green card medical exam weed

Immigrants are being denied US citizenship for smoking legal pot

Immigrants are getting caught between federal and state marijuana laws.

US Citizenship and Immigration Services (USCIS), the federal agency in charge of processing visa and citizenship applications, has been rejecting immigrants who work for the marijuana industry or have admitted to using the drug in states where it’s legal, immigration lawyers and advocates say.

It’s yet another example of how the contradiction between state and federal laws is spilling over beyond issues related to the legal marijuana industry itself. While 33 US states and the District of Columbia allow some kind of pot use, the drug remains illegal when it comes to any kind of federal matter, including green cards and naturalization.

Friction between federal and local authorities has been increasing under the Trump administration, which is less tolerant than its predecessor when it comes to both immigrants and local pot laws.

Yesterday, USCIS issued a bulletin (pdf) underscoring that marijuana use is a disqualifying factor in citizenship applications, regardless of whether it’s legal locally.

Drug use is not a new USCIS criteria—the agency has long used it to determine whether an immigrant has “good moral character” and deserves to stay in the US. But until now, denials related to legal pot have been mostly seen in Colorado and Washington, the two states that first legalized recreational marijuana, says Kathy Brady of the Immigrant Legal Resource Center (ILRC), a California nonprofit that advocates for immigrants’ rights.

Brady fears the new policy bulletin will mean more marijuana-related denials as USCIS officers extend the practice to other states that have legalized the drug. She tells Quartz the announcement is “part of the Trump administration’s plan to get rid of or block as many immigrants as they can.”

A USCIS spokesperson says the bulletin is consistent with federal law, under which marijuana is considered a prohibited substance in the same category as LSD or ecstasy.

USCIS’s probing

There are several ways in which USCIS can find out if someone has used drugs. The most straightforward is by asking, either through an application or during an interview, whether an immigrant has abused drugs or broken the law.

For example, one green-card applicant who is married to an American citizen now risks being deported after an immigration officer asked him if he had ever used marijuana. The man replied that he had tried it once or twice at parties since DC legalized pot, but that he didn’t like it.

“Just by admitting that, he was declared permanently inadmissible,” says Brady, who was introduced to the man through his attorney. “He did not get a green card and now he could be deported.”

Drug use can also come up during the required health exam for green-card applicants. The doctor performing it can order a drug test for a variety of reasons, including a history of substance abuse, physical or psychological signs of a drug problem, or even long gaps between schooling or employment.

Marijuana industry jobs

A place of employment with a cannabis-related name is another red flag for USCIS. Even an accountant or a secretary working for someone in the marijuana industry could be considered to be trafficking in a controlled substance, in the federal government’s eyes.

Jeff Joseph, a Colorado-based immigration lawyer, says he gets at least a case a week involving someone who is no longer eligible to become a citizen because they’ve worked at a pot company. USCIS may even deny benefits to the immigrant spouses of, say, dispensary workers, because they’ve technically benefitted from the profits of selling drugs, he says.

“Marijuana has significant consequences across the board for all types of immigration applications,” he adds.

More awareness

The new USCIS guidelines will likely raise awareness of the pitfalls associated with legal pot use. Many people don’t even realize what they’re doing is illegal under federal law.

Joseph, for example, says he recommends that clients invoke their right against self-incrimination under the Fifth Amendment when USCIS asks them about marijuana.

The ILRC, meanwhile, advises non-citizens to never leave the house carrying marijuana or paraphernalia, a medical marijuana card, or wearing clothing with marijuana imagery on it. It also recommends that immigrants not have anything pot-related on their phones, or post messages on social media—which is reportedly monitored by immigration authorities—about any personal relationship with the drug.

It concludes: Only people who are already US citizens can use marijuana or work in the legal industry without any concern.

Only people who are already US citizens can use marijuana or work in the legal industry without concern.

How to Prepare for your Green Card Medical Exam

To be eligible for a U.S. Green Card, you must first complete a medical exam. However, this isn’t just a normal checkup.

Instead, you must have a USCIS-approved physician sign off on a number of specific tests and checks. They will also review your medical history and may conduct short, non-invasive procedures.

In this article, we’ll talk about the best way to prepare for a Green Card medical exam. First, however, we’ll briefly talk about finding the right doctor.

How Do I Find a Doctor to Conduct My Green Card Medical Exam?

In most cases, your regular doctor cannot conduct a green card medical exam. Instead, you will need to go to a physician who has been explicitly approved to do so.

This process will work slightly differently depending on whether or not you are currently in the United States.

Keep in mind that the U.S. government does not regulate the fees that doctors can charge for a Green Card medical exam.

For this reason, it can be a good idea to do your own research before settling on a doctor.

If You Currently Live in the United States:

If you are already in the United States, your medical exam must be conducted by an approved civil surgeon.

Despite the name, most civil surgeons aren’t actually surgeons. Instead, they are physicians licensed by USCIS.

The best way to find a civil surgeon near you is USCIS’s find a doctor website. You can also contact USCIS directly.

If You Currently Live Outside the United States:

If you are currently outside the United States, you will have to find an approved physician. This is a doctor authorized by the U.S. Department of State to conduct medical exams outside the U.S.

The state department website lists approved physicians according to the closest embassy or consulate.

For example, if you were looking for a physician in the Netherlands, you would check the Amsterdam consulate page. This will direct you to a list of physicians, any of whom can perform the exam.

You can also find further instructions about your medical exam on this page.

What Will Happen at My Medical Exam?

During a green card medical exam, your doctor will generally do the following:

  • Briefly review your paperwork, including your passport.
  • Perform a brief physical exam, which may include x-rays.
  • Perform tests for infectious diseases, such as tuberculosis, gonorrhea, and syphilis.
  • Administer any vaccines that you still need. If a vaccine is not available in your area, you may be able to obtain a waiver.

In unusual circumstances, your doctor may need to conduct additional tests or refer you to another physician.

This may delay your green card, but it’s not the same as failing the medical exam.

If everything goes well, at the end of your visit your doctor will give you a sealed envelope. Leave this enveloped sealed, and include it with your green card application.

What Will Disqualify Me from Receiving a Green Card?

According to law, you may not be admitted to the United States if you have any of the following conditions, and are not being treated for them:

  • Chronic infectious diseases, including gonorrhea, infectious leprosy, syphilis, and tuberculosis.
  • Other potentially dangerous diseases, such as several types of influenza.

In these cases, your physician can sign off on your green card as soon as they are satisfied that your condition was treated.

Additionally, having a history of drug or alcohol abuse, as well as violent or harmful behavior, can potentially pose issues.

If you have such a history, your doctor may require you to present additional information, and possibly undergo treatment. Once this treatment is complete, you may be able to proceed in the process.

How Do I Prepare for My Green Card Medical Exam?

For the most part, preparing for your green card medical exam is mostly a matter of getting your medical records together.

However, you should also avoid actions that would put your results in jeopardy.

For example, never do drugs in the weeks and months leading up to your medical exam.

Assemble Your Paperwork

The most common issues which pop up during green card medical exams come from incorrect or incomplete paperwork.

You should always bring up to date versions of the following documents to your medical examination:

  • Your passport
  • A full a copy of your medical history (including a list of any medications you are taking as well as records of previous tests)
  • Vaccination and immunization records
  • Previous chest X-rays (if any)
  • Insurance information

Keep in mind that this paperwork must all be in English. If your documents were not originally in English, you must include certified translations.

In some cases, it may be difficult to get access to your previous medical records. Fortunately, this is not usually a bar to receiving a green card.

Simply contact the examiner ahead of time to notify them of the issue.

By working with the designated physician, you can find out what vaccinations or other procedures you will need to fulfill the requirements for a green card.

Avoid Illegal Drugs

Often, Green Card medical exams involve incidental drug tests.

For this reason, you should never go to your green card medical exam with illicit drugs in your system. This includes marijuana.

Failing to do so could result in serious delays in the green card process or even complete disqualification.


Overall, most people who go through a green card medical exam complete it without major issues.

However, it can still be a long, stressful process, especially if there is confusion with your medical history and paperwork.

For this reason, you should never hesitate to contact your immigration lawyer before your medical exam.

An experienced immigration attorney can help you understand the medical exam’s requirements, and the best way to fulfill them.

In order to qualify for a U.S. green card, you must first attend a medical exam given by a USCIS-approved "civil surgeon."