The ‘health-related’ grounds of inadmissibly are found at INA §212(a)(1) and are the first set of grounds of inadmissibility listed in the Immigration and Nationality Act. Anyone who wishes to come to the United States with a non-immigrant visa or as a lawful permanent resident must prove that they do not pose a public health risk.

There are four health-related grounds of inadmissibility:

  1. Those who have a “communicable disease of public health significance;”
  1. Individuals applying for adjustment of status who fail to submit for I-693 reflecting certain vaccinations;
  1. People who are determined to have, or who have had, a mental or physical disorder that poses a threat to public safety; and
  1. People who are drug abusers or addicts.

Communicable Diseases of Public Significance

The Centers for Disease Control and Prevention maintains a list of communicable diseases and diseases for which a vaccine is available. Currently on the list are tuberculosis, syphilis, gonorrhea, leprosy, certain quarantinable diseases that have been designated by Presidential Executive Order, and any public health outbreak concerns. Some of the ‘quarantinable diseases’ that have been designated are “cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and… pandemic flu.” Notably, HIV is not on the list.

Form I-693, Report of Medical Examination and Vaccination Record

All applicants for adjustment of status must submit form I-693 signed by a civil surgeon (doctor) approved by USCIS; USCIS maintains a list of approved civil surgeons. The I-693 verifies that the applicant has been vaccinated against certain diseases. The Immigration and Nationality Act specifically mentions mumps, measles, rubella, polio, tetanus, pertussis, influenza type B, hepatitis type B, and any other vaccines “recommend by the Advisory Committee for Immunization Practices.” The CDC also maintains a list of vaccine-preventable diseases and also lists the vaccines recommended by the Advisory Committee. Currently, the Advisory Committee recommends getting vaccinated against rotavirus, hepatitis A, meningococcal disease, varicella, pneumonia, and the flu.

Form I-693 is also the place where a doctor would document their concerns about the following two grounds of inadmissibility (mental and physical disorders, and drug abuse or addiction).

You should not obtain form I-693 from the civil surgeon more than 60 days before you plan to submit your application for adjustment. Once your exam is complete, you will receive the signed exam sealed in an envelope. You should not open the envelope, however, you can ask for a copy of the completed exam. Give the copy of the exam to your attorney, who will check for any issues. The form is valid for two years from the date of the signature. An officer can ask for an updated medical exam at the time of the interview.

Mental or Physical Disorders

Having a psychological or physical illness in-and-of-itself does not make you inadmissible. According to the Foreign Affairs Manual, a doctor must determine that the mental or physical disorder is either (1) associated with harmful behavior, or (2) the person has a past of displaying harmful behavior and that behavior is likely to recur. To be found inadmissible under this ground, the mental or physical disorder should be found in the World Health Organization’s Manual of International Classifications of Diseases.

A person with a history of Driving Under the Influence could be found inadmissible under this ground.

Drug Abuse and Addiction

USCIS doctors do not routinely administer drug tests. This ground of inadmissibly typically arises if an applicant admits to the doctor that they’ve used drugs in the past, or if an officer sees that they have previous arrests for drug-related crimes.

Waivers of inadmissibly are available for the health-related grounds.

If you have a history of drug or alcohol arrests or abuse, please contact an immigration attorney who is trustworthy and knowledgeable before applying for an immigration benefit! Our attorneys at Landerholm Immigration, APC, are experienced in cases involving health-related grounds of inadmissibility and waivers. Please feel free to call us at (510) 491-0291 to see how we can help!