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:

  1. state who they are and what their credentials
  2. state the length of relationship with the patient
  3. state what (in layman’s terms) has led the doctor to diagnose a patient’s medical condition or disability
  4. state how and why the patient CAN NOT understand or communicate:
    • English Language
    • Civic test question
    • Oath of Allegiance
  5. state ANY likelihood that the patient’s medical condition or disability could change in the near future
  6. Sign the letter on the doctor’s letterhead and provide his or her state license number authorizing them to practice in the US

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 Designatre 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:

  1. US Passport, US Birth Certificate, or US Naturalization Certificate
  2. State ID
  3. Certificate to prove familial relationship: Birth Certificate, Marriage Certificate, or Adoption Decree
  4. 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

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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