The N-648 exam is a medical certification for disability exceptions that certain people need for the United States immigration application process.
Who needs the N-648 exam?
The English language and civics education requirements of the United States naturalization process can be waived for applicants who are unable to meet those requirements due to a physical, developmental, or mental impairment. The applicant must demonstrate a disability or impairment that affects functioning such that, even with reasonable accommodations, he or she is unable to demonstrate the educational requirements for naturalization.
Who must conduct the N-648 exam?
Ideally, the primary care physician or the physician or psychologist treating the naturalization applicant for the condition which led to the impairment should complete the N-648 exam and paperwork. Any medical physician (MD), a doctor of osteopathic medicine (DO), or a clinical psychologist (PhD or PsyD) licensed to practice in any United States state or territory can complete this exam. However, the naturalization applicant might not have a primary care provider, or his or her provider might be unable to complete the N-648 paperwork or might not be experienced with this exam.
Why be selective about your provider?
USCIS is very particular about how the N-648 exam and paperwork are completed. Even the smallest mistake or omission of information in the documentation can lead to denial of the application. Many patients have ended up at our clinic after having their N-648 application denied, not because they do not meet the criteria, but because their exam was conducted by a provider that did not complete the forms correctly or did not gather the necessary information to justify their application. To help you avoid the hassle and expense of having to redo these exams, here are some tips for selecting the right provider to complete your N-648 exam.
How to choose a good provider for the N-648 exam
- Ensure that you have an impairment that will actually qualify for the exception. See What might qualify as grounds for a medical exception?
- Ask if a physician or psychologist will personally conduct the exam. Exams completed by nurses, nurse practitioners, physician assistants, or social workers–even if under the direction of a physician or psychologist–will not be accepted. Avoid providers who have an assistant do the exam.
- Ask how long the appointment will take and what records you need to bring. Avoid providers who schedule very short appointments (e.g., 15 minutes) or who do not ask for supporting, relevant medical history. They might not gather enough information to successfully document your case.
- Ask how many N-648 exams the provider conducts in a year. The N-648 paperwork is complex, and providers that have experience are more likely to complete it correctly. It is best to select a provider that does these exams as a regular part of their practice. Often United States civil surgeons are well-suited to provide these exams.
How to check that the provider did everything correctly
Examine the N-648 forms that your provider completed. The forms must:
- Clearly explain the nature and extent of the medical condition.
- Explain how the medical condition relates to the applicant’s inability to comply with the English and civics requirements.
- Attest that the medical condition has lasted or is expected to last at least 12 months.
- Attest that the cause of the medical condition is not related to the illegal use of drugs.
- Certify that the applicant’s medical condition prevents the applicant from meeting the English requirement or the civics requirement or both.
- Include a formal clinical diagnosis with relevant ICD or DSM diagnosis code.
- Document which clinical and laboratory measures were used to arrive at the conclusions of the reported condition.
Don’t delay in submitting your application
Submit your completed N-648 exam paperwork to USCIS within six months. Exams older than six months will not be accepted.
Video appointments accepted
- USCIS accepts N-648 exams that were conducted via telehealth video visit.
- Live outside the San Francisco Bay Area? Call us at 415-409-3456 to arrange a video appointment.
- Live inside the San Francisco Bay Area? You can request a video appointment or an in-person exam. Call us at 415-409-3456 or request an appointment online.
More info
USCIS website: Medical Disability Exception (Form N-648)
Contact us
Are you in the San Francisco Bay Area? Book an appointment with one of our certified U.S. civil surgeons to learn more. Call us at 415-409-3456 or request an appointment online.