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Naturalization with N-648 Medical Waiver and Oath Waiver

Naturalization is the process of becoming a US Citizen through the USCIS Form N-400. The N-400 can (should always now) be done electronically on WWW.USCIS.GOV Website.
However, there are instances due to age, medical conditions, and disabilities that occurred at birth where the N-400 can be daunting. This post will discuss two possible waiver options.
Medical Waiver
First, the Form N-648 Medical Certification for Disability Exceptions is able to WAIVE the English and Civics testing requirements for naturalization because of physical or developmental disability or mental impairment. The N-648 MUST be supported by medical records, hospital records, SSD Records, or any other common records to prove the disability or impairment. The N-648 MUST be completed by a licensed doctor and SHOULD be performed by your current treating physician. If you do not regularly visit a doctor, then you would need to find a new doctor and explain the N-648 form and provide the N-648 instructions to the Doctor’s Staff.
Apart from the N-648, USCIS also REQUIRES the certifying doctor to provide a separate letter detailing:
- state who they are and what their credentials
- state the length of relationship with the patient
- state what (in layman’s terms) has led the doctor to diagnose a patient’s medical condition or disability
- state how and why the patient CAN NOT understand or communicate:
- English Language
- Civic test question
- Oath of Allegiance
- state ANY likelihood that the patient’s medical condition or disability could change in the near future
- Sign the letter on the doctor’s letterhead and provide his or her state license number authorizing them to practice in the US
To Recap, the Medical Waiver will Need:
- Doctor and Patient to sign the N-648 during the in-person appointment
- Medical Records to show when the disability occurred and how it is permanent
- Separate Letter from the Doctor
Can the Medical Exam be Virtual?
USCIS National Policy does state that a virtual medical exam is possible; HOWEVER, it is not recommended. Our office STRONGLY RECOMMENDS the appointment be in person as the virtual appointment run into one very important and reoccurring issue, the N-648 is not physically signed on the day of the medical examination.
Do I have to go to a special Doctor?
No, actually it is heavily recommended to ask your current primary care doctor to conduct the N-648 Evaluation. You can go to any doctor, as any doctor can do the evaluation; however, USCIS Values the doctor that has spent years with a patient versus a 10 minute first/last encounter with a new doctor.
Oath Waiver
Second, if the medical condition or disability is too extreme to permit providing the Oath of Allegiance with a USCIS Officer, USCIS would require a: Legal Guardian, Surrogate, or Designated Representative to take the oath on the applicant’s behalf. This is known as an OATH Waiver.
Persons eligible to act on behalf of the Applicant include:
- A person who a proper court has designated as the applicant’s Legal Guardian or Surrogate and who is authorized to exercise legal authority over the Applicant’s Affairs; or
- In the absence of a Legal Guardian or Surrogate, a:
- US CItizen Spouse
- US Citizen Parent
- US Citizen Adult Son or Daughter
- US Citizen Adult Brother or Sister
- AND, such a family member MUST be the primary custodial caregiver who takes responsibility for the Applicant.
Family “Stand-ins” are more common than a Legal Guardian or Surrogate. A Family Member would have to provide:
- US Passport, US Birth Certificate, or US Naturalization Certificate
- State ID
- Certificate to prove familial relationship: Birth Certificate, Marriage Certificate, or Adoption Decree
- Income Tax Returns, Social Security Administration Documents, or Affidavits from family regarding (a) primary custodial care and (b) that person’s responsibility for the Applicant
- Signed Letter Requesting the Oath Waiver
To Recap, the Oath Waiver will Need:
- Someone to attend
- US Documentation to prove Citizenship
- Photo ID
- Birth/Marriage Certificate to prove relationship or a court order if legal guardian or surrogate
- Signed Letter from the Family Member or legal guardian/surrogate
Should I prepare for both?
Depends, if the applicant has difficulty speaking or signing their name, then the Oath Waiver should also be requested with the N-648 Medical Waiver.
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