Applying for Canadian permanent residence (PR) is a life-changing opportunity, but one of the most common and often misunderstood reasons for refusal is medical inadmissibility. The good news is that there are steps you can take to strengthen your application and reduce the risk of refusal. With the guidance of experienced professionals like Jane Katkova & Associates, Canadian Immigration Law Consultants, you can navigate these challenges with confidence.
New Requirement: Upfront Medical Exams for Express Entry Applicants
As of August 21, 2025, all new Express Entry applicants are required to submit an upfront Immigration Medical Exam (IME) with their application. Previously, Immigration, Refugees and Citizenship Canada (IRCC) would only request the exam after it was submitted. This change means that preparing your medical documentation properly at the start of your application is now more critical than ever.
The Three Grounds for Medical Inadmissibility
IRCC may find an applicant medically inadmissible for one of three reasons:
1. Excessive Demand on Health or Social Services
This is the most common issue for Express Entry applicants. If IRCC believes your health condition could place a strain on Canada’s healthcare or social services system, your application may be at risk.
Key factors considered include:
- Your IME results and current health condition
- The likely prognosis of your condition
- Whether your treatment needs would increase wait times for others
- Whether costs would exceed Canada’s threshold for “excessive demand”
In 2025, that cost threshold is $27,162 per year or $135,810 over five years.
Examples of conditions that may trigger review: diabetes, kidney disease, heart conditions, developmental disorders (e.g., Down syndrome, autism), certain psychiatric disorders, and infectious diseases requiring ongoing treatment.
What you can do: Applicants may include proof of private health insurance, updated test results, or letters from doctors confirming stable management of their condition. Jane Katkova & Associates often assist clients in compiling this type of evidence into a strong submission package.
2. Danger to Public Health
If IRCC determines that your condition could pose a public health risk, your application may be refused. This typically involves concerns related to infectious diseases, such as tuberculosis.
How IRCC assesses this risk:
- IME and specialist reports
- Exposure to or history of infectious diseases
- Whether the condition is contagious and how it may impact others
What you can do: Submitting specialist medical reports, proof of treatment compliance, and up-to-date lab results can demonstrate that your condition is not a public health threat. Jane Katkova’s team regularly works with medical professionals worldwide to gather the required evidence.
3. Danger to Public Safety
Finally, IRCC may find you inadmissible if your health condition poses a risk to public safety. This includes risks of sudden incapacity (e.g., seizures, unpredictable loss of consciousness) or behaviours associated with psychiatric or neurological conditions.
What you can do: Providing medical documentation that shows stability, proof of ongoing treatment, and compliance with medical advice can reassure IRCC officers. Jane Katkova & Associates are skilled at preparing the right evidence to show that applicants pose no safety risks.
Overcoming Medical Inadmissibility
Responding to a Procedural Fairness Letter:
Before refusing your application, IRCC typically issues a Procedural Fairness Letter (PFL), outlining its concerns and providing you with 90 days to respond.
Applicants may submit updated medical reports, proof of treatment compliance, or financial evidence demonstrating that care will not rely on public resources. Extensions may be requested if additional time is needed.
Submitting a Mitigation Plan
In cases where excessive demand is a concern, IRCC may invite applicants to submit a mitigation plan. This plan shows how you will manage your condition privately and without undue reliance on Canadian health services.
A strong mitigation plan might include:
- Private health insurance coverage
- Financial documentation proving you can fund your care
- Physician letters confirming treatment plans
- A signed Declaration of Ability and Willingness form
These cases require meticulous preparation, something that Jane Katkova & Associates specializes in.
Why Choose Jane Katkova & Associates in 2025
Medical inadmissibility is one of the most complex areas of Canadian immigration law, but with the right guidance, it can be successfully addressed. Jane Katkova & Associates bring decades of expertise helping clients overcome medical inadmissibility challenges, respond to Procedural Fairness Letters, and prepare mitigation plans that stand up to IRCC’s scrutiny.Whether you’re applying for permanent residence through Express Entry, or a study permit in 2025, having a trusted legal team by your side can make all the difference. With Jane Katkova & Associates, you can be confident that your application is thorough, strategically prepared, and positioned for the best possible outcome – helping you achieve your dream of studying, working, and building a future in Canada.
If you are facing a tight deadline or fear refusal or deportation, do not wait and let our certified immigration law experts with decades of expertise give you c clear picture and potential timeline for your case, book an online consultation without delay!
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