Instructions For Medical Certification For Disability Exceptions (Form N-648)

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OMB No. 1615-0060; Expires 03/31/2019
Instructions for Form N-648, Medical
Department of Homeland Security
Certification for Disability Exceptions
U.S. Citizenship and Immigration Services
What Is the Purpose of This Form?
How to Complete This Form
In general, applicants for naturalization must demonstrate an
All parts of Form N-648 except the "Applicant Attestation"
understanding of the English language, including an ability to
and "Interpreter's Certification", must be certified by a
read, write, and speak words in ordinary usage. They must
licensed medical professional. Before certifying Form N-648,
also demonstrate a knowledge and understanding of the
the medical professional must have conducted an in-person
fundamentals of the history and principles and form of
examination of the applicant.
government of the United States. Together, these are known
All questions or items must be answered fully and accurately.
as the English and civics requirements for naturalization. This
USCIS will not accept an incomplete Form N-648. Responses
form is intended for applicants who seek an exception to the
should use common terminology, without abbreviations, that a
English and/or civics requirements due to a physical or
person without medical training can understand. If completed
developmental disability or mental impairment that has lasted,
in writing, all responses must be legible and appear in black
or is expected to last, 12 months or more.
ink. USCIS recommends that the certifying medical
professional use the electronic Form N-648 located in the
"FORMS" section at
Who Should Submit This Form and When?
Failure to provide all information requested on the form may
An applicant for naturalization seeking an exception to the
result in USCIS determination that the form is insufficient. In
English and/or civics requirements for naturalization because
addition to providing a detailed assessment of the applicant's
of a physical or developmental disability or mental
physical or developmental disability or mental impairment as
impairments should submit this form at the time he or she files
requested on the form, a medical professional completing the
an N-400, Application for Naturalization, with USCIS. Per
form may attach supporting medical diagnostic reports or
Immigration and Nationality Act (INA) 312(b)(1), applicants
records. However, these attachments may not take the place
are not required to fulfill the English and/or civics
of written responses to each question or item on Form N-648.
requirements if the person is unable to do so because of
physical or developmental disability or mental impairments.
The following are examples of sufficient responses to some of
the items on Part 3 of Form N-648:
NOTE: Failure to submit Form N-648 with Form N-400
may delay the time for the adjudication of Form N-400.
1. Provide the clinical diagnosis of the applicant's medical
disability and/or impairments that form the basis for
seeking an exception to the English and/or civics
Who Should Not Submit This Form?
requirements. If applicable, please provide the relevant
An applicant who can satisfy the English and civics
medical code as accepted by the Department of Health and
requirements for naturalization with reasonable
Human Services (HHS). This includes the Diagnostic and
accommodations provided under the Rehabilitation Act of
Statistical Manual of Mental Disorders (DSM) and the
1973 does not need to submit this form. Reasonable
International Classification of Diseases (ICD).
accommodations include, but are not limited to, sign language
For example, DSM-V 318.1 Intellectual Disability (Severe)
interpreters, extended time for testing and off-site testing. An
or 2015/16 ICD-10-CM F72 Severe intellectual disabilities.
applicant requesting an accommodation should so indicate on
Part 3 of his or her completed Form N-400. Illiteracy alone is
2. Provide a basic description of the disability and/or
not a valid reason to seek an exception to the English and
impairments.
civics requirement by submitting this form.
"Severe intellectual disability is a genetic disorder that
causes lifelong intellectual disability (also referred to as
Who Is Authorized to Certify This Form?
mental retardation), developmental delays, and other
problems."
Only medical doctors, doctors of osteopathy, or clinical
psychologists licensed to practice in the United States
8. What caused the applicant's medical disability and/or
(including the U.S. territories of CNMI, Guam, Puerto Rico,
impairments listed in Part 3. Item Number 1?
and the Virgin Islands) are authorized to certify the form.
While staff of the medical practice associated with the
"Severe intellectual disability is usually caused by an error
medical professional certifying the form may assist in its
in cell division occurring in utero. The cause of such
completion, the medical professional is responsible for the
errors in cell division is currently unknown."
accuracy of the form's content.
Form N-648 Instructions 03/21/17 Y Page 1

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