Questions and Answers: 2009 Update to the Tuberculosis Screening Required for Adjustment of Status

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These Questions and Answers only provide information about the assessment by the civil surgeon to determine whether an applicant has been infected with TB and address the most recent updates to the Tuberculin (TB) Component of the Technical Instructions for the Medical Examination of Aliens in the United States.

Background
The Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), on Nov. 1, 2009, updated the Tuberculosis Component of the Technical Instructions for the Medical Examination of Aliens in the United States (May 2008). This update is available on CDC's Web site, see the "CDC: Technical Instructions for Civil Surgeons" link to the right. This update makes the traditional Tuberculin Skin Test (TST), and as of Nov. 1, 2009, the QuantiFERON®-TB Gold (QFT-G) Test, the QuantiFERON®- TB Gold in Tube (QFT-G IT) test, and the T-Spot TB test available for TB testing. USCIS anticipated this change and made the necessary amendments to Form I-693, Report of Medical Examination and Vaccination Record.
The civil surgeon is required to comply with the Technical Instructions for the Medical Examination of Aliens in the United States (Technical Instructions), and any updates, issued by the CDC. The update to the TB Component of the Technical Instructions is effective and applies to the completion of any medical assessment made on or after Nov. 1, 2009. The update supplements the Tuberculosis Component of the Technical Instructions for the Medical Examination of Aliens (May 2008) (TB Component of the Technical Instructions); it does NOT replace it.
The screening for TB is one part of the medical examination only; the civil surgeon has to screen an applicant for other conditions that render an applicant inadmissible to the United States. These conditions include other communicable diseases of public health significance, as defined in the Department of Health and Human Services’ (HHS) regulations at 42 CFR part 34; mental and physical disorders with associated harmful behaviors; and drug abuse or drug addiction. The civil surgeon also has to assess whether the individual has received vaccinations against vaccine preventable diseases, and administer appropriate vaccines, as required by HHS.
For more information about the medical examination, see the "Immigration Medical Examinations" link to the right. For more information about civil surgeons, see the "Designated Civil Surgeons" link to the right.

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