Do a patient-restraint 'Security Vest' and 'Tie-Back Vest,' sold to hospitals and nursing homes, qualify for New York's under-$110 clothing exemption, or as exempt medical equipment?

Plain-English summary

Medline Industries, a medical equipment distributor, sells two products from the "Patient Safety Devices" section of its catalog: a Security Vest (which criss-crosses in front, with a waist belt tied out of the patient's reach and shoulder loops with extra straps) and a Tie-Back Vest (which ties in back to make removal harder, with corset buckles to secure straps to a bed frame or wheelchair). Both are designed to prevent a patient from sliding down or sitting up unassisted.

New York exempts clothing and footwear under $110 per item, but a 2001 guidance memo clarifies that not everything worn on the body counts as "clothing" — items like tool belts, hard hats, and protective sport equipment stay taxable even though they're worn. The Department applied that same logic here: because the vests' primary purpose is to function as a safety restraint — comparable to a seat belt — rather than as clothing, and because a patient would need ordinary clothing underneath regardless of whether they're wearing the restraint, the vests don't qualify for the clothing exemption even though patients wear them.

Instead, the vests qualify under New York's separate medical-equipment exemption: they're used in patient treatment to alleviate physical incapacity, and they're not generally useful to someone without that medical need — the two hallmarks of exempt medical equipment. That exemption has an important carve-out, though: medical equipment isn't exempt when purchased by someone performing medical or similar services for compensation (think: a hospital or nursing home billing patients for care using the vest). So sales to such providers are taxable, while sales to entities not billing for medical services — or sales to a tax-exempt organization, or to a reseller who provides a proper resale certificate — stay exempt.

What this means for you

Medical equipment and supply distributors

A product being worn on the body doesn't automatically make it exempt "clothing" — check its primary function. A genuine restraint, protective device, or safety equipment item stays outside the clothing exemption even if patients or workers wear it, but it may separately qualify as exempt medical equipment if it treats or alleviates a medical condition.

Hospitals, nursing homes, and other paid care providers

Watch the medical-equipment exemption's carve-out: if you're billing patients for medical or similar services and the equipment is used in providing that billed care, your purchase of the equipment itself is taxable — the exemption is really aimed at direct purchases by (or for) the patient, not equipment purchased by the paid provider for use in its billable services.

Accountants and tax professionals

This ruling is a clean two-step framework for any body-worn medical device: first ask whether it's genuinely "clothing" (a garment) or something else worn for a specialized purpose (restraint, protective gear); if it's the latter, separately check whether it meets the medical-equipment definition and whether the buyer falls into the paid-medical-services carve-out.

Common questions

Q: Does wearing an item on the body automatically make it exempt clothing?
A: No — items that function as equipment, restraints, or protective gear (rather than as garments) don't qualify for the clothing exemption even though they're worn on the body.

Q: If these vests aren't clothing, are they taxed like ordinary medical devices?
A: They're exempt as medical equipment in most sales, but taxable when sold to a purchaser who performs medical or similar services for compensation, unless that purchaser is tax-exempt or resells the item with a proper certificate.

Q: Would a similar item marketed purely as clothing (not a restraint) be treated differently?
A: Yes — the outcome here turned specifically on the vests' restraint function; a garment without that specialized safety purpose would be analyzed as ordinary clothing under the $110 exemption instead.

Citations and references

Statutes and regulations:

• Tax Law § 1101(b)(15) (clothing and footwear definition)
• Tax Law § 1115(a)(3) (medical equipment/supplies exemption); § 1115(a)(30) (clothing/footwear under $110 exemption)
• 20 NYCRR § 528.4(e) (medical equipment definition); § 528.4(g) (medical supplies); § 528.4(h) (taxable medical equipment/supplies)
• TSB-M-01(02)S (Feb. 12, 2001, clothing and footwear exemption guidance)

Source

• Landing page: https://www.tax.ny.gov/pubs_and_bulls/advisory_opinions/sales_ao_2002.htm
• Opinion: https://www.tax.ny.gov/pdf/advisory_opinions/sales/a02_38s.pdf

Original ruling text

New York State Department of Taxation and Finance

Office of Tax Policy Analysis
Technical Services Division

TSB-A-02(38)S
Sales Tax
July 25, 2002

STATE OF NEW YORK
COMMISSIONER OF TAXATION AND FINANCE
ADVISORY OPINION

PETITION NO. S020109A

On January 9, 2002, the Department of Taxation and Finance received a Petition for
Advisory Opinion from Medline Industries, Inc., One Medline Place, Mundelein, IL 60060.
The issue raised by Petitioner, Medline Industries, Inc. is whether its Security Vest and the
Tie-Back Vest, as described below, are exempt from sales and compensating use tax.
Petitioner submitted the following facts as the basis for this Advisory Opinion.
Petitioner is a distributor of medical equipment and supplies, mainly to hospitals, medical
centers and nursing homes. Petitioner asks whether its Security Vest and Tie-Back Vest are
“clothing to be worn by human beings,” which having a cost of under $110 per item, would be
exempt from the 4% New York State sales and compensating use tax under Section 1115(a)(30) of
the Tax Law.
These items are in the “Patient Safety Devices” section of Petitioner’s catalog. The Security
Vest is described as follows: “Easy to put on and remove. Vest criss-crosses in front. Waist belt
ties out of reach. Shoulder loops may be used with extra straps provided to help prevent patient
from sliding down or sitting up in bed.”
The Tie-Back Vest is described as follows: “Vest ties in back, making it difficult for patient
to remove. Shoulder loops can be used to help prevent sitting up or sliding down in bed. Available
in polyester mesh. Corset buckles used to secure straps to bed frame or wheelchair lock spurs.”
Applicable Law and Regulations
Section 1101(b) of the Tax Law provides, in part:
When used in this article for the purposes of the taxes imposed by
subdivisions (a), (b), (c) and (d) of section eleven hundred five and by section eleven
hundred ten, the following terms shall mean:
*

*

*

(15) Clothing and footwear. (i) Clothing and footwear to be worn by human
beings, but not including costumes or rented formal wear, and (ii) fabric, thread,
yarn, buttons, snaps, hooks, zippers and like items which are used or consumed to
make or repair such clothing (other than such costumes or rented formal wear) and

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which become a physical component part of such clothing, but not including such
items made from pearls, precious or semi-precious stones, jewels or metals, or
imitations thereof.
Section 1115 of the Tax Law provides, in part:
(a) Receipts from the following shall be exempt from the tax on retail sales
imposed under subdivision (a) of section eleven hundred five and the compensating
use tax imposed under section eleven hundred ten:
*

*

*

(3) Drugs and medicines intended for use, internally or externally, in the cure,
mitigation, treatment or prevention of illnesses or diseases in human beings, medical
equipment (including component parts thereof) and supplies required for such use
or to correct or alleviate physical incapacity, and products consumed by humans for
the preservation of health but not including . . . medical equipment (including
component parts thereof) and supplies, other than such drugs and medicines,
purchased at retail for use in performing medical and similar services for
compensation.
*

*

*

(30) Clothing and footwear for which the receipt or consideration given or
contracted to be given is less than one hundred ten dollars per article of clothing, per
pair of shoes or other articles of footwear or per item used or consumed to make or
repair such clothing and which becomes a physical component part of such clothing.
Section 528.4 of the Sales and Use Tax Regulations provides, in part:
*

*

*

(e) Medical equipment. (1) Medical equipment means machinery, apparatus
and other devices (other than prosthetic aids, hearing aids, eyeglasses and artificial
devices which qualify for exemption under section 1115[a][4] of the Tax Law),
which are intended for use in the cure, mitigation, treatment or prevention of
illnesses or diseases or the correction or alleviation of physical incapacity in human
beings.
(2) To qualify, such equipment must be primarily and customarily used for
medical purposes and not be generally useful in the absence of illness, injury or
physical incapacity.
*

*

*

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(4) Medical equipment is not exempt if purchased by a person performing
medical or similar services for compensation. . . .
*

*

*

(g) Supplies. (1) Supplies used in the cure, mitigation, treatment or
prevention of illnesses or diseases or for the correction and alleviation of physical
incapacity are exempt.
*

*

*

(2) Medical supplies are not exempt if purchased by a person performing
medical or similar services for compensation. . . .
(h) Taxable medical equipment and supplies. (1) Medical equipment and
supplies purchased for use in performing medical or similar services for
compensation are not exempt from tax.
Technical Services Division Memorandum entitled Sales and Use Tax Exemption on
Clothing, Footwear, and Items Used to Make or Repair Exempt Clothing, February 12, 2001,
TSB-M-01(02)S provides an explanation of the amendment to the Tax Law with respect to the
imposition of sales tax on clothing, footwear and other items used or consumed to make or repair
such clothing.
TSB-M-01(02)S provides, in part:
Beginning March 1, 2000, clothing and footwear costing less than $110 per
item is exempt from the 4% New York State sales and compensating use taxes. This
exemption does not apply to any locally imposed sales and use taxes unless the
county or city imposing those taxes elects to provide for it. . . .
The exemption applies only to clothing and footwear worn by humans. It
also applies to most fabric, thread, yarn, buttons, snaps, hooks, zippers, and like
items which become a physical component part of exempt clothing, or that are used
to make or repair exempt clothing. . . .
While the exemption applies to items of clothing and footwear worn on the
body, not all items worn on the body are clothing and footwear. . . Equipment items,
such as tool belts, hard hats, and sport, bicycle, and motorcycle helmets, though worn
on the body, remain taxable. Protective goggles and safety glasses (unless
prescription) for sport or occupational use, protective sport or occupational masks

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or pads . . . fireplace mittens, and similar pieces of equipment (sporting or otherwise)
also remain taxable. . . .
Opinion
Petitioner is a distributor of medical equipment and supplies, mainly to hospitals, medical
centers and nursing homes. Petitioner has described the products in question, the Security Vest and
Tie Back Vest, as items which are worn by patients to limit their movement while sitting or lying
in a chair or bed.
Section 1115(a)(30) of the Tax Law provides an exemption from sales and use tax for
clothing and footwear worn by humans which costs less than $110 per article of clothing. However,
TSB-M-01(02)S, supra, provides that not all items worn on the body are clothing or footwear. It is
necessary to consider the purpose for which the Security Vest and Tie Back Vest are used to
establish if these items qualify as clothing or footwear. The primary purpose of these items is to
provide a safety restraint for patients in a sitting or lying position as evidenced by the product
descriptions in Petitioner’s catalog. Consequently these items would only be purchased for use by
a patient in need of a safety restraint. Although these items are worn by patients requiring such
restraint, the fact that these items include characteristics which might resemble clothing does not
classify them as such. These items are not designed to be worn as clothing, rather they are intended
to serve as a more comfortable restraint for patients. These items function only as a restraint, similar
to a seat belt, and are not useful as clothing. The patient would need the same appropriate covering
or clothing to protect against indoor or outdoor temperature or weather conditions whether or not
the patient was using these restraints. The Security Vest and Tie Back Vest are not clothing,
therefore, and do not qualify for the exemption provided for in Section 1115(a)(30) of the Tax Law.
Section 1115(a)(3) of the Tax Law exempts medical equipment from sales and use tax,
except when purchased by a person performing medical or similar services for compensation.
Medical equipment means machinery, apparatus and other devices which are intended for use in the
cure, mitigation, treatment or prevention of illnesses or diseases in human beings, and are not
generally useful in the absence of illness, injury or physical incapacity.
The Security Vest and Tie Back Vest as described above are used in patient treatment and
to alleviate physical incapacity, and are not generally useful in the absence of illness, injury or
physical incapacity. Therefore, these items qualify as medical equipment, exempt from tax under
Section 1115(a)(3) of the Tax Law when sold to a purchaser who is not performing medical or
similar services for compensation. The sale of the Security Vest and Tie Back Vest to a purchaser
who is performing medical or similar services for compensation would be subject to sales tax and
compensating use tax. However, if the sale is to an organization exempt under Section 1116(a) of

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the Tax Law or to a person who will resell the vests, such as a wholesaler, then no sales or use tax
will be due, provided that Petitioner obtains the appropriate exemption document from the
purchaser.

DATED: July 25, 2002

NOTE:

/s/
Jonathan Pessen
Tax Regulations Specialist IV
Technical Services Division

The opinions expressed in Advisory Opinions are
limited to the facts set forth therein.