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Policy Manual
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INA
8 CFR
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Book outline for Policy Manual
  • Policy Manual
    • Search
    • Updates
    • Table of Contents
    • Volume 1 - General Policies and Procedures
    • Volume 2 - Nonimmigrants
    • Volume 3 - Humanitarian Protection and Parole
    • Volume 4 - Refugees and Asylees
    • Volume 5 - Adoptions
    • Volume 6 - Immigrants
    • Volume 7 - Adjustment of Status
    • Volume 8 - Admissibility
      • Part A - Admissibility Policies and Procedures
      • Part B - Health-Related Grounds of Inadmissibility
        • Chapter 1 - Purpose and Background
        • Chapter 2 - Medical Examination and Vaccination Record
        • Chapter 3 - Applicability of Medical Examination and Vaccination Requirement
        • Chapter 4 - Review of Medical Examination Documentation
        • Chapter 5 - Review of Overall Findings
        • Chapter 6 - Communicable Diseases of Public Health Significance
        • Chapter 7 - Physical or Mental Disorder with Associated Harmful Behavior
        • Chapter 8 - Drug Abuse or Drug Addiction
        • Chapter 9 - Vaccination Requirement
        • Chapter 10 - Other Medical Conditions
        • Chapter 11 - Inadmissibility Determination
        • Chapter 12 - Waiver Authority
      • Part C - Civil Surgeon Designation and Revocation
      • Part D - Criminal and Related Grounds of Inadmissibility
      • Part E - Terrorism
      • Part F - National Security and Related Grounds of Inadmissibility
      • Part G - Public Charge Ground of Inadmissibility
      • Part H - Labor Certification and Select Immigrant Qualifications
      • Part I - Illegal Entrants and Other Immigration Violators
      • Part J - Fraud and Willful Misrepresentation
      • Part K - False Claim to U.S. Citizenship
      • Part L - Documentation Requirements
      • Part M - Citizenship Ineligibility
      • Part N - Noncitizens Previously Removed
      • Part O - Noncitizens Unlawfully Present
      • Part P - Noncitizens Present After Previous Immigration Violation
      • Part Q - Practicing Polygamists, International Child Abductors, Unlawful Voters, and Tax Evaders
    • Volume 9 - Waivers and Other Forms of Relief
    • Volume 10 - Employment Authorization
    • Volume 11 - Travel and Identity Documents
    • Volume 12 - Citizenship and Naturalization
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  2. Policy Manual
  3. Volume 8 - Admissibility
  4. Part B - Health-Related Grounds of Inadmissibility
  5. Chapter 2 - Medical Examination and Vaccination Record

Chapter 2 - Medical Examination and Vaccination Record

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  • Guidance
  • Resources (9)
  • Appendices (0)
  • Updates (6)
  • History (0)

A. Purpose of the Medical Examination and Vaccination Report

The results of the medical examination and vaccination record determine whether an applicant is inadmissible on health-related grounds. The medical examination documentation indicates whether the applicant has either a Class A or Class B medical condition and the vaccination record shows whether the applicant has complied with all vaccination requirements.

B. Class A and B Conditions and Their Impact on Admissibility

Class A and B conditions are defined in Department of Health and Human Services (HHS)regulations. [1] 

Class A conditions are medical conditions that render a person inadmissible and ineligible for a visa or adjustment of status. [2] A Class A medical condition is a:

  • Communicable disease of public health significance per HHS regulation;

  • A failure to present documentation of having received vaccinations against vaccine-preventable diseases; [3] 

  • Present or past physical or mental disorder with associated harmful behavior or harmful behavior that is likely to recur; and

  • Drug abuse or addiction.

Class B conditions are defined as physical or mental health conditions, diseases, or disability serious in degree or permanent in nature. [4] This may be a medical condition that, although not rendering an applicant inadmissible, represents a departure from normal health or well-being that may be significant enough to:

  • Interfere with the applicant’s ability to care for himself or herself, to attend school, or to work; or

  • Require extensive medical treatment or institutionalization in the future.

C. Completion of a Medical Examination

When a medical examination is required to determine the applicant’s admissibility, the person must be examined by a physician who is designated to perform this examination.

By statute, any medical officer in the U.S. Public Health Service may conduct the examination. However, this rarely occurs. Most medical examinations are conducted by a physician designated as a civil surgeon by USCIS [5] or designated as a panel physician abroad by the U.S. Department of State (DOS). Civil surgeons complete medical examinations for applicants in the United States, while panel physicians complete medical examinations for immigrant visa and refugee applicants seeking immigration benefits from outside the United States. 

Footnotes


[^ 1] See 42 CFR 34.2.

[^ 2] Class A conditions are medical conditions mentioned in INA 212(a)(1)(A). See 42 CFR 34.2(d).

[^ 3] This Class A medical condition only applies to noncitizens who seek admission as immigrants, or who seek adjustment of status to one lawfully admitted for permanent residence. Additionally, a child who is adopted and under the age of 10 years or younger is not deemed to have a Class A condition if the following conditions apply: Prior to the admission of the child, an adoptive parent or prospective adoptive parent of the child, who has sponsored the child for admission as an immediate relative, has executed an affidavit stating that the parent is aware of the vaccination requirement , and will ensure that, within 30 days of the child’s admission, or at the earliest time that is medically appropriate, the child will receive the vaccinations required for immigration purposes. See 42 CFR 34.2(d)(2).

[^ 4] See 42 CFR 34.2(e) .

[^ 5] See INA 232 and 8 CFR 232.

Resources

Legal Authorities

42 CFR 34 - Medical examination of aliens

42 U.S.C. 252 - Medical examination of aliens

INA 212(a)(1) - Health-related grounds

INA 221(d) - Physical examination

INA 232, 8 CFR 232 - Detention of aliens for physical and mental examination

Technical Instructions for Civil Surgeons

Forms

G-28, Notice of Entry of Appearance as Attorney or Accredited Representative

I-693, Report of Medical Examination and Vaccination Record

Other Materials

How to Use the USCIS Policy Manual Website (PDF, 2.99 MB)

Appendices

No appendices available at this time.

Updates

Technical Update - Replacing the Term “Alien”

May 11, 2021

This technical update replaces all instances of the term “alien” with “noncitizen” or other appropriate terms throughout the Policy Manual where possible, as used to refer to a person who meets the definition provided in INA 101(a)(3) [“any person not a citizen or national of the United States”].

Affected Sections

1 USCIS-PM - Volume 1 - General Policies and Procedures

2 USCIS-PM - Volume 2 - Nonimmigrants

6 USCIS-PM - Volume 6 - Immigrants

7 USCIS-PM - Volume 7 - Adjustment of Status

8 USCIS-PM - Volume 8 - Admissibility

9 USCIS-PM - Volume 9 - Waivers and Other Forms of Relief

10 USCIS-PM - Volume 10 - Employment Authorization

11 USCIS-PM - Volume 11 - Travel and Identity Documents

12 USCIS-PM - Volume 12 - Citizenship and Naturalization

Technical Update - Moving the Adjudicator’s Field Manual Content into the USCIS Policy Manual

May 21, 2020

U.S. Citizenship and Immigration Services (USCIS) is updating and incorporating relevant Adjudicator’s Field Manual (AFM) content into the USCIS Policy Manual. As that process is ongoing, USCIS has moved any remaining AFM content to its corresponding USCIS Policy Manual Part, in PDF format, until relevant AFM content has been properly incorporated into the USCIS Policy Manual. To the extent that a provision in the USCIS Policy Manual conflicts with remaining AFM content or Policy Memoranda, the updated information in the USCIS Policy Manual prevails. To find remaining AFM content, see the crosswalk (PDF, 350.49 KB) between the AFM and the Policy Manual.

Affected Sections

1 USCIS-PM - Volume 1 - General Policies and Procedures

2 USCIS-PM - Volume 2 - Nonimmigrants

3 USCIS-PM - Volume 3 - Humanitarian Protection and Parole

4 USCIS-PM - Volume 4 - Refugees and Asylees

5 USCIS-PM - Volume 5 - Adoptions

6 USCIS-PM - Volume 6 - Immigrants

7 USCIS-PM - Volume 7 - Adjustment of Status

8 USCIS-PM - Volume 8 - Admissibility

9 USCIS-PM - Volume 9 - Waivers and Other Forms of Relief

11 USCIS-PM - Volume 11 - Travel and Identity Documents

12 USCIS-PM - Volume 12 - Citizenship and Naturalization

Technical Update - Replacing the Term “Foreign National”

October 08, 2019

This technical update replaces all instances of the term “foreign national” with “alien” throughout the Policy Manual as used to refer to a person who meets the definition provided in INA 101(a)(3) [“any person not a citizen or national of the United States”].

Affected Sections

1 USCIS-PM - Volume 1 - General Policies and Procedures

2 USCIS-PM - Volume 2 - Nonimmigrants

6 USCIS-PM - Volume 6 - Immigrants

7 USCIS-PM - Volume 7 - Adjustment of Status

8 USCIS-PM - Volume 8 - Admissibility

9 USCIS-PM - Volume 9 - Waivers and Other Forms of Relief

10 USCIS-PM - Volume 10 - Employment Authorization

11 USCIS-PM - Volume 11 - Travel and Identity Documents

12 USCIS-PM - Volume 12 - Citizenship and Naturalization

POLICY ALERT - Validity of Report of Medical Examination and Vaccination Record (Form I-693)

October 16, 2018

U.S. Citizenship and Immigration Services (USCIS) is updating policy guidance in Volume 8, Part B of the USCIS Policy Manual regarding the period of time during which a Form I-693 submitted in support of a related immigration benefits application is considered valid.

Read More
Affected Sections

8 USCIS-PM B - Part B - Health-Related Grounds of Inadmissibility

POLICY ALERT - Definition of Certain Classes of Medical Conditions and Other Updates Relating to Health-Related Grounds of Inadmissibility

November 02, 2016

U.S. Citizenship and Immigration Services (USCIS) is updating guidance regarding health-related grounds of inadmissibility in accordance with the U.S. Department of Health and Human Services (HHS) rulemaking updating Title 42 of the Code of Federal Regulations, part 34 (42 CFR 34).

Read More
Affected Sections

8 USCIS-PM B - Part B - Health-Related Grounds of Inadmissibility

POLICY ALERT - Health-Related Grounds of Inadmissibility and Waivers

January 28, 2014

U.S. Citizenship and Immigration Services (USCIS) is issuing guidance in the USCIS Policy Manual on the health-related grounds of inadmissibility under INA 212(a)(1) and corresponding waivers under INA 212(g).

Read More
Affected Sections

8 USCIS-PM B - Part B - Health-Related Grounds of Inadmissibility

9 USCIS-PM D - Part D - Health-Related Grounds of Inadmissibility

Version History

No historical versions available.

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