at certain areas during the operation, he then staightned up my nose at the same time. No problem with insurance or deduction

I would think if the cosmetic part was done seperately you would have a problem.

[erchess]

My two cents

I would deduct the expenses of this cosmetic surgery if either the doctor who did it signed what this doctor said he would sign or if the patient had the documentation from ten years ago. I believe that under the new regime the preparer who wants to be safe from IRS penalties needs to either see the statement or documentation or disclose the fact that he has not seen it.

However, everyone on this board knows that getting reimbursed by the insurance company is a better deal for the taxpayer than deducting the expense. If I were the patient or spouse of the patient in this scenario I would not accept the insurance company's refusal to pay for the cosmetic surgery without asking my lawyer to read my policy and consider writing a letter to the company. However, I do have a plan that gives me among other things the free review of a short contract and the writing of a letter each month and a 20% discount on un covered legal services from my provider firm.

[taxea]

My question to the doctor would be "was the rhinoplasty necessary in order to correct the medical problem?" If the answer is yes then I would take the deduction. taxea