Operational Bulletin 425


OB 425

Announcement of the closure of the Buffalo, NY CIC processing office.

One thing that can make the immigration process frustrating for those living through it is that there is such a total lack of control.  The process has profound impact on one’s life and any bump or wrinkle in the process sends jolts of fear through those currently in the middle of the process.

For the past two months the processing time of applications at CPC-M (“Case Processing Centre Mississauga”) has been increasing about 1/2 week per elapsed week.  Thus, when we submitted the sponsored application (in early March) the estimated processing time was 55 days.  By May 14 (9 weeks later) the estimated processing time was 90 days (so an increase of 35 days in a period of 63 days.)  That number hasn’t been updated in two weeks.

Then the other shoe drops and suddenly the backup in Mississauga makes sense – CIC has decided to close Buffalo.  My suspicion (entirely random speculation since I’m just another leaf caught in the maelstrom here) is that this decision was made back in March as part of the new budget.  So the backup would be due to the shifting of processing to other centres – in this case, it seems that the permanent resident processing will be moving to New York City (who already denied me once, so I wasn’t too thrilled to see that change) or to Ottawa.

In the meantime, we sit and wait for the court to make a decision on my judicial review application.  Today marks six weeks since the Registry forwarded the file to the Court for a determination.  I’ve only seen one case in my own (random) study that’s taken this long and it was ultimately rejected.  I’m hoping to avoid the same fate.

Immigration will certainly teach you the meaning of patience – and of what it is like to put your life on hold for several years while the process winds along.  I suppose I should be grateful I’m not one of the pre-2008 people who have recently had their applications withdrawn and sent back to them.  CIC did refund the fees, but if I were one of those people I’d be furious – in at least some cases, their files were finally being considered.

 

Advertisements

Ovalle v MCI


Court Decision (Gavel)It’s been several weeks since I reviewed the recent court decisions.  I was glad to see a new one that is pertinent to my case: Ovalle v MCI (2012 FC 507).  It was argued by the same attorney that I am using and – interestingly enough – the government was represented by the same attorney as well.  At some point I suspect these two will feel like old friends (or perhaps rivals at least.)

At any rate, in this case, Mr. Ovalle applied for immigration, was HIV positive when he applied, was taking drugs provided to him by a non-profit known as Aid for AIDS International and they agreed to continue providing him with the drugs, even if he were to immigrate to Canada.  He also showed that he was stable and other than the meds, he would not be an excessive demand on the health services of Canada.

The medical officer reviewed the additional evidence and said that it did not change the diagnosis or prognosis.  The visa officer relied solely upon the feedback from the medical officer, discounted everything submitted by Mr. Ovalle, and rejected him.

The Court was not happy with this decision – this was reviewed strictly on the “fairness” of the actual decision (an admittedly challenging basis on which to win a decision):

While the officer had detailed information before him about the medication Mr. Ovalle would require, its cost, and his ability to meet that cost, the officer merely reiterated the medical officer’s opinion that Mr. Ovalle’s diagnosis and prognosis had not changed. But neither the prognosis nor the diagnosis was the issue. There was no dispute about that. The issue was whether Mr. Ovalle would impose an excessive demand on Canadian resources. The officer did not address that issue in his reasons. It is not possible, therefore, to understand the basis for his conclusion that Mr. Ovalle’s plan was not satisfactory.

(Paragraph 9).

As a result, the judge decided the decision was not reasonable.   Kudos to Justice O’Reilly in holding CIC accountable to the standards as set forth in Sapru v MCIas I previously discussed.

The decision in this case is a narrow one (e.g., it applies to the specifics of this case) but it does demonstrate that the Courts are not allowing the Minister to simply reject people without a reasonable explanation as to why they are being rejected.

My own case has now been pending a decision on my application (to see if we even get to have a hearing) for 27 days.  While there is no guarantee of any specific time frame, it is now longer than most decisions of this type based upon my review of other cases – I have seen as long as two months to make a decision (twice – once it was granted, once it was denied).

Only time will tell.

The least expensive treatment option


One of the most difficult parts of formulating a response to the fairness letter in my particular case was even determining what the actual costs are to the Canadian Government.  It took me a while to find a source for such information, but it turns out that the Government of Quebec publishes a complete list of what they are willing to pay; my understanding is that this in turn is based upon the actual negotiated prices of the Canadian Government.  The liste de médicaments provides exactly this information.

By using this information I have been able to find what would be the least expensive option for treating an HIV infection in Canada at the present time.  While not the “preferred first line” treatment, it is still listed as a valid first line treatment and thus should be an option for anyone arguing the fairness letter.

Specifically, the combination of lamivudine, zidovudine and nevirapine (also known as Combivir and Viramune) now involves two drugs that are off patent (zidovudine and nevirapine) in Canada as well as the third (lamivudine) for which the patent expires June 2, 2012 (it is already off patent in the United States).

The current cost (as I write this) according to the Quebec price list is:

Zidovudine (100mg x 3) twice per day = $6.32/day

Lamivudine 150 mg twice per day = $9.30/day

Nevirapine 200mg twice per day = $2.47/day

Total cost per day = $18.09/day

$542.70 per month.  At $6,512.40 per year, this is above the maximum allowed, albeit only slightly over that limit.  With the impending generic status of Lamivudine, I would expect those prices to fall so they are below the threshold.

For a comparison, I used an online Canadian pharmacy (based in Quebec) to determine the price of generic equivalents.(Canadian Family Pharmacy – Your Cart)

Canadian Family Pharmacy

Canadian Family Pharmacy

It is a bit of a challenge to put this all together cleanly, but let’s go through the math:

Zidovudine is $4.56/day

Lamivudine is $2.00/day

Nevirapine is $3.40/day

Total per day: $9.96.

That’s $298.80 per month for this treatment option.  I did not combine the first two drugs together because that combination is covered by a patent still (“Combivir”) that has not yet expired.  However, my point is that all of these drugs are available as generics staring June 2, 2012.  This is a Canadian based company selling these drugs.  Note that this company will not ship products to Canada.  This is due to the Canadian rules that these drugs may not be imported (they are “Schedule F”) but for the purposes of computing the cost of generics, this is a reasonable place to start – if the government wishes to disagree, they can but they would need to be in a position to explain how they reached their conclusion.

Bottom line: if you find yourself arguing against a fairness letter due to your HIV positive status, obtain a letter from your doctor indicating that this combination is an acceptable starting therapy for you.  Then use this cost analysis to point out that the total cost of treatment is now under $3600 per year.  Even with periodic testing, your total costs will be well under the current limit (just over $6000 per year).

I didn’t make this argument because the emphasis by CIC in the past was on insurance.  Their response to me was “your insurance doesn’t matter, all that matters is the total cost of treatment, which is paid for by the provincial government”.  If I had known insurance didn’t matter, I’d have focused on costs.  Hopefully, if you find yourself in the same situation you can avail yourself of this argument.

Good luck!