NACARA Overview

The Nicaraguan Adjustment and Central American Relief Act (NACARA) was enacted in 1997 to provide immigration relief to certain Nicaraguans, Cubans, Salvadorans, Guatemalans, and nationals of former Soviet bloc countries who had been in the United States for a specified period.

NACARA Section 202 allows certain Nicaraguans and Cubans to adjust status to permanent residence. NACARA Section 203 provides suspension of deportation or special rule cancellation of removal for certain Salvadorans, Guatemalans, and nationals of former Soviet bloc countries.

Medical Exam Requirement

NACARA applicants who file Form I-485 must complete an immigration medical examination with a USCIS-designated civil surgeon and submit Form I-693. The medical exam requirement applies to all I-485 applicants regardless of the basis for the application.

NACARA applicants who have been in the United States for many years may have limited vaccination records from their home countries. The civil surgeon will review available records and administer any missing required vaccines.

What the Exam Covers

The immigration medical exam covers a complete physical examination, tuberculosis testing, required laboratory tests, and a vaccination review. The civil surgeon will administer any missing required vaccines.

There are no special medical requirements for NACARA applicants. The exam is the same as for any other I-485 applicant.

Vaccination Records

NACARA applicants who have been in the United States for many years may have received some vaccinations here. Bring any vaccination records you have, including records from your home country and records from U.S. healthcare providers.

If you do not have vaccination records, the civil surgeon can administer the required vaccines at the appointment.

TB Testing

All I-485 applicants must be tested for TB. Central American countries have varying TB prevalence rates. If your TB test is positive, the civil surgeon will order a chest X-ray.

A positive TB test does not automatically disqualify you from obtaining a green card, but you may need to complete treatment.

Practical Tips

Bring your identity documents, vaccination records, and any relevant medical records. If you need language assistance (Spanish), contact the civil surgeon's office in advance. Many civil surgeon offices can accommodate Spanish-speaking patients.