I am working on an Immigration Appeal Division (“IAD”) case involving the sponsorship of a family member who was found medically inadmissible. An interesting legal issue came up, which I found has not been widely discussed in immigration law texts, but may be very useful for practitioners and applicants alike: what happens if the Applicant’s condition or drug prices have changed since the initial negative decision and you are now at the IAD?

Facts

The loose factual situation is that since the negative medical inadmissibility report was issued several years ago, there have been several developments which (arguably) may not leave the individual medically inadmissible today. For example, as of June 2014, the minimum cost threshold (beyond which medical inadmissibility for excessive demand on health and social services would kick in) increased from $4,057 to $6,387 per month. This is a very substantial amount.

In our situation and in my estimate, the Applicant, according to today’s figures and our estimates of today’s prescription drug prices, may indeed fit under the new threshold and possibly the threshold from two years ago too.

Issue

Asides from the issue of challenging the reasonableness or correctness of the Visa Officer’s decision, can we introduce this new De Novo evidence as evidence of non-inadmissibility? In other words, can the IAD consider this evidence as a legal argument that the Applicant is no longer medically inadmissible?

Analysis provided by Vazirizadeh

The short answer appears to be no. The relevant case law authority for this is Vazirizadeh v. Canada (Minister of Citizenship and Immigration) 2009 FC 807. In Varzirizadeh, the Applicant had knee surgery following a medical inadmissibility finding based on osteoperosis. It was determined following the inadmissibility finding that one of her knees no longer required surgery. The IAD refused the Applicant’s appeal based on humanitarian and compassionate considerations, and the Applicant brought an Application for Leave and Judicial Review to the Federal Court now also challenging the legal validity of the decision.

The Applicant argued that as the IAD hearing was de novo, it should have considered the appellant’s changed medical status, whereas the Respondent Minister argued that the IAD considered both pre-surgery and post-surgery circumstances, and determined the medical inadmissibility had not changed (para 18). The Respondent also argued that de novo evidence could only reverse a medical inadmissibility finding if the evidence demonstrated that either the visa officer’s decision was incorrect at the time or breached the Applicant’s procedural fairness (at para 19).

Justice Frenette, citing the still oft-cited decision of the Federal Court of Appeal in Mohamed v. Canada (Minister of Employment and Immigration),  68 N.R. [1986] 3 FC 90, adopted the Respondent’s position concluding that “subsequent improvement in the medical condition was only relevant to whether special relief should be granted on appeal” (at para 20).

Therefore, it appears that arguments relating to change in medical condition or drug costs will not assist in challenging the legal validity of the Officer’s decision.

But, it is still useful in an appeal?

Application in a Recent IAD Case based on Special Relief – Boukrab

Boukrab v. Canada (Minister of Citizenship and Immigration) [2015] IADD No. 25 is an interesting case of a self-represented litigant who was found medically inadmissible by a visa officer as a result of rheumatoid polyarthritis (para 4).

The visa officer’s medical report itself [it was in French, so pardon my limited French translational abilities] found that the Applicant’s condition would likely continue to deteriorate and listed several drugs that he would require under Ontario’s medical insurance program.

In an effort to likely bolster the medical report, the Minister’s Delegate in hearing disclosure provided a Globe and Mail article which showed that injections or infusions for treating the condition would cost upwards of $20,000.

The Applicant’s arguments regarding the ability to “pay for his mother’s drugs,” were not accepted by the IAD which argued that as the government was statutorily obligated to pay, any undertaking to the contrary by the Applicant would be irrelevant.

However, the Applicant won the appeal on the basis of an updated letter from a rheumatologist dated August 29, 2014 indicating the condition was now stable and that the over-the-counter medication she took cost only $47.25 a month, an amount well below the threshold.

The Member upheld the medical inadmissibility finding but granted special relief (Humanitarian and Compassionate considerations). The Member was similarly impressed by the family’s attention to detail in establishing housing and transfer payments that were to be made.

Practical Tip: Estimating Drug Costs

Drug costs and equivalent treatment can sometimes be difficult to establish, particularly when the Applicant is located overseas and being treated by an overseas doctor. Many medications cost different amounts in different jurisdictions, sold under different labels and may have generic equivalents.

A good tip for Applicants or Counsel is to contact local support/non-profit groups relating to the condition that renders the Applicant inadmissible. These organizations, particularly local chapters, may have updated reports and studies which provide more accurate estimates of medical and social service costs.

It is important to recognize, particularly for negative decisions rendered abroad at foreign visa offices by foreign doctors/officers, is that the cost estimates are often done abroad and based on reports and surveys which possibly are less reliable (and possibly less individualized, local) than the ones you may have at your fingertips.

I also have this handy tool, provided to me by the kind folks at one of the organizations mentioned above, which may assist you in assessing the pre-subsidy prescription medication costs.

As stated on the website by the Pacific Blue Cross: “The Pharmacy Compass is an online tool developed by Pacific Blue Cross that may help you save money by comparing the average price for prescription drugs at different pharmacy locations across British Columbia based on claims submitted to Pacific Blue Cross over the past three months.” http://www.pharmacycompass.ca/FAQ

Once you have a cost estimated for the medication, it will be useful to do two steps. First, compare this amount to the cost threshold. In an ideal world, the cost is under $6,387 a month you may be in good shape. If the amount is slightly over, it may be worth investigating into the province’s subsidy scheme and determining the percentage paid by the government annually (reimbursed to the beneficiary). Here, your individual who is wealthy, but can’t use that wealth to demonstrate that they can pay for the costs out of their own pocket may be able to demonstrate that it affects the subsidized amount. Again, this analysis will have to be done on a province-specific basis and may not ultimately yield positive results. However, as summarized very well by one of my favourite Canadian immigration lawyers, Mario D. Bellissimo in  Chapter 11 – page 31 of Canadian Citizenship and Immigration Inadmissibility Law (2014) “The end result: excessive demands in one province may not be excessive demands in another province.”

Conclusion

Medical inadmissibility is a fascinating area of immigration law, one that is constantly changing based on changes to our health system and our knowledge of scientific treatments.

From what I have seen of it so far, it is often one of the most controversial. Medical inadmissibility cases often make it to the front page of the media, for the devastating affect it has in separating families.

I think it is an area where more case law will emerge, as applicants and counsel are better prepared to challenge the legal validity and put forth strong humanitarian and compassionate grounds for how they are not excessive burdens on the Canadian health system.

Let’s see what happens. Excited to see what happens to our case!

Introduction

From a logical perspective, the more requirements there are for something you wish to obtain, for example job requirements or minimum scholarship requirements, the less room there is for any discretion.

Using a Canadian immigration example, part of the reason Labour Market Impact Assessments (“LMIA”) Applications are able to facilitate employment when the Employer clearly has a Foreign National candidate in mind is due to Employer’s ability to set the requirements for the job to meet the Foreign National’s unique profile. This allows them to prove to Service Canada that the decision to hire was not discretionary and therefore that the genuine efforts were made to hire Canadians.

However, contrary to the examples above, I believe there is a growing trend that will see requirements being used as a way to create discretion and will affect the consistency of Officer decision-making.

How Discretion Might Work

With both the new Express Entry application process and the Government’s proposed SIN-sharing regulations on both Permanent Residents (http://gazette.gc.ca/rp-pr/p1/2015/2015-02-28/html/reg2-eng.php) and Citizens (http://gazette.gc.ca/rp-pr/p1/2015/2015-02-28/html/reg1-eng.php), information will be requested from applicants that will exist beyond available memory and likely, even, available records.

In order to submit an Electronic Application for Permanent Residence under Express Entry, applicants are asked to provide a reference letter for every employment they have ever held, setting out terms of employment (duration, wage, benefits, etc.). Under the proposed SIN/data sharing legislation, Applicants are provided the “option” of providing SIN numbers. These SIN numbers will then be shared with CRA to access the Income Verification  Program. While not providing a SIN number cannot be a stand-alone reason for application refusal (according to the Regulatory Impact Analysis Statement), the groundwork is there for it being a reason to severely delay the application. [Editor’s note: Will be doing more indepth paper on this topic coming May 2015]

The ability of any human, let alone even tax/accounting software, to ensure all this information is accurate is in my opinion impossible. The requirements are high. I remember back in 2013 when I applied for Government of Canada Security Clearance (for an internship I never did), I only had to provide a 10-year work/employment history.

Now applicants will need to know the date of every trip ever taken, every dollar ever earned and possibly even spent. Past failures to keep accurate records of flights or the use of a less than capable tax accountant can now come back to bite an applicant in the behind.

Every application will contain errors. It is inevitable under this new “compliance heavy” regime. Yet, every application cannot be refused. Doing so would be a waste of everybody’s resources and make Canada an unattractive immigration destination. Needless to say, I believe immigration practitioners can no longer rely on the self-declarations/draft responses of an applicant when filling out forms and will ultimately need a piece of hard evidence (tax form, employment letter, or visa stamp) to verify each date and dollar provided.

Conclusion

I think that the new requirements give a discretion to immigration officers to refuse any application and to ensure that the application is not susceptible to appeal or review.

It will be interesting down the road, to compare reasons for refusal and uncover how said discretion is being applied. I wouldn’t be surprised if net worth and country and origin play a huge factor.

Introduction

With the introduction of Express Entry earlier this year and the Government of Canada’s corresponding efforts to make the application system more accessible to the average Canadian, one intended consequence may be Applicants making what amount to “unforced errors” during the application process.

Corresponding, the Government appears to be taking an increasingly hard line towards Applicant’s who submit incorrect and possibly misleading information for the purposes of obtaining immigration status.

When do mistakes become misrepresentation? What happens if you forget important dates, names, and information on your Express Entry Application and realize this fact later on.

Misrepresentation Provisions of IRPA

As a result of recent changes to the legislation, the bar for misrepresentation has increased from 2 years to 5 years. Furthermore, Applicants will be barred from making a permanent residence application for the duration of that 5 years.

Prior to the change, many applicants would leave Canada but simultaneously file an application for permanent residence such as a spousal sponsorship which would be processed by the time the two years had been fulfilled.

Finally, as a backend issue, it is important to note that the ban applies retroactively. Even if the misrepresentation occured prior to the new legislation, the uncovering of the misrepresentation on today’s date would create the 5-year ban.

The provisions themselves state as follows:

Misrepresentation

• 40. (1) A permanent resident or a foreign national is inadmissible for misrepresentation

  • (a) for directly or indirectly misrepresenting or withholding material facts relating to a relevant matter that induces or could induce an error in the administration of this Act;

  • (b) for being or having been sponsored by a person who is determined to be inadmissible for misrepresentation;

  • (c) on a final determination to vacate a decision to allow their claim for refugee protection or application for protection; or

  • (d) on ceasing to be a citizen under paragraph 10(1)(a) of the Citizenship Act, in the circumstances set out in subsection 10(2) of that Act.

• Marginal note:Application

  (2) The following provisions govern subsection (1):

  • (a) the permanent resident or the foreign national continues to be inadmissible for misrepresentation for a period of five years following, in the case of a determination outside Canada, a final determination of inadmissibility under subsection (1) or, in the case of a determination in Canada, the date the removal order is enforced; and

  • (b) paragraph (1)(b) does not apply unless the Minister is satisfied that the facts of the case justify the inadmissibility.

• Marginal note:Inadmissible

  (3) A foreign national who is inadmissible under this section may not apply for permanent resident status during the period referred to in paragraph (2)(a).

For the purposes of finding whether an error is a misrepresentation or not, we must determine whether the applicant “directly or indirectly misrepresenting or withholding material facts relating to a relevant matter that induces or could induce an error in the administration of this Act”

Without going specifically into the case law/administrative guidance on this issue, there are several factors that could be taken into consideration:

• How material is the error (i.e. does the error affect outcome?)?
• Was it an honest error? –
• In the case of non-disclosure,  did the individual honestly and reasonably they were not misholding material facts?
• Is there sensitive personal situation being concealed to avoid embarrassment?
• As the applicant been given a chance to respond to the error?
• And most importantly, what are the specific facts and surrounding circumstances of the case?

Why the Risk Has Increased with Express Entry

In many ways, Express Entry is the same as the paper form and misrepresentation is assessed no differently. However, with Express Entry rather than making one paper application, there are three stages (arguably more) where you are submitting information to Citizenship and Immigration Canada. Information must be substantiated at all three stages and that information is also very likely to change during that period.

When creating an Express Entry profile, applicants are asked to create a profile which asks questions about their individual bio-data, their employment and educational histories, and their finances and family ties (among others). This information is used to generate a Comprehensive Ranking Score, by which they can later be selected from the pool.

Upon receiving an Invitation to Apply for Permanent Residency (“ITA”) Applicants will then have to provide significant documentation (within only 60 days) in order to create an Electronic Application for Permanent Residency (“E-APR”). This documentation includes a reference letter for each employment ever held, dates for each trip ever made, relevant pay stubs, tax documents, and family information.

To complicate matters, information can change and the Comprehensive Ranking Score/eligibility for Express Entry can change during the time a profile is created, and ITA is issued, and a E-APR is granted. This information has to be up-to-date throughout. For example, work permits may expire, family members may be born, and educational/work histories can change.

CIC appears to still be in the process of figuring out how it will assess misrepresentation specific to Express Entry. They have however, in a program delivery update, put out the following information

Assessing for misrepresentation

Applicants are warned that if they misrepresent their qualifications in their Express Entry profile or their e-APR, they may face a five-year ban from submitting any further immigration applications to Canada, including temporary residence applications.

If there are discrepancies between the information in an applicant’s profile and the information entered in the applicant’s e-APR which are not the result of a legitimate change in the applicant’s circumstance, the officer should determine whether a finding of misrepresentation under A40 applies.

For additional guidance on misrepresentation, processing offices should consult the misrepresentation section of ENF29 (PDF, 604.30 KB). The procedures for determining misrepresentation, including procedural fairness, remain the same under Express Entry.

If both A11.2 and A40 apply, the application should be refused on both grounds.

Because the very process of Express Entry is points-based, and minor changes can lead to differences in points and thus could affect whether an individual meets the threshold to be selected – the materiality of Express Entry errors is arguably greater than it was with paper-based forms.

Also, one of the reasons that misrepresentation is also more likely to occur during Express Entry is that the system itself (and the way data is inputted) can lead to mistakes.

When creating a profile and filing out the online forms, a series of boxes open up, some allowing you to select options and others requiring you to type answers. However, unlike with a paper form, it is difficult to see this information side by side, as some boxes close while others open and there is presently no option at the end to “review all information.”

Five Steps You Can Take to Try and Mitigate Express Entry Misrepresentation

1. Know when to hold them, know when to fold them – if information comes up that could be significantly erroneous consider declining ITAs and not submitting E-APRs until that information is corrected.

2. Gather the evidence up front- Unfortunately (or fortunately), lawyers now have to serve as both legal advisors and information auditors. An applicant can fill out a paper-based survey, swear on their lives, but until they have a letter from the employer stating X is X, it is nearly impossible to confirm this. Even though requirements are at the backend, try and get them done on the front end.

3. Follow-up with CIC during process – Whether you are an immigration rep or applicant, it is important to follow up with CIC throughout the process. We know that CIC has admitted that the algorithms and forms aren’t perfect, that changes to the forms are pending, and has even recommended that Applicant’s put in covering letters to explain discrepancies.

4. Write a covering letter prior to submitting E-APR –The value added that reps used to provide prior to Express Entry was submitting a covering letter explaining discrepancies. That should not change and may be useful when an Officer is looking at the error down the road.

5. Have a record of everything – It is too risky these days not to have a paper trail (again whether you are a rep or applicant), of what you have corresponded to the client, what you have corresponded to CIC, and the documents that have been submitted. Just because the process has moved virtually, it does not eliminate the need to have paper evidence of this correspondence and communication. If necessary, take tons of screenshots!

Hope this has somewhat helped 🙂