Blood Clotting Disorders Are Not Grounds of Inadmissibility

Under U.S. immigration law, the medical grounds of inadmissibility are limited to communicable diseases of public health significance, failure to meet vaccination requirements, physical or mental disorders with associated harmful behavior, and drug abuse or addiction. Blood clotting disorders — including hemophilia, von Willebrand disease, thrombophilia, and conditions managed with anticoagulant therapy — do not fall into any of these categories.

Whether your condition is a bleeding disorder (where blood does not clot properly) or a clotting disorder (where blood clots too readily), neither type will affect your eligibility for a green card or other immigration benefit. The civil surgeon will note your medical history, but the diagnosis itself carries no immigration consequence.

Informing Clinical Staff Before Your Appointment

The most important step you can take is to notify the clinic when you schedule your appointment and again when you check in on the day of your exam. Let the staff know that you have a blood clotting disorder and whether you are currently taking anticoagulants such as warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), or heparin. This allows the clinical team to prepare appropriately and assign an experienced phlebotomist for your blood draw.

If you have a bleeding disorder such as hemophilia, inform the staff of your factor level and any factor replacement therapy you use. If you have a clotting disorder and are on anticoagulant therapy, let them know the name and dose of your medication. The more information you provide in advance, the smoother your appointment will be.

Blood Draws and Anticoagulant Therapy

The immigration medical examination requires blood testing for syphilis serology and, for applicants aged 15 and older, HIV testing. These blood draws are standard and cannot be waived. If you are on anticoagulant therapy, the blood draw itself is generally safe, but you may bleed more than usual from the venipuncture site.

After the blood draw, apply firm, continuous pressure to the site for longer than a typical patient would — at least five to ten minutes, or until bleeding has fully stopped. Do not remove the pressure bandage prematurely. If you have a bleeding disorder and are concerned about the blood draw, speak with your hematologist before your appointment to discuss any precautions specific to your condition.

The clinical staff will apply a pressure bandage after the draw. You may want to keep the bandage on for several hours and avoid strenuous activity with that arm for the rest of the day. If you experience prolonged bleeding or bruising that concerns you, contact your hematologist.

Vaccine Injections With a Clotting Disorder

Required vaccinations are administered as intramuscular or subcutaneous injections. If you have a bleeding disorder, intramuscular injections carry a small risk of hematoma formation at the injection site. The Advisory Committee on Immunization Practices (ACIP) recommends that individuals with bleeding disorders receive intramuscular vaccines using the smallest gauge needle available and that firm pressure be applied to the site for at least two minutes after the injection without rubbing.

If you are on anticoagulant therapy, the risk of significant bleeding from a vaccine injection is generally low, but you should still inform the clinical staff. In some cases, your hematologist or anticoagulation provider may have specific guidance about timing injections relative to your medication schedule. If you have received guidance from your specialist, share it with the civil surgeon at your appointment.

Subcutaneous injections, such as those used for some live vaccines, carry a lower risk of hematoma than intramuscular injections. The civil surgeon and nursing staff are trained to manage these situations and will take appropriate precautions once they are aware of your condition.

What to Bring to Your Appointment

Bring a complete and current list of all medications, including the name, dose, and frequency of any anticoagulants or clotting factor products. If you have documentation from your hematologist or treating physician — such as a letter describing your condition, your current INR range if you take warfarin, or your factor level — bring that as well. This documentation helps the civil surgeon accurately record your medical history on Form I-693.

You should also bring your vaccination records, a government-issued photo ID, and any prior medical records relevant to your condition. If you have a medical alert card or bracelet related to your clotting disorder, wear or bring it to the appointment so clinical staff are immediately aware of your condition.

What the Civil Surgeon Documents

The civil surgeon will record your blood clotting disorder as part of your medical history on Form I-693. This is a factual notation and does not constitute a finding of inadmissibility. The civil surgeon will also document your current medications and any relevant clinical findings from the physical examination.

Form I-693 is sealed and submitted to USCIS. The information is used to assess whether any of the statutory grounds of inadmissibility apply — and because a blood clotting disorder is not a ground of inadmissibility, the notation will not negatively affect your case. USCIS adjudicators review the form in its entirety, but a documented clotting disorder will not trigger a request for additional evidence or a finding of inadmissibility.