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Thread: Xray Abnormality

  1. #1
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    Default Xray Abnormality

    I've submitted my medical and xray for my working holiday visa to NZ.

    I was told by the panel physician who coordinated these tests that my xray was a bit abnormal with some shadowing on the lungs.

    I have no symptoms of anything and have never been to a TB risk country, nor have I left the country or been sick more than a few times in literally a decade.

    I was advised by the panel physician to submit my application and wait; that immigration nz will contact me if there is any issues in a few days.

    It's been over a month now and there is no response; I've been told my application has been forwarded to the medical assessors, which can take a while to hear back.

    What I am wondering is if seeing my family doctor to receive xrays and further tests to rule out any issues can then be presented as evidence to immigration/case office/medical assessor to help my application? I want to avoid taking TB or other tests that will prolong the application process for even more months.

    Can a family doctor help to speed things along by having evidence to give immigration to show there is nothing wrong and my xray isn't an issue? I am worried when they get back to me I might have a finite amount of time to prepare a response with evidence, or else I might have to go through some of their lengthy tests; if I had evidence on hand showing I didn't have any issues it might help?

  2. #2
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    Yes, it is often possible to pre-empt a knee-jerk reaction on the part of an MA (when the file eventually works its way to the front of the date-order queue for attention) if some tests/reports have been done and sent in to catch up with the original medical, so some or all of the questions are answered already.

  3. #3
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    Hmm. How exactly would I present the evidence to the MA though? The panel physician that coordinated all of this and forwarded the completed medical tests via eMedical to NZ said the family doctors opinion/tests would be irrelevant to immigration and that I had to do everything through them. However, the panel physician admitted they had little knowledge regarding NZ immigration as usually they handle incoming immigration.

    So if I did do such tests through a family doctor, what exactly would I do with them to help avoid visa delays by the MA/CO. When I did call immigration to check status, I did get my CO's contact email, if that helps.
    Last edited by johnc12; 4th June 2019 at 10:53 PM.

  4. #4
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    You can send the doctor's letter/test results/report to your CO to pass on to the MA, giving your eMedical number to make sure of linking it to the correct case. You could scan the paperwork and email it, saying you'll also send the originals by post.

  5. #5
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    The "panel physician only" thing is only for the initial medical. If the MA wants to follow up on something, s/he asks for a doctor's or specialist's report of whatever kind, and it's then up to the applicant to go to an appropriate person, which does NOT have to be the panel doctor.

  6. #6
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    Quote Originally Posted by JandM View Post
    The "panel physician only" thing is only for the initial medical. If the MA wants to follow up on something, s/he asks for a doctor's or specialist's report of whatever kind, and it's then up to the applicant to go to an appropriate person, which does NOT have to be the panel doctor.
    Do you know if it has to be an immigration approved specialist or doctor or can it be my GP in which the followup occurs?

    As in if I were to get a xray/skin/blood test or something to rule out TB/the original xray abnormality from my GP, and the MA/CO does call and say they are iffy about me, could I then say over the phone that I had these additional tests done and they came back negative and thus avoid the need for the MA/CO's additional tests s/he would have asked for?

    Or am I to send them in to the MA/CO before the MA/CO has even contacted me for the first time?

    I am really confused how to approach all of this. I also worry that getting additional tests and sending them in might be "poking the bear" and make it look worse then it is; perhaps the shadowing is very minor/an obvious glitch, but if I start sending in additional tests it will look like I think its a serious issue when the MA might have just passed it.

    This whole thing is stressful and confusing.... I just want to avoid delays without making things worse.

  7. #7
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    No, it does NOT have to be a doctor or specialist anything to do with Immigration. The "panel doctor" specification is ONLY for the initial medical, filling in the form and sending off the eMedical.

    Send them as soon as you can. As I said above, the way to pre-empt, we hope, the requirement for extra tests etc. is to try to have the letter/report/tests from your own doctor catch up with the eMedical which has been referred. The eMedical will be sitting in a queue for several weeks, probably, so catching up is a good possibility if you act quickly. Then, with luck, by the time an MA picks up your medical when it gets to the front of the queue and its turn for attention, the further information you have supplied will be there, and, also with luck, it will answer what queries the MA may have in mind after looking at the original medical.

    The MA's job is to understand the applicant's state of health so as to be able to say that s/he is not likely to cost the NZ Health Service too much for treatment and/or care. The MA has the power to require as many doctor's reports and/or tests as s/he thinks fit, until s/he thoroughly understands. So it is possible that, even after seeing your GP's opinion, s/he could even so require something more, even several times, and there is no way to argue against that. INZ can't grant a visa without getting a declaration from the MA that the applicant is ASH (Acceptable State of Health), so if you want a visa, you do what they tell you.

    You won't be poking the bear. No MA seeing an X-ray with a shadow on the lung can calmly say, 'Oh, that's okay,' without seeing some supporting evidence. By supplying the supporting evidence ahead of being asked, all you'd be doing is being realistic.

  8. #8
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    Thank you for the help.

    I am wondering:

    Is it possible that sending more information to add to my current eMedical which is in the queue would delay my eMedical from being seen by the MA further? In other words, when they add something to my eMedical which is in the queue, does that cause me to be pulled out and lose my spot in the queue, starting from the bottom again? Or do I keep my spot despite them pulling and adding more info?

    Also, does my GP just have to determine what it is or specifically rule out TB for me to get the pass? For example, I know apex shadowing can be suggestive of active TB. Now I'm pretty darn sure I don't have active TB as I have no symptoms, healthy, work from home, etc, but they won't take my word for it. As far as I know the only way to conclusively determine if you have active TB is a sputum test -- which is what I'm trying to avoid getting as it takes months.

    So lets say my doctor determines I have benign scarring or some lingering benign infection. He has now determined what I have and it is consistent with my xray images. He is satisfied. However, he has not actually proved that I DO NOT have active TB as that requires a sputum.

    Would immigration MA look at this evidence and think that I could possibly have both a benign infection as proved by my doctor and active TB as my doctor has not -- with definitive proof -- ruled out TB entirely? Are they THAT picky?

    I realize I am overthinking but it seems appropriate given the how wrenching a delay would be for me
    Last edited by johnc12; 5th June 2019 at 08:15 AM.

  9. #9
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    No, sending the extra information would not make your case lose its place.

    Given that the MA's job is to understand the applicant's state of health, what is needed is an explanation of whatever abnormality has come to light - a diagnosis and prognosis. I can't tell you what *your* MA's reaction would be if your GP says the reason for the shadow is (whatever) that you recovered from some time back. As I said above, they give ASH if they feel they understand your present condition, you're not a danger to others, and that you're not going to be too expensive - see here. https://www.immigration.govt.nz/opsmanual/#44856.htm I'm guessing it will depend on how convinced that MA is that s/he's got the whole story. You'd like to know the outcome NOW, though, and nobody can tell you that, particularly as not even you know yet what your GP will say.

    I do understand how important this is to you, but I'm afraid there is nothing to be done except to go through the necessary procedure.

  10. #10
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    Hi JandM

    Thank you again for the help.

    I took your advice and went to my GP. He wasn't very worried. He thinks likely it was a glitch.

    I had a chest xray last year that was clear; so he recommended that I get another chest xray now and then if it's clear and matches the one from last year, send both of those to the MA. This should make the xray they have look like a glitch, considering if I did have an infection like TB there is no way it would be cleared up completely in a month since the xray immigration made me take.

    As I've gathered my xray report and image from last year, I've noticed an issue though. How exactly would the MA verify that the xray reports and images are indeed legitimate and belong to me?

    Xray reports are a sheet of paper with some text that anyone could alter or create in a word document processor. Even the xray images don't have my name attached to them and could be altered as well. Even the original report which I have in my file folder at home I could create in a word processor. The only unique characteristic of these chest xray reports are unique numbers for the patient like the ACCESSION# (e.g. 1234567A) or MRN # (e.g. 123456) -- not sure if this means anything to immigration.

    Is the MA likely to call the Xray clinic or your family doctor to verify?

    I imagine this is why immigration uses panel-approved physicians for the medical exams at the beginning, and then immediately appends your eMedical and sends them off to Immigration without the patient having any part in the process.

    Obviously, if the MA is in doubt then all of this will be for naught.
    Last edited by johnc12; 6th June 2019 at 10:17 AM.

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