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Guidelines for Medical Assessors:
Haemophilia
Version 1 June 2023
Contents
Purpose of this document ......................................................................................................... 2
Background ............................................................................................................................... 2
Diagnosis of haemophilia .......................................................................................................... 2
Assessing haemophilia for ASH requirements .......................................................................... 2
ASH outcomes for applicants with haemophilia ....................................................................... 2
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PURPOSE OF THIS DOCUMENT
The information in this document provides guidance about how haemophilia is diagnosed and
how to word your opinions.
BACKGROUND
Severe haemophilia is a non-waiver condition under A4.60(a) of Immigration Instructions.
DIAGNOSIS OF HAEMOPHILIA
Haemophilia can be difficult to detect through blood tests. We rely on the applicant’s medical
history and the examination by the Panel Physician to determine if an applicant has
haemophilia.
A history of the following symptoms may indicate haemophilia:
• spontaneous or pathological:
o bruising or swelling
o bleeding into joints, muscles or soft tissues
• a history of blood or blood product transfusion.
ASSESSING HAEMOPHILIA FOR ASH REQUIREMENTS
If you suspect haemophilia, always make a FIR for a haematologist’s assessment so you can
exclude it or assess its severity.
ASH OUTCOMES FOR APPLICANTS WITH HAEMOPHILIA
Your opinion for any applicant with severe haemophilia must be NOT ASH no matter what type
of visa they are applying for.
Include the following statement in your opinion:
The applicant has haemophilia. Haemophilia is a non-waiver condition.
This signals to the IO that:
• they cannot consider a medical waiver for residence visa applicants, and
• an Exception to Instructions (ETI) is not an appropriate outcome for a temporary visa
applicant.
If the haematologist’s report suggests that the applicant’s haemophilia is mild and would not
require hospitalisation or specialist input, discuss the results with our MOs. In some cases
these applicants may be considered ASH or AWC.
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