With certain limited exceptions detailed below, petitioning for a foreign-born registered nurse (“RN”) to work in the United States involves sponsoring her for permanent residence.It currently takes long time to immigrate a registered nurse to the U.S., more if the RN was born in Philippines, India or China.
Applying for the Registered Nurse Green Card:
- The Registered Nurse Green Card application process consists of filing the I-140 and I-485 petitions.
- The I-140 petition can be prepared and filed immediately.
- The I-485 petition can only be filed when the priority date is current.
- It is hoped that Congress will allocate additional visas or separate quota to make the priority date for RN’s current but bill is still pending in house.
What Regulations?
- The Department of Labor (DOL) maintains a schedule of occupations in its regulations for which the individual permanent labor certification procedure is not required.
- The schedule of precertified occupations is referred to as Schedule A, and is included in DOL regulations at 20 CFR 656.10.
- Based on an occupation’s inclusion on Schedule A, an employer may file an immigrant visa petition (I-140) directly with the (USCIS) without first going to DOL for a labor certification.
- The position of Professional Nurses is included on Schedule A.
Who Qualifies?
This category consists of registered nurses only. A licensed practical nurse is not considered a Professional Nurse under this category.
The Registered Nurse must possess:
Generally, if a RN is in the United States, the nurse will be able to start working for the employer more expeditiously than if she resides abroad.
- The RN is required to present to the CIS many of the same documents as stated later in this article. However, since she is in the U.S., she may take the RN licensing examination (officially known as the National Council Licensure Examination for Registered Nurses or the “NCLEX-RN”) in any state. The NCLEX-RN is administered by the National Council of State Boards of Nursing. For more information regarding the exam, see http://www.ncsbn.org
- The employer must submit an immigrant visa petition to the appropriate CIS Service Center on behalf of the nurse. In order for the visa petition to be approved, the RN must have passed either the CGFNS exam or the NCLEX exam, or be in possession of a “full and unrestricted license” as a registered nurse in the state of intended employment.
Simultaneously with the submission of the visa petition, the RN and her accompanying family members may apply for adjustment of status to permanent residence, for work permits, and in most cases, for travel permits. A nurse need not be in possession of a VisaScreen certificate in order to apply for permanent residence. However, she cannot obtain permanent residence without being in possession of a VisaScreen certificate
If the RN resides abroad, the following steps must be completed before the nurse may be employed in the U.S.:
1. The RN must be in possession of:
a. A diploma from a nursing school in her country;
b. An RN license in her country; and
c. A full and unrestricted license to practice professional nursing in the state of intended employment, or a certification issued by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or evidence that she has passed the NCLEX-RN licensing examination but cannot obtain a license because she lacks a social security number.
Although some states require that foreign nurses pass the CGFNS examination before taking the state RN licensing (NCLEX) examination, the number of such states is on the decline. This is because, it now possible to take the NCLEX abroad.
The examination is offered in Australia (Sydney), Canada (Montreal, Toronto and Vancouver), Great Britain (London), Hong Kong, India (Bangalore, Chennai, Hyderabad, Mumbai and New Delhi), Japan (Chiyoda-ku and Yokohama), Korea (Seoul), Germany (Frankfurt), Mexico (Mexico City), Philippines (Manila) and Taiwan (Taipei). In addition, RNs may take the NCLEX in Guam, Puerto Rico and Saipan.
2. RNs together with physical therapists are listed as shortage, or “Schedule A”, occupations in regulations (20 C.F.R. §656.22) issued by the Department of Labor. An employer who wishes to immigrate an RN is exempt from having to submit a PERM application to the Department of Labor.
Application Process if the Nurse is Outside the U.S.:
- The Employer files the Form I-140 and ETA 9089 along with the required supporting documents with the USCIS.
- Once the USCIS approves the I-140 Petition (3-6 months), the USCIS first sends the I-140 Petition to the National Visa Center (NVC) in Portsmouth, New Hampshire.
- The nurse (or her attorney) receives a “fee bill” asking for all government processing fees to be paid in advance of processing her application and those of her immediate family members. After the fees are paid, the NVC forwards a packet to the nurse or her attorney containing biographical information forms to be completed by her and her family members, and a list of documents, which must be presented at her interview for permanent residence.
- The RN, or her attorney, sends the signed and completed forms and documents to the NVC which then schedules an appointment for an Immigrant Visa for the RN and her family at the U.S. Consulate or Embassy where they will have their interviews for permanent residence.
- At this interview, the nurse must present various documents including the following:
a. Application for Immigrant Visa
b. Police Clearance
c. Birth Certificate
d. Marriage Certificate, if any
e. Divorce or Death Certificate of Spouse, if any
f. Valid Passport
g. Medical Examination
h. USCIS Photographs
i. Recent job offer letter (or employment contract)
j. Financial information regarding employer
k. Government filing fee
l. VisaScreen Certificate
The VisaScreen Certificate requirement was imposed by §343, a last-minute amendment to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA). It added “uncertified health-care workers” to the list of persons who are inadmissible to the U.S. See §212(a)(5)(C), INA. A nurse need not be in possession of a VisaScreen certificate in order to apply for permanent residence. However, she cannot obtain permanent residence without being in possession of a VisaScreen certificate
A VisaScreen Certificate is issued only after the RN has demonstrated that:
- her education, license and training in her country are equivalent to education, licensure and training in the U.S., and,
- her level of competence in oral and written English are appropriate to practice professional nursing in the U.S.
The USCIS regulations provide that the only organization authorized to issue VisaScreen certificates to RNs is the Commission on Graduates of Foreign Nursing Schools (CGFNS).
In addition, unless the nurse was educated in an English-speaking country (U.S., Australia, New Zealand, Ireland, United Kingdom or Canada – all provinces except Quebec), she must achieve a certain score on tests in written and spoken English administered by TOEFL (Test Of English As A Foreign Language) or MELAB (Michigan English Language Assessment Battery) in order to qualify for a VisaScreen certificate.
Passing scores for RNs on English exams are as follows:
- IELTS: Academic Module or the General Training Module 6.5, Overall Band Score, 7.0 Speaking
- TOEFL: Paper-Based 540; TOEFL Computer-Based 207; Test of Written English (TWE) 4.0; Test of Spoken English (TSE) 50.
- TOEIC: 725; plus TWE: 4.0 and TSE: 50
- Passing scores for the MELAB were as follows: Final Score 79+; Oral Interview 3+.
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