Medical exam
for visa holders

IMMIGRANTS and non-immigrants alike -- such as holders of tourist, working, student and business visas -- are subject to medical examination before visas can be issued.

In some cases, even if a visa has been issued, the immigration officer -- currently from the Bureau of Customs and Border Protection (BCBP), the agency that replaced the enforcement function of the Immigration and Naturalization Service (INS) at the borders -- could make a determination of whether a nonimmigrant visa holder would be admitted into the United States.

A person wishing to enter the United States must be inspected as part of the admission process. The admission process includes the presentation of one's valid passport with the U.S. visa, as well as the completed customs declaration and I-94 Arrival/Departure document.

Section 212 of the Immigration and Naturalization Act, as amended, requires the following types of visa applicants or permanent residency applicant s to undergo medical examination.

1. Beneficiaries of approved immigrant visa petitions -- in the family-sponsored, employment-based and other visa categories. In the Philippines, the medical examination is conducted only by the Saint Luke's Medical Center. The immigrant visa will not be issued without a clean bill of health, meaning the applicant must be free of a communicable disease that could pose as a public health threat or hazard. Persons issued their immigrant visas must present the medical examination to the BCBP officer at the port of entry.

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

3. Individuals in the United States who have approved immigrant visa petitions (in the various visa categories) and are applying for adjustment of status to become lawful permanent residents because their priority dates are current and immigrant visas are therefore immediately available. These adjustment applicants must submit to and pass a medical examination at a designated clinic or hospital. Their application for adjustment of status will not be accepted -- and thus will not proceed -- without the medical examination.

4. Non-immigrants in the following circumstances:

a). A consular officer may require an applicant to submit to an examination prior to issuance of a non-immigrant visa; or

b) An INS officer at ports-of-entry may require a non-immigrant (arriving with or without a visa) to submit to medical examination.

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

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

There are 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 meaning they would not be issued a visa or allowed entry into the US or the application for adjustment of status will be denied.

1. chancroid

2. gonorrhea

3. granuloma inguinale

4. Acquired Immune Deficiency Syndrome (HIV/AIDS)

5. Hansen's 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 that 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 non-medical 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 applicant's medical records indicate past non-medical use of a psychoactive substance.

Medical exams

The medical examination is done by an authorized civil surgeon who must perform the exam according to the specific guidelines published by the Center for Disease Control and Prevention. Unlike in the Philippines, an applicant's own admission is not sufficient to uphold a finding of inadmissibility on medical grounds. Saint Luke's Medical personnel ask immigrant visa applicants if they have experimented or even tried marijuana, metamphetamine hydrochloride ("shabu" or "crack") or other controlled substances. An admission usually goes into the report and the applicant is subsequently denied the visa. Controlled substance is non-waivable. In the US, admission itself is not the basis. The determination must be based on the medical examination that is required by certain persons seeking admission into the United States.

The evaluation includes a general physical examination and a mental status evaluation. Applicants two years and older must have a tuberculin skin test (TST). A chest X-ray is required only when the reaction to the TST is five 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 applicant's age and/or possible exposure to a particular disease.

Vaccinations

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 non-immigrants that adjust their status to lawful permanent resident

6. internationally adopted children within 30 days of admission

Crispin R. Aranda may be reached at usvisacenter@yahoo.com , www.visacenter.org, or at the Immigrant Visa Center in Quezon City +632 411-0806, +632 414-2655 and +632 373-6799. In the US his phone number is +415 834-1052.