Green Card: EB-3 for Nurses & Physical Therapists

The Green Card or Resident Alien Card or Form I-551, is the permanent work and residence permit for foreign nationals who reside legally in the U.S.

Employment-based immigrant visas typically involve three main steps (the entire process can take several years):

First, the employer files a Labor Certification application with the U.S. Department of Labor, the purpose of which is to test the employer's local labor market for available workers. If no qualified and available workers are located, the position is certified as open for a foreign worker.

Second, the employer files an I-140 Alien Worker Petition with the USCIS. The purpose of this petition is to verify that the foreign worker has the minimum requirements to fill the open position, and serves to classify the foreign person as eligible for a particular visa category.

Third, on the basis of the Labor Certification and Alien Worker Petition, the foreign worker makes an application for an immigrant visa at a U.S. Consulate. If the foreign worker is legally present in the U.S., he or she may instead apply for permanent resident status via a process called adjustment of status. A nurse in the US can simultaneously apply for the I-140 and for adjustment of status.

The immigrant visa is normally the only option for nurses because most of the non-immigrant visa classifications are not available to the typical registered nurse seeking employment in the United States. Presently, shortages exist in the U.S. health care industry and if you are a nurse or other health care professional, you may be able to offer your skills and be part of America's solution to the burgeoning health care deficit.

Registered nurses may enter the U.S. directly as a lawful permanent resident (LPR) or Green Card status. A benefit afforded to the nursing profession is that presently, the Petition for Alien Worker and U.S. Department of Labor classifies nursing as what is referred to as a "Schedule A" occupation. The advantage is that the oftentimes lengthy and expensive Labor Certification Process can be circumvented. LPR status also allows a nurse and his or her family to permanently reside in the U.S. through a sponsor after meeting certain requirements.

• Registered nurses with a job offer from a U.S. hospital or medical center;
• Physical therapists with a job offer from a U.S. employer;
• Foreign nationals qualified to work in one of the shortage occupations designated by the Department of Labor on the Schedule A list;
• U.S. companies to sponsor the Green Card application for foreign nationals on one of the shortage occupations designated by the Department of Labor on the Schedule A list.

The Director, United States Employment Service (Director), has determined that there are not sufficient United States workers who are able, willing, qualified, and available for the occupations listed below on Schedule A and that the wages and working conditions of United States workers similarly employed will not be adversely affected by the employment of aliens in Schedule A occupations.

Persons who will be employed as physical therapists, and who possess all the qualifications necessary to take the physical therapist licensing examination in the State in which they propose to practice physical therapy.

Aliens who will be employed as professional nurses; and (i) who have passed the Commission on Graduates of Foreign Nursing Schools (CGFNS) Examination; or (ii) who hold a full and unrestricted license to practice professional nursing in the State of intended employment.

Definitions of Group I occupations:

"Physical therapist" means a person who applies the art and science of physical therapy to the treatment of patients with disabilities, disorders and injuries to relieve pain, develop or restore function, and maintain performance, using physical means, such as exercise, massage, heat, water, light, and electricity, as prescribed by a physician (or surgeon).

"Professional nurse" is defined in Sec. 656.50.

Aliens (except for aliens in the performing arts) of exceptional ability in the sciences or arts including college and university teachers of exceptional ability who have been practicing their science or art during the year prior to application and who intend to practice the same science or art in the United States. For purposes of this group, the term "science or art" means any field of knowledge and/or skill with respect to which colleges and universities commonly offer specialized courses leading to a degree in the knowledge and/or skill. An alien, however, need not have studied at a college or university in order to qualify for the Group II occupation.

The initial step in a Schedule A case is to file a Form I-140 application package with the appropriate supporting documentation to the appropriate USCIS Service Center. There are four regional USCIS Service Centers, located in Vermont, Texas, Nebraska, and California and each service center has jurisdiction over a section of the country. A case is properly filed in the service center having jurisdiction over the place of employment or in the service center covering the region where the employer's office is located.

Supporting documentation must be submitted with the I-140 as prescribed in 20 C.F.R. 656.22(c)(2). This supporting evidence includes the following:

• Completed PERM labor certification forms (the recruiting process under PERM need not, however, be completed);
• A posted notice of the job opening. This notice must include a job description, work hours, and rate of pay. The notice must be posted in the worksite for a minimum of ten business days;
• Evidence that the petitioning employer has the financial ability to pay the salary offered to the nurse. Evidence of this ability shall be either in the form of copies of annual reports, federal tax returns, or audited financial statements. If the U.S. employer employs 100 or more workers, the USCIS may accept a statement from a financial officer of the organization;
• CGFNS certificate or nurse license from state where the nurse will be working or proof of passing the NCLEX licensing exam and evidence that the nurse cannot obtain a license because he or she cannot obtain a social security number;
• Nursing diploma or degree;
• Nursing registration/licensure from the country where the degree was obtained. The CGFNS certificate provides evidence that the nurse has complied with a three step review of their nursing skills: (1) a credentials evaluation; (2) passage of an English language proficiency exam; and (3) passage of the CGFNS qualifying exam. Once these requisites have been met, the Commission on Graduates of Foreign Nursing Schools will issue the nurse a CGFNS certificate. The purpose of this certification program is to serve as a predictive evaluation process to accurately judge which nurses will be able to meet the requirements for U.S. licensure once admitted to the country. If the nurse has already passed the NCLEX-RN exam, they are exempted from the requirement of obtaining a CGFNS certificate.

The VisaScreen certificate is the health care workers' credentialing certificate, and it must be presented to the USCIS prior to adjustment of status and a US consulate prior to issuance of a permanent residency visa. The certificate is NOT required at the start of adjustment application or prior to an I-140 application's approval.

Registered Nurses, who are already present in the U.S., may now file for LPR status on behalf of his or her employer/sponsor. Typically for these nurses, the process is much easier. He or she will receive work authorization (much more quickly than through consular processing) within approximately 90 - 120 days of filing the Petition for Alien Worker and Adjustment of Status application. Adjustment applications typically take 18 to 24 months at USCIS regional service centers. A nurse still needs to present a VisaScreen Certificate prior to completing adjustment of status.

Finally, nurses must meet and satisfy the requirements of the Petition for Alien Worker and State Board of Nursing in the state for which he or she intends to practice nursing. Additional limiting criteria may vary among the state's department of professional regulation.