Canadian immigration says son with Asperger’s ‘inadmissible’

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Well, I used to be a Canadian immigration medical officer, so I will try to shed a little light on this issue.

There are two broad categories of medical assessment for immigration purposes: risk to public health and safety; and excessive demand.

The first category (which is not involved, in this case) involves very few inadmissible cases (over the course of 8 years in the foreign service, I saw no more than a handful). These are generally multiple or extreme drug resistant TB. (People with active TB are given six months to undergo treatment and are then reexamined, if the TB is inactive, they are admissible subject to ongoing screening, so TBs that respond to treatment generally won't keep someone out of Canada.) All temporary residents, immigrants and refugees are subject to admissibility screening under this category.

The criterion for a finding of inadmissibility under the excessive demand criteria (which is what is at play here) is that the individual is expected to require, during the five years immediately following admission as a temporary/permanent resident (as the case may be) medical and social services costing more than five times the annual average for Canadian citizens, or services that will displace Canadian citizens and permanent residents requiring those services.

Convention refugees and spouses, common-law spouses, same-sex partners and children sponsored by a Candian citizen or permanet resident (not those accomanying a principal applicant) are exempt from inadmissibility under this category.

This inadmissibility covers a vast range of medical circumstances, but the assessment is based on an objective review of real costs borne by the public health system for people presenting similar conditions, and the real supply and demand for services in Canadian communities.

The simple fact of the matter is that there are not enough support services for the Canadian citizens and permanent residents presenting ASDs, and the admission of new permanent residents seeking those services is going to exacerbate that problem. There is no provision in Canadian health care coverage for people to "opt out." I would routinely see letters from applicants who were found to be inadmissible on excessive demand pledging not to make use of publicly funded health care--but there is no provision in law to allow for this, and a permanent resident, once admitted, has the full suite of rights of access to health and social services.

So what about this particular case. Well, assuming that the diagnosis of Asperger's Syndrome is correct, then the only question left is, "what medical and social services are likely to be required by this person during the five years after his admission." We all know full well that not all cases of Asperger's are alike--some of us have much more profound needs t han others and the simply label really tells us little. There is nothing in the article to tell us what was included in the medical assessment, but based on other cases that I have seen (and signed off on), no medical officer would sign off on an M7 determination without a solid indication of what those requirements would be.

Yes this is discrimination. But that does not make it illegal discrimination. The delivery of the immigration program is engaged in a daily litany of decision making--of deciding who is qualified and admissible and who is not. Immigration officers are involved in evaluating applicants against selection criteria and admissibility requirements all the time, and the simple fact of the matter is that some people qualify and some do not.

We are also being denied permanent residency because our three year old was diagnosed with autism after our arrival. My husband is an academic and I'm a nurse, so it's not like we immigrated to live off the state or anything. I get it, about autistic kids needing so many resources. I do find the system of classifying and funding autistic people in Canada frustrating. Everyone is funded the same amount, regardless of severity of symptoms, and that amount is how the government does its calculations of how much a given child will need . Yet autism is a spectrum. There are kids who could use a lot more help than my kid, and certainly there are plenty who would need less. Yet everyone gets the same amount of money, and that money buys roughly the same amount of therapy and intervention for everyone. And for the purposes of immigration, everyone is lumped together.

My experience with people who work in autism related fields, from doctors to interventions to speech paths, is that they have no idea that someone can be deported for something like this.