The Centers for Disease Control and Prevention (CDC) has released detailed instructions for panel physicians evaluating health status of immigrants or refugees applying for US status. The guidance is particularly aimed at identifying physical or mental disorders that could present harmful behaviors, or substance use disorders which could make an applicant inadmissible.
The evaluation process will involve the identification and diagnosis of any mental or physical disorders, or substance use disorders. Subsequently, the identification of any harmful behavior associated with these disorders, the likelihood of a recurrence of harmful behaviors, and determining the remission status are undertaken.
The report identified three separate categories of potential health classifications. Firstly, a Class A classification which would be applied to applicants with current physical or mental disorder with associated harmful behavior, a non-CSA substance use disorder with associated harmful behavior, or a CSA substance use disorder. Class B classification would be applied to applicants with current physical or mental disorder with no associated harmful behavior, a non-CSA substance use disorder without associated harmful behavior, or a diagnosed physical or mental disorder with a history of associated harmful behaviors. Lastly, a no class A or Class B classification would be applied to applicants with no diagnosis of physical or mental disorder, those with occasional substance use but no substance use disorder, or applicants with harmful behavior not associated with any diagnosable physical or mental disorder.
The document outlines the categories of harmful behaviors and substances as well as the mental and physical disorders, detailed guidance on how to carry out examinations and the diagnostic criteria. It provides an overview of the process for referring an applicant to a specialist, deferring a diagnosis or classification and determining remission.
The instructions also highlight the impact of prescription drugs, sexually dangerous behaviors, and the viewing of child pornography, along with the use of marijuana and its legal status in some parts of the United States. Cases can also be referred to CDC’s Division of Global Migration Health for additional guidance if necessary.
The purpose of the outline is to ensure a uniform approach to health screenings of applicants and ensure that harmful behaviors or substance use disorders are accurately and consistently diagnosed and recorded. This process aids in maintaining the safety of the U.S. population while also ensuring the health and wellbeing of the immigrants and refugees.
Summary:
1. The Manual Release has updated the Medical PM/WAG for Asylum Applicants and Torture Victims (AATV) and Victims of Trafficking, Torture, or Other Serious Crimes (VTTC). There are new procedures for handling AATV/VTTC cases and new policies regarding “Derivative Family Members” (DFM) and verification of status for AATV/VTTC. It also highlights the distinction between state and federally funded medical coverage. There have been legislative amendments to the eligibility factors for VTTC benefits, which now require Illinois residency, having a child or DFM, filing a T Visas, U Visa, or asylum, and meeting financial criteria. The amendments do not allow single adult applicants without DFMs to be eligible. To qualify for AATV assistance, an individual must have an application for asylum pending, or an appeal, or should be receiving treatment for torture from a federally funded torture treatment center.
2. The U.S. Citizenship and Immigration Services announced an update regarding Form I-693 for green card applicants. The form signed by a civil surgeon on or after November 1, 2023, will only remain valid while the associated application is pending. If the application is denied or withdrawn, a new form needs to be submitted. This policy will apply to applications filed on or after June 11, 2025. The exam and completion of Form I-693 typically cost between $400 and $1,000.
3. The Trump administration announced immediate changes to green card applications. It made it a requirement for all new permanent residency applications to have a renewed medical examination form. The applicants were previously allowed to use forms indefinitely. This change will impact immigrants applying for adjustment of status. The cost of the exam ranges from $100 to $500.
4. Immigrants arriving in Kansas City face long waiting times and steep costs when it comes to receiving medical examination forms required for immigration. Only seventeen locations in the metro area have civil surgeons licensed to carry out the exams, at a cost of between $400 and $1,000. Local health centers, such as KC CARE Health Center, provide these services more affordably, at $250. However, delays and shortages remain an issue.
5. The U.S. Citizenship and Immigration Services (USCIS) updated its policy on the validity of Form I-693 medical exams for green card applications. Now, I-693 exams completed and signed on or after November 1, 2023 will be considered valid indefinitely. This could lead to fewer future requests for evidence for I-485 applicants whose applications have been pending for over two years. However, officers retain the right to request a new or updated exam if they believe the applicant’s health condition has changed.
