Every applicant for naturalization as a U.S. citizen must, among other requirements, demonstrate 1) an understanding of the English language, including an ability to read, write, and speak words in ordinary usage in the English language and 2) a knowledge and understanding of the fundamentals of the history and government of the United States.
There is an exception to the English language requirement for anyone who, on the date they file, is over 50 years old and who has been living in the United States for at least 20 years after becoming a permanent residence (or if one is over 55 years old if they have been living in the United States for at least 15 years after becoming a permanent resident).
But there is another important exception to both the language requirement and the civics requirement for those who are unable satisfy these requirements because of “a medically determinable physical or mental impairment or combination of impairments which has lasted or is expected to last at least 12 months”
Medically determinable means that the impairment has to result from “anatomical, physiological, or psychological abnormalities which can be shown by medically acceptable clinical or laboratory diagnostic techniques”. If you need to apply for such an exception, you do so by submitting Form N-648, Medical Certification for Disability Exceptions, which has to be completed by a U.S. licensed medical or osteopathic doctor. You then submit the completed N-648 with your N-400 Application for Naturalization.
It’s essential, of course, to be completely honest in consulting with the doctor who is preparing the N-648 and, if the applicant entered the U.S. on an immigrant visa from overseas, it would have been equally important to be honest with panel doctor who conducts the medical exam prior to the applicant’s immigrant visa interview.
If there is a mental health issue at the time of the applicant’s immigrant visa application, the applicant should not pretend that there’s not in the hope that the doctor will write up a fully favorable report. If that happens, and then years later when an applicant files for citizenship and needs a medical certification for disability exception, that panel doctor’s report may be completely inconsistent with the N-648—so much so that it could raise issues of fraud.
Reference to a chronic, lifetime mental impairment on an N-648 when compared to a panel doctor report that makes no reference to any history of a mental impairment is going to be very problematic at the time of a naturalization interview.
At the time of a panel doctor’s exam, an applicant must bring all medical records of vaccinations, prior illnesses, and treatments and has to be prepared to discuss their medical history and current medical conditions, treatments, and medications with the panel physician, including mental health issues. Be honest with the doctor. If there is a problem, it is entirely possible that there is a waiver that is available to allow the immigrant visa to be approved despite the mental health issue.
