Immigrating to another country is an exciting opportunity, but there are many requirements that must be met in order to be approved. One of these is passing the immigration medical exam. This comprehensive exam is required by most countries to ensure newcomers are healthy enough to enter, as it would put strain on their healthcare systems if immigrants had serious medical issues. While many conditions will not lead to automatic rejection, there are some that can cause you to fail the immigration medical exam. Knowing what these are can help you get any required treatment ahead of time and increase your chances of passing.
What is the Immigration Medical Exam?
The immigration medical exam, also sometimes called a medical screening or green card medical exam, is a required step for most people immigrating to the United States, Canada, Australia, New Zealand, and the United Kingdom. It consists of a physical exam, blood tests, a chest x-ray, and a review of your vaccination records. The purpose is to screen for health conditions that could pose a public health risk or be too costly for the country’s healthcare system. The required components are standardized across immigration medical clinics.
Some visas may not require the full exam. The exam must be performed by a doctor who is designated as a civil surgeon by the government. Results are reported to immigration authorities, who make the final decision on whether you pass or fail. Failing does not necessarily mean your application will be denied, but it does mean additional paperwork and costs to provide further evidence you will not burden the healthcare system.
General Health Condition
One of the main reasons applicants fail the immigration health exam is due to general poor health. While there are few automatic bans for specific health conditions, immigration authorities want to see that you are in good general health and physical condition. Applicants who appear frail or sickly may require further testing to prove they are healthy enough for entry.
Factors that can contribute to appearing in poor general health include:
- Being underweight or overweight – Medical examiners will check your BMI.
- Poor hygiene and self-care
- Skin issues such as rashes, boils, or significant acne
- Rotting, missing, or otherwise unhealthy teeth
- Physical disabilities limiting mobility
- Signs of malnutrition
If the medical examiner finds your general health below standards, additional tests may be required such as blood tests, chest x-rays, and evaluation by specialists. You may also need to provide records demonstrating you are managing any underlying health conditions. Failing to pass the follow up screening could lead to rejection of your immigration application.
Most countries screen for mental illnesses that could pose a risk to others or make you unable to care for yourself. If such a condition is uncovered, it does not necessarily mean you will automatically fail, but further examination and records will need to be presented to prove you are managing the illness and are not a danger.
Mental health conditions that are most likely to lead to rejection or additional scrutiny include:
- Bipolar disorder
- Dementia or severe cognitive impairment
- Intellectual disability
- Drug or alcohol addiction
- Anorexia nervosa
- Suicidal ideations or previous suicide attempts
To pass the medical exam with these conditions requires providing a recent psychiatric evaluation showing effective ongoing treatment and management of symptoms, as well as evidence you are unlikely to be a risk to yourself or others.
A major category of health conditions that can lead to failure of the immigration medical exam are communicable diseases. This includes diseases that could pose a public health risk by spreading in the community. Examples include:
- Hepatitis B
- Hepatitis C
- Intestinal parasites
Testing for communicable diseases is a routine part of the immigration health screen process. Contracting one of these illnesses does not necessarily mean automatic rejection. With effective treatment and management, you may still be able to pass. However, untreated communicable diseases are likely to lead to exam failure.
A rising health concern globally is infections that are resistant to drug treatment. These include multidrug-resistant tuberculosis (MDR-TB), extensively drug-resistant tuberculosis (XDR-TB), and methicillin-resistant Staphylococcus aureus (MRSA). Screening for and treating these infections is expensive and difficult, so migrants found to have drug-resistant infections are much more likely to fail the medical exam.
While most common chronic diseases like diabetes, heart disease, arthritis, and hypertension will not directly cause you to fail immigration health screening, they can still complicate the process. The concern with chronic diseases is that treatment costs may become a burden on the healthcare system.
To pass the exam with a chronic condition requires providing thorough medical records proving it is well-controlled through diet, lifestyle, and medication. For diabetes for example, you would need records showing consistently normal blood sugar levels. High cost conditions to manage like cancer, end stage renal disease, and hemophilia are more likely to result in rejection.
Physical or mental disabilities generally do not directly cause immigration exam failure. However, certain disabilities can prompt additional scrutiny or requirements:
- Intellectual disabilities may require further testing to show you can live independently. Educational assessments may be requested.
- Physical disabilities may need occupational therapy assessments to show how you can perform daily self-care tasks.
- Vision or hearing impairment may need testing to show how you can safely navigate daily activities.
- Conditions requiring intensive medical care may need further records and significant financial resources proven.
While not an automatic fail, disabilities should be thoroughly documented with your capability for independent living in your destination country.
Age itself does not cause immigration medical exam failure. However, health conditions associated with aging can. For elderly migrants, the process often involves more extensive screening for chronic diseases, mobility issues, cognitive decline, and other age-related problems. Financial requirements showing ability to cover healthcare costs are also higher for older applicants.
A cancer diagnosis does not inherently mean exam failure but it does require extensive medical records to pass. You will need to provide recent oncologist reports showing effective treatment leading to full remission. Cancers with poorer prognosis may face greater scrutiny or rejections. Cancer screening like mammograms may be required for applicants over a certain age.
Being pregnant itself does not cause immigration medical exam failure and is not grounds for visa rejection. However, pregnant applicants should expect additional requirements:
- Medical records from prenatal checkups showing a healthy pregnancy.
- Pregnancy screening blood tests.
- Chest x-rays deferred until after birth due to radiation concerns.
- Further health exam shortly after giving birth.
Complications like a high risk pregnancy or gestational diabetes may also prompt further records or evaluation after birth.
Family Medical History
Your family’s medical history is relevant to your exam results. You may be required to disclose family history of:
- Genetic disorders
- Heart disease
- Mental illness
- Substance abuse
These prompt further testing based on your predispositions. Hereditary conditions you are at risk for may require additional exam measures or documentation to pass.
Past Health Issues
Previous significant health problems, even if you have recovered from them, should be disclosed and records provided showing successful treatment. These include:
- Heart disease history
- Past cancer diagnosis and remission
- Major injuries like car accidents
- Chronic disease diagnosis
Deliberately hiding past health problems can be grounds for visa rejection if later discovered. Visible scars or disabilities may also need documentation if their cause is not obvious.
Illegal Drug Use
If you fail the immigration medical exam drug test or admit to illegal drug use, you can be denied entry. Testing positive for illegal substances like:
will require you to undergo chemical dependency assessment and treatment before reapplying. Evidence of past treatment and rehabilitation may still allow those previously addicted to pass.
Alcoholism can also lead to visa denial, as alcohol abuse strains healthcare systems. Signs of alcoholism include:
- Failing the medical exam liver function test
- Visible signs of alcoholism like facial redness
- Admitting to alcohol addiction
Like with drug addiction, passing after being diagnosed as alcoholic requires proof of rehabilitation such as alcohol abuse treatment records. Ongoing support group participation may also be requested.
Even if your health condition itself does not make you inadmissible, resulting healthcare costs can. Conditions requiring expensive ongoing care and treatment may be denied entry if you cannot prove ability to cover the costs without relying on public healthcare funds. To pass, have a concrete financial plan for treatment budgeting.
Preparing for the Immigration Medical Exam
To ensure you pass your immigration health screening:
- Disclose any past or current medical issues upfront.
- Get any required vaccinations completed well in advance.
- Have a thorough physical exam with your current doctor prior to the official immigration screening.
- Get any necessary treatments for medical issues ahead of time.
- Gather all relevant medical records and documentation.
- Stick to healthy lifestyle habits leading up to exam date.
Being forthright instead of hiding conditions and having complete medical records makes it more likely for immigration authorities to admit you despite health issues. Trying to conceal medical problems often backfires. Discuss any complex health history openly with your immigration lawyer when applying.
Can You Appeal Medical Exam Rejection?
If you do fail your immigration medical exam, you may have the opportunity to appeal the decision:
- Consult your immigration lawyer immediately about appeal options.
- For minor health issues, corrective treatment then re-taking exam may be allowed.
- Provide any requested follow-up medical records.
- Second opinion consultations with approved physicians can be requested.
- Offer clear financial plans for covering healthcare costs.
- Alternative visa options like temporary visas may still be open.
- Appeals processes vary significantly between countries.
While appealing rejection is possible, it involves extra time and expense. Your odds of overturning exam failure improve by being proactive before the initial immigration screening exam.
Using Medical Waivers
For medical conditions that normally result in visa denial, medical waivers may still allow entry in some cases. Waivers basically pardon your health disqualification, allowing immigration despite it. Whether waivers are an option depends on the specific country and condition. Common cases where waivers apply:
- A family member already a citizen/resident can petition for your waiver.
- You have refugee or asylum status.
- A U.S. employer is sponsoring your green card application.
- You qualify based for a special waiver category.
- Your home country’s healthcare is lacking.
Waivers are complex and several steps:
- Apply for initial visa, get medical exam, and get denied due to health grounds.
- File waiver application and supporting documents.
- Have medical exam by approved physician.
- Get waiver recommendation letter from US consular surgeon.
- Submit recommendation to consular officer and US Citizenship and Immigration Services.
- Wait for official waiver approval notice.
This lengthy process can take from 6 months up to 1 year. Success is not guaranteed either. Discuss waiver options with your immigration attorney.
When Further Medical Exams Are Required
Passing your initial immigration medical exam does not always mean you are done with medical requirements. Further examinations may be requested in some cases after you arrive:
- As a routine follow-up exam after landing as a permanent resident.
- If health issues develop during a temporary visa.
- To confirm initial exam results if any indications of invalid data.
- Random spot checks for verification.
- If medical exam expires before landing.
Make sure to comply with any requests for additional health screening to avoid jeopardizing your immigration status. You must still meet health standards throughout the visa process.
While the immigration medical examination is strict on health standards, most applicants pass without issues. Arriving with proper vaccinations, managing any medical conditions, having complete health records, and disclosing issues early makes success most likely. Certain contagious diseases, uncontrolled mental illness, and conditions requiring high cost care do warrant extra preparation. Discuss any complex medical history openly and early when applying. Patience through additional screening and appeals can still lead to approval in most legitimate cases.