Immigrant Visas

General Green Card Rules

Immigrant Visas (permanent residence) are the most common way to bring foreign-born registered nurses to the United States. An employer may file an immigrant visa petition for a nurse requesting that the nurse enter the United States as a permanent resident - a so-called "green card".

This is a several stage process. Nurses inside the U.S. can often file for permanent residence (green card) at the same time as the immigrant visa petition. Nurses outside the U.S. must wait until the petition is approved before filing for permanent residence at the U.S. consulate in their country. In either case, the spouse and children (under 21) may join the nurse, and apply for green cards together.

Nurses seeking to qualify for an immigrant visa must show they possess (1) a valid nursing license in the country of nationality; (2) a diploma from a nursing school; (3) a full and unrestricted nursing license in the U.S. state of intended employment or evidence of passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) or a Certificate by the Commission on Graduates of Foreign Nursing Schools (CGFNS); and (4) that the nurse has obtained a VisaScreen Certificate issued by the International Commission for Healthcare Professionals (ICHP).

When the employer has reached a conditional agreement with an RN, the employer, or its attorney, begins the immigration process by filing an immigrant visa petition with the USCIS accompanied by Labor Department ETA certification forms, and various documents regarding the petitioner and the nurse. Typically, the USCIS will approve the petitions in 3-5 months, and the case will be forwarded to the National Visa Center, after which the appropriate visa documents will be sent to the US Embassy where the RN lives.

If the nurse is present in the U.S. in valid immigration status, she may also take advantage of recent changes in the immigration laws permitting concurrent filing. In essence, if the registered nurse qualifies for an immigrant visa, he or she may simultaneously file applications for permanent residence and interim work authorization. Thus, a nurse may become authorized to work in a few months. The nurse’s immediate family members may also file applications for permanent residence and interim work authorization at the same time.

Nurses outside the United States must spend at least several more months to process their green card at a US consulate there. Nurses outside the U.S. must file their immigrant visa applications at a U.S. Embassy. In addition to the visa application, police clearance, medical examination, birth certificate, and other documents, the nurse must present a “Visa Screen” certificate. This certificate is issued by the Commission on Graduates of Foreign Nursing Schools. CGFNS will issue the certificate after reviewing the nurse’s education, license and training credentials, and after the nurse has passed stringent tests of her written and oral English skills. Even nurses who are educated in English in the Philippines and India have only a 50% pass rate on the test of spoken English. Even if a foreign-born RN is educated, licensed and trained in the U.S., she must still obtain a Visa Screen certificate.

When the RN has passed the FBI/CIA security clearance, she will be called in for an interview, and issued an immigrant visa which will allow her (and her immediate relatives) to immigrate to the U.S. Upon arrival, she will normally be required to take and pass the NCCEX before receiving her RN license. When these RNs enter the U.S., KHR will assist them in getting started with housing, transportation, and other basic survival skills.

Please note that hospitals normally cover the immigration costs for the nurse, but will not normally pay the immigration, travel and housing expenses for family members. In overseas cases, it is often best for all parties for the nurse to come first, settle in to her new job, and have her family members join her shortly thereafter.

As of January 1, 2005, there was a "retrogression" in the visa backlog for workers from China, India, and the Philippines. The number of green card visas available for these countries is now limited. If legislation is not enacted to make more immigrant visas available, this could mean additional delays for these nurse applicants. No one knows how long these delays could be. This is a serious and contentious political issue. Many large health care facilities and other employers have already begun putting pressure on Congress to resolve this problem, and there is a reasonable possibility that Congress will change the rules to eliminate or circumvent this visa retrogression, but no changes can be expected before early summer.

If you have questions about your family, please have one of the professionals at KHR arrage a free consultation with the law firm of Curran & Berger.