Applying to immigrate to Canada involves meeting several eligibility and admissibility requirements. One of these is medical admissibility. Depending on the type of application, applicants may be required to complete an Immigration Medical Examination (IME), and certain medical circumstances can result in a finding of medical inadmissibility.
However, having a medical condition does not automatically mean that you will be refused entry to Canada. Immigration, Refugees and Citizenship Canada (IRCC) assesses medical admissibility on an individual basis and considers several factors before making a decision.
In this article, we explain what medical inadmissibility means, how IRCC assesses medical conditions, what “excessive demand” means, and what applicants can do if they receive concerns about medical inadmissibility.
What Is Medical Inadmissibility?
Medical inadmissibility means that an individual may not be permitted to enter or remain in Canada because of certain medical concerns.
Under Canada’s immigration rules, medical inadmissibility can arise when a person’s medical condition:
- Poses a danger to public health;
- Poses a danger to public safety; or
- Is expected to cause excessive demand on Canadian health or social services.
IRCC considers medical inadmissibility as one of several possible grounds of inadmissibility under Canadian immigration law.
Importantly, there is no simple list of medical conditions that automatically makes every applicant inadmissible. IRCC evaluates the circumstances of each applicant individually.
What Is an Immigration Medical Examination?
An Immigration Medical Examination is a medical examination required by IRCC for certain applicants.
For permanent residence applications, the applicant and applicable family members generally need to complete an immigration medical examination. Family members may need to undergo the examination even if they are not accompanying the principal applicant to Canada.
Temporary residents, including visitors, students and workers, may also need a medical examination depending on factors such as the length and purpose of their stay, their intended occupation, and where they have lived or travelled.
The examination must be completed by an IRCC-approved panel physician. Your regular family doctor cannot perform the immigration medical examination unless they are also an approved panel physician.
Does Having a Medical Condition Mean My Application Will Be Refused?
No.
This is one of the most important things applicants should understand about medical inadmissibility.
IRCC does not simply look at the name of a medical condition and automatically refuse an application. For excessive-demand assessments, officers consider the applicant’s individual circumstances, including:
- The current state of the medical condition;
- The likely prognosis;
- The health or social services that may be required;
- The estimated cost of those services over the relevant assessment period; and
- The potential effect of the required services on wait times in Canada.
Therefore, two applicants with similar diagnoses may not necessarily receive the same immigration outcome.
What Does “Excessive Demand” Mean?
Excessive demand generally refers to a situation where an applicant’s anticipated use of Canadian publicly funded health or social services may place an excessive demand on those services.
This can involve either:
- The anticipated cost of the required services; or
- The potential impact of the applicant’s need for services on existing wait times.
Examples of health and social services considered in this assessment can include services provided by doctors, specialists, nurses, hospitals, laboratories, pharmacists and other publicly funded providers.
Social services can include certain forms of home care, specialized residences, residential services, special education, social or vocational rehabilitation and personal support services.
What Factors Does IRCC Consider?
Medical admissibility is not determined solely by the existence of a diagnosis.
When assessing excessive demand, IRCC considers the applicant’s overall medical circumstances and the expected need for services.
Factors may include:
1. Current Medical Condition : IRCC may consider the applicant’s current health status and the nature of their condition.
2. Prognosis : The likely progression or prognosis of the condition can also be relevant.
3. Expected Health Services : IRCC may assess what medical treatment, medication, therapy, hospitalization or other services the applicant is expected to require.
4. Expected Costs : The anticipated cost of required health and social services may be considered over the relevant assessment period.
5. Impact on Canadian Services : IRCC may also consider whether the applicant’s anticipated need for services could negatively affect existing wait times for Canadian health or social services.
Are All Applicants Subject to the Excessive Demand Assessment?
No.
There are important exemptions.
According to IRCC, the excessive-demand provision does not apply to certain categories of applicants, including:
- Refugees;
- Protected persons; and
- Certain members of the family class, including dependent children, spouses and common-law partners.
Because exemptions depend on the specific immigration category and circumstances, applicants should determine whether the rules apply to their particular application rather than assuming that every applicant is treated the same way.
What Happens If IRCC Has Concerns About Medical Admissibility?
If IRCC has concerns about an applicant’s medical admissibility based on excessive demand, the applicant may receive a procedural fairness letter (PFL).
Depending on the circumstances, an applicant may be invited to provide additional information and, where applicable, submit a mitigation plan.
A mitigation plan explains how the applicant intends to manage the anticipated need for certain services and how the associated costs will be addressed.
IRCC states that a mitigation plan must be credible, detailed and specific to the individual applicant. It should explain:
- What services will be required;
- How those services will be provided;
- How the applicant will pay for the applicable services; and
- The applicant’s financial circumstances for the period in which services are expected to be required.
A signed Declaration of Ability and Willingness form is also required when submitting a mitigation plan.
Can an Applicant Prepare a Mitigation Plan for All Medical Services?
No.
This is an important distinction.
Applicants cannot simply promise to privately pay for all publicly funded Canadian health services.
IRCC explains that applicants generally cannot opt out of publicly funded health services. However, in some circumstances, a mitigation plan may address certain services, such as outpatient prescription medication or eligible social services.
The contents of a mitigation plan therefore need to be carefully tailored to the specific medical circumstances and services identified by IRCC.
What Should You Do If You Receive a Procedural Fairness Letter?
Receiving a procedural fairness letter concerning medical inadmissibility is a serious matter, but it is not necessarily the end of the application process.
Applicants should carefully review the concerns identified by IRCC and respond within the deadline provided.
Depending on the case, supporting documentation may include:
- Updated medical reports;
- Specialist reports;
- Treatment information;
- Information about prognosis;
- Details regarding anticipated medical services;
- Evidence relating to the availability of services;
- Financial documentation;
- Insurance information where relevant; and
- A detailed mitigation plan, where applicable.
The response should directly address the concerns raised by IRCC rather than simply providing unrelated medical records.
Can Medical Inadmissibility Be Overcome?
In some circumstances, applicants may be able to respond to the concerns raised by IRCC and demonstrate that the requirements for medical inadmissibility are not met.
Where a mitigation plan is available, a carefully prepared and credible plan may also be relevant to the assessment.
However, there is no guaranteed strategy that applies to every applicant. The appropriate response depends on the immigration program, medical circumstances, anticipated services and the specific concerns raised by IRCC.
Medical Exams and Canadian Immigration Applications
Applicants should also understand that the timing and requirements for medical examinations can vary depending on the immigration program.
For example, Express Entry applicants are generally required to complete an immigration medical examination after receiving an Invitation to Apply and before submitting their permanent residence application. Other permanent residence applicants generally receive instructions from IRCC after submitting their application.
For temporary residence applications, some applicants can complete an upfront medical examination, depending on the circumstances.
Medical examination results are generally valid for 12 months, although applicants may be required to complete another examination in certain circumstances.
Be Honest About Your Medical History
Applicants should provide accurate information about their medical history and follow the instructions provided by IRCC and the panel physician.
Attempting to hide or misrepresent relevant information can create additional immigration problems. Medical inadmissibility should be addressed through accurate medical information and an appropriate immigration response rather than through omission or inaccurate declarations.
How MyRoaming World Immigration And Citizenship Consulting Can Help
Medical inadmissibility cases can be complicated because immigration decisions involve more than simply identifying a medical diagnosis.
At MyRoaming World Immigration And Citizenship Consulting, we can help applicants understand the immigration implications of their situation and review the documentation relevant to their application.
Our assistance may include:
- Reviewing the immigration application and medical-related concerns;
- Helping applicants understand IRCC correspondence;
- Reviewing a procedural fairness letter;
- Assisting with the preparation of a response;
- Helping organize supporting documentation;
- Assisting with mitigation-plan documentation where applicable; and
- Providing immigration guidance throughout the process.
Every case is different, so an individualized assessment is important before deciding how to respond to a medical inadmissibility concern.
Final Thoughts
Medical inadmissibility does not mean that every person with a medical condition will automatically be refused entry to Canada.
IRCC assesses medical admissibility based on the circumstances of each applicant and, where excessive demand is considered, factors such as the applicant’s condition, prognosis, anticipated services, costs and potential impact on Canadian health and social services.
If you have received a procedural fairness letter or are concerned that your medical history could affect your Canadian immigration application, it is important to understand the specific immigration rules that apply to your situation and respond appropriately.
Need help with a Canadian immigration matter involving medical inadmissibility? Contact MyRoaming World Immigration And Citizenship Consulting to discuss your situation and learn about the available options.
This article is provided for general informational purposes only and does not constitute legal advice or a guarantee of the outcome of any immigration application. Canadian immigration rules and policies may change, and applicants should obtain advice based on their individual circumstances.