N-648 Medical certification for disability

Naturalization with form n-648 medical disability waiver

Under Section 312 of the Immigration and Nationality Act, an applicant for US citizenship must be able to read, write and speak basic English. He must also demonstrate a knowledge of U.S. history and government. But what happens when an applicant can barely remember that he had egg omelets for breakfast this morning?  What happens when an applicant is  not able to learn or retain information because of a disability? The law allows someone who is incapable of meeting the English and Civics requirements to apply for a medical disability waiver (using Form N-648) on account of an impairment or disability. However, a waiver will not be granted if the disability results from the use of illegal drugs. N-648

A licensed medical doctor who has examined the applicant must complete and sign n-648

The regulation [8 C.F. R. 312.2 (a)] require that the waiver must be completed by a US licensed medical or osteopathic doctor. The law requires that the medical professional signing the medical disability waiver N-648 must examine the patient and use diagnostic tests.  A medical professional who signs form N-648 does so under penalty of perjury and must do so in a complete and truthfully manner. With doctor shortage in the United States primary care is increasingly being delivered by physician’s assistants. Under Florida law for example, a physician’s assistant is licensed to practice medicine under the supervision of a medical doctor. The medical doctor need not be present but must be “easily available”. In practice many patients may be examined by a physician’s assistant for years without ever being examined by the supervising medical doctor. It is not uncommon for a medical doctor have never met the patient who is examined by the physician’s assistant. This may cause the doctor to be reluctant to sign form N-648 under penalty of perjury. The diagnosis and certification of certain illnesses can cost thousands of dollars when working with a medical professional with no prior knowledge of the patient. Therefore should a physician’s assistant who regularly examines the patient be authorized to sign form N-648? The view of the United States Citizenship and Immigration Service is that a disability waiver signed by a physician’s assistant is insufficient and will be rejected. It could be argued that the practice of medicine today suggests that the law should be interpreted to allow physician’s assistants to sign N-648. After all, they are licensed medical examiners and would sign under penalty of perjury and would also be subject to civil penalties for document fraud. Furthermore requiring a disabled person to incur the cost of a new diagnosis can impose financial hardship on a person who may already be suffering hardship as a result of their medical disability or impairment. But on the other hand granting citizenship to an alien is an important and sacred act of government that requires a high level of confidence that exemption from the civics and English requirements is warranted.  In some cases an exemption may even have implications for national security because the full interview may reveal grounds for further inquiry. An approved waiver dispenses with the general examination process.

Seek experienced legal counsel when contemplating a medical disability waiver

Persons requesting a medical disability waiver as part of a citizenship application should seek experienced legal counsel to determine eligibility and to quickly secure the benefits of US citizenship. Even if a medical doctor will complete and sign the waiver a doctor who has never done a medical disability waiver may have questions concerning the regulations in particular the nexus requirement. If you have questions about whether you or a family member may qualify for naturalization using a medical disability waiver, give our Las Vegas naturalization law office a call to speak with an experienced US naturalization lawyer in further detail about your case.

Gary Goodin, Las Vegas Naturalization Attorney