The following questions and answers are based on those frequently posed to the attorneys at the Murthy Law Firm. As a courtesy to our clients and the immigrant community, we generously share this useful information.
 

1.	How may a foreign national nurse obtain an H1B visa?
2.	May a nurse obtain an H1B visa even when s/he does not have a license in the state where a job has been offered?
3.	Are nurses who are nationals of either Canada or Mexico eligible for the TN visa?
4.	What is the difference between a "CGFNS Certificate" and a "VisaScreen Certificate"?
5.	If a foreign national nurse obtains her/his R.N. degree from an accredited U.S. school and has a nursing license from the state in which s/he is working, will s/he still need to have a VisaScreen Certificate?
6.	Must the VisaScreen Certificate be filed when the I-140 is filed? If not, what happens in concurrent filing cases?
7.	There are companies that contract nurses to various medical facilities throughout the United States but may not know exactly where the nurse will be placed at any given time. May these companies still file I-140s for nurses?
8.	If a nurse is licensed in State A, which does not require the CGFNS qualifying exam, but a hospital wishes to file an I-140 for that nurse to work in State B, and State B requires the NCLEX but also grants a license based on reciprocity with State A, does that nurse need to take the CGFNS qualifying exam?
9.	Is there any way to avoid taking the CGFNS exam and obtain an approval of the I-140?
10.	If a nurse obtains a CGFNS certificate abroad but does not have a state nursing license, may s/he complete consular processing and enter the U.S. as a lawful permanent resident?
11.	If a nurse chooses to file the I-485 before obtaining the VisaScreen Certificate, will USCIS wait to issue the advance parole and employment authorization document until they receive the VisaScreen Certificate?
12.	May a nurse download the CGFNS paperwork from the Internet?
13.	Will CGFNS contact me if they are waiting for documents from a certain school or state?
14.	Must a foreign national nurse have a current license in his/her home country in order to qualify for either the CGFNS Certificate or a VisaScreen Certificate?
15.	Once the I-140 is approved for a nurse, can s/he obtain a Social Security Number?
16.	If a nurse has an EAD and a valid state nursing license, may s/he engage in employment as a nurse while the I-485 is pending?
17.	How do I obtain state licensure as a registered nurse?

Nonimmigrant Visas


Question 1. How may a foreign national nurse obtain an H1B visa? TOP

Not all nurses will qualify for an H1B visa. The reason is that many registered nursing positions do not require a Bachelor's degree. USCIS will generally approve an H1B petition if: the nurse works in a supervisory capacity; the state where the nurse will work requires a Bachelor's degree in nursing to obtain a license; the nurse is an Advanced Practice Registered Nurse or otherwise has additional, specialized training or experience required for the position; or the Petitioner can successfully show why a four-year degree is necessary for the particular nursing position.



Question 2. May a nurse obtain an H1B visa even when s/he does not have a license in the state where a job has been offered? TOP

Nurses who qualify for an H1B petition approval in all respects except for possessing the nursing license to practice in a particular state may obtain an H1B petition approval valid for up to one year, provided the only barrier to the license is the need for a social security number. There was a 'Catch 22' situation created where the Social Security Administration could not issue the Social Security Number (SSN) to a person who did not have an H1B petition approval and the then INS could not approve the H1B petition without the SSN. So legacy INS agreed to issue an H1B petition approval for a period of one year to enable the nurse to qualify for the state licensure requirements and obtain the SSN. Accordingly, a nurse will be able to enter on the H1B visa, obtain the required social security number and finalize the licensure requirements in order to practice as a RN. S/He would have to show the valid nursing license in order to extend the H1B status beyond the first year approval period.



Question 3. Are nurses who are nationals of either Canada or Mexico eligible for the TN visa? TOP

Yes, nursing is a qualifying "Profession” under the North American Free Trade Agreement (NAFTA). A registered nurse holding a state/provincial license and having an appropriate sponsoring employer meets the criteria for admission on the nonimmigrant TN visa status. There are significant benefits attendant to the TN visa. First, eligibility for the TN visa is not predicated on meeting the high bar set by the “specialty occupation” requirement for obtaining an H1B visa. Second, time to issuance in many cases is shorter for the TN visa than for a nurse green card case. Finally, because there is no statutory limitation on stay, nurses are not restrained by the maximum stay limitations that exist for other nonimmigrant visas. TN visas are valid for 1 year, and are renewable each year. Filing procedures vary depending on whether the nurse is a Canadian national or a Mexican national.



Question 4. What is the difference between a "CGFNS Certificate" and a "VisaScreen Certificate"? TOP

A “CGFNS Certificate” is awarded after the successful completion of the CGFNS Certification Program. The Program is designed specifically for first-level, general nurses educated and licensed outside the United States who wish to assess their chances of passing the U.S. registered nurse licensing exam, the NCLEX-RN® examination, and attaining licensure to practice as registered nurses within the United States. The program is comprised of three parts: a credentials review of the nurse's education, registration and licensure; the CGFNS Qualifying Exam, a one-day qualifying exam testing nursing knowledge; and an English language proficiency exam. Nurses who do not hold a state licensure in their state of intended practice must have a CGFNS certificate in order to file an immigrant visa petition. Also, many state boards of nursing require the CGFNS Certificate for state licensure.

The “VisaScreen Certificate” by contrast is needed for consular processing or adjustment of status. The document must be presented to a consular office or, in the case of adjustment of status, the USCIS, as part of a visa application. The VisaScreen Certificate evidences that the holder has completed a required screening program for health care professionals (other than physicians) in order to qualify for certain occupational visas. Screening includes an assessment of the applicant's education to ensure it is comparable to a U.S. graduate in that same profession; verification that licenses are valid and unencumbered; English language proficiency; and, in the case of nurses, verification that the nurse has either earned a CGFNS Certificate or passed the NCLEX-RN® Examination. Since July 26, 2004, it has been necessary for any nonimmigrant nurse seeking admission to the United States to obtain a VisaScreen.


Immigrant Visas


Question 5. If a foreign national nurse obtains her/his R.N. degree from an accredited U.S. school and has a nursing license from the state in which s/he is working, will s/he still need to have a VisaScreen Certificate? TOP

Unfortunately, yes, according to current USCIS interpretations of the law and regulations. In a strange anomaly of the law, a nurse who has studied in a U.S.-accredited school will still need to obtain a VisaScreen Certificate in order to demonstrate that the U.S. Nursing degree and state licensure equate to a U.S. Degree in Nursing. This is an area where hospitals and health care facilities may do well to lobby for a change in the law.



Question 6. Must the VisaScreen Certificate be filed when the I-140 is filed? If not, what happens in concurrent filing cases? TOP

The VisaScreen Certificate need not be filed when the I-140 petition is filed. If the VisaScreen Certificate is not included at the time of filing the I-485, typically the USCIS will send a Request for Evidence to ask for the VisaScreen Certificate. This RFE generally requires a response within 12 weeks of its issuance.



Question 7. There are companies that contract nurses to various medical facilities throughout the United States but may not know exactly where the nurse will be placed at any given time. May these companies still file I-140s for nurses? TOP

Generally, yes. The contracting company may wish to file the I-140 designating the state where the nurse is licensed or will be licensed as the location where the nurse will work, rather than designating a particular hospital or other health care facility that may be unknown at the time of filing the I-140 petition.



Question 8. If a nurse is licensed in State A, which does not require the CGFNS qualifying exam, but a hospital wishes to file an I-140 for that nurse to work in State B, and State B requires the NCLEX but also grants a license based on reciprocity with State A, does that nurse need to take the CGFNS qualifying exam? TOP

Likely not. The reason it is difficult to provide definitive answers is that the USCIS has recently issued regulations on nurses and many of their policies are not consistent among the various Service Centers and from one USCIS examiner to the next. Accordingly, it may be possible to file the I-140 petition showing the nurse has the license in State A but will work in State B. At least one Service Center has approved such a petition. When the I-485 is filed, the nurse should obtain an EAD and get the license from State B as soon as possible, to be prepared for the likelihood of an RFE.



Question 9. Is there any way to avoid taking the CGFNS exam and obtain an approval of the I-140? TOP

According to the regulations, a nurse need not take the CGFNS exam if s/he has either a valid, full and unrestricted nursing license from a state in the U.S. to obtain the I-140 approval or a certified copy of a letter from the state board of nursing from his/her intended state of employment which confirms that s/he has passed the NCLEX/RN exam and is eligible to be issued a license to practice nursing in that state.  However, in most instances, s/he will still need the VisaScreen Certificate in order to obtain permanent residence status and for the USCIS to approve the I-485 application for the Nurse.



Question 10. If a nurse obtains a CGFNS certificate abroad but does not have a state nursing license, may s/he complete consular processing and enter the U.S. as a lawful permanent resident? TOP

In most cases, yes, as long as the nurse also has the VisaScreen Certificate. A number of employers indicate in their contracts with nurses that they will first be employed as a nursing assistant when they enter the U.S. until they are able to pass the NCLEX and obtain their RN license. To date, most consulates have accepted this position as valid.



Question 11. If a nurse chooses to file the I-485 before obtaining the VisaScreen Certificate, will USCIS wait to issue the advance parole and employment authorization document until they receive the VisaScreen Certificate? TOP

In most cases, there is no delay in issuing the EAD and AP. USCIS would typically approve the employment authorization document and advance parole document applications.



Question 12. May a nurse download the CGFNS paperwork from the Internet? TOP

Yes, the necessary forms may be downloaded from the CGFNS Website.



Question 13. Will CGFNS contact me if they are waiting for documents from a certain school or state? TOP

Not usually. It is best to check with CGFNS periodically to determine whether they need any additional information to process your application.



Question 14. Must a foreign national nurse have a current license in his/her home country in order to qualify for either the CGFNS Certificate or VisaScreen Certificate? TOP

In order to be eligible for the CGFNS Certificate Program, a nurse must be educated and hold both initial and current registration / licensure as a first-level, general nurse as defined historically by the International Council of Nurses (ICN). A nurse need not have a current license to register for the VisaScreen Certificate, but as a practical matter most nurses will have become licensed by this stage of the process.



Question 15. Once the I-140 is approved for a nurse, can s/he obtain a Social Security Number? TOP

No, the Social Security Administration does not accept the approval of the I-140 as a valid reason to grant a social security number, as the approval of the I-140 is not an approval to work.



Question 16. If a nurse has an EAD and a valid state nursing license, may s/he engage in employment as a nurse while the I-485 is pending? TOP

Yes, this is permitted.



Question 17. How do I obtain state licensure as a registered nurse?

Each state has a State Board of Nursing that establishes eligibility requirements and confers licenses to qualified registered nursing applicants. Each state has its own individual requirements for licensure of foreign-born applicants, and the requirements are often different from those of the USCIS and DOS. A convenient link to the National Council State Boards of Nursing is available from the Allied Health Care Professional page of our website. This link offers access to boards of nursing contact information & websites for all U.S. states and territories.