PIC 4007 Health Waiver


The following is kindly supplied by a subclass 309 applicant that had to go through what looks like a very arduous procedure to fulfil the relevant PIC 4007 Health Waiver conditions to be able to get a successful subclass 309 grant.

This is their story..

In April 2019 we applied for a 309 Offshore partner visa (having been married for 10 years). In September 2019 we were sent notification that a Health Waiver (PIC4007) would need to be completed as a result of my partner having arthritis that would require ongoing treatment and could represent an undue cost to the Australia Health-care system. We received a letter from the MOC estimating the cost to be in the order of $230,000 (which is well over the $49K) threshold as well as a blank PIC4007 Health Waiver PART A form to complete.

Lets start by talking about the PIC4007 Health Waiver PART A form itself.

This form is a PDF formatted document that is broken into a series of segments that you must respond to. The form itself does not contain enough space to answer many of the questions and even with Adobe it is virtually impossible to add extra space. As such we spent many hours creating little text boxes and using different fonts to insert our responses to each section of the form. What is more important however was that knowing we could not fill our answers completely into the form we started adding references to additional documents we were creating for each section. We would write a brief answer to each section in the space provided on the PIC4007 form and have a note that would say something like [SEE ATTACHED PIC 4007 INCOME (Sponsor) DOCUMENT]. The sections in the PIC 4007 form include:

  • Education and Qualifications
  • Current Employment Details
  • Income
  • Financial Assets and Liabilities
  • Residential Property
  • Existing Care Arrangements and Impact of The Condition
  • Community Ties and Links
  • Other relevant Documentation
  • Information Regarding non-migrating Family members

For each of these main areas we created separate documents where we responded in detail to each question and also scanned in our supporting evidence – which we would reference. In many cases we had 2 versions of each section – one for the sponsor and one for the applicant. For example we had 2 documents in response to the first section called: 1. PIC4007 Education and Qualifications (Sponsor) then a second document called 1. PIC4007 Education and Qualifications (Applicant). This was very important as there is a size limit of 5MB to each document and by the time we had included things like scanned university qualifications or bank statements or tax returns, etc, we were typically blowing our document size limits. Having separate Sponsor and Applicant versions of each document helped in that respect although we did have some documents that we called (Joint) where we only had one document. This was especially necessary when we were disclosing information about our finances and property as these are joint accounts / assets / liabilities.

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Before moving on to the content – The way we built each document was to use MS (WORD) on PC and Pages on MAC to create the documents. Then we used ADOBE to compress the documents down to 5MB. I can’t stress enough how important it is to really work with different scanning methods to maximize the quality of your scanned images whilst minimizing the space as the final compression of documents cannot compress a really large document down to 5MB. In many cases we just spent hours of trial and error scanning and rescanning images into our PIC4007 documents and then working to compress them into 5MB or less files that are still readable. Additionally I would just like to take a moment to explain that we ended up with over 100 pages of documentation for the PIC4007 in what represents approximately 120 hours of work. We were fortunate enough to have started on this long before we actually got the RFI in August (knowing that there might be a problem) so we already had much of the material and our compassionate circumstances and reasoning ready.

In the end we uploaded the completed PIC4007 Health Waiver PART A document (filled in to the best of our ability in the spaces provided) then approximately 20 supporting documents for each section in the PIC4007. These were labeled with a section number, section name and who the document covered (Joint, Sponsor/Applicant). (IE. 2. PIC4007 Current Employment Details (Applicant))

Onto the documents themselves:

1. PIC4007 Education and Qualifications

This is probably the simplest section and document to complete. We placed our brief details in the PIC4007 form that was sent to us and then added references to two separate documents that we created called 1. PIC4007 Education and Qualifications (Sponsor) and 1. PIC4007 Education and Qualifications (Applicant). The first page of each of these document detailed the qualifications starting with High school that we had and the dates and places that we received those qualifications. We then included scanned images of each qualification (be it a high school certificate or degree or any other training certificate) as appendices that were referenced back to the first page.

2. PIC4007 Current Employment

Again we responded to the questions on the PIC4007 form in the spaces provided and then added references to two external documents: 2. PIC4007 Current Employment (Sponsor) and 2. PIC4007 Current Employment (Applicant). On the first page of each document we detailed our work history with our current employers including: roles, dates and salaries as we had both held various roles for our current employers. We also added copies of our letters of employment as appendices. In one case we requested the HR department to create a letter stating when the person was employed, their salary etc. We also added copies of the most recent payslips, copies of letters from Australia supporting our employability (from a recruiter – the kinds of jobs, expected salaries, industry demand etc) as well as some screen shots from www.seek.com.au showing the kinds of jobs we were qualified for. This was all included as appendices and reference back to the commentary on the first page

3. PIC4007 Income

Following in the same fashion as the previous sections, this time we only created a single external document: 3. PIC4007 Income (Joint). Again we included details of our work and salaries in both USD and AUD (we performed the USD to AUD conversion utilizing the current exchange rate which we detailed) . We also included: letters of employment from our employers stating how long we had worked with them and our current salaries, our 3 most recent payslips (6 in total) as well as our last 3 joint tax returns. The sponsor also included the last 3 AUD tax returns from 10 years ago prior to moving overseas. All of these scanned documents were included as appendices and referenced on the first page of the document.

4. PIC4007 Financial Assets and Liabilities

Following in the same fashion as the previous sections, this time we started by creating a single document: 4. PIC4007 Financial Assets and Liabilities (Joint).This first page of the document listed our: bank accounts, home loan, share portfolio, superannuation, retirement savings, credit cards, etc with the current balance/valuation in both USD and AUD. This first page really explains our total financial situation, but because there are a multitude of assets and liabilities we created 3 other documents called 4. PIC4007 Deferred Savings, 4. PIC4007 Pension, 4. PIC4007 Other Assets. We referenced these other documents from the first page of the 4. PIC4007 Financial Assets and Liabilities (Joint) document. The appendices on the main document were focussed on our bank accounts and credit card balances.

In essence the main document just had an overview of our current accounts (bank accounts) and all of the bank statements stored as appendices. The 4. PIC4007 Deferred Savings document detailed things like 401K and superannuation (including the relevant scans of statements). The 4. PIC4007 Pension document included both statements of our employee pensions and what we could expect from social security. Most pension plans and social security have websites where you can get a history (statement) and an estimate of what you will be entitled to at retirement. Finally the 4. PIC4007 Other Assets detailed the value of: our cars (including pictures and online valuations and registration documentation) as well as statements of our share portfolio (including the net worth). This section was probably the second most labour intensive one to prepare (after the compassionate reasons section) because we had to pull together multiple bank, share portfolio, car valuations, superannuation, social security, deferred pension fund, 401K, home loan documents and put it all together in a cohesive manner. Hence the idea of a main document 4. PIC4007 Financial Assets and Liabilities that then referenced 3 other documents. The first page of the main document pulls all of these items together and basically gives a ‘Net Worth’ amount at the end.

5. PIC4007 Residential Property

Following in the same fashion as the previous sections, this time we only created a single document: 5. PIC4007 Residential Property (Joint). This first page of the document explained we live together at the detailed address and listed the purchase price, current valuation and home loan (outstanding). Supporting documents included in the appendices were:

  • a/ pictures of the house,
  • b/ purchase details from the county assessor-treasurer website showing the purchase date, price and grantee (purchaser)
  • c/ current assessment value from zillow and the county assessor-treasurer websites
  • d/ energy and utilities bills for several months
  • e/ bank statements showing the original loan amount the current loan amount and some interim amounts (we highlighted the account owner, the dates and the amounts by circling relevant areas in the scanned images

Note: We referenced this document on the first page of 5. PIC4007 Assets and Liabilities (Joint) as this is where our biggest liability (home loan) was detailed.

6. PIC4007 Existing Care Arrangements and impact of the Condition

As well as responding briefly to the main PIC4007 PDF document we created a separate document called 6. PIC4007 Existing Care Arrangements and Impact of Condition.

This was an important document that highlighted how the applicants condition does not interfere with their ability to work and contribute to society. The first page listed 10+ points of activities the applicant performs on a regular basis with photos included in the Appendices of the applicant performing those activities. There was also a reference to a second document 6. PIC4007 Existing Care Arrangements (Doctor’s statement) where the applicants doctor wrote a letter explaining the condition and the impact that it has on the applicant and how it is managed. These documents pertain only to the applicant.

7. PIC4007 Community Ties and Links.

As well as responding briefly (in the space provided) to the main PIC4007 PDF document, we created 2 separate documents for the applicant and sponsor to detail ties with Australia. For the Sponsor, the document 7. PIC4007 Community Ties and Links (Sponsor) the first page listed all of the community groups, musical groups, theatre groups, church groups etc that the sponsor belongs to in both Australia and the USA. This was followed up with photos (with dates) demonstrating the involvements. There was also a letter of recommendation included demonstrating community service provided by the sponsor as well as text message and Facebook clippings showing how the sponsor has continued to interact with family and friends in Australia. For the applicant we created a 7. PIC4007 Community Ties and Links (Applicant) document that essentially walked through the applicants history with Australia and the sponsor. This included a historical retrospective of trips and visits, discussions about favorite places to go, favorite foods to eat, favorite bands, discussion of possible markets to visit and a lot of photos demonstrating over 20 years of connection with Australia. This document was quite large in that it told a story of the applicants initial, and ongoing connection with Australia, the culture, the sponsor and family as well as the desire to become an Australian. All supported with photo evidence.

8. PIC4007 Compassionate and Financial Documentation

Without doubt this was the most difficult (and large) document to create. It probably took in excess of 40 hours to create over several months. We tackled this document by first laying out a half page on each the sponsor and the applicant (a quick review of who they are, what they do, their income and their desires). We then broke the document into sections:

  1. We produced multiple cost models of the contribution the sponsor and applicant could make financially to Australia over a 10 year period including tax contribution, money that they would bring with them into the economy, the value of community services provided, and the value of parental support they would provide) In these financial models we backed each of the numbers we used by including screen shots of tax calculators, values of similar services provided etc
  2. Because we have family requiring support in Australia we spend a lot of time explaining and costing the value of the support we could provide as well as detailing the emotional costs of the waiver being declined. We proposed that we could save the government significant amounts of money over a 10 year period by providing aged care support to the applicants parents – we valued this using reports the Aus. Govt provides on the cost of aged care funding at various levels and what the sponsor parents would likely need if the applicant and sponsor were denied the opportunity to return to Australia.
  3. We detailed an alternative medical treatment that the applicant was trying that would cost a lot less than what the applicant was on at the time of the application. Including the name of the medicine and the fact it was on the PBS. Because the MOT doesn’t provide a detailed breakdown of how they came to the estimated cost the applicants condition it is hard to provide an alternate valuation that can be compared other than anecdotally knowing the alternate treatment is significantly cheaper in the US and a quick look at the PBS costing of the existing medicine and alternate medicine seems to be cheaper. Again I would stress that we did not question the MOT estimate as we were not privy to exactly how it is calculated rather we accepted it and suggested there is an alternative, that appears significantly cheaper and that the applicant is trying it.
  4. We detailed the community services and volunteer contributions both the applicant and sponsor would be providing in Australia and a rough estimate of the value. For example the sponsor provided free music lessons to children. – The cost benefit of this was included in the first section (cost models) as well. Specifically we included calculations such as : Sponsor provide free music lessons to 3 students per week for 1 hour that would normally cost $40 per hours so 3 students x $40 x 40 weeks per year x 10 years = ??? In community contribution. We also listed club , church and community donations.
  5. We included patriotic reasoning around why refusal of the applicants visa would mean the sponsor could not return to Australia and how both the applicant and sponsor had unique professional knowledge that would therefor be denied to Australia by them not being able to migrate back

This section is really unique to every couple – we actually paid $200 for a Skype call with an Australian immigration specialist to see how to approach this. His advice was:

  1. Detail the cost benefit you can bring to Australia both in income and cash to the economy and savings that you can make (point 1)
  2. Detail the implications of a visa refusal and if that would cause any disadvantage to any Australians (point 2)
  3. Look for ways to reduce the cost of medical treatment (point 3)
  4. Detail what you bring to Australia and the economy (points 4 and 5)

I can’t state how important it is to provide evidence for everything you state. Managing all of those screen shots and scanning statements , doctors letters, personal attestations etc is time consuming and complex when managing documents such as this most important one.

9. PIC4007 Information Regarding non-migrating family members.

This document detailed my stepson (the applicants son). In this document we detailed his living arrangements and future (he about to turn 18 and going to college) we spent time discussing the ongoing family support he would have in the USA as well as the ongoing support we would provide to him from Australia. Because he wants to stay in the USA, has a job and is enrolled in college (plus a place to stay at his Dads) this was a fairly easy document. None the less we probably spent 6-8 hours writing and re-writing it.


We invested over 120 hours of time in the PIC4007 preparation

We created over 100 pages of documentation

We wrote and re-wrote the whole thing at least 5 times (I takes about an hour just to read it all)

We guessed this might be a requirement so we had already prepared 70% of the documentation prior to receiving the RFI – which only gives your 28 days to respond.

Physical preparation of the PIC4007 document is a technical challenge and you need Adobe (we had to subscribe).

Preparing the supporting external documents is a challenge to keep them under 5MB each.

Being prepared is critical so you are not chasing around doctors letters, or paystubs or tax returns or even investigating alternative treatments and costs at the last minute.

Note: We did not question the MOT medical cost estimate rather we showed how :

A/ We could offset the cost (what we could bring to Australia financial).

B/ We offered alternate medical treatment options (which the applicant is now on and we updated subsequently to this RFI) that are cheaper.

C/ We demonstrated the cost (emotional and otherwise) of the waiver not being granted. (Compassionate reasoning).

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