Despite the shortage of Health Care Professionals in the United States, the process to legalize foreign born Physicians, Dentists, Nurses, Physical Therapists, Occupational Therapists, Speech Pathologists, and other allied healthcare workers continues to require complex administrative processes before the US Department of Labor and the US Citizenship & Immigration Services. The first step in securing valid work authorization for such healthcare workers is through the H–1B visa filed by a US employer; once the healthcare worker is in the US, he/she can then apply for permanent residence.

H–1B Petitions For Registered Nurses

Employers may file an H–1B non–immigrant visa petition on behalf of a registered nurse if these conditions apply:

• The nurse received a certificate form the Commission on Graduates in Foreign Nursing Schools (CGFNS); or
• The nurse has passed the National Council Licensure Examination for Registered Nurses (NCLEX–RN) exam; or
• The nurse received an unrestricted license from the state in which he/she intends to be employed.

The USCIS issued a guidance memorandum entitled: Guidance on Adjudication of H–1B Petitions Filed on Behalf of Nurses, which further clarified the manner in which the USCIS will adjudicate H–1B visa petitions for these workers. Under the aforementioned memorandum, the USCIS will approve an H–1B visa filed on behalf of a registered nurse only if the state in which the nurse intends to be employed requires a bachelor’s degree in order to seek licensure. Furthermore, this guidance memorandum created “advanced practice occupations" for which H–1B visas are more likely to be favorably considered. These specialized nurses listed in the guidance memorandum include:

• Clinical Nurse Specialists (CNS): Acute Care, Adult, Critical Care, Gerontological, Family, Hospice and Palliative Care, Neonatal, Pediatric, Psychiatric and Mental Health–Adult, Psychiatric and Mental Health–Child, and Women’s Health;
• Nurse Practitioner (NP): Acute Care, Adult, Family, Gerontological, Pediatric, Psychiatric & Mental Health, Neonatal, and Women’s Health;
• Certified Registered Nurse Anesthetist (CRNA); and
• Certified Nurse–Midwife (CNM).

In addition to nurses in advance practice occupations, the USCIS memorandum explains that certain nurses in administrative positions, such as nurse supervisors and management level nurse professionals, may also be qualified for H–1B visas.

H–1B Petition For Physical Thereapists

US Healthcare providers seeking to employ foreign born physical therapists often require these workers to have acquired state licensure as a practical matter. This is true even though the Specialty Occupation H–1B visa regulations do not require physical therapists to possess state licensure in order to be accepted under the program. Now, the USCIS will issue H–1B visas for Physical Therapists who do not possess a state license but who otherwise qualify for the H–1B visa for a one year term to allow them to obtain licensure in their state of intended employment.

In late 2008 and 2009, the USCIS began a series of denials for physical therapist occupations where the alien lacked a Master’s Degree. After a series of correspondence with the USCIS by members of industry including the Foreign Credentialing Commission on Physical Therapy, National Board for Certification in Occupational Therapy (NBCOT), CGFNS, and the American Immigration lawyers Association, urging the USCIS to reconsider its position. In May 2009, the USCIS issued a guidance memorandum entitled: Requirements for H–1B Beneficiaries Seeking to Practice in Health Care Occupations wherein it laid down clearer guidelines for the issuance of H–1B visas to Physical Therapists and other health care professionals. The memorandum urges adjudication officers to look at the Occupational Outlook Handbook (OOH), as well as other authoritative sources, in determining whether a Master’s Degree is required for a particular position sought for H–1B visa classification. The policy memorandum states that despite what the OOH or similar authoritative source requires, the USCIS will approve an H–1B visa where the foreign Physical Therapist possesses a state license. It is worthy to note that the OOH states that a post baccalaureate degree is required for entrance into the Physical Therapy occupation.

Immigrants Visa Options For Nurses And Physical Therapists

Immigration laws introduced in 2005 permit employers to file immigrant petitions on behalf of Registered Nurses and Physical Therapist professionals through a special category called Schedule A. This is an expedited green card process which bypasses most of the rigorous processes of the labor certification (PERM). The documented shortage of these professionals is the main reason that the US Department of Labor had determined there are not sufficient U.S. workers who are able, willing, qualified, and available to occupy these positions, and that a particular expedited labor certificate process is warranted.

The Law Firm of Shihab & Associates, Co., LPA is experienced in representing healthcare professionals of all kinds. We represent healthcare providers and companies as well as professionals in applying for H–1B, J–1, waivers, and green cards for healthcare professionals. Our experienced immigration lawyers can assist you in Columbus, Ohio, Cleveland, Ohio, Southfield and Detroit area, Michigan, as well as Washington, DC. Please do not hesitate to call The Law Firm of Shihab & Associates, Co., LPA for a consultation today or use our Contact Form.