An individual may be found medically inadmissible on three grounds: a danger to public health a danger to public safety, or more commonly, that the individual’s condition is reasonably expected to cause excessive demand on health or social services in Canada. As Canada has publically funded healthcare and education systems, a medical condition which is anticipated to require more public funding than the average funding expected to be provided for a Canadian citizen or permanent resident (over a five year period), can result in an allegation or finding of being medically inadmissible to Canada. A medically inadmissible family member will render all dependent family members inadmissible. For example, if an application for permanent residence includes two parents and two children and one of the children has moderate developmental disabilities, then the entire family may be medically inadmissible to Canada. In this scenario, before Immigration, Refugees and Citizenship Canada (IRCC) can refuse an application the Immigration Officer must provide a ‘procedural fairness’ letter so that the family has the opportunity to provide evidence that they will not cause ‘excessive demand’ on health or social services. If the application for permanent residence is still refused, this decision can be challenged at the Federal Court of Canada on judicial review. If the application that is refused for medical admissibiltiy is a sponsorship application – either the sponsorship of parents, grandparents, a spouse, or children – other factors must be considered. For parents and grandparents, there is a similar procedure: if during the processing of the permanent residence application a parent or grandparent is thought to be medically inadmissible, a ‘procedural fairness’ letter will be provided and submissions requested from the family. If the permanent residence application is refused, the decision may be appealed to the Immigration Appeal Division. Spouses and children cannot be found to be medically inadmissible for causing excessive demand to health or social services.