An analysis of medical inadmissibility rules and strategies for overcoming them through effective evidence and submissions.
Included with our Passes – Learn more
Deanna Okun-Nachoff
March 19, 2026 at 12:00pm EST
$90
3 hours
Attend Live Online and On-Demand Recording
This course provides a comprehensive, practical examination of medical inadmissibility under s. 38 of the IRPA, guiding practitioners through the full lifecycle of a medical admissibility file. Participants will learn how to identify potential medical inadmissibility issues early, assess excess-demand risk, obtain and interpret medical evidence, and advise clients strategically from the first consultation through to procedural fairness. The session also covers responding to s.44 reports, building persuasive submissions, understanding key policy guidance, and applying both the “soft skills” and “hard skills” needed to manage complex medical cases with care and precision. Through practical examples and case studies, this course equips practitioners to confidently advocate for clients facing medical inadmissibility concerns.
• Why does Canada exclude certain foreign nationals on medical grounds?
• What is the legal authority for excluding on medical grounds?
• When do medical assessments occur in the immigration life-cycle? Can they be revisited at a later point?
• What are the different types of medical inadmissibility?
• Where can I find relevant policy guidance?
• Who is exempt from an “excess demand” (ED) determination?
• What is the legal threshold for establishing A38 inadmissibility?
• Which costs are excluded from consideration in an ED assessment?
• What is the duty to disclose in a medical admissibility case?
• What practices should you employ to effectively (and proactively) identify medical admissibility cases in your practice?
• What things do you need to consider when conducting an ED assessment?
• Tips and resources for obtaining and leveraging medical evidence (including a practitioner’s “top 10” resource list)
• Techniques and practice tips for complex medical files (with a focus on prioritizing informed consent and managing client expectations)
• Practice tips re. having difficult conversations with clients around medical inadmissibility
• Understanding the case to be met: What is the relevant standard of proof? And who bears the burden of proving/disproving medical inadmissibility?
• What you need to know before you can respond to a Medical Admissibility allegation?
• Dealing with s.44 reports and responding to procedural fairness letters alleging medical inadmissibility (what to send, what to argue and what to expect)
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Partner and Lawyer, Evolution Law Group
Deanna has been working in the immigration field for over 20 years, and has recently founded Evolution Law Group – to further focus her work on strategic litigation aimed at redressing systemic injustices in the immigration system. She started her career in the non-profit sector serving the needs of foreign live-in caregivers. Her current practice focuses on litigation and permanent migration to Canada, especially for those seeking to overcome admissibility and eligibility barriers. She represents refugees, foreign nationals and permanent residents at all levels of the IRB and at the Federal Court. Deanna runs a trauma-informed practice and has extensive experience assisting victims of domestic violence and undocumented workers.
Deanna speaks at various conferences and for grassroots organizations and has been an active volunteer with the Canadian Bar Association’s national immigration section, where she has served in various executive positions over the years, including that of section Chair. She also co-hosts Borderlines, a weekly podcast and YouTube show on immigration and other topical social justice issues.
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Absolutely. Every LPEN course is recorded, and the recording is added to your account within a few business days. You can log in anytime to watch it on demand and still receive your digital certificate of completion.
LPEN seeks accreditation for each course from the College of Immigration and Citizenship Consultants (CICC) and the Law Society of Ontario (LSO),the Law Society of BC (LSBC) when applicable. Accreditation details and approved CPD hours are listed in the CPD Credits section on each course page, so you can easily confirm how the course qualifies toward your professional development requirements.
A digital certificate of completion will be available once the course recording has been uploaded. After that, you can follow the steps at the top of your My Courses page—where you’ll also find a short video explaining how to download your certificate. Be sure to save it as part of your documentation for your CPD hours.
This course may be included in one or several LPEN Passes. Passes offer discounted rates and access to multiple courses, making CPD compliance simpler. Check out our Passes page to see where it is included.
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