Adult visa for dependent parent: Medical proof


The requirements for a Adult Dependent Relative Visa (ADR) are set out in the EC-DR section of Schedule FM of the Immigration Rules. In this article, we explore what medical evidence may be required to support an application under the dependent adult visa category.

Requirements for a Dependent Adult Parent Visa

The evidence to be provided in order to satisfy the requirements of the visa rules for adult dependent relatives contained in Annex FM are set out in FM-SE Immigration Rules Appendix: Evidence Specified by Family Members.

An applicant is required to provide proof that they require long-term personal care which must take the form of:

a) Independent medical evidence demonstrating that the applicant’s physical or mental condition prevents him or her from performing daily tasks; and

(b) It must be from a physician or other healthcare professional.

In addition, evidence of available care must come from:

a) a central or local health authority;

(b) a local authority; Where

(c) a physician or other healthcare professional.

Medical evidence for an Adult Dependent Relative Visa (ADR)

(1) Evidence that due to age, illness or disability, the applicant requires long-term personal care

If applicable Family Policy Dependent Adult Parents Version 3.0 The guidelines set out the evidence an entry clearance officer expects to see in support of an adult dependent relative visa application. He is pointing out that “medical evidence that the applicant’s physical or mental condition means that they require long-term personal care because they cannot perform daily tasks.The tips go on to provide examples of such tasks, including washing, dressing and cooking. Those wishing to join loved ones whose state of health does not meet these high standards cannot apply under the dependent adult visa category.

The need for long-term personal care may have arisen unexpectedly, due to a serious illness or accident, or following a gradual decline in health. Although an entry clearance officer has the authority to refer an applicant for a medical examination, this discretion is not often used. As such, it is essential that a medical expert report be provided in support of the request. Our immigration attorneys can help you identify and advise a qualified medical professional and/or expert of the issues they need to address in their medical report.

(2) Evidence that the applicant is unable, even with the practical and financial assistance of the sponsor in the UK, to obtain the level of care required in the country where they live

In order to obtain an adult dependent relative visa, it is necessary to prove that the ‘level of care required‘ is not available in the applicant’s home country and no one there can reasonably provide it. The rules refer to the required level of care available within the country where the candidate is from, which is a very broad test – not, as one might expect, one that may be available in the candidate’s region. This care includes that provided by one or more relatives, a home help, a cleaning lady, a nurse, a carer or a nursing home.

Furthermore, the level of care required should not be available even with the practical and financial assistance of the applicant’s family members in the UK. This proof must come from a central or local health authority, local authority, doctor or other healthcare professional in the country in question. An applicant will need to confirm why any private arrangement, which may have been in place, can no longer continue and, if no longer affordable, proof and an explanation of why.

The evidence required to support an application under the adult dependent relative visa category can be difficult to obtain. In many cases, where the care required is available in the applicant’s home country, the sponsor will need to demonstrate that they have sufficient resources to care for the dependent adult relative in the UK, while claiming that they cannot afford the treatment required in the applicant’s country. Given the complex nature of these applications, sponsors and dependent adult relatives may consider seeking expert advice.

In the case of Ribeli v Entry Clearance Officer, Pretoria [2018] EWCA Civil 611the Court of Appeal upheld the “rigorous and demanding” nature of the rules relating to the adult dependant, following the cessation of Britcits v Secretary of State for the Home Office [2017] EWCA Civil 368. In Britishthe Master of the Rolls notes at paragraph 59:

“… as reflected in the Rules and Guidance, the focus is on whether the care required by the ADR applicant can be “reasonably” provided and to the “standard required” in their home country. As Mr. Sheldon confirmed in his oral submissions, the provision of care in the home country must be reasonable from both the perspective of the provider and the perspective of the claimant, and the standard of that care must be that which is required for that particular applicant.

It is possible that insufficient attention has been given in the past to these considerations, which focus on the care that it is both necessary and reasonable for the claimant to receive in their country of origin. These considerations include issues relating to accessibility and geographic location of care delivery and standard of care. They are able to embrace emotional and psychological demands verified by expert medical evidence. What is reasonable must, of course, be assessed objectively.”

In deciding whether the required level of care cannot be “reasonably” provided, the Entry Authorization Officer will consider the applicant’s circumstances, including distance and difficulty for the applicant to travel to access care, and whether he has an emotional or psychological need for a specific type of care. Proving that an applicant has an emotional and psychological need to be cared for by a relative in a country different from their own, i.e. the UK, can be very difficult.

The impact of adult dependent parent rules may result in the permanent separation of elderly parents from their children who are settled in the UK and may also be UK citizens, or may require settled children to leave the UK to return take care of their parents. . Only very rarely will settled British sponsors be able to prove that no one can reasonably care for their vulnerable relatives in their home country, although the Court of Appeal’s reminder in British that emotional needs should be considered by the Secretary of State when evaluating an adult dependent relative application has proven helpful for some applicants.

The British Medical Association, along with other leading medical bodies, have repeatedly called for an amendment to the rules to allow settled migrant doctors to bring their adult relatives to seek treatment from them at the UK. The BMA’s joint letter to the Home Secretary asking him to exempt doctors from the dependent adult rule can be read here. However, since the letter was submitted, no further changes to these rules have been announced.


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