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Thread: Medical PPIs very vague

  1. #1
    Join Date
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    Default Medical PPIs very vague

    I am surprised by the vague letters that Immigration NZ is sending out. Especially when sending out PPIs there is an expectation that they will provide decent information for us to respond on. I am hoping someone in this forum will help provide some insight into the mysterious world of medical PPIs!

    Background
    I recently applied for a Parent and Grandparent visitor visa for my parents. We have provided all medicals for my mom and my dad and also extra heart reports along with cardiologist's report. I understand that one my mom's heart tests is abnormal but that's controlled through medicine. As part of her medical documents, we informed INZ about my mom's heart condition. Her cardiologist had just confirmed it was acceptable and just needed to be managed through medications. She is close to 65 so this is now part of life.

    We have just received a PPI stating the follwoing:
    The details of the medical assessorís assessment are as follows:
    ? Likely to impose significant health costs or demands.
    ? High risk for future cardiac events


    The PPI is addressed to my dad and does not mention my mother at all. So I am not even sure who does this assessment relate to. On calling the INZ Contact center I was informed that my dad is ASH (with conditions for future visas) but my mom is NOT ASH. However, if the PPI does not state that then I am not sure what do I need to do. Even the INZ contact center are not sure.

    Moreover, the text 'high risk for future cardiac event' is so vague that I am not even sure what do I do to address this. My mother's cardiologist is one of the best in the country and is involved in several high profile cases. I know this may not seem relevant to INZ but his opinion is pretty much going to be mirrored by other doctors. My mom has already done all possible tests (Resting ECG, Echocardiography, Exercise ECG test, Angiography, Thallium test ) in the last 3 months so there is nothing else left to do.

    I am sitting staring at this PPI and wondering what am I supposed to do next!

    Any suggestions would be great.

  2. #2
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    Feb 2008
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    35,991

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    You say that the specialist said your mother's condition was "acceptable and just needed to be managed through medications". That doesn't tell the MA the details s/he needs. For instance, acceptable - to whom and for what purpose? What medications in what quantities (and therefore, at a cost that can be calculated)? That is why s/he hasn't just been able to tick off your mother's case.

    You will need to ask the cardiologist to write another letter specifically stating that this lady has (whatever) condition, being managed by (whatever) medicine(s) at (whatever) dosage(s). He has conducted (whatever) tests, and here are the results. Based on these, and his experience as a senior consultant (or whatever his exact title) since (whenever), his opinion is that the patient's condition is stable, and the chances of any future cardiac events in the next five years are (whatever) per cent.

  3. #3
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    Sep 2016
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    Thank you for this information JandM - I really appreciate it. We have got the medical assessor's comments through an OIA (it was very fast - hardly one day to respond from INZ which was really appreciated!). It appears that their assessment is opposite of the findings in the cardiologist's report. They have not even referred to the cardiologist's reports in the assessment and only noted their interpretation of the report. We are working on getting some response from the cardiologist about this but my mom's original doctor is away vacationing in the Swiss Alps and we will now have to find somebody else. I will update this post in case there are any learnings.

  4. #4
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    A PPI about a medical is NOT an assessment. A PPI is actually INZ being helpful, saying, 'Here is something that, from what we have at the moment, LOOKS AS THOUGH it is a problem, so we're giving you the chance to supply more information or explanation. If you don't, we'll have to judge the case on what we have so far, and would have to refuse.' And this particular PPI quotes the MA as putting a question mark by the two points on the list, "? Likely to impose significant health costs or demands. ? High risk for future cardiac events." Like I said, the original letter from the cardiologist isn't detailed enough - the cardiologist can't judge FOR the MA (which he would be doing if they just took his word that it was 'acceptable', since they don't know the criteria he was using). What they need is for him to show his reasoning. If the things I mentioned WERE included with his letter, and the MA has overlooked it (some of them sometimes can be "rushed", if we're being charitable, or we might be less polite!), it needs the Great Man to repeat it all the same piece of paper. If the PPI has given you a deadline, don't worry - as long as you reply before the deadline, acknowledging that you've had the communication, and explaining what you're doing to supply more information (e.g. a copy of the letter to the clinic asking for the information, or another appointment, or whatever it may be), INZ allow the time necessary.

  5. #5
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    Thank you J&M for the detailed information you have provided to us.

    I have now received this email from the Immigration officer -
    'Unfortunately given the medical assessment which is completed we canít grant your mother a Visitor visa Ė parent/grandparent visa. However, you can lodge an online VV-General application for 3 months and the medicals can be referred again to the health assessment team for this category (shorter duration of 3 months). Please make a new application and advise the application number. I will then remove your mother from this application and approve your fatherís application.'

    I had asked the Immigration officer to consider giving my mom a limited visa as part of the Parent and Grandparent visa application but he has decided not to. Knowing this I am not sure how will the same medicals be assessed for another limited visa.

    Do immigration officers have the discretion to grant a limited visa in my situation and help save time that will be spent on another visitor application applied from scratch by another immigration officer? I am finding this a bit strange - the double up of work and effort (not to mention the fees that I will have to pay). Surely the existing medical assessors can make an assessment of a shorter duration visa for my mom.

    I am sorry if I am ranting but this just appears to be operationally unsound.

  6. #6
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    Short answer to your last question - no, a CO can't do that. Different kinds of visas are dealt with in totally separate departments, so it has to be a separate application. Remember, INZ has all the power - their processes don't have to make sense to us, or be what we would organize ourselves. They just ARE, and we have to go along with them if we want to be granted a visa.

    Medical requirements are not as strict for a short general visitor visa as they are for the parent/grandparent visa (which carries the same medical requirements as for residence). Again, there's no point in asking why this happens - it just IS.

    I hope your arrangements will move forward more smoothly now. Good luck.

  7. #7
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    Thank you J&M. I am sure countless on this website agree how nice it is to be able to speak to someone and get some sound advice. You have been very helpful. I will update this thread when my applications are concluded.

  8. #8
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    So I just spoke to the Contact Center and they are surprised that the Immigration officer did not ask the medical assessor to just review the medicals for a limited visa. It seems that in most situations they do ask for this.

    I am thinking of writing to the Immigration officer again and see if he will just ask the medical assessors to look at my mom's medical for a limited visa (as part of the ongoing application) once again and keep my fingers crossed that maybe this time he will take this in stride.

  9. #9
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    Worth an ask - even if the CO refuses, you'd be no worse off.

  10. #10
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    So I have had to submit a new visitor visa application for my mom which I have been told will be processed on an urgent basis. The medicals will be referred again to a medical assessor for a 3 month visitor visa. This process has been so draining and there is still no guarantee that anything will come through.

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