Meeting the Acceptable Standard of Health (ASH)

If you receive a Potentially Prejudicial Information (PPI) letter from your case officer stating that you may not meet the acceptable standard of health (ASH), do not accept this at face value and seek professional opinion.  
 
It is because the initial opinion from the Immigration New Zealand medical assessor may not be correct or in some cases, the assessor may not have applied the medical-related visa policy correctly. In this case, our firm engages with a consultant physician and/or specialist who will assess your case and may come up with a different assessment. We will present the case to your CO to identify the areas wherein the medical assessor has not applied the standard and policy correctly. With this justification, we will argue that the medical issues are not serious enough for your case officer to decline your visa application.

In some cases, your case officer will say “relatively high probability” to raise their concern with your medical situation. It means the possibility to pressure to the New Zealand hospital system with the costs and treatments to be more than 50% but below 100%. Therefore, our firm will engage with you to justify your case and not that it will not be in the range.

When you apply for a temporary visa, you must meet the acceptable standard of health (ASH).  But if the duration of the visa you’re seeking is short, your ASH will not be scrutinized as your case officer would usually do with your resident visa application.

For your temporary visa to be declined due to failing ASH, your case must require hospitalization, residential care, high-cost pharmaceuticals, and/or high-cost disability services during the term of the visa requested.  

When you are not meeting ASH for your residence visa application, you will need to apply for a medical waiver. Our firm can engage with you to prepare your medical waiver for you to meet ASH.

The list of health conditions not meeting ASH.
  • Hepatitis B-surface antigen positive and meeting criteria for anti-viral treatment in New Zealand.
  • Hepatitis C-RNA positive and meeting criteria for anti-viral treatment in New Zealand.
  • Malignancies of organs, skin (such as melanoma) and haematopoietic tissue, including past history, or currently under treatment. Exceptions are:
    • treated minor skin malignancies
    • malignancies where the interval since treatment is such that the probability of recurrence is below 10%. 
  • Requirement for organ transplants (with the exclusion of corneal grafts), or following organ transplant when immune suppression is required (with the exclusion of corneal grafts).
  • Severe, chronic or progressive renal or hepatic disorders.
  • Musculoskeletal diseases or disorders such as osteoarthritis with a high probability of surgery in the next 5 years.
  • Severe, chronic or progressive neurological disorders, including but not limited to:
    • any dementia including Alzheimer's disease
    • poorly controlled epilepsy
    • complex seizure disorder
    • cerebrovascular disease
    • cerebral palsy
    • paraplegia, quadriplegia
    • poliomyelitis
    • Parkinson’s disease
    • motor neurone disease, Huntington’s disease, muscular dystrophy
    • prion disease
    • relapsing or progressive multiple sclerosis or both.
  • Cardiac diseases, including but not limited to:
    • severe ischaemic heart disease
    • cardiomyopathy
    • valve disease with a high probability of surgical and or other procedural intervention in the next 5 years
    • aortic aneurysm with a high probability of surgical or other procedural intervention or both in the next 5 years.
  • Chronic respiratory disease, including but not limited to:
    • severe or progressive restrictive (including interstitial) lung disease or both
    • severe or progressive obstructive lung disease or both
    • cystic fibrosis.
  • Significant or disabling hereditary disorders, including but not exclusive to:
    • hereditary anaemias and coagulation disorders
    • primary immunodeficiencies
    • Gaucher’s disease.
  • Severe autoimmune disease which may require treatment in New Zealand with immune-suppressant medications other than Prednisone, Methotrexate, Azathioprine or Salazopyrin.
  • Severe (71-90 decibels) hearing loss or profound bilateral sensori-neural hearing loss after best possible correction at country of origin, where significant support is required, including cochlear implants.
  • Severe vision impairment with visual acuity of 6/36 or beyond after best possible correction at country of origin, or a loss restricting the field of vision to 15-20 degrees where significant support is required.
  • Severe developmental disorders or severe cognitive impairments where significant support is required, including but not exclusive to:
    • physical disability
    • intellectual disability
    • autistic spectrum disorders
    • brain injury.
  • Major psychiatric illness or addiction or both, including any psychiatric condition that has required hospitalisation or significant support or both.
  • A history, diagnostic findings or treatment for MDR-TB or XDR-TB, unless cleared by a New Zealand Respiratory or Infectious Diseases specialist upon review of any file or applicant according to the New Zealand Guidelines for Tuberculosis Treatment.
INZ may also decline your visa application if in the medical assessor’s opinion your health services costs are likely to be more than NZ$81,000 (NZ$41,000 if you applied for a visa before 4 September 2022).
​
In most instances where an individual doesn’t meet the ASH, this does not necessarily mean the individual will not qualify for the grant of a residence visa.

Medical Waivers – Residence Class Visas
Your case officer (CO) will not decline your application without providing you with an opportunity to respond to their request for further information. Your CO may take into account in their decision to grant a medical waiver, including (but are not limited to) the following:
The objectives of health requirements policy and the objectives of the policy or category under which the application has been made;
  • The degree to which the applicant would impose significant costs and/or demands on New Zealand’s health or education services;
  • Whether the applicant has immediate family lawfully and permanently resident in New Zealand and the circumstances and duration of that residence;
  • Whether the applicant’s potential contribution to New Zealand will be significant;
  • the length of intended stay (including whether a person proposes to enter New zealand permanently or temporarily).

Our firm can engage with you to apply for a medical waiver for your case engaging with you, a medical consultant and your CO.
​The cost of HIV (human immunodeficiency virus) treatment is NO longer considered significant by Immigration New Zealand (INZ) and the Ministry of Health.

INZ has therefore removed HIV infection from the list of high-cost health conditions used to assess resident visa applications.

INZ will still consider the medical circumstances of applicants with HIV but will NOT automatically determine that an applicant with HIV does not have an acceptable standard of health, which could lead to the decline of a visa application. 
​
PHARMAC, National HIV and AIDS Forum, UNAIDS and New Zealand AIDS Foundation supported the proposal to update the list.

Note: Immigration Trust managed several medical waiver cases with HIV, which were successful. Currently, we manage a few clients with HIV as well. ​
"I was on the verge of giving up on applying for visa here in new zealand due to my medical result is considered as "not ASH". lots of stress and sleepless nights. Luckily I found Immigration Trust and Simon." 

Change of LIA

Are you not happy with your current lawyer or immigration adviser? Talk to us to discuss a switch.
​Are you looking for anything in particular?