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What is a civil surgeon? And what does that have to do with an immigration medical exam?

Updated on October 10, 2012

When applying for a “Green Card” or Permanent Lawful Residence in the United States, whether through family or employment, you will have to get a physical. It would be too simple to go to your own doctor. Immigration requires you go to a doctor on their list. However, they do not call them doctors, they use the term “civil surgeons”. Immigration relies, in part, on the Center for Disease Control (CDC) for the requirements for the physicals.

Civil Surgeon Locator Tool on USCIS Website

How do I find a civil surgeon in my area?

You can find out who is on the list by going using the Civil Surgeon Locator tool on Immigration’s website.

You simply enter your zip code and the closest civil surgeons with their contact information will be displayed.

Be careful, costs vary.

Immigration does not control the fees the civil surgeons may charge. Call ahead and get two or three quotes if possible. Ask what the cost of shots or x-rays might be. The fees will vary widely. If you have previously received vaccinations, make sure and bring proof of those vaccinations to the civil surgeon, otherwise you might get pricked with more shots and pricked again in the pocketbook to pay for the privilege of getting shots you don’t really need.

What happens at the physical exam?

The civil surgeon mainly does a standard physical. The doctor will also make sure your vaccinations are current. Below is a list of vaccinations that you will need. The list changes from time to time.

Vaccinations:

• Hepatitis A

• Hepatitis B

• Influenza

• Influenza type b (Hib)

• Measles

• Meningococcal

• Mumps

• Penumococcal

• Pertussis

• Polio

• Rotavirus

• Rubella

• Tetanus and diphtheria toxoids

• Varicella

The doctor will also administer a blood test to check for syphilis and a skin test to check for tuberculosis (TB). The TB test will require you to come back one to two days later to get the results. He or she should give you the completed form in a sealed envelope for you to send to immigration. Do not open the envelope. However, the doctor should give you an unsealed copy for your records. If not, request one before leaving the office. Read over the I-693. Pay special attention to the date on the top of the form. The biggest problem with the I-693 is the civil surgeon using an out of date form. Immigration cannot approve you with an expired form. You can check here (www.uscis.gov/forms) to see what the current form versions are being accepted.

I-693 Expiration date

What if I have a disease? Will the Civil Surgeon deny me?

In addition to ensuring an immigrant’s vaccinations are up to date, the other main purpose of the physical exam requirement to screen out applicants that my have contagious diseases that present a public health threat or health conditions that is associated with harmful behavior or who are a drug addict or alcoholic.

The list of communicable diseases changes from time to time but currently is as follows:

• Tuberculosis

• Syphilis

• Chancroid

• Gonorrhea

• Granuloma Inguinale

• Lymphogranuloma Venereum

• Hansen's Disease (Leprosy)

• Cholera

• Diphtheria

• Plague

• Smallpox

• Yellow fever

• Viral hemorrhagic fevers

• Severe acute respiratory syndrome (SARS)

• Influenza caused by novel or re-emergent influenza (pandemic flu)

• Polio

If you have one of the listed diseases you may be denied a “green card” or lawful permanent residence. Depending on the disease you may also be able to still qualify for the green card if you first get treatment and the civil surgeon acknowledges you have completed treatment or are likely to continue to receive treatment. This is often the case for TB.

The category of health conditions that are associated with harmful behavior is broad and subjective. I am aware of a woman who was initially denied a green card because she had sleep apnea and did not want to use a “CPAP machine”. She was eventually granted a waiver. If the civil surgeon designates you as having a contagious disease, harmful medical condition, or drug addict, you should seek advice from an attorney. You may be eligible for a waiver, or you may need to get a second opinion. However, never submit a physical to immigration you have not first seen and understood.

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