Need Urgent Help!!!Can HIV positive person get PR ?

[canadacalling2012]

Hi..I recently completd medical examination. I am the primary applicant and my reports are normal. my spouse also went for medical examination and we come to know that my spouse is HIV positive. How it will affect my file ?

 

[computergeek]

I know quite a lot about this area and have advised others in the past.

An HIV positive person can obtain a PR visa, but it can be challenging and it will increase the amount of time to process your application.

Your Panel Physician (formerly "Designated Medical Practitioner") should have drawn blood for an HIV-1 RNA test ("viral load") and a CD-4 test (a specific type of white blood cell used for cell mediated pathogenic response). Those results will then be forwarded to Immigration Medical Service. Their decision may be predicated, at least in part, on the province in which you will be landing. For example, if you plan on landing in BC, while they will go through all the process in the end because BC provides 100% coverage for the drugs unless your wife is not expected to require them for most of the next 10 years she will likely be declared inadmissible, though I can provide you with some information that you can use to argue against this decision.

Drug coverage varies by province, though, so a complete analysis cannot be done without that information.

Normally, what IMS will do next is send a sealed letter to you to take to the Panel Physicial (DMP). Normally this will ask for additional information and whether or not you will require treatment in the next 5-10 years. What this means is that you need to be looking for a sympathetic doctor now. Ideally, you want one that can either say definitively or probably that she will not require treatment within that time period. Not every doctor will say that, so you may wish to consult with more than one.

If after reviewing the additional medical information they determine she will require medication in the 10 year time period, they will advise you that she is "probably" medically inadmissible. This is done by way of a fairness letter. You will have 60 days to respond to the fairness letter.

You may challenge the finding of the medical condition, e.g., she had a "false positive". This is actually quite likely. The doctor may tell you the test is 99.6% accurate, but will not advise you that the positive predictive value (PPV) is much lower than that, because the prevalence of the condition is very low in the general population.

You may challenge the medical officer's estimate of costs. This is an area in which I can provide you with guidance, particularly if you can present a particular treatment regimen to her doctor and have the doctor agree that it is a viable treatment model - this is because one approved treatment is now made up of generic medications that have much lower cost and thus do not exceed the excessive demand cost threshold.

You may provide a plan to mitigate costs. This can include insurance plans, NGOs that will pay for treatment, and health savings plans.

If you do receive or expect to receive a fairness letter, I would strongly suggest you engage an attorney to assist you. I can recommend someone who specializes in HIV medical inadmissibility cases and can point out a handful of other attorneys specializing in medical inadmissibility. A well formulated response to the fairness letter potentially will overcome the initial inadmissibility conclusion and ultimately lead to a successful conclusion. In addition, it will set the stage for a successful challenge to a negative decision.

If you are refused, you may challenge the refusal in Federal Court. That will require you have an attorney. CIC's track record in medical admissibility cases for FSW applications is not good - they lose about 75% of such cases according to my own review of case law. If you are interested, look up the following four decisions: Sapru, Rashid, Companioni and Ortiz at canlii.org. These are all on-point cases with respect to medical inadmissibility and the last two are specific to HIV (CIC lost both of those cases).

If you need more information, feel free to ask (I won't hand out attorney names in public, but will send them privately.) You don't have 10 posts yet, so you won't be able to send PMs.

 

[bundoo]

I know quite a lot about this area and have advised others in the past.

An HIV positive person can obtain a PR visa, but it can be challenging and it will increase the amount of time to process your application.

Your Panel Physician (formerly "Designated Medical Practitioner") should have drawn blood for an HIV-1 RNA test ("viral load") and a CD-4 test (a specific type of white blood cell used for cell mediated pathogenic response). Those results will then be forwarded to Immigration Medical Service. Their decision may be predicated, at least in part, on the province in which you will be landing. For example, if you plan on landing in BC, while they will go through all the process in the end because BC provides 100% coverage for the drugs unless your wife is not expected to require them for most of the next 10 years she will likely be declared inadmissible, though I can provide you with some information that you can use to argue against this decision.

Drug coverage varies by province, though, so a complete analysis cannot be done without that information.

Normally, what IMS will do next is send a sealed letter to you to take to the Panel Physicial (DMP). Normally this will ask for additional information and whether or not you will require treatment in the next 5-10 years. What this means is that you need to be looking for a sympathetic doctor now. Ideally, you want one that can either say definitively or probably that she will not require treatment within that time period. Not every doctor will say that, so you may wish to consult with more than one.

If after reviewing the additional medical information they determine she will require medication in the 10 year time period, they will advise you that she is "probably" medically inadmissible. This is done by way of a fairness letter. You will have 60 days to respond to the fairness letter.

You may challenge the finding of the medical condition, e.g., she had a "false positive". This is actually quite likely. The doctor may tell you the test is 99.6% accurate, but will not advise you that the positive predictive value (PPV) is much lower than that, because the prevalence of the condition is very low in the general population.

You may challenge the medical officer's estimate of costs. This is an area in which I can provide you with guidance, particularly if you can present a particular treatment regimen to her doctor and have the doctor agree that it is a viable treatment model - this is because one approved treatment is now made up of generic medications that have much lower cost and thus do not exceed the excessive demand cost threshold.

You may provide a plan to mitigate costs. This can include insurance plans, NGOs that will pay for treatment, and health savings plans.

If you do receive or expect to receive a fairness letter, I would strongly suggest you engage an attorney to assist you. I can recommend someone who specializes in HIV medical inadmissibility cases and can point out a handful of other attorneys specializing in medical inadmissibility. A well formulated response to the fairness letter potentially will overcome the initial inadmissibility conclusion and ultimately lead to a successful conclusion. In addition, it will set the stage for a successful challenge to a negative decision.

If you are refused, you may challenge the refusal in Federal Court. That will require you have an attorney. CIC's track record in medical admissibility cases for FSW applications is not good - they lose about 75% of such cases according to my own review of case law. If you are interested, look up the following four decisions: Sapru, Rashid, Companioni and Ortiz at canlii.org. These are all on-point cases with respect to medical inadmissibility and the last two are specific to HIV (CIC lost both of those cases).

If you need more information, feel free to ask (I won't hand out attorney names in public, but will send them privately.) You don't have 10 posts yet, so you won't be able to send PMs.

plus one for your absolutely superb reply uasail(sir)

 

[canadacalling2012]

Thanks ... Champion member for your immediate help in this regards. I hope that my spouse gets the visa without much hassle. One more thing i would like to know on medical ground if my spouse wants to continue treatment in my home country and we are ready to bear the expenses as we just came to know that cost of the treatment in my home country because of Generics medicines and NGO is very low (Almost $ 200 / Annum ) . On basis of this can they accept the application ?

 

[computergeek]

Thanks ... Champion member for your immediate help in this regards. I hope that my spouse gets the visa without much hassle. One more thing i would like to know on medical ground if my spouse wants to continue treatment in my home country and we are ready to bear the expenses as we just came to know that cost of the treatment in my home country because of Generics medicines and NGO is very low (Almost $ 200 / Annum ) . On basis of this can they accept the application ?

Ovalle v MCI (http://canlii.ca/t/fr6j0) deals with a case of a man from Panama who had an NGO that agreed to continue providing his medication even after he came to Canada. CIC rejected his application, but that rejection was overturned by the Court because CIC refused to consider this information. With this decision on record, they should consider it, yes.

As a general rule, if your spouse requires treatment the process will be much more difficult - it is easier if you can argue that treatment is not necessary or justified. If the cost of medication will be born by the province, then you will have to argue about costs. One good source for (low price) drug cost information is http://www.blueskydrugs.com, a pharmacy based out of Surrey, BC (and thus inside Canada.) I did not try using the information from them, but have subsequently suggested that this could be used as a cost driven argument. This is important because the CIC medical officers are vague about estimated costs here, just declaring that it is "expensive". Actual cost information for provincial governments is generally quite difficult to find. I did find that Quebec publishes cost data for pharmaceutical drugs.

Some provinces pay 100% of HIV drug costs (e.g., BC) while others (e.g., ON) do not. Low cost drugs that might be available in your home country may not be available in Canada. Even determining which drugs are generic in Canada can be challenging. For example, tenofovir (the most commonly prescribed drug, alone or in combination, for treatment of HIV) was invented in 1986, but is still covered by a Canadian patent. That same patent was rejected in the US and not recognized in India. So the drug is very expensive in Canada (~$800 per month) and would be delivered in combination with other drugs as well. By itself, the cost will push you over the excessive demand threshold (currently just over $6,100 per year). That same drug is ~$100 per month in generic form.

I hope this helps.

 

[itiswell]

Hi..I recently completd medical examination. I am the primary applicant and my reports are normal. my spouse also went for medical examination and we come to know that my spouse is HIV positive. How it will affect my file ?

Please go to this link and click on "List of IMEs related to conditions of significance".
http://www.cic.gc.ca/english/department/partner/pp/index.asp
It will give u an idea of what exactly will be done during medicals in regards to ur case andgives u better understanding about the whole process. I think results of ur additional tests may play a determining role in ur getting the PRV. But, my advice ...arm urself with the knowledge and get ready to fight...and pray ofcourse.

 

[Aquib]

I know quite a lot about this area and have advised others in the past.

An HIV positive person can obtain a PR visa, but it can be challenging and it will increase the amount of time to process your application.

Your Panel Physician (formerly "Designated Medical Practitioner") should have drawn blood for an HIV-1 RNA test ("viral load") and a CD-4 test (a specific type of white blood cell used for cell mediated pathogenic response). Those results will then be forwarded to Immigration Medical Service. Their decision may be predicated, at least in part, on the province in which you will be landing. For example, if you plan on landing in BC, while they will go through all the process in the end because BC provides 100% coverage for the drugs unless your wife is not expected to require them for most of the next 10 years she will likely be declared inadmissible, though I can provide you with some information that you can use to argue against this decision.

Drug coverage varies by province, though, so a complete analysis cannot be done without that information.

Normally, what IMS will do next is send a sealed letter to you to take to the Panel Physicial (DMP). Normally this will ask for additional information and whether or not you will require treatment in the next 5-10 years. What this means is that you need to be looking for a sympathetic doctor now. Ideally, you want one that can either say definitively or probably that she will not require treatment within that time period. Not every doctor will say that, so you may wish to consult with more than one.

If after reviewing the additional medical information they determine she will require medication in the 10 year time period, they will advise you that she is "probably" medically inadmissible. This is done by way of a fairness letter. You will have 60 days to respond to the fairness letter.

You may challenge the finding of the medical condition, e.g., she had a "false positive". This is actually quite likely. The doctor may tell you the test is 99.6% accurate, but will not advise you that the positive predictive value (PPV) is much lower than that, because the prevalence of the condition is very low in the general population.

You may challenge the medical officer's estimate of costs. This is an area in which I can provide you with guidance, particularly if you can present a particular treatment regimen to her doctor and have the doctor agree that it is a viable treatment model - this is because one approved treatment is now made up of generic medications that have much lower cost and thus do not exceed the excessive demand cost threshold.

You may provide a plan to mitigate costs. This can include insurance plans, NGOs that will pay for treatment, and health savings plans.

If you do receive or expect to receive a fairness letter, I would strongly suggest you engage an attorney to assist you. I can recommend someone who specializes in HIV medical inadmissibility cases and can point out a handful of other attorneys specializing in medical inadmissibility. A well formulated response to the fairness letter potentially will overcome the initial inadmissibility conclusion and ultimately lead to a successful conclusion. In addition, it will set the stage for a successful challenge to a negative decision.

If you are refused, you may challenge the refusal in Federal Court. That will require you have an attorney. CIC's track record in medical admissibility cases for FSW applications is not good - they lose about 75% of such cases according to my own review of case law. If you are interested, look up the following four decisions: Sapru, Rashid, Companioni and Ortiz at canlii.org. These are all on-point cases with respect to medical inadmissibility and the last two are specific to HIV (CIC lost both of those cases).

If you need more information, feel free to ask (I won't hand out attorney names in public, but will send them privately.) You don't have 10 posts yet, so you won't be able to send PMs.

+1 for you.
Its really informative.
One of my friend in India waiting for his medicals. (fSW 3). And he got worried and called me couple of day ago telling that his wife told that she during her childhood diganosed with early stage of TB and got a year treatment. Then she was allright and never got any problem .

That makes my friend worried (he is not a foroum member ) and he ask me and i dont had any answer , i tell him that I will try to find out and told him to go and check with Dr too .

But reading this i got hope for him .
Can you tell anything about past TB too ?

Thanks

 

[computergeek]

If you are interested, look up the following four decisions: Sapru, Rashid, Companioni and Ortiz at canlii.org.

I must have been tired when I typed this. The last reference should be Ovalle. The decision is from May 2012.

 

[computergeek]

One of my friend in India waiting for his medicals. (fSW 3). And he got worried and called me couple of day ago telling that his wife told that she during her childhood diganosed with early stage of TB and got a year treatment. Then she was allright and never got any problem .

That makes my friend worried (he is not a foroum member ) and he ask me and i dont had any answer , i tell him that I will try to find out and told him to go and check with Dr too .

But reading this i got hope for him .
Can you tell anything about past TB too ?

Inactive TB is not a disqualifying condition. Depending upon the Panel Physician's findings, it may lead to a medical surveillance letter being issued, but a childhood case that was treated and cleared and no longer present should not present a condition that would be a threat to public health/safety and does not sound like it would be an issue of excessive demand.

There is specific information in the linked material from OB 470 (the new medical examination operational bulletin) that describes how Panel Physicians are to treat TB (current and past) cases.

Even someone with active TB can ultimately be successful in being admitted to Canada - they just must undergo treatment and then show clear results for 12 months. Thus, it slows down the immigration process, but by itself having a condition - any condition - is not a bar to permanent residency in Canada.

That's the point of the Hilewitz decision - CIC may not exclude people based upon their condition by itself. CIC must evaluate the condition with respect to the individual person and make a decision specific to that person. This is an area in which they don't always do what is required and one reason why they have a poor track record in Court.

 

[gacajias]

+1 for you.
Its really informative.
One of my friend in India waiting for his medicals. (fSW 3). And he got worried and called me couple of day ago telling that his wife told that she during her childhood diganosed with early stage of TB and got a year treatment. Then she was allright and never got any problem .

That makes my friend worried (he is not a foroum member ) and he ask me and i dont had any answer , i tell him that I will try to find out and told him to go and check with Dr too .

But reading this i got hope for him .
Can you tell anything about past TB too ?

Thanks
[/quote]


I under went medical

When i was about 9 year old i was diagnose that i had the virus that cause TB i was treated with pills for a year, When i went for medical i did not say anything to the doctor when he asked for TB.

An luckily nothing came out in my medical and got my visa a month ago

i do not thing that will come out in medical because i do not even have to go under surveillance

 

[computergeek]

I under went medical

When i was about 9 year old i was diagnose that i had the virus that cause TB i was treated with pills for a year, When i went for medical i did not say anything to the doctor when he asked for TB.

An luckily nothing came out in my medical and got my visa a month ago

i do not thing that will come out in medical because i do not even have to go under surveillance

Your friend should have disclosed it to the doctor - it would not have mattered to the evaluation, but you never want to withhold information like this because if CIC were to find out they might charge you with misrepresentation. But it doesn't make any difference in a case like this. TB must be treated before coming to Canada, but it's not grounds for refusal simply because you have it or have had it.

In fact that is the point: no disease is a barrier to admission to Canada. The grounds for rejection relate to cost of treatment or danger to public health/safety. TB actually falls in the latter category, but once it has been treated successfully the person is not a threat and thus may enter Canada.

 

[sogood]

Your friend should have disclosed it to the doctor - it would not have mattered to the evaluation, but you never want to withhold information like this because if CIC were to find out they might charge you with misrepresentation. But it doesn't make any difference in a case like this. TB must be treated before coming to Canada, but it's not grounds for refusal simply because you have it or have had it.

In fact that is the point: no disease is a barrier to admission to Canada. The grounds for rejection relate to cost of treatment or danger to public health/safety. TB actually falls in the latter category, but once it has been treated successfully the person is not a threat and thus may enter Canada.

WELL DONE +1 FOR U

 

[canadacalling2012]

No reply from the consulate for the past 6 months . We have submitted our passport to embassy on 18th november 2012 . They have received but still the online status shows " In Process " and when i mailed them in January enquiry for my file , reply was that it is in process in march 2013. Need to know what would be there next step as my passport is with embassy for past 6 months.

While medical : I was negetive in HIV
but my spouse was HIV positive . Let me know what would be there next step

 

[computergeek]

No reply from the consulate for the past 6 months . We have submitted our passport to embassy on 18th november 2012 . They have received but still the online status shows " In Process " and when i mailed them in January enquiry for my file , reply was that it is in process in march 2013. Need to know what would be there next step as my passport is with embassy for past 6 months.

While medical : I was negetive in HIV
but my spouse was HIV positive . Let me know what would be there next step

Which office? If it is NDVO, they "request" your passports at the BEGINNING of the process and thus the PPR means nothing - they can hold your passports for many months. In your case it is likely to be more than a year.

If your spouse was HIV positive, the normal protocol would be for them to request additional tests for your spouse as well as prognosis information from your spouse's doctor. If the medical officer concludes that your spouse's medical condition will create excessive demand, the visa officer will send you a "fairness letter" and you will have some period of time (typically 60 days) to respond. You may request time for an extension to formulate the response.

It can take 6 months from the time you get the request for further medical information before they even issue the fairness letter, and it can take an additional 6 months beyond the time you submit a fairness letter response for them to make a decision.

 

[on-hold]

Just to emphasize something that was said up above -- if you have not done this, your wife needs to be retested. The usefulness of the test is not its sensitivity, which is very high, but the combination of its sensitivity and the prevalence of HIV. False positives are known. You should also be retested, although your negative test is more likely to be correct.

Other than that, keep going as you are -- I work in public health and HIV prevention , and would like to emphasize that the public perception of HIV has not changed in the last 20 years, even though the medical state of knowledge has. HIV today is a chronic, manageable infection, and if your wife is treated, complies with her doctor and testing regime, and takes care of herself, she can expect to lose about 5 years of life (on average). By comparison, if you smoke, you will lose 13 life years (on average). The fear and stigma associated with HIV are out of proportion for disease that is quite comparable to Hepatitis B.

If you have any questions, feel free to PM me.