How the USCIS Interviewer Will Approve or Deny an N-648 Disability Waiver

Learn how the USCIS evaluates N-648 disability waiver requests and what you can do to increase the chances your request will be approved.

Updated by , Attorney

If you are helping a relative apply for U.S. citizenship (naturalization), and have requested a disability-based waiver of the citizenship exam, how will U.S. Citizenship and Immigration Services (USCIS) decide whether to approve or deny the request?

You can submit Form N-648 Medical Certification for Disability Exceptions as well as the basic application Form N-400 when you apply for citizenship but, due to a documented medical disability, are unable to learn or speak English sufficiently to pass the citizenship tests or answer questions in English. This form must be very well prepared and contain no indications that either the applicant or the doctor are not "credible" (believable).

It's important to realize that USCIS is unlikely to review the request for a disability waiver before the naturalization interview itself. The person who actually conducts the interview will review the Form N-648 that the doctor filled out in conjunction with interacting with the applicant.

Now let's look at some of the factors that the USCIS interviewer will likely take into account.

Did You Submit the Right Edition of the Form?

USCIS regularly updates many of its immigration forms, and can refuse to accept older versions of the forms after switching to a new one. Some of the changes can be substantive. To check which edition of Form N-648 USCIS is accepting at the time your relative applies for citizenship, go to www.uscis.gov/n-648.

Did You Submit the Form While Its Results Are Still Valid?

The doctor needs to have filled out the Form N-648 no more than 180 days before you file the N-400 naturalization application with USCIS. Once this requirement is satisfied, the Form N-648 remains valid for the entire naturalization process connected to that particular Form N-400. Also, though USCIS once required that the N-648 be submitted at the same time as the N-400, that requirement was lifted in 2022, and you can now submit the N-648 later; for example, at your naturalization interview.

Did the Doctor Fill Out the Form Completely?

The immigration officer will look to see whether the doctor completed all sections of the form and answered all of the questions. The officer will also confirm that all required signatures are present. If the doctor left any question unanswered or did not provide the required information, or failed to sign the form, the officer may reject the waiver request.

Even if a question does not directly apply to you or the family member you're helping to prepare the paperwork, advise the doctor to fill out every single question, including writing "N/A" or "none" for sections that do not apply. USCIS has been known to deny applications for being incomplete if any question is left unanswered, even if those questions do not directly fit the applicant's situation.

Is the Connection ("Nexus") Clear?

The USCIS officer will check that the doctor has made completely clear, using "lay" terms and defining any medical terminology or acronyms, the connection ("nexus") between the applicant's disability and inability to learn English or U.S. history and civics.

It does not matter if the connection seems obvious. For example, the doctor cannot assume that everybody knows that dementia causes memory problems, and therefore provide one-sentence answers such as: "Because the patient has dementia, she cannot learn English or U.S. history and civics."

Instead, the doctor will need to have explained the type of negative effects that dementia has on cognitive abilities, including a description of which cognitive abilities are negatively affected. Then, the doctor will need to have explained that, because of these negative affects on cognitive abilities, the patient is unable to learn English or U.S. history and civics. For example: "Mrs. Torres suffers from dementia, which has a severe negative affect on her cognitive abilities, including memory. Because of these dementia-related negative cognitive effects, including impaired memory, Mrs. Torres is unable to learn English and/or U.S. history or civics."

Do the N-648 or Applicant Exhibit Indications of Fraud?

An N-648 can be rejected and the applicant can face serious penalties if the immigration officer finds credible doubt, discrepancies, misrepresentation, or fraud as to the applicant's eligibility for the disability exception.

The officer will review the Form N-648 for signs that the doctor or the applicant is lying about the need for a waiver of the citizenship exam. The officer may also ask applicants questions to evaluate whether they are attempting a fraud. However, the officer will allow the applicant's interpreter to interpret any questions asked of the applicant during this phase of reviewing Form N-648.

Possible "fraud questions" include:

  • How did you find the doctor who completed the form for you?
  • Did anybody refer you to this doctor?
  • What language do you use to communicate with your doctor?
  • Do you use an interpreter at your appointments with your doctor?

The immigration officer will also be looking for potential credibility "red flags," such as whether the applicant submitted more than one application from different doctors, whether the doctor is or was under investigation in another case for N-648 fraud, whether the form has sufficient detail, or whether the applicant's previous medical documentation submitted (such as the I-693 submitted during the green card application process) did not identify a long-term medical condition. Therefore, if your previous medical documentation is inconsistent with your current diagnosis, make sure to address that in detail in your N-648 and have the medical records to back it up.

The U.S. immigration officer can also deny an N-648 for credibility grounds for "any other articulable grounds that are supported by the record." This broad, catch-all language (added by the Trump Administration) has opened the door for extensive denials by immigration officers for discrepancies, real or perceived, large or small. Thus, any N-648 submitted must be impeccably prepared and the medical reasons for the waiver well-documented.

What the USCIS Officer Should Not Do: Act Like a Doctor

The immigration officer is not a medical professional, and is supposed to rely on the doctor's diagnosis and opinion regarding whether an applicant can take the citizenship exam. The officer's focus should be on the Form N-648, namely:

  • whether the doctor completed it properly and completely, and
  • whether the doctor provided enough information, in clear, non-technical language, to make it clear that the applicant has a disability or impairment that makes the applicant unable to take the citizenship exam.

Some USCIS officers, however, will ask questions that touch on issues that the doctor does not have to, and did not, address in the form, especially under the broad discretionary powers they've been given. As a practical matter, it's typically a good idea to simply answer the officer's questions. However, the applicant's interpreter or attorney can also ask to speak with a supervisor if the questions seem improper or the USCIS officer appears to be "acting like a doctor" by making an independent judgment about the need for a disability waiver (for example by demanding that the applicant take a particular medical test).

The USCIS Officer's Final Decision on the Disability Waiver

If a doctor indicated that an applicant qualifies for a complete exam waiver, and the USCIS officer accepts this, the applicant will not have to speak English, write a sentence in English, read a sentence in English, or answer any questions about U.S. civics or U.S. history.

Instead, the officer will then allow the applicant's interpreter to interpret all of the officer's questions during the rest of the interview. Then, the officer will review the applicant's Form N-400 and ask the applicant many of the questions on that form to make sure that all of the information is complete, accurate, and truthful.

It is also possible that the doctor indicated that the applicant qualifies only for a partial waiver of one, two, or three of the elements of the citizenship exam (the four elements of the citizenship exam are: (1) speaking English; (2) reading English (3) writing English; and (4) correctly answering at least 6 out of 10 "civics" questions regarding U.S. history, government, and geography.)

If the applicant qualifies for only a partial waiver, the immigration officer will conduct only the part of the citizenship exam that the doctor said the applicant is able to take and pass.

If the doctor also indicated that the applicant is unable to take the oath waiver owing to the disability, and the naturalization application is approved, the applicant will not need to attend the citizenship swearing-in ceremony. However, a qualifying
U.S. citizen relative who is also a primary caregiver or a court-ordered legal guardian, surrogate, or designated representative will act on the applicant's behalf at every step in the application process.

What If USCIS Denies the N-648?

In most cases, an N-648 is a low-risk application. Nevertheless, because the penalties for fraud can be so severe, if you intend to file an N-648, it's best to work with an attorney or qualified advocate before submitting. If your N-648 is denied, the reason for the denial is extremely important. An immigration officer may deny an N-648 for insufficiency, lack of credibility, fraud, or material misrepresentation.

If your N-648 is denied simply for being insufficient, the immigration officer will proceed with your interview as if you had not submitted an N-648 (testing you on English, civics, and so forth). You can choose not to continue. However, your refusal will count as a failed attempt to pass the English and civics test. You can also choose to submit additional information, and the immigration officer will conduct a re-examination. However, if you do this, make sure that the new information is consistent with your previously submitted documentation, or you risk a fraud finding.

In the worst-case scenario, if the immigration officer suspects that you or your doctor has committed fraud or made a material misrepresentation in the N-648, the officer might refer a case to their fraud investigation unit, the Fraud Detection and National Security Directorate (FDNS). If the officer determines that fraud occurred, USCIS will send you an explanation in your naturalization denial notice. Penalties for committing fraud or making material misrepresentations can be serious, up to and including deportation.

Your best chance of success is to invest significant time in working closely with the medical professional, including visiting the provider several times if necessary, to get a comprehensive N-648 and preventing any opportunity for a denial.

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