Oakton Health Center

The Centers for Disease Control and Prevention (CDC) has set out mental health technical instructions for panel physicians evaluating immigrant and refugee health statuses. The instructions follow the criteria of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, for diagnosing mental or physical disorders associated with harmful behaviors or substance use disorders.

The purpose of these health examinations is to identify any health-related conditions that may affect an applicant’s immigration status. Conditions which fall under Class A disqualifications include current physical or mental disorders with harmful behavior, disorders with past harmful behavior likely to reoccur, and drug abuse or addiction of substances listed in the Controlled Substance Act.

To proceed, the panel physicians must identify and diagnose any physical or mental disorders, determine the likelihood of harmful behavior recurrence, and determine the remission status. The severity of an applicant’s substance misuse is determined by 11 criteria listed in the American Psychiatric Association’s DSM: impaired control, social impairment, risky use, and physical dependence.

Regarding exclusions from defined harmful behaviors, instances are excluded where harmful behaviors are a direct result of the applicant’s environment, non-suicidal self-harm, or harmful behaviors resulting from an applicant’s significant intellectual disability, without the intent to harm. Panel physicians may refer applicants to a mental health specialist when necessary, however, this is not mandatory.

The achievement of remission for applicants with Class A conditions must consider that the disorder is controlled by medication, therapy, or its natural history, and it has been at least 12 months since the last occurrence of harmful behavior. In conclusion, the regulations are an essential aspect of the immigration process, ensuring potential immigrants and refugees are fit to adjust their status in the U.S.

1. October 2025 Visa Bulletin Released: The new October 2025 Visa Bulletin has been released, signalling opportunities for many to progress in the green card queues. For those waiting for employment-based green cards, the bulletin may finally open a path either to file Adjustment of Status (I-485) or to receive approval on pending cases due to visa availability. The bulletin is divided into two categories: people who just became eligible to submit their I-485 and those who already have a pending I-485. The Visa Bulletin controls the rate of green card processing each month. USCIS usually uses the Dates for Filing (DOF) chart at the beginning of the fiscal year to dictate who can file their I-485. The Final Action Dates (FAD) chart determines when a case can be approved. A specific strategy is outlined for each group, emphasizing gathering necessary evidence, scheduling medical exams, filing promptly, submitting Supplementary Forms, and responding quickly to USCIS. Anyone with a priority date becoming current in this fiscal year should consult with trusted counsel about the fastest, safest route to approval.

2. Trump Administration Announces Green Card Change: The Trump administration has announced immediate changes to green card applications, arguing that a policy introduced a year ago could threaten public health. The United States Citizenship and Immigration Services (USCIS) is now making it mandatory for all new permanent residency applications to include a renewed medical examination form. This policy change will impact immigrants currently applying for an adjustment of status, who were previously able to use forms indefinitely. This could mean affected immigrants might have to pay for repeat exams. As of December 2024, every green card applicant is required to file a medical examination form, not just those needing to prove they are not medically inadmissible. This comes during increased scrutiny of immigrants applying for visas in the U.S., as the Trump administration looks to crackdown on those violating immigration laws. The new policy took effect on June 11, 2025.