IR1 immigrant visa received with annotation: Class B req ATTN of USPHS at POE - not TB-related

[MexicoExpat 18]

My wife received her immigrant visa and sealed yellow packet today, after what has been a very long process for us. 
 

She has 2 annotations on here immigrant visa. First is a 221 (g)(2)(B) which I understand is a waiver for not needing a vaccine, which seems strange as her doctor during the medical never mentioned not needing a specific vaccine, but this isn't really the part we are worried about. 
 

It's the class B we are worried about. I've been reading up on it but most results I find are related to tuberculosis, but they all have a "TB" included along with the class, which our annotation doesn't. Nothing unusual was discovered during her medical for TB either.
 

during her first medical exam (before covid) she admitted to past but seldom marijuana use and did not receive a sealed packet from the clinic when she was done. Our interview ended up being cancelled due to COVID, and we just recently re-took the medical and had our visa interview. She did receive the sealed medical packet during her second medical exam, and the interviewing officer did not inquire about her marijuana use. 
 

I'm thinking the class B is almost certainly related to the marijuana use and have read that class B indicates full remission. Pretty silly IMO for someone who has smoked pot less than a handful of times in their entire life, but that's another story...

 

the real question that I have here, is what we can realistically expect at the POE from USPHS? I understand a class B doesn't make her inadmissible but is there any chance they find her inadmissible upon further questioning? Or face any obstacles at the POE? She does not currently use marijuana and has not since before the first medical exam.

 

It also seems like people with this type of annotation for TB have some things they need to complete shortly after arrival. We had been planning to arrive and spend a week or so in the US before visiting my wife's family in her home country (US is between our current location and her home country so logistically makes sense) for a month or so before returning to the US. 
 

Now we're not sure if we'll need to really be around for some type of further screen or counseling or something. Making it really difficult to plan our arrival. 
 

any advice would be appreciated.  

[Villanelle 4,122]

As you already researched its commonly used in relation to TB. In those cases they refer you to a local health dept clinic type place (usually with in 30 days) for an appt related to the TB follow up testing. I would assume the same applies here except you would be referred to the appropriate place (general clinic- perhaps for follow up drug test or psych eval follow up). 

 

Now it may take longer the 30 days for the first appt due to the pandemic. You may also have it all resolved in one appt or they may request additional appts. For drug testing in general they have a lot of leeway in deciding whats 'enough'. They may do one test and release her. They may say they want her to come at random times over the next 6 months to a year. Whatever they decide is how it is unfortunately. Are you sure its for drugs? Class B can also cover mental health issues. Does she have a history of depression or anxiety or self harm or anything like that? 

 

Im really sorry I can not give you more specific advice. This is a rare situation and I can not think of anyone who has posted about such- the closest experiences you see are TB related. So i would suggest the following. Contact the Dr that did the medical and see if they can give you any info about the contents of the medical they gave to USCIS. Specifically what caused the "B" label. CBP is going to have limited info on their end and will be asking questions based on what they know. You dont know what they know right now. Its never a good idea to "assume". It very well could be an error that it was notated as such! So again first contact the Dr and confirm they labeled her as B and why. If it was for marijuana then she needs to be prepared to answer questions about such at CBP if asked. She also doesnt want to show up with luggage filled with 'paraphernalia' or a tshirt with a giant pot leaf and wording blaze it up (lol). 

 

But honestly I would scrap your plans to immediately leave with in 1 week of entering until you get this sorted with the clinic you are referred to.

[MexicoExpat 18]

Thanks for this. I truly couldn’t find anything online with people with the B classification that wasn’t related to TB. Only documentation from the US govt saying class B for drug abuse means in full remission. 
 

another thing to overcomplicate things - things have changed a bit for us and we are no longer planning to move to our final destination that’s on on our DS-260. This isn’t misrepresentation of any sort and we are still able to move there if absolutely necessary, but some family related issues will make that non-ideal. 
 

would we be able to request at the airport to be referred to to a physician closer to the airport at the first port of entry as opposed to the final destination written on our DS-260? 
 

If we need to do multiple

appointments in the area of our final destination, this will massively disrupt our plans and lives and almost (but not quite) make the move to the US itself

not worth it in the end. 

[MexicoExpat 18]

To answer your other question, no she doesn’t have a history of depression, self harm or anything else. The only issue she has ever had in the medical exam is related to marijuana. 
 

I know we just need to deal with this now, but the whole thing is completely insane to us. She has smoked marijuana less than a handful of times in her entire life. Nobody who knows her would describe her as a drug user. Going to all these lengths for a few times having tried weed in the past just seems so outrageous and unnecessary. It’s also shocking that no one else has ever received an annotation such as this on this forum. Marijuana is a common thing, seems it should come up more often. 
 

Even in the first medical exam the doctor said he didn’t think she was an abuser but did not give her a sealed packet but did give her a note with a recommendation for counseling if the interviewing officer required it. 
 

Second interview went great and she received her packet. She hadn’t used marijuana since before the first interview and confirmed she had no desire to ever use it again. We thought we were in the clear when she received her medical packet and it wasn’t brought up during the interview. 
 

our entire process has been a complete nightmare. At no point of the process, have we ever been able to just feel relieved and happy about our progress. Even receiving her passport with visa back form the consulate was only 5 minutes of joy before we saw this annotation. Sorry, I’m just venting at this point, but my wife has been treated incredibly poorly by the US gov throughout the entirety of all her dealings with them, ever since her first tourist visa application. 

[Villanelle 4,122]

[Villanelle 4,122]

Try to look at it in a more optimistic way. They could have imposed a 1 yr ban on her but they didnt. They are allowing her to enter and sort out this "class B" issue- so thats good news. I did a bit of digging and found the following "you must annotate the immigrant visa with "IV Docs in CCD."  Customs and Border Protection (CBP) officers will be able to view the case documents electronically upon the applicant's arrival at the port of entry. The Immigrant Data Summary page is not required to be scanned or uploaded into eDP.  No paper visa packet is required, except for MIV cases with paper medical forms for an applicant with a Class A or Class B condition (except Class B other).  For such cases, the Immigrant Data Summary page must be included with the skinny packet. "https://fam.state.gov/fam/09FAM/09FAM050410.html#M504_10_3_B_1

 

"Class B conditions are defined as physical or mental health conditions, diseases, or disability serious in degree or permanent in
nature. This may be a medical condition that, although not rendering an applicant inadmissible, represents a departure from
normal health or well-being that may be significant enough to:
Interfere with the applicant’s ability to care for himself or herself, to attend school, or to work; or
Require extensive medical treatment or institutionalization in the future."https://www.aila.org/File/Related/19060633y.pdf

 

So it seems CBP is going to be able to view her documents and will view them due to the notation. The class B does not make her inadmissible but it does open up another can of worms (public charge related) so perhaps try to bring documentation related to that. Just like a tourist would want to show proof of ties- she will want to try to show (if needed) proof she is not going to be a public charge/needs to be sent to rehab once in the US/is able to work and function because she is not a hardcore drug user they shouldnt let in. Her flight isnt going to be a long one (I dont think) or she may even be entering at a land crossing. Traveling is always exhausting but I would encourage her to dress up a bit nicer and not appear at CBP looking like she just had a long night out in Vegas if that makes sense. If questioned on what she plans on doing in the US she should have some responses ready like she is eager to enroll in whatever school or if she has a career established already her looking forward to doing such for a US employer. If her plan is to be a stay at home mom thats admirable as well. Whatever she says she needs to be confident. Are you able to travel with her? It might make you both feel better to enter together. Most likely CBP will refer her to a health dept for a follow up (thats why they make said notation). You can attempt to explain the 'drug use' was one isolated incident (whatever was said to the medical examiner is what should be said to CBP) and perhaps they decide to just let her be but its more likely they will refer her to the health dept. You would then have to contact them about what exactly they want from you, how many appts and how frequently. 

 

 

Arrive with immigrant visa packet at a port of entry

You are admitted into the United States as a lawful permanent resident.
If the address where you will live in the United States has changed or will change immediately after you are admitted to the United States, make sure you give the U.S. Customs and Border Protection (CBP) officer your new address.  https://www.uscis.gov/forms/filing-fees/uscis-immigrant-fee#Who_Pays_the_Fee

 

They should be able to change your address and refer you to the local health dept place based on the new address you provide them. Once established at said health dept you may have a hard time changing it so be sure of the address change.

 

 

sorry for the awkward formatting I am using a different device and its a bit hard to navigate.

 

Edited March 14, 2021 by Villanelle

[MexicoExpat 18]

Thanks for this but a couple questions: 

 

1. We do not have that annotation in her passport about the IV docs, although we do have the yellow packet (2 separate packets, one clearly medical) and a paper immigrant data summary. Does that change your answer at all?

 

2. we actually don't have a new address, our plan was to rent an Airbnb for a couple months while checking out a new city. Not sure if they would take that address or not since it won't be permanent. 
 

3. maybe our plans are just too ambitious and this is much more important to het sorted out first. In which case we would just need to go directly to what's listed as our final destination. But when would she receive some sort document that shows her living at that address?

[MexicoExpat 18]

There’s also a larger problem we are now worried about that seems like we may be stuck between a rock and a hard place upon entry where she is medically admissible but criminally inadmissible. 
 

“

However, continuing with the example of an applicant who admits to past recreational drug use such as marijuana, a more serious consequence of the admission exists.

Depending on exactly what the applicant admits to during the medical examination, and what the civil surgeon or panel physician explains to the applicant about the illegality of  drug use, the applicant may be inadmissible under INA 212(a)(2)(A)(i)(II).  This section of the INA states that an applicant is inadmissible if he is found to have admitted “committing acts which constitute the essential elements of . . . a violation of (or a conspiracy or attempt to violate) any law or regulation of a State, the United States, or a foreign country relating to a controlled substance (as defined in section 102 of the Controlled Substances Act (21 U.S.C. 802)).”

Notice here that mere admission of drug use that would constitute a controlled substance violation is enough to make a person inadmissible.   A conviction is not required.  There is no waiver available.”

 

https://www.smartimmigrationlawyer.com/drug-use-inadmissibility/

[MexicoExpat 18]

We were able to het in touch with the doctor today. She was confused by it and said everything was fine during her medical exam and that my wife was told by the doctor already all information that was relevant to her case. Really hoping this is all just a big error and we enter quickly and easily. 

[MexicoExpat 18]

We entered the US today successfully and without issue. They did not mention anything related to this issue at all. 
 

They gave us back the medical packet and said it was ours to keep. They did not take our X-rays that were on a CD and said those were ours to keep also. 
 

We checked what was in the medical packet and the class B was indeed related to the marijuana use, and while they did inflate her usage in the report, she was deemed in full remission. 
 

There was an attached psychological report that did make a recommendation for her to attend a drug rehabilitation or narcotics anonymous program, however nothing of this was mentioned by the officer. 
 

Would this mean we are fully in the clear on this issue or could we expect to be called in later? We are considering continuing with our original plan to take a trip outside the US, but if there’s a chance they do contact us we would of course not want to be too far away. 

[balogunadeniyi200 1]

On 3/19/2021 at 6:34 PM, MexicoExpat said:

We entered the US today successfully and without issue. They did not mention anything related to this issue at all. 
 

They gave us back the medical packet and said it was ours to keep. They did not take our X-rays that were on a CD and said those were ours to keep also. 
 

We checked what was in the medical packet and the class B was indeed related to the marijuana use, and while they did inflate her usage in the report, she was deemed in full remission. 
 

There was an attached psychological report that did make a recommendation for her to attend a drug rehabilitation or narcotics anonymous program, however nothing of this was mentioned by the officer. 
 

Would this mean we are fully in the clear on this issue or could we expect to be called in later? We are considering continuing with our original plan to take a trip outside the US, but if there’s a chance they do contact us we would of course not want to be too far away. 

CONGRATULATION.please i want to know if after her 6 month treatment the medical result was sent back to DOS via embersy before it was finally approved?