Understanding the N-648 Medical Certification

This medical certification form allows the USCIS to better assess whether a naturalization applicant will have their English/Civics portion of the N-400 waived because of a disability and/or impairment.

The N-400 is the naturalization application that applicants need to complete in order to start the process of becoming a U.S. citizen. One of the major components of this application process is the Civics and English Test, which will occur toward the end of the application cycle. Almost every applicant will need to go into a live appointment (Covid-19 has not changed this) with USCIS officers and complete a written portion of an English, as well as answer 20 out of the 128 civics test questions. Applicants must answer at least 12 questions correctly to pass the 2020 version of the civics test. All questions on the test are asked orally.

However, there are a few exceptions for those who are not apt enough to complete the English and Civics portion and can have it waived. These exemptions include applicants who fit into the following categories: 

  1. Applicants who are 50 years or older at the time of filing for naturalization and have lived as a permanent resident in the United States for at least 20 years.
  2. Applicants who are unable to comply with the USCIS requirements because of a physical or developmental disability, or mental impairment.  

For those with a disability that is affecting the completion of their English or Civics test, such applicants will need to have an N-648 Medical Certification filled out on their behalf by a licensed physician.

Who should file an N-648?

Applicants need to print out the N-648 and bring it to a licensed physician’s office in order for an appropriate completion. According to the USCIS, “only medical doctors of osteopathy, or clinical psychologists licensed to practice in the United States are authorized to certify this form.”  

The N-648 needs to file at the same time as ones N-400 in order to be processed by the USCIS.  In addition, those who simply need a reasonable accommodation, such as having a translator present during their testing period, those asking for an extended period of time to complete the English test, or those requesting off-site testing should not file an N-648. Rather, such applicants should simply list this information in Part 3 of their N-400 if they need such accommodation. In addition, illiteracy alone, according to the USCIS, is not a valid reason to seek an exception to the English and civics requirement by submitting this form.

How to Complete the N-648? 

As mentioned, the principal applicant who will be seeing a licensed physician needs to print out and bring this form to the doctor's office in order to start the certification process. Applicants should print this form out on the USCIS website, to ensure the most up to date copy of this form.

The physician will fill in the following information about the application in Part 1: their name, current physical address, their A-number (which applicants will need at the ready), their email address, and U.S. social security number.

In Part 2, the licensed physician will complete a section with regards to their own personal information, their address, license number, email address, and what type of medical practice they work in.

In Part 3, the doctor will need to write in a series of questions pertaining to the applicant’s condition/disability. Applicants should note that in being asked questions that are directly related to the form, they should seek to give complete answers, as the more detailed information the applicant gives, the more detailed information the physician will be able to record in the N-648.

Questions asked are as follows:

1.     Dates of diagnosis/when did the disability or impairment begin?

2.     What caused the applicant's medical disability or impairment, if known?

3.     Describe how relevant the disability and/or impairment is as it relates to specific functions in the applicant's life i.e. including the ability to work or go to school, including the ability to read, write and speak?

4.     How the applicant's disability affects their N-400 application with regards to completing the civics/English portion of the test?

At the end of the form, the principal applicant will need to sign their name, authorizing the doctor they have seen to release any relevant physical or mental health information (in addition to this form) for the purpose of evaluating the exemption from the English/Civics portion of the naturalization exam.

The physician will also sign the form in Part 6, and certify that the applicant's identity has been verified through either presenting a Permanent Resident Card at the appointment or a State ID number. 

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