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Thread: Medical waiver for parents

  1. #1
    Join Date
    Feb 2011
    Location
    Auckland, NZ
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    136

    Post Medical waiver for parents

    Hi All,

    I am posting this on a friend's behalf who's having some issues while posting with his userID:

    Hi all,

    My father has COPD(listed in appendix 10) and we have been asked to submit a response for a medical waiver.

    Could you help with what all can we possibly argue?

    1. MA has shown concerns in long-term after five years. Even after five years, the MA has not quoted what the costs are. Did he/she need to?

    2. Our specialist had suggested that long-term prognosis is stable. only oral medications of $40 per month will manage the disease for now.

    3. Prediction of costs after 5 years will be notoriously hard.

    4. Both the children of our parents are in NZ with their spouses and 3 grandkids. All four of us are listed under long term skills shortage list.

    5. My father is a qualified mining engineer and aged 65. Maybe he can work as a consultant after moving here.

    6. Maybe we will set up our own business.

    Not sure what else can we argue? what evidences we may need?

    Can someone help, please?

    I guess we have our last chance here to present all the arguments.
    Thanks.

  2. #2
    Join Date
    Feb 2008
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    37,822

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    ChrisMwn, have you anything you can comment?

    I think what the father's own doctor/specialist says about him can make a big impact, giving the impression of how severe (or not) the condition is. COPD covers a very wide range, and not all the possible diagnoses would come under the paragraph at A4.10.

    As to extra points the children could make on the father's behalf, I believe it has been said in the past that the strong worth of the family who are already in NZ can help. Here are four people already using their skills to benefit NZ, and obviously they are paying tax and buying goods and services locally, and children raised by skilled parents are likely also to grow up as assets to the community. Besides that, they can list anything they do outside of work to benefit their neighbourhood - any volunteering, e.g. at the children's school(s), charity work, participating in local projects, etc.. And these people are concerned for their parents, away from them, and strongly wish to reunite the family, for the benefit that the parents' society and influence will have.

  3. #3
    Join Date
    Feb 2011
    Location
    Auckland, NZ
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    Quote Originally Posted by JandM View Post
    ChrisMwn, have you anything you can comment?

    I think what the father's own doctor/specialist says about him can make a big impact, giving the impression of how severe (or not) the condition is. COPD covers a very wide range, and not all the possible diagnoses would come under the paragraph at A4.10.

    As to extra points the children could make on the father's behalf, I believe it has been said in the past that the strong worth of the family who are already in NZ can help. Here are four people already using their skills to benefit NZ, and obviously they are paying tax and buying goods and services locally, and children raised by skilled parents are likely also to grow up as assets to the community. Besides that, they can list anything they do outside of work to benefit their neighbourhood - any volunteering, e.g. at the children's school(s), charity work, participating in local projects, etc.. And these people are concerned for their parents, away from them, and strongly wish to reunite the family, for the benefit that the parents' society and influence will have.
    Thanks for your reply JandM.
    I am sure my friend has already seen your reply.
    I will post any follow ups if I get it from him.

    Cheers.

  4. #4
    Join Date
    Oct 2017
    Location
    New Zealand
    Posts
    7

    Default

    Quote Originally Posted by JandM View Post
    ChrisMwn, have you anything you can comment?

    I think what the father's own doctor/specialist says about him can make a big impact, giving the impression of how severe (or not) the condition is. COPD covers a very wide range, and not all the possible diagnoses would come under the paragraph at A4.10.

    As to extra points the children could make on the father's behalf, I believe it has been said in the past that the strong worth of the family who are already in NZ can help. Here are four people already using their skills to benefit NZ, and obviously they are paying tax and buying goods and services locally, and children raised by skilled parents are likely also to grow up as assets to the community. Besides that, they can list anything they do outside of work to benefit their neighbourhood - any volunteering, e.g. at the children's school(s), charity work, participating in local projects, etc.. And these people are concerned for their parents, away from them, and strongly wish to reunite the family, for the benefit that the parents' society and influence will have.
    Thanks JandM. Very useful info.

    In second PPI the first medical assessor noted that

    “No new medical information has been provided. The applicant has been reported as having an FEV1 of 42% on one occasion and 33% on another. (Based on standard definitions of severe COPD an FEV1 <40% is severe) so it is reasonable to state that the applicant has moderately severe to severe airflow obstruction. He does have reasonable function at present but the issue here is that this application is for residence and we have to look at long term prognosis. While the prognosis in the next 2-3 years is probably reasonable, he is young and there has obviously been significant, presumably occupational, damage to the airways and prognosis for 5 or more years becomes more guarded. It is possible that the applicant will then require considerably more health resource”.


    Second medical assessor noted that

    “I am reviewing this case as the Medical Referee. Having reviewed all the information submitted including the disputing information the opinion is that the applicant is unlikely to have an acceptable standard of health. The applicant is reported to have moderate Chronic Obstructive Pulmonary Disease (COPD), likely secondary to previous coal mine and air particle exposure. While the applicant is currently reported as stable, with no previous hospital admissions relating to his COPD, there are progressive abnormalities on the CXR dated Feb 2018 when compared to the 2016 image. COPD is a chronic, progressive condition and is an A4.10 INZ Listed condition. The applicant is NOT ASH”.

    On digging further, It seems the appendix 10 was updated in 2013.

    Old ops manual has below ( before 2013 )

    "Chronic obstructive respiratory disease with limited exercise tolerance and requiring oxygen"

    whereas current manual says

    "Chronic respiratory disease, including but not exclusive to:
    severe and/or progressive restrictive (including interstitial) lung disease
    severe and/or progressive obstructive lung disease
    cystic fibrosis"

    The point is that as per previous instructions, my dad would get a visa easiliy as he has moderate to severe COPD without any excercise tolerance and qxygen requirements.

    Whereas new instructions are more generic. Consequently causing a not ASH.
    (Although our medical specialist has provided a report and said the his category of COPD has stable long term prognosis.)

    Not sure if we have an argument here. Old instructions can be useful in any ways?

  5. #5
    Join Date
    Feb 2008
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    Old instructions can be useful in any ways?
    I'm afraid not - they have been superseded, and not even very recently.

  6. #6
    Join Date
    Oct 2017
    Location
    New Zealand
    Posts
    7

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    Thanks, JandM for your help so far.

    We almost have a draft ready. But I am paranoid as it is our last chance.

    Has anyone ever been granted a medical waiver in parent catagory?

  7. #7
    Join Date
    Oct 2017
    Location
    New Zealand
    Posts
    7

    Default Medical Waiver

    We think we may have a strong case. However, we are not sure on

    1. How to determine the degree to which applicant's condition will impose significant costs

    2. What will make the contribution significant?


    Your guidance on above will be appreciated.

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