Need suggestions to reply fairness letter.Thanks

[Worried2008]

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.

Medical officer is refusing on the basis of future cost.If we go for home dialysis then its 45K/year.
No one knows when she will go or not.As i mentioned earlier we will opt for immediate transplant.

i have to wait for reports to se if i can challenge the medical officers opinion.

The thing I need most is how to offset the future costs.i am thinking along those lines.Only if i could provide a practical solid plan .

 

[opmama]

Medical officer is refusing on the basis of future cost.

I don't know that - it's just a guess. (And this is why I think you need someone with real experience doing this, so that you don't chase down the wrong rabbit holes putting your letter together).

No one knows when she will go or not.

It's hard to know what an individual patient will need in the future, but there are probabilities based on the average patient in your mom's current condition (stage of CKD, co-morbid conditions like diabetes/high blood pressure, compliance and effectiveness of current medications). Doctors don't like to make guesses like that for individual families (because individual outcomes are really hard to predict), but there are things that would put her in a higher or lower risk group, and I'd guess you want to be figuring out where on the spectrum she is.

As i mentioned earlier we will opt for immediate transplant.

That's easier said than done, even with the coverage in your home country. Is she a good candidate for transplant, health and age-wise? Is there a donor match in the family? If not, what percentage of people who need kidney transplants in your home country get them (and how long does it tend to take)? Is end-stage renal disease possibly going to make it too dangerous to fly? Do you or your parents have the funds stashed away for a medically-supported flight if necessary? (In other words, can you provide a good, coherent explanation and data to show that your statement above is actually likely...)

 

[Worried2008]

I will try to get a letter from hospital of home country to state how the procedure is and how they will respond to my Moms need.I will get affidavit letters from possible family donors.And I will show funds and how long it takes to get on a flight.I was thinking to provide documentation.

Yes she has diabetes too.MO thinks its stage 4.unless a very different lab test or prognosis come its hard to challenge.Even if she goes to stage 3 i think MO is not going to change his opinion.

Only thing I can provide for medical is that she is not at risk of dialysis in so and so years.Its upto MO.Which after reading Canlii I am not very hopefull,They rarely change their opinion.

Need a really good Plan.My only hope

 

[opmama]

Yeah, with stage 4 and diabetes, I don't think you can make a convincing case that she is unlikely to need dialysis/transplant in the next 5-10 years. (She might not, and I personally hope she stays very healthy, but it's not the best case scenario the CIC is worried about).

Has anyone in your family been matched to your mom as a donor?

And on a more personal note - I'm really sorry you're going through this. Stinks.

 

[user828]

Worried

CIC will reply on expert review, so best is gather opinion form 2-3 specialists who favour your side ( if that's the case ) - the fact she will come back home won't work with them ( they might defer case ) or something
I still feel the letter should be drafted by an experience appeal lawyer in this case

 

[Pippin]

Like Opmama was asking, I also wondered if family members had been tested and a match found. This could go either way - if not imminent, why would someone go to this length OR, if proof of being a match accompanied that person's affidavit it would be a much stronger statement. I am also sorry that your family is dealing with this chronic condition and hope that all goes well. It is heartening to see how everyone is contributing to this post. I hope you find the answers you need. Do you have to request a Judicial Review?
If so, be sure you start the process within the required timeframe.

 

[Worried2008]

Worried

CIC will reply on expert review, so best is gather opinion form 2-3 specialists who favour your side ( if that's the case ) - the fact she will come back home won't work with them ( they might defer case ) or something
I still feel the letter should be drafted by an experience appeal lawyer in this case

Hi user828
Nice to see you here.
So far I have decided to write myself.Lets see if later I found it difficult I could hire some help.I know a case fron ND where the person did his own research,wrote the letter himself and got VO review in his favour.
If only I get some satisfactory plan I have some hope.

( if that's the case ) - the fact she will come back home won't work with them ( they might defer case ) or something

Please explain this.Do you mean the doctors? like if she go there just for checkup? being not a regular patient?
I would appreciate if you explain a bit.
Thanks

 

[Worried2008]

Like Opmama was asking, I also wondered if family members had been tested and a match found. This could go either way - if not imminent, why would someone go to this length OR, if proof of being a match accompanied that person's affidavit it would be a much stronger statement. I am also sorry that your family is dealing with this chronic condition and hope that all goes well. It is heartening to see how everyone is contributing to this post. I hope you find the answers you need. Do you have to request a Judicial Review?
If so, be sure you start the process within the required timeframe.

Thats a very good point.I will ask my sisters to get tested for a donor.I still need to know how many tests there are to see this.

Yes Pippin fairness letter and this chronic disease.too much

No so far I dont have any judicial review letter.I have to reply this letter and it will be addressed to VO and MO.

I am very thankful to all the friends who are coming here to encourage me.Thanks .

 

[user828]

Hi user828
Nice to see you here.
So far I have decided to write myself.Lets see if later I found it difficult I could hire some help.I know a case fron ND where the person did his own research,wrote the letter himself and got VO review in his favour.
If only I get some satisfactory plan I have some hope.

( if that's the case ) - the fact she will come back home won't work with them ( they might defer case ) or something

Please explain this.Do you mean the doctors? like if she go there just for checkup? being not a regular patient?
I would appreciate if you explain a bit.
Thanks

What I mean, is that your letter probably will show intent to come back to home country ( if indeed a transplant or some other treatment is required ) so it doesn't burden the system here, but this is like a promise and CIC won't have any way to verify this and she has full rights to get medical help here and shouldn't have to go back to home country

The positive aspect is that they haven't refused it outright, there is a room to convince them but I think they are looking more into a medical opinion BUT I think I remember reading long time back ( could be a rumour ) that case was refused on medical grounds but the judge asked the applicant to bear the cost of meds or get own insurance - it was a special case
Thus better to consult an appeal lawyer who specializes in this

 

[Worried2008]

Yes user828
Its mostly a promise.My only hope is to convince them with the waiting list of 4 years and our option to get treatment from other country where we will be having residency status as well.Only weighing argument from us would be why suffer when we have a option and a living donor.

Thats what I was thinking.The waiting list might work,which is true as well.

 

[user828]

Yes user828
Its mostly a promise.My only hope is to convince them with the waiting list of 4 years and our option to get treatment from other country where we will be having residency status as well.Only weighing argument from us would be why suffer when we have a option and a living donor.

Thats what I was thinking.The waiting list might work,which is true as well.

Thats good but what if its something like dialysis

 

[Pippin]

That is the crux of the matter. As a PR or citizen your Mum would have full rights to medical care and that is what it is all about. Thinking outside the box, would your parents' medical coverage possibly cover their care in Canada if dialysis became necessary? What if your Mum waited to come after having the transplant? would cost of future care still be a burden if you carried private prescription coverage. Just thoughts that popped into my head.
I agree with those who recommend that you get advice from a lawyer well versed in this aspect of immigration law. It would be cheaper to get the situation sorted out at this point rather than having to go on to a full blown judicial review.

 

[Worried2008]

Thats good but what if its something like dialysis

I guess after complete renal failure transplant is the best choice.dialysis is a choice too .transplant is elective.Once you decide you are put into waiting list queue.Until the time you find a donor or your number comes you have the only option of dialysis.Being on dialysis is not the best option but you have no choice.People on dialysis are waiting for kidneys.

Thats the point I want to highlight in my Plan that we want and will opt to go to country where this is available to us.
Next thing is I found some research work where Canadians are already involve in commercial/tourisim transplant.

When they are doing why to doubt us.

 

[Worried2008]

That is the crux of the matter. As a PR or citizen your Mum would have full rights to medical care and that is what it is all about. Thinking outside the box, would your parents' medical coverage possibly cover their care in Canada if dialysis became necessary? What if your Mum waited to come after having the transplant? would cost of future care still be a burden if you carried private prescription coverage. Just thoughts that popped into my head.
I agree with those who recommend that you get advice from a lawyer well versed in this aspect of immigration law. It would be cheaper to get the situation sorted out at this point rather than having to go on to a full blown judicial review.

Yes thats right.But cic needs to know what plans I have in order to offset the excess cost.They don't give us option to pay ourselves.You can't opt out of health care system.Thats why its difficult.You can't prove you will not use it.even if you really won't in order to get out of this mess.
Then its upto them to accept or reject our plan.

unfortunately my parents coverage can't be transferred here,Even there are people who offered to have private coverage,some enen had two coverages ,but cic rejected them.

By reading canlii for similr cases so far I know lawyer can't help me a lot.It depends on my individual case situation.Thats why I have all you friends.May be we will think of a solution.It is just first week.Lets see may be later if I get tired then may be.
Thanks a lot guys

 

[opmama]

I guess after complete renal failure transplant is the best choice.dialysis is a choice too .transplant is elective.Once you decide you are put into waiting list queue.Until the time you find a donor or your number comes you have the only option of dialysis.Being on dialysis is not the best option but you have no choice.People on dialysis are waiting for kidneys.

Not everyone with kidney failure is a candidate for transplant, unfortunately.

By reading canlii for similr cases so far I know lawyer can't help me a lot.It depends on my individual case situation.Thats why I have all you friends.May be we will think of a solution.It is just first week.Lets see may be later if I get tired then may be.
Thanks a lot guys

The medical details are case by case, and I assume the lawyer would want input from relevant medical experts. But how that plan gets explained, which arguments are the focus of your plan - that is what an experienced lawyer can help with. For example, you say above that you are reading cases where people tried to offer up private insurances as an option, and CIC rejected them. A good lawyer will know which arguments have previously been unsuccessful AND which ones might be rejected by CIC but tend to win on appeal (so for example, it might be that other insurance doesn't convince CIC, but it does tend to convince a judge).

There are a lot of ways you could put together your plan that sound reasonable to people like us. But none of us have experience in this process, and someone who does could be invaluable to you right now, making sure the right information is collected and assembled in a way to make a strong case now and set you up well for an appeal if necessary. If affording a lawyer is absolutely not an option, then yeah, do the best you can on your own. But if you can possibly afford a lawyer, I would at least try to have an initial phone consult and see if their value becomes more evident as you talk.