A fairness letter is sent by a VO to an applicant stating that the applicant may not meet the requirements to immigrate. It can be sent if the VO has concerns about a health condition, documents the applicant submitted, or information in the application itself.
For example, if the concern is medical, Operational Bulletin 63 says the following:
PROCEDURAL FAIRNESS LETTER
Medical inadmissibility — Excessive demand on social services
INSERT LETTERHEAD
Our Ref.:
INSERT ADDRESS
Dear INSERT NAME:
This letter concerns your application for an immigrant visa [or: application for permanent residence in Canada]. Based on a review of your file, it appears that you or your family member may not meet the requirements for immigration to Canada.
I have determined that you/your family member, [name], are/is a person whose health condition might reasonably be expected to cause excessive demand on social services in Canada. An excessive demand is a demand for which the anticipated costs exceed the average Canadian per capita health and social services costs, which is currently set at $4,806.00 per year. Pursuant to subsection 38(1) [and pursuant to section 42 in the case of a family member] of the Immigration and Refugee Protection Act, it therefore appears that you may be inadmissible on health grounds.
You/your family member, [name], have/has the following medical condition or diagnosis: Insert name of disease or condition and diagnosis from IMM 5365. In particular:
Insert narrative from IMM 5365 – excluding the list of social services required and cost implications.
In consultation with the Health Management Branch of Citizenship and Immigration Canada, I have determined that the following social services will be required:
Insert list of social services required, cost implications and period indicated by the medical officer from IMM 5365.
Before I make a final decision, you have the opportunity to submit additional information that addresses any or all of the following:
The medical condition(s) identified
Social services required in Canada for the period indicated above
Your individualized plan to ensure that no excessive demand will be imposed on Canadian social services for the entire period indicated above and your signed Declaration of Ability and Intent.
You must provide any additional information within 60 days of the date of this letter. If you choose not to respond, I will make my decision based on the information before me, which may result in your application being refused.
In order to demonstrate that you/your family member will not place an excessive demand on social services, if permitted to immigrate to Canada, you must establish to the satisfaction of the assessing officer that you have a reasonable and workable plan, along with the financial means and intent to implement this plan, in order to offset the excessive demand that you would otherwise impose on social services, after immigration to Canada. The sections of the Immigration and Refugee Protection Regulations that define the meanings of “social services” and “excessive demand” are included for your reference.
Please ensure that you quote the file number indicated at the top of this letter on any information you submit.
Yours truly,
Officer
Essentially, the applicant is requested to provide additional information to address the specific concern the VO has indicated in the letter.