Medical Requirements for U.S. Citizenship: Everything You Need to Know

1. Introduction

The United States Citizenship process is a complex journey with multiple steps that require time, dedication, and attention to detail. It involves providing documentation, taking tests to prove your knowledge of the United States, and demonstrating good moral character. One vital aspect of this journey is fulfilling medical requirements, which ensure the safety and well-being of both the applicant and the broader United States public.

In this article, we will take an in-depth look at the medical requirements for U.S. Citizenship, focusing on the importance of these guidelines and the medical examination process. By understanding these critical elements, applicants can be better prepared to meet all necessary criteria and successfully complete the naturalization process.

2. Medical Examination

Purpose of the Medical Examination

The primary goal of the medical examination is to *identify applicants with specific health-related issues that might impact their eligibility for citizenship. By addressing these concerns, the United States Citizenship and Immigration Services (USCIS) can ensure both the applicant’s well-being and the protection of the public. The medical examination helps USCIS identify and screen for infectious diseases, mental health issues, and other serious medical conditions.

Quoting the explicit instructions given by USCIS, the medical examination’s purpose is:

“…to determine whether you have any health conditions that need attention before you become a permanent resident.” Source

Authorized Civil Surgeons

U.S. Citizenship and Immigration Services (USCIS) only accepts medical examinations conducted by authorized civil surgeons. They are licensed medical professionals who have received special certification from USCIS to conduct these examinations. It is crucial to have your medical examination performed by an authorized civil surgeon, as examinations conducted by other doctors will not be accepted.

To find an authorized civil surgeon in your area, use the USCIS online locator tool or contact your local USCIS field office. By selecting a doctor from this list, applicants can be confident that their medical examination will meet the necessary standards for the naturalization process.

3. Form I-693, Report of Medical Examination and Vaccination Record

Purpose of Form I-693

Form I-693, Report of Medical Examination and Vaccination Record, serves as the official record of an applicant’s medical examination and vaccination history required for U.S Citizenship. The primary goal of this form is to ensure that applicants meet all the necessary health-related criteria for eligibility. Specifically, this form helps U.S. Citizenship and Immigration Services (USCIS) verify that the applicant doesn’t pose a public health risk and has received all required vaccinations.

USCIS defines the purpose of Form I-693 as follows:

“…to report results of a medical examination to USCIS to determine whether an applicant for an immigration benefit in the United States is inadmissible under the health-related grounds of inadmissibility.” Source

Completing and Submitting Form I-693

It is essential that the applicant and the authorized civil surgeon follow the proper steps when completing and submitting Form I-693 to avoid any delays or issues in the naturalization process. After receiving a medical examination from an authorized civil surgeon, the civil surgeon will complete, sign, and seal Form I-693 in an envelope, which the applicant must then submit to USCIS.

To ensure accuracy and prevent potential problems, applicants should:

Read the Form I-693 Instructions carefully.
Fill out Part 1 of Form I-693 before the medical examination.
Provide valid government-issued identification during the medical examination.
Submit the sealed envelope containing the completed Form I-693 to USCIS as instructed on the form.

It is important to note that Form I-693 is valid for two years from the date of the civil surgeon’s signature. Applicants should submit the form to USCIS within 60 days of the civil surgeon’s signature to avoid potential expiration.

Required Documentation

When attending the medical examination appointment, applicants must provide the following documentation to the authorized civil surgeon:

A valid government-issued identification (such as a passport or driver’s license)
A copy of any prior medical examinations or health records, especially those related to vaccination history
Payment for the medical examination (fees vary depending on the civil surgeon)

By providing these documents and ensuring that all necessary information is accurate, applicants can streamline the medical examination process and improve their chances of meeting the medical requirements for U.S. Citizenship.

4. Medical Requirements

The medical examination for U.S. citizenship encompasses various tests and evaluations to assess the health of applicants. It includes a physical examination, mental health evaluation, infectious disease screening, and vaccination requirements. Each component is designed to ensure that applicants meet medical eligibility criteria and do not pose a risk to public health.

Physical Examination

A thorough physical examination is conducted to identify any significant medical conditions that might affect the applicant’s eligibility. This examination includes taking vital signs (blood pressure, pulse, and temperature), assessing general appearance, checking vision and hearing, and evaluating other body systems such as the heart, lungs, abdomen, nervous system, and musculoskeletal system. The civil surgeon will document the findings on Form I-693.

Mental Health Evaluation

As part of the overall medical assessment, the civil surgeon also conducts a mental health evaluation to identify any psychiatric or psychological issues that might affect the applicant’s ability to meet good moral character requirements. This evaluation includes screening for substance abuse disorders and any history of psychiatric illness or treatment.

Infectious Disease Screening

A critical component of the medical examination is the infectious disease screening. Applicants must undergo tests for several infectious diseases, as outlined below, to ensure that they do not pose a risk to public health:

Tuberculosis (TB): Screening for TB includes a skin test (or blood test for those unable to have a skin test) and a chest X-ray if the skin test result is positive or if there are other clinical indications of potential TB infection.
Syphilis: All applicants aged 15 years and older must have a blood test for syphilis.
Gonorrhea: Applicants aged 15 years and older must be tested for gonorrhea.

Vaccination Requirements

To meet the U.S. citizenship medical requirements, applicants must also show proof of having received the following vaccinations, as mandated by the Centers for Disease Control and Prevention (CDC):

Measles, Mumps, Rubella (MMR)
Polio
Tetanus and Diphtheria Toxoids
Pertussis
Haemophilus influenzae type B
Hepatitis A
Hepatitis B
Rotavirus
Meningococcal
Varicella
Pneumococcal
Seasonal Influenza

The civil surgeon will review the applicant’s vaccination history and administer any missing vaccinations during the medical examination. All vaccination information will be documented on Form I-693. For information on the specific vaccine requirements and age groups, please refer to the CDC’s vaccination requirements.

5. Waivers for Medical Conditions

Overview of Waivers

In some cases, applicants for U.S. citizenship may be eligible for waivers to bypass certain medical requirements that would otherwise render them inadmissible for naturalization. Waivers are granted at the discretion of immigration officials, and applicants must demonstrate that they are warranted due to the specific circumstances of their individual cases.

A waiver may be granted for a Class A medical condition (which renders an applicant inadmissible) if the applicant can demonstrate that they would face extreme hardship if not admitted to the U.S., or if their U.S. citizen or lawful permanent resident family member would face extreme hardship. On the other hand, a Class B medical condition (which doesn’t, by itself, render an applicant inadmissible) may still require a waiver if it is a significant deviation from the vaccination requirements.

Process for Applying for a Waiver

To apply for a waiver, applicants must submit Form I-601, Application for Waiver of Grounds of Inadmissibility, along with the required evidence to demonstrate their eligibility for the waiver. This form can be found on the USCIS website.

Qualifying Medical Conditions

Medical conditions that may qualify for a waiver include, but are not limited to, the following:

Certain communicable diseases
Physical or mental disorders with associated harmful behavior
Drug abuse or addiction
Lack of required vaccinations (under specific circumstances)

It is important to note that not all medical conditions qualify for a waiver, and applicants should consult with an immigration attorney or other expert to determine their eligibility.

Documentation and Evidence Needed for Waivers

Applicants seeking a waiver must provide sufficient documentation and evidence to support their claim. This may include:

Medical records
Proof of rehabilitation (if applicable)
Testimonials from medical professionals
Statements from family members detailing the impact of the medical condition on their lives
Evidence of extreme hardship to the applicant or their U.S. citizen or lawful permanent resident family members

6. Special Considerations for Refugees and Asylees

Overview of Refugee and Asylee Medical Requirements

Refugees and asylees are subject to a slightly different set of medical requirements compared to other applicants for U.S. citizenship. While they still need to undergo a medical examination, there are some differences in the scope of the examination and certain modified vaccination requirements.

Applicable Waivers and Modifications

Special considerations for refugees and asylees include:

Vaccination Requirements: Refugees and asylees are not required to be fully vaccinated at the time of their initial medical examination. However, they must receive any missing vaccinations within a reasonable time frame after their arrival in the United States. Additionally, some refugees and asylees may qualify for exceptions to the standard vaccination requirements if they can demonstrate a history of persecution related to these vaccinations.
Waivers: Refugees and asylees may be eligible for waivers if they can demonstrate that their medical conditions are not a public health risk and will not create undue burden on U.S. healthcare resources. This may apply to certain communicable diseases or mental health disorders. Furthermore, refugees and asylees with Class B medical conditions may also qualify for a waiver for the vaccination requirement if the condition is a significant deviation from the standard requirements.

When seeking a waiver or exemption to the standard medical requirements for U.S. citizenship, refugees and asylees should consult with an immigration attorney or other expert to ensure they meet the necessary criteria and properly complete the application process.

7. U.S. Citizenship and Immigration Services (USCIS) Decision-making Process

Review of Medical Examination Results and Vaccination Records

Once the applicant submits their completed Form I-693, Report of Medical Examination and Vaccination Record, the U.S. Citizenship and Immigration Services (USCIS) will thoroughly review all the provided documentation. This review process involves assessing the medical examination results, vaccination history, and any additional records submitted to ensure that the applicant meets the necessary medical requirements for U.S. citizenship.

Possible Outcomes and Next Steps

Upon reviewing the medical examination results and vaccination records, USCIS may arrive at one of the following outcomes:

Approval: If the applicant meets all medical requirements, their application will proceed to the next step in the naturalization process.
Request for Further Evidence (RFE): If USCIS determines that additional documentation or clarification is needed, they may issue a Request for Further Evidence (RFE) to the applicant. Applicants must then provide the requested information within the given timeframe to avoid delays in the naturalization process.
Medical Inadmissibility: If the applicant does not meet the medical requirements and is determined inadmissible on health-related grounds, their application may be denied, or they may be granted a waiver if they qualify (see section 5: Waivers for Medical Conditions).

8. Conclusion

Importance of meeting medical requirements for U.S. citizenship

Meeting the medical requirements for U.S. citizenship plays a crucial role in the naturalization process. Applicants who successfully fulfill these conditions demonstrate their commitment to public health and safety, which is essential for both the individual and the broader United States community. As such, understanding and preparation are vital to ensure the best possible outcome when applying for U.S. citizenship.

Resources for Applicants and Additional Information

For more information about medical requirements, waivers, and related processes, applicants can consult the following resources:

By utilizing these resources, applicants can educate themselves on the medical requirements for U.S. citizenship, positioning themselves for success in the naturalization process.

U.S. citizenship Medical Examination