Tb test???

[Nich-Nick 3,354]

And here's some FAQ written for Civil Surgeons

FAQs Tuberculosis Component of the Technical Instructions (TIs) for the Medical Examination of Aliens in the United States

I would like to add that the USCIS is probably as confused with these changes as the Civil Surgeons are. Personally, my fiance/husband falls into the group of medical exams after June 1, 2008 and should be following the new rules. We did not submit any version of an I-693, nor has he had a TB skin test. We have been expecting an RFE. So far the AOS has been transferred to California, and he has both AP and EAD card in hand.

Edited December 31, 2008 by Nich-Nick

[Jasman0717 9]

the CS decided not to give me a TB test..and i only paid $25..

Great deal We paid $70 but he had to give her a tetanus shot because they didn't have it at St. Lukes.

[ez2007 1]

I took the chance of submitting the AOS without the TST on my I-693 and is still waiting for an RFE. I had my Medical Exam last June 2008. I have received my AP and EAD already. I am just hoping no RFE will come.

[citlembik 0]

Looking at timelines:

Sunlyk had a medical before the new rules.

Claudeth went through this in 2005.

If they had read Eric-Pris post that the rules are different after June 1, 2008, there wouldn't be so much confusion here with differing information.

citlembik---These are the new posted requirements about the TB test for AOS. Read the questions and answers and look at the little chart toward the bottom of the page.

http://www.uscis.gov/portal/site/uscis/men...0004718190aRCRD

Sample question:

Q: Will USCIS accept Form I-693 if the civil surgeon performed a chest x-ray without the TST?

No, the civil surgeon must administer the TST, unless one of the exceptions listed in the Technical Instructions applies. If the civil surgeon performs a chest x-ray without giving the applicant the TST, the reason for omitting the TST must be noted on Form I-693.

Oke//I've read this.My q is :does the civil surgeon complete part 2 in form I-693,also?..the tst test result and x-ray appear in part two...and the civil surgeon told me he will complete just the vaccination list(so part 3).Until Monday I can't do anything.everything is closed.I'm wondering if a civil surgeon would accept the TB test made at a local health departament.I'm thinking to call and ask...but I was hoping there's smbd that passed though this.Caz if my civil surgeon refuse to do the tb test...I really don't have where else to go and it's already very late.All the other civil surgeons from my area refused me!!!

Anyway...I wish everybody a Happy New Year!

[Nich-Nick 3,354]

I just don't know if he will complete that part or not. There is too much confusion on the subject. The problems happen because we have many US Government agencies making up rules. You have the USCIS making up rules for immigrants. The Dept of State issues the visas. The Center for Disease Control makes up the immunization requirements. The Department of Homeland Security puts in their rule somewhere too. So when one agency makes up a new rule, the other tries to fit their requirements around it and sometimes it ends up being a big mess for those of us who are trying to follow the rules and also for the Civil Surgeons to know what they are supposed to do. They're instructed how to do medicals for immigrants...full medicals. Then the USCIS comes along and says, but the K visa people don't have to do the medical over and the CS can do a supplement form. Then they ditch that supplement form and make a new I-693 because the CDC came up with some new immunizations and TB rules. So immunization is in one place on the new form. BUT the TB part isn't. It's a freakin' bad form.

How is a Civil Surgeon supposed to keep up? They are all over the country and don't live and breathe immigration like we do. They probably get new memos in the mail and don't have time to read them. They are seeing regular patients too, not just immigrants needing papers filled out. So we folks are having problems doing our paperwork and think every CS should have all the answers. I'm pretty sure they don't.

[sunlyk 1]

I took the chance of submitting the AOS without the TST on my I-693 and is still waiting for an RFE. I had my Medical Exam last June 2008. I have received my AP and EAD already. I am just hoping no RFE will come.

Hope you won't get RFE since you already have interview schedule this January 29, will see once you're done then you can share your experience. Goodluck and Happy New Year to everyone.

[Eric-Pris 1,607]

I just don't know if he will complete that part or not. There is too much confusion on the subject. The problems happen because we have many US Government agencies making up rules. You have the USCIS making up rules for immigrants. The Dept of State issues the visas. The Center for Disease Control makes up the immunization requirements. The Department of Homeland Security puts in their rule somewhere too. So when one agency makes up a new rule, the other tries to fit their requirements around it and sometimes it ends up being a big mess for those of us who are trying to follow the rules and also for the Civil Surgeons to know what they are supposed to do. They're instructed how to do medicals for immigrants...full medicals. Then the USCIS comes along and says, but the K visa people don't have to do the medical over and the CS can do a supplement form. Then they ditch that supplement form and make a new I-693 because the CDC came up with some new immunizations and TB rules. So immunization is in one place on the new form. BUT the TB part isn't. It's a freakin' bad form.

How is a Civil Surgeon supposed to keep up? They are all over the country and don't live and breathe immigration like we do. They probably get new memos in the mail and don't have time to read them. They are seeing regular patients too, not just immigrants needing papers filled out. So we folks are having problems doing our paperwork and think every CS should have all the answers. I'm pretty sure they don't.

I agree. The change that took place in May 2008 (effective June 1) regarding the TB test doesn't fit well with the rule that AOS applicants only need to get the vaccination section filled out. If AOS applicants are required to undergo a TB test, where does the CS record the results? There's nothing in the vaccination section. There is a TB test results section in part 2 (Medical), but applicants with valid medicals only need the vaccination section filled out.

Another part of the problem is that it looks like overseas doctors are still ordering chest X-rays, and not the Tb skin test. My daughters just had their exams about 6 weeks ago. They did not receive the chest x-ray because they are little kids, but I saw the requirements, and they still have chest x-rays for adults. The overseas doctors either aren't performing the Tb skin tests, or USCIS hasn't gotten around to notify them to do so. It's one big confusing mess.

At this point, I would probably recommend just sending in a DS-3025 and hope for the best. That's what my wife and I did. Her medical was in March 2008 (before May) and her vaccinations were required as part of the K-1 visa process. She got her greencard a couple of weeks ago with no interview (CSC).

[Nich-Nick 3,354]

Another part of the problem is that it looks like overseas doctors are still ordering chest X-rays, and not the Tb skin test. My daughters just had their exams about 6 weeks ago. They did not receive the chest x-ray because they are little kids, but I saw the requirements, and they still have chest x-rays for adults. The overseas doctors either aren't performing the Tb skin tests, or USCIS hasn't gotten around to notify them to do so. It's one big confusing mess.

The Center for Disease Control's (CDC) technical instructions for Panel Physicians (overseas doctors) for TB screening have a revison date of 2007 and that's the newest. Before that, the technical instruction were the 1991 version.

Looking at a summary chart, the following is what they are instructed to do.

CXR (Chest x-ray): Required for all applicants ≥15 years.

TST: All applicants 2-14 years of age living in countries with a WHO-estimated incidence rate ≥20 per 100,000. All applicants who are contacts of a known tuberculosis case. So unless a person is living in a country that the World Health Organization deems has a high incidence of TB, or they live with a person with TB, then the panel physician is not instructed to give a TB skin test.

And it goes further to say only the following countries are being screened by the 2007 rules and the rest use the old rules.

Map of countries being screened for TB with skin test

In another area of the CDC it states this:

Tuberculin skin test examination. (i) All aliens 2 years of age or older in the United States who apply for adjustment of status to permanent residents, under the immigration laws and regulations, or other aliens in the United States who are required by the INS to have a medical examination in connection with a determination of their admissibility, shall be required to have a tuberculin skin test. Well you can see how the USCIS can't quite fit their rules and forms around these CDC mandates. No TST required in most foreign countries, but required of ALL aliens in US to adjust status. So when USCIS says the medical doesn't have to be repeated in the US, that little problem of the TB skin test doesn't quite fit into the plan or the new form.

[citlembik 0]

Looking at timelines:

Sunlyk had a medical before the new rules.

Claudeth went through this in 2005.

If they had read Eric-Pris post that the rules are different after June 1, 2008, there wouldn't be so much confusion here with differing information.

citlembik---These are the new posted requirements about the TB test for AOS. Read the questions and answers and look at the little chart toward the bottom of the page.

http://www.uscis.gov/portal/site/uscis/men...0004718190aRCRD

Sample question:

Q: Will USCIS accept Form I-693 if the civil surgeon performed a chest x-ray without the TST?

No, the civil surgeon must administer the TST, unless one of the exceptions listed in the Technical Instructions applies. If the civil surgeon performs a chest x-ray without giving the applicant the TST, the reason for omitting the TST must be noted on Form I-693.

Can you please tell me if the civil surgeon has to fill out part 2 also in form I-693..the q with TB test result??Becauase initially the K-1 instructions say the doctor has to fill out only part 3 and 5 and the patient part 1.