The Memo expressly states that the applicant's reexamination should be limited to a mental status evaluation, specifically involving the alcohol-related events. If the physician has indicated on the originally submitted Form I-693 that these incidents were considered and no subsequent incidents have occurred, reexamination of the person will not be required. If the physician has taken the correct measures to examine the person for dangerous mental status due to alcohol-related events and determines that the person does not fit within a medically inadmissible category, the USCIS cannot second-guess or override this determination. If the USCIS objects to the doctor's determination, it may seek a review of the physician's finding by the U.S. Public Health Service. This review is limited to exceptional cases.

Other Cases Requiring Medical Reexamination

The Memo provides that medical reexamination may be required in other, similar situations where evidence is found that indicates a potential medical ground of inadmissibility that was not taken into consideration by the physician. This could include: other types of arrests, such as assault or domestic violence, where alcohol or other psychoactive substances were a contributing factor; other crimes that may indicate a mental health disorder; a prior finding of inadmissibility due to a mental disorder; or a history of institutionalization for a mental disorder. In each of these cases reexamination is only necessary if the physician has not indicated that these arrests or convictions were made known to him/her during the medical examination.

Waiver Still Available

If a person is found inadmissible due to health-related factors, s/he may still file an I-601 waiver. There is no guarantee that the I-601 waiver will be approved. In addition, the USCIS, in consultation with the public health officials of the Center for Disease Control (CDC), may place terms, conditions, or controls on the waiver, which may include the posting of a bond.

May Not Preclude Other Findings of Inadmissibility

A person who is not found inadmissible due to alcohol-related incidents may, under some circumstances, still be found inadmissible under the criminal provisions of the INA for crimes of domestic violence, aggravated assaults, or impaired driving. Many DUIs (Driving While Under the Influence) and DWIs (Driving While Intoxicated) are not deemed to be crimes of moral turpitude. It is important, however, to consult with a qualified immigration attorney who understands the criminal and immigration implications of the particular laws in the state where the charge occurred. It is always best to seek immigration advice at the time of the arrest, so that appropriate decisions can be made as to how to handle the case defense. Many people decide to plead guilty to seemingly minor offenses without considering the immigration consequences.

What to Do

The categories under which a reexamination may be required are largely circumstantial. A potential applicant for an immigrant visa, adjustment of status, or a K or V visa should consult with a qualified immigration attorney any time an arrest has occurred to determine whether criminal, and now health-related, grounds of inadmissibility may apply. People who have a problem with alcohol should seek treatment before it leads to an arrest. If an arrest occurs, they should still seek treatment to address the problem, both for personal reasons and so that they may be able to overcome any questions as to whether they have an ongoing problem which renders them inadmissible to the United States.