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Medical Exam's by the USCIS: Everything you wanted to know

Note: Canadian USCIS civil surgeons are now requiring pictures in order to have the medical exam, and others may also require these. It would be wise to have pictures ready when you go to your medical exam. Canadian doctors are requiring passport-style pictures, however this may not be a uniform requirement for all consulates. Check with the facility/doctor where you will have your medical exam to confirm whether they will require pictures and if so, what type (adit or passport).

Here is a helpful URL regarding the medical exam.

One vital thing that you need to understand is this: IF there are any irregularities regarding your
medical exam, it is the CONSULATE (or the USCIS if you are filing adjustment while inside the U.S.) who
has the final say on whether this allows you to get the visa. The consulate or USCIS may consult the
doctor for answers to questions they may have, and while the doctor can make recommendations, the
USCIS or consulate makes the final decision.

You can also read the 9FAM consular directives regarding medical examinations.

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I have seen many questions from anxious foreign fiances and spouses about the medical exam that they must
take prior to the interview. Frankly, it is rare to have someone flunk this exam. The primary problem that the
doctor is checking for would be infectious diseases that are a public health threat, the most notable of
these being HIV/AIDS and active TB, however there are other factors involved that you need to read about.
One other factor to consider is whether the fiance or spouse or child of the alien relative has a disease or
disorder which could lead to debilitation and inability to wok. Another factor would be whether the
immigrant was a danger to himself or others (such as mental illness in which psychosis was involved and
was not controlled).

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Many people want to know whether they will have any trouble passing this exam if they have a chronic
medical problem of asthma, depression, diabetes, heart trouble, high blood pressure and other similar
problems. Generally the answer is that you will have no problems. As an example, one fiance had high blood
pressure...on the day of his exam, his blood pressure was around 160/120, and he passed the exam. The only
word he received from the doctor was "in the US you will get better treatment because they have better
medicines there." However the examining doctor did require the fiance to have a letter from his doctor attesting
to the fact that his hypertension was under treatment and was causing him no problems--it is a good idea to go
ahead and get a letter of this type prior to your medical exam, just to be on the safe side, if you have a
questionable health condition that may need clarification.)

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Concerning depression: having depression does not mean that you flunk this test...there are many people who
have this medical problem who have passed the medical exam. A primary concern would be whether the
disease was being treated successfully and the person was FUNCTIONAL...that is, stable and able to work.
Another consideration regarding mental disorders would be whether the person was having problems currently
with psychoses, as these would be disabling and possibly require institutionalization, or might be a threat to
himself or others. If there was no psychosis, then you would have a good chance of passing the exam. Mental
and mood disorders do not automatically mean you flunk the exam. Again, physician documentation regarding
the problem, it's treatment, and the success of that treatment could be very important.

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If you have a chronic medical problem which causes you concern regarding your ability to pass the exam,
you should obtain copies of your medical records and bring these to your exam. Also, obtain a letter signed by
your doctor, attesting to the stability of your problem, and that you were being successfully treated. If you have
a history of drug abuse, you need to obtain a letter which states for what period of time you have been
drug-free, and you *might* want to even obtain a drug test and bring the results with you to the exam. These
are just suggestions you may want to consider in building your case for having a medical problem which will not
cause you problems when you immigrate.

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When you read the documents below, you will note that another one of the primary considerations the
doctor must make is whether the person has a problem that might cause him/her to be debilitated and
institutionalized, unable to work, a threat to others, and being so debilitated that someone would have
to provide care for the immigrant fiance. Thus even chronic diseases would not automatically fall into this
category. One thing that might be a deciding factor would be the stability of a disorder, if it fell into a
questionable type of disease....read on below...

Let's consider some of the more serious diseases such as multiple sclerosis, for an example. Some types of
multiple sclerosis cause rapid deterioration, and fall into the category of a rapidly deteriorating problem where
the person will not be able to function independently for very long. A person in this category might be rejected
on the medical examination. But consider another person with this disease who is doing well and has been
stable for, say, five years. This person would very possibly pass the exam, based on the stability of the disease.
It would all fall back to the documentation provided by the treating physician, I think...

On the other hand, someone with amyotropic lateral sclerosis (known as ALS or Lou Gehrig's disease) would
most definitely flunk the medical exam, simply because this disease is characteristically always a deteriorating
disease with a debilitating and finally fatal outcome. Multiple sclerosis, on the other hand, is not always fatal,
and can even go into total remission. So there are times when there may be a fine line regarding who passes
and does not pass the medical in these types of situations. Arming yourself with as much medical information
as you can from your past medical file, and a letter from your doctor, even blood testing if appropriate, may be
the factors which enable you to pass the medical exam instead of failing it....I cannot overemphasize this point!

Here is another example: a fiance was denied recently due to his having a cancerous mole. The consulate
would not issue the visa until the mole was removed and he had a clean bill of health. One plausible reason is
that cancerous moles can be associated with melanoma, which is a disease that can cause debilitation.

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However, for you worry-warts who need "mental satisfaction" about the exact criteria used by the examining
doctor for the medical exam, I am giving you links here to the CDC recommendations to doctors who perform
the medical exam on aliens outside the United States.

One thing I would note: if you read these instructions carefully, you will see that it does give the
examining physician some leeway regarding exactly what he tests for...for instance, IF he so chooses,
he can test for drugs in the blood test, especially if the person has a history of drug abuse recently.

These are the Technical Instructions for Medical Examination of Aliens (June 1991, with changes of July
1992 and addendum of April 1997 for Vaccination Requirements for Immigrant Visa applicants with
changes of March 1998) used by the Panel Physicians in the medical examinations conducted outside
the United States. (Files are in Adobe Acrobat format. )

View the Technical Instructions for Panel Physicians

Addendum (Both parts are needed):
Part 1
Part 2

Read the actual I-693 medical form that USCIS civil surgeon uses for recording data about the medical exam, this
is a PDF document.

If you have HIV/AIDS, see this URL

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Time is now: 20th November 2009 - 11:03 PM

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