Required Evaluation Components Other Physical or
Mental Abnormality, Disease or Disability

Technical Instructions for the Medical Examination of Aliens in The United States

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 medical examination is one means of evaluating the health of aliens applying for admission or adjustment of status as permanent residents in the United States.


These instructions are for the use of civil surgeons and U.S. Department of Homeland Security (DHS) officials who are evaluating aliens applying for adjustment of status to permanent resident, and any other alien required by DHS to have a medical examination.  This document supersedes the June 1985 Guidelines for Medical Examination of Aliens in the United States.

Required Evaluation Components

Other Physical or Mental Abnormality, Disease or Disability

  1. Required Evaluation

    After completing the required evaluation for communicable diseases of public health significance, for physical and mental disorders that may result in harmful behavior, and for psychoactive substance abuse, the civil surgeon 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 civil surgeon 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 civil surgeon should:

    1. Estimate the severity of the 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 civil surgeon 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.

Required Evaluation Components Other Physical or
Mental Abnormality, Disease or Disability

Centers for Disease Control and Prevention 

GeoSalud, March 30, 2013