People who apply for naturalization to become U.S. citizens go through a rather long process before they are sworn in as naturalized citizens of the United States. One step involves going through a citizenship test, which consists of three parts: English reading, English writing, and civics and history.

This requires the applicant to learn English so that they can take and pass the citizenship test. But there may be exemptions, such as in the case of medical disabilities.

Citizenship Test Exemption: Form N-648

Some individuals have cognitive disabilities that can hinder their capacity to learn and therefore take the citizenship test. In these instances, they can apply for a test exemption by filing Form N-648.

This form should be filled up by a doctor, providing an extremely detailed explanation of the medical disability and its clear connection to the applicant’s inability to learn English. They should also include a detailed description of the condition’s effects, whether severe, mild or progressing, etc.

Form N-648 must establish a nexus, i.e. a clear connection between the disease, its effects on the mind and body, and how it affects the applicant’s ability to learn English and answer the questions on the test.

What Kind of Disabilities Exempt an Applicant From the Citizenship Test?

Because a requisite to be exempted from the citizenship test requires the establishment of a clear connection between the disability and the capacity to learn, not all medical conditions or disabilities can be used to exempt an applicant.

The medical disability must affect a person’s cognitive abilities, and therefore not allow them to learn or absorb new information. Age, however, is not a good enough reason to be given a medical waiver and be exempted from the tests. Physical disabilities will also not cut it because they don’t necessarily affect a person’s ability to learn.

As a general rule, the medical disability that can exempt an applicant from taking the citizenship test should be cognitive. For example, an elderly applicant with Alzheimer’s disease or dementia may be able to get a medical waiver, provided that the doctor clearly establishes how the disease hampers their ability to learn and communicate in Form N-648.

Can Immigration Disagree With the Doctor’s Opinion?

Having a doctor fill out Form N-648 detailing the applicant’s medical condition and its effects on their ability to learn does not immediately guarantee an exception from the citizenship test. The immigration officer has the power to disagree with the doctor’s opinion on the N-648 form and refuse to provide a medical waiver to exempt the applicant from the citizenship test.

There are three common grounds on which an N-648 form can be rejected:

  1. The doctor was too vague and was not able to provide a clear connection between the disability and its effects on learning capacity
  2. The diagnosis was given long ago and the applicant seems to have recovered
  3. From the immigration officer’s observation during the interview, the applicant’s medical disability does not hinder their ability to learn English.

If the immigration officer does not agree with the doctor’s opinion, they can either reject it and refuse to give the medical waiver or require the candidate to get a better and more detailed diagnosis.