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

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 USCIS decide whether to approve or deny the request?

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 USCIS decide whether to approve or deny the request?

Fortunately, the rules governing the review of the disability waiver have become clearer and more beneficial to applicants in the last few years. Specifically, U.S. Citizenship and Immigration Services (USCIS) has become much more willing to accept the doctor's sworn statements about the applicant's inability to take the citizenship exam. However, as described in more detail below, the form must still be very well prepared and must not contain any indications that either the applicant or the doctor is lying.

It's also 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 relative will review the Form N-648 Medical Certification for Disability Exceptions 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. Sometimes USCIS will accept older versions of forms after it switches to a new one, sometimes it will not. To check which edition of Form N-648 USCIS is accepting at the time your relative applies for citizenship, go to

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 has to reject the waiver request and follow the steps described in the article “What Happens If USCIS Rejects an N-648 Disability Waiver Request.”

Is the Connection (“Nexus”) Clear?

The 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 his or her 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 the patient's cognitive abilities, he or she 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 Any Indications of Fraud?

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 the applicant questions to evaluate whether he or she is attempting a fraud. However, the officer will allow the applicant's interpreter to interpret any questions that he or she asks 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? How long have you been seeing this doctor? What language do you use to communicate with your doctor? Do you use an interpreter at your appointments with your doctor?

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

The immigration officer is not a doctor. He or she is supposed to rely on the doctor's diagnosis and opinion regarding whether the applicant can take the citizenship exam. Therefore, as described above, 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 officers, despite the explicit rules that limit them to a careful review of the form, will ask questions that touch on issues that the doctor does not have to, and did not, address in the form.

For example, although doctors need not provide information about how the applicant's disability affects “activities of daily living,” some officers will improperly ask questions about an applicant's living situation. The officer may ask who the applicant lives with, whether anybody helps him or her with cooking and cleaning, whether the applicant takes public transportation unassisted, and whether the applicant has a driver's license.

As a practical matter, it's a good idea to just answer the officer's questions about “activities of daily living.” The officer may be asking these questions just out of habit; there was a time when the disability waiver form required that doctors provide information about an applicant's activities of daily living. However, if the officer determines that the applicant's ability to perform a particular activity of daily living, such as preparing meals, means that the applicant does not qualify for a medical waiver, the applicant's interpreter or attorney should ask to speak with a supervisor.

When speaking with a supervisor in this type of case, point out that the officer did not identify any deficiencies in the form, and instead improperly used the applicant's answers about activities of daily living to reach his or her own determination about whether the applicant qualifies for a waiver. Also point out that the most recent N-648 memorandum specifically prohibits officers from substituting their own medical determination for that of the doctor.

An officer may ask other improper questions. Again, however, unless the questions are outrageous – impolite, unprofessional, or improper – it is probably best to answer them and then ask to speak to a supervisor if the officer appears to be “acting like a doctor” by making an independent judgment about the need for a disability waiver.

Finally, the officer may say that the doctor failed to perform a particular medical test, or may request medical records or proof that the applicant takes prescription medications. Under current USCIS rules, the officer is not supposed to make these sorts of requests, because they amount to an attempt to undermine and question the medical determination of the doctor. Again, asking to speak to a supervisor is the best option.

Filing Form N-648 at the Interview Should Not Cause USCIS to Reject It

In the past, USCIS officers viewed submission of Form N-648 at the interview as a possible sign of fraud.

Under current rules, the USCIS officer is not supposed to be concerned with whether the Form N-648 was submitted with the naturalization application or at the interview. A USCIS memo specifically says: “the USCIS Officer must consider Form N-648 even if it is submitted after the filing of Form N-400 and must not draw any negative inference regarding the applicant's medical condition as a result of the late filing.”

However, it is still better to submit Form N-648 together with the Form N-400, because some officers are still skeptical of, and try to find reasons to reject, any Form N-648 that is filed at the interview. Of course, providing an updated Form N-648 is different, and should not cause any problems, unless there are problematic inconsistencies between the original and updated forms.

The Officer's Final Decision

If the applicant's doctor indicated that he or she 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 will 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, however, the officer decides not to accept the N-648, see "What Happens If USCIS Rejects an N-648 Disability Waiver Request" for further information."

Talk to a Lawyer

Need a lawyer? Start here.

How it Works

  1. Briefly tell us about your case
  2. Provide your contact information
  3. Choose attorneys to contact you

Talk to an Immigration attorney.

We've helped 85 clients find attorneys today.

How It Works

  1. Briefly tell us about your case
  2. Provide your contact information
  3. Choose attorneys to contact you