The United States Citizenship and Immigration Services (USCIS) released new policy guidelines on June 13 regarding the “Medical Certification for Disability Exceptions” form (Form N-648) in naturalization applications, emphasizing enhanced scrutiny on the authenticity of medical certifications. The USCIS explicitly stated that they will more strictly review the validity of medical evidence and focus on combating fraudulent practices aimed at evading the requirements for English and civics courses in the naturalization process.
For decades, there have been numerous cases across the United States where individuals fraudulently obtained citizenship through false medical certifications, seriously undermining the credibility of the American citizenship system. When healthcare professionals provide false disability certifications, leading to unqualified individuals being granted citizenship, it not only undermines the original intent of the disability waiver system but also affects the trust foundation of the overall review process.
According to U.S. law, applicants for naturalization typically need to demonstrate proficiency in English and have a basic understanding of American history and government. However, if individuals are unable to meet these requirements due to disabilities, developmental disorders, or mental illnesses that are expected to last or have lasted for over 12 months, they may submit the Form N-648 for an exemption.
The updated guidelines emphasize that the mere presence of a disease or disability is not sufficient to warrant an exemption. Physicians must specifically explain how the condition prevents the applicant from understanding or learning the content of English and civics courses. Moreover, if multiple N-648 forms from the same medical institution or physician are submitted simultaneously, it may raise suspicions and lead to further scrutiny.
This policy update is immediately effective and applies to all naturalization applications and N-648 forms submitted on or after June 13, 2025, and is included in Volume 12 of the USCIS Policy Manual.
The Trump administration had previously raised doubts about the authenticity of some disability exemption cases during its first term. Since 2019, media reports have highlighted several investigations into suspected falsification of medical certifications, including instances where individual clinics issued hundreds of nearly identical N-648 forms in a year, attracting the attention of the USCIS. This policy revision continues the Trump administration’s efforts to strengthen reviews and combat immigration fraud.