If you are helping a parent or other relative apply for U.S. citizenship (naturalization), particularly if that person is elderly or has medical problems, you might be concerned that they will not be able to take and pass the citizenship test.
Fortunately, there is a "disability exception" to these citizenship test requirements for persons who have serious physical or mental conditions. These can include a wide range of illnesses, such as dementia, heart disease, post-traumatic stress disorder (PTSD), and a developmental disability that significantly affects their ability to learn. A short-term issue won't qualify: The disability must either have lasted or be expected to last at least 12 months. It cannot, however, be the result of illegal drug use.
Under this exception, U.S. Citizenship and Immigration Services (USCIS) will excuse an applicant from taking one or more of the naturalized citizenship tests (English reading, writing, and speaking, as well as civics/government) if the person has a disability or impairment that makes them unable to do so. (See I.N.A. § 312(b).)
USCIS can also waive the usual requirement that the applicant take the oath of allegiance at the citizenship swearing-in ceremony, if warranted for medical reasons. In other words, a parent or relative who is too disabled to understand or understand what it means to apply for U.S. citizenship or promise to be loyal to and support the U.S. constitution and form of government could benefit from this waiver.
However, an oath waiver request should be reserved for applicants with the most limited of physical and cognitive capacities. For one thing, as a practical matter, claiming an oath waiver will require the applicant to have a qualifying U.S. citizen relative who is also a primary caregiver or a court-ordered legal guardian, surrogate, or designated representative act on their behalf at every stage in the process. (See the USCIS Policy Manual at 12 USCIS-PM J.3(C)2.)
To request a disability exception and potentially an oath waiver, a citizenship applicant must submit not only the usual Form N-400 (used to apply for naturalized U.S. citizenship), but a filled-out Form N-648.
Only a U.S. licensed medical doctor, doctor of osteopathy, or clinical psychologist can complete Form N-648, based on an actual examination of the applicant (though a telehealth appointment is permitted). And USCIS can approve a request for a disability exception and/or oath waiver only if the form is properly and fully completed and the doctor provides a clear and detailed explanation of the connection between the applicant's disability and inability to take the citizenship test or recite the oath of allegiance.
In other words, it's not enough for the doctor to say something on the form like, "Mrs. Torres has had a stroke and qualifies for a disability waiver." Better for the doctor to give details about the diagnosis, its connection to the demands of the test, and the doctor's conclusion, such as "Mrs. Torres has had a recent stroke affecting her cognitive abilities, including memory, which makes it impossible for her to learn English and/or U.S. history or civics or repeat and comprehend the oath of allegiance."
Because only a medical doctor, osteopath, or psychologist can complete Form N-648, the best way to determine whether your parent or relative might qualify for a disability exception is to talk to the doctor. Give them a copy of the Form N-648 and the USCIS instructions that go with it (available for free download on the N-648 page of the USCIS website).
Requests for a disability exception, particularly among the elderly, are often based on diseases and medical impairments such as Alzheimer's dementia, vascular dementia, and major depressive disorder. However, every patient is different, and cognitive difficulties can be the result of many different diseases and medical conditions, or a combination of medical issues. As a result, there is no set rule regarding which disabilities, diseases, or impairments will or will not qualify an applicant for a disability exception.
If the case is hard to explain within the N-648 form, ask the doctor to provide a separate letter as well. This is a good idea if, for example, the applicant is able to hold down a job. The medical professional could help by writing up a clear, simple explanation regarding why the person can perform work tasks but cannot learn, retain, and demonstrate knowledge of English (reading, writing and speaking) and U.S. history, civics, and geography.
It's wise to review the N-648 and any accompanying letter after the doctor has finished it (besides which, the applicant needs to sign an "attestation" within the form as well). Many immigration attorneys report having to go back to doctors multiple times because they didn't fully answer all the questions, which would lead to USCIS denial of the waiver request. It will be easier to ask your doctor to redo the form now than to go through the bureaucratic hassles of having USCIS deny the case, request a new Form N-648, schedule a second interview, or ask for other documentation.
In particular, make sure the doctor didn't assume that you would be requesting an oath waiver if that's not the case. Again, that would require you to have a qualifying family member or other court-appointed representative act entirely on the applicant's behalf.
The Form N-648 can be submitted together with the naturalization application (Form N-400) or at the citizenship interview. In the past, USCIS officers viewed submission of Form N-648 at the interview as a possible sign of fraud, but the policy was changed in 2022.
Submitting Form N-648 does not excuse an applicant from attending an interview with an immigration officer and answering questions about the information that provided on the naturalization application. However, the applicant will be able to bring an interpreter along, who can translate all of the immigration officer's questions and the applicant's answers.
The interviewing officer will make a decision on the N-648 at the interview. The officer will give the applicant the "opportunity" to proceed in English if the officer feels unable to approve the N-648 as filed.
Even if you or a doctor decides that your parent or relative does not need or qualify for a disability exception, they might still qualify for either an age-related exception, "due consideration" or "reasonable accommodations."
Another possibility is to make use of special rules allowing some applicants who meet specific residency and age requirements, at the time of filing, to take an "easier" citizenship test:
An applicant who is over 50 years old and has been a lawful permanent resident (LPR) for 20 years (see the "resident since" date on the green card to find out when LPR status began) does not have to take the English test, but does have to take the civics test in their own language.
An applicant who is over 55 years old and has been an LPR for 15 years does not have to take the English test, but does have to take the civics test in their own language.
An applicant who is over 65 years old and has been an LPR for 20 years does not have to take the English test, but does have to take a simplified civics test in their own language (the applicant only has to learn and be prepared to answer 20 of the 100 civics questions).
If your relative qualifies for and can pass one of these "easier" versions of the test, they may not need a disability exception at all.
Due consideration allows USCIS to consider a citizenship applicant's education, background, age, time as a U.S. resident, opportunities available and efforts made to prepare for the citizenship test, and any other relevant factors when deciding what to ask the applicant about, how to phrase questions, and how to evaluate an applicant's answers. In other words, USCIS can go easy on the applicant, if justified.
Your parent or relative can request due consideration at the interview. But it is a good idea to also submit to USCIS a letter from a doctor explaining why "due consideration" should be given in this case.
On Form N-400, applicants can advise USCIS as to whether they have any physical or mental disabilities that could make taking the exam or attending the interview difficult; and also whether some reasonable accommodation could overcome existing barriers. For example, applicants might ask for a relative to accompany them, a sign language interpreter, reading tests in large print or Braille, and so on. The USCIS Policy Manual contains more detail on what's appropriate to request.
Whatever you decide to do, remember that it is never a good idea to lie about your parent or relative's medical problems or disability just to try to get a disability exception. All applicants for citizenship must show that they have good moral character. Lying to the immigration authorities is one easy way to be found lacking in good moral character.
If at all possible, hiring an attorney to help with this process will increase the likelihood that your family member will be granted the disability waiver. The attorney can also help the applicant prepare for the actual interview experience, which is likely to include questions about their disability and how it impacts their daily life.