A4.10 Acceptable standard of health (applicants for residence) (30/07/2012)

1. Applicants for residence class visas must have an acceptable standard of health unless they have been granted a medical waiver. An application for a residence class visa must be declined if any person included in that application is assessed as not having an acceptable standard of health and a medical waiver is not granted (see A4.60).
2. Applicants for residence class visas are considered to have an acceptable standard of health if they are:
   1. unlikely to be a danger to public health; and
   2. unlikely to impose significant costs or demands on New Zealand's health services or special education services; and
   3. able to undertake the work on the basis of which they are applying for a visa, or which is a requirement for the grant of the visa.
3. The conditions listed in A4.10.1 are considered to impose significant costs and/or demands on New Zealand's health and/or special education services. Where an immigration officer is satisfied (as a result of advice from an Immigration New Zealand medical assessor) that an applicant has one of the listed conditions, that applicant will be assessed as not having an acceptable standard of health.
4. If an immigration officer is not satisfied that an applicant for a residence class visa has an acceptable standard of health, they must refer the matter for assessment to an Immigration New Zealand medical assessor (or the Ministry of Education as appropriate).
5. Despite (d) above, referral to an Immigration New Zealand medical assessor (or the Ministry of Education) is not required where the applicant is the partner or dependent child of a New Zealand citizen or residence class visa holder, unless the provisions of A4.60(a) or A4.60(b) apply.

   Note: These instructions do not apply to residents and former residents applying for a permanent resident visa or a second or a subsequent resident visa.

A4.10.1 Medical conditions deemed to impose significant costs and/or demands on New Zealand's health and/or education services

• HIV infection
• Hepatitis B surface antigen positive, with abnormal liver function
• Hepatitis C, RNA positive, with abnormal liver function
• Malignancies of solid organs and haematopoietic tissue, including past history of, or currently under treatment

  Exceptions are:

  1. treated minor skin malignancies (not melanoma)
  2. malignancies where the interval since treatment is such that the probability of cure is > 90%, e.g.: early stage (I & IIA) breast cancer at 5 years; low risk prostate cancer at 5 years; early stage (Dukes A & B1) colorectal cancer at 5 years; childhood leukaemia at 5 years
• Solid organ transplants, excluding corneal grafts more than 6 months old
• Chronic renal failure or progressive renal disorders
• Diseases or disorders such as osteoarthritis with a high probability of arthroplasty in the next four years
• Central Nervous System disease, including motor neurone disease, complex partial seizures, poorly controlled epilepsy, prion disease, Alzheimer's and other dementia, and including paraplegia and quadriplegia
• Cardiac disease including ischaemic heart disease, cardiomyopathy or valve disease requiring surgical and/or other procedural intervention
• Chronic obstructive respiratory disease with limited exercise tolerance and requiring oxygen
• Genetic or congenital disorders: muscular dystrophies, cystic fibrosis, thalassaemia major, sickle cell anaemia if more than one sickle crisis in 4 years, severe haemophilia, and severe primary immunodeficiencies
• Severe autoimmune disease, currently being treated with immuno-suppressants other than prednisone
• In a person up to the age of 21 years, a severe (71-90 decibels) hearing loss or profound bilateral sensori-neural hearing loss
• In a person up to the age of 21 years, a severe vision impairment with visual acuity of 6/36 or beyond after best possible correction, or a loss restricting the field of vision to 15-20 degrees
• In a person up to the age of 21 years, a severe physical disability, where they are unable to stand and walk without support, and cannot independently dress, eat, hold a cup, or maintain their stability when sitting.

  Note: The list above at A4.10.1 is not an exhaustive list of conditions which may indicate that an applicant does not have an acceptable standard of health.

A4.10.2 Assessment of whether an applicant for a residence class visa is unlikely to impose significant costs on New Zealand's health services

1. The requirement that an applicant for a residence class visa must be unlikely to impose significant costs on New Zealand's health services is not met if, in the opinion of an Immigration New Zealand medical assessor, there is a relatively high probability that the applicant's medical condition or group of conditions will require health services costing in excess of $25,000.

   Note: Assessment will be in terms of current costs with no inflation adjustment.

2. In the case of acute medical conditions, the medical assessor will provide an opinion on whether there is a relatively high probability that the condition or group of conditions will require health services costing in excess of NZ$25,000 within a period of four years from the date the assessment against health requirements is made.
3. In the case of chronic recurring medical conditions, the medical assessor will provide an opinion on whether, over the predicted course of the condition or group of conditions, there is a relatively high probability that the condition or group of conditions will require health services costing in excess of NZ$25,000.
4. The following factors have no bearing on whether an applicant is unlikely to impose significant costs on health services:
   1. The ability of a person or organisation to pay for health services, pharmaceuticals, or residential care which may be required.
   2. The ability of an applicant to gain access to the private health system.
   3. The applicant’s possession of health insurance.
   4. The capacity of family, friends, or a charitable organisation to provide care for an applicant.

A4.10.5 Assessment of whether an applicant for a residence class visa is unlikely to impose significant costs on New Zealand's special education services

1. The requirement that an applicant for a residence class visa must be unlikely to impose significant costs on New Zealand's special education services is not met if the Ministry of Education (MoE) has determined that there is a relatively high probability that the applicant's physical, intellectual, or sensory condition or their use of language and social communication would entitle them to Ongoing Resourcing Scheme (ORS) funding.
2. Where it has been determined that there is a relatively high probability that an applicant would be entitled to ORS funding, the following factors have no bearing on whether an applicant is unlikely to impose significant costs on New Zealand’s special education services:
   1. The ability of a person or organisation to pay for education services.
   2. The ability of a person to provide in-home education services.

A4.10.10 Assessment of whether an applicant for a residence class visa is unlikely to impose significant demands on New Zealand's health services

1. The requirement that an applicant must be unlikely to impose significant demands on New Zealand's health services is not met if, in the opinion of an Immigration New Zealand medical assessor, there is a relatively high probability that the applicant's medical condition or group of conditions will require health services for which the current demand in New Zealand is not being met.
2. Where it has been determined that there is a relatively high probability that an applicant may require health services for which the demand in New Zealand is not being met, the following factors have no bearing on whether the applicant is unlikely to impose significant demands on New Zealand’s health services:
   1. The ability of a person to gain access to the private health system.
   2. The capacity of family, friends, or a charitable organisation to provide care for an applicant.

      Note: These instructions do not apply to people applying for a further residence class visa under RV2 or RV4.

Effective 30/07/2012