Tuberculosis (TB) screening is a mandatory test of the immigration medical examination for all applicants seeking permanent residency in the United States. Because there is a risk to the public’s health that untreated tuberculosis will spread to others, this infectious disease is treated very carefully.

The majority of applicants will have negative results; nevertheless, on occasion, the civil surgeon will record on Form I-693 Report of Medical Examination a positive or abnormal TB test result. What follows if you receive this result throughout the medical examination process for a green card?

Chest X-Ray and Testing Protocol

Civil surgeons usually start by ordering a chest x-ray in order to check for any abnormalities that would point to either current or latent tuberculosis. If there are other risk factors, such as the following, targeted testing will be done even if the x-ray looks normal.

HIV-positive condition

Close proximity to a person suffering from active tuberculosis.
Having worked or resided in an area where tuberculosis is common.
Having experience in a dangerous field such as healthcare.
Symptoms such as fever, chills, coughing, or sudden weight loss.

The civil surgeon will seek further testing and evaluation in accordance with the TB technical guidelines from the Centers for Disease Control (CDC) if any of those risk factors are present, or if the chest x-ray is abnormal.

Additional TB Testing

Some of the additional examinations and tests that might be necessary, depending on the circumstances of the person, include:

In order to ascertain whether the applicant has an active latent tuberculosis infection (LTBI) or an inactive TB disease, the civil surgeon is responsible for supervising this medical evaluation and gathering adequate diagnostic evidence. Determining the applicant’s admissibility and the next course of action requires a proper diagnosis of tuberculosis.

TB Status Classifications

The civil surgeon will designate a tuberculosis classification for immigration purposes based on the test results:

Class A TB: This indicates that the candidate is suffering from a contagious, clinically active case of tuberculosis. Currently, a Class A TB condition prevents an applicant from entering the country until after they have finished personally monitored treatment through an authorized public health program.

Class B1 TB: The applicant has clinically active non-infectious TB, but no active illness has been detected. This may include certain cases that are culture positive but smear negative that nevertheless need to be evaluated for therapy. If therapy and evidence of recovery or completion are provided, it is not a reason for denial of admission.

Inactive, non-infectious latent tuberculosis infection (Class B2 LTBI). There is no problem with admission if latent TB treatment is completed before entering the United States.

However, if the treatment plan is not followed, the LTBI may become inadmissible under Class A.

No TB Classification: After a thorough review, if test results indicate that the applicant does not have an active or latent tuberculosis infection, they will not be classified as having TB.

Treatment Requirements

For candidates who get a Class A or B notification and have been diagnosed with latent or active tuberculosis:

Class A Active TB: Not eligible until after successfully completing personally observed treatment under a program for tuberculosis control run by a health department. After receiving appropriate treatment, applicants must show the civil surgeon documentation that they are free of active tuberculosis.

Class B1 Active TB: Requires reporting to the local health authorities, as well as following the prescribed treatment plan while continuing to be closely monitored. Must give the civil surgeon the proof of a successful course of therapy.

Class B2 LTBI: Prior to entering the United States, you must get medical supervision and finish the recommended course of treatment for latent tuberculosis infection. Health departments can offer monitoring and treatment support. Evidence of treatment fulfillment needed.

Monitoring and Follow-Up

When treatment is finished or the TB classification changes, the civil surgeon is crucial in ensuring that the applicant’s medical exam records are updated and in keeping track of any necessary TB treatments.

The document needs to be completed with medical records attesting to proper therapy, a negative response to treatment, and confirmation that the patient is clear of active or latent TB. This aids immigration authorities in verifying that, before receiving final permission for an immigrant visa or green card, the applicant has taken care of any TB-related inadmissibility issues.

Immigration applicants can be appropriately diagnosed and treated for tuberculosis through the medical exam procedure, despite the fact that an atypical or positive TB test result may seem concerning. Those with tuberculosis (TB) who adhere to the health reporting, treatment, and monitoring requirements can get the care they need and eventually be cleared for U.S. immigration purposes.

In the event that you do receive a Class A or Class B TB notification during your immigration medical exam, having expert legal counsel can also help clarify what to do next. You can apply for any necessary inadmissibility exemptions based on your TB status, update your medical exam results, and seek treatment supervision by following the correct processes, all of which can be guided by an expert attorney.


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