Not every applicant for a disability-based waiver of the U.S. citizenship (naturalization) exam is successful in receiving this waiver. It may happen that, after the applicant has had a doctor fill out Form N-648, submitted the form, then gone to the interview at an office of U.S. Citizenship and Immigration Services (USCIS), the officer conducting the interview rejects the waiver request.
This doesn’t mean that the person is ineligible for citizenship, just that he or she will have to pass the English and civics exams in order to become a citizen.
First, while the interview is still going on, the officer will give the applicant an opportunity to take the citizenship exam in English. The officer will give the applicant this “opportunity” by asking the interpreter to stop interpreting. Then the officer will address the applicant directly in English.
At this point, an applicant whose disability is not too severe may be able to respond to all of the officer's questions and actually end up passing the entire citizenship exam, or may just pass parts of the exam. The officer is unlikely to ask the most difficult exam questions, but should choose ones better suited to a person with disabilities. Or, the applicant may not understand any English at all and may simply reply in his or her native language that she understands nothing the officer is saying.
If the applicant passes the entire exam, even though he or she had asked for a medical waiver, that is mostly good news. The immigration officer is not supposed to automatically conclude that the applicant or the doctor committed fraud by completing and submitting Form N-648. Instead, the officer should ask the applicant why she submitted Form N-648 and find out more about the applicant's relationship with the doctor.
The immigration officer wants to make sure that the applicant did not, for instance, hear from friends that there was a doctor who would see people once for a fee of $500 and then complete the N-648 so that they would not have to study for the citizenship exam. If such information comes out, USCIS could deny the naturalization application based on the applicant not having “good moral character” (i.e. not being a “moral” person). Also, if such information comes out after USCIS has already granted the application for naturalization, USCIS might take away the applicant's U.S. citizenship for having lied in the application.
If the applicant is unable to answer any of the officer’s questions at the first interview, or passes only part of the citizenship exam, the USCIS officer will schedule a second interview. The officer will also give the applicant a “results sheet,” showing the outcome of the interview, and a Form N-14, explaining what the problems were with the N-648.
Then, at the second interview, the applicant can submit a new N-648 that addresses the problems that the officer identified at the first interview. If the N-648 is rejected again at the second interview, and the applicant again is unable to answer any questions or does not pass all remaining parts of the citizenship exam, the officer will deny the application for naturalization.
After a denial, the applicant can always appeal or apply for naturalization a second time. However, in both cases, a new fee would be required and the assistance of an attorney would be advisable.