UK AOS 2009 Thread

[English Muffin 59]

1. many (some?) UK residents have TB tests (or is it vaccinations?) as children. jamie has a little scar on his upper arm which he tells me is from a TB shot(?). (incidentally, i see these scars on lots of british people! am i making that up?)

That would be Smallpox with the big scar..

BCG leaves a big(ish) scar too, on the upper arm.

[Jason&Sarah 0]

Just finishing up the last bits for AOS, and sending off...we've been busy busy busy with the Little One and all that...plus I changed hours at work, so it's a bit hectic!!!!

We ran into a wall with SSN, as the stupid woman at our office didn't understand the policy even with it spelled out in front of her...so we're going to try again on Thursday...

[mr and mrs 187]

1. many (some?) UK residents have TB tests (or is it vaccinations?) as children. jamie has a little scar on his upper arm which he tells me is from a TB shot(?). (incidentally, i see these scars on lots of british people! am i making that up?)

That would be Smallpox with the big scar..

BCG leaves a big(ish) scar too, on the upper arm.

jamie's is a circle about oh.. about a centimeter in diameter.

[mr and mrs 187]

2. having had a TB vaccination can sometimes cause you to have a positive result from a TB skin test (as an adult)

UK people often got BCG? shots as a child to prevent TB. It often causes a false positive on a skin test. It didn't on Daymo. Some people have been made to undergo six months of a strong antibiotic (Bex&Alan-UK) after a positive skin test even if their x-ray was clear. Insane IMO. There's some controversy about the antiobiotic being very harsh and you have to be monitored for liver function while taking it. Sorry, didn't bookmark that reference to give you.

never apologize because you are helpful beyond all reproach.

3. the TB test/vaccination is oftentimes not transcribed onto the I-693 DS-3025 vaccination record at the time of the knightsbridge medical (because often there is no documentation to prove it) This is not about being vaccinated as a child. It's about taking a skin test to see if you have TB. That's also why you get an x-ray at Knightsbridge. The skin test is not immunization. It's a test, like HIV blood test, so it isn't on an immunization record. The TST is not part of the instructions to the Panel Physicians (Knightsbridge) so they aren't required to do it.

so, if you have completed the required vaccinations BEFORE entering the US and they have been transcribed on to the DS-3025 (thanks for the correction!) you then have the option to (in order of pain-in-the-assness):

A. just mail the DS-3025 with your AOS package and hope for the best (or wait for an RFE)

B. contact Dr Aronld (or another civil surgeon) to have your vaccinations transcribed on to the DS-3025. (what is the point of this if you arent lacking anything but a TST?)

C. visit a civil surgeon/health clinic/local GP and have the TST performed and evaluated and send these results along with the DS-3025 when you submit the AOS package

D. redo the whole medical with a civil surgeon who fills out a new DS-3025, and I-693 and cant probably do the TST too. submit all this stuff with your AOS package. (again, why?)

i think that we will probably gamble, because as long as we are together in the same place, waiting for the AOS should be bearable. i just want to make sure i understand the details (though it seems like there are definitely some grey areas here) so i see the bigger picture when things start to fall apart.

nich, thanks for taking the time to post. i feel like i have learned quite a bit and feel better prepared for what may come.

not that i dont have more questions! ill study these points and d o some more research before i ask.

[English Muffin 59]

jamie's is a circle about oh.. about a centimeter in diameter.

That sounds right. Mine is on my upper left arm, now covered by a tattoo of a cat.

[Nich-Nick 3,354]

so, if you have completed the required vaccinations BEFORE entering the US and they have been transcribed on to the DS-3025 (thanks for the correction!) you then have the option to (in order of pain-in-the-assness):

A. just mail the DS-3025 with your AOS package and hope for the best (or wait for an RFE) If all your jabs are complete.

B. contact Dr Aronld (or another civil surgeon) to have your vaccinations transcribed on to the DS-3025 I-693. (what is the point of this if you arent lacking anything but a TST?) Because the AOS application says to send an I-693

C. visit a civil surgeon/health clinic/local GP and have the TST performed and evaluated and send these results along with the DS-3025 I-693 when you submit the AOS package

D. redo the whole medical with a civil surgeon who fills out a new DS-3025, fills out a whole I-693 and can do the TST too. submit all this stuff with your AOS package. (again, why?) No need unless you get an RFE that your medical info in the brown envelope got lost between POE and meeting up with your AOS file. That has happened a lot of times.

Yes, those summarize what you might choose to do. You're still fuzzy on the forms.

Outside of the US, the doctors are called Panel Physicians. The forms are DOS forms (DS-xxx) because Dept of State is over the Embassy and DOS issues visas. These are the Panel Physician (Knightsbridge) forms that are in the brown envelope you turn in at POE amongst your file items.

DS3025 DS3024 DS3026 DS2053 I think that's it.

In the US, the approved doctors are called Civil Surgeons. Their form is a USCIS form (I-xxx) because USCIS issues Green Card (AOS)

I-693 and I-693 Instructions

The biggest problem people encounter with Civil Surgeons is they are quite often uninformed or refuse to just copy your immunizations to the I-693 without doing the whole medical. They insist you have to do the whole medical. You will find many posts saying "I called 10 Civil Surgeons in my area and they won't sign unless they do the whole medical." The prices range mostly in the hundreds of dollars. Some are lucky and find one. That's why so many people use Dr. Arnold. He will take your DS-3025 or any record of shots you have signed by a doctor and put them on part B of the I-693 for fee of $30(?) and mail to you Priority Mail all signed and sealed.

[mr and mrs 187]

im feeling embarrassed at how off i was about some of my ideas about the process. it is coming in to focus. thanks for the patience.

i have seen that there are lots of posts about people looking for CS's to deal with and how the CS's often dont understand the process. thats a shame and waste of time. it also seems very stressful to families trying to navigate through all of this.

[Nich-Nick 3,354]

im feeling embarrassed at how off i was about some of my ideas about the process. it is coming in to focus. thanks for the patience.

i have seen that there are lots of posts about people looking for CS's to deal with and how the CS's often dont understand the process. thats a shame and waste of time. it also seems very stressful to families trying to navigate through all of this.

Don't be embarrassed. You know alot more than I did at the same point in the process. It takes awhile to get your head around all the forms and abbreviations. Yes the Civil Surgeon part and the "new" TB skin test rules threw a monkey wrench into the process. It was so confusing to me and so new that I just threw up my hands and said "I'll worry about this later when they RFE me." They apparently saw all shots were complete and the medical was there and indicated no TB...I dunno...but that's how it happened.

If you're placing odds...what about this scenario?

A ) Get a TST from Civil Surgeon and it turns red (because of BCG shot in UK) and he reports it and says you must take the pills 6 mo.

or

B ) Don't send in a TST and maybe get by without one

or

C ) Get TST at the health dept and if it turns red, throw report away and try to get by without it. If clear, send in with AOS.

Geez...there are so many options you can play around with in your confused head.

Not all Civil Surgeons will prescribe the dreadful pills. They would probably make you pay for another x-ray. There's just too dang many of them all over the US to know what kind you're going to get and what they will charge you. That's the frustration.

Edited April 5, 2009 by Nich-Nick

[mr and mrs 187]

If you're placing odds...what about this scenario?

A ) Get a TST from Civil Surgeon and it turns red (because of BCG shot in UK) and he reports it and says you must take the pills 6 mo.

or

B ) Don't send in a TST and maybe get by without one

or

C ) Get TST at the health dept and if it turns red, throw report away and try to get by without it. If clear, send in with AOS.

Geez...there are so many options you can play around with in your confused head.

this kind of occurred to me. but its hard to know when you can outsmart the USCIS and when to shut up and do as youre told. i think once he is on american soil, we will be able to be a bit braver.

jamie will not be hot on taking pills. at all. so we hope to avoid that all together.

and thanks for being not only helpful, but kind, nich. much, much, MUCH appreciated.

<dreams of AOS vj merit badge>

[Big Papa Zone 93]

[C ) Get TST at the health dept

This the problem (that I only realised after I had forked out for a private TST) it has to be done (like everything else involved in the medical) by a CS, so your local doctor's test counts for diddly squat anyway. I say just submit I-693 anyhoo.

jamie will not be hot on taking pills. at all. so we hope to avoid that all together.

OK, neither would I. So just make sure the receipt of the pills is registered, and then sling 'em straight down the bog.

[mr and mrs 187]

I say just submit I-693 anyhoo.

so, wait. i think im confused. looks like there are a bunch of parts to the I-693. and from what i am hearing, the CS only needs to sign off on part of the form, part 5, because jamie is a K-1 applicant and all of his jabs were in order at the time of the medical. jamie will fill out part one. and that's ALL for the medical stuff (until/unless we get an RFE)?

how does the TB play into things? i see it is mentioned on the I-693 form (in part 2.2), but since this is not a section that the doctor is signing off on, how is the USCIS satisfied that the AOS applicant does not have TB?

and finally, ugh sorry, do we already have the DS-3025 that needs to be submitted to the CS for transcription? is this what he got after his medical was completed in london?

i am being completely inarticulate. ill stop for the moment.

jamie will not be hot on taking pills. at all. so we hope to avoid that all together.

OK, neither would I. So just make sure the receipt of the pills is registered, and then sling 'em straight down the bog.

OH! great! perfect solution! : D

[Big Papa Zone 93]

I say just submit I-693 anyhoo.

M&M, the 3025 is what you got from Knightsbridge. Look, just call Dr Arnold's office, and Tammi wil explain everything, OK? Really, simple as that.

jamie will not be hot on taking pills. at all. so we hope to avoid that all together.

OK, neither would I. So just make sure the receipt of the pills is registered, and then sling 'em straight down the bog.

OH! great! perfect solution! : D

I think so. B)

[mr and mrs 187]

'kay. : )

i feel better now. i made a file folder and labeled it neatly as 'AOS'. <nod>

[Nich-Nick 3,354]

this kind of occurred to me. but its hard to know when you can outsmart the USCIS and when to shut up and do as youre told. i think once he is on american soil, we will be able to be a bit braver.

and thanks for being not only helpful, but kind, nich. much, much, MUCH appreciated.

<dreams of AOS vj merit badge>

It's not really about outsmarting the USCIS. It's trying to figure out exactly what is acceptable to them. For me the form from Knightsbridge and no TST was acceptable to the person who initially checked my file and the person who ultimately adjudicated it. I actually think the I-693 applies well for people adjusting from within the US who didn't do the K1/K3 visa route.....students, nannies, workers, VWP overstays...who met and married a US citizen or somebody's mother who lives abroad. Those people didn't have a medical or shots a few months back to get here. So that's the form to go through their process. But then the feds say, oh what about those K1/K3 people and put some vague info in to cover in a one-size fits all way. Then when you consider you have various agencies in on our process...Homeland Security (USCIS & CBP), Dept of State (Embassy), Health & Human Services (Center for Disease Control)...and each makes up rules. Then the other agencies try to fit their rules to go along with the other agency. Well it sometimes sounds contradictory to common people like us. The I-485/AOS instructions still say a K1 does not have to do another medical and only has to complete the vaccination supplement I-693A. So before you read that and go looking for that form...it's been eliminated by the "new" I-693. So why didn't they amend the AOS instructions to explain that? Too much trouble? They don't know it drives us crazy when we try to be too literal when we follow their directions?

I'm not real good with literal. I try to understand the outcome of why they are asking for information...to know we have all the immunizations, signed by an approved agent/doctor and to know we don't have TB. Well I think Knightsbride covered that and any logical person could know that too by looking at the papers. I'm old and conservative. I am not a risk taker at all. I really see it that way, while others don't. I guess I look at the forest, while others look at the trees. Heck some look at every twig.

The CDC came up with the new skin test idea. So somebody at USCIS has to incorporate that into their thing without considering telling the doctors overseas to do it. Is that because DOS is in charge of the overseas part? Is it because not every country has the meds to do a TST? I dunno. I've read all the instructions to panel physians and civil surgeons. I've read volumns on the CDC website. There is actually documents saying that they want to make the requirements flexible so they can require more stringent requirements of countries at anytime there is a high incidence of a disease. They want to be able to quickly add requirements for immigrants of specific geographic areas if there is a new and emerging disease threat instantly without waiting for all the rules and forms to change in a one-size-fits-all manner. Now that makes sense.

I know, too much information. M&M--I don't know the perfect answer. I just did what I did and you've got to pick what you're going to do.

(DAYMO---I love your thinking, dude!)

[Talyss 0]

I think the TST test was added because its actually a less invasive screening tool than an x-ray and can be used for pregnant women etc. So people in the US only have an x-ray if their TST is positive.

The downside of it is it requires 2 visits to the doctors which is not really feasible overseas where people are traveling from many miles away for their medical appointments which is why the overseas medicals seem to be sticking with the x-rays for initial screening.

I think the instructions on USCIS are confusing. The general instructions for AOS page says everyone needs the I-693 except for those on fiance visas and then there are other pages that seem to suggest that everyone must have it regardless.

The I-693 includes instructions for those on K1 visas on which parts to complete (which does not include the section with the TST) is this because we all need to complete it? or because not all K1 visa applicants complete their immunisations before their medical and they need to complete to show they have done so before AOS?

I have gambled on the latter and just sent a copy of the DS-3025 and will send an I-693 if I get an RFE.