Required Evaluations - Other Physical or Mental Abnormality, Disease, or Disability

Technical Instructions For Medical Examination Of Aliens

Table Of Contents

Preface

• III. Required Evaluations
  • D. Other Physical or Mental Abnormality, Disease or Disability
    • Required Evaluation
    • Reporting of Results

Preface

The Centers for Disease Control (CDC), United States Public Health Service (PHS), is responsible for ensuring that aliens entering the United States do not pose a threat to the public health of this country. The visa medical examination is one means of evaluating the health of aliens applying for entry into the United States.

These instructions are for the use of panel physicians and consular officers who are evaluating aliens applying for immigrant visas and aliens applying for refugee status at locations outside the United States.* Other aliens, not applying for an immigrant visa, may in some instances be referred for an examination. These technical instructions also apply to those examinations. This document supersedes the June 1984 Guidelines for Medical Examination of Aliens.

*Other instructions have been prepared for the examination of aliens applying for adjustment of status at locations within the United States.

III. Required Evaluations

D. Other Physical or Mental Abnormality, Disease, or Disability

1. Required Evaluation

After completing the required evaluations for communicable diseases of public health significance, for physical and mental disorders that may result in harmful behavior, and for psychoactive substance abuse, the physician must consider any other findings in the history or physical examination that constitute a substantial departure from normal health or well-being, and must complete any diagnostic procedures necessary to determine

1. the likely diagnosis
2. whether the disorder will affect the alien’s ability to care for himself or herself, attend school, hold a job, or engage in other age-appropriate activities
3. whether rehabilitation or special training will be required
4. whether the applicant is likely to require extensive medical care or institutionalization after arrival in the United States.

2. Reporting of Results

The panel physician should provide additional information about each of the Class B conditions in the “Remarks” section of the medical report form. For each condition identified, the panel physician should

1. estimate the severity of impairment as mild, moderate, or severe
2. if possible, estimate the likely outcome of rehabilitation as minimal, partial, or full recovery of function
3. predict the need for hospital or institutional care beyond that expected for a person of the applicant’s age (i.e., normal need for increased medical care in the elderly should not be considered)

If the panel physician identifies a physical or mental abnormality but is unable to make a diagnosis, assess the potential for harmful behavior, estimate the severity of impairment, or determine the potential for rehabilitation, the applicant should be referred for diagnostic evaluation. Completion of the medical report should be deferred until the evaluation is complete.