Liver Disease Is Not a Ground of Inadmissibility

Liver disease — including cirrhosis, non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, alcoholic liver disease, and other hepatic conditions — is not a ground 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. A diagnosis of liver disease, regardless of its cause or severity, does not fall into any of these categories and will not affect your eligibility for a green card or other immigration benefit.

Hepatitis B and C Testing

The immigration medical examination includes blood testing for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV). These tests are required for all applicants aged 15 and older. If you already have a known diagnosis of hepatitis B or hepatitis C, inform the civil surgeon at your appointment.

Hepatitis B was previously a ground of inadmissibility, but it was removed from the list of communicable diseases of public health significance in 2009. Hepatitis C has never been a ground of inadmissibility. A positive result on either test will be documented on Form I-693 but will not, by itself, result in a finding of inadmissibility.

If you are currently receiving treatment for hepatitis B or hepatitis C — such as antiviral therapy — bring documentation of your treatment and your most recent viral load or liver function test results. This information helps the civil surgeon accurately document your medical history and demonstrates that you are under appropriate medical care.

Vaccine Considerations for Liver Disease Patients

Applicants with liver disease are subject to the same vaccination requirements as all other applicants. However, individuals with chronic liver disease have specific vaccine recommendations that may be relevant to your immigration medical exam.

Hepatitis A vaccine is strongly recommended for all individuals with chronic liver disease who are not already immune. If you have not received the hepatitis A vaccine series, it may be administered at your immigration medical exam. Hepatitis B vaccine is recommended for individuals with liver disease who are not already immune or chronically infected. If you have chronic hepatitis B, you are already infected and do not need the vaccine.

Bring your complete vaccination records to your appointment. If you have received hepatitis A or hepatitis B vaccines from your gastroenterologist or hepatologist, bring documentation so the civil surgeon can verify your vaccination status. Pneumococcal and influenza vaccines are also recommended for individuals with chronic liver disease and may be administered at your appointment if you are not up to date.

What the Civil Surgeon Documents

The civil surgeon will record your liver disease diagnosis and current medications as part of your medical history on Form I-693. The physical examination will include assessment of the abdomen, and any relevant findings — such as hepatomegaly (enlarged liver) or signs of portal hypertension — will be noted. These findings are documented as part of the standard physical examination and do not constitute a finding of inadmissibility.

The results of the hepatitis B and hepatitis C blood tests will be recorded on Form I-693. If either test is positive, the civil surgeon will document the result and note your known diagnosis if applicable. The form is sealed and submitted to USCIS. Because liver disease is not a ground of inadmissibility, the documentation of your condition will not negatively affect your immigration case.

What to Bring to Your Appointment

Bring a complete list of your current medications, including any antiviral medications for hepatitis B or C, immunosuppressants for autoimmune hepatitis, diuretics, lactulose, or other liver-related medications. Include the name, dose, and frequency of each medication.

If you have documentation from your gastroenterologist or hepatologist — such as recent lab results, liver biopsy reports, or a summary of your current treatment — bring it to your appointment. This documentation helps the civil surgeon accurately record your medical history. Also bring your complete vaccination records and a government-issued photo ID.

Special Considerations for Alcohol-Related Liver Disease

If your liver disease is related to alcohol use, be aware that the immigration medical examination includes an evaluation for substance use disorders. Alcohol use disorder is a ground of inadmissibility if it is associated with harmful behavior. However, a history of alcohol use that has resulted in liver disease — without a current diagnosis of alcohol use disorder with harmful behavior — is not automatically a ground of inadmissibility.

Answer the civil surgeon's questions about alcohol use honestly. If you have a history of alcohol use disorder and are currently in recovery, bring documentation of your treatment and recovery. The civil surgeon will evaluate your history in the context of the applicable legal standards. If you have concerns about how your history may be evaluated, consult with an immigration attorney before your appointment.