Medical Waiver

[doreysc]

OK I've done the search on medical waivers but I can't find our situation on the various threads.

After fairly long saga OH who is principal applicant and on the LTSS - Surgical Nurse has been found to have a 3.5mm pituitary microadenoma.

Her consultant has said it is probably benign, 10-20% of the population have them and her original issues were exercise induced as they have now resolved themselves. At the original health screening when she mentioned her symptoms she came out on the fitness scale at the lower end of 'athlete' and was training 15 - 20 hours per week. She cut back on the training and put on a few pounds and everything went back to even more normal. To be on the safe side the consultant recommended the MRI should be repeated in a year 'just in case'.

MA has deemed that this probably benign growth could cost too much even though it won't be known if there is any cost at all until the repeat scan in about 9 months now.

We can apply for a medical waiver but if the current diagnosis is 'healthy' and the potential cost is indeterminate until the repeat scan is the probable outcome that we have 9 months of this wait and see before we get a decision?

I'd be grateful if anyone who has had vaguely a similar situation could share outcome of waiver application and their timelines.

Thanks in advance,


Simon

[yokomist]

As far as the Medical Waiver timeline goes, our case officer sent our case to London on the 5th of feb for a decision on our medical waiver and we are expecting word any day now.

We were not asked to write a letter or "apply" for a medical waiver. Once the MA decided my Wife did not have a acceptable standard of health the case officer sent the case to his manager for consideration right away.

We applied in December of 2010 knowing we would need a waiver and we are hoping for a good conclusion any day now

Bevan

(Sorry if not quite the info you were looking for but anything helps right!)

[doreysc]

Everything does help, thank you. We have been told we can apply for a waiver I'm just confused what they will base the decision on - currently healthy, potentially unhealthy to a greater or lesser extent.
And good luck with your waiver application

Simon

[yokomist]

Thanks Simon,

From what I understand the waiver is based on lots of things like your connection to NZ, what you can offer NZ, if you have a NZ spouse etc. It has struck we as odd that they do consider you burden on the health system for a medical waiver. I thought the whole point of a waiver was to waive your health? lol

You can read more here about the considerations:

Taken from the INZ operations manual (under administration)
http://www.immigration.govt.nz/opsmanual/i35154.htm

A4.60 Medical waivers (applicants for residence class visas)

Applicants for residence class visas in New Zealand who are assessed as not having an acceptable standard of health and whose applications meet all other requirements for approval under the relevant Government residence instructions may be considered for the grant of a medical waiver unless:
they require dialysis treatment, or an Immigration New Zealand medical assessor has indicated that they will require such treatment within a period of four years from the date of the medical assessment; or
they have active pulmonary tuberculosis; or
they have severe haemophilia; or
they have a physical incapacity that requires full time care.
Medical waivers will also not be granted to people:
who are applying for residence under one of the Family Categories; and
who were eligible to be included in an earlier application for a residence class visa (or a residence visa or residence permit issued or granted under the Immigration Act 1987) as the spouse or partner of a principal applicant or the dependent child of a principal applicant or their spouse or partner; and
were not declared on that earlier application.
People who:
were eligible to be included in an earlier successful application for a residence class visa (or a residence visa or residence permit issued or granted under the Immigration Act 1987) as the spouse or partner of a principal applicant or the dependent child of a principal applicant or their spouse or partner; and
who were declared in that application but were not included in that application as non-principal applicants; and
whose application for a residence class visa (or a residence visa or residence permit issued or granted under the Immigration Act 1987) under one of the Family Categories is sponsored by a person, or supported by a partner who was, included in the application for a residence class visa referred to in (i) above
will be assessed for the grant of a medical waiver as if they had been included in the earlier application and as if the sponsor or supporting partner was not resident in New Zealand.

Applicants (and dependants included in their application) who have been recognised as refugees may be granted medical waivers.


and:

A4.70 Determination of whether a medical waiver should be granted (residence and temporary entry)

Any decision to grant a medical waiver must be made by an immigration officer with Schedule 1-3 delegations (see A15.5).
When determining whether a medical waiver should be granted, an immigration officer must consider the circumstances of the applicant to decide whether they are compelling enough to justify allowing entry to, and/or a stay in New Zealand.
Factors that officers may take into account in making their decision include, but are not limited to, the following:
the objectives of Health instructions (see A4.1) and the objectives of the category or instructions under which the application has been made;
the degree to which the applicant would impose significant costs and/or demands on New Zealand's health or education services;
whether the applicant has immediate family lawfully and permanently resident in New Zealand and the circumstances and duration of that residence (unless the limitations on the grant of medical waivers set out at A4.60(c) apply);
whether the applicant's potential contribution to New Zealand will be significant;
the length of intended stay (including whether a person proposes to enter New Zealand permanently or temporarily).
An applicant who is the partner or dependent child of a New Zealand citizen or residence class visa holder, may generally be granted a medical waiver unless there are specific reasons for not granting such a waiver or the limitations on the grant of medical waivers to such persons set out at A4.60(c) apply.
An immigration officer should consider any advice provided by an Immigration New Zealand medical assessor on medical matters pertaining to the grant of a waiver, such as the prognosis of the applicant.
An immigration officer must record decisions to approve or decline a medical waiver, and the full reasons for such a decision.


Bevan

[chickadee]

Here are some extracts from messages our CO sent about waivers which may be helpful to you:

The process is that the medical certificate is sent to a Medical Assessor (one of 5 Medical Assessors).
Medical Assessor number one will assess the medical and they may ask for more information, which we then request from you, or they may assess that the person does not have an acceptable standard of health.

When this happens we must send a letter advising the applicant of this and advising them of the procedure when a medical is first deemed not of acceptable health. We must also at this time advise the applicant of the medical waiver procedure even though the medical must be looked at two further times before the waiver process can begin.

We must give the applicant the opportunity to challenge the medical assessors opinion, or provide further medical information and/or evidence detailing their strong tie to New Zealand.

This information will be returned to the medical assessor and they will again review the medical along with any additional information provided. If their finding is the same (eg not of acceptable health) the medical is then given to another medical assessor to consider.

The second medical assessor may agree with the first medical assessor and from there we will write up a report and send a request to our manager for a medical waiver, using all the information provided by the applicant in response to the letter sent advising of the first medical assessors opinion
The second medical assessor may wish for further information before making a decision, and this is what has happened in your instance. The second medical assessor has requested more information to make their decision.

Until we have the decision from the second medical assessor we cannot apply for a medical waiver to our manager.

ALSO

The link/ ties to New Zealand are closely considered by Immigration Managers when considering these waivers. I suggest you highlight the duration of your relationship nd mention any other ties you have to New Zealand (eg family, regular visits, property, funds etc).

---------------------------------------------------

After the first medical referral in July, we sent information in support of a waiver application in early September (instead of sending further medical information, which was the other option given at that stage), were asked for additional medical information in early November, sent that by mid January and are currently waiting for news....

[yokomist]

Here are some extracts from messages our CO sent about waivers which may be helpful to you:


When this happens we must send a letter advising the applicant of this and advising them of the procedure when a medical is first deemed not of acceptable health. We must also at this time advise the applicant of the medical waiver procedure even though the medical must be looked at two further times before the waiver process can begin.

Hmm thats odd that your CO said that, I wonder if that is policy or if it is at the CO's discretion.

I wrote a letter when I submitted our application stating that my wife does not have an acceptable standard of health and that we do not have any further medical information. Our case officer acknowledged this and sent our application for a Medical Waiver after directly after the first MA's denial.

"We have noted Bevan ______'s letter of 16 December 2010 where he acknowledges that you do not meet the Acceptable Standard of Health required to be approved residence, and that you have provided all medical records available and are unable to obtain further medical documentation for review. Please confirm by 16 February 2011 if still no further medical records or documentation is available for submission. If this is still the case then I will forward your application onto my Manager for the consideration of a medical waiver."

It worries me that the two CO have a different story...!

Bevan

[chickadee]

Originally Posted by yokomist

Originally Posted by chickadee
Here are some extracts from messages our CO sent about waivers which may be helpful to you:

When this happens we must send a letter advising the applicant of this and advising them of the procedure when a medical is first deemed not of acceptable health. We must also at this time advise the applicant of the medical waiver procedure even though the medical must be looked at two further times before the waiver process can begin.

Hmm thats odd that your CO said that, I wonder if that is policy or if it is at the CO's discretion.

I wrote a letter when I submitted our application stating that my wife does not have an acceptable standard of health and that we do not have any further medical information. Our case officer acknowledged this and sent our application for a Medical Waiver after directly after the first MA's denial.

"We have noted Bevan ______'s letter of 16 December 2010 where he acknowledges that you do not meet the Acceptable Standard of Health required to be approved residence, and that you have provided all medical records available and are unable to obtain further medical documentation for review. Please confirm by 16 February 2011 if still no further medical records or documentation is available for submission. If this is still the case then I will forward your application onto my Manager for the consideration of a medical waiver."

It worries me that the two CO have a different story...!

I don't think it's totally contradictory... Your approach was just far more efficient than ours

We didn't anticipate the need for a waiver in advance as well as you did so were referred to the MA, then were given the choice of supplying further medical opinions etc or sending information in support of a waiver; we chose the latter option and were surprised when the request for different medical information arrived sometime later (hence the first message I quoted from the CO - in reply to my query about why more medical information had been requested).

I assume that if we had nothing to submit in response to that second request the waiver process would have kicked in at that point...

[yokomist]

Ah ok, I guess that sounds about right then, the only part the confused me was:

"We must also at this time advise the applicant of the medical waiver procedure even though the medical must be looked at two further times before the waiver process can begin. "

I took that as meaning that you HAD to go through the second MA. I was worried that things wern't as far along as I assumed.

The purpose of writing the letter was an incorrect assumption that I could go directly to Medical Waiver and skip the loooong MA stage. Turns out you do have to go to at least one MA.

Thanks for the replies and info!

Bevan

[doreysc]

Here are some extracts from messages our CO sent about waivers which may be helpful to you:

When this happens we must send a letter advising the applicant of this and advising them of the procedure when a medical is first deemed not of acceptable health. We must also at this time advise the applicant of the medical waiver procedure even though the medical must be looked at two further times before the waiver process can begin.

.

Thanks, interesting.
We didn't have that on our communications because I really don't think the MA actually read and understood the report - the consultant's diagnosis is that OH is, and always has been completely healthy but in the course of investigations a fairly common small benign growth was found that ought to be kept an eye on; in the same way suspect moles should be checked for skin cancer signs. Being in the middle of her head it needs an MRI to check - and they cost a few hundred quid, the odds of it turning nasty are small and if we thought that a significant possibility we would not be emigrating to New Zealand now!

Simon

[doreysc]

Well, we got a letter from OH's consultant (another £50) that disputed the MA's assessment in no uncertain terms - 'of no consequence whatsoever' was the term used to describe the benign microadenoma and also advised the prognosis was excellent and repeat scan was merely 'for completeness' not to monitor a chronic recurring medical condition.

CO has passed letter on to MA and we have advised her if first MA still determines her condition unacceptable we will ask for a second opinion from another MA (as per section 4.45 of the Operational Manual) before considering going for a medical waiver.
At least the other three of us have been passed by the MA after being referred to GP for high cholesterol.

Simon