If you are helping a parent or relative apply for U.S. citizenship (naturalization), particularly if that person is elderly or has medical problems, you might be concerned that he or she will not be able to take and pass the citizenship test.
To become a U.S. citizen, most applicants must pass tests showing that they can speak, read, and write English, and that they can correctly answer questions about U.S. history, civics, and geography. Fortunately, there is a “disability exception” to these citizenship test requirements for persons who have serious medical problems, such as dementia, that significantly affect their ability to learn.
Under the disability exception, U.S. Citizenship and Immigration Services (USCIS) will excuse an applicant from taking the citizenship tests if the person has a disability or impairment that makes him or her unable to do so. (See I.N.A. § 312(b).)
Only a U.S. licensed medical doctor, doctor of osteopathy, or clinical psychologist can complete Form N-648. And USCIS can approve a request for a disability exception 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.
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.”
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 his or her doctor. You should also give the doctor a copy of the Form N-648 and the USCIS instructions that go with it. These are 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. 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.
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 determines that he or she cannot approve the N-648 as filed.
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.
In the current USCIS Policy Manual, however, it says that "USCIS may consider a later-filed Form N-648 if the applicant provides a credible explanation for filing the N-648 after filing the Form N-400 and submits sufficient evidence in support of that explanation." The manual then gives the example of "a significant change in the applicant’s medical condition" as a good reason for a late filing. Your safest bet might be to submit the N-648 along with the N-400.
Submitting Form N-648 does not excuse an applicant from attending an interview with an immigration officer and answering questions about the information that he or she 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.
Even if you or a doctor decides that your parent or relative does not need or qualify for a disability exception, he or she may still qualify for something called “due consideration.” 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.
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:
If an applicant is over 50 years old and has been a lawful permanent resident (LPR) for 20 years (see the “resident since” date on your parent or relative's green card to find out when LPR status began), he or she does not have to take the English test, but does have to take the civics test in his or her own language.
If an applicant is over 55 years old and has been an LPR for 15 years, the person does not have to take the English test, but does have to take the civics test in his or her own language.
If an applicant is over 65 years old and has been an LPR for 20 years, he or she does not have to take the English test, but does have to take a simplified civics test in his or her 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, he or she may not need a disability exception at all.
It is also possible that your parent or relative is too disabled to understand or take the naturalization oath. That would mean your relative does not understand what it means to apply for citizenship or promise to be loyal to and support the U.S. constitution and form of government.
This is most likely to occur in someone with severe cognitive or mental difficulties. In this case, an N-648 must still be submitted, but additional documents must also be submitted in order to request an “oath waiver”.
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.
Also, make sure to read whatever your parent or relative's doctor writes on Form N-648. Doctors, like everybody else, can make mistakes and may make statements that are incorrect or incomplete. 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.