By Nikita St. Amour
Filing for US immigration can be a complex process. There are many moving parts to an immigration application, and one of those parts may seem unexpected: the medical exam. The information below addresses many FAQs we've received about the immigration medical exam process and requirements.
History of medical exams
The medical exam is a formal step of the process to ensure a foreign national doesn't have health conditions that make them ineligible for US immigration benefits. In the late 1800s and early 1900s when Ellis Island was still an active port of entry for immigrants, tuberculosis (then known as consumption) was highly contagious and running rampant. Back then, Ellis Island doctors were tasked with watching for signs of contagious diseases such as tuberculosis, and other states of poor health. Foreign nationals with questionable health were then pulled aside and underwent further examination. While Ellis Island doctors did not have a deciding role in determining if a foreign national was fit to enter the country, that soon changed with the implementation of the Immigration Act of 1882. [source]
According to USCIS:
The Immigration Act of 1882 first granted the Secretary of the Treasury the authority to examine noncitizens arriving in the United States to prohibit the entry of any “person unable to take care of himself or herself without becoming a public charge.” The Act provided that the examination be delegated to state commissions, boards, or officers.
The term “civil surgeon” was first introduced in the Immigration Act of 1891 as an alternative to surgeons of the Marine Hospital Service if such surgeons were not available to perform the medical examination on arriving noncitizens. [source]
Regulatory requirement for medical exams
Medical eligibility is required per INA Sections 212(a) and 221(d). [source.] These statutes explain that, in general, any foreign national who has a "communicable disease of public health significance", has had or currently has any mental or behavioral disorders that may pose a threat to the safety and health to the alien or others, or is a drug abuser or addict, may be inadmissible, meaning they’re ineligible to to successfully immigrate to the US a receive a green card. [source]
According to the CDC, communicable diseases of public health significance include:
Also included are any quarantinable diseases such as measles and cholera; and any diseases reported as public health emergencies, like the COVID-19 outbreak was considered in 2020. You can see a full list of current diseases and outbreaks that fall into this category on the CDC's website here under the heading "What are the communicable diseases of public health significance that would cause an applicant to fail a medical examination or be inadmissible?"
What if I fail the immigration medical exam?
The US government further divides certain medical conditions into categories based on severity. The above-mentioned diseases, including findings of drug abuse or mental or physical disorders that pose a threat to the safety of yourself or others, are considered Class A conditions, and these automatically render you ineligible to immigrate to the US. Class B conditions are "defined as physical or mental health conditions, diseases, or disabilities serious in degree or permanent in nature." [source] While a Class B condition doesn't automatically make an applicant ineligible for immigration, it is considered a departure from normal health and may be significant enough to interfere with daily life, an person's ability to care for themselves, or require extensive treatment. If you are found to have a Class A or B condition, or any other condition that may complicate your application for US immigration, you may need to apply for a waiver and submit additional evidence that the condition no longer applies or is well controlled.
Who needs to obtain a medical exam?
All immigrants, including those adjusting status from within the US and those applying for an immigrant visa abroad at a US consulate, refugees, and certain nonimmigrants like fiancés, are required to have the medical exam with a designated panel physician. [source and source] Most other nonimmigrants, or those visiting the US for a short vacation are not required to undergo a medical exam.
Where do I get a medical exam?
If you're applying for permanent residence from within the US (i.e. adjusting status), then you can follow this link here to find a designated civil surgeon near you. The exam must be done by a doctor who is authorized by USCIS. Military physicians are also authorized to perform immigration medical exams at a military treatment facility within the US for veterans, current members of the U.S. military and their dependents.
If applying for an immigrant visa at a US embassy abroad, you'll need to carefully check the consulate's website for their designated doctors that are authorized by the Department of State and meticulously read any instructions provided to you from the consulate in order to prepare for your interview. You can also find your consulate from this list to view their interview preparation instructions, including where to obtain your medical exam.
When do I get a medical exam?
Timing is a critical factor to note when obtaining your medical exam. If applying at a US embassy abroad, you should not obtain your medical exam until you've received your interview appointment and explicit instructions from the consulate giving you the green light. However, you can complete the necessary vaccinations ahead of time.
If applying for immigration benefits within the US, you may obtain and submit your medical exam with the filing or later on in the process at the interview stage. It used to be that USCIS would accept the medical exam only if it was done within 60 days before filing (or any time after filing). At the end of 2021, USCIS changed that policy and it no longer has to have been done within 60 days before filing. However, that policy, as of right now, is only in effect until September 30, 2022 (it’s possible it will be extended). There is no delay or other negative effect if you choose to submit your medical exam with the pre-filing or post-filing. Please note that this information is accurate as of the date of this blog post, but it may change in the future.
In summary, the medical exam is just another formal step of the kaleidoscopic US immigration process to ensure you don't have any health conditions, physical or mental disorders with associated harmful behavior, or drug abuse that may render you ineligible for immigrating to the US. While the implementation of medical exams in the immigration process developed in response to the severe tuberculosis and other disease outbreaks in the late 1800s, the medical exam still plays a critical role in ensuring the health and safety of those who currently live in the US and want to live in the US.
As always, the above information is for educational purposes only and is not legal advice. Please speak with a qualified immigration lawyer before taking action. If you need help navigating the immigration process with confidence, please contact us today to get the process underway! We are immigration lawyers in Richmond, VA but we serve clients throughout the US and around the world. You can call us at 804-396-3412 or send us an email at firstname.lastname@example.org. We look forward to hearing from you!