How Alcohol Use Disorder Is Evaluated

The civil surgeon evaluates alcohol use disorder using the diagnostic criteria established by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) and the CDC Technical Instructions for civil surgeons. The evaluation includes a clinical interview, review of medical history, and consideration of any documented harmful behavior associated with alcohol use.

The key distinction in immigration law is not whether you have a diagnosis of alcohol use disorder, but whether that disorder is associated with harmful behavior — defined as behavior that has posed or is likely to pose a threat to the property, safety, or welfare of the applicant or others.

Class A vs. Class B Findings

A Class A finding is a ground of inadmissibility and can prevent you from obtaining a green card without a waiver. Alcohol use disorder is classified as Class A only when it is associated with harmful behavior — such as DUI convictions, domestic violence, assault, or other documented incidents.

A Class B finding is a significant medical condition that does not bar admission but is documented on Form I-693 for USCIS awareness. Alcohol use disorder in remission, or alcohol use disorder without associated harmful behavior, is typically documented as Class B. Class B findings do not prevent you from obtaining a green card.

What Counts as Harmful Behavior

The civil surgeon considers the following types of documented harmful behavior when evaluating alcohol use disorder:

• DUI or DWI convictions or arrests
• Domestic violence incidents associated with alcohol use
• Assault or other violent incidents associated with alcohol use
• Child endangerment or neglect associated with alcohol use
• Property damage associated with alcohol use
• Any other documented behavior posing a threat to safety or welfare

Alcohol Use Disorder in Remission

If you have a history of alcohol use disorder but are currently in remission — meaning you have not met the criteria for alcohol use disorder for a sustained period — the civil surgeon will document this on Form I-693. Remission is generally not a ground of inadmissibility, particularly if there is no associated harmful behavior.

Bring documentation of any treatment you have completed, including records from treatment programs, counseling, or support groups. This helps the civil surgeon accurately document your current status.

Steps That Can Help Resolve a Class A Finding

If the civil surgeon determines that your alcohol use disorder meets the criteria for a Class A finding, you may be eligible for a medical waiver (Form I-601). The waiver process considers factors including the nature and severity of the harmful behavior, evidence of rehabilitation, and the likelihood of future harmful behavior.

Completing a substance use treatment program, maintaining sobriety, and demonstrating rehabilitation can strengthen a waiver application. Consulting with an experienced immigration attorney is strongly recommended if you receive a Class A finding.

What to Expect at Your Appointment

The civil surgeon will ask you questions about your alcohol use history, including frequency, quantity, and any treatment you have received. Be honest and complete in your responses. The civil surgeon is not there to judge you — they are completing a clinical evaluation required by USCIS. Accurate information ensures your Form I-693 is completed correctly and helps avoid RFEs or delays.