(a) General. Medical Examination and Immigration Interview, Form I-486, shall be used to notify applicants to appear for the medical examination and Service interview. The procedure establish for medical examinations and immigration interviews shall be strictly adhered to unless a modification for any area is authorized by the Central Office pursuant to the request of the district director and recommendation of the regional commissioner. If a modification is authorized, Form I-486 shall be appropriately revi sed and, if necessary, an instruction sheet concerning the medical examination and interview may be reproduced locally.

The Form I-486 should show the name and address of the civil surgeon who will perform the medical examination if there is only one civil surgeon in the locality. When there is more than one civil surgeon in the locality, a list of their names and addresses shall be attached to the Form I-486 so that the applicant may select the one he prefers. The applicant must arrange with the civil surgeon for the completion of the medical examination within the time specified by the Service.

If deemed desirable, a local form notice may also be attached to the Form I-486 to insure that the applicant understands that he must make immediate arrangements for any required X-ray, and serology test; that he must bring the X-ray, physician's report interpreting the X-ray, and serology report when he appears for his medical examination; that the X-ray, serology test, and medical examination are at his expense; that he is to obtain the report of medical examination from the examining physician and br ing it with him when he appears for his interview at the immigration office, and that he is to appear for that interview at the appointed hour only. X-rays are not required of pregnant women if the results of a tuberculin skin test are negative. (TM 2/83)

The district director shall furnish the civil surgeon with a supply of Form FS-398 and assure that the medical examination is limited to those matters relevant to the alien's admissibility.

If the applicant is free of disqualifying medical defects, the civil surgeon will endorse the Form I-486A and will hand it to the alien with the X-ray and other pertinent laboratory reports in a sealed envelope for delivery to the Service at the time of interview. The endorsed Form I-486A shall be placed in the applicant's file. The medical examination shall be considered valid for a period of one year from the date of examination. The applicant shall be asked whether he would like to retain the X-r ay and laboratory reports, and they shall be returned to him if he so desires. Otherwise, they shall be destroyed. The application will be adjudicated on the basis of the civil surgeon's finding when the alien is free of disqualifying medical defects. (TM 2/83)

When the alien is not free of disqualifying medical defects, the civil surgeon will hand the completed copies of FS-389 to the alien with the X- ray and other pertinent laboratory reports in a sealed envelope for delivery to the Service at the time of interview and final adjudication shall be held in abeyance until the findings of the Director, Division of quarantine, Center for Prevention Services, Center for Disease Control, Atlanta, Georgia 30333, are received.

Medical examination of an applicant paroled into the United Stated under section 212(d)(5) of the Act, who was medically examined when processed for parole by a Service officer in the United STates or abroad, shall not be required unless there were medical grounds for exclusion when the applicant was processed for parole or there presently appears to be such grounds. If the file indicates that an applicant for adjustment of status under the Act of October 28, 1977 was processed through one of the relocation camps (Guam, Camp Pendleton, CA, Fort Chaffee, AR, Indiantown Gap, PA, Eglin AFB, FL), t he required medical examination shall be considered to have been performed and shall not be required unless medical grounds for exclusion are apparent.

Although a medical examination may have been conducted for an applicant under the Cuban Adjustment Act who was processed through one of the Service's relocation camps, a new medical examination must be submitted with any adjustment of status application. (TM 3/85)

(a-1) Psychiatric examination. When psychiatric examination of an applicant for adjustment of status is determined necessary, the applicant may be examined by any psychiatrist of his choice who has been certified by the American Board of Psychiatry and Neurology. However, there is no objection to having a district director reach an understanding with regard to fees with individual Board-certified Psychiatrists affiliated with a medical facility which has been selected by the district director for examination of aliens pursuant to 8 CFR 234.2(b) , located in areas convenient to the alien's place of residence. Where such an understanding has been reached, the alien may be informed thereof, but shall also be informed that he is free to select any Board-certified psychiatrist of his choice.

The examining psychiatrist shall be required to submit the report of his examination to the Service office having jurisdiction over the case. If the report indicates the alien is suffering from any mental disability, it shall be forwarded to the Director, Foreign Quarantine Program, Center for Disease Control, Atlanta, Georgia 30333, for determination as to whether a Class A or other medical certificate will be issued.

(b) Interview. Section 245 interviews will be conducted under the One-Step procedure unless a supervisory examiner authorizes the deferral of an interview because of the complexity of a case or for another substantive reason. The adjudicator shall conduct the interview prior to the acquisition of an existing A file or other records unless there is reason to believe that a record may contain information which is essential for the interview. In Service offices having Master Index Remote Access (MIRAC), a reco rd check may be completed prior to the interview. After the completion of the interview, records which may exist in another Service office will be requested within 48 hours. In order to insure completion of a case within 60 days of filing, a supervisory examiner may authorize a telephonic request for the relating record.

Unless a case involves complex questions of fact or law, the adjudicator shall complete an interview of an individual or family group within a period of 15-30 minutes. IN no event may an interview exceed 30 minutes without the authority of a supervisory immigration examiner. Supervisory Immigration Examiners are accountable for insuring that subordinates under their supervision conduct prompt and efficient interviews and that cases are completed in a timely manner.

All applicants, regardless of age must a[[ear at the interview. A Form I-89, (ADIT Card Data Collection Card) containing the required fingerprint shall be completed for each applicant. The interview shall be conducted in the office adjudicating the application, unless this is impractical because of distance, health, or advanced age.

Interviews shall be structured to verify the identity of the applicant, clarify and update the required information, review the applicant,s eligibility for status as a lawful permanent resident, and examine other facts relevant to the adjudication of the application and any concurrently filed visa petition. Except for affirmation of the truthfulness of the information contained on the application, it will normally be unnecessary to directly question dependent children under the age of 14. Questions di rected to the applicant shall be abbreviated if possible, and take into consideration the applicant's educational level and facility with the English language. For example, in the absence of any adverse information, a person fully fluent in english may be asked if he or she has read and understands the paragraphs enumerating the grounds of exclusion and if ny of these grounds are applicable to him or her. Conversely, when it is likely that the applicant would not understand the enumerated exclusion and if any of these grounds are applicable to him or her. Conversely, when it is likely that the applicant would not understand the enumerated exclusion grounds, it would be necessary to review them individually and very carefully with the applicant.

Experience has demonstrated that most applicants who file properly documented applications are eligible for adjustment of status. The appearance interview should be conducted primarily to identity the clearly approvable cases quickly and to complete processing. When an interview discloses a complex array of fats or interpretation of law or involves adverse factors, the adjudicator, with supervisory approval, shall remove the proceeding from the one Step procedure. The interview discloses a complex ar ray of facts or interpretation of law or involves adverse factors, the adjudicator, with supervisory approval, shall remove the proceeding form the On Step procedure. The interview should be completed on the same day, but may be rescheduled if conditions in a given Service office so dictate. The applicant's admission that he or she engaged in unauthorized employment, was government, was governmentally sponsored admissible as a result of not meeting a technical requirement of law shall not be a cause for removing an application from the ONe-step process. The applicant's admission to one or more of these elements shall be obtained in a short narrative statement signed by the applicant.

If the appearance interview discloses the need for a more detailed and thorough examination, and adjudicator shall obtain the approval of his or her supervisor before continuing or scheduling the interview for a later date. If there is an indication that the applicant has obtained a nonimmigrant visa or admission to the United States to circumvent the application process for an immigrant visa, the adjudicator shall question the applicant's true purpose in coming to the United States and the length of t ime he had intended to remain in this country when he applied for the nonimmigrant visa; what he told the consular officer when he applied for the visa; the applicant's explanation of any discrepancy between the true purpose and intended length of stay and what he told the consular officer; when and why the applicant decided to remain in the United States permanently; and any facts which have a bearing on the question of whether the visa was obtained by fraud or misrepresentation. When the information eli cited during the interview will be used as the basis for denial of the application or will constitute the basis for further shall be recorded in a narrative affidavit or a question and answer statement.

If the evidence clearly establishes that the visa was obtained by fraud or misrepresentation, the application shall be denied, unless the applicant qualifies for a waiver of that ground of excludability pursuant to section 212(i).

In the absence of other adverse factors, an application for adjustment of status as an immediate relative should generally be granted in the exercise of discretion notwithstanding the fact that the applicant entered the United States as a nonimmigrant with a preconceived intention to remain. Matter of Cavazos, Int. Dec. 2750(BIA 1980) clarified and reaffirmed. Matter of Ibrahim, Int. Dec. 2866 (BIA 1981).

When the information obtained does not clearly establish inadmissibility under section 212 (a) (19) or warrant denial of the application for adjustment as a matter of discretion, but the pertinent circumstances make further inquiry necessary, a copy of the alien's affidavit or statement with a copy of sheet 1 of Form G-325A shall be forwarded by memorandum to the appropriate consular officer for his /her review and comment. The memorandum should state that the attached affidavit or statement indicates the alien may have obtained his/her nonimmigrant visa by fraud. The memorandum should also give the visa symbol and date of visa issuance and request any relating evidence or information available to the consul or advice that relating evidence or information is not available. The consular officer's response shall be awaited before a decision is made on the application.

Because of the frequent incidence of misrepresentation regarding qualifying work experience allegedly acquired in Hong Kong, Taiwan and India by nonpreference applicants for adjustment, any nonpreference adjustment case on Form I-485 based upon such work experience shall be referred either to the District Director Rome or if within the jurisdiction of the District Director Bangkok directly to the officer in charge of the particular office for the investigation unless in the opinion of the adjudicating o fficer the supporting documentation is credible and clearly substantiates th alleged experience. (TM 2/87)

If an applicant is subject to the labor certification requirement of section 212(a)(14) of the Act, his/her intention concerning employment shall be confirmed during the interview if he/she is a sixth preference alien or a nonpreference alien whose certification was based on a jog offer. In these cases, if the alien claims present employment with the petitioner or employer who furnished the job offer, the alien should be questioned a to whether the actual duties performed, wages received, and working c onditions are in accordance with those specified by the job offer. In doubtful cases, evidence such as payroll slips, current letter or affidavit from employer should be requested; and in nonpreference cases where the alien's alleged qualifying experience was obtained abroad and is suspect, overseas investigation may be requested.

If the applicant is a third preference alien or a nonpreference professional, scientist, or artist, his/her intention to engage in such profession, science, or art shall be confirmed. Addition ally, if the applicant has been issued an individual labor certification for which no job offer was required, and is presently residing in a state other than the one shown as the intended place of residence on the Statement of Qualifications of Alien form to which the certification is affixed, the action describ ed in the last paragraph of OI 245.2(c)(2) shall be taken (if not done during prior processing). Third preference petitions filed subsequent to December 31, 1976, must be accompanied by job offers and such applicants must confirm that they still are or intend to be employed by the person, firm or organization which issued the job offer.