# Health Waiver Advice



## ozmikal (Oct 3, 2010)

Hi everyone!

Does anyone know how to deal with MOC costings?

We got our health waiver costing advice the other day and the number at the bottom is almost twice that which we had researched and been prepared for.

We think that human error is the cause of this outrageous number.

Who should we talk to about the possibility of the MOC making a mistake?
Do you think that our CO will help us sort out this mess or will we just be advised to take the number 'on the chin'?
Should we try talking to the Health Operations Centre directly and save time and the CO's effort?

Some visa applicants can get a cost breakdown from the HOC. 
How do we go about getting one of those??

Thanks in advance!


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## iain (Nov 11, 2009)

*questions...*

Hi ozmikal, I see no-one has offered you advice and sadly I cannot either.

Without sharing personal details, can you tell us anything you've learnt about the waiver or medical appeals?

1. I read* that applicants are 'given the opportunity to comment' if they fail the medicals. Were you and did they listen to your comments?

2. I read* that they prepare some costing of what you'll cost Australia for medical care and it has to fall under some threshold - some multiple of the average Australian's healthcare costs. Did they share any detail of that assessment?

(* 'I read' - don't know where so please no-one rely on this information )

3. Can they assess your skills/expected taxes and give some leeway for migrants of high economic value?

4.


ozmikal said:


> We got our health waiver costing advice the other day


Can you share it? Again please don't if it's a personal question.

5.


ozmikal said:


> Some visa applicants can get a cost breakdown from the HOC.


Do you have any source for that - or any other useful info? Besides the medical forms & fact sheet.

PS Sorry for hijacking the thread - Anyone with information, please comment on ozmikal's post


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## ozmikal (Oct 3, 2010)

Hi Iain,

It seems that this particular issue is not able to be addressed on this forum; however, there are other similar forums on which there is a slew of experience and information available on the waiver issue. A Google search will provide you with many ideas.

> 1. I read* that applicants are 'given the opportunity to comment' if they fail the medicals. Were you and did they listen to your comments?

This is the standard DIAC wording regarding the waiver of the health requirement under the Public Interest Criterion 4007 (that the applicant's condition will result in a significant lifetime cost to the Australian community which the applicant must prove is NOT an undue cost):

_We must consider whether your circumstances warrant a waiver of the need to meet the Health Requirement. In order for us to do this, we ask you for detailed information, particularly regarding any compassionate and compelling circumstances surrounding your case and whether there are circumstances which potentially mitigate the cost or prejudice of access involved. Once this information is provided, we are able to assess all available information to determine whether the estimated costs and prejudice to access levels are likely to be considered 'undue' as required by The Regulations.

The fact that all other visa criteria have been met is not enough to waive the requirement to need to meet the Health Requirement. Each decision regarding a waiver of the health requirement is made on a case by case basis and must take into account the level of care required, cost, and level of prejudice to access.
_

2. I read* that they prepare some costing of what you'll cost Australia for medical care and it has to fall under some threshold - some multiple of the average Australian's healthcare costs. Did they share any detail of that assessment?

No details at all. It's a figure that appears at the bottom of the page. I am trying to find out how to get such details right now in order to work out how to show what the actual numbers are as opposed to DIAC's set figure based on a hypothetical person with the applicant's condition.

3. Can they assess your skills/expected taxes and give some leeway for migrants of high economic value?

DIAC ask to be informed of both the applicant's and the sponsor's work history and the applicant's skills and potential contribution to Australia (no explanation is given as to what kind of contribution should be described). They also want to know the applicant's and sponsor's level of wealth.

5. Do you have any source for that - or any other useful info? Besides the medical forms & fact sheet.

Iain, the best source of information on what's happened IN THE PAST with the waiver of the health requirement is to look at the decisions of the Migration Review Tribunal, the Federal Magistrates Court, and the Federal Court of Australia. All of these are accessible via Australasian Legal Information Institute (AustLII). I have been reading a slew of these decisions and some of them have given me hope.

However, it must be kept in mind that:
1. historically, the members of the Migration Review Tribunal are much more likely to waive the health requirement then the department's officers;
2. the policy (as described in the Procedures Advice Manual or PAM) keeps changing;
3. all legal decisions are historical and cannot be relied upon if there is new statute law or new regulations that apply to a particular situation;
4. all visa applications are decided on the facts involved and no two applications are the same.

There is a number of serious conditions which require the Medical Officer of the Commonwealth (the MOC - the doctor who provides the cost advice) to use when making a costing. These are NOT in the public domain and require a Freedom of Information request in order for you to see them. Furthermore, these Notes for Guidance have been found to be notoriously out-of-date in past enquiries about what the MOCs rely upon to make their decisions, and there is no information that new Guidance Notes have been released to the MOCs at this stage.

My best friend in this quest has been Google, as always.

I hope that helps!


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## iain (Nov 11, 2009)

Thanks for that, I really appreciate it. For now I just have these worries in the back of my mind, that I may end up going through what you're going through now.
Have my fingers crossed for you - Best of luck and please do let us know what develops...


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## ozmikal (Oct 3, 2010)

Thanks for that, Iain. I hope no-one has to go through the sheer nonsense that we are trying to overcome right now...


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## Wanderer (Jun 16, 2007)

I can understand your disappointment with the process ozmikal as finding out near the end of a visa application process that an application will be rejected on medical grounds is never going to be something desired.
It is not so much that the medical examination situation can be addressed on this forum but that it is more something that only detailed information can be obtained from people having been through a full process, be that applicants or agents and some forums do run more with agents and I have seen them reticent to accept input from non agents as though those forums may even be run to be a recruiting ground for clients.

But that said, there are times when a view of an agent with experience in the area can be helpful and I know of one solicitor, not actually having a direct involvement in immigration applications who went about getting an elderly mother into Australia against an initial rejection on health grounds, it possibly being a case of knowing what to fight and on what grounds.

But to some of your specifics:
There is a sticky thread re the MOC role, but again more general info.
Immi departmental officers can certainly not waive medical decisions and nor should they be able to for they are far from qualified in that field and hence the very reason why MOCs are used.
That policy, I would never see being changed but in general terms, of course policies and the PAM get updated when there is any new legislation passed and there is a change in regulations.

The core of decisions is " which potentially mitigate the cost or prejudice of access involved. " and what you state with 


> DIAC ask to be informed of both the applicant's and the sponsor's work history and the applicant's skills and potential contribution to Australia (no explanation is given as to what kind of contribution should be described). They also want to know the applicant's and sponsor's level of wealth.


And there you need to do some more analysis re *" no explanation is given as to what kind of contribution should be described "*
especially if you intend tackling sonething in a DIY approach, ie.
. There's a medical cost that MOCs will consider with all the variations that some people may try and create as fallacies because of guidelines not having tees crossed and Is dotted.
. What Immi are saying is if you have skills and can show a definite ability to contribute significantly to Australia that may be a basis for a waiver, mitigating the cost!

One example of that was a Doctor whose son suffered from Downs Syndrome and with the rule of a family mmber fails, the applicant fails, even the MRT rejected his appeal and because prior to the appeal there had been some community support developed, before the rejection was even stamped, the Minister had overruled the MRT.
That was the very rarest of rare events and you could argue for and against it, it being more a political decision than anything and that nonsense.

What you are going through may appear to be nonsense but if you want to appeal a rejection of a waiver application on an MOC decision re costs an MOC has used, first you would need to ask yourself what is the basis of your own cost estimates and then how confident would you be in showing an MOC/HOC decision to be in error.
As for


> Some visa applicants can get a cost breakdown from the HOC.
> How do we go about getting one of those??


I imagine thE HOC will be able to advise if they can, or alternately ask the CO and the CO may be able to advise if there is any way of seeking the medical costs review to save a trip to the MRT.
If the MRT is where you are potentially ultimately headed I would seek to discuss it first with an agent, one who has had experience in such matters for questioning the medical profession professionalism is never going to be easy and the chances of having their decisions overturned is I suspect somewhat remote.


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## ozmikal (Oct 3, 2010)

Thanks as always, Wanderer.


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## ozmikal (Oct 3, 2010)

One of the strangest thing about all of this process is that DIAC is asking for so much info for what is in effect a 2-year visa; the applicant may or may NOT apply for the permanent visa at the end of the two years. 

If the applicant cannot make it in Australia or if they die or if something else happens that prevents them from applying for the permanent residency, then all this effort is really wasted.

Surely it would be easier if the applicant was allowed into Australia with few checks and THEN, showing how well they have done in Australia, including the medical costs to Medicare during that time, then DIAC could say, "well, you seem to be costing the Australian taxpayers too much. Go home to your original country." But to not let an applicant have a go at all... Eh!


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## Wanderer (Jun 16, 2007)

Unfortunately it is because that two year visa can lead to PR without any more than a maintaining of the status quo with partnership visas.
Both Immi and likely yourselves will not want to have revisit the situation in two years time and that may be harsh but they are an organisation dealing with thousands of visas annually, just about a thousand a week onshore when it is TR to PR conversions and I suppose the last thing desired in that scene is to bog the system down with greater complexities of reviews.
And as tough as it may be for an Australian sponsor to accept, Immi do look at what it'll mean for Australia and all Australians, our health care system in enough of a mess as it is with over servicing and lack of services and that not likely to get any better too soon with an ageing population and a younger population hell bent on heading to an earlier grave with lifestyle choices and then all that to be topped off with technology and use of it for fear of prosecution with medicos.
Gone are the days when a local doctor would know by feel if you had something needing hospital services and now even a kid with constipation gets Xrayed.

But back to your situation, the only chance I suspect you'll have of a review is to have some solid facts on what existing treatment is costing and projected prognosis.
If you have that and want to go down the MRT path which you may have to, I can PM you an agents details who does do some good work in the MRT area and at least you could get a consultation at a fee to start with and get a guide to your chances.


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## ozmikal (Oct 3, 2010)

Thanks, Wanderer. I will appreciate your PM.


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## scrubber28 (Aug 5, 2013)

Hi Ozmikal, 

I came across this forum while doing some research on my own situation. I know nearly 2 years has passed now, but was wondering if you could provide some further information on how you got on with your health waiver process with DIAC.

Before I ask questions directly, could you reply to let me know if you are still able to discuss the matter here on this forum.

Many thanks


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