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Thanks for tuning in, my name is Miatrai Brown, and I am a U.S. immigration attorney based in Washington DC. I am also the Principal Attorney at Direct U.S. Immigration where we work with clients in all 50 states and around the world. Before we start, click the like and subscribe button to follow our immigration hub to get the latest immigration information that could be vital to your case. And also, be sure to stick around until the end to get a bonus tip on preventing or challenging a health-related denial.
As you may know, an immigration medical exam is necessary for immigrating to the United States and becoming a permanent resident (green card holder). The medical exam is a routine part of the process to ensure public safety and remove the grounds for inadmissibility for intending immigrants.
Certain diseases of public health can make an individual inadmissible to the United States. That means it could prevent the applicant from getting a green card. The exam is the process of removing these grounds of inadmissibility. We at Direct U.S. Immigration can help you prepare the entire adjustment of status application, but you’ll need to attend the exam on your own. Therefore, knowing what to expect and how to prepare for your medical examination is important.
Purpose of an Immigration Medical Exam
The medical grounds of inadmissibility, the medical examination of foreign nationals, and the vaccinations administered to foreign nationals are designed to protect the health of the United States population. The immigration medical examination, the resulting medical examination report, and the vaccination record provide the information that USCIS uses to determine if a foreign national meets the health-related standards for admissibility.
Any of these four basic medical conditions may make an applicant inadmissible on health-related grounds:
- Communicable disease of public health significance
- An immigrant’s failure to show proof of required vaccinations
- Physical or mental disorder with associated harmful behavior
- Drug abuse or addiction
The immigration medical examination is not a complete physical examination. Its purpose is to screen for specific medical conditions relevant to U.S. immigration law. The U.S. government doesn’t require the doctor to evaluate you for any conditions except those the U.S. Public Health Service specifies for U.S. immigration purposes. Likewise, the government doesn’t need the doctor to provide you with a diagnosis or treatment even if they discover other issues related to your health. This examination is not a substitute for a full physical examination, consultation, diagnosis, or treatment by your primary healthcare provider.
Selecting a Doctor for your Exam
You won’t be able to go to any doctor for your immigration medical exam. A government-approved doctor must perform the examination. Outside the United States, the U.S. embassy or consulate will refer you to an authorized “panel physician.” Applicants applying inside the United States will go to a “civil surgeon.” In both situations, they are doctors authorized to administer your exam.
Suppose you apply for an immigrant visa through a U.S. embassy or consulate (known as consular processing). In that case, they will provide a list of panel physicians certified by the Department of State. In most cases, you’ll have a choice of physicians. But it’s always best to check with the procedure at your local consulate. You may need your appointment notification before the panel physician will see you.
When to Schedule an Immigrant Medical Exam
The National Visa Center will tell consular applicants when it’s time to schedule the appointment. You must complete the medical exam and vaccinations before your scheduled immigrant visa interview date.
When applying inside the U.S., the exam results must be signed by the doctor no more than 60 days before you submit Form I-485. The results are valid for two years from the signature date.
What to Take to your Medical Exam
In preparation for the medical examination, you will need to take several items. This list will vary based on the location of your exam. If you are attending an exam outside the United States, the U.S. embassy will give you specific guidance for your country. However, you will generally need to take the following items to an immigration medical exam:
- Valid passport or other government-issued photo identification.
- Vaccination records.
- Form I-693, Report of Medical Examination and Vaccination Record (if adjusting status).
- The required fee (varies by the doctor).
- If applying abroad, required number of U.S. passport photos (check with the consular office).
- If anyone in your family is immigrating with learning disabilities, report the condition and any special education or supervision requirements.
- If you are being treated for a chronic medical condition or taking medications regularly, a list of medications.
- If you’ve had a previous positive skin test for tuberculosis, the tuberculosis certificate from your doctor proving that you were adequately treated.
- If you have had Syphilis, a certificate of clearance signed by a doctor or public health official proving that you were adequately treated.
- If you have a history of harmful or violent behavior resulting in injury to people or animals, information that will allow the doctor to determine whether the behavior was related to a psychiatric or medical problem or to drug or alcohol use.
- If you have been treated or hospitalized for psychiatric or mental illness or alcohol or drug abuse, written certification including the diagnosis, length of treatment, and your prognosis.
The doctor will make sure that you have had all the required vaccinations. The Immigration and Nationality Act expressly requires some vaccines, and others are required because the Centers for Disease Control and Prevention (CDC) have determined they are in the interest of public health. Regardless, you must receive the following vaccinations before being admitted as a permanent resident, though exceptions do apply for certain vaccinations such as the COVID-19 vaccine:
- Mumps, measles, rubella
- Tetanus and diphtheria toxoids
- Haemophiles influenza type B
- Hepatitis B
- Pneumococcal pneumonia
- Hepatitis A
If you already have some or all vaccinations, take your vaccination reports to the doctor. The report will need a certified translation if it is not in English. If you need additional vaccinations, the doctor will administer them. Depending on the type of vaccination, an additional visit may be required. Upon the physician’s recommendation, he or she may provide certain requests of waivers of the vaccination requirement.
Effective October 1, 2021, most new green card applicants must be fully vaccinated. If not vaccinated, the U.S. government will consider them inadmissible to the United States. This applies to:
- Adjustment of status applicants inside the U.S.
- Consular processing applicants outside the U.S.
Immigration officials may require people to get revaccinated with an FDA-authorized vaccine if they initially received a COVID-19 vaccine not currently authorized in the U.S.
How to Prove Vaccination Status
At the immigration medical exam, green card applicants must show the doctor evidence that they are fully vaccinated against COVID-19. Acceptable forms of proof include:
- Official vaccination record
- Copy of a medical chart
The record should include the dates the applicant received the vaccine and, if available, the name or manufacturer and lot number.
Certain applicants may be entitled to a waiver for the COVID-19 vaccination requirement. Waivers may be provided for the following:
- Contraindication (negative reaction to the vaccine)
- Vaccines not routinely available
- Religious or moral convictions
The doctor or a member of the doctor’s staff will ask questions about your medical history. Of particular interest to the doctor is any time you have ever:
- Stayed at a hospital or experienced significant events in your health history;
- Been put in an institution for a chronic physical or mental condition; or
- Been sick or disabled so seriously that it resulted in a “substantial departure from a normal state of well-being or level of functioning.”
The doctor will also ask specific questions about habitual drug use. Applicants who are found to be drug abusers or addicts are inadmissible. Recovering drug addicts who are in remission, however, are admissible. If you have a history of drug abuse, even if it’s not in your medical records, consult with an immigration attorney before attending the green card medical exam.
The doctor will then give you a physical examination. Typically, the physical exam includes examining your eyes, ears, nose and throat, extremities, heart, lungs, abdomen, lymph nodes, skin, and external genitalia.
The doctor will also order a chest X-ray and blood test to check for syphilis. Children will generally be excused from the X-ray and blood test requirements. If you are pregnant, contact your respective embassy or consular office to inquire about a postponement.
The doctor will perform a mental status exam assessing your intelligence, thought, comprehension, judgment, mood, and behavior. Applicants with physical or mental disorders and harmful behavior associated with those disorders are inadmissible. The inadmissibility ground is divided into two subcategories:
- Current physical or mental disorders with associated harmful behavior.
- Past physical or mental disorders with associated harmful behavior that is likely to recur or lead to other harmful behavior.
Cost of Immigration Medical Exam
Costs for immigration medical exams can vary significantly based on the country where they will be performed and the specific doctor. Prices can vary from $100 to over $400.
The U.S. government doesn’t set a standard fee so the cost will depend on the doctor you visit. Therefore, check with a few doctors to find out how much each one charges for the immigration medical exam. You should also consider the indirect costs of the exam, as you may need to travel to the interview city early for the medical exam.
What happens after completing the examination depends on your location. In some countries, the panel physician will send the results directly to the U.S. embassy. In other countries, the doctor will give the applicant his/her medical exam results in a sealed envelope which the applicant must take to the interview.
If your immigration medical exam is inside the United States, the civil surgeon will give you a completed Form I-693, Report of Medical Examination and Vaccination Record, in a sealed envelope. Do not open the envelope under any circumstance. Submit the medical exam along with Form I-485, Application to Adjust Status. If you have already filed your adjustment of status application, submit the envelope at the USCIS green card interview or upon USCIS requesting it through a Request for Evidence (RFE). The results of your immigration medical exam are generally valid for two years.
As promised, here’s some bonus information that you may not know about:
A relative seeking a green card generally would not be denied on medical grounds if they:
- Have a cold at the time of the medical exam.
- Have a chronic but well-managed disease, such as diabetes or heart disease.
- Are HIV-positive.
- Previously had one of the communicable diseases listed above (and have since been cured).
If, however, a relative seeking a green card has a previously tested positive for a health-related condition that could lead to the denial of their application, it’s important to show USCIS or the State Department that you have been successfully treated. Typically, the best way to do so is to bring copies of your medical records showing the treatment you received and the results of that treatment, as well as a statement from your regular doctor confirming that your disease is either cured or being managed.
Drug Abuse or Mental Illness History
It’s important to bring proof to the medical exam that your drug addiction has been treated or that your mental health is controlled.
Any Other Potentially Serious Disease
It is good practice to get a letter from your regular doctor explaining how your disease is controlled and how your life is affected — including how your illness impacts your ability to work, if at all.
Green Card Application Denial for Health-Related Reasons
Depending on the situation, you can apply for a “waiver of inadmissibility” (basically, “forgiveness” from the U.S. government to enter the United States).
USCIS will generally consult with the CDC to determine if a waiver should be granted. USCIS can also attach conditions to the waiver grant as they see fit.
I hope you found this video helpful. Subscribe if this content or information helps you in any way, comment below if you want me to talk about something in specific, and share this resource because you never know who needs answers to these questions. Additionally, if you have any specific questions about this video as they pertain to your unique circumstances, please schedule a consultation with us at the link below. I’ll see you in the next video.
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