Medicals for Express Entry: High Blood Pressure

[kgllewellyn]

Hello,

I''m wondering if you can help me with this. Me and my partner went for our upfront medical test so that we may submit our eAPR for Express Entry. My medicals didn't raise any issues on the day, however my partner had high blood pressure which was tested twice. It may have been down to nerves and probably a diet containing an excess of salt.

He's been referred to a cardiologist to have ECG exercise and rest, echo and possibly 24 hour ECG monitoring. However it looks like this might cost upwards of £800 to do privately, if we get this done on the NHS we could be looking at a wait of many months, where my ITA will most likely have expired by.

What shall I do in respect to our application, proceed as normal and and provide the eMedical document and wait until what CIC instruct? Or proceed to get him seen by the cardiologist privately before submitting our eAPR?

He's not being medicated for high blood pressure and he hasn't had a history of it previously.

Thanks!

 

[DEEPCUR]

That's a lot of test.

Did cic request for furtherance tests or clinic prescribed them seeing high blood pressure? Generally cic provides the list of furtherance test to be done after doctor submits your tests. You get email from local cic medical office asking you to reach out to your clinic.

If cic had requested for these tests, then not much choice for you. You'll have spend that money and get tests done at panel clinic only. They won't accept tests done at other hospitals.

 

[kgllewellyn]

Hi,

Nope we haven't had anything back from CIC, we haven't submitted the PR application yet. This was the 'upfront medical exam'.

The clinic prescribed the further tests upon seeing the high blood pressure.

 

[olipearce1987]

Hi,

Nope we haven't had anything back from CIC, we haven't submitted the PR application yet. This was the 'upfront medical exam'.

The clinic prescribed the further tests upon seeing the high blood pressure.

You don't need to submit the application for CIC to come back to you. The CIC medical department may come back and ask for you to do test without the application submitted. Also if further tests are needed for this, it will be down to CIC to say what they are....I learnt this from experience!

 

[DEEPCUR]

Hi,

Nope we haven't had anything back from CIC, we haven't submitted the PR application yet. This was the 'upfront medical exam'.

The clinic prescribed the further tests upon seeing the high blood pressure.

Even for upfront medical tests, CIC will reach you out with the email address that you give during your application. They will reach you out even if you haven't submitted your application. As I mentioned earlier, you will get an email from your country specific CIC medical office.

Clinics sometimes prescribe additional tests based on their past experiences for certain conditions, like they would know for sure that CIC is going to get back with couple of tests. You could check with clinic and ask them if you can wait till CIC gets back. If they agree to that, you can pause with furtherance for a while, but it is pretty likely that they will come back with furtherance tests given that your blood pressure was high in two back to back readings.

 

[kgllewellyn]

The clinic has given me the choice of holding back them submitting the eMedical report until the further tests are done, or release them to CIC. It looks like releasing them to CIC in any case might be the best option.

One thing of note is that they did a full cardiologist referral, rather than just requesting that the serum cretinine test be carried out. According to the IMEI on Hypertension. They'd only do a cardiologist referral if my partner had a history or clinical evidence of the below (which both of us believe he does not, nor has any clinical evidence been provided to substantiate it)
-Coronary artery disease
-Valvular heart disease
-Cardiomyopathy
-Congenital heart disease
-Peripheral vascular disease.
http://www.cic.gc.ca/english/department/partner/pp/pdf/IMEI_Hypertension.pdf


So I'm getting the feeling that the clinic is trying to get us for all our money, rather than just doing what CIC would ordinarily ask for.

Aside from putting this in a Letter of Explanation, I'm not sure what else we can do, as doing the full cardiologist referral rather than just the serum cretinine test would be many hundreds of pounds more. So I'm keen to avoid that if possible.

On the side, we're gonna get this raised with the GP as well to see if there are any medical concerns as well.

 

[DEEPCUR]

The clinic has given me the choice of holding back them submitting the eMedical report until the further tests are done, or release them to CIC. It looks like releasing them to CIC in any case might be the best option.

One thing of note is that they did a full cardiologist referral, rather than just requesting that the serum cretinine test be carried out. According to the IMEI on Hypertension. They'd only do a cardiologist referral if my partner had a history or clinical evidence of the below (which both of us believe he does not, nor has any clinical evidence been provided to substantiate it)
-Coronary artery disease
-Valvular heart disease
-Cardiomyopathy
-Congenital heart disease
-Peripheral vascular disease.
http://www.cic.gc.ca/english/department/partner/pp/pdf/IMEI_Hypertension.pdf


So I'm getting the feeling that the clinic is trying to get us for all our money, rather than just doing what CIC would ordinarily ask for.

Aside from putting this in a Letter of Explanation, I'm not sure what else we can do, as doing the full cardiologist referral rather than just the serum cretinine test would be many hundreds of pounds more. So I'm keen to avoid that if possible.

On the side, we're gonna get this raised with the GP as well to see if there are any medical concerns as well.

True. You should ask them to release the report.

As you mentioned, as far as I know, Serum Cretanin is the only additional test that is given for hypertension just to make sure kidneys are good. I know couple of people with hypertension history who just did that test. All other tests seem unnecessary and are meant only for heart issues.

 

[kgllewellyn]

Sorry if I'm unearthing a somewhat old thread, but I thought I would provide an update regarding this.

My other half has had most of the tests now done under the NHS. He has also had a 24-hr blood pressure monitor which had the average of 134/84 (decently below the hypertension definition of 140/90), and is awaiting blood test results. It looks like a case of white coat syndrome at the hospital after all and that for the most part he's pretty healthy (although has changed his diet to bring his bp down further).

Unfortunately it's now the matter of dealing with the red tape, because it looks unlikely that the NHS will refer him to a cardiologist as it would be a waste of public funds if the tests concluded that he does not have hypertension. But the eMedical is requiring a cardologists opinion in order to proceed, so it's looking like we *have* to get this done privately, we are hoping that the cardiologist will see the test results from the NHS and conclude that, 'yep, you're fine' and submit the eMedical and not rinse us for additional tests privately. Unfortunately the hospital hasn't been very helpful in anticipating what will happen, but if anyone else has gone through this ordeal and can share experiences, it would certainly ease our anxiety out of this process.

Thanks again!

 

[abcvita2012]

What were his initial two back-to-back readings that resulted in these requirements?

 

[DEEPCUR]

Sorry if I'm unearthing a somewhat old thread, but I thought I would provide an update regarding this.

My other half has had most of the tests now done under the NHS. He has also had a 24-hr blood pressure monitor which had the average of 134/84 (decently below the hypertension definition of 140/90), and is awaiting blood test results. It looks like a case of white coat syndrome at the hospital after all and that for the most part he's pretty healthy (although has changed his diet to bring his bp down further).

Unfortunately it's now the matter of dealing with the red tape, because it looks unlikely that the NHS will refer him to a cardiologist as it would be a waste of public funds if the tests concluded that he does not have hypertension. But the eMedical is requiring a cardologists opinion in order to proceed, so it's looking like we *have* to get this done privately, we are hoping that the cardiologist will see the test results from the NHS and conclude that, 'yep, you're fine' and submit the eMedical and not rinse us for additional tests privately. Unfortunately the hospital hasn't been very helpful in anticipating what will happen, but if anyone else has gone through this ordeal and can share experiences, it would certainly ease our anxiety out of this process.

Thanks again!

As per CIC guidelines, 140/90 is normal reading. So anything less than that is fine. Has CIC reached out to you yet? Like you got any emails on furtherance tests?

 

[kgllewellyn]

As per CIC guidelines, 140/90 is normal reading. So anything less than that is fine. Has CIC reached out to you yet? Like you got any emails on furtherance tests?

Not as of yet. The hospital mention that they cannot submit *any* part of the eMedical form without the cardiologist's report, so at the moment CIC won't see anything for him, as far as I know.

 

[kgllewellyn]

What were his initial two back-to-back readings that resulted in these requirements?

The two that were taken were 152/106 and 164/117 much, much higher than his 24 hour average.

I should add that the 1st reading was taken before they took his blood and the 2nd reading was after.

 

[esos4real]

Hi guys, i need your expert opinions.
I am March 2 aor and on ip2. However, due to long delay in my app,I called cic to ask why my medicals was on review. Officer said he would look into it and I would get an update.

So today, i got an update to do furtherance test and contact my doctor. Anyways I anticipated it because i am 30, known hypertensive for 2years on medications. Did serum creatinine and was fine. However, i had some mild form of cardiomegaly due to long standing hypertension i had when undiagnosed for some time.

Sincerely speaking, will I be rejected after echo and ecg? I have done ecg privately and it's fine. My echo was within upper limits.

 

[esos4real]

I really wish @qorax and @legalfalcon could make some input on my issue.

Missed these guys on these threads

 

[legalfalcon]

Hi guys, i need your expert opinions.
I am March 2 aor and on ip2. However, due to long delay in my app,I called cic to ask why my medicals was on review. Officer said he would look into it and I would get an update.

So today, i got an update to do furtherance test and contact my doctor. Anyways I anticipated it because i am 30, known hypertensive for 2years on medications. Did serum creatinine and was fine. However, i had some mild form of cardiomegaly due to long standing hypertension i had when undiagnosed for some time.

Sincerely speaking, will I be rejected after echo and ecg? I have done ecg privately and it's fine. My echo was within upper limits.

Please see http://www.cic.gc.ca/english/department/partner/pp/pdf/IMEI_Hypertension.pdf

This lists the additional tests that have to be done in case an applicant is diagnosed with hypertension. If the additional tests come clear, no need to worry. Even if they do not come clear, it will then depend on the cost threshold.

Each case is dealt on a case by case basis.

IRCC has stated the following with regard to the cost threshold.:

The cost threshold is determined by multiplying the per capita cost of Canadian health and social services by the number of years used in the medical assessment for the individual applicant. This cost threshold is updated every year.

Effective January 1, 2017, the updated cost threshold is $6,655 per year. This figure is usually multiplied by five (unless the anticipated length of stay is shorter than five years or there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years). This results in the legislated threshold of $33,275.

Also, see <http://www.cic.gc.ca/english/resources/tools/medic/admiss/excessive.asp> This explains the procedure as regard to the express entry