The Legal Basis for TB Screening in Immigration

Under the Immigration and Nationality Act (INA), applicants seeking admission to the United States or adjustment of status must demonstrate that they are not inadmissible on health-related grounds. Tuberculosis is classified as a communicable disease of public health significance by the U.S. Department of Health and Human Services (HHS), making active TB disease a statutory ground of inadmissibility.

USCIS requires all applicants for lawful permanent residence (green card) to undergo a medical examination conducted by a USCIS-designated civil surgeon. TB screening is a mandatory component of this examination, regardless of the applicant's country of origin, age (with limited exceptions for very young children), or health history.

What TB Screening Involves

The TB screening component of the immigration medical exam includes a review of your TB history, a TB blood test (IGRA/QuantiFERON-TB Gold), and — if indicated — a chest X-ray. The civil surgeon also performs a physical examination to assess for signs and symptoms of TB disease. All findings are documented on Form I-693, which is submitted to USCIS as part of your immigration application.

• TB history review and symptom assessment
• IGRA blood test (QuantiFERON-TB Gold Plus)
• Chest X-ray if clinically indicated or if IGRA is positive
• Physical examination for signs of active TB disease
• Documentation on Form I-693

Why TB Is a Priority for U.S. Immigration Health Policy

Tuberculosis remains one of the leading infectious disease killers worldwide. The United States has maintained low rates of TB in part through public health measures including immigration screening. By identifying applicants with active TB disease before they enter the country, USCIS and the CDC help prevent the spread of TB within U.S. communities.

The CDC Division of Global Migration Health sets the technical instructions that civil surgeons must follow when conducting immigration medical examinations. These instructions are updated periodically to reflect current evidence and public health priorities. Civil surgeons are required to follow these instructions precisely.

What Happens If TB Is Found During the Exam

If your TB screening reveals active TB disease, your Form I-693 cannot be finalized until treatment is completed and you are no longer infectious. Active TB disease is a ground of inadmissibility, meaning your immigration application may be denied or placed on hold until the condition is resolved.

If your screening reveals latent TB infection (positive blood test with normal chest X-ray and no symptoms), this is generally not a ground of inadmissibility. The civil surgeon will document the finding on Form I-693, and USCIS may recommend follow-up care after you obtain your green card.

Our Clinic's Approach to TB Screening

As a USCIS-designated civil surgeon practice, we follow all CDC technical instructions for TB screening. We use the IGRA blood test (QuantiFERON-TB Gold Plus) as the primary screening method for all eligible applicants. Our staff is experienced in guiding applicants through the TB screening process and explaining results clearly. If additional evaluation is needed, we will coordinate with you to ensure your Form I-693 is completed accurately and efficiently.