Information for Medical Professionals Completing Form N-648

About Form N-648

Naturalization applicants with a physical or developmental disability or mental impairment may seek a waiver of the English and/or U.S. history and government testing requirement(s) in the naturalization process. Waiver requests must include a certification by a medical professional regarding the disability. To complete a certification, the medical professional must use Form N-648, Medical Certification for Disability Exceptions. USCIS grants medical disability waivers to applicants who are medically impaired with an extreme condition or combination of conditions such that they are unable to learn or demonstrate knowledge of English and/or U.S. history and government.

The purpose of this page is to summarize the main points covered by Form N-648 and provide additional background information for medical professionals to consider when completing the form.

Summary of Form N-648

When completing Form N-648, the medical professional needs to:

  1. Establish and certify the applicant's diagnosis;
  2. Explain how he or she, as a medical professional, diagnosed the anatomical, physiological, or psychological impairment, including citation to any and all medically acceptable clinical or laboratory diagnostic tests or methods that were used to form the diagnosis; and
  3. Explain how this condition affects the applicant's ability to learn or demonstrate knowledge of English and/or U.S. history and government, particularly focusing on the connection between the disability, impairment, or combination of impairments and the applicant's inability to demonstrate knowledge of English and/or U.S. history and government.

Additional Background Information

There are applicants whose disabilities do not render them unable to learn or demonstrate knowledge, but which make it extremely difficult to learn or demonstrate knowledge. USCIS will not grant such applicants a waiver of the English and/or U.S. history and government testing requirements. Under the law, an applicant's difficulty in fulfilling the testing requirements is not sufficient to warrant a waiver. Instead, they may be eligible under the Americans with Disabilities Act and/or the Rehabilitation Act for an accommodation that will give them an opportunity to fulfill these requirements. No form is required for this. Please ensure that your patient does not fall into this category before proceeding to certify a medical exception. Note that illiteracy in the applicant's native language is insufficient, by itself, to support a finding of inability to learn and/or demonstrate knowledge.

The following are just a few accommodations/modifications that may be made to the English and/or U.S. history and government tests:

  • Questions in plain language
  • Written tests for people who have hearing difficulties
  • Tests in large print or oral examinations for applicants with vision impairments.

In some cases, applicants with physical impairments such as vision or hearing loss may be unable to take the English and/or Civics exams even with an accommodation or modification. These applicants will need to file Form N-648.

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