Medical Assessments – back to the grindstone.
Filed under: Getting to New Zealand, NZIS & Immigration issues
Well, once again, even though INZ say clearly they won’t even look at an application for a gazillion years – they have already sent my brother’s paperwork to the Medical Assessor and asked for some further tests. Now one difference we did notice is that this time, the letter was sent by a “support officer” whereas with my parents application, it was an immigration officer who sent out this letter. Im wondering if that means they are using lower grade staff to do a lot of the background work before the Immigration Officers take up the case and make the decisions. Sensible if they are – except I understood that it was up to the warranted officers to make the decision as to whether an application had to go to the MA or not.
I’d check – but that would be “systematic”.
The other thing which I am being gently “optimistic” about is that they aren’t asking any questions about the epilepsy – which would suggest that they are comfortable with this aspect of my brothers health. I would like to be wildly optimistic and say that this means the epilepsy is in the clear – but the last MA – having got conformation that my dad’s Diabetes was not an issue then went looking for other things to make a fuss about. So we can’t quite tick that one off just yet.
What they want to look at is Liver Function. It seems on the forums that a lot of people are being picked up on this. My brother does have lowered function, but then Epilepsy medication will over time bugger up your liver to a certain extent. It does not however tend to result in needing transplants or anything hideous.
Most people in this situation of needing renewed LFT’s take Milk Thistle supplements and avoid alcohol for a while before the second blood tests. I’m quite a fan of Milk Thistle anyway, and Brother has been taking a daily since the original set of tests were done and the LFT’s came out higher than normal. (Sometimes having someone in the family who can read blood tests results is handy!). And thankfully – the second bloods were taken before the Alcohol-Fest which is Toast Martinborough.
They also want to test for Hepatitis C. At first I thought this was a re-test and was quite worried, thinking that there must have been a bad test result. Which would be odd. But looking back at the original medical – they don’t actually test for Hep C as standard, only Hep B.
(Note: A lot of people believe wrongly that you are not allowed to look at the medicals once they are done. You can. And you should. You should also take copies of all medical test results – so you have something to prove your case if you start getting the run-around. You may also need – as we did – to be able to give the full set of medical paperwork to your own doctors for a second opinion.)
There is an annoying aspect to this though. Once again, INZ have made a silly mistake with the application. The paperwork for the MA has a comment on it that the original lab results were not sent to them. As we know we sent them to INZ, it means that INZ forgot to pass them on.
It would be nice if they would just take a bit more care with these things, and at least try to prevent screwing things up. Its not rocket science!
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How to Sponsor your family into New Zealand Part 4: What is an acceptable standard of health?
Your parents have to be reasonably healthy in order to emigrate to New Zealand, and Immigration New Zealand has what is called an “acceptable standard of health” that they need to have.
There are certain medical conditions that are automatically deemed to show that you do not have an acceptable standard of health when you want to emigrate to New Zealand. These are known as Appendix 10 Conditions and are:
- HIV infection
- Hepatitis B surface antigen positive, with abnormal liver function
- Hepatitis C, RNA positive, with abnormal liver function
- Malignancies of solid organs and haematopoietic tissue, including past history of, or currently under treatment. Exceptions are:
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- o treated minor skin malignancies (not melanoma)
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- o malignancies where the interval since treatment is such that the probability of cure is > 90%, e.g.: early stage (I & IIA) breast cancer at 5 years; low risk
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- o prostate cancer at 5 years; early stage (Dukes A & B1) colorectal cancer at 5 years; childhood leukaemia at 5 years
- Solid organ transplants, excluding corneal grafts more than 6 months old
- Chronic renal failure or progressive renal disorders
- Diseases or disorders such as osteoarthritis with a high probability of arthroplasty in the next four years
- Central Nervous System disease, including motor neurone disease, complex partial seizures, poorly controlled epilepsy, prion disease, Alzheimer’s and other dementia, and including paraplegia and quadriplegia
- Cardiac disease including ischaemic heart disease, cardiomyopathy or valve disease requiring surgical and/or other procedural intervention
- Chronic obstructive respiratory disease with limited exercise tolerance and requiring oxygen
- Genetic or congenital disorders: muscular dystrophies, cystic fibrosis, thalassaemia major, sickle cell anaemia if more than one sickle crisis in 4 years, severe haemophilia, and severe primary immunodeficiencies
- Severe autoimmune disease, currently being treated with immuno-suppressants other than prednisone
- In a person up to the age of 21 years, a severe (71-90 decibels) hearing loss or profound bilateral sensori-neural hearing loss
- In a person up to the age of 21 years, a severe vision impairment with visual acuity of 6/36 or beyond after best possible correction, or a loss restricting the field of vision to 15-20 degrees
- In a person up to the age of 21 years, a severe physical disability, where they are unable to stand and walk without support, and cannot independently dress, eat, hold a cup, or maintain their stability when sitting.
So basically – if you have any of those conditions: you are not considered healthy enough to Emigrate to New Zealand.
If you don’t have any of those conditions – you may not be in the clear yet – as you can also be told your health is not acceptable if Immigration New Zealand (INZ) believe (and more importantly can show) that your health is likely to cost more than $25,000 to the New Zealand Health service.
There are two sections to this bit – one if you have an acute condition (something that lasts a relatively short time and is treatable) in which case they want to know if you will cost $25,000 over 4 years. The other is if you have a chronic condition (lasts a long time, and probably isn’t curable – but manageable), in which case they want to know if you will cost the $25,000 over the length of the condition.
If INZ and it’s Medical assessors cannot show clearly that you are likely to cost over $25,000 to the New Zealand Health Service, or that you have an Appendix 10 Medical Condition – then you have an acceptable standard of health.
If you are assessed as having an unacceptable standard of health, the application for residency has to be declined on that basis. Your only option then is to apply for a Medical Waiver. Do make sure though that a second opinion on your Medical Assessment has been sought. You or your parents should not be turned down for a residency visa on the say so of just one Medical Assessor. INZ also have to explicitly state why they believe you do not have an acceptable standard of health.
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How to Sponsor your family into New Zealand Part 3: Medicals Explained
Filed under: Getting to New Zealand, NZIS & Immigration issues
This is something that can cause a huge amount of trauma to applicants trying to emigrate to New Zealand, whichever route they take to get here. I’m guessing that it affects more parent sponsorship applications because generally the applicants are older.
So what is the deal?
Your parents have to be reasonably healthy in order to emigrate to New Zealand. NZIS has what is called an “acceptable standard of health” that they need to have.
When your parents have their original medicals done, the panel doctor will record any issues or problems, and has to tick one of two boxes:
- No abnormal or significant findings
- Abnormal or significant findings.
If the second box is ticked – you will almost certainly have the medicals referred to a Medical Assessor (MA). It is worth noting however that, despite what many people believe, having a tick on the “No abnormal or significant findings” box does not mean you have “passed the medical” and that it won’t be referred to a medical assessor. It was pointed out to us rather snottily that “Case Officers look at the whole medical certificate in deciding whether to refer a medical: we don’t just read the last page.”
The medical form says, “A significant finding is one that should be reviewed by the Immigration New Zealand Medical Assessor. Note this is not an assessment of whether or not the applicant has an acceptable standard of health in relation to the Immigration New Zealand standard.” (My emphasis)
When a Medical assessor reviews the file they have a number of choices about what to do. They get a 5 page document to fill out and send back to the case officer. The medical assessors can either:
- Ask for further tests and information (they have a whole host of boxes to tick to specify which ones, and plenty of room to make comments).
- Give a favourable opinion (in which case you are home and dry)
- Give an adverse opinion (they think your health is unacceptable)
- Defer the application (this gives you up to 3 months (or 6 months in the case of Pulmonary Tuberculosis) to treat the condition and prove you have improved your health.
If the Medical assessor says they will not give you a favourable opinion – they need to specify why that is. There are cases that you can read at the Residence Review Board where the Medical Assessor failed to do this – and it can be enough to overturn their decisions.
If the Medical assessors ask for further information – they should be specific. Again, the Residence review board has overturned immigration decisions on the basis of
“The exceedingly brief comments provided by the Medical Assessor in the Report”
If you are asked for more information – you can actually refuse to provide it if you wish. You need to let NZIS know in writing. This can be useful if like us, you get the run-around for over a year! We also found though, that while NZIS staff were happy to repeat over and over that we had the right to do this – they didn’t want to accept it when we actually did refuse to get them more information.
If the Medical Assessor refuses to give an opinion on your health, then NZIS will send the information to another Medical Assessor for a second opinion. If the Medical Assessor says your health is not acceptable – you have the right to ask for a second opinion as well.
A second opinion is final, so if that also comes up as “unacceptable”- your only choice is to then apply for a Medical Waiver.
It is well worth noting that the burden of proof in this is squarely on the Medical Assessor to show that you have an unacceptable standard of health if NZIS want to turn you down. If they cannot prove that, then you are deemed to actually meet the standard required. Again, reading the Residence Review Board cases shows quite clearly that unless NZIS shows specifically that you do not meet the standard of health required, a decision not to grant residency can be overturned.
Coming next: what is an “acceptable standard of health”.
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How to sponsor your family into New Zealand Part 2
In theory – the Parent Sponsorship process is fairly straightforward.
Once you have satisfied all the requirements (see Part 1), it is simply a matter of sending in the application forms (Both the Sponsorship form 1024, and the residency application form 1000), along with the Medicals Certificates, police forms, forms of Identity, and money, and then you wait.
And wait.
And wait a bit more.
Parent sponsorship is probably the least important section of the immigration policy as far as New Zealand is concerned – so it is placed at the bottom of the priority pile.
The first thing that will happen once your application is accepted, is that you will get a letter advising you of this, and certainly at the moment, it will also tell you how long it will be before a Case Officer is appointed to you case. In early 2009 applicants are being given anything from 10 months to 2 years as a guide. We were told it would be 9-12 months at the start of 2008.
Now, I know that sounds awful but bear this in mind: no two applicants get through this process the same way. There is a huge amount of variance in the timescales that people actually have to go through and the ease with which they get through this process. It can be ridiculously unfair and stressful – but hang in there. This often has absolutely nothing to do with the applicants suitablilty – it is purely luck (or not).
To put this in context, even though we were told a Case Officer would not be assigned for 9-12 months – one was actually assigned straight away, one of the medicals was referred and we were asked to provide some further medical tests within 2 months. So what they tell you isn’t necessarily true. (Hmmm – that seems to happen a lot!)
It is quite possible that the Medicals could get flagged as needing some further checks if your parent’s health is not perfect. This means that the medical certificates will be sent to a Medical Assessor to be reviewed. If the medical assessor wants more information, you will hear about this from your Case Officer and then you have to get the extra reports that they ask for.
This is where things can get really tricky, as it can take many weeks for the Medical Assessors to review the file and get back to the case officer. The system is a shambles, and if you get unlucky as we did, with a lazy Medical Assessor and a “Can’t be arsed” case officer – you could be in for a bumpy ride. On the other hand – other people fly through this process and get accepted really easily. From what I have seen on the forum, if the medicals are referred it can take 2-3 referrals before they are happy.
It took us 6. Which is why we kicked up an almighty stink.
But, despite what immigration may have you think – this is not usual.
Once you are through that – it is simply a matter of getting a letter of “approval in principle” which will then be followed by a final letter inviting you to send more money to NZIS along with your passports so you can get the coveted blue Visa Stickers.
Coming next….. Medical Referrals explained.
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