From the days when immigrants lined the broad halls of Ellis Island, waiting for physicians to examine them, health problems have been a major factor in determining whether an individual can immigrate to the US.

Procedures have changed since the early 1900s, but health remains a potential barrier to immigration. Individuals may be barred from immigrating to the US because of communicable diseases, failure to receive vaccinations, physical or mental disabilities, and drug abuse and addiction.

Beginning in 1957, responding to hardships caused by inadmissibility based on a tuberculosis diagnosis, Congress began creating waivers of inadmissibility. The waivers have now become a permanent part of immigration law and are available for most health-related grounds of inadmissibility, except drug abuse and addiction.

Here are some typical situations requiring a health waiver:

• Vaccinations The waiver for vaccinations may be obtained two ways. A physician can determine that the vaccine is medically "contraindicated" -- not advisable for the individual. Or, if appropriate, the waiver may be granted based on religious beliefs or moral convictions forbidding the immigrant from obtaining the vaccination.
  
• Tuberculosis If the waiver is required because of tuberculosis, two requirements must be satisfied. First, the immigrant must agree that upon admission to the US, he will immediately see a doctor to whom he will present medical records relating to his diagnosis. Secondly, the immigrant's sponsor must present evidence that arrangements have been made for the immigrant's medical care once in the US.

AIDS and HIV

To obtain a health waiver for AIDS or the HIV virus, immigrants must meet a number of requirements. Generally, they must show they have arranged for medical treatment in the US and are aware of the seriousness of their condition and how it is spread. A notice of formal consent from a government agency that the agency will be responsible for treatment may also be required. In addition, immigrants with AIDS or HIV must:

• Demonstrate that their admission would not be a risk to US public health.
• Show there is not much likelihood they will spread the condition.
• Show their condition will not impose any costs on any government agency without the agency's prior consent.

Mental and Physical Disorders and Disabilities

Waivers for mental or physical disorders require substantial documentation. First, the immigrant must submit a medical report containing a complete medical history, including details about any hospitalizations. The report should also include an examination by a psychiatrist. If the immigrant has a history of mental illness, the report should include information that would support a finding that the immigrant has recovered. Once the report is found acceptable, the immigrant must submit a statement from a hospital or physician that it will examine the immigrant upon the individual's arrival in the US.