If the visa officer considers, based on the opinion of the Citizenship and Canada medical officer, that admitting the applicant to Canada may result in “excessive demand on health and social services”, the visa office may issue a “medical fairness letter” inviting the applicant to show cause why the permanent residence application should not be refused on medical grounds. A “threshold amount” is periodically edtablished by Citizenship and immigration Canada as the figure to be used in determing whether a particular applicant will impose costs on Canadian health and social services that exceed the average.
The medical fairness letter gives the applicant an opportunity to explain what arrangements will be made to ensure the cost to the Canadian health care system will not exceed the threshold limit. It also allows for Humanitarian and Compassionate concerns to be raised, and the visa officer ia obliged to take these into account when making a decision on the application.
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