Medical Inadmissibility

Has your immigration case been refused because of medical inadmissibility?
Have you received a procedural fairness letter?
At Bellissimo Immigration Law Group PC we specialize in immigration medical inadmissibility cases.


Dealing with a medical issue alone can be life changing, having to deal with medical and immigration issues at the same time is unbelievably challenging.  The good news is that for decades we have taken this journey with so many wonderful individuals and families and helped them navigate the process and realize their dreams.  At Bellissimo Immigration Law Group PC we have litigated medical immigration cases right to the Supreme Court and are responsible for most the cases that have shaped this area of law.  Continuing the brilliant legacy began by Mr. Cecil L. Rotenberg Q.C. over fifty years ago.  This area of law is extremely complex and good advocacy can be the difference so ensure you are well represented.  Let’s review some of the general principles involved. 

Who can be found to be medically inadmissible?

The law says that a foreign national, which is anyone who is not a Canadian citizen or permanent resident, can be found to be medically inadmissible on 1 of 3 separate grounds:

  • You are likely to be a danger to public health;
  • You are likely to be a danger to public safety; or
  • You might reasonably be expected to cause excessive demand on health or social services.

What does it mean to be “a danger to public health” or “a danger to public safety”?

Assessments if a foreign national’s medical condition is likely to cause a danger to public health generally requires consideration of (1) the communicability of the disease and/or (2) the impact it could have on persons living in Canada . Examples of conditions that fit within this description and have resulted in medical inadmissibility include Pulmonary Tuberculosis and untreated syphilis.

Assessments of danger to public safety take account if a foreign national’s medical condition will likely result in sudden incapacity, or unpredictable or violent behaviour.

What is excessive demand?

It means you will not be allowed to enter or remain in Canada because your health condition has been determined to cause an excessive demand on health or social services. This can mean:

  • the need for health services to treat your condition would negatively affect medical service wait times in Canada and/or
  • the treatment you need for your condition would likely cost more than the Canadian average for health and social services (per person). HINT: It does not have to be proven to be true, just more likely than not.

There is a clear threshold available now which is equal to 3 times the Canadian per capita cost for health and/or social services over a 5-year period.   Presently, the annual cost threshold is set at $24,057, or $120,285 over 5-years.

The changes started with the Temporary Public Policy Regarding Excessive Demand on Health and Social Services when the definition of “social services” was amended limiting medical assessments of excessive demand to only those publicly funded social services that are related to health services and/or the provision of continual supervision and care. In doing so, this excluded special education services and social and vocational rehabilitation services. HINT: be mindful though not all social services are exempted.

On 4 March 2022 IRCC announced  law changes, determined from the Public Policy Regarding Excessive Demand on Health and Social Services :

  1. IRCC increased the excessive demand cost threshold to 3 times the average amount that federal, provincial and territorial governments spend per capita on certain health and social services;
  2. The 10-year time period was eliminated from excessive demand calculations and the five-year time period has been universally applied;
  3. “Health services” and “social services,” as used in excessive demand determinations have been redefined, by:
    1. removing reference to certain social services like special education services, that persons with disabilities require to help them overcome limitations to their participation in society (social and vocational rehabilitation services, and personal support services);
    2. focusing on publicly funded social services that provide constant supervision and care for those who are not able to integrate into society; and
    3. refining the definitions to provide clarity to the concepts of majority of funding and of publicly funded services, as well as eliminating any overlap between the definitions of health services and of social services.
  4. Clarifications have been made to which officers are responsible for reviewing medical and non-medical information for applications that deal with excessive demand assessments.

How is an Admissibility decision made?

Most foreign nationals hoping to travel and all Foreign national applying to migrate to Canada must undergo an immigration medical examination, unless in rare circumstances they are exemptAfter the examination has been completed by the Panel Physician, he or she makes a decision on the “Grade”. A Foreign national either receives  a “Grade A” or “Grade B”:

  • Grade A indicates that there are no abnormal findings present and no significant abnormal history.
  • Grade B indicates that there are significant abnormal findings present and/or an abnormal history.

Usually if a foreign national receives a Grade B, admissibility is a concern and the Regional Medical Office begins an assessment of the results of the foreign national’s medical exam results and officers decide if the foreign national’s health condition falls within the parameters for admissibility or inadmissibility

Before a decision is made on admissibility, the foreign national is provided with an opportunity to respond to the Officer’s “Procedural Fairness Letter (PFL). Usually, a foreign national will have 60 days to respond.

How can Bellissimo Immigration Law Group PC help?

Many medical and certain psychological conditions can lead to refusal of an immigration visa, on both temporary and permanent categories. It is critical to respond to the PFL with a medical and legal immigration plan (called a mitigation call) that is well researched, supported and presented in a convincing and substantive way in order to have a chance to overcome a medical inadmissibility finding.  The strict definition of mitigation reads to make less severe, serious, or painful.  In this context it means to highlight the health or social service costs or addition to a waiting list is less severe and under the threshold. 

If a medical inadmissibility finding is made, it is permanent, so the response to the PFL is extremely important, and you only have the one opportunity to present your plan. We routinely work on  plans for Immigration, Refugees and Citizenship Canada (IRCC) and the Immigration Appeal Division. We have fought hard over the past decades to bring the factors considered by officers assessing medical inadmissibility to where they are today, now part of IRCC’s policy, having to take into account a foreign national’s individual circumstances, and ensuring consideration of an applicant’s plan to offset any costs with their resources is measured.  As well to ensure there is not an inadmissibility finding because of adding to existing medical wait lists in Canada.  Finally, ensuring that the appropriate officers undertake the accurate steps and make decisions they are empowered to make.

One of the most common mistakes we see in medical inadmissibility cases is the decision not to challenge the health or social service excessive demand filing and trying to mitigate and instead seeking humanitarian and compassionate (H&C) relief.   Although H&C relief can be effective in certain cases in many cases it is not necessary nor the best strategy to overcome the initial medical inadmissibility finding.   

We have successfully helped to prepare mitigation plans for so many different medical conditions over several decades and some of the more common conditions we deal with for both children and adults include:

  • Chronic Kidney Disease
  • Developmental Delay
  • Heart Disease
  • Diabetes & Hypertension
  • Cancers
  • Autoimmune Disease, i.e.: Multiple sclerosis Lupus, Ankylosing Spondylitis, Rheumatoid Arthritis, etc.
  • Inflammatory bowel diseases, i.e.: Crohn’s disease and Ulcerative colitis
  • Hepatitis B and C, and Liver Disease
  • Blood Disorders, i.e.: Sickle Cell Disease and Thalassemia
  • Bladder disease
  • Lung disease, i.e.: Tuberculosis, Chronic obstructive pulmonary disease (COPD), Cystic fibrosis, Pneumoconiosis, etc.
  • Neurological Disorders, i.e.: Alzheimer’s Disease, Dementia, Parkinson’s, Strokes, etc.
  • Psychological/psychiatric disorders, i.e.: major depression, bipolar disorder, or schizophrenia
  • Addictions to drugs or alcohol

Do not wait until your immigration visa is refused. Instead, be proactive. If you or your dependent family member has a medical condition, contact us to discuss. If one of your immediate family members is medically inadmissible you and your whole family may be too! Timing is critical as steps can be taken before a decision is made to alter the outcome. Please click below to read what our client’s whom we have assisted with medical cases say.


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Inadmissibility Testimonials

Important Immigration Court Decisions


What Our Clients Are Saying
Sahira Samad
Sahira Samad
Highly recommended for any kind of immigration support. Me and my husband are fully satisfied with their professionalism and support. Thank you so much Bellissimo team for our successful judicial review.
Frances Guingon
Frances Guingon
During our visit to the BLG office yesterday, we had the opportunity to meet with the Attorney. My husband and I were deeply impressed with the consultant's knowledge and guidance.
Daryl P
Daryl P
There's something to be said for an honest attorney who advises you to save your money instead of burning it in the hopes of a miracle outcome.I contacted Bellissimo Law Group regarding options for addressing a 12-month Exclusion Order. I'd been in contact with other firms, and each was anxious to get me to sign on for thousands of dollars, while Bellissimo's advice was more grounded. They advised to just wait the 12 months and then maybe consider migrating legitimately because of factors like expense, time, and likelihood of success. To me, that demonstrates a level of integrity you won't often find in most attorneys and when my exclusion ends I will be contacting them to help with my migration to Canada.
Hesham Elsebaei
Hesham Elsebaei
I reached out for a consultation. They were knowledgeable, provided thorough feedback on my documents, and sincerely ensured my needs were met with punctuality and excellent communication. I highly recommend their services!
YIQI ZHU
YIQI ZHU
Ms. Cao and Ms. Dong are truly responsible immigration lawyers who helped my family out of a terrible situation, and you can always trust them.
Abdallah Albakheet
Abdallah Albakheet
Very friendly and professional staff. My partner and I had a session. It went great. We got all the information we needed to proceed with our application. We were advised to do something we wouldn’t know how to do/think of on our own.
Mary Dadula
Mary Dadula
Bellissimo team your amazing.!!!Thank you for helping my case and of course I would like to give a big shout out to this team specifically to Alexandra,Michael, Magdalena,Athena and Justina.and the whole team.Bellissimo group your fantastic.Once again thank you very much.
Sergey Ka
Sergey Ka
We would like to express our deepest gratitude to Bellissimo and personally to Alexandra for their outstanding assistance in helping us navigate the sponsorship process to reunite with family in Canada. From the initial consultation to the successful completion of our case, their thorough understanding of immigration laws, procedures and professionalism were evident at every step. They took the time to understand our unique circumstances and tailored their guidance accordingly. We felt supported and well-informed at all times thanks to their timely updates and guidance. Clear instructions, strategic approach to our case and instant responses to our inquiries, coupled with attention to detail, gave us reassurance and confidence throughout the process. We are very thankful for these efforts that have culminated in a successful outcome allowing us to reunite in Canada. Bellissimo's professionalism and expertise are very much appreciated! We are happy to recommend Bellissimo to everyone who needs help with immigration to Canada.