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Health Care Worker Visa

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Currently, the only viable option for Register Nurses (RN), Physical Therapists (PT), and other allied health professionals to come to the U.S is through an H-1B non-immigrant petition sponsored by a U.S. employer. Title V, Section 502 of the REAL ID Act of 2005, enacted on May 11, 2005, allows employers to sponsor a RN and a PT through what is called a Schedule A (limited to 50,000 recaptured immigrant visas from 2001-2004). As of November 1, 2006, USCIS announced that only immigrant petitions, through Schedule A, by employers up to October 1, 2005 will be processed. All other I-140 petitions filed by employers will be put on hold until new legislation allows for more immigrant petitions. Additionally, H-1C visas are limited to twenty-five (25) H-1C non-immigrant visas for states with 9 million citizens or less, and fifty (50) H-1C for states with more than 9 million citizens (including Texas) as of June 1, 2005. Thus, unless the alien employee is from Mexico or Canada, where a TN-1 Visa may be obtained, the H-1B Visa is the only available option for employers to sponsor Register Nurses, Physical Therapists, and other allied healthcare professionals from other countries.

The Houston Immigration Attorneys at Garg & Associates, PC are experienced professionals and can assist you in applying for H-1B applications and will be able to assist you in applying for H-1B visas. We have helped clients in the Houston Texas, The Woodlands, Conroe, Harris County, and Sugar Land & Fort Bend County in the H-1B application process. Because H-1B visa's limited to 65,000 visas per year, and the process requires multiple steps, all necessary requirements must be done before April 1 of each year so that your applications are timely filed. Please do not hesitate to call Garg & Associates at 281-362-2865 for a consultation today or use our Contact Form.


H-1B Application for Registered Nurses

H-1B non-immigrant visas may be filed for professional nurses if:

  • The beneficiary nurse received a CGFNS Certificate; or,
  • The Nurse evaluated by a Credential Evaluation Service (CES), in some states only; or,
  • If the nurse received a full license from the state in which he/she intends to work.

Not all Registered Nurses can apply for an H-1B visa. On November 27, 2002, The Executive Associate Commissioner, Johnny N. Williams, issued a field-guidance to USCIS Adjudicating Officers and identified which nurses are allowed to be sponsored by a U.S. employer under H-1B.

Based on the November 27, 2002 field guidance, normal RN positions will not qualify for H-1B visas unless the State where the nurse seeks a license requires a bachelor's degree. In Texas, as in all other states except for North Dakota, only specialized nurses ("advanced practice occupations") are able to obtain an H-1B. The specialized nurses listed under the field guidance manual are as follow:

  • Clinical Nurse Specialists (CNS): Acute Care, Adult, Critical Care, Gerontological, Family, Hospice and Palliative Care, Neonatal, Pediatric, Psychiatric and Mental Health-Adult, Psychiatric and Mental Health-Child, and Women's Health;
  • Nurse Practitioner (NP): Acute Care, Adult, Family, Gerontological, Pediatric, Psychiatric & Mental Health, Neonatal, and Women's Health;
  • Certified Registered Nurse Anesthetist (CRNA); and
  • Certified Nurse-Midwife (CNM);

Additionally, nurses in administrative positions, upper-level "nurse managers" in hospital administration positions, are also qualified to receive an H-1B visa.

What are the requirements for "advanced practice occupation" nurses to apply for an H-1B?

Before a nurse can apply for an H-1B, he or she must have received a CGFNS certification, or be evaluated by a Credential Evaluation Service (in some states only), or be fully license in the State where they plan to practice. Licensure in the State is impracticable unless the candidate is already here in the U.S and is able to take the state licensing examination, such as an F-1 student or a B-1/B-2 Visitor.

CGFNS (the Commission on Graduates of Foreign Nursing Schools) is an internationally recognized authority on credentials evaluation and on the verification process pertaining to the education, registration and licensure of nurses and healthcare professionals worldwide. In many states, a foreign nurse must apply to CGFNS to get his or her credentials evaluated. In Texas, the applicants have the option of getting a CGFNS certification or being evaluated by any Credential Evaluation Service (CES) that belongs to the National Credential Evaluation Services, Inc. (an association of independent evaluation services). Following the basic requirements before one can apply for an H-1B as an advance practice occupation nurse;

  • Has a decree that is equivalent to a 4-years nursing degree in the U.S;
  • Passed all certifications in the petitioner's home country;
  • Passed a CGFNS certification or by CES;
  • Passed the NCLEX-RN (pronounced "N – CLEX"), a nursing examination by the National Council of State Boards of Nursing;
  • Passed the TOEFL or equivalent.

Because the application process is tedious and time consuming, it is crucial that you have sound legal advice. The Houston Immigration attorneys at Garg & Associates will assist in establishing the whether or not your applicant is qualified and ensuring the application process is smooth and efficient. Please contact Garg & Associates, PC today!

How do I get started?

Before an employer can file an H-1B petition for an alien employee, the employer must file what is called "a preliminary wage determination" with the Department of Labor (here in Texas, it is the Texas Workforce Commission). The TWC will determine whether the proposed job description and salary meets the requirements and salary comparable to a non-alien employee. Once the TWC has approved the proposed preliminary wage determination, the employer must file a Labor Condition Application (LCA) with the Department of Labor. After receiving the LCA, the employer may file an H-1B application for the alien employee with USCIS. If approved, USCIS will then send the application package to the Consular Office in the alien's country for processing.

Once the employer identifies a likely candidate (i.e. passed all the requirements), the employer will need to immediately contact an experienced immigration attorney as early as possible. Every year, beginning April 1st, employers can file H-1B applications for their potential alien employees. There are 65,000 visas available every year for H-1B visas. In 2007, USCIS announced that it received the maximum limit on the same day that it was open (April 1, 2007). Because the application process requires several stages, and each stage is very time-consuming, please contact Garg & Associates, PC immediately so that your application will be reserved and in place to be filed on April 1, 2008. Our experienced immigration attorneys will walk you through and simplify this complicated process.

H-1B Petition for Physical Therapists

A physical therapist does not need to be licensed in the U.S. in order to get an H-1B visa. As a practical matter, however, many employers in the U.S. cannot make use of a PT if the PT is not licensed in the state of intended employment. Some employers will sponsor PTs on the condition that they obtain their license as soon as possible. The licensing exams are given in the U.S. and at a few international locations such as in Singapore. Because it is difficult for foreign PTs to sit for the licensing exam unless they are in the U.S., the USCIS and the State Department allow PTs to obtain a one-year H-1B visa. This allows the PT one year in which to obtain the state license. The PT must have the license in order to extend his H-1B visa status. If a license is not obtained, the H-1B extension will not be issued.

What are the requirements for a Physical Therapist?

The first step in the H-1B process for physical therapist is to obtain their VisaScreen certificate also known as §343 document requirement of the IIRIRA. This certificate certifies that a foreign-born health worker's education, experience, training, and English language ability are equivalent to that of a U.S. worker. The VisaScreen also verifies the applicant's foreign license is current and valid. The requirements for VisaScreen are as follow:

  • Passed the English Proficiency Exam. For physical therapist, the only accepted exam is the TOEFL;
  • Obtain a credential certification by an evaluation organization. In many states, the credential evaluation is obtained through either Commission of Graduates of Foreign Nursing Schools (CGFNS) or the Foreign Credentialing Commission on Physical Therapy (FCCPT). In Texas, however, the Texas Board of Physical Therapist Examiners accepts credential from three organizations:
    • The FCCPT;
    • International Credentialing Assoc. (ICA); or
    • The University of Texas, at Austin.

FCCPT has various levels of credential evaluations:

  • Type I Certificate is used primarily for the alien applicant who has never been licensed in the U.S. This certificate combines both an educational credentials review and covers the requirements for the VisaScreen certificate.
  • Type II Certificate is used for alien applicants who are currently licensed in the U.S. that needs the VisaScreen certificate for nonimmigrant (such as H-1B) or immigrant (I-140) petition. The review process for this certificate focuses on the verification of education, current licensure, and English language proficiency.
  • The Educational Credentials Review is used primarily for licensure. The review process focuses on the on the evaluation of the applicant's individual education credentials through a course-by-course review. In most cases, Type I certificate is required because the alien has not been admitted or practiced in the U.S, or is currently in the U.S under another nonimmigrant category, such as an F-1 student.

How do I file for an H-1B as a physical therapist?

The application process for H-1B physical therapist is similar to an H-1B application for register nurses. That is, the employer must file a preliminary wage determination with the Texas Workforce Commission (TWC). The TWC will determine whether the proposed job description and salary meets the requirements and salary comparable to a non-alien employee. Once the TWC has approved the proposed preliminary wage determination, the employer must file a Labor Condition Application (LCA) with the Department of Labor. After receiving the LCA, the employer may file an H-1B application for the alien employee with USCIS. If approved, USCIS will then send the application package to the Consular Office in the alien's country for processing. As stated previously, H-1B applications are tedious, time consuming, and extreme time-sensitive. Therefore, let an experienced immigration attorney, such as Garg & Associates, PC, assist you in your application.

If you or someone you know is need of family law services, please do not hesitate to call Garg & Associates at 281-362-2865 for a consultation today or use our Contact Form.

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