Citizenship waivers: Medical opinions

This section contains policy, procedures and guidance used by Immigration, Refugees and Citizenship Canada staff. It is posted on the Department’s website as a courtesy to stakeholders.

For applications received at the CPC-S before June 11, 2015

Request for Medical Opinion form

All requests to waive the requirements of Oath, language and/or knowledge must include the Request for Medical Opinion form [CIT 0015]. This form can be mailed or given to an applicant at various points of processing the application:

  • at the file review stage if it is indicated on the application form that the applicant has a medical condition that might prevent them from meeting the requirements;
  • at the test session or program integrity interview; or
  • at any point in the process up to the completion of a hearing.

When requesting a medical opinion form from the applicant, officers will also send the Notice – Request for Medical Opinion which gives the applicant 45 days to comply. If no response is received, the applicant will be sent the Final Notice – Request for Medical Opinion. If the applicant does not comply, the application will be treated as abandoned, and the file closed with no further action being taken on the case. The applicant will be sent the Abandonment of Citizenship Application form [CIT 0543].

Responsibilities

Citizenship officers and the Case Management Branch (CMB) both have responsibilities regarding processing waiver requests. These responsibilities apply to all types of waiver requests. For additional information see the instructions on the ministerial discretion to waive some requirements.

Citizenship officer (level 2)

Citizenship officers are to use their judgment in assessing the applicant’s eligibility requirements for citizenship including administering the language and/or knowledge assessments as necessary during the hearing and before referring a case to the CMB for waiver consideration and decision. The citizenship officer must administer as well as they can the two assessments to better document and strengthen the arguments for referring a waiver request. For example, if the applicant’s ability is limited for medical reasons or if the applicant has a learning disability, ask as many questions of the oral knowledge test and of the language assessment as necessary, mark the tests, and add notes to the effect that the applicant is not capable of understanding the questions asked or responding to them.

Note: In cases where a medical disability is apparent, officers must use their judgment in assessing the applicant’s language or knowledge abilities. Officers should be alert and sensitive to an applicant’s ability to convey essential information at a hearing and the result that further inquiries can have on the applicant’s well-being if further questioning is pursued. When there is a clear indication that a medical and/or cognitive impairment exists, officers should record their observations and seek a medical opinion from the applicant’s doctor. Conducting a complete assessment of an applicant’s language and/or knowledge abilities may result in undue stress for the applicant. Such a result is clearly not the intention of conducting a hearing under these circumstances.

When is a language and/or knowledge hearing not required?

A citizenship officer can decide not to schedule a hearing only in the following exceptional circumstance:

  • When an applicant appears for a written knowledge test or program integrity interview and falls within the following parameters:
    • the applicant is not capable of taking the written knowledge test even with officer assistance;
    • the applicant will not be able to meet the language and/or knowledge requirements due to a permanent and/or cognitive impairment; and
    • there is no doubt that a request for a waiver is required.

For example, an applicant who cannot appreciate the significance of the Oath of Citizenship due to a mental disability would not need to be further assessed at a hearing.

In all other situations, a hearing must be scheduled to provide the applicant with an opportunity to demonstrate their language and/or knowledge abilities.

If a hearing is not scheduled, the citizenship officer should record their observations and seek a medical opinion from the applicant’s doctor if one is not already on file. The complete file will be forwarded to the CMB for consideration and decision of the waiver request.

If the CMB approves the waiver request, the citizenship officer will complete the grant decision and schedule the applicant for a ceremony unless a waiver of the Oath has also been approved.

If the CMB refuses the waiver request, the local office should schedule the applicant for a knowledge and/or language hearing. If the applicant fails the assessment, the application will be refused as the applicant does not meet language and/or knowledge requirements.

It is the responsibility of the citizenship officer to ensure that the request for waiver is relevant to the applicant’s condition. The medical opinion provided by the applicant’s doctor must therefore provide information relevant to the request for the waiver. The reasons for the waiver request, which may be medical and/or psychological, must be clearly stated in the officer’s referral for waiver and must be supported by the doctor’s report.

The doctor’s report must include the following information:

  • a formal diagnosis;
  • when the patient was first examined;
  • when the patient was last examined;
  • when the medical condition developed;
  • when the condition caused the applicant to become disabled to the point that they could not learn or understand the significance of the Oath of Citizenship;
  • a full report/test results if the condition is cognitive, psychiatric or psychological in nature;
  • a description of current treatment;
  • when the current treatment was initiated;
  • whether the condition prevents the applicant from attending to their normal daily activities and work; and
  • the doctor’s address and signature and the client’s authorization and signature.

If the citizenship officer is unable to refer a waiver request because of the way the medical opinion is written, or because there is inadequate substantiation, they should seek additional information from the applicant. Citizenship officers should make one attempt to obtain additional information or documentation. If a citizenship officer has requested additional information but no response is provided by the applicant, the citizenship officer should forward the waiver request to the CMB for consideration and decision based on the information that is available on file. The CMB will then try to contact the applicant and/or medical office if required. If a medical opinion form is submitted with any supporting information or evidence then it will be considered. Citizenship officers will only abandon cases where the applicant fails to provide the medical opinion form.

If the condition is cognitive, psychiatric or psychological in nature, a full report must be provided which includes any medical test results, specialist reports and/or referral notes by psychologists and/or psychiatrists.

The citizenship officer must provide a memo to the CMB to support the request for a waiver. It is not sufficient to only reference the medical opinion form. This memo will become part of the applicant’s file and must

  • clearly indicate what requirement(s) of the Citizenship Act is requested for waiver;
  • indicate if the waiver request was initiated by the applicant or offered by the citizenship officer, see the instructions on the ministerial discretion to waive some requirements;
  • clearly state that the knowledge and language assessment were conducted but not completed because of the applicant’s condition;
  • include information about the program integrity interview and/or hearing, such as the officer’s impression about the applicant;
  • if they noticed anything out of the ordinary;
  • any information that the applicant provided regarding their medical condition(s);
  • if the applicant declared attending language and/or citizenship test preparation training courses/classes.

Prior to the hearing

The citizenship officer is responsible for

  • preparing the file and making one request from the applicant for additional information in cases where the medical opinion is not clear enough regarding the severity of the condition, or if there are inconsistencies in the way the doctor responded to the question(s) on the form;
  • identifying if the applicant is unable to understand the significance of the Oath of Citizenship;
  • obtaining the required information from the applicant or the applicant’s legal guardian, as applicable. Further information may be requested following the program integrity interview or hearing, if the officer still requires clarification regarding the applicant’s medical condition or the documents submitted;
  • ensuring that all requests to waive the Oath, knowledge and/or language requirements include the 5(3) Waiver Referral form and a completed Request for Medical Opinion form signed by the applicant’s physician and all accompanying documentation relevant to the request.

Note: Where there is doubt as to the authenticity of the doctor providing the medical opinion, it is the responsibility of the citizenship officer to verify this information. This can be done by checking the telephone directory and/or by contacting the appropriate provincial college of physicians and surgeons.

If the medical opinion indicates that the client is unable to understand the Oath of Citizenship, an affidavit attesting to the mental condition of the patient must be provided.

If the evidence to support the request for waiver is still incomplete or unclear following efforts to seek clarification, the file will be forwarded to the CMB to render a decision on the waiver based on the information available. The CMB may contact the medical office or the applicant for further information.

Case Management Branch

Officers in the CMB are the Minister’s delegates for the purposes of determining whether a request for waiver falls within the guidelines established by the Minister.

Usually the CMB, on behalf of the Minister, grants a waiver when a medical condition clearly prevents the applicant from ever satisfying the knowledge and or the language requirements. The CMB can grant a waiver for other medical reasons only in exceptional circumstances (i.e., terminal illness).

To expedite the processing of requests for waivers under subsection 5(3), it is imperative that all documentation be included on the file before it is forwarded to the CMB. If there is insufficient documentation for the CMB to make an informed decision, the CMB will seek clarification from the applicant or the doctor and may, in certain circumstances, request assistance from the local office. The CMB will review and make the final decision on a request to waive the requirements under subsection 5(3). Officers in the CMB are obligated to review all the evidence provided by the citizenship officer and to communicate the final decision to the citizenship officer. Where the Minister’s delegate does not grant the waiver, the reasons for not granting are also communicated to the citizenship officer. Once a citizenship officer receives the decision from the CMB, they complete their own decision (grant or not grant) and notify the client that the application is either approved or refused.

An applicant may challenge a refused grant decision by the citizenship officer by making an application for leave and judicial review to the Federal Court. See the instructions on judicial review.

For applications received at the CPC-S on or after June 11, 2015

Request for Medical Opinion form

All requests to waive the requirements of Oath, language and/or knowledge, or intent to reside must include the Request for Medical Opinion form [CIT 0547]. Some exceptions apply; see Waivers for renunciation of citizenship under section 9. This form can be mailed or given to an applicant at various points of processing the application:

  • at the file review stage if it is indicated on the application form that the applicant has a medical condition that might prevent them from meeting the requirements;
  • at the citizenship knowledge test session or program integrity interview; or
  • at any point in the process up to the completion of a hearing.

When requesting a medical opinion form from the applicant, officers will also send the Notice – Request for Medical Opinion which gives the applicant 45 days to comply. If no response is received, the applicant will be sent the Final Notice - Request for Medical Opinion. If the applicant does not comply, the application will be treated as abandoned, and the file closed with no further action being taken on the case. The applicant will be sent the Abandonment of Citizenship form [CIT 0543].

Responsibilities

Citizenship officers and the Case Management Branch (CMB) both have responsibilities regarding processing waiver requests. These responsibilities apply to all types of medical waiver requests. For additional information see the instructions on the ministerial discretion to waive some requirements.

Citizenship officer (level 2)

Citizenship officers are to use their judgment in assessing the adult or minor applicant’s eligibility requirements for citizenship including administering the language and/or knowledge assessments as necessary during the hearing and before referring a case for medical waiver consideration and decision. The citizenship officer must administer as well as they can the two assessments to better document and strengthen the arguments for referring a waiver request. For example, if the applicant’s ability is limited for medical reasons or if the applicant has a learning disability, ask as many questions of the oral knowledge test and of the language assessment as necessary, mark the tests, and add notes to the effect that the applicant is not capable of understanding the questions asked or responding to them.

Note: In cases where a medical condition is apparent, officers must use their judgment in assessing the applicant’s language or knowledge abilities. Officers should be alert and sensitive to an applicant’s ability to convey essential information at a hearing and the result that further inquiries can have on the applicant’s well-being if further questioning is pursued. When there is a clear indication that a medical condition and/or cognitive impairment exists, officers should record their observations and seek a medical opinion from the applicant’s doctor. Conducting a complete assessment of an applicant’s language and/or knowledge abilities may result in undue stress for the applicant. Such a result is clearly not the intention of conducting a hearing under these circumstances.

When is a languageand/or knowledge hearing not required?

A citizenship officer can decide not to schedule a hearing only in the following exceptional circumstance:

  • When an applicant appears for a written knowledge test or program integrity interview and falls within the following parameters:
    • the applicant is not capable of taking the written knowledge test even with officer assistance;
    • the applicant will not be able to meet the language and/or knowledge requirements due to a permanent and/or cognitive impairment; and
    • there is no doubt that a request for a waiver is required.

For example, an applicant who demonstrates that they cannot appreciate the significance of the Oath of Citizenship due to a mental disability would not need to be further assessed at a hearing.

In all other situations, a knowledge and/or language hearing must be scheduled to provide the applicant with an opportunity to demonstrate their abilities.

If a hearing is not scheduled, the citizenship officer should record their observations and seek a medical opinion from the applicant’s doctor if one is not already on file. The complete file will be forwarded to the CMB for consideration and decision of the waiver request.

If the CMB approves the waiver request, the citizenship officer will complete the grant decision and schedule the applicant for a ceremony unless a waiver of the Oath has also been approved.

If the CMB refuses the waiver request, the local office should schedule the applicant for a knowledge and/or language hearing. If the applicant fails the assessment, the application will be refused as the applicant does not meet language and/or knowledge requirements.

It is the responsibility of the citizenship officer to ensure that the request for waiver is relevant to the applicant’s condition. The medical opinion provided by the applicant’s doctor must therefore provide information relevant to the request for the waiver. The reasons for the waiver request, which may be medical and/or psychological, must be clearly stated in the officer’s referral for waiver and must be supported by the doctor’s report.

The doctor’s report must provide substantive reasons for the medical exemption, that is, provide the diagnosis and specifically state why the adult or minor applicant cannot form the intent to reside in Canada, learn one of the official languages and/or acquire knowledge about Canada in one of the official languages, and appreciate the significance of the Oath of Citizenship, if applicable. The report must include the following information:

  • a formal diagnosis;
  • when the patient was first examined;
  • when the patient was last examined;
  • when the medical condition developed;
  • when the condition caused the applicant to become disabled to the point that they could not learn or understand the significance of the Oath;
  • a full report/test results if the condition is cognitive, psychiatric or psychological in nature;
  • a description of current treatment;
  • when the current treatment was initiated;
  • whether the condition prevents the applicant from attending to their normal daily activities and work; and
  • the doctor’s address and signature and the client’s authorization and signature.

If the citizenship officer is unable to refer a waiver request because of the way the medical opinion is written, or because there is inadequate substantiation, they should seek additional information from the adult applicant or in the case of minor, from the parent or legal guardian. Citizenship officers should make one attempt to obtain additional information or documentation. If a citizenship officer has requested additional information but no response is provided by the applicant, the citizenship officer should forward the waiver request to the CMB for consideration and decision based on the information that is available on file. The CMB will then try to contact the applicant and/or medical office if required. If a medical opinion form is submitted with any supporting information or evidence, it will be considered. Citizenship officers will only abandon cases where the applicant fails to provide the medical opinion form.

If the condition is cognitive, psychiatric or psychological in nature, a full report must be provided which includes any medical test results, specialist reports and/or referral notes by psychologists and/or psychiatrists.

The citizenship officer must provide a memo to the CMB to support the request for a waiver. It is not sufficient to only reference the medical opinion form. This memo will become part of the applicant’s file and must:

  • clearly indicate what requirement(s) of the Act is requested for waiver;
  • clearly state that the knowledge and language assessment were conducted but not completed because of the applicant’s condition;
  • indicate if the waiver request was initiated by the applicant or offered by the citizenship officer (see the instructions on the ministerial discretion to waive some requirements);
  • include information about the program integrity interview and/or hearing, such as the officer’s impression about the adult or minor applicant;
  • if they noticed anything out of the ordinary;
  • any information that the applicant provided regarding their medical condition(s);
  • if the applicant declared attending language and/or citizenship test preparation training courses/classes.

Prior to the hearing

The citizenship officer is responsible for

  • preparing the file and making one request for additional information in cases where the medical opinion is not clear enough regarding the severity of the condition, or if there are inconsistencies in the way the doctor responded to the question(s) on the form;
  • identifying if the applicant is unable to understand the significance of the Oath of Citizenship;
  • obtaining the required information from the applicant or the applicant’s legal guardian, as applicable, following the program integrity interview or hearing, if the officer still requires clarification regarding the applicant’s medical condition or the documents submitted.
  • ensuring that all requests to waive the Oath, knowledge and/or language requirements, intent to reside, as applicable, include the 5(3) Waiver Referral form [CIT 0548] and a completed Request for Medical Opinion form signed by the applicant’s physician and all accompanying documentation relevant to the request.

Note: Where there is doubt as to the authenticity of the doctor providing the medical opinion, it is the responsibility of the citizenship officer to verify this information. This can be done by checking the telephone directory and/or by contacting the appropriate provincial college of physicians and surgeons.

If the medical opinion indicates that the client is unable to understand the Oath or incapable of forming the intent to reside (adults only), an affidavit attesting to the mental condition of the patient must be provided.

If the evidence to support the request for waiver is still incomplete or unclear following efforts to seek clarification, the file will be forwarded to the CMB to render a decision on the waiver based on the information available. The CMB may contact the medical office or the applicant for further information.

Case Management Branch

Officers in the CMB are the Minister’s delegates for the purposes of determining whether a request for a waiver falls within the guidelines established by the Minister.

Usually the CMB, on behalf of the Minister, grants a waiver when a medical condition clearly prevents the applicant from ever satisfying the knowledge and or the language requirements. The CMB can grant a waiver for other medical reasons only in exceptional circumstances (i.e., terminal illness).

To expedite the processing of requests for waivers under subsection 5(3), it is imperative that all documentation be included on the file before it is forwarded to the CMB. If there is insufficient documentation for the CMB to make an informed decision, the CMB will seek clarification from the applicant or the doctor and may in certain circumstances request assistance from the local office. The CMB will review and make the final decision on a request to waive the requirements under subsection 5(3). Officers in the CMB are obligated to review all the evidence provided by the citizenship officer and to communicate the final decision to the citizenship officer. Where the Minister’s delegate does not grant the waiver, the reasons for not granting are also communicated to the citizenship officer. Once a citizenship officer receives the decision from the CMB, they complete their own decision (grant or not grant) and notify the client that the application is either approved or refused.

An applicant may challenge a refused grant decision by the citizenship officer by making an application for leave and judicial review to the Federal Court. See the instructions on judicial review.

Date Modified: