Which listed braces, supports, splints, pads, and foot products qualified as exempt orthotic devices?

Plain-English summary

California treated the listed knee, ankle, elbow, wrist, finger, back, rib, abdominal, thigh, calf, and other braces or supports as exempt orthotic devices when sold to a physician for patient treatment or directly to a patient under a doctor's order or prescription. Listed Wonder Straps, “Prrddure Dots,” and flexible ice inserts qualified only when sold as part of a support item.

The opinion taxed listed silicone heel cups, ice cubes and mats, scissors, premolded foot orthotics, insoles, heel and metatarsal cushions or pads, wedges, a hand exerciser, and waffle-pattern fabric. It separately described the statutory requirements for a custom-made biomechanical foot orthosis.

Common questions

Did every brace or support qualify automatically?

No. The opinion imposed the physician-sale or doctor-order condition on its exempt list.

Were separately sold support accessories exempt?

The three conditionally listed components qualified only when sold as part of a support item.

Did the listed foot products qualify?

No. The listed premolded orthotics, insoles, cushions, pads, and wedges were taxable.

Citations and references

• California Revenue and Taxation Code section 6369 — medicine definition and exclusions discussed in the opinion
• California Revenue and Taxation Code section 6369(c)(1)-(2) — sutures, listed implants, and permanent-implant rules summarized
• California Revenue and Taxation Code section 6369(c)(3) — orthotic-device provision applied to the listed qualifying products

Source

• Annotated Legal Opinions collection: https://cdtfa.ca.gov/taxes-and-fees/annotations-menu.htm
• Annotation page: https://cdtfa.ca.gov/lawguides/vol2/suta/425-0000-all.html
• Original supporting opinion: https://cdtfa.ca.gov/lawguides/annotations/425-0615-350.pdf

Original ruling text

STATE OF CALIFORNIA

425.0615.350

STATE BOARD OF EQUALIZATION
916-324-5589

June 1, 1990
Dear X-----------------,
This is in response to your letter of March 29, 1990. You have requested our opinion regarding the correct application of tax to the orthopedic products your company sells and distributes. California Sales and Use Tax Law imposes tax on the sale or use of tangible personal property in this state, unless such sale or use is otherwise exempt from taxation. Revenue and Taxation Code section 6369 exempts from tax the gross receipts from the sale, storage, use or other consumption in this state of medicines. “Medicines” as defined in section 6369 means and includes: “ … any substance or preparation intended for use by external or internal application to the human body in the diagnosis, cure, mitigation, treatment or prevention of disease and which is commonly recognized as a substance or preparation intended for such use.” Section 6369(c)(1) and (2) provide that the term “medicines” includes sutures, whether or not sutures are permanently implanted, bone screws, bone pins, pacemakers, and other articles permanently implanted in the body to assist the function of all or any part of any natural organ, artery, vein or limb. Section 6369(c)(3) provides that the term “medicines” includes orthotic devices or replacement parts for such devices, designed to be worn on the person of the user as a brace, support, or correction for the body structure. Notwithstanding the above analysis, as to tax exempt medicines, the following items are specifically excluded from the term “medicines” unless they come within one of the exceptions listed above: “splints, bandages, pads, compresses, supports, nonmedicated dressings, instruments, apparatus, contrivances, appliances, devices or other mechanical, electronic, optical or physical equipment or component parts thereof.” Also excluded from the term “medicines” are orthopedic shoes and supportive devices for the foot unless they are an integral part of a leg brace or artificial leg or a “custom made biomechanical foot orthoses.”

A “custom-made biomechanical foot orthoses” means an individually prescribed foot orthosis which is custom fabricated over a neutral or near neutral subtalar joint with a pronated midtarsal joint position positive plaster model of the patient's foot, which model, when the cast is modified to support the osseous position of the forefoot in relationship to the rear foot, embodies the angular osseous relationships of the anterior and posterior portions of the foot. We have reviewed the items listed in your letter. The following items qualify as exempt “orthotic” devices under section 6369(c)(3) when they are sold to a physician for treatment of a patient or sold directly to a patient pursuant to a doctor's order or prescription: Dricast Orthopedics Miracle Knee Supports - THl09, TH209,TB309, TH409, TH509, TH609 Neoprene and Felt Buttress Pads - TH19, TH 191 Stabilizer Brace - TH192 Brace Hinge w/hyperextension stop - TH193B Interior Patellar Pull Component - TH193B Laterial Release Pad - THl95 Lumbro-Sacral Back Supports – TH10l, TH20l, TH301 Rib Belt - TH401 Abdominal Support - TH501 Thigh Calf Support - THl04 Magic Wrist Support -THI07 Ankle Elbow Support – TH108A & B Tennis Elbow Support – TH108C Wonder Straps - TH197 - exempt, if sold as part of a support item. Prrddure Dots - TH198 - Exempt, if sold as pact of a support item. Flexible Ice Inserts - FI-4 - Exempt, if sold as part of a support item. Ezy Wrap (Professional Products Inc.) 840 Ankle Brace Arm Sling - #2341 Velcro Elastic Bandages - #4792 Wrist/Forearm Supports - #901, 903, 905, 907 Thumb/Finger Splints - #2552 Hinged Knee Brace - #1267 MediUSA Genumedi - Elastic Knee Support Levamedi - Elastic Ankle Support Epicomed - Elastic Elbow Support

OMNI Scientific
OMNI II Bi-Lateral Knee Support
Anderson Knee Stable Knee Brace
OS-5 Off-The Shelf Custom Knee Brace
TS-7 Custom Knee Brace
Orthoglass
Orthoglass Fiberglass Splinting (Casting) Material
Orthoglass Elastic Bandage
Swede-O Universal
Swede-O Padded Ankle Support
The following items do not qualify as exempt orthotic devices. Tax will therefore apply to the sale of these items. Orthopedic Product Sales Healers Heel Silicone Cups Kool Kubes Kool Kube Ice Cubes and Mats Orthoglass Fiskars Razor-edge Scissors Parker Medical Supply UCO 4PP Heal Bed foot Orthotic System UCO Pre-Molded Foot Orthotics Chattanooga Corporation Viscolas Foot Orthotics – Full-Cushion Insole Heel Cushions Heel Spur Cushions Metatarsal Pads Longitudinal Arch Pads Corrective Heel Wedges Neuroma Pads

Toe Crest Pads
Viscolas Hand Exerciser
Viscolas Waffle Pattern Fabric

If you have further questions concerning this matter, please write this office again. Very truly yours,

Mary C. Armstrong
Senior Tax Counsel
MCA:wak