Health-Related Grounds for Inadmissibility to the United States -

Health-Related Grounds for Inadmissibility to the United States

Jordi S Bayer

While you will not be denied admission to the United states for having a common cold or flu, there are certain medical grounds of inadmissibility that are designed to protect the health of the general public in the United States. The requisite immigration medical examination report and vaccination record provide important information that the U.S. Department of State (“DOS”) and U.S. Citizenship & Immigration Services (“USCIS”) use to determine whether an individual meets health-related standards for admissibility.

The Medical Examination

During the immigration medical exam, the doctor will perform a physical examination and review your medical history, vaccination records and lab results. Individuals who are in the United States and applying for adjustment of status will need to make this appointment with a USCIS-designated civil surgeon. For those who are applying for immigrant visas through consular processing at a U.S. Embassy or Consulate abroad, a visit to a DOS-approved panel physician is required.

After the examination, the doctor will prepare a medical examination report with his or her findings. You may be deemed inadmissible to the United States on health-related grounds if you:

  1. Have a communicable disease of public health significance
  2. Fail to provide proof of required vaccinations
  3. Have a physical or mental disorder that causes you to behave in a way that makes you harmful to yourself or others
  4. Have a history of drug abuse or addiction

Communicable Diseases of Public Health Significance

The U.S. Centers for Disease Control (“CDC”) maintains a list of communicable diseases that would cause someone to fail their medical examination or be prevented from entering the United States. Such diseases include the following:

  • Tuberculosis (active)
  • Syphilis (infectious stage)
  • Chancroid
  • Gonorrhea
  • Granuloma Inguinale
  • Lymphogranuloma Venereum
  • Hansen’s Disease (Leprosy, infectious)

There are also two additional general categories of communicable diseases of public health significance that only apply to applicants abroad who are examined by panel physicians:

  • Communicable diseases that may make a person subject to quarantine, as listed in a Presidential Executive Order (currently cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, and viral hemorrhagic fevers, among others)
  • Communicable diseases that may cause a public health emergency of international concern (“PHEIC”) (currently polio, smallpox, SARS, influenza)

As of January 2010, HIV infection is no longer defined as a communicable disease of public health significance and does not make an individual inadmissible on health-related grounds for any immigration benefit. 

At the time of your medical examination, the doctor will determine whether you have traces of any of the abovementioned communicable diseases by conducting a physical exam and evaluating your medical record, travel history, and blood work.

Failure to Show Proof of Required Vaccinations

If you are applying for an immigrant visa, you are required to be vaccinated for several diseases, including mumps, measles, rubella, and polio, among others. In order to avoid the need to be revaccinated at your immigration medical examination, you should bring a copy of your vaccination records with you as proof of past vaccinations.   

If any of the required vaccinations are not received, you will be deemed inadmissible. However, some vaccinations are not required if they are not age / medically appropriate. For instance, certain vaccines are not medically appropriate during pregnancy (known as a “medical contraindication”). If this is the case, that vaccine requirement will be waived as not medically appropriate. 

Physical or Mental Disorder with Associated Harmful Behavior

Individuals who are diagnosed with physical or mental disorders with associated harmful behavior are inadmissible. You may even be found inadmissible for a prior harmful disorder, if that disorder is likely to recur. Harmful behavior is that which causes psychological or physical injury or poses a threat to the property, safety, or welfare of the self or others. For instance, if you have a history of pedophilia or suicidal behavior you will be inadmissible on this ground.

Additionally, alcohol use disorders are treated as a physical or mental disorder for purposes of determining inadmissibility. However, someone with an alcohol use disorder will only be deemed inadmissible if this disorder is also associated with current harmful behavior or past harmful behavior that is likely to recur. A record of alcohol-related offenses with associated harmful behavior, such as an accident when driving while intoxicated (“DWI”) or driving under the influence (“DUI”), or domestic violence involving alcohol could lead to a referral for a mental examination and a subsequent finding of inadmissibility.

Moreover, DOS recently released an updated Foreign Affairs Manual (“FAM”) which included a new prudential visa revocation provision requiring U.S. consular posts to revoke nonimmigrant visas for DUI arrests. This is very different from the previous policy in which an applicant with a prior DUI conviction would be required to provide a report from a panel physician, but was not automatically barred from admission. In explaining this marked change, DOS explained that a DUI arrest in itself may demonstrate visa ineligibility for a physical or mental disorder with associated harmful behavior.

Drug Abuse or Addiction

A history of drug abuse or addiction according to the Diagnostic and Statistical Manual of Mental Disorders (“DSM”) will make you inadmissible to the United States on health-related grounds. Drug abuse is defined as anything beyond a single non-medical use of a controlled substance. If you are classified as a drug abuser or addict, you can only apply for immigration benefits if the drug abuse or addiction is in remission.

Drug tests are not administered at every immigration medical examination; the physician conducting the exam will determine whether a drug test is necessary on a case-by-case basis. For example, if an individual has a prior drug-related arrest or conviction, a doctor may determine that a drug test is necessary as part of the medical exam. Note that a drug-related arrest or conviction could also make someone inadmissible on criminal grounds.  

Waiver of Health-Related Grounds of Inadmissibility

Under INA 212(g), USCIS can provide waivers for some medical grounds of inadmissibility.  Depending on the immigration benefit sought, there are waivers available for all health-related grounds of inadmissibility except drug abuse and addiction. USCIS will balance the U.S. public health interests against family unity and an applicant’s needs in deciding whether to grant waivers of health-related inadmissibility.

Thus, we recommend consulting with your immigration lawyer before applying for a U.S. visa or green card if you may be subject to a health-related ground of inadmissibility to determine if a waiver is available.

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