Using Dr. Arnold for medical - legal or not?

[jbmail 0]

Anything new JB?

Hello Gary,

Just to update. To this date, only ONE attorney has written to me about this post. You would think that with all the pay per click advertising that gets sent thru this site with these lawyer ads , wwwould get a little FREE advice, but then again, who needs them. Currently two calls to USCIS officer that called me and NO return calls, so i went with the formal PAPER route CERTIFIED MAIL. Then I have records of everything. I guess they expect that we will just wait forever while our file sits in a draw somewhere until we buckle under and agree to see another surgeon all over again? I think not. If I am being asked to do something that is NOT in the USCIS rulebook, then I want to see it in WRITING, RFE, etc. Like the wife said, we are not in a hurry, but we'd like to be FREE of USCIS forever. She can work in 2010 when all this settles down and we have green card. Right now she is enjoying her quiet time at home, learning more English and waiting for good old Maine Snow, which she did not have at the Black Sea, so this will be different for her this year. She may want to work, but transportation is an issue and I think she enjoys helping me organize my businesses and act like office manager. Good for me she works for FREE!!! I will have something to post as soon as I get formal answers from my mailings, but for now we wait. I can't imagine that the higher ups will make us do this over when Dr Arnold has been supplying quality work to USCIS for so long and nothing EVER rejected according to his office. Thanks for asking and I will update soon...J

[Bobby+Umit 161]

JB

Read what the comments of a Director at the VSC were regarding CSs at the top of the K-1 forum. His wife is also from Russia and arrived without all her vaccinations. He went to the local county health dept., got the vaccinations and sent the records to a CS, just like you. I have never seen and he never mentioned in any of our discussions (and this was a topic we discussed at length) about having to see a CS in person to sign the I-693

The signature is also the only issue I can think of. The instructions on the I-693 do say this:

You must sign the form in the presence of the examining physician.

That might be the source of the problem, IF that bit of instruction is actually derived from law code or regulation, but I would be a little surprised if it is.

I was about to suggest this as being the reason.

found this on USCIS:

USCIS may revoke a physician’s authority to act as a civil surgeon if the physician regularly fails to follow CDC's Technical Instructions, or has fraudulently completed a Form I-693, or has had his or her license suspended, revoked or terminated.

Signing it without the presence of the examining physician "could" be considered fraud.

Bobby,

Could you send me by PM or quote where you are seeing this. This line about signing in presence of a CS, I also found, but is quoted in the MEDICAL EXAM portion and not the Vaccinations section

Please correct me if I am wrong as I want this forum topic to be exact and finalized. I dount any attorneys will comment on it , as they don't want to bring attention to their firms by commenting, but the gentlemen I spoke to says that no where in the code of conduct, does it say that a CS has to see you sign these papers when updating vaccinations. it DOES say that He MUST verify by passport or photio, your identity BEFORE performing the MEDICAL part of I-693..Thanks...J

Sure - look at the I-693 instructions:

How do I file Form I-693?

(step 1-3)

Step 4: Attend your medical exam appointment and all follow up exams, as may be required. Sign Form I-693 in front of the civil surgeon. (emphasis added)

I would imagine an argument could be made that your medical exam could be considered the same as the vaccination record, since they are suppose to be done at the same time. (there are no seperate instructions for the two parts)

Toss in the actual verification of the person (kinda hard to do when people are out of state) - this would make me give the hairy eyeball on records coming in that way...

But I am not a lawyer - plus, USCIS (or this one office) seems to be giving the hairy eyeball now to Dr. Arnold.

(FWIW - I thought it was strange reading all the posts of people in other states referring to Dr. Arnold to do vaccinations for them (out of state, not even going to see him in person), it seemed strange to me then, and this just cements it even more for me.)

[Gary and Alla 3,694]

JB

Read what the comments of a Director at the VSC were regarding CSs at the top of the K-1 forum. His wife is also from Russia and arrived without all her vaccinations. He went to the local county health dept., got the vaccinations and sent the records to a CS, just like you. I have never seen and he never mentioned in any of our discussions (and this was a topic we discussed at length) about having to see a CS in person to sign the I-693

The signature is also the only issue I can think of. The instructions on the I-693 do say this:

You must sign the form in the presence of the examining physician.

That might be the source of the problem, IF that bit of instruction is actually derived from law code or regulation, but I would be a little surprised if it is.

I was about to suggest this as being the reason.

found this on USCIS:

USCIS may revoke a physician’s authority to act as a civil surgeon if the physician regularly fails to follow CDC's Technical Instructions, or has fraudulently completed a Form I-693, or has had his or her license suspended, revoked or terminated.

Signing it without the presence of the examining physician "could" be considered fraud.

Bobby,

Could you send me by PM or quote where you are seeing this. This line about signing in presence of a CS, I also found, but is quoted in the MEDICAL EXAM portion and not the Vaccinations section

Please correct me if I am wrong as I want this forum topic to be exact and finalized. I dount any attorneys will comment on it , as they don't want to bring attention to their firms by commenting, but the gentlemen I spoke to says that no where in the code of conduct, does it say that a CS has to see you sign these papers when updating vaccinations. it DOES say that He MUST verify by passport or photio, your identity BEFORE performing the MEDICAL part of I-693..Thanks...J

Sure - look at the I-693 instructions:

How do I file Form I-693?

(step 1-3)

Step 4: Attend your medical exam appointment and all follow up exams, as may be required. Sign Form I-693 in front of the civil surgeon. (emphasis added)

I would imagine an argument could be made that your medical exam could be considered the same as the vaccination record, since they are suppose to be done at the same time. (there are no seperate instructions for the two parts)

Toss in the actual verification of the person (kinda hard to do when people are out of state) - this would make me give the hairy eyeball on records coming in that way...

But I am not a lawyer - plus, USCIS (or this one office) seems to be giving the hairy eyeball now to Dr. Arnold.

(FWIW - I thought it was strange reading all the posts of people in other states referring to Dr. Arnold to do vaccinations for them (out of state, not even going to see him in person), it seemed strange to me then, and this just cements it even more for me.)

I will let JB update us all when he has a chance. I can tell you from my conversations with him that this USCIS office is taking a very hard line on this issue and absolutely will not accept Dr. Arnold's signature. Despite hundreds of others that have done the same and despite any clear requirement that the CS must see the applicant for the vaccination section only.

So, it may be something for VJ members to consider until this gets sorted out. Local offices can and at least in this case, will take a hard line and strict interpretation.

[Aubrey 10]

This doesn't affect the debate on the legality of the service Dr. Arnold is providing. However, I would like to say one thing. My ex-husband and his family saw Dr. Arnold as their primary care physician since my ex was a child. He was not on my health plan so I never got care from him, but Dr. Arnold still provided services for my now ex and his parents. It was very common for him to prescribe drugs for common illnesses without ever seeing them in person (giving them Z-pacs, for example, when they called to say they had certain symptoms) and giving them several refills so they could self-medicate.

That having been said, he seemed like he was trying to save them the headache of coming in, basing his care on trust. I'm not judging what he did, but thought you guys should know that he may possibly be aware that it's not quite ethical.

[cdneh 3,112]

You would think that there would be ONE set of rules that apply for all. Not dependent on one person in one location taking it on his own back to alter what he doesn't agree with. To hold applicants hostage unless they follow HIS own interpretation of a set of rules already in place. Dr Arnold is not illegal as if he was he wouldn't appear on the list of certified civil surgeons. And he does.

How procedures are followed shouldn't be affected by how the planets line up.

I hope this guy that is jerking you around jbmail ..how was it so well put.. gets a knot tied in him?

[TBoneTX 45,155]

...Dr. Arnold still provided services for my now ex and his parents. It was very common for him to prescribe drugs for common illnesses without ever seeing them in person (giving them Z-pacs, for example, when they called to say they had certain symptoms) and giving them several refills so they could self-medicate.

That having been said, he seemed like he was trying to save them the headache of coming in, basing his care on trust.

This is not uncommon, especially when a physician is familiar with a patient, his medical history, his manner of presenting medical issues (stoic, hypochondriac, in between), etc. I have this kind of relationship with my own general practitioner. Trust, familiarity, and knowledge together are powerful and meaningful.

As for the issue in this thread, I consider it appalling that anyone at USCIS would question the signing of an I-693 vaccination supplement "sight-unseen." The matter would not arise at all except that 99.44% of all OTHER civil surgeons charge usurous fees and hold people over a barrel to get a full medical -- it is the LATTER behavior that's ignorant, criminal, or both.

[Gage 2]

...Dr. Arnold still provided services for my now ex and his parents. It was very common for him to prescribe drugs for common illnesses without ever seeing them in person (giving them Z-pacs, for example, when they called to say they had certain symptoms) and giving them several refills so they could self-medicate.

That having been said, he seemed like he was trying to save them the headache of coming in, basing his care on trust.

This is not uncommon, especially when a physician is familiar with a patient, his medical history, his manner of presenting medical issues (stoic, hypochondriac, in between), etc. I have this kind of relationship with my own general practitioner. Trust, familiarity, and knowledge together are powerful and meaningful.

As for the issue in this thread, I consider it appalling that anyone at USCIS would question the signing of an I-693 vaccination supplement "sight-unseen." The matter would not arise at all except that 99.44% of all OTHER civil surgeons charge usurous fees and hold people over a barrel to get a full medical -- it is the LATTER behavior that's ignorant, criminal, or both.

I agree, and it's really not that unusual. I have a similar relationship with my doctor, and it's the kind of relationship I demand from a physician. I have a chronic muscle problem in my back where it will give out and leave me darned near bed ridden for about 1 week out of every year. Having done the x-rays and exam years ago to diagnose exactly what is causing it, he prefers to simply call in my standard "back pack" to the pharmacy when I call to tell him I'm having problems. It's the standard week's worth of Flexeril, Hydrocodone, and prescription strength ibuprofen. In a week I'm back on my feet and usually good for another year. That's all I need would be some quack telling me I have to crawl to my car and drive to his office just so he can run up hundreds of dollars of tests to justify the same end result.

[jbmail 0]

You would think that there would be ONE set of rules that apply for all. Not dependent on one person in one location taking it on his own back to alter what he doesn't agree with. To hold applicants hostage unless they follow HIS own interpretation of a set of rules already in place. Dr Arnold is not illegal as if he was he wouldn't appear on the list of certified civil surgeons. And he does.

How procedures are followed shouldn't be affected by how the planets line up.

I hope this guy that is jerking you around jbmail ..how was it so well put.. gets a knot tied in him?

OK, heres the latest. As far as Dr Arnold goes. Anyone who uses him, is risking that their papers will be rejected, at some point, someday, as the Civil Surgeon Code says that a CS MUST verify your identity IN PERSON before both parties sign off. I also read on the USCIS page ( don't ask me where), where it says basically the same thing, but I never saw it for 6 months, so it isn't easy to see. The director showed it to me and was willing to say that we made a mistake and it was NOT intentional FRAUD, for which would mean INSTANT DENIAL, and no motion could overturn that. So, here we go again. The FRAUD was determined to be on the doctors part.

As far as THIS office and THIS officer go, I ended up in a special meeting with the director and a different IO on Friday. They were VERY pleasant to me and the wife, and understood our plight, but the govt makes the rules and they are there for a reason. It didn't help that several foreign speaking couples were arguing loudly in the background while we tried to plead our case. We agreed and decided to move on and not fight this. How could we, its IN WRITING. There are memos going around the service centers about Dr Arnold, so its only a matter of time before things come to a halt. Was my immigration officer wrong?no, maybe saw a memo, or just more educated on fine-tuning the law than some others, I presume. I was told that IF Dr Arnold doesn't know this IN PERSON requirement, then he will soon enough, what ever that meant. So as far as being DENIED, we are still there. All so far that we have lost is time and alot of headaches. In our part of Maine, there are only 2-3 CS, one is a crook and we have submitted a complaint to the OIG about wanting to charge us $530.00 for a vaccination write off. The other two work wierd hours and have a month backlog, so we were lucky to get an appt in 2 weeks. Our first try in October, neither could see us in 30 days. Thats why we sent to doctor Arnold, so we would not have to ask for an extension of time..We have another meeting with the director and this officer NEXT Friday the 4th of December. I had to see a CS and get everything resigned and sealed and must present to them on the 4th. I must file a SERVICE MOTION and this Director said she certainly understands what happened & will TRY to make sense of all this and will speak to the officer and she hopes it can be resolved WITHOUT a fee and without showing fault on either side, but to label it a misunderstanding as we did not get enough time to see the NEW doctor and we have proof that the new appt was made when he called on the 17th. If this doesn't work, then its $595.00 to file a Motion To Reopen, which could ALSO be denied, so I discussed with her, the option of just paying the $1000 over again and starting fresh, which would guarantee AOS, just take more time, but like I said, we are not going anywhere out of the country and the wife isn't planning on working, so why CHANCE another refusal? If it was refused, you'd lose the $595 anyways and its 3-4 months to reopen a case, estimate! I can have the whole AOS done in less time, see my point?

I guess this sums it up until we see what happens. ...jb

[SuperDuper! 230]

If Dr. Arnold is deemed to be a "fraud" (I dont like that word, but for simplicity of conversation I will use it), then MANY cases will be effected. I hope this is not the case. Please, Let's get to the bottom of this and get the facts out. Thanks for chasing this down, dude.

[Nich-Nick 3,354]

I can see where a person going in for a full medical exam would have to be identified with some kind of photo id and seen in person. But to only copy a list of immunizations from several sources onto one form???

Just throwing something else into the discussion--

Here are the technical instructions for Civil Surgeon concerning immunizations. This document supercedes any previous sections of previous instructions. It includes the changes to the immunization schedule from Spring/Summer 2008. And it includes "Procedure for Completing Form I-693, Report of Medical Examination and Vaccination Record." It doesn't mention the old/retired I-693A separate immunization form which changed with the new schedule. This DOES NOT say the applicant must meet in person with the Civil Surgeon.

Technical Instructions to Civil Surgeons - Immunization 2008

I totally understand the OPs predicament and he has to go along with anything his IO determines as the correct procedure, but I'm not convinced that Dr. Arnold is committing fraud on a widescale basis.

Edited November 29, 2009 by Nich-Nick

[jbmail 0]

If Dr. Arnold is deemed to be a "fraud" (I dont like that word, but for simplicity of conversation I will use it), then MANY cases will be effected. I hope this is not the case. Please, Let's get to the bottom of this and get the facts out. Thanks for chasing this down, dude.

To be PRECISE, as Iwas told, We don't feel you did anything wrong...Dr Arnold is DEFRAUDING his clients by giving them a false sense of security , in that he KNOWS what he is doing & is providing legal CS policy ( or maybe he doesn't know) and that everything is ABOVE BOARD.

(note) The examining CS, whether he is giving a medical or just signing off on the vaccinations part, must VERIFY the identity of the applicant

In this regard, you must take reasonable steps to ensure

that the person appearing for the medical exam is the same

person applying for the requested immigration benefit. All

applicants must present a valid government-issued photo

identification. The law imposes severe penalties for

knowingly and willfully falsifying or concealing a

material fact or using any false documents in connection

with this medical exam.

Attend your medical exam appointment and all

follow-up exams, as may be required. Sign Form

I-693 in front of the civil surgeon.

So there it is, at least what the IO's will be using as Evidence for Denial.

Thats what stated in our DENIAL letter

Do I think every case who used Dr Arnold will be reversed? Hardly. But I think more & more will be getting rejected as this memo goes around and I'm sure some of the larger city offices will just miss it and slip thru the cracks. Signing off...

Thats all I can tell you for now. I am done fighting...we were made the scapegoat, so don't shoot the messenger. I just hope no one has to go thru this BS...J

[new2visajourney 0]

i had my interview on November 23rd , got approved on November 25th ,

used Dr ARNOLD for my vaccines despite i know it is not right because he has to see you in person and make sure of your id as it says in the I-693 , but you know what i was lucky to get approved because most Ios dont look at the doctor's name . BUT I'M SURE THAT DR ARNOLD 'S VACCINES ARE NOT LEGALLY VALID

[Hugglebuggles 60]

The problem I see is that many of the USCIS approved civil surgeons are completely unaware of immigration laws and procedures and what type of services they can and should provide to clients. When I was trying to get my I-693 transcribed I called 7 offices representing a dozen civil surgeons in the Denver metro area and was unable to find one individual willing to provide this service. Most doctors told me I needed a new medical, all for different reasons, and one doctor even went as far as telling me the immigration medical I had in Canada when applying for the K-1 wasn't valid and that it should have taken place in the US. I had 2 doctors tell me they didn't even know what I was talking about when I referred to the I-693. Very reassuring when the doctors have absolutely no idea what the rules and guidelines are. One doctor even told me she would need to charge $850 and administer a new medical.

I ended up seeking Dr. Arnold's services. I went to the interview prepared with a list of doctors I had called and the poor excuses they gave me, knowing Dr. Arnold has recently raised some eyebrows with USCIS. Fortunately I made my case at the interview, saying my medical was still valid and the officer interviewing me didn't even request the I-693. If anyone is committing a crime its these doctors that are supposed to be certified to perform immigration medical services but are completely unaware of standard procedures and want to get every dollar possible from you. USCIS should be more focused on standardizing their guidelines and the training of civil surgeons. Perhaps then people wouldn't be so tempted to commit "fraud" when "fraud" is really the only available option.

jbmail- Thanks for all of this great information. It will surely help people in the future.

[TBoneTX 45,155]

JB -- what, please, is the EXACT CITATION (printed source, URL, etc.) for the information that you were told? Without knowing this, "what you were told" -- no matter by whom -- would seem to fly in the face of the document that Nich-Nick provided (see post #55).

[taisia 0]

we've recently used dr.Arnold's services and sent AOS package to USCIS. we thought we made a good deal and now after reading JB's hardships with 693 signed by dr.Arnold we are confused-what should we do now? wait till they send RFE and then redo I693 (for more money)? or redo it now in case an IO finds out "fraudulent" I693at the interview?