medical immigration services, forms I-693 and N-648

N-648 Waiver Certification

By Jacob Mirman, MD

There may be many reasons for new immigrants to the United States to become citizens. It is a matter of pride for many. My family immigrated to the US in 1979 from Soviet Union.  I remember how happy we were when we finally became United States citizens in 1985. All applicants for Citizenship must pass an exam, including knowledge of English (speaking, reading and writing) and American Civics (history, Government, etc). The exam is not easy for some people. Most study hard and pass it. Some can’t. Form N-648 (Medical Certification for Disability Exceptions) is available to those that are truly unable to pass the naturalization exam due to medical reasons. It is intended for applicants who are looking to get an exception due to physical or mental impairment or developmental disability.

The law:

According to United States law, the Form N-648 is “intended for an applicant who seeks an exception to the English and/or civics requirements due to a physical or developmental disability or mental impairment that has lasted, or is expected to last, 12 months or more. An applicant who with reasonable accommodations provided under the Rehabilitation Act of 1973 can satisfy the English and civics requirements does not need to submit this form. Reasonable accommodations include, but are not limited to, sign language interpreters, extended time for testing, and off-site testing.”

Help is available for people unable to learn the material necessary to pass the Citizenship Exam.

If an applicant qualifies for the exemption, I can complete this form for them. I have extensive experience doing this since 1996 and have accumulated hundreds of successful cases. Most of the time I am able to complete the form correctly the first time, to avoid rejection by the immigration department.  The form has to be filled out in a particular way, providing the officer with explanation of the applicant’s medical conditions in layman’s language, as well as explaining the connection between the conditions and the applican’t inability to learn the material necessary for passing the Citizenship Examination.  Rejection of the form by USCIS officers is a fairly common occurrence, usually due to inadequate explanation.

In the event the form is rejected, I will take the necessary steps to fix it at no additional cost to you. A small minority of the applicants have to apply for the second time with the corrected form. My first pass acceptance rate of the form N-648 by the immigration officers is over 90%.  Most of the rejections are approved at the next interview, and in only 3 cases so far a third try was required.

That is why I can offer you this money back guarantee: If I feel the applicant qualifies for the exemption and agree to complete the Form N-648 for them, I guarantee its eventual acceptance by the USCIS officer. If it is initially rejected, I will fix it as many times as necessary to gain its acceptance by the immigration officer at no extra cost to you, until it is approved. If it is not approved and you are not allowed to re-apply, we will refund all the fees you paid us for this work.

I will agree to complete the Form N-648 for the applicant, once I evaluate their case according to commonly accepted standards of medical  practice and determine that they are actually disabled and unable to learn the material necessary to pass the Citizenship Exam.

If you are unsure if you or your loved one is eligible for a medical waiver of Citizenship Exam requirements, we can schedule a consultation at no charge to go over your individual case. I often talk with prospective clients by phone before they come in.  Call the clinic or email me ( if you want to discuss it.

The base charge to complete the Form N648 is $1,500 per person. If a married couple is coming to get it done together, it is $2,500 for both. Long term patients of our medical and psychology services may get other discounts. In some situations some tests are needed to substantiate the disability, and may cost extra.  They may be covered by your medical insurance if they are medically necessary.

For out of state clients.

Please realize the following.  Any licensed medical doctor can fill out the Form N648.  One does not need a special certification from the USCIS to do this work. Some sites claim that one needs to be a Civil Surgeon to do it.  Not true!  However, this job is not trivial and few doctors know how to do it well.  If the applicant is not in Minnesota, there are two ways I can help you:

  1. You can bring the applicant to my clinic and we will do it.  Much of the workup can be done ahead of time, utilizing telemedicine options and existing medical record review, so when you arrive, I will examine the applicant, confirm that they are indeed disabled and fill out the form in MN, the state where I am licensed.
  2. I can do all this work except seeing the applicant in person, then help your own doctor in your state fill out the form properly.  Then they can sign it.  For this I will need to be in communication with your doctor.  I’ll explain everything to them.  I’ll suggest appropriate workup as necessary.  I will do most of the paperwork under their supervision. The same charges and guarantee apply in both cases.

And one last thing:

In my extensive experience, most people asking me for this service are actually disabled and unable to learn the material for the Citizenship Exam.  Otherwise, why would you want to embarrass yourself and pay this much money too? I am happy to help honest people experiencing difficulties. However, I’ve seen a couple cases where people were just lazy and didn’t want to do the work of learning. I refused to do the form for them. Therefore, please keep in mind:

I will not do the following for anybody: I will not fake workups and diagnoses or enter anything dishonest on the form.  This would be illegal, as well as disrespectful to the USCIS officers reading my forms.  Please don’t ask me for it.

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Life Medical Building
4215 Excelsior Blvd.
St. Louis Park,
MN 55416
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