Noncitizens seeking admission into the U.S. as a nonimmigrant or immigrant to work as a health care worker, other than as a physician, are not admissible unless they have certification from a credentialing agency recognized by the United States Citizenship and Immigration Services (USCIS) attesting to their completion of the minimum requirements for education, training, licensure, experience, and English proficiency in their field.

Specifically, the health care worker certification verifies the noncitizen has:
1. Education, training, licensing, and experience that:

•  Are comparable with that required for an American health care worker of the same type;
• Are authentic and, in the case of a license, unencumbered; and
• Meet all applicable statutory and regulatory requirements for admission into the U.S.

2. The necessary level of competence in oral and written English as shown by passage of one or more nationally recognized, commercially available, standardized test(s) of the noncitizen’s ability to speak and write in English; and

3. Passed either:

• A predictor test (if the majority of States licensing the profession in which the
  noncitizen intends to work recognize a test predicting a worker’s success on the
  profession’s licensing or certification examination) or
•  The occupation’s actual licensing or certification examination.

The following health care professions require certification:

•  Licensed practical nurses, licensed vocational nurses, and registered nurses;
• Physical therapists;
• Occupational therapists;
• Speech-language pathologists and audiologists;
• Medical technologists;
• Medical technicians; and
• Physician assistants.

A valid health care worker certification (the certification is only valid for five years) is required each time the noncitizen worker:

•  Seeks admission into the U.S.;
• Changes status;
• Extends status; or
• Adjusts status.

The following organizations have the authority to provide health care worker certifications:

• The Commission on Graduates of Foreign Nursing Schools (CGFNS): Authorized to issue certifications to all 7 health care occupations.
• The National Board for Certification in Occupational Therapy (NBCOT): Authorized to issue certifications for occupational therapists.
• The Foreign Credentialing Commission on Physical Therapy (FCCPT): Authorized to issue certifications for physical therapists.
• Josef Silny & Associates, Inc. (JSA): Authorized to issue certifications for nurses.

As discussed above, the health care worker certification is required each time a nonimmigrant or immigrant health care worker seeks admission into the U.S., a change of status, an extension of status, or an adjustment of status.

In regards to immigrant petitions, for example, the health care worker certification is required during the Schedule A green card process. The Schedule A green card process is a streamlined way for noncitizen workers in Schedule A occupations to obtain permanent residency in the U.S.  Schedule A occupations include physical therapists and professional nurses. A physical therapist or professional nurse in the U.S. applying for Schedule A designation will be required to submit the health care worker certification at the time of filing the Form I-485, Application to Register Permanent Residence or Adjust Status. If the physical therapist or professional nurse is not in the U.S. but is applying abroad, he/she will be required to present the health care worker certification to the consular officer at the time the visa is issued.

In regards to nonimmigrant petitions for noncitizen workers in any of the 7 health care occupations, the health care worker certification is required with the Form I-129, Petition for Nonimmigrant Worker. For example, if the noncitizen worker is in the U.S. seeking a change of status or an extension of stay, submission of the healthcare worker certification is required at the time of filing the Form I-129. If the noncitizen worker is not already in the U.S., he/she will be required to present the health care worker certification at the time of visa issuance or admission.

Reddy Neumann Brown PC is dedicated to helping our clients navigate the U.S. business immigration system. Because the U.S. business immigration system can be tricky, it is always best to contact a qualified immigration attorney to help come up with the proper solution for each individual case.

By: Camille Joson

Camille Joson is a Senior Associate Attorney in Reddy Neumann Brown PC’s PERM Labor Certification
Department, where she assists clients in the beginning stages of the green card process.