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HIV MEDICAL INADMISSIBILITY

Jun 4, 2014
3
1
Dear ALL, urgent help needed!!!!!!!!!!!!!!!!

I have been given a fairness letter on medical inadmissibility based on my HIV status. My intended destination is Quebec. Can someone please suggest how to go about responding to this letter or someone should please share a similar experience? Your comments and suggestions are welcome please.

Please see details of letter below:

[color=red]
Dear Mrs....,
This letter concerns your 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 the principal applicant, is a person whose health condition might reasonably be expected to cause excessive demand on health 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 $5,143.00 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.

Mrs ..... has the following medical condition or diagnosis: Human Immunodeficiency Virus (HIV)
The following assessment was made by the Medical Officer:
This female applicant was born on ..... She made an application in the Skilled Worker (SW1-QC) category and her province of destination is Quebec. She intends to stay in Canada permanently.

She has been found to have Human Immunodeficiency Virus (HIV) infection, a chronic and currently incurable viral infection, compromising the affected individual`s immune system. HIV infects vital cells in the human immune system such as helper lymphocyte T cells (specifically lymphocyte CD4 T cells) and other cells of the immune system. HIV infection leads to low levels of CD4 T cells thus repeat laboratory tests measuring the CD4 lymphocyte count at regular intervals allow monitoring the progress of the infection and immunity levels of the individual. This also serves as a baseline for making therapeutical decisions as when to start antiretroviral therapy, as principles of the initiation of the therapy has been based on individually monitored CD4 lymphocyte levels and HIV plasma viral load. Although the natural course of the infection is one of clinical deterioration due to profound immune suppression, with modern drug treatment and specifically since the introduction of highly active antiretroviral therapy and prophylaxis against opportunistic pathogens (pathogens infecting a compromised immune system), HIV infection can be viewed as a chronic condition requiring indefinite management and treatment.

The applicant was diagnosed with HIV infection and has been followed-up. Laboratory investigations revealed CD4 lymphocytes count of 532 cells/ mm3 in December 2011. Repeat tests done in March 2012 showed CD4 lymphocytes count of 585 cells/mm3. The laboratory test results were deemed satisfactory thus the applicant did not qualify for active antiretroviral therapy (ARV) to be commenced.

A recent evaluation and report by a Consultant Physician- HIV/AIDS Coordinator from specialist confirmed an asymptomatic HIV infection in the applicant. She presented with no complaints and no health problems. Her general laboratory tests were within normal limits. Plasma HIV viral load was 13000 copies/ ml. CD4 lymphocytes count was of 585 cells/ mm3. Recommendations included:
- Close infectious disease specialist follow up
- Repeat laboratory CD4 lymphocyte count every 6 month (if CD4 count levels stable)
- Repeat laboratory CD4 lymphocyte count every 1 month (if decline in CD4 count levels noted)
- Follow-up by Community Relay Agents for psychological and emotional support

In conclusion it was stated that the applicant will qualify for the antiretroviral therapy (ARV) to be started once her CD4 lymphocyte count will reach the threshold of 350 cells/ mm3 or will decrease below it. Antiretroviral therapy could be initiated earlier if there will be evidence of any opportunistic infection.

Recent laboratory result of CD4 lymphocyte count was 373/ mm3 (done in September 2012). The comparison showed that levels of CD4 lymphocytes dropped from 585 cells/ mm3 in March 2012 to 373 cells/ mm3 in September 2012. It is clear that the applicant's condition will continue and it is likely that her immunity levels will deteriorate which will show in her decreasing CD4 lymphocytes counts. It is reasonable to expect that although in good general condition and asymptomatic, the applicant will require the antiretroviral therapy to be initiated at some stage in the near future, when her CD4 lymphocytes levels reach the threshold of 350 cells/ mm3 or when opportunistic infections develop. Once on antiretroviral therapy (ARV) the applicant will require to continue the antiretroviral therapy indefinitely.

If admitted to Canada she will require review and monitoring by medical personnel experienced in dealing with patients infected with HIV. She will also likely continue to require costly antiretroviral drugs provided at public expense.

Based upon a review of the results of this client's immigration medical examination and all reports received with respect to this individual's health condition, I conclude that this client has a health condition (HIV infection) that might reasonably be expected to cause excessive demand on Canadian health services.

Specifically, this client's health condition ( HIV infection) might reasonably be expected to require services (regular specialist review and follow- up, medical treatment in a form of highly active antiretroviral therapy) the costs of which would likely exceed the average Canadian per capita costs over five consecutive years immediately following her immigration medical examination.

In view of the above mentioned health related service requirements, admission of this client will likely create an excessive demand on Canadian health services making her inadmissible under Section 38(1) (c) of the Immigration and Refugee Protection Act.

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
• Health services required in Canada for the period indicated above
• Your individualized plan to ensure that no excessive demand will be imposed on Canadian health services for the entire period indicated above and your signed Declaration of Ability and Intent.

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please advise
 

computergeek

VIP Member
Jan 31, 2012
5,143
278
124
Vancouver BC
Category........
Visa Office......
CPP-O/LA
Job Offer........
Pre-Assessed..
App. Filed.......
06-03-2012
AOR Received.
21-06-2012
File Transfer...
21-6-2012
Med's Done....
11-02-2012
Interview........
Waived
Passport Req..
26-09-2012
VISA ISSUED...
10-10-2012
LANDED..........
13-10-2012
victorious2014 said:
Very many thanks for your prompt response.
You have sent me several PMs, but I cannot respond as your mailbox is full.
 

Maulevet

Newbie
Nov 15, 2014
2
0
Hello
I am actually with this same issue.. I mean, i sent the tests n exams as requested and im Hiv+
For my CIC response, I havent received any yet, but it has been around 5 months so i guess it is going to be soon.
I know it depends from case to case. But was wondering.. how long did it pass since you sent the medical exams till they gave your response? Did you hired a lawyer or made any additional attemp??
 

computergeek

VIP Member
Jan 31, 2012
5,143
278
124
Vancouver BC
Category........
Visa Office......
CPP-O/LA
Job Offer........
Pre-Assessed..
App. Filed.......
06-03-2012
AOR Received.
21-06-2012
File Transfer...
21-6-2012
Med's Done....
11-02-2012
Interview........
Waived
Passport Req..
26-09-2012
VISA ISSUED...
10-10-2012
LANDED..........
13-10-2012
Maulevet said:
Hello
I am actually with this same issue.. I mean, i sent the tests n exams as requested and im Hiv+
For my CIC response, I havent received any yet, but it has been around 5 months so i guess it is going to be soon.
I know it depends from case to case. But was wondering.. how long did it pass since you sent the medical exams till they gave your response? Did you hired a lawyer or made any additional attemp??
The specific time varies, but it generally seems to take about 6 months from the time you submit your medical furtherance to the time the visa officer sends you an excessive demand medical inadmissibility response.

Are you on treatment? If so, you can use the Quebec information to compute the Canadian cost. Depending upon your treatment, it may also be possible to argue about when specific therapy options become generic. Last I checked (6 months ago) the only generic option that was acceptable was nevirapine, lamivudine and zidovudine. The most frequently prescribed drug (tenofovir) is still on patent in Canada, though that will expire in less than three years, which may impact a cost analysis report. Efavirenz has now expired (http://www.genericsweb.com/index.php?object_id=1175). Emtricitabine expires in 2015, as does darunavir. Thus, the cost arguments will become increasingly easy to make with respect to excessive demand.

So far, I know one person who was successful at arguing the nevirapine/lamivudine/zidovudine therapeutic combination costs successfully with CIC, but this isn't a mainstream first line treatment option anymore (it was at one point - Combivir and Virimune). Atripla (efavirenz/tenofovir/emtricitabine) will have two generic legs, so a separate dosing schedule may be convincing because CIC routinely takes the 10 year cost model for HIV - so while it will fail on five year cost analysis, it will be successful over 10 years because of the dramatic price drop that happens with generic drugs.
 
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sergeimx74

Newbie
Jan 28, 2015
5
0
Hi, I've read some of the posts and there are many things I was not considering, so thanks for the information. I have a question: I am going to study a PhD in BC. I know that for Study Permit I am not required to have MEDS. So in theory I could go to study. The situation is that I may apply for PR later on. What do you suggest?
Also, I am traveling with my partner. He would go with an Open Work Permit.
Please if you could give me your answer stating if its better to disclose my status in the SP application.
Thanks for your help.
 

optimistic candi

Hero Member
Jun 17, 2014
716
37
BC
Category........
Visa Office......
NDVO
Job Offer........
Pre-Assessed..
App. Filed.......
May 17/2016
AOR Received.
June 07/2016
File Transfer...
Aug 2/2016
Med's Done....
sent along
Interview........
waived
Passport Req..
BGC in progress on 15 December
VISA ISSUED...
DM on 25 December
sergeimx74 said:
Hi, I've read some of the posts and there are many things I was not considering, so thanks for the information. I have a question: I am going to study a PhD in BC. I know that for Study Permit I am not required to have MEDS. So in theory I could go to study. The situation is that I may apply for PR later on. What do you suggest?
Also, I am traveling with my partner. He would go with an Open Work Permit.
Please if you could give me your answer stating if its better to disclose my status in the SP application.
Thanks for your help.
that's not true that for student visa medical is not needed.
it us mandatory to undergo medical for student visa in canada.
Police clearance certificates( pcc) are not needed for student visa in canada.
 

optimistic candi

Hero Member
Jun 17, 2014
716
37
BC
Category........
Visa Office......
NDVO
Job Offer........
Pre-Assessed..
App. Filed.......
May 17/2016
AOR Received.
June 07/2016
File Transfer...
Aug 2/2016
Med's Done....
sent along
Interview........
waived
Passport Req..
BGC in progress on 15 December
VISA ISSUED...
DM on 25 December
sergeimx74 said:
Hi, I've read some of the posts and there are many things I was not considering, so thanks for the information. I have a question: I am going to study a PhD in BC. I know that for Study Permit I am not required to have MEDS. So in theory I could go to study. The situation is that I may apply for PR later on. What do you suggest?
Also, I am traveling with my partner. He would go with an Open Work Permit.
Please if you could give me your answer stating if its better to disclose my status in the SP application.
Thanks for your help.
it's better you disclose everything when you apply for anything with cic.
because the data will be in cic database. Later on if they find something odd one may face misinterpretation charges.
and rejection.
 

sergeimx74

Newbie
Jan 28, 2015
5
0
Yes I know that if you do not disclose HIV status it could be considered as misrep.
I was just wondering if I could be denied of a SP if I'd disclosed my HIV status.
How should I proceed with my application, stating that I have been HIV since 1992 and that I am healthy with good Cd and undetectable VL? what are the chances that they would deny the SP for medical inadmisibility
 

optimistic candi

Hero Member
Jun 17, 2014
716
37
BC
Category........
Visa Office......
NDVO
Job Offer........
Pre-Assessed..
App. Filed.......
May 17/2016
AOR Received.
June 07/2016
File Transfer...
Aug 2/2016
Med's Done....
sent along
Interview........
waived
Passport Req..
BGC in progress on 15 December
VISA ISSUED...
DM on 25 December
sergeimx74 said:
Yes I know that if you do not disclose HIV status it could be considered as misrep.
I was just wondering if I could be denied of a SP if I'd disclosed my HIV status.
How should I proceed with my application, stating that I have been HIV since 1992 and that I am healthy with good Cd and undetectable VL? what are the chances that they would deny the SP for medical inadmisibility
it depends on your medical. The medical panel decides it. You should probably be fine if there are no complications related to the condition.
 

computergeek

VIP Member
Jan 31, 2012
5,143
278
124
Vancouver BC
Category........
Visa Office......
CPP-O/LA
Job Offer........
Pre-Assessed..
App. Filed.......
06-03-2012
AOR Received.
21-06-2012
File Transfer...
21-6-2012
Med's Done....
11-02-2012
Interview........
Waived
Passport Req..
26-09-2012
VISA ISSUED...
10-10-2012
LANDED..........
13-10-2012
I would disagree with the advice to disclose it on your application. I do so because I know that the specific wording of the question was changed precisely to permit HIV positive individuals to apply for work and study permits without being required to disclose their medical condition. The wording (Background Question 1(b) on IMM1294E as of 06/2014):

"Do you have any physical or mental disorder that would require social and/or health services, other than medication, during a stay in Canada?"
(emphasis added)

The reason this extra clause was added was specifically for cases such as yours. It is not a misrepresentation to answer the question in the negative simply because one has HIV (or any other chronic medical condition requiring drug therapy).

If you are required to have a medical examination (required of applications from some countries), then you will have to disclose that information. In such a case, you will then have to go through the normal fairness procedure when the medical officer determines you are medically inadmissible to Canada - and the arguments become very similar at that stage.
 
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