What does "in good health" mean with respect to Canadian entry?

7/25/2018 7:20:25 PM

The policies adopted by Immigration, Refugees, and Citizenship Canada (IRCC) are given in the Immigration & Refugee Protection Regulations. The regulations concerning "public health" and "public safety" are in Paragraphs 31 & 33, respectively; they deal with, effectively, communicable diseases and mental illness that could lead to the applicant harming someone.

I was unable to find a list of specific diseases and conditions that fall on either side of the admissibility line; such guidelines may exist but not be publicly available, or the decisions may be made on an ad hoc basis based on the guidance in the above-mentioned paragraphs. As pointed out user71659 in the comments, the standards may need to change quickly during outbreaks of communicable disease, such as the SARS outbreak of 2002–3.


The "excessive demand" clause is more interesting. The current definition is

Excessive demand means

(a) a demand on health services or social services for which the anticipated costs would likely exceed average Canadian per capita health services and social services costs over a period of five consecutive years immediately following the most recent medical examination required under paragraph 16(2)(b) of the Act, unless there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years; or

(b) a demand on health services or social services that would add to existing waiting lists and would increase the rate of mortality and morbidity in Canada as a result of an inability to provide timely services to Canadian citizens or permanent residents.

The actual procedures followed by IRCC to determine whether an immigrant would cause "excessive demand", along with the notification and appeals process, are listed on a page titled "Excessive demand on health services and on social services" on the IRCC webpage. In particular, any cases that are potentially inadmissible due to "excessive demand" are evaluated by a dedicated unit, not your front-line level immigration officers:

When a review of immigration medical examination (IME) results shows that the foreign national (principal applicant, accompanying family member or non accompanying family member) is potentially inadmissible on health grounds, responsibility for final assessment of the IME is transferred to the MHB Centralized Medical Admissibility Unit (CMAU) in Ottawa.

Once the IME is accepted for continued processing by the CMAU, MHB medical officers should complete all medical assessments, based on the definition of excessive demand found in subsection R1(1).

Until recently, the threshold for "excessive demand" was if your estimated medical costs over five years were more than the Canadian per capita average, or about CAD 33,000 for a five-year period. However, earlier this year, the Government of Canada announced a large increase in the cost threshold for inadmissibility (specifically, tripling it to approximately CAD 100,000), as well as the exemption of some social services from this calculation. A temporary policy to this effect was enacted in June 2018, and presumably more permanent regulations will be enacted soon.

As an aside, this clause has caused approximately 1000 people per year with chronic diseases and/or disabilities to be deemed inadmissible due to their conditions. Moreover, the inclusion of "social services" in the paragraph above means that some of the applicants were denied due to disabilities that would require ongoing care. This policy therefore amounted to constructive discrimination against the disabled, which understandably caused a certain amount of criticism among disabled-rights advocates. The new policy was largely designed to lessen this discrimination.

Credit:stackoverflow.com

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