Introduction

On December 12, 2018, the United States Citizenship and Immigration Services (USCIS) issued Policy Alert (PA)-2018-12, titled “Sufficiency of Medical Certification for Disability Exceptions (Form N-648)” [PDF version]. The alert updates the USCIS Policy Manual with new guidance on when an applicant for naturalization may be granted an exception to the English language and civics requirements due to a physical or developmental disability. The new rules become effective on February 12, 2019, and have been published in the USCIS Policy Manual (PM) at 12 USCIS-PM E.3 [PDF version].

In this article, we will examine the new policy guidance for disability exceptions to the English and civics requirements for naturalization. We will also discuss the related issue of accommodations for those seeking to satisfy the English language and/or civics requirements.

Background of English and Civics Requirements for Naturalization and Exemptions

Under section 312(a)(1) of the Immigration and Nationality Act (INA), an alien may not be naturalized as a U.S. citizen unless he or she demonstrates “an understanding of the English language, including an ability to read, write, and speak words in ordinary English language: Provided, That the [these requirements] shall be met if the applicant can read or write simple words and phrases to the end that a reasonable test of his literacy shall be made and that no extraordinary or unreasonable condition shall be imposed upon the applicant…” Section 312(a)(2) provides that the alien must also demonstrate “a knowledge and understanding of the fundamentals of the history, and of the principles and form of government, of the United States.”

Section 312(b) provides several limited exemptions from and exceptions to the English language and civics requirements.

Exemptions from English Language Requirement for Age and Duration of U.S. Residence

First, section 312(b)(2) provides that the following classes of naturalization applicants are exempt from the English language requirement only if :

The applicant is over 50 years old and has resided in the United States for at least 20 years subsequent to a lawful admission for permanent residence at the time of applying for naturalization; or
The applicant is over 55 years old and has resided in the United States for at least 15 years subsequent to a lawful admission for permanent residence at the time of filing for naturalization.

Section 312(b)(3) provides that special consideration may be provided regarding the civics requirement to an applicant who is over 65 years old and has resided in the United States subsequent to an admission for lawful permanent residence for at least 20 years prior to applying for naturalization. Federal regulations at 8 C.F.R. 312.2(c)(2)(iii) and (iv) list the applicant’s age and length of residence in the United States as factors that may be considered “[i]n choosing the subject matters, in phrasing questions and in evaluating responses…” It is worth noting that any applicant described by section 312(b)(3) of the INA is exempt from the English language requirement under section 312(b)(2).

Exceptions to the English Language and Civics Requirements for Disability

The new USCIS policy discussed in our article focuses solely on a different exception which applies to both the English language and civics requirements. Under section 312(b)(1) of the INA, the English language and/or civics requirements “shall not apply to any person who is unable because of physical or developmental disability or mental impairment” to satisfy the requirement(s). The new policy concerns the requisite evidence necessary to establish and the procedures for establishing that an applicant cannot comply with one or both requirements for reason of “physical or developmental disability or mental impairment.”

The new policy, and by extension this article, will focus on the first exemption, which covers any applicant for naturalization who is unable to satisfy the English language and/or civics requirements due to “physical or developmental disability or mental impairment.”

Federal regulations in 8 C.F.R. 312.1(a)(3) set the parameters of the exemption from the literacy requirement and 8 C.F.R. 312.2(b) does the same with regard to the civics requirement. In both cases, the regulations apply only to “medically determinable physical or mental impairment or combination of impairments which has lasted or is expected to last for 12 months…” To the extent that an impairment is the direct result of illegal drug use, it will not be considered toward an applicant’s eligibility for an exemption. The term “medically determinable” is defined in regulations as “an impairment that results from anatomical, psychological, or physiological abnormalities which can be shown by medically acceptable clinical or laboratory diagnostics techniques to result in functioning so impaired” as to make the individual unable to satisfy the English language or civics requirements even with reasonable accommodations.

Revised USCIS Guidance on Exceptions from the English Language and/or Civics Requirements

The USCIS’s new guidance on exceptions from the English language and/or civics requirements for naturalization are found in 12 USCIS-PM E.3. The PM provides guidance to USCIS officers on how to adjudicate cases in accordance with the relevant statutes and implementing regulations. In the following subsections, we will examine the revised chapter of the USCIS PM. Before proceeding with our discussion, it is important to note that a request for an exception is filed on the Form N-648, Medical Certification for Disability Exceptions, which must be completed and signed by a licensed medical professional. We will discuss the rules for properly filing the Form N-648 and the underlying medical examination below.

Burden of Proof is On the Applicant

The PM provides at 12 USCIS-PM E.3(A) that the burden of proof is on the applicant to demonstrate such an impairment that he or she warrants an exception to the English language or civics requirements. The standard of proof is the preponderance (weight) of the evidence. The applicant must show that his or her impairment would prevent him or her from meeting the English and civics requirements for naturalization even with reasonable accommodations. The PM makes clear that illiteracy, in and of itself, does not establish that the applicant warrants an exception. Old age, in and of itself, is also not sufficient for establishing eligibility for an exception because it “is not a medically determinable physical or developmental disability or medical impairment.”

Proper Filing of Request for Exception

Under 12 USCIS-PM E.3(B)(1), in order to request an exception, the applicant must file the Form N-648, Medical Certification for Disability Exceptions. The Form N-648 is filed as an attachment to the Form N-400, Application for Naturalization. In general, the USCIS “only considers a Form N-648 that is concurrently filed with a Form N-400 to be filed timely…” This means that the applicant should attach the completed Form N-648 to his or her application for naturalization rather than file it later. The applicant’s medical examination certified on the Form N-648 should not be completed more than 6 months prior to the filing of the Form N-400.

12 USCIS-PM E.3(B)(2) provides that the USCIS may accept a late Form N-648 in specific circumstances. The USCIS may accept a late Form N-648 “if a significant change in the applicant’s medical condition since the submission of the initial Form N-648 has taken place…” Furthermore, “other explanations … may also be acceptable.” The applicant should submit an explanation and supporting documentation for any late Form N-648. The PM states that without supporting documentation, “a late submission can raise credible doubts about the validity of the medical certification…” These doubts may be bolstered if the applicant states that the impairment was present before he or she filed the Form N-400. To resolve doubts, the USCIS may, in its discretion, “require the submission of an additional Form N-648 or refer the applicant to another medical professional for a supplemental disability determination or completion of a new Form N-648…”

12 USCIS-PM E.3(B)(3) states that multiple Forms N-648 submitted at the same time may also raise doubts for the adjudicating officer. If multiple Forms N-648 are submitted, the USCIS will likely question the applicant about why he or she submitted more than one Form N-648. Furthermore, the USCIS will assess the multiple submissions to see if there are any discrepancies. Significant discrepancies may result in the USCIS concluding that the evidence for medical certification is insufficient. If the Forms N-648 were completed by different medical professionals, the USCIS will carefully consider whether there are credibility issues regarding the validity of the medical certification. Multiple submissions may be more likely to raise doubts “where the stated disability or impairment was not discussed earlier.” The USCIS may, in its discretion, refer the applicant to another medical professional for a new disability determination or completion of a new Form N-648.

At 12 USCIS-PM E.3(B)(4), the PM includes a useful chart explaining the components of a properly filed Form N-648. We have reproduced the chart below for your convenience:

Properly Filed Medical Certification for Disability Exceptions (Form N-648)
Completed, certified, and signed by all appropriate parties.
In addition, the medical certification must contain the following information:
Clinical diagnosis of the applicant’s medical condition(s) and, if applicable, the relevant medical code recognized by the Department of Health and Human Services (HHS). This includes the most current Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) codes.
Description of the medical condition(s) forming the basis for the disability exception.
Date(s) the medical professional examined the applicant.
Description of the doctor-patient relationship indicating whether the medical professional regularly treats the applicant for the cited conditions or an explanation of why he or she is certifying the disability form instead of any regularly treating medical professional.
Statement that the medical condition has lasted, or is expected to last, at least 12 months.
Statement whether the medical condition is the result of the illegal use of drugs.
Explanation of what caused the medical condition, if known.
Description of the clinical methods used to diagnose the medical condition.
Description of the medical condition’s effect on the applicant’s ability to successfully complete the educational requirements for naturalization.
Statement whether the medical professional used an interpreter to examine the applicant.

Authorized Medical Professionals

Under 8 C.F.R. 312.2(b)(2), only licensed medical doctors, doctors of osteopathy, and clinical psychologists are authorized by USCIS to certify the Form N-648. The medical professional must be licensed to practice in any state of the United States, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, or the Commonwealth of the Northern Mariana Islands.

12 USCIS-PM E.3(D) requires the medical professional to, at a minimum (quoted):

Conduct at least one in-person examination of the applicant;
Explain the nature and extent of the medical condition on [the] Form N-648;
Explain how the medical condition relates to the applicant’s inability to comply with the educational requirements;
Attest that the condition has lasted or is expected to last 12 months; and
Attest that the cause of the medical condition is not related to the illegal use of drugs.

Medical professionals are required to complete the Form N-648 using plain English that a person without medical training can understand. Staff associated with the medical professional may assist in completing the Form N-648. However, “the medical professional alone is responsible for providing the necessary information, answering the questions, and verifying and attesting to the accuracy of the form’s content.”

< p>The medical professional certifying the Form N-648 may, in his or her discretion, “choose to provide medical diagnostic reports, records, and statements as attachments to the Form N-648 as evidence of the disability.” However, “supporting documentation should be clearly probative of the medical disability that prevents the applicant from completing the required English and civics requirements.”

It is important for the medical professional to carefully follow the Form N-648 instructions in completing the entire form. Deficiencies in Form N-648 completion may result in the USCIS concluding that the Form N-648 is insufficient for establishing the applicant’s eligibility for an exception.

Medical Certification Requirements and Review

Upon receiving a Form N-648, the reviewing officer will assess whether it establishes that the applicant is eligible for a medical exception from the English language and civics requirements for naturalization. The following chart, reproduced from the The 12 USCIS-PM E.3(E)(1) for your convenience, shows the steps that the USCIS will follow in reviewing the Form N-648:

N-648 Review Guidelines
When reviewing the form, the officer should:
Determine whether the form has been properly completed.
Ensure that the medical professional has fully answered all of the required questions and has signed and certified the Form N-648 along with the applicant.
Ensure that the Form N-648 relates to the applicant and that there are no discrepancies between the form and other available information, including biographic data, testimony during the interview, or information contained in the applicant’s A-file.
Determine whether the Form N-648 contains enough information to establish that the applicant is eligible for the exception by a preponderance of the evidence. This determination includes ensuring that the medical professional’s explanation is both sufficiently detailed as well as specific to the applicant and to the applicant’s stated disability (rather than a generic, “one size fits all” explanation).
Ensure the Form N-648 fully addresses the underlying medical condition and its causal connection or nexus with the applicant’s inability to comply with the English or civics requirements or both.
If the record reflects that the applicant has a regularly treating medical professional, but another medical professional has completed the Form N-648, ensure that the Form N-648 includes a credible and sufficiently detailed explanation for the reason that the regularly treating medical professional did not complete the Form N-648.
When reviewing the form, the officer should not:
Attempt to determine the validity of the medical diagnosis or second guess why this diagnosis precludes the applicant from complying with the English and civics requirements.
Request to see an applicant’s medical or prescription records solely to question whether there was a proper basis for the medical professional’s diagnosis unless evidence exists that creates discrepancies or anomalies that those records can help resolve. The officer may ask follow-up questions to resolve any outstanding issues.
Require that an applicant undergo specific medical, clinical, or laboratory diagnostic techniques, tests, or methods.
Conclude that the applicant has failed to meet the burden of proof simply because he or she did not previously disclose the alleged medical condition in other immigration-related medical examinations or documents. It is appropriate, however, to consider this as a factor when determining the sufficiency of the Form N-648. The officer should always carefully examine the evidence of record and ask follow-up questions to resolve any outstanding issues.
Refer an applicant to another medical professional solely because the applicant sought care from a professional who shares the same language, culture, ethnicity, or nationality.

12 USCIS-PM E.3(E)(2) makes clear that the Form N-648 must support that the applicant has a disability or impairment and include sufficient information about its nature. However, a disability or impairment, in and of itself, does not establish that the applicant is eligible for an exception from the English or civics requirements or both. Thus, the N-648 must include an explanation of “how the applicant’s disability or impairment prohibits the applicant from being able to demonstrate the English or civics requirements or both.” The USCIS will look to see whether the explanation is “sufficiently detailed and tailored to the applicant’s diagnosed medical disabilities or impairment.” The USCIS will only grant an exception if the Form N-648 shows, with sufficient detail, both that the applicant has a disability or impairment and that there is a causal connection between that disability or impairment and the applicant’s inability to demonstrate the English and/or civics requirements for naturalization. The medical professional must describe the effect that the disability or impairment has on the applicant’s day-to-day life and the basis for the assessment.

The USCIS may compare the information on the Form N-648 with answers provided by the applicant about his or her day-to-day life in the naturalization process. If there are discrepancies, the USCIS may question the applicant about the discrepancy.

Interpreters

12 USCIS-PM E.3(E)(3) makes clear that interpreters may be used during the medical examination. If an interpreter is used, the interpreter must also certify the Form N-648. If the interpreter does not certify the Form N-648, the N-648 will be deemed to be deficient and the applicant will be required, upon notice, to bring a properly completed Form N-648 for the re-examination. If the officer is unsure whether an interpreter was used during the medical examiner, he or she is required to ask the applicant whether an interpreter was used.

The USCIS may, in its discretion, subpoena and question the interpreter who was present during the medical examination about his or her translations. In general, where the interpreter for the medical examination is the same interpreter who is interpreting for the naturalization interview, the USCIS must disqualify the interpreter going forward (however, a “good cause” exception may be granted in the discretion of USCIS in limited cases). If the interpreter is disqualified on this basis, the USCIS officer should reschedule the naturalization interview to permit the applicant to find a new interpreter. In the alternative, the USCIS may use its own language service after the interpreter is disqualified. We discuss interpreters at USCIS interviews generally in a separate article [see article].

Supplemental Forms N-648

12 USCIS-PM E.3(E)(4) explains that in most cases the USCIS will not request a supplemental disability determination from another doctor. However, in cases where the officer has questions about whether the certifying medical professional actually examined and diagnosed the naturalization applicant or where evidence on the Form N-648 is contradicted by other evidence, the USCIS may request a new Form N-648 completed by a different doctor. The officer should explain the reasons for requesting a supplemental Form N-648, including the reasons for doubting the original Form N-648. The officer should also provide the applicant with information to assist him or her in finding another qualified medical professional.

Reasonable Doubt and Findings of Insufficiency

12 USCIS-PM E.3(E)(5) instructs USCIS officers that they should generally accept the medical professional’s diagnosis of the applicant. In some cases, the officer may find that the Form N-648 is insufficient based for a finding of credible doubt, discrepancies, or misrepresentation or fraud. Where an officer finds that there are credible doubts regarding the sufficiency of a Form N-648, he or she should give the naturalization applicant the opportunity to address the specific issues in the naturalization interview. The officer may issue a request for evidence for the sole purpose of determining the sufficiency of the Form N-648. As we noted above, the USCIS may require the applicant to undergo an additional medical examination and submit a new Form N-648. The PM provides a non-exhaustive list of factors that may raise credible doubts about the sufficiency of a Form N-648 (paraphrased and condensed):

The Form N-648 lacks sufficient detail or fail to establish nexus between the stated diagnosis and the applicant’s inability to learn, speak, or read or understand English;
The medical professional did not explain the specific medical, clinical, or laboratory diagnostic techniques he or she used in diagnosing the applicant;
The Form N-648 does not explain the doctor-patient relationship between the medical professional and the applicant;
The Form N-648 was completed more than 6 months before the filing of the naturalization application;
The information provided on the Form N-648 is inconsistent with the information provided by the applicant in his or her naturalization interview;
Previous medical-related filings by the applicant (including the Form I-693, Report of Medical Examination and Vaccination Record) did not identify the long term medical condition specified on the Form N-648 or are otherwise inconsistent with the Form N-648’s statement on when the condition began;
The Form N-648 was filed late and the applicant or medical professional did not provide sufficient justification for the late filing;
The applicant indicates in the interview that he or she was not examined or diagnosed by the medical professional who certified the Form N-648 (including cases where the applicant paid for the Form N-648 without a doctor’s examination or diagnosis);
The medical professional did not certify the Form N-648 him or herself;
The medical professional completing the Form N-648 is under investigation for immigration fraud, Medicaid Fraud, or other fraud schemes by the Department of Homeland Security (DHS) or another federal, state or local agency, or a state medical board;
The interpreter used during the medical examination, the Form N-400 interview, or both, is suspected by the USCIS’s Fraud Detection and National Security (FDNS) Directorate or another state or federal agency to be involved in any immigration fraud;
The USCIS identifies a pattern of similar Forms N-648 submitted by the same medical professional which include standard or boilerplate language;
The evidence in the record or other credible information available to the USCIS officer indicates fraud or misrepresentation;
The applicant submits multiple Forms N-648 with inconsistent information and from different doctors;
Any other articulable grounds for doubting the Form N-648 that are supported by the record.

The USCIS may, in its discretion, refer the applicant, interpreter, or medical professional to FDNS if it believes that any of those individuals committed fraud in the process of seeking a medical disability exception. A finding of fraud may lead to the denial of the naturalization application. The USCIS must articulate the findings in the naturalization denial notice.

The USCIS will conclude that a Form N-648 is insufficient if credible doubts about the Form N-648 are not resolved. The USCIS should also conclude that the Form N-648 is insufficient in the following cases (quoted):

The Form N-648 is not properly completed;
The medical professional fails to explain how the applicant’s medical condition prohibits the applicant from meeting the English requirement, the civics requirement, or both requirements;
The medical professional who certified the Form N-648 is not authorized to make such certification;
The applicant was not examined or diagnosed by the same certifying medical professional;
The applicant described in the Form N-648 is not the same person as the naturalization applicant;
The Form N-648 was completed or certified by someone other than the certifying medical professional; or
Significant anomalies, discrepancies, or fraud indicators exist that preclude a finding of eligibility under a preponderance of the evidence standard.

The PM provides guidance to USCIS officers on the steps to follow upon finding a Form N-648 insufficient. A Form N-648 may be found to be insufficient at any phase of the naturalization examination. We have reproduced the chart below for your convenience:

General Procedures Upon Determination the Form N-648 is Insufficient
If the Form N-648 is insufficient at the naturalization examination or hearing:
USCIS proceeds with the initial or re-examination or hearing on a denial as if the applicant had not submitted a Form N-648.
USCIS must provide the applicant with an opportunity to take all portions of the English and civics requirements.
An applicant has a total of two opportunities to pass the English and civics requirements before the application for naturalization is adjudicated: once during the initial examination and then later during the re-examination interview.
An applicant may decline to complete the English and civics requirements. However, declining to continue the interview or complete the requirements counts as a failed attempt to pass the English and civics requirements. [16]
An applicant’s failure to appear at the re-examination or hearing on a denial, or to complete the requirements for any reason results in a denial, unless excused by USCIS for good cause.

Please continue to our next section to learn about what may happen after the USCIS finds a Form N-648 insufficient.

Process After Finding Form N-648 Insufficient

If the USCIS officer finds that a Form N-648 is insufficient, the applicant is provided with the opportunity to try to meet the English and civics requirements as if no Form N-648 was submitted. If the applicant meets the English and civics requirements, 12 USCIS-PM E.3(F)(1) provides that the applicant be allowed to proceed with the naturalization examination. The applicant may discontinue the interview, but this would count as a failed attempt to meet the English and civics requirements. USCIS officers are instructed to not find that the applicant engaged in fraud or lacks good moral character solely on the basis that he or she met the English and civics requirements after submitting the Form N-648. However, the USCIS officer may question the applicant on why he or she submitted the Form N-648, his or her relationship to the medical professional, and other factors. Whether the USCIS finds indicia of fraud or a lack of good moral character will depend on the facts of each individual case.

If the applicant fails to meet the English and/or civics requirements after submitting an insufficient Form N-648, the USCIS officer will notify the applicant of the reasons for the insufficiency finding in writing. The USCIS may also issue a request for evidence regarding the Form N-648. The USCIS officer will schedule the applicant for a re-examination between 60 and 90 days after the initial examination.

12 USCIS-PM E.3(F)(2) sets forth procedures for re-examinations after an applicant’s Form N-648 is deemed insufficient and the applicant fails to meet the English and/or civics requirements at the initial examination.

If the applicant brings new evidence supporting his or her eligibility for a medical exception at the re-examination, the USCIS officer should review that evidence. The officer should compare the new evidence to the initial Form N-648 to assess whether the information is consistent.

If the applicant submits a Form N-648 for the first time at a re-examination interview, the officer should question the applicant on why he or she did not submit the Form N-648 at the time of filing the Form N-400. The officer must then assess whether the applicant provides sufficient justification for the late filing. The officer should follow the same procedures for multiple filings.

If the applicant establishes on re-examination that he or she is eligible for a disability exception, the officer should allow the naturalization interview and examination to continue, with the use of an interpreter (if applicable).

If the applicant fails to establish eligibility for a disability exception (including if he or she does not provide sufficient evidence that a late initial filing is due to a material change in his or her medical condition), the applicant may be found to be ineligible for the disability exception. In this case, the officer should generally offer the applicant the opportunity to meet the English and civics requirements. If the applicant fails any portion of the tests or declines to proceed with the application, the naturalization application will be denied. The USCIS officer must provide an explanation for why the Form N-648 was found to be insufficient in the denial notice. The applicant will not under any circumstance be given a third opportunity to submit the Form N-648 in the re-examination.

12 USCIS-PM E.3(F)(3) explains that in the event that the naturalization application is denied, the applicant may submit a Form N-336, Request for a Hearing on a Decision in Naturalization Proceedings (Under Section 336 of the INA), for a hearing on the denial. The Form N-336 must be submitted within 30 calendar days of receiving the adverse decision. This process is available to all applicants whose naturalization applications are denied.

The USCIS may review the denial of a naturalization application from the beginning. Such a review may include a review of any previously submitted Form N-648. An applicant may submit a new or initial Form N-648 as well as additional evidence in the hearing on denial. However, the PM notes that an officer may question the credibility of an initial Form N-648 in this circumstance. The applicant will only be allowed to submit one Form N-648 in the hearing and one opportunity to meet the educational requirements.

Finding that the Form N-648 is Sufficient

Under 12 USCIS-PM E.3(G), the USCIS officer should find that a Form N-648 is sufficient if, at a minimum (quoted):

The Form N-648 is properly completed per the form instructions;
The medical professional explains in detail how the applicant’s medical condition prevents the applicant from meeting the English requirement, the civics requirement, or both requirements; and
No anomalies, discrepancies, or fraud indicators exist, based on the totality of evidence of record, that call into question a finding of eligibility under a preponderance of the evidence standard.

The USCIS provided the following table for USCIS officers on making a positive finding on an Form N-648, reproduced below for your convenience:

General Procedures Upon Determination the Form N-648 is Sufficient
If the officer determines an applicant’s Form N-648 is sufficient at the naturalization examination or hearing:
USCIS first proceeds with the interview in the applicant’s preferred language with the use of an interpreter, if applicable.
If the medical professional indicated on the form that the applicant is unable to comply with any or part of the English and civics requirements, USCIS waives the indicated requirement(s).
USCIS then proceeds to determine whether the applicant meets all other naturalization eligibility requirements.

Differences Between Exceptions and Accommodations

12 USCIS-PM E.3(C) explains that requesting an exception from the English and civics requirements is different than requesting an accommodation.

The PM discusses accommodations at 12 USCIS-PM C.1. An applicant for naturalization may make a request for an accommodation at any time during the naturalization process. Requests for accommodations are reviewed on a case-by-case basis. The USCIS is not required to make major accommodations that would result in a fundamental change to the naturalization process. However, the PM instructs officers to make every effort to provide reasonable accommodations.

12 USCIS-PM C.2(A)(1) states that it is the applicant’s responsibility to request an accommodation in advance. Accommodation requests should generally be submitted with the naturalization application. However, requests can be made by calling the USCIS Contact Center or at any other time during the naturalization process, as needed. The timeliness of the request may affect the USCIS’s ability to make reasonable accommodations. Unlike requests for exceptions, there is no formal documentation requirements associated with accommodation requests. However, the USCIS may in rare cases be asked to provide documentation in support of the request. The USCIS may reschedule an appointment if it needs time to prepare an accommodation.

12 USCIS-PM C.3(B) provides a list of examples of accommodations that may be provided for the English and civics tests (please note that accommodations are also available for the naturalization examination). The PM includes the following list of common accommodations for the English and civics tests:

Accommodations for the Naturalization Test  
Accommodation Explanation
Providing reading tests in large print Partially blind applicants may be unable to read small print
Oral writing test Applicants with physical impairments or with limited use of their hands may be unable to write sentences in the test itself
Allowing nonverbal communication Applicants may be unable to speak sufficiently to respond to questions but may be able to communicate in non-verbal ways
Providing English sign language interpreters Deaf or hard of hearing applicants may need a sign language interpreter to complete the tests

Other types of accommodations may be available on a case-by-case basis.

Applicants who are not unable to complete the English and civics requirements due to a medical condition, but who need one of the above accommodations or similar, should request an accommodation rather than an exception. It may not be clear-cut which route is appropriate in any given case. At 12 USCIS-PM E.3(C), the USCIS states: “The impact of a particular medical condition may vary between individual cases. It may be possible to accommodate one applicant who is affected by a particular medical condition, while another applicant affected by the same condition may be eligible for a disability exception.” For example, the USCIS describes a case where one applicant with poor eyesight is able to complete the requirement with larger print but another applicant is not. In the latter case, the applicant would need to file the Form N-648. If an accommodation proves to be insufficient, the USCIS may accept a late Form N-648 requesting an exception.

Conclusion

When applying for naturalization, applicants are well advised to consult with an experienced immigration attorney. Where the applicant has an impairment which make it difficult or impossible for him or her to complete the English and/or civics requirement, the applicant’s attorney may assist him or her in requesting an accommodation or an exception. When seeking an exception, it is important for the applicant to undergo a proper medical examination and be forthright in his or her naturalization examination. Medical professionals completing the Form N-648 should ensure that each part of the Form is properly filled out in order to avoid complications later in the process. Applicants should be prepared for the possibility that the Form N-648 will be deemed insufficient, even in cases which that seems unlikely.

To learn more about citizenship and naturalization and the naturalization process, please see our growing selection of articles on site [see category]. We also have a full article dedicated to the current edition of the Form N-400 [see article].