Naturalization Medical Waivers (Form N-648)

Some applicants for naturalization may be unable to meet the English and civics testing requirements due to serious physical, developmental, or mental impairments. In such cases, Form N-648 allows for a medical exemption from these tests—but only if strict legal and medical criteria are met.

What Is Form N-648?

Form N-648 is a Medical Certification for Disability Exceptions, issued by USCIS. It permits applicants who cannot comply with the English language and U.S. civics testing requirements—due to medical impairments—to request a waiver of these requirements as part of their naturalization application.

Legal Requirements for the N-648 Waiver

To qualify for an exemption under Form N-648, two conditions must be met:

1. Qualifying Medical Condition: The applicant must have a physical, developmental, or psychological disorder that results in long-term or permanent functional impairment.

2. Inability to Learn or Demonstrate Knowledge: The condition must prevent the applicant from learning or demonstrating knowledge of English and/or civics, even with the use of interpreters, special education, or assistive devices.

   
   

Who Can Complete the Form?

Only the following licensed professionals can complete and certify Form N-648:

• Medical Doctor (M.D.)

• Doctor of Osteopathy (D.O.)

• Clinical Psychologist (Ph.D. or Psy.D.)

Forms signed by individuals who do not meet these qualifications will be automatically rejected by USCIS.

Examples of Approved Cases

Our office has successfully represented clients in obtaining N-648 waivers in the following situations:

• Applicants on the autism spectrum with profound cognitive delays and no English proficiency.

• Elderly individuals with dementia or other age-related cognitive impairments.

• Stroke survivors with significant mobility and communication limitations.

In each case, we ensured the medical documentation clearly linked the diagnosis to the applicant’s inability to meet naturalization requirements.

Common Misunderstandings

• Old age or poor English alone is not enough. There must be a medically documented impairment.

• Short-term illness or temporary conditions do not qualify. The impairment must be expected to last at least 12 months or be permanent, pursuant to 8 CFR § 312.2(b)(2).

• The wrong type of medical provider will result in denial. Only licensed M.D.s, D.O.s, or clinical psychologists are accepted.

How We Can Help

Our firm regularly assists applicants in obtaining N-648 medical waivers. We work with qualified physicians to ensure that the medical certification meets all USCIS standards and provide legal guidance to ensure a strong and complete application.

Contact us to schedule a consultation and determine whether you or your family member may qualify for a medical exemption from naturalization testing.