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http://www.cic.gc.ca/english/resources/publications/dmp-handbook/#chap4.4
4.4 IME grading
Prior to submitting the IME, the panel physician must provide a grade for the IME.
eMedical-enabled Panel Clinics
An IME grade will be provided automatically by the system based on the reported findings.
Grade A indicates that there are no abnormal findings present and no significant abnormal history.
Grade B indicates that there are significant abnormal findings present and/or an abnormal history.
If the system has provided an A-grade and the panel member believes that there are significant abnormal findings, he/she may change the grade to B.
If the system has provided a B-grade, it cannot be changed to an A-grade.
No comments are permitted for A-grade IMEs.
Comments are mandatory for B-grade IMEs.