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Every person(s) applying for a Canadian permanent resident visa is required to undergo a medical evaluation. Even some individuals seeking access to Canada as temporary visitors are required to undergo a medical examination by a CIC-approved physician.  Typically, medical examinations are limited to a physical examination, including blood tests and x-rays, as well as a review of prior medical records.

Grounds for medical inadmissibility

A foreign national may find themselves medically inadmissible to Canada if their condition is likely to be a danger to the health or safety of the Canadian public.

For example, Citizenship and Immigration Canada (CIC) lists Active Pulmonary Tuberculosis (TB) and untreated Syphilis as ailments considered a health risk to Canada. Such afflictions will likely lead to issuance of a Procedural Fairness Letter opining an intention to refuse the applicant on grounds of medically inadmissibility; unless the foreign national is treated in accordance with Canadian standards.

Other conditions include;

  • several impulsive sociopathic behavioural conditions and some sexual disorders such as pedophilia;
  • a variety of paranoid states or some organic brain disorders linked to violent behaviour or risk of harm to others;
  • applicants with substance abuse issues that lead to antisocial behaviour such as violence, and impaired driving;
  • other types of hostile, disruptive behaviour.


A foreign national might be found medically inadmissible to Canada if their admission might reasonably be expected to cause excessive demand on health services or social services provided by the government.

“Health services” are defined as those services for which the majority of funds are derived from the federal and provincial governments, including that of family physicians, various specialists, nurses, and physiotherapists, laboratory services and the supply of pharmaceutical or hospital care.

Examples of social services for the purposes of medical inadmissibility include, but are not limited to, the following government–funded services; specialized residence and residential services (home care), social rehabilitative services, personal support services and the provision of their related devices, and services intended to assist a person in their physical emotional, social, psychological or vocational function.

Excessive demand considerations include the anticipated costs associated with a given condition that would likely exceed Canadian per capita health services and social services costs over a 5 to 10 year period.  Canadian immigration officers are bound by law to enforce these restrictions.

Procedural Fairness Letter and medical inadmissibility

When a foreign national submits an application for Canadian permanent residency in the prescribed manner, but a Canadian immigration officer suspects the candidate is medically inadmissible to Canada, the immigration officer will issue a Procedural Fairness letter to the applicant. The purpose of a Procedural Fairness Letter is to provide the applicant an opportunity to respond to an allegation of medical inadmissibility.

Unfortunately for some, a variety of commonplace conditions, and developmental afflictions, can lead to the issuance of a Procedural Fairness Letter for a finding of medical inadmissibility. Conditions such as depression, or even a slight learning disability can possibly be considered an excessive demand on Canada’s system. Sometimes these borderline conditions come down to the discretion of the assessing Canadian immigration officer. Which is why it is so important to have a well-researched and informed response to a Procedural Fairness Letter.

Our Canadian immigration law firm regularly encounters individuals who are simply unaware of their legal options or the ramifications of a medical inadmissibility allegation.  If you are concerned about the possibility of receiving a Procedural Fairness Letter due to medical inadmissibility to Canada, contact First Immigration Law Firm.