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Health-related grounds

INA §212(a)(1), 8 U.S.C. §1182(a)(1)

U.S. immigration law has always been concerned about allowing people into the country who could impact public health. There are three categories of health-related inadmissibility issues you need to assess: (1) diseases of public health significance; (2) vaccination records; and (3) mental health and substance abuse issues. The rules governing health-related inadmissibility are set by Health and Human Services, and can be updated quickly – for example – in the event of a health crisis.

A – Disease of public health significance.

The following list of diseases make a person inadmissible.

  • Gonorrhea;
  • Leprosy (if infectious)
  • Syphilis (if infectious stage); and
  • Tuberculosis (TB) (if clinically active and communicable).

Any of the list of “quarantinable” diseases. These are updated by the Centers for Disease Control and Prevention and listed at As of the time of writing these include: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers, severe acute respiratory syndromes, and flu that can cause a pandemic.

It is important to understand that other health conditions can also cause inadmissibility issues. Being HIV-positive, for example, is no longer a ground of inadmissibility per se. But there is a major caveat. For someone with a serious health condition, the immigration agencies will be concerned about how the person plans to pay for treatment. If the person is not able to demonstrate that, such as by showing heath insurance, then the person can be found inadmissible on “public charge” grounds. (See below for more discussion of that ground of inadmissibility). If your fiancée has a serious health condition you will need to be prepared to show the consulate how you will provide for care.

B – Vaccination records.

Before your fiancée’s consular interview she will be scheduled for an official medical examination. That examination will include a screening for required vaccinations. The currently required vaccinations are:

  • Mumps, measles and rubella (MMR);
  • Polio;
  • Tetanus and diphtheria;
  • Pertussis;
  • Influenza type B; and
  • Hepatitis B.

If your fiancée is missing one of these vaccinations the Civil Surgeon conducting the medical exam will typically be able to administer it. Note that some vaccinations must be administered more than once. So if your fiancée is missing any of the items from his list, she may want to address this before the medical examination.

C – Mental health and substance abuse issues.

This ground of inadmissibility is overlooked too often, even by immigration lawyers. A person is inadmissible if she suffered a mental disorder that has threatened the property, safety or welfare of anyone – including the person herself. For example, a person can be inadmissible if she suffered from depression in the past, leading to self-harming behavior like cutting.

Read more about mental health inadmissibility and self-harming behavior. If you have concerns about this topic, read the detailed article I wrote with my wife, Dr. Julia McLawsen, who is a clinical psychologist. You can download the article free of charge here.

Drug and alcohol abuse also renders a person inadmissible. The rules on this are somewhat tricky. Generally, speaking, a person is inadmissible if she has used any illegal drug in the past 3 years. This includes the use of marijuana, even where legal under local laws, as marijuana is still illegal under U.S. federal law.

Alcohol abuse is taken very seriously by U.S. immigration authorities. Alcohol abuse also make the person inadmissible if it occurred in the past two years. Merely drinking alcohol does not make the person inadmissible – it must amount to abuse of the substance. A DUI arrest or conviction, for example, will trigger a substance abuse finding.

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Greg is recognized as the leading national authority on enforcement of the Form I-864, Affidavit of Support. Greg represents low-income green card holders in lawsuits to recover support from their sponsors. Practicing family-based immigration law, Greg also focuses on helping married and engaged couples with U.S. immigration.

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