When an applicant has a health condition which is a public health concerns to the
United States, he/she may not get immigration benefit on Medical Grounds of Inadmissibility.
The medical grounds of inadmissibility under U.S. immigration laws are divided into
four categories:
(a) Communicable diseases of public health significance;
(b) Lack of required vaccinations;
(c) Physical or mental disorders with harmful behavior; and
(d) Drug abuse or addiction.
The Civil surgeon is required to perform a general
physical examination and specific evaluations, as described below.
Communicable Diseases of Public Health Significance.
The Civil surgeon is required to perform specific
tests for TB, syphilis. The medical exam also indicates an evaluation for other
sexually transmitted diseases and Hansen's Disease (leprosy).
Tuberculosis (TB)
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All applicants two years of age and older are required to be tested for tuberculosis
(TB) with an initial screening test. Civil Surgeons may require an applicant younger
than two years of age to undergo testing if there is evidence of contact with a
person known to have TB or other reasons to suspect TB.
The physician may use either the Tuberculin Skin Test (TST) or an Interferon Gamma
Release Assay (IGRA).
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Tuberculin Skin Test (TST) given by the Mantoux technique. After the skin test,
you will need to return to the Civil surgeon within
48 to 72 hours to have the result read. If you have a reaction of four millimeters
or less, generally, you will not need any further tests for TB. A chest x-ray is
required when the reaction to the TST is five millimeters or more. The Civil surgeon will explain the medical requirements to you in more detail.
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IGRA: IGRAs are blood tests that are options to the TST (see update to the Technical
Instructions at CDC Website)
You will not have to return to the Civil surgeon's
office for the result to be read. The result is generally available within 24 hours.
If the test is negative or indeterminate/borderline/equivocal, you generally will
not need any further tests for TB. Depending on the result of the test, further
evaluation with a chest x ray may be required.
Tests not listed in the materials published on this link may not be
used for purposes of this immigration medical examination.
The Civil surgeon will explain the medical
requirements and the suitability and availability of IGRA testing to you in more
detail.
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Syphilis
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All applicants 15 years of age and older must have a blood test for syphilis. Civil
Surgeons may require applicants under 15 years of age to be tested if there is reason
to suspect the possibility of infection.
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If you are found to have a communicable disease of public health significance, the
Civil surgeon will advise you how to obtain any necessary
treatment. It also may be necessary for you to apply for a waiver of inadmissibility.
USCIS will advise you if this is necessary. To obtain more information about this
waiver, visit the
USCIS Web site.
Vaccination Requirements
All applicants for adjustment of status must present documents showing they have
been vaccinated against a broad range of vaccine-preventable diseases. The Civil
Surgeon will review your vaccination history with you to determine whether you have
all the required vaccinations. Make sure you take your vaccination records with
you to your appointment with the Civil surgeon.
NOTE:
Do not attempt to meet the requirements before you are evaluated by the Civil surgeon, in case it is not medically appropriate for you to have one
or more of the required vaccines.
By law, the required vaccines for the immigration population are the vaccines as
recommended by the ACIP for the immigrant population. You may obtain a list of the
required vaccines from CDC's Web site at
CDC Website)
If you never received or are unable to prove you received certain vaccines, the
Civil surgeon can administer them to you. After evaluation
by the Civil surgeon, you also have the option of
asking your family doctor to administer those vaccines to you and showing the records
to the Civil surgeon to note on Form I-693.
If you initially did not have documents proving you received all the required vaccines
but later submit those documents, or if the Civil surgeon
certifies that it is not medically appropriate for you to have one or more of the
missing vaccine(s), USCIS may grant you a waiver based on the Civil surgeon's certification on the vaccination supplement.
HHS has determined that a vaccine is "not medically appropriate" if :
(a) The vaccine is not recommended for your specific age group;
(b) There is a medical reason why it would not be safe to have the vaccine (for
example, allergies to eggs and yeast, hypersensitive to prior vaccines, other medical
reasons);
(c) You are unable to complete the entire series of a required vaccine within a
reasonable amount of time; or
(d) For the influenza vaccine, it is not the flu season.
If you object to receiving the recommended vaccinations because of your sincerely
held religious beliefs or moral convictions, you may apply for a waiver of these
requirements. If you hold these objections, inform the
Civil
surgeon
that you will apply for a waiver. If the waiver application is denied,
you may be ineligible for the immigration benefit that you are seeking. To obtain
more information about these waivers, visit the
USCIS Web site
.
Physical or Mental Disorders
Are all physical or mental disorders considered health-related grounds of
inadmissibility?
No. The emphasis is more on the behavior associated with the physical or mental
disorder, instead of the physical or mental disorder itself. This means that the
Civil surgeon must determine that there is behavior
associated with the disorder that is harmful either to you, to others, or to property.
If you have had a history of a physical or a mental disorder, there must be associated
harmful behavior that is likely to recur in order for you to be considered inadmissible.
The Civil surgeon will ask you general questions
during the medical exam to determine whether you have such a condition. Depending
on the outcome of the initial exam, the Civil surgeon
may find it necessary to refer you to a specialist for further testing.
If the Civil surgeon finds that you have a physical
or mental disorder with associated harmful behavior, you may apply for a waiver
according to the terms, conditions, and controls determined necessary by USCIS in
consultation with HHS. To obtain more information about these waivers, visit the
USCIS Web site.
Drug Addiction/Drug Abuse
What are the guidelines for determining whether someone is a drug abuser/drug
addict?
The Civil surgeon will review your medical history
during the medical exam and ask you questions necessary to determine whether you
are currently using or have used in the past any drugs or other psychoactive substances.
The medical guidelines for determining drug abuse and drug addiction are determined
by HHS.
If the Civil surgeon determines you have a medical
condition of drug addiction/abuse, you are
noteligible to apply for a waiver
unlessyou are applying for adjustment of status one year after you were admitted
as a refugee, or you are applying for adjustment of status one year after you were
granted asylum. If you are ineligible to apply for a waiver, but are later found
by the Civil surgeon to be in remission from the
drug abuse or drug addiction (as determined by HHS), you may proceed with your adjustment-of-status
application, if eligible.