Anyone applying to visit or reside in U.S., whether on a temporary visa or a permanent green card, must prove that he or she does not present a health risk to the general public. These requirements are known as health-related grounds of inadmissibility.
You might not be allowed to enter or remain in the United States if you:
• have a communicable disease of public health significance
• lack required vaccinations
• have or have had a physical or mental disorder that causes you to engage in behavior that might be harmful to yourself or others, or
• have a history of drug abuse or addiction.
Even if you have never been diagnosed with an alcohol- or drug-related health issue, a record of alcohol- or drug-related arrests or criminal offenses can result in your being found inadmissible on health grounds.
There are waivers available for all health-related grounds of inadmissibility except drug abuse and addiction.
How Your Health-Related Inadmissibility Will Be Discovered
Health-related inadmissibility issues are typically discovered when immigration officials review either your answers to questions about your health in your visa or green card application forms, the results of your immigration medical examination (required for every immigrant—that is, permanent resident—visa or green card, and for some temporary visitors), criminal and court records you submit with your application, and any other documents or information you provide at interviews and inspections.
You will need to answer questions regarding your health on almost any application you might submit, whether it’s for a temporary (nonimmigrant) or an immigrant visa. The questions you see on the forms asking about your history of communicable disease, substance abuse, and physical and mental disorders all pertain to your potential inadmissibility on health-grounds.
What to Expect During the Medical Examination
In an immigration medical examination, the physician will most likely review your medical record, vaccinations, chest x-rays, and laboratory results, and perform a physical examination. If you are applying from outside the U.S. to enter and reside permanently, you must undergo a medical examination by a physician certified by the Department of State. If you are already residing in the United States and applying for permanent residency (adjustment of status), you will need to attend a medical examination by a physician certified by U.S. Citizenship and Immigration Services (USCIS).
The physician will prepare a report summarizing his or her medical findings for the immigration authorities.
Communicable Disease Ground of Inadmissibility
The list of communicable diseases that bar people from entering the United States, which is kept by the U.S. Centers for Disease Control (CDC), continues to grow. The list includes a number of quarantinable diseases (such as cholera, plague, smallpox, and yellow fever), as well as leprosy, tuberculosis, and pandemic flu. Recently HIV and other sexually transmitted diseases (such as chancroid and gonorrhea) were removed from this list.
The physician conducting your medical examination (if any) will ask you about certain diseases depending on what countries you’ve lived in or traveled to. The physician will also examine your medical history, blood test, and chest x-rays for traces of communicable diseases.
Physical or Mental Disorder Ground of Inadmissibility
Having a physical or mental disorder that creates behavior harmful to property, safety, or public welfare can make you inadmissible. Harmful behavior is defined as psychological or physical injury to the applicant or another person (such as a suicide attempt or pedophilia), a threat to health or safety (such as driving while intoxicated or threatening to kill someone), or damage to major property. Mental illness alone without any harmful behavior will not make you inadmissible.
Even if you no longer have a harmful disorder, you may still be inadmissible if the disorder is likely to reoccur. And even if you have no prior diagnosis or record of any disorders, a history of crimes such as assaults and domestic violence involving alcohol and drugs could result in a referral for a mental examination and ultimately a finding of inadmissibility.
A record of alcohol-related offenses, or any other evidence of alcohol abuse, like driving while under the influence, may lead to a referral to a physician to determine whether you have and alcohol-related mental or physical disorder causes harmful behavior. Anything more than a single drunk driving arrest or conviction may result in a referral to a physician.
Drug Abuse and Addiction
A history of drug abuse or addiction will bar you from entering the U.S. on health grounds. Drug abuse is broadly defined to mean anything beyond mere experimenting. In general, experimenting is considered just one use. Anything beyond one non-medical use of a controlled substance will be considered drug abuse. Normally, the physician giving the medical examination will administer a drug test only upon deciding that it is necessary in the individual person’s case.
If you have any drug- or alcohol-related arrests or convictions on your record, consult with an immigration attorney before applying for a U.S. visa or residency. These items on your record may also make you inadmissible on criminal or controlled substance trafficking grounds.
Vaccinations and Inadmissibility
Applicants for green cards or immigrant visas (but not temporary visas) are required to have vaccinations against a number of diseases, including influenza, measles, mumps, and rubella. (See the USCIS Web page on “Vaccination Requirements” for the full list.) The influenza vaccine will be required only if you are entering the United State during flu season, generally between October and March of each year.
Bring your vaccination records to your immigration medical examination: If you show the physician the proof of your past vaccinations, you can avoid getting them again, and paying for them! The physician will determine which vaccines are appropriate for your age.
Internationally adopted children under the age of ten are not required to have vaccinations before they enter the United States. However, they will be required to have their vaccinations completed within 30 days of arrival. Vaccinations that are against your religious beliefs will not be required.