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Medical Inadmissibility

6/12/2018

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If you wish to immigrate to Canada, and in some cases if you are applying for a temporary visa, you must undergo a medical examination. The purpose of immigration medical examinations is to determine that you do not cause a danger to public health and that you do not have a medical condition that may be excessively costly to treat when you arrive in Canada.
 
Grounds for Medical Inadmissibility
Immigration medical examinations are carried out by designated physicians and Immigration, Refugee and Citizenship Canada (“IRCC”) has a list of physicians that can assist you in countries around the world. The medical examination is a standard physical exam and includes a series of tests (blood and urine) and x-rays. You will also be asked about your prior medical history and your mental state as part of the examination. The results of these examinations are extremely important as you may be found inadmissible to Canada if:
1)      your condition would endanger the health or safety of the Canadian population at large, or
2)      your condition may cause excessive demand on existing social or health services provided by the government.
 
An example of a medical condition that may make you inadmissible under the first category is Active Pulmonary Tuberculosis (TB). There are also other conditions that can make you inadmissible under this category such as suffering from a variety of  brain disorders or applicants who have substance abuse issues that cause them to behave antisocially or in a violent manner, and other types of hostile and disruptive behaviour.
 
In the second category, you may be found inadmissible if your condition requires  government–funded health services such as specialists, nurses, physiotherapists, laboratory services, medications or hospital care, as well as social services such as specialized residence or home care, social rehabilitative services, personal support services, and services intended to assist a person in their physical, emotional, social, psychological or vocational function. If the anticipated costs for these services are found to exceed the Canadian per capita health services and social services costs over a 5 to 10 year period, then the immigration officer may find you inadmissible due to excessive demand.
 
Recent Changes to Excessive Demand
Many believed that Canada's excessive demand rules were outdated and asked for recognition of the discriminatory nature of this provision on people with disabilities. The good news is that Canada increased the threshold for “excessive demand” significantly effective on 1 June 2018.
 
Under the old provisions, approximately 1,000 applicants are denied immigration to Canada each year because of medical inadmissibility, with at least a quarter of these being families that have children who require special education services that will cost more than the minimum threshold. This means hundreds of applicants are refused each year under the provision because they or their children have a health condition or disability that can be accommodated by Canadian society.​

The new threshold for excessive demand is now $19,965 per year (based on 2017 figures) and no longer includes costs associated with special education, social and vocational rehabilitation services and personal support services that an applicant may need in Canada.

Can you overcome medical inadmissibility?
An immigration officer that is of the opinion you may be medically inadmissible will issue a “Procedural Fairness Letter” to you. This letter will provide you with an opportunity to respond to the allegation of medical inadmissibility within 60 days.

Medical inadmissibility cases are very complicated and many medical and even psychological conditions can lead to your immigration application being refused. It is very important to act quickly and receive legal advice as soon as possible. You are most likely to overcome medical inadmissibility if you can provide a response to the Procedural Fairness Letter that is fully researched and supported by specialized documents and legal arguments. If your application is refused due to medical inadmissibility a lawyer may also assist you in appealing the decision.

In some cases you can act proactively to increase your chances of avoiding medical inadmissibility. If you suspect that there may be medical concerns for yourself or any family member included in your application you can consult a specialized lawyer to determine the best way to proceed with your immigration application to avoid a finding of medical inadmissibility.
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Updating Canada's Medical Inadmissibility Policy & Increasing inclusiveness in Canadian Society

26/4/2018

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On 16 April 2018 the Minister of Immigration, Refugees and Citizenship announced an update to the policy regarding medical inadmissibility under Canada's Immigration and Refugee Protection Act. The changes that will come into effect on 1 June 2018 will enable more applicants for permanent residence to be approved even if they have a medical condition or disability that may have previously rendered them inadmissible to Canada because of “excessive demand” on the Canadian health care and social services system.

In November 2017 I wrote in depth about the requirement for all applicants for immigration to Canada to undergo medical examinations. Some classes of immigration such as spousal sponsorship or refugees are exempt from medical inadmissibility regulations. However, for many applicants, if the applicant or any accompanying family member has a medical condition that “may cause excessive demand on existing social or health services provided by the government” they can be found medically inadmissible. The threshold for “excessive” demand was set at $6,655 per year (based on 2017 figures), meaning if the officer determined that an applicant would require care and social services in excess of this amount they would be deemed medically inadmissible.

However, this approach has long been criticized as being out-of-date and out-of-touch with Canada's current approach to inclusion and disabilities. Annually approximately 1,000 applicants are denied immigration to Canada because of medical inadmissibility, with at least a quarter of these being families that have children who require special education services that will cost more than the minimum threshold. This means hundreds of applicants are refused each year under the provision because they or their children have a health condition or disability that can be accommodated by Canadian society.

The new policy that will be effective as of 1 June will make two important changes:
1- it will increase the minimum threshold considerably to $19,965 per year (based on 2017 figures), and
2- it will change in the definition of “social services” so as to remove references to special education, social and vocational rehabilitation services and personal support services that an applicant may need in Canada.

The aim of this new policy on medical inadmissibility is to better balance the need to protect publicly funded health and social services with Canada's commitment and views on the inclusion of all persons, including those with disabilities.

To make this policy a reality, the federal government is making important administrative changes including creating a centralized office to make decisions regarding medical inadmissibility, ensuring that information on procedures and requirements are presented in plain-language and that the decision makers and medical officers have updated training to support these changes.

The federal government has been reviewing medical inadmissibility since 2016. However these changes will likely not be the last development in this area. The Standing Committee on Citizenship and Immigration recommended the full elimination of the medical inadmissibility policy and the federal government is collaborating with the provinces and territories to make this recommendation a reality.  
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Medical Inadmissibility

3/12/2017

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Picture
If you wish to immigrate to Canada, and in some cases if you are applying for a temporary visa, you must undergo a medical examination. The purpose of immigration medical examinations is to determine that you do not cause a danger to public health and that you do not have a medical condition that may be excessively costly to treat when you arrive in Canada.

Grounds for Medical Inadmissibility
Immigration medical examinations are carried out by designated physicians and Immigration, Refugee and Citizenship Canada (“IRCC”) has a list of physicians that can assist you in countries around the world. The medical examination is a standard physical exam and includes a series of tests (blood and urine) and x-rays. You will also be asked about your prior medical history and your mental state as part of the examination. The results of these examinations are extremely important as you may be found inadmissible to Canada if:
  1. your condition would endanger the health or safety of the Canadian population at large, or
  2. your condition may cause excessive demand on existing social or health services provided by the government.

An example of a medical condition that may make you inadmissible under the first category is Active Pulmonary Tuberculosis (TB). There are also other conditions that can make you inadmissible under this category such as suffering from a variety of brain disorders or applicants who have substance abuse issues that cause them to behave antisocially or in a violent manner, and other types of hostile and disruptive behaviour.

In the second category, you may be found inadmissible if your condition requires government–funded health services such as specialists, nurses, physiotherapists, laboratory services, medications or hospital care, as well as social services such as specialized residence or home care, social rehabilitative services, personal support services, and services intended to assist a person in their physical, emotional, social, psychological or vocational function. If the anticipated costs for these services are found to exceed the Canadian per capita health services and social services costs over a 5 to 10 year period, then the immigration officer may find you inadmissible due to excessive demand.

Can you overcome medical inadmissibility?
An immigration officer that is of the opinion you may be medically inadmissible will issue a “Procedural Fairness Letter” to you. This letter will provide you with an opportunity to respond to the allegation of medical inadmissibility within 60 days.

Medical inadmissibility cases are very complicated and many medical and even psychological conditions can lead to your immigration application being refused. It is very important to act quickly and receive legal advice as soon as possible. You are most likely to overcome medical inadmissibility if you can provide a response to the Procedural Fairness Letter that is fully researched and supported by specialized documents and legal arguments. If your application is refused due to medical inadmissibility a lawyer may also assist you in appealing the decision.


In some cases you can act proactively to increase your chances of avoiding medical inadmissibility. If you suspect that there may be medical concerns for yourself or any family member included in your application you can consult a specialized lawyer to determine the best way to proceed with your immigration application to avoid a finding of medical inadmissibility.


Potential Changes Coming to Medical Inadmissibility
One of the only exceptions to the strict requirements for medical admissibility has been the case of applicants under the family sponsorship category. These applicants are not subject to the excessive demand component of medical inadmissibility. However, the Minister of Citizenship and Immigration, Ahmed Hussen, appeared before the Standing Committee on Citizenship and Immigration on 22 November 2017 and stated that the “excessive demand” provisions for medical inadmissibility are out-dated and need to be changed.


These discussions about the need to change this part of medical inadmissibility are fuelled by a recognition of the discriminatory nature of this provision on people with disabilities. There are a number of proposals for updating this provision to better reflect Canada's view towards people with disabilities and implement legislation and policies that can increase inclusiveness in our society. We will need to wait to see recommendations of the Committee and whether these will be adopted into new law to change medical inadmissibility in the future. 
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    Authors: 
    Zeynab Ziaie 
    Zahra Ziaie 

    Note: This information is not intended as legal advice or opinion. You should always seek specialized legal advice with regards to your situation as the facts of each case are unique and the application of law varies in every case. 

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