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Health-Related Grounds Of Inadmissibility

by Gregory Siskind

Section 212 of the Immigration and Naturalization Act designates four health-related grounds that render an applicant for a visa, admission, or adjustment of status inadmissible. The medical grounds are determined according to the regulations published by the Department of Health and Human Services and include having communicable diseases, physical or mental disorders, drug abuse or addiction problems as well as failing to demonstrate vaccination against certain vaccine-preventable diseases.

The following communicable diseases render a person inadmissible:


1.  chancroid

2.  gonorrhea

3.  granuloma inguinale

4.  acquired immune deficiency syndrome (HIV/AIDS)

5.  Hansenís disease (infectious leprosy)

6.  lymphogranuloma venereum

7.  infectious state syphilis

8.  infectious tuberculosis (TB) (clinically active)


The following vaccinations are required of all immigrant visa and adjustment applicants: 


1.  mumps

2.  measles

3.  rubella

4.  polio

5.  tetanus and diphtheria toxoids

6.  pertussis

7.  Haemophilus influenzae type b

8.  hepatitis B


Note: The Advisory Committee on Immunization Practices may recommend additional vaccinations for the following diseases (though they are not yet required):


9.  varicella

10.  influenza

11.  pneumococcal 


Physical or mental disorders which render one inadmissible include the following:


1.  Current physical or mental disorders, with harmful behavior associated with the disorder.

2.  Past physical or mental disorders with associated harmful behavior that is likely to recur or lead to other harmful behavior.


Note:  Harmful behavior is behavior that may pose, or has posed, a threat to the property, safety or welfare of the applicant or others. A person who mentally retarded is no longer inadmissible unless there is a determination that the applicant is exhibiting or has exhibited in the past, associated harmful behavior.


Drug Abuse or Addiction


Drug abuse or addiction applies to the nonmedical use of a psychoactive substance that is part of a pattern of abuse. There is an exception for experimentation. Clinical judgment is used to determine abuse or experimentation when the applicants medical records indicates past nonmedical use of a psychoactive substance.


Medical Exams


Information about the health of an applicant for a visa is acquired through a medical examination by an authorized civil surgeon who must perform the exam according to the specific guidelines published by the Center for Disease Control and Prevention.  An applicantís own admission is not sufficient to uphold a finding of inadmissibility on medical grounds. The determination must be based on the medical examination that is required by certain persons seeking admission into the United States. 


Four groups of people are required to get medical examinations under the immigration laws. They include the following:


1.  immigrant visa applicants

2.  refugees applying for admission under Section 207 of the Act who are not eligible for a waiver

3.  adjustment of status applicants (including asylees)

4.  nonimmigrants in the following circumstances:

     i.  a consular officer may require an applicant to submit to an examination prior to issuance of a nonimmigrant visa; or

     ii.  an INS officer at ports-of-entry may require a nonimmigrant (arriving with or without a visa) to submit to a medical examination.

     iii.  K or V visa applicants outside the United States must undergo a medical exam as part of the visa application process. 

     iiii.  V visa applicants inside the United States must submit with their application a medical exam report.


An authorized civil surgeon must endorse the Form I-693, Medical Examination of Aliens Seeking Adjustment of Status and an accompanying vaccination supplement.  That form can be found on the BCIS web site at To obtain names and telephone numbers of the designated civil surgeons in a particular area, one can call the BCIS' National Customer Service Center at 1-800-375-5283. The caller will be asked to provide a zip code and will then have to write down the contact information for the doctor. Many INS offices will also distribute the list upon request or post the list at the BCIS office.

Generally, the Form I-693 is normally valid for a period of 1 year from the date it was endorsed by the civil surgeon. The Bureau of Citizenship and Immigration Services has taken a relaxed approach in accepting a medical evaluation as valid because it has been taking well over one year to complete the application process.  An adjudicating officer may accept a medical exam report that is more than 1 year old if it was initially filed with an adjustment of status application and there is no medical condition noted that would render the applicant inadmissible.


In addition to being signed by a designated civil surgeon, the Form I-693 must be completed legibly in English. The surgeon must clearly indicate that all required tests were performed and the results. The form must be sealed in an envelope by the civil surgeon and must have no evidence of tampering.


The evaluation includes a general physical examination and a mental status evaluation.  Applicants 2 years and older must have a tuberculin skin test (TST). A chest X-ray is required only when the reaction to the TST is 5 millimeters or more. Serologic (blood) tests are required of all applicants 15 years of age and older to see if an applicant has syphilis or a human immunodeficiency (HIV) infection. Other tests may be required depending on the applicantís age and/or possible exposure to a particular disease.



The following people must be vaccinated:


1.  adjustment of status and immigrant visa applicants

2.  refugees applying for adjustment of status under Section 209 of the Act

3.  asylees applying for adjustment under Section 209 of the Act

4.  K and V visa applicants outside the United States, but will not be refused admission solely because the requirement has not been met

5.  K and V nonimmigrants that adjust their status to lawful permanent resident

6.  internationally adopted children within 30 days of admission


Civil surgeons are required to document that the applicant has the necessary vaccinations by including a special supplement form with the I-693 form. The vaccination form is not available on the Internet. However, the Centers for Disease Control and Prevention (CDC) has sent the vaccination supplement directly to the civil surgeons for them to photocopy, fill out on behalf of each applicant, and attach to Form I-693 for submission to BCIS.

When a person is found to be inadmissible for health reasons, it does not definitively prevent the person from being issued a visa or entering the United States. A physical or mental condition can be corrected or one can prove that they do not fall into the categories. Waivers are also available for most of the medical grounds of inadmissibility and will be discussed in a future article.

About The Author

Gregory Siskind is a partner in Siskind, Susser, Haas & Devine's Memphis, Tennessee, office. After graduating magna cum laude from Vanderbilt University, he received his Juris Doctorate from the University of Chicago. Mr. Siskind is a member of AILA, a board member of the Hebrew Immigrant Aid Society, and a member of the ABA, where he serves on the LPM Publishing Board as Marketing Vice Chairman. He is the author of several books, including the J Visa Guidebook and The Lawyer's Guide to Marketing on the Internet. Mr. Siskind practices all areas of immigration law, specializing in immigration matters of the health care and technology industries. He can be reached by email at

The opinions expressed in this article do not necessarily reflect the opinion of ILW.COM.