A. Background​

Historically, civil surgeon designation was an informal process handled by ​USCIS ​District Directors. By regulation, USCIS District Directors are authorized to designate civil surgeons in their respective jurisdictions.​ [1] Physicians submit​ted​ informal written requests for civil surgeon designation to the district or field office with jurisdiction, along with documentary evidence showing they m​e​et the professional qualifications to be a civil surgeon. ​

As of ​March 11, 2014​, USCIS replaced the informal, decentralized civil surgeon application process with a formal, centralized process by (a) requiring centralized filing of the Application for Civil Surgeon Designation ​(​Form I-910​ (http://www.uscis.gov/i-910))​, at a Lockbox facility, and (b) delegating the District Directors​’​ authority to grant, deny, and revoke civil surgeon designation to the Director of the National Benefits Center (NBC).​ [2] These changes were made to improve the application intake process, enhance case management, promote consistency and uniformity in ​decision-making​, and improve the overall efficiency and integrity of the program.​

B. Application​

A physician generally must apply for civil surgeon designation with USCIS. However, physicians who qualify under a blanket designation are exempt from the filing and fee requirements.​ [3]

USCIS will only ​accept​ [4] and ​consider ​complete​ applications for civil surgeon designation; applications must be submitted in accordance with the form instructions.​ [5]

A complete application consists of the following: ​

1. Application for Civil Surgeon Designation​ (​Form I-910​ (http://www.uscis.gov/i-910))​

A physician seeking designation as a civil surgeon must complete all required parts of the Application for Civil Surgeon Designation.​ [6]

2. Filing​ Fee​

The physician must include the required filing fee​ [7] with the completed Application for Civil Surgeon Designation.​Applications for civil surgeon designation that do not include the correct filing fee will be rejected.​

3. Evidence​

The physician must include evidence that shows that he or she meets the eligibility requirements to be designated a civil surgeon. At a minimum, the civil surgeon applica​n​t must submit all of the following evidence ​with the completed Application for Civil Surgeon Designation ​(​Form I-910​ (http://www.uscis.gov/i-910))​:​ [8]

Proof of U.S. citizenship, legal status, or authorization to work in the United States; ​

A copy of the physician’s current medical license in the state in which he or she seeks to perform immigratio​n medical examinations; ​

A copy of​ the physician’s medical degree​ verifying he or she is an M.D. or D.O.; and​

Evidence to verify the requisite professional experience, such as letters of employment verification.​

4. Signature​

The physician must sign the application.​ [9] The signature must be submitted to USCIS ​on Application for Civil Surgeon Designation ​(​Form I-910​ (http://www.uscis.gov/i-910))​. ​Applications for civil surgeon designation that do not include a signature may be rejected or returned to the physician. ​

C. Adjudication of ​C​ivil ​S​urgeon ​A​pplications​

1. Adjudication​

To determine whether to approve or deny the application for civil surgeon designation, the officer should follow these steps:​

Adjudication of Civil Surgeon Applications​

Step 1: Determine whether the physician meets all of the eligibility requirements to be designated a civil surgeon:​

Is the physician authorized to work in the United States?​ [10]

Is the physician an M.D. or a D.O​?​

Is the physician licensed without restriction in the state in which he or she seeks to perform immigration medical examinations? ​

Does the physician have at least ​four​ years of professional experience, not including residency or internships or other experience related to training?​

If there is insufficient information in the application and evidence submitted with the application to make this determination, the officer may issue a Request for Evidence (RFE) for additional information such as documentary evidence establishing any of the eligibility requirements. ​

If the physician does not meet all of the eligibility requirements, the officer should ​deny​ the application. Otherwise, go to Step ​2​.​

Step 2: ​Determine whether the application warrants a favorable exercise of discretion.​ [11] In general, a favorable exercise of discretion is warranted unless there are a​dverse factors that prevent it.​

An unfavorable exercise of discretion may, for instance, be applied to any applications submitted by physicians who had a prior civil surgeon designation revoked by USCIS, and where the concerns underlying that rev​ocation have not been resolved.​

If there is insufficient evidence in the application to make this determination, the officer may request additional information through the issuance of a Request for Evidence (RFE).​

Examples:​

Example: ​The physician had a prior civil surgeon designation revoked due to the physician’s​ confirmed ​participation in an immigration fraud scheme. ​T​he officer should deny the civil surgeon application​ as a matter of discretion​.​ T​he fee ​will ​not be refunded since USCIS performed an adjudication of the application.​

Example:​The physician had a prior civil surgeon designation revoked due to suspension of her medical license. However, the officer determines that the underlying reason for the suspension has been resolved, is unlikely to recur, and the physician now has a current, unrestricted medical license. In this case, the officer may approve the civil surgeon application if the physician otherwise meets the eligibility requirements.​

2. Approval​

If the application for civil surgeon designation is approved, the officer should do the following: ​

Notification​

Notify the physician in writing of the approval.​

Files​

Either create a new file for the physician ​who was ​granted civil surgeon designation; or, if a file for the physician already exists, update the file to reflect the grant of designation. ​

T​he files should be maintained in such a way as to facilitate retrieval or review of information relating to the specific civil surgeon. The file should be retained according to the​ established​ records retention schedule. ​

Updating ​C​ivil ​S​urgeon ​L​ist​

The NBC should coordinate with Customer Service and Public Engagement Directorate (CSPE) to ensure the civil surgeon list is updated in a timely manner to reflect all newly designated civil surgeons. At a minimum, the newly designated civil surgeon​’​s full name, name of medical practice, address, and telephone number should be added to the list. Particular care should be taken when entering the civil surgeon​’​s zip code and telephone number since these are the primary ways that applicants search for civil surgeons.​

3. Denial​

If the application for civil surgeon designation is denied, the officer should do the following: ​

Notification​

Notify the physician in writing of the denial. There is no appeal from a decision denying designation as a civil surgeon. However, the physician may file a motion to reopen or reconsider.​ [12] In the decision denying designation as a civil surgeon, the officer must notify the physician of the possibility to file a timely motion to reopen or reconsider.​

A physician who is denied designation is not precluded from reapplying for civil surgeon designation. In the decision denying designation as a civil surgeon, the officer should also notify the physician that he or she may reapply if the physician believes that he or she has overcome the reason(s) for denial.​ [13]

Files​

Create a new file for each physician ​who was ​denied designation; or, if a file for the physician already exists, the officer should update the file to reflect the denial of the designation. ​

4. File ​M​aintenance​

The files should be maintained in such a way as to facilitate retrieval or review of information relating to the specific civil surgeon. The file should be retained according to the​ established​ records retention schedule.​