Class A vs. Class B: The Critical Distinction

Form I-693 uses a two-tier classification system for medical findings. A Class A finding means the applicant has a condition that is a ground of inadmissibility under INA § 212(a)(1). A Class B finding means the applicant has a condition that is a significant departure from normal health but does not rise to the level of a ground of inadmissibility.

For substance use, a Class A finding means the civil surgeon has determined that you currently meet the DSM criteria for a substance use disorder. A Class B finding might be noted for a history of substance use that does not currently meet the diagnostic criteria — for example, a past disorder that is now in sustained remission.

What a Class A Finding Means for Your Application

A Class A finding is a ground of inadmissibility. USCIS will not approve your adjustment of status application while a Class A finding is on record without a waiver. The Class A finding is documented on Form I-693 and submitted to USCIS in the sealed envelope.

Receiving a Class A finding does not mean your immigration case is over. A waiver under INA § 212(g) may be available. The waiver process requires demonstrating that the disorder is being treated and is under control, and that you are not likely to engage in harmful behavior in the future.

What a Class B Finding Means

A Class B finding for substance use history is a notation that you have a history of substance use that is a significant departure from normal health, but that does not currently meet the criteria for a substance use disorder. A Class B finding is not a ground of inadmissibility — it does not prevent USCIS from approving your application.

However, a Class B finding may prompt USCIS to request additional information or monitoring. It is a notation on your record, not a bar to admission.

How the Civil Surgeon Makes the Classification

The civil surgeon classifies substance use findings based on the DSM diagnostic criteria. A Class A finding requires that the applicant currently meet the diagnostic criteria for a substance use disorder — not simply that they have a history of use.

The civil surgeon considers: current use patterns, frequency and quantity of use, negative consequences of use, prior treatment history, and current remission status. The classification is a clinical judgment based on the totality of the evidence.

Can a Class A Finding Be Challenged?

If you believe the civil surgeon's Class A finding is incorrect, you can seek a second opinion from another USCIS-designated civil surgeon. A re-examination may result in a different classification if the clinical picture has changed or if the original evaluation was incomplete.

You can also address the Class A finding through the waiver process. Even if the finding is clinically correct, a waiver may be available if you can demonstrate treatment, remission, and no likelihood of future harmful behavior.

Next Steps After a Class A Finding

If you receive a Class A finding for substance use, consult with an immigration attorney as soon as possible. The attorney can help you evaluate your waiver options, build the strongest possible waiver record, and navigate the USCIS process. Do not delay — the waiver process takes time, and acting promptly gives you the best chance of a favorable outcome.