Need suggestions to reply fairness letter.Thanks

[Worried2008]

Hi Guys
I want to write the response to the fairness letter.
I need to lay out a plausible plan to off set the costs in Canada for chronic kidney disease.

How can I assure them that we won't be excess demand ?

So please give me your sugestions or any important point which comes to your mind.

I would also want some data of expected costs of services and drug prescriptions for kidney patients .If anyone knows anything?

Thanks in advance

 

[frege]

Hi, this seems quite complicated. I would think advice from an immigration lawyer would be essential.

I believe Computergeek may have had a similar situation at one point, and may know a lot about it.

Here is a previous thread on a similar topic: http://www.canadavisa.com/canada-immigration-discussion-board/my-son-has-down-syndrome-t148470.0.html

Perhaps you should modify the topic so that it says "excessive demand fairness letter". Also, should this be in the family class section?

 

[Worried2008]

Thanks a lot frege

I am going to check the link.

 

[wowsers]

I do not think you will get useful advice concerning the cost of treating chronic kidney disease on this forum: you need detailed advice from a doctor and probably a pharmacist also, related specifically to the severity and prognosis of the disease. All I can tell you - I am not a doctor - is that every 6 months or thereabouts it is necessary to consult a nephrologist to monitor progress.The tests on these occasions usually consist of an urine analysis and a monitoring of blood pressure. I understand that the ideal systolic pressure for kidney patients is about 130 (the pressure when the heart is pumping). Some of the monitoring can be done by the patient himself or by someone in his family, using his own blood pressure machine. You can buy one at Boots' in the UK for about £100 The mix of BP tablets needs to be carefully considered by the medics because all tablets have some unpleasant side effect: some tablets though effective to lower blood pressure also cause a deterioration of kidney function; and some also cause a build-up of uric acid in the joints which causes gout, which is very painful. So it is a constant battle between drugs which improve bp and drugs which cause kidney function to deteriorate and other unpleasant side effects. Eventually if the disease worsens substantially dialysis may be required. I have no idea of the cost of all this: under the NHS it is all free You will only get an idea of the true cost by consulting an expert. I do not think you neeed to consult an immigration lawyer on the subject: all that a lawyer can do is to make the inquiries which you yourself can make. To consult a lawyer would be simply to throw money away.Try consulting a nephrologist at your local hospital first.

 

[Worried2008]

Thanks Wowser
Your reply is very helpful.I am not going to hire a lawyer.Going to write letter by myself.
I think I will get reports of my Mom and her prescription.then I would see a Nephrologist here and ask him to write a prognosis and how many time we need to see him .
Then I will consult with phrmacist for medicine cost.

 

[wowsers]

You are welcome. If once you have gathered together the facts you need help to draft the letter. you are welcome to contact me. I will do my best to help.

 

[Worried2008]

I can't tell you how happy I am with your offer.I am definitely going to use it.Right now I am in middle of making a Plan which could work.

Thinking ways how to bring the cost down or make them believe I will not use it.
They are worried for dialysis and transpant cost.

My parents have a lifelong free medical coverage back home without any wait times or waiting lists.The truth and reality is even My Mom is a PR and we need transplant we will go back home instead of waiting 4 years in Canada.But problem is how to make CIC believe this.I need reliabe paperwork.
Canadian health coverage is not our wish or need.We already have one back home.But how unfortunate is this that I have to deal with it.

What are the acceptable ways to mske them believe we will not use it other then my promise or affidavit.
Thanks

 

[Pippin]

You have been given some good suggestions. Using the information from your doctor regarding expected medical and pharmaceutical requirements, I think the financial figures must relate to costs in Canada, not your home country. Do a google search for the provincial health care provider where you plan to live, and ask if they can give you the costs of services. You may want to think about purchasing additional health insurance although Computergeek's posts will give you more information on that.
I just read your comment about free lifetime medical coverage! How amazing is that, although not much help with dialysis if that is required. I don't know if affidavits and promises have much sway with a VO. You might also try contacting the Canadian kidney foundation and see what they can do regarding stats. Good luck.

 

[Pippin]

http://ottawa.cioc.ca/record/OCR0178?UseCICVw=13
One of the kidney foundation websites.

 

[Worried2008]

Thanks pippin
you guys are amazing.

Yes Pippin those medical coverage back home is wonderful and its because of my Dads job.It is available to him and my Mom.No premiums no ,no waiting time.
I will get letter from that organization to show to visa officer.

 

[opmama]

This is a situation where I'd definitely be wanting to speak to a lawyer with experience and a good track record with medical admissibility cases. Yes, you'll certainly want information from a kidney specialist (not all CKD is equal - the stage of your mom's condition and her co-morbid diseases, e.g. does she have diabetes, are big factors in how expensive her care will probably be and how likely she is to need a transplant). It sounds like the very solid insurance your parents have might weigh in their favor, but transplant patients often require long-term monitoring and care, and frequently experience complications, and you wouldn't be able to fly to another country every time something like that came up. So from a medical perspective, I'd guess your best bet is focusing on your mom's well-managed condition and her low risk for needing a transplant, assuming that's actually true.

But this is a complex issue, and one where it sounds like CIC officers often struggle. I'd want someone on my team who knew how to line up and lay out the facts in exactly the right way (and knew what facts were needed in the first place!), and lay a strong foundation for appeal/court case should that be necessary (based on what computergeek said in the linked thread above, these are often necessary and successful, but I suspect it's cheaper to try to get it right the first time if you can).

 

[Worried2008]

Thanks opmama
You are right.
First thing I want to know what services,medicines and cost Medical officer had in his/her mind when he gave this decision.
Then I will check what medications my Mom is taking.She is not on any dialysis yet.
I will convert the cost in Canadian $.
Then I will see what services actually cost in Canada,what are available to me through different organisations.
Then I will check what it costs me actually.And all the years she doesn't go on dialysis will save lot of money too.

Do I have to write a plan for 5 or 10 years. they consider as 5-10.
I am going to order gcms notes and request the visa officer for detailed decision of Medical officer.Only then I can counter the costs.

Thanks every one for your suggestions.

 

[frege]

Here are a couple of resources for you.

www.cba.org/cba/cle/PDF/IMM11_Gomberg_Paper.pdf‎

www.cic.gc.ca/english/resources/manuals/bulletins/2013/ob504.asp

Unfortunately, that operational bulletin says it's expired, and I wasn't able to locate what replaced it.

 

[opmama]

First thing I want to know what services,medicines and cost Medical officer had in his/her mind when he gave this decision.

Just a guess, but "CKD = transplant = expensive!!!" I suspect it's not the current costs that factor in here as much as the future risk of very expensive costs. Even the way you put it, "she's not on dialysis yet" - that suggests there is at least a reasonable chance she will get there.

It looks like dialysis might be the more expensive option in Canada, actually... this source says $60K/year. And $23K for a transplant (wow, is that different than here in the US!), and $6K/year for anti-rejection drugs after the transplant.

Those are numbers well above the excess medical demand limits, so I'd imagine that is at least one factor in the CIC officer's mind.

 

[Worried2008]

Thanks frege

I am from Alberta.if anyone want to add more pooints keeping in mind the province or knows some resources.
i will be greatful.

Thanks everyone for your help at this moment.