Blanket Civil Surgeon Designation for Military Physicians
The U.S. Citizenship and Immigration Services (USCIS), in collaboration with the Centers for Disease Control and Prevention (CDC), has implemented a blanket civil surgeon designation for Military Doctors. This policy simplifies the process for U.S. armed forces members, veterans, and certain dependents to complete their required immigration medical examinations. This designation also extends to specific Afghan nationals seeking a special immigrant visa under Operation Allies Refuge, acknowledging the crucial service of these individuals.
Who are Eligible Military Physicians?
Participation in this blanket designation is voluntary for medical facilities and depends on the discretion of each facility. However, to qualify under this blanket designation, military physicians must meet specific criteria:
- Professional Qualifications: They must meet the standard professional qualifications of a civil surgeon. A key difference for military physicians is that their medical license can be from any U.S. state, not necessarily the state where they are conducting the immigration medical examination.
- Employment: Eligible physicians are employed by the Department of Defense (DOD) or provide medical services to U.S. armed forces members, veterans, and their dependents as military contract providers or civilian physicians.
- Authorization: They must be authorized to provide medical services at a Military Treatment Facility (MTF) within the United States.
It’s important to note that military medical facilities and physicians who meet these criteria do not need to apply for individual approval from USCIS to perform immigration medical examinations under this blanket designation. They are automatically exempt from the standard application and fee requirements for civil surgeon designation. However, familiarity with the CDC’s Technical Instructions for the Medical Examination of Aliens in the United States is mandatory before conducting these examinations.
Scope of the Blanket Designation for Military Doctors
The blanket civil surgeon designation for military physicians is applicable under specific conditions, as agreed upon by USCIS and CDC. These conditions relate to both the location of the examination and the individuals being examined:
- Location: The immigration medical examination must be conducted within the United States at an MTF or another authorized location for examining Afghan nationals under Operation Allies Refuge.
- Eligible Individuals: This blanket designation covers immigration medical examinations for:
- U.S. armed forces members or veterans.
- Dependents of U.S. armed forces members or veterans who are eligible for medical care at an MTF.
- Certain Afghan nationals seeking a special immigrant visa, including principal applicants and their eligible family members, in coordination with Operation Allies Refuge.
If these conditions are not met, military physicians must pursue the standard civil surgeon designation process to perform immigration medical examinations. Similarly, U.S. armed forces members, veterans, or dependents who prefer a non-military physician, want the exam outside of an MTF (or authorized location), or lack access to a participating military physician must seek a civil surgeon through the standard application process.
Recording and Certification Requirements for Military Civil Surgeons
Military physicians operating under the blanket civil surgeon designation are required to meticulously document the results of each immigration medical examination on the official Report of Immigration Medical Examination and Vaccination Record (Form I-693). They must adhere to the standard procedures applicable to all civil surgeons.
Certification of Form I-693 by a military civil surgeon necessitates the following:
- Physician Signature: The designated military civil surgeon must personally sign Form I-693. While a signature stamp is permissible, the signature of a licensed physician is essential. Forms signed solely by nurses, physician’s assistants, or other medical professionals without a physician’s signature are not acceptable.
- MTF Stamp or Seal: The MTF must also affix its official stamp or raised seal in the designated area on Form I-693.
After completion and certification, the signed Form I-693 must be placed in a sealed envelope, following the instructions provided with the form, just as with any other immigration medical examination.
Blanket Designation for State and Local Health Departments
USCIS has also granted a blanket civil surgeon designation to all state and local health departments. This designation, established in agreement with the CDC, is specifically intended to streamline the vaccination assessment component for refugees seeking adjustment of status.
Overview of Health Department Designation
This blanket designation aims to alleviate challenges faced by refugee applicants in meeting vaccination requirements and reduces the administrative burden on USCIS of maintaining lists of designated health departments and physicians.
Eligible Physicians within Health Departments
Participation in this blanket designation is voluntary for health departments. To participate, health departments must have physicians authorized to provide medical services who meet the professional qualifications of a civil surgeon. These qualified physicians are responsible for certifying the vaccination assessment for refugees seeking adjustment of status. This includes volunteer physicians working with these health departments.
While eligible physicians at health departments are ultimately responsible for certification, they may delegate the vaccination assessment itself to nurses or other medical professionals. In such cases, the physician must review and certify the completed vaccination record on Form I-693. Similar to military physicians under the blanket designation, health departments and their eligible physicians do not need to seek prior approval from USCIS and are exempt from application fees. However, they must be thoroughly familiar with the Technical Instructions for vaccination requirements before conducting assessments.
Scope of Health Department Designation
Health departments operating under this blanket designation are specifically authorized to perform vaccination assessments only for refugees seeking adjustment of status. They must verify the applicant’s refugee status using government-issued documents. It is crucial to note that this blanket designation does not extend to asylees seeking adjustment of status.
Health departments under this blanket designation are limited to the vaccination component of the immigration medical examination for refugees. If a health department physician wishes to conduct other parts of the immigration medical examination, they must apply for individual civil surgeon designation through the standard process. Refugees requiring a complete medical examination must also visit a physician with standard civil surgeon designation, although blanket-designated health departments can still administer the vaccination component.
Recording and Certification Requirements for Health Department Civil Surgeons
Health departments operating under the blanket civil surgeon designation must accurately record the vaccination assessment on Form I-693. This includes:
- Ensuring the applicant’s information and certification sections are complete.
- Completing the vaccination record accurately.
- Completing the civil surgeon’s information and certification sections.
To properly certify Form I-693, health departments must obtain the attending physician’s signature and apply the health department’s official seal or stamp. The physician’s signature, which can be a signature stamp, is mandatory. A form signed only by non-physician medical staff is insufficient and will result in a Request for Evidence (RFE). The health department’s official stamp or raised seal must also be affixed to Form I-693. The completed and signed Form I-693 must then be sealed in an envelope as per the form’s instructions.
Footnotes
[1] See INA 209.
[2] As specified under INA 232(b), 8 CFR 232.2(b), and 42 CFR 34.2(c).
[3] See INA 209.
[4] As described in Chapter 1, Purpose and Background, Section C, Professional Qualifications [8 USCIS-PM C.1(C)].
[5] The Technical Instructions are available online at: cdc.gov/immigrant-refugee-health/hcp/civil-surgeons/vaccination.html.
[6] See INA 209.
[7] Refugees may present their Arrival-Departure Record (Form I-94), Refugee Travel Document (Form I-571), or Employment Authorization Document (Form I-766) as evidence of refugee status. However, health departments completing the vaccination assessment will not know whether a refugee seeks adjustment under INA 209 or under another provision. Therefore, when reviewing a vaccination assessment completed by a blanket designated civil surgeon for a refugee seeking adjustment, the officer should confirm that the refugee is adjusting under INA 209 before accepting the vaccination assessment performed by a blanket designated health department.
[8] See INA 209.
[9] As outlined in Chapter 2, Application for Civil Surgeon Designation [8 USCIS-PM C.2].
[10] See 8 CFR 209.1(b).
[11] However, blanket-designated health departments may still perform the vaccination component of the medical exam for refugees who require the entire medical exam.
[12] See U.S. Embassy in Afghanistan’s Operation Allies Refuge webpage. See Section 602(b) of the Afghan Allies Protection Act of 2009, Title VI of Pub. L. 111-8 (PDF), 123 Stat. 524, 807 (March 11, 2009). See Section 1059 of the National Defense Authorization Act for Fiscal Year 2006, Pub. L. 109-163 (PDF), 119 Stat. 3136, 3443 (January 6, 2006). For more information, see Volume 6, Immigrants, Part H, Designated and Special Immigrants, Chapter 9, Certain Afghan Nationals [6 USCIS-PM H.9] and Chapter 10, Certain Iraqi and Afghan Translators and Interpreters [6 USCIS-PM H.10]; and Volume 7, Adjustment of Status, Part F, Special Immigrant-Based Adjustment, Chapter 9, Certain Broadcasters [7 USCIS-PM F.9] and Chapter 10, Certain Afghan and Iraqi Nationals [7 USCIS-PM F.10].
[13] As described in Chapter 1, Purpose and Background, Section C, Professional Qualifications [8 USCIS-PM C.1(C)].
[14] The Technical Instructions are available online at: cdc.gov/immigrant-refugee-health/hcp/civil-surgeons/index.html.
[15] As outlined in Chapter 2, Application for Civil Surgeon Designation [8 USCIS-PM C.2].
