Search Ethnomed:

Part II of N-648: SECTION TO BE COMPLETED BY A LICENSED MEDICAL DOCTOR OR LICENSED PSYCHOLOGIST

1. Date of your most recent examination of the applicant.
2. Is this your first examination of the individual? Yes___ No___
3. Based on your examination, describe any findings of a physical or mental disability or impairment which, in your professional medical opinion, would prevent this applicant from demonstrating knowledge of basic English language and/or U.S. history and civics. Describe in detail. If applicant has a mental disability or impairment, please provide DSM diagnosis.
• Do not assume anything when completing this form.  The INS officers conducting the immigration interview do not have in depth training re: health care, the training of primary care physicians or the meaning of DSM-IV codes.
• Describe any diagnostic tests or techniques used and state they are accepted medical practice. The INS officers are looking for a DSM-IV code, so if none is available state that fact but emphasize that for the medical reasons given the patient still cannot pass the English/history/civics sections.  Consider these recommendations from a neuropsychologist.
• State the medical diagnosis, including any relevant DSM-IV codes (some suggestions).
• Explain the extent of the patient's impairment: Protection and Advocacy, Inc. says to describe cause, connection, consequence - see examples in Question 3 (Examples)
• How the impairment affects memory and understanding necessary to learn English and/or the 100 questions necessary for the history and civics test.
• Note that the patient must be "competent" to take the oath of citizenship(i.e., understand the nature of the oath). If the patient's condition is such that INS might mistakenly conclude that the patient is incompetent, state clearly that you believe the patient to be competent to take the oath.
 
• With a disability exception the applicant can have the interview in his/her native language and will not have to answer questions about U.S. history and government.
• Additional medical reports may be submitted, but must not be more than two pages. Each page should have the name of the applicant, alien registration number, and the provider's signature.
• Examples of answer to question #3
4. Did the applicant's disability or impairment result from the illegal use of drugs? If the applicant is developmentally disabled, did this condition first manifest itself before age 22? Please explain.
• If the impairment is due to the illegal use of drugs see Moral Character section.
• If the disability is a developmental one, state whether or not it occurred before age 22. If you have not been treating the patient that long, you may express a medical opinion as to whether it is likely to have occurred before age 22.
 
5. What is the duration of the applicant's disability or impairment? Is it temporary (less than 12 months) or permanent. Explain.
• The patient will not qualify for a waiver if his condition is not expected to last at least one year. For the purposes of this form, any condition which lasts one year or longer is "permanent."
 
6. Please provide your medical specialty. If you are not specialized, provide your medical experience and other qualifications that permit you to make this assessment.
• State either that you are a licensed MD or a licensed clinical psychologist.
• If you are relying on the expertise or records of other providers attach copies of their findings or records.
• It is important that whoever fills out this form is qualified to do so. If you are not a psychiatric or neuropsychologist, you should be able to state some experience in this area. Many people who handle this paper work do not understand that the primary care givers, e.g., physicians in Family Practice, Geriatrics and General Internal Medicine, are specialists who routinely evaluate patients' general ability to function.
• If you are a specialist you might want to develop a standard statement to insert in this section of the form, including
• Your specialty
• Your training and experience relevant to making this diagnosis