Hello,
I am from China, and is in the process of immigration to Canada via Federated Skilled Worker program.
My application status is that i received a letter from the CIC, saying that my personal health condition might reasonable be expected to cause excessive demand on health or social services in Canada. To make it specific, my expected cost is $64,579 over five years while the average threshold is $6,387/year.
I took the physical examination on April 1st, 2015 and the result is :
HBsAg, HBeAg and HBcAb positive
DNA: 1.57*10E8 IU/ml
HBeAg: 1400+ ( Don’t know the exact value)
ALT: 18U/L
B-mode ultrasound: Normal. There isn’t any hepatic fibrosis or hepatocirrhosis.
The VO gave me 60 days to submit additional information to prove that i will not place an excessive demand on social or health services, otherwise, my application will be refused.
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Here is the original letter from the VO:
Diagnosis: CHRONIC HEPATITIS B (070.3)
Narrative:
Ms. Song has a diagnosis of CHRONIC HEPATITIS B made during her immigration medical examination. Her diagnosis was confirmed based on all information gathered. Hepatitis B is an infectious disease affecting the liver caused by the Hepatitis B virus (HBV), which can often be asymptomatic and go unnoticed, but which will eventually usually cause chronic liver disease and if left untreated, can progress to portal hypertension, liver fibrosis and cirrhosis, hepatocellular carcinoma and even liver failure requiring liver transplant. HBV infection can be treated and the aim of the treatment is to impede progression of the patient's liver disease by obtaining a sustained viral eradication or long-term suppression of viral replication. Treatment is through the use of antiviral medications.
The applicant's hepatitis B profile showed the HBe Ag marker to be reactive. Her HBV-DNA viral load of March 23, 2015 was significantly elevated at 1.57 x 10E8 IU/ml and the liver enzyme ALT was 18 U/L. Ms. Song is HBeAg positive, which indicates the presence of active Hepatitis B virus replication and high infectivity. Patients who are HBeAg positive usually require prolonged treatment with antivirals to decrease the viral load and maintain it at a level that decreases the risk of progression. Often patients who are HBeAg positive experience suboptimal response or a relapse of the chronic hepatitis B on one antiviral and must be switched to either another more expensive antiviral or a combination of antivirals long term. In the Canadian context, this applicant would likely be offered long term treatment with anti-viral medications (e.g. Adefovir, pegylated interferon) to maintain a suppressed HBV viral load. This is required in order to prevent progression to liver failure and the development of liver cancer. The treatment for chronic active hepatitis B is expensive and publicly funded.
Other Information:
The expected cost for health related services for this applicant is $64579 over five year. This amount exceeds the average per capita threshold of $6,387 annually and therefore would likely exceed the average Canadian per capita health services and social services costs over a period of five consecutive years. A detailed list of health services required, cost implications as well as sources used to determine these costs are included in Appendix I.
Based upon my review of the results of this applicant's immigration medical examination and all the reports I have received with respect to the applicant's health condition, I conclude that this applicant is inadmissible under Section 38(1)(c) of the Immigration and Refugee Protection Act which states that "A foreign national is inadmissible on health grounds if their health condition might reasonably be expected to cause excessive demand on health or social services."
Appendix I: Expected Costs of Services
Medication(s)
Details of Services: Anti-viral medications (e.g adefovir) -$12,915.80 for one year ($64,579 in 5 years)
Source of Information: In house document on price of various anti-viral medications used for treatment of Chronic Hepatitis B
Date Accessed: April 24, 2015
TOTAL COST OF ALL LISTED SERVICES: $ 64,579 in 5 years
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After received this fairness letter, I contacted 'computergeek' (a million thanks) who gave me some very helpful suggestion and a couple of lawyers' contact information, so I began contacting these lawyers, meanwhile doing some research myself.
I have contacted 3 lawyers in total, one of them haven't replied me for 3 days, and another two lawyers asked for a consultant fee first. To be honest, this is the first time I turned my help to a lawyer, and I don't even know what should I ask in a consultant.
Anyway, I have actively done some research and got some findings (I may post my findings later), now I am wondering if I can handle my case myself.
The first thing I am going to do is reply the VO and order my medical records that may contain additional information and insight into how the medical officer reached that conclusion and that cost (computer geek suggested to do so), so that I can prepare my response accordingly.
Since English is not my mother language and I haven't seen similar cases by searching in Chinese. I haven't written this kind of letter before, shall I use challenging words? or formal words? How to orderly format the response? Do you have any suggestion or could you please give me some samples? Thank you so much.
Sincerely,
DD from China
I am from China, and is in the process of immigration to Canada via Federated Skilled Worker program.
My application status is that i received a letter from the CIC, saying that my personal health condition might reasonable be expected to cause excessive demand on health or social services in Canada. To make it specific, my expected cost is $64,579 over five years while the average threshold is $6,387/year.
I took the physical examination on April 1st, 2015 and the result is :
HBsAg, HBeAg and HBcAb positive
DNA: 1.57*10E8 IU/ml
HBeAg: 1400+ ( Don’t know the exact value)
ALT: 18U/L
B-mode ultrasound: Normal. There isn’t any hepatic fibrosis or hepatocirrhosis.
The VO gave me 60 days to submit additional information to prove that i will not place an excessive demand on social or health services, otherwise, my application will be refused.
---------------------------------------------------------------------------------------------------------------------------------------
Here is the original letter from the VO:
Diagnosis: CHRONIC HEPATITIS B (070.3)
Narrative:
Ms. Song has a diagnosis of CHRONIC HEPATITIS B made during her immigration medical examination. Her diagnosis was confirmed based on all information gathered. Hepatitis B is an infectious disease affecting the liver caused by the Hepatitis B virus (HBV), which can often be asymptomatic and go unnoticed, but which will eventually usually cause chronic liver disease and if left untreated, can progress to portal hypertension, liver fibrosis and cirrhosis, hepatocellular carcinoma and even liver failure requiring liver transplant. HBV infection can be treated and the aim of the treatment is to impede progression of the patient's liver disease by obtaining a sustained viral eradication or long-term suppression of viral replication. Treatment is through the use of antiviral medications.
The applicant's hepatitis B profile showed the HBe Ag marker to be reactive. Her HBV-DNA viral load of March 23, 2015 was significantly elevated at 1.57 x 10E8 IU/ml and the liver enzyme ALT was 18 U/L. Ms. Song is HBeAg positive, which indicates the presence of active Hepatitis B virus replication and high infectivity. Patients who are HBeAg positive usually require prolonged treatment with antivirals to decrease the viral load and maintain it at a level that decreases the risk of progression. Often patients who are HBeAg positive experience suboptimal response or a relapse of the chronic hepatitis B on one antiviral and must be switched to either another more expensive antiviral or a combination of antivirals long term. In the Canadian context, this applicant would likely be offered long term treatment with anti-viral medications (e.g. Adefovir, pegylated interferon) to maintain a suppressed HBV viral load. This is required in order to prevent progression to liver failure and the development of liver cancer. The treatment for chronic active hepatitis B is expensive and publicly funded.
Other Information:
The expected cost for health related services for this applicant is $64579 over five year. This amount exceeds the average per capita threshold of $6,387 annually and therefore would likely exceed the average Canadian per capita health services and social services costs over a period of five consecutive years. A detailed list of health services required, cost implications as well as sources used to determine these costs are included in Appendix I.
Based upon my review of the results of this applicant's immigration medical examination and all the reports I have received with respect to the applicant's health condition, I conclude that this applicant is inadmissible under Section 38(1)(c) of the Immigration and Refugee Protection Act which states that "A foreign national is inadmissible on health grounds if their health condition might reasonably be expected to cause excessive demand on health or social services."
Appendix I: Expected Costs of Services
Medication(s)
Details of Services: Anti-viral medications (e.g adefovir) -$12,915.80 for one year ($64,579 in 5 years)
Source of Information: In house document on price of various anti-viral medications used for treatment of Chronic Hepatitis B
Date Accessed: April 24, 2015
TOTAL COST OF ALL LISTED SERVICES: $ 64,579 in 5 years
---------------------------------------------------------------------------------------------------------------------------------------
After received this fairness letter, I contacted 'computergeek' (a million thanks) who gave me some very helpful suggestion and a couple of lawyers' contact information, so I began contacting these lawyers, meanwhile doing some research myself.
I have contacted 3 lawyers in total, one of them haven't replied me for 3 days, and another two lawyers asked for a consultant fee first. To be honest, this is the first time I turned my help to a lawyer, and I don't even know what should I ask in a consultant.
Anyway, I have actively done some research and got some findings (I may post my findings later), now I am wondering if I can handle my case myself.
The first thing I am going to do is reply the VO and order my medical records that may contain additional information and insight into how the medical officer reached that conclusion and that cost (computer geek suggested to do so), so that I can prepare my response accordingly.
Since English is not my mother language and I haven't seen similar cases by searching in Chinese. I haven't written this kind of letter before, shall I use challenging words? or formal words? How to orderly format the response? Do you have any suggestion or could you please give me some samples? Thank you so much.
Sincerely,
DD from China
