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NPZ Immigration Law Blog

Thursday, January 9, 2014

USCIS Form N-648 for Naturalization Candidates Seeking Medical Disability Exceptions.


Several years ago, the U.S. Citizenship and Immigration Services (USCIS) announced the release of revised Form N-648, Medical Certification for Disability Exceptions, for those seeking an exception from the English and civics requirements for naturalization because of disabilities. Immigration law requires that individuals applying for Naturalization/Citizenship must exhibit proficiency of U.S. civics and the English language. Individuals, who have disabilities or impairments, may seek exceptions from either or both of these requirements. Applicants, who ask for such an exception, must file Form N-648.

Form N-648 was revised following input from USCIS subject-matter experts, customers, medical professionals, community-based organizations and immigration lawyers. The intentions of these revisions were to clarify the requirements and instructions as well as to standardize the process for applicants, medical professionals and USCIS officers. The Form allows medical professionals to provide information that is necessary for USCIS so that immigration officials can better understand the medical professional's diagnosis and how it relates to the naturalization requirements.

  •  The requirements for submitting Form N-648 are explained clearer for applicants and medical professionals. USCIS also revised the instructions so that they are clearer on how to complete the form.

  •  Medical professionals can focus their evaluation specifically on their medical diagnosis and not worry about the applicant's daily activities, which may be irrelevant to the filing process.

  •  Medical professionals can complete the form electronically or on paper.

  •  Applicants are no longer required to report any previous disability evaluations from other government agencies.

  •  A certification section was included in the new, revised Form N-648, that interpreters, for applicants or medical professionals are required to prepare.

Form N-648 is for applicants who seek an exception to the English and/or civics requirements of the naturalization process due to a physical or developmental disability or mental impairment that has lasted or is expected to last twelve months or more. A Form N-648 applicant should submit Form N-648 at the time he or she files Form N-400, Application for Naturalization. Form N-648 applicants are not required to fulfill the English language and civics requirements if the applicant is unable to do so due to physical or mental disabilities. However, applicants who can meet the English and civics requirements but only with accommodations, should not use Form N-648. These applicants include those needing sign language or extended time for testing. It needs to be specifically noted that illiteracy alone is not a valid reason to seek an exception using the Form N-648.

Form N-648 must be certified by a licensed medical professional. Before certifying Form N-648, the medical professional must have conducted an examination of the applicant. Of course, it is always best for the medical professional to have had a significant history of care with the applicant. Medical professionals preparing the Form are advised that Form N-648 responses must be indicated in common language, without abbreviations, so that a person without medical training would be able to understand. Only medical doctors, doctor of osteopathy, or clinical psychologists licensed to practice in the United States may complete Form N-648.

The Adjudicatory Officers for the USCIS have also received more guidance about the Form N-648. The Adjudicator's role is to determine whether the Form N-648 contains sufficient information to establish that the applicant is eligible for a disability exception under section 312 of the Immigration and Nationality Act ("INA"). The Adjudicator is supposed to focus on determining whether the medical professional has established and documented the nature and extent of the diagnosed medical condition and how the applicant's diagnosed condition has impaired functioning so severely that it has rendered the applicant unable to learn or demonstrate knowledge of English and/or United States history and government.

To this end, the Adjudicator must ensure that the Form N-648 contains:

• An explanation of the origin, nature, and extent of the medical condition which is established and documented by medically acceptable clinical or laboratory diagnostic techniques, including a list of the medically acceptable clinical or laboratory diagnostic tests employed in reaching the diagnosis.

• An explanation of how the applicant's diagnosed medical condition or impairment so severely affects the applicant that it renders him/her unable to learn or demonstrate English proficiency and/or knowledge of United States history and government;

• An attestation that the disability has lasted, or is expected to last, 12 months or longer; and

• An attestation that the disability is not the direct effect of the illegal use of drugs.

It is important to note that the Adjudicator is not a physician and should not be placed in the position of making a medical determinations. Hence, the Adjudicator should not engage in medical determination practices reserved for and performed by a licensed medical professional. As mentioned in guidance to the field officers, the Adjudicator should assume that the medical professional's diagnosis is valid in the absence of credible doubt. As a general rule, USCIS does not want an applicant with a disability to submit extensive medical reports or medical background information regarding the applicant's condition.

The Adjudicator should not presume the existence of fraud merely based on the number of applicants who seek a medical examination from a particular medical professional. Because applicants of an immigrant community commonly seek the care and services of medical professionals who share the same language, culture, ethnicity, and/or nationality, this practice is not, in and of itself, an indication of fraud. If the Adjudicator has reason to suspect fraud, the Adjudicator is supposed to consult with the Office of Fraud Detection and National Security (FDNS) according to the current fraud referral policy. All referrals to FDNS should be based on fraud indicators that can be articulated. In the event that FDNS is unable to provide a final response within a period of 120 days from the date of the initial interview, the Adjudicator should proceed with the adjudication of the application.

8 CFR 312.2(b)(2) indicates that Form N-648 must be submitted as an attachment to the applicant's Form N-400, Application for Naturalization. Notwithstanding, USCIS routinely encounters instances where USCIS has not required the submission of more than one Form N-648 and yet the N-400 applicant submits multiple Form N-648s upon and after initially filing his or her N-400. This practice can cast doubt on the credibility of the applicant's claim to the disability exception, especially if the Adjudicator discovers discrepancies between and among the N-648s.

It is also important to note that the submission of Form N-648 after the filing of the Form N-400 or the submission of multiple Form N-648s is not, by itself, sufficient grounds to reject a request for an exception to the English and/or U.S. history and government requirements. However, the submission of late or multiple Form N-648s may be considered in determining whether there are credible doubts about the veracity of the medical certification or justify additional scrutiny to ensure the applicant is entitled to the exception unless there is evidence of changed facts or circumstances that would explain the basis for filing multiple forms. In addition, USCIS reserves the right to require the submission of additional N-648s, if there are credible doubts about the veracity of the medical certification. It should be noted also that a properly submitted Form N-648 will remain valid indefinitely unless the Adjudicator determines that the N-400 applicant doesn't qualify for the exemption.

For additional information about the Citizenship and/or Naturalization process to become a U.S. Citizen or about how to file a Disability Waiver on Form N-648, please feel free to contact one of the U.S. Immigration Lawyers or U.S. Immigration Law Attorneys at the Nachman Phulwani Zimovcak (NPZ) Law Group, P.C. by e-mailing us at info@visaserve.com or by calling our offices at 201-670-0006 (x107).

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