What medical conditions disqualify people from passing their medical exam? Either with USCIS because they’re adjusting their status inside the United States or if they’re abroad and they’re getting a fiance visa or a spouse visa, you have to go through a medical clearance process.

There’s a lot of concern and fear out there if you have any kind of medical condition. What is it they’re actually looking for? I want to talk about this to put some of you at ease because I think there are some misunderstandings about what they’re actually looking for.

The first thing you want to know about is that the entity within the US government that controls these rules or that’s primarily responsible for the backstory of these rules is the CDC (Center for Disease Control and Prevention). It’s an organization inside the US government that’s in charge of making sure that we don’t have major public health crises. Things that are highly contagious that could spread quickly in the population is what they’re really worried about.

They don’t check like when you normally go to your doctor for a checkup they’ll say, “Oh, your heart sounds good” and “Is your weight correct” and things like that are just about whether you as a person are healthy. They’re not going to do those sorts of things at this medical exam to get into the United States. It’s only about whether you have any condition that could harm people if you’re allowed into the United States and not every condition that can be transmitted is on the list. The primary ones that are on there are: tuberculosis, gonorrhea, syphilis, and then there’s also a catch-all for anything that’s under current presidential proclamation or that is currently being watched by the CDC like SARS

If you went to an exam and you actively had COVID, they would tell you to come back later. They wouldn’t let you in. That’s an example of a thing that they could say if you actively have this disease. You can’t come in. Because they really just want to prevent people from coming in and spreading a really contagious disease. Hemorrhagic fevers, things like that are all on this list and we can give you a link to the list. You can look up the CDC requirements for medical exams for USCIS if you want to read all the nerdy details about it.

See: Chapter 6 – Communicable Diseases of Public Health Significance in the USCIS Policy Manual

Another important category to understand is that you have to also have been vaccinated for a long list of diseases for which there exist vaccines. So things like polio and smallpox, in some cases. You have to get the vaccinations that the US government requires and there are some minor exceptions for people who have established religious or personal considerations where they don’t want to receive vaccines. It is a huge expense like thousands of dollars and months or years of time to get a waiver for that.

If that’s the hill you want to die on, not getting the vaccines to get into the US, there is a process we can go through to do that but for most people, just get the vaccines they want so that you don’t have that particular problem. There are people that are medically contraindicated to get the vaccines where they have some kind of allergic reaction or some reason why it’s not medically advisable. That’s okay. If it’s not flu season, they’re not gonna give you a flu shot.

And then the final category has to do with mental and physical conditions that could cause you to harm someone else. Some of the questions people ask are, “If I’m having depression or anxiety or things like that are technically mental health diagnoses, is this something that is actually going to prevent me from coming in?” What they’re really going to be looking at is it’s not about whether you have a certain diagnosis. It’s about if you have a diagnosis and you have associated harmful behavior or high risk of doing that. What would that mean? Honestly, I’ve never actually seen someone that had a mental health condition that was specifically turned down in my entire career for this reason. I think it would have to be something like you have a diagnosis of compulsively starting fires or compulsively trying to kill people and it’s expected to continue and you’ve tried that before. That’s what they would be looking for. It’s not very common.

It is common, however, for people to say things at the interview that trigger additional inquiry. So, we always prepare our clients very carefully depending on their particular diagnoses; how to answer those questions to make sure that you’re telling the truth and at the same time you’re not opening yourself up to multiple examinations or psychological examinations that you don’t necessarily have to go through. There’s a fine line there of being very truthful and at the same time not opening a can of worms into total craziness.

The other medical category has to do with whether you are a substance abuser or addict and they also look at associated harmful behavior for that. Sometimes if you might say, “I’ve never abused drugs” but they find marijuana in your system and they will say, “Okay, well, you have to wait a year or longer to prove that you’ve been clean this whole time so we know you’re not addicted to drugs”. It’s very important that you don’t have any drugs in your system and until you become a US citizen even in places that legally allow marijuana in the United States. Don’t use it until you become a US citizen if you choose.

We also see a lot of situations where people will have been arrested for things that involved drugs or alcohol like if you’ve had a driving under the influence or driving while intoxicated charge previously or some equivalent in a foreign country, then the government will say this is proof that you have been addicted to or abusing alcohol or drugs. Those are cases that get more complex and we have ways of trying to present that. But there’s always a risk of the medical exams for people with those conditions.

If you have some kind of health condition that doesn’t affect other people and it’s not on this list of huge public health concerns, then it’s not going to count. One thing I want to clarify for those of you who have received an HIV positive test at some point in your life and you have that under control. HIV and AIDS were previously on the list but it was removed in 2010 and it was removed because ultimately they realized this is a condition that people are now able to control with medication. They put it on the list in the 80s when there was a lot of panic and fear about how it was spread. Now, we understand that you have to have really close physical contact with someone sharing bodily fluids to actually be able to spread it. It’s not like allowing someone to immigrate to the United States who is HIV positive creates a public health concern. It’s not like coronavirus where you can cough and pass it to someone else.  They do not currently test for HIV at the medical exam and it’s not a problem if you are HIV positive. That’s a big relief to some people who are dealing with that as part of their health profile.

And as always, if you have specific questions about a specific health concern that you have and you want to talk through how it might be impacted by your case, we’re happy to do that in a consultation and give you a really specific answer about whatever your specific condition is. If you have some sort of condition that’s on the list, most of those things are treatable by antibiotics and things like that. Although sometimes, it can take a year or longer to treat them and so what would happen if you don’t pass the medical exam is you get the treatment to prove that your system is clean and then you are able to come in. It’s not a permanent problem if you have something like tuberculosis.