Medical health assessment Q: Eye condition - anyone else? will it pass for Skilled migration?

[wrussell]

Thanks wrussell, that's a really useful guide for instructing our medical specialist. He will be a UK opthalmologist, we will be producing a full report from him for our medicals and we will ensure that it incorporates the above. Am I right in thinking however that as others have said, it's a 'lifetime' assessment they will want, not a 5 year period?

 

We do have a migration agency here on 'standby' for us as when we went for the initial assessment it was all positive in terms of being accepted re points/skills assessment, however they weren't sure re. the eye issue and told us to contact a former panel GP for advice. Which we did - but who hasn't contacted us back...we've since been making our own enquiries to see if this whole exercise is going to be a waste of time before we actually pay the migration agency to start the process...hence my posts! And I've been doing a lot of research myself.

 

I'm not sure I can actually ask the RMA we had our assessment with to look into this as I'm not actually a paying client until we tell them to start the process...seems its up to us to find out the answer, otherwise I'll be paying an initial £1.4k (part payment of full visa application service, the remainder upon completion and successful application) for them to research only...I'm not sure what to do to be honest.

 

If you pay me a small fortune I will send you this link:

 

http://www.immi.gov.au/allforms/health-requirements/my-health-declarations.htm

[wrussell]

And you will see the the DIBP, even if they know, will not let you have your medical assessment until they have gouged a visa application charge out of you. Is this is a job for snooperman, the Ombudsperon, AKA the Paper Tiger who as a rule does SFA about immigration complaints unless they are all over the newspapers.

[wrussell]

If anyone suggests that you undertake a medical examination and then lodge a (free) Freedom of Information request (form 424A) for the file, don't blame me.

[Lizzywills]

Thanks Westly, we did consider using My Health Declarations service but even if we did, and then requested our records, it would be absent of any decision of whether we meet the health criteria until we actually submitted our application?

[Lizzywills]

A further thought. I've just trawled through the guidelines for Panel GP and now I'm even more confused....see my notes in red!

 

First of all, the guide to grading visual impairment:

 

A-Grade: VA ≥ 6/12 in better eye.

 

B-Grade: If VA< 6/12 in better eye, comment on functional capacity. Specialist report not required unless requested.

 

My husband would get an A Grade as his VA is way better than 6/12

 

Secondly - is his condition significant?

 

43 Question 24: Grading A or B

 

Panel physicians must complete this section in accordance with the following guidelines:

 

A-Grade: Applicants without significant conditions or findings

B-Grade: Applicants with significant conditions or findings.

 

The most important decision is whether or not a condition or finding is significant.

 

43.1 When is a condition or finding significant?

 

A significant condition or finding has current or foreseeable future implications (defined as 10 years according to these guidelines) for the applicant’s health and/or functional capacity. Any condition is considered significant if any of the following applies:

 

a. represents a possible public health risk NO: OH eye condition does NOT represent a health risk

 

b. is likely to require substantial medical treatment either now or in the future NO: No treatment available

 

c. negatively impacts the applicant’s capacity for independent living NO: AND WILL NOT IN NEXT 10 YEARS…(the 'forseeable future')

 

d. negatively impacts the applicant’s intended activity in Australia NO

 

e. presents a barrier to travel. NO

 

Important examples of significant conditions are TB, HIV, organ failure, diabetes with end-organ involvement, psychiatric disorders, including dementia, and intellectual or physical disability.

 

If in doubt, mark as B graded and/or contact Global Health by email for clarification.

 

 

43.2 When is a condition or finding not significant?

 

A condition or finding is not significant if it does not have current or future implications for the applicant’s health. Minor past surgery, incidental anatomical variations, trivial medical conditions, and previous illnesses with no ongoing implications are not significant. Routine medications taken for uncomplicated disorders of mild severity (such as Ventolin for mild asthma) are not significant.

 

43.3 ‘A’ Gradings

 

‘A’ should be written when all the criteria below are met:

 

• No significant conditions or findings are noted. ?????? IS THE EYE CONDITION SIGNIFICANT IF NO IMPACT ON CURRENT/ FORSEEABLE FUTURE (10 YEARS?)

 

• Physical findings are completely normal, including a blood pressure at or below the recommended levels, no significant cardiac murmur, no albumin, glucose or blood in the urine, and a visual acuity, corrected if necessary, of no worse than 6/12 in the better eye. CONFIRMED - HIS VISUAL ACUITY IS WAY BETTER THAN THIS

• No medical or surgical condition is present which would require further investigation or treatment currently or in the foreseeable future (10 years). CONFIRMED no current treatment now or in the forseeable future: Note here that they say the forseeable future is defined as 10 years.

 

• The applicant is independent with the activities of daily living without family or other assistance. Nursing or institutional care is not required now or in the near future (in the next 10 years, or three years in people 75 or more years of age - see Attachment 3: Activities of Daily Living (ADL) Assessment. CONFIRMED OH is independent with activities of daily living without family or other assistance....Note again here that they say the forseeable future is defined as 10 years...

 

• The results of the x-ray examination is completely normal, except for conditions listed in Part C, page 35. hopefully yes...

 

Where any condition is identified as stable (stable for past 2 years....by its nature it is a progressive disease however) and of no clinical significance, ‘A’ is the appropriate grade.

 

 

43.4 ‘B’ Gradings

 

‘B’ should always be written when any of the above conditions are not met, when conditions or findings are present, or if the panel physician has reservations about an applicant’s fitness.

 

Notwithstanding the absence of abnormal findings, physicians should note that the grading does not determine that a visa will be granted. Further, a ‘B’ grading does not mean that an applicant will not meet the health criteria. The grading is simply a means of processing forms efficiently. For details on the recommendations to be given for commonly seen conditions, please refer to Attachments 4 and 5.

 

 

So yet again more confusion...based on the above could it be that the Panel GP decides he is A grade despite his condition?? Obviously once they have digested his report, which will be taken along...AAARGH I'm going to be bald by the time this is done and dusted and we have made a decision.

 

I've also emailed our standby MRA with full details of what I've found so far asking for his professional guidance and a copy of the Legend notes on assessing eye conditions, he has access to Legend....and also your point Westly re. doing a My Health Declaration and submitting an FOI request....whether that is an option....

[wrussell]

It is an option alright, just make sure the medicos have had time to assess your case before you lodge the FoI request. I make a living driving trucks through defective legislation. Spare a thought for the medicos, they are expected to act as forensic accountants make it easy for them.

 

You might want to take some professional advice about a health waiver.

 

Have fun.

[wrussell]

BTW the BIPB (and others) must acquit an FoI request, or lodge a claim of exemption - not going to tell you, because you have not paid enough might not be good enough.

[Lizzywills]

Hmmmm!!! Very very interesting re. medical FOI etc we will definitely look into this....sadly a health waiver isn't an option, we will be applying under a 190 visa state sponsored (NSW), hubby is an accountant so on the skills list for NSW state sponsorship

[CollegeGirl]

If anyone suggests that you undertake a medical examination and then lodge a (free) Freedom of Information request (form 424A) for the file, don't blame me.

 

Obviously you didn't recommend this... but if someone were to say that hypothetically it's possible to get an immigration medical exam before filing your application (i.e., without having a HAP ID yet) and get the panel doctor's findings through FOI, that would be accurate? However, wouldn't that only provide the grading (A,B) and the panel doctor's recommendations? If there were a condition serious enough that it would surely be referred, and have to go through the MOC, it's not possible to get what the MOC's findings would be ahead of actually applying... is it?

[Lizzywills]

Yes I think that's right CollegeGirl....but hey, finding out now what the panel doc thinks and spending £300 or so on a medical would at least give us some info about what he thinks...at the moment it's all up in the air no one can even say what the definitions are with regards to how a Panel GP would 'rate' my hubby's condition. At the moment it looks like- based on my previous comment - that he meets all the criteria for an A rating....but it depends on how 'stable' a condition needs to be for it to get an A....I am back in touch with the Professor George Lombard put me in contact with, seeing if he knows...George says the Prof may contact the DIBP for clarification on the definitions. I'll keep you all posted....as an aside in prep hubby is booked in for his Academic IELTS on 12 Dec in Manchester, ready for his skills assessment with the ICAA....

[CollegeGirl]

George is great, isn't he? I'll be keeping my fingers crossed for your hubby! I know nothing about what happened to my medicals once they left the panel doc's office. Never heard what they were graded, if they were referred or not (though I'm pretty darn positive they were - very different issue). I don't know if they're back from being referred, if they were. I don't know if I'll have to go through the Health Waiver process and potentially be waiting another 6-12 months for that... or if, even after all that, they'll turn us down.. It's such a scary, stressful place to be with everything up in the air. I really hope your hubby just gets an A-graded medical!

[Lizzywills]

Oh my goodness is there no one who can update you? They can't just leave you in limbo surely? Why the hold up? Have they lost them somewhere in the system?!!

[Lizzywills]

DECISION MADE! In part at least, we are hiring George Lombard to take our application forward. If he thinks he can help us that is...wish us luck!

[CollegeGirl]

 

Oh my goodness is there no one who can update you? They can't just leave you in limbo surely? Why the hold up? Have they lost them somewhere in the system?!!

It's complicated. We're worried that asking directly about my medicals would just call unneeded attention to my issues.

[Lizzywills]

Maybe if you just queried where they were up to....surely that can't influence anything anyway? I can't imagine the stress you must be feeling!!

[pacticenurse]

Thanks Oppyddrum! It's not glaucoma, but glad to hear all went well for you Dad We are going to get a report from my OH optician (he was the one who diagnosed it all those years ago) - outlining Diagnosis, Prognosis, Treatment and Impact on Independent Living/Work (prediction of next 5-10 years). We're then going to take this when we see the former Panel Doctor recommended to us today by our migration agent. To see what he would do/advise based on the info we give him. He may have an understanding of how DIAC and MOC view these conditions which have no cost/ongoing treatment, but are a long-term health condition. Appreciate your reply, thanks again.

 

Hi, what is the condition if you don't mind me asking,

My son was diagnosed with keratoconus, a degenerative condition. His consultant has given me his email so that once my son is under the care of consultant in aus he can contact him with any info re my sons records etc.

[Lizzywills]

Not at all, it is a form of Retinitis Pigmentosa, the group of diseases where pigment grows on the retina over time. It's the opposite condition to macular degneration, With MD, it's central vision which goes. With RP, it's periphery. Some people suffer with this from birth and are legally blind at an early age, others - the 'lucky ones' like my husband - don't get diagnosed until late in life and should keep relatively good vision for the rest of their lives. I think it depends how you get it. It is a genetic defect, most who have it very badly have it in their families. My husband doesn't, he was told it was just an unfortunate 'blip' and one of those things, as no one else in his family has this. In my hubby's case it is very, VERY slow progression. His condition at the moment is what I would say is mild....he drives, works, and is as independent as a person with 20/20 perfect vision.

 

Although there is no treatment or cure, in the USA lutein and high strength Vitamin A Palmiatate are prescribed to people with RP as studies have shown it slows the progression of the disease. My husband's been taking it for nearly 3 years now...and his last vision tests showed hardly any change, certainly nothing worth noting. Which is the best we can hope for.

 

Have you made it to Oz or are you in the early stages like us?

[pacticenurse]

Ah right. We are awaiting visa finalisation. Hoping to get there in early December. Heading to NSW South Coast :-)

[Lizzywills]

Ah well done!! We are hoping to get to Sydney. We are wishing....wish us luck! With George Lombard hopefully supporting us, we may just get there....

[pacticenurse]

Sending lots of luck your way!! :-)

[shejshej]

On 08/11/2013 at 22:43, pacticenurse said:

 

Hi, what is the condition if you don't mind me asking,

My son was diagnosed with keratoconus, a degenerative condition. His consultant has given me his email so that once my son is under the care of consultant in aus he can contact him with any info re my sons records etc.

what is your status ? Did you make it was it employee sponsored ?