Regulations for health-based grounds of inadmissibility have been updated by U.S. Citizenship and Immigration Services. The Nov. 2, 2016, update to the USCIS Policy Manual reflects changes made earlier this year to Department of Health and Human Services and Centers for Disease Control regulations. Effective March 28, 2016, the HHS final rule amended the regulations governing the medical exam that intending immigrants and refugees must undergo before admission to the United States. (42 CRF § 34) The recent updates to Volume 8, Part B of the USCIS Policy Manual incorporate the HHS/CDC amendments. The updates are highlighted here.

The Policy Manual now includes updated definitions of Class A and Class B medical conditions. Following medical exams, civil surgeons and panel physicians are required to report their findings of Class A or Class B conditions to consular officers or USCIS. The medical notification forms used by the physicians list the specific conditions for which the applicant may be inadmissible. The specific conditions include: ​communicable diseases of public health significance as determined by HHS​; p​resent or past physical or mental disorders with associated harmful behavior; and drug abuse or addiction. The Class A definition now says failure to present documentation of receiving required vaccinations is a Class A condition. This update doesn’t change the current practice of requiring certain vaccinations, but simply updates the language to align with existing requirements in the Immigration and Nationality Act.

The definition of a Class B condition was also updated and is now defined as “a physical or mental ​health condition, disease or disability serious in degree or permanent in nature that, although not rendering an applicant inadmissible, represents a departure from normal health or well-being that may be significant enough to:​ interfere with the applicant’s ability to care for himself or herself, to attend school or to work​;​ or​ require extensive medical treatment or institutionalization in the future.​” (8 USCIS – PM, Part B, Chapter 2)

Revisions were made to the definitions of physical and mental disorders with associated harmful behavior to reflect changes in HHS regulations on criteria for diagnosing these disorders. As per HHS regulations, a physical disorder is defined as a currently accepted medical diagnosis as defined by the current edition of the Manual of International Classification of Diseases, Injuries, and Causes of Death published by the World Health Organization or by another authoritative source as determined by the CDC director. (42 CFR § 34.2 (p)) A mental disorder is defined as a currently accepted psychiatric diagnosis, as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association or by another authoritative source as determined by the CDC director. (42 CFR § 34.2(n)) These changes signal the intent of HHS/CDC that the diagnosis of these conditions align with current science and medical practices.

Changes made to the definitions of drug abuse and drug addiction can also be found in the updated version of the manual. The guidance explains that “drug abuse and drug addiction are current substance-use disorders or substance-induced disorders of a controlled substance listed in Section 202 of the Controlled Substance​s​ Act, as defined in the DSM published by the American Psychiatric Association or by another authoritative source as determined by the director.”​ (8 USCIS – PM, Part B, Chapter 8)

Finally, the Policy Manual was updated to remove three medical conditions – chancroid, granuloma inguinale and lymphogranuloma venereum – from the list of communicable diseases of public health significance that would render an applicant inadmissible. This list continues to include the following: gonorrhea, infectious leprosy, infectious stage syphilis and active tuberculosis.