Confusion Over TB Testing

[yvrsyd]

Thank God we finally got through the visa process and my dear one is here and we are now married. She came on a K-1 Visa.

However, I continue to be absolutely confused as to whether she needs any TB testing to be done here before filing the I-485 (with the I-693 Vaccination Supplement).

She had her medical exam done in GZ in December, 2008. She does not recall having a TB test at the time and does have chest X-ray films in her possession from that exam.

Do we need to do any further TB testing before filing for AOS, or is the vaccination supplement sufficient?

Thanks.

[george lee]

if her x-ray shows negative for TB, she dont need TB testing.

[rogerinca]

Q: When did the new TB requirements become effective?

The new TB testing and treatment requirements became effective on May 1, 2008. However, CDC allowed a 30 day grace period. Therefore, any medical exam that takes place on or after June 1, 2008 must be performed in accordance with the new TB testing requirements.

 

Above from USCIS.

 

 

My wife had her med exam in the latter part of May 2008, and had the x-ray but no skin test (TST). It was my understanding, that after the 30 day grace period, there would be no more chest x-rays and only the TST; with a chest x-ray if the TST reached a certain level of the positive result.

[sweattrl1]

in our case my wife and daughter had to get the tb test in the usa even with the X-rays, and my daughter had to get two Vaccination Supplement done,one before and then a RFE during the green card process, so it depend who look at your paper work,

[Bill & Angel]

Thank God we finally got through the visa process and my dear one is here and we are now married. She came on a K-1 Visa.

However, I continue to be absolutely confused as to whether she needs any TB testing to be done here before filing the I-485 (with the I-693 Vaccination Supplement).

She had her medical exam done in GZ in December, 2008. She does not recall having a TB test at the time and does have chest X-ray films in her possession from that exam.

Do we need to do any further TB testing before filing for AOS, or is the vaccination supplement sufficient?

Thanks.

 

If you had the medical in Dec 2008, the TB testing is required. The question is, does the x-ray constitute a TB test? Our x-ray says something vague, such as "nothing found", but it does not specifically state that it was negative for TB. So I would think that if you want to base it on the x-ray, you'll need to have a medical doctor examine the x-ray to validate that TB is negative, specifically. Or, probably the cheaper route, is to have a TB skin test performed (it cost us only $10). They'll do a skin test, and in a few days, you go back for the results.

 

THEN, you'll need to find a civil surgeon that will transfer these results to the I-693 (the Dr Arnold in Texas that has received so many rave reviews has stated that they will not transfer the TB test results to the I-693.

 

Hope this helps.

[LeeFisher3]

The chest x-ray that was done in China was the TB test. If someone insists on a TB test you need to know that your spouse probably received the BCG Vaccine and should inform the health professional.

 

If your spouse tests positive to the standard TB skin test you should consider insisting on the QuantiFERON®-TB Gold Test before allowing treatment for TB, many medical professionals in the US are not up to speed concerning the BCG Vaccine.

[Bill & Angel]

The chest x-ray that was done in China was the TB test. If someone insists on a TB test you need to know that your spouse probably received the BCG Vaccine and should inform the health professional.

 

If your spouse tests positive to the standard TB skin test you should consider insisting on the QuantiFERON®-TB Gold Test before allowing treatment for TB, many medical professionals in the US are not up to speed concerning the BCG Vaccine.

 

This is the first I've heard of that. My wife doesn't recall getting a BCG vaccine. Are you sure that we could submit the x-ray to the civil surgeon, and he would accept that as the TB test? Can anyone verify having done that? (if it's true, we could simply discard the TB skin test)

[Guest Pommey]

if your medical was done after May 30th 2008 you need a skin test

[LeeFisher3]

The chest x-ray that was done in China was the TB test. If someone insists on a TB test you need to know that your spouse probably received the BCG Vaccine and should inform the health professional.

 

If your spouse tests positive to the standard TB skin test you should consider insisting on the QuantiFERON®-TB Gold Test before allowing treatment for TB, many medical professionals in the US are not up to speed concerning the BCG Vaccine.

 

This is the first I've heard of that. My wife doesn't recall getting a BCG vaccine. Are you sure that we could submit the x-ray to the civil surgeon, and he would accept that as the TB test? Can anyone verify having done that? (if it's true, we could simply discard the TB skin test)

In the past the Civil Surgeons accepted that the TB test or x-ray was done prior to the visa being issued and didn't pursue this, but the new requirements may force you down this path.

 

The odds are she was treated with the BGC vaccine, perhaps as a child. A large percentage of the population in China was given this vaccine in the past for the safety of the general population in China to prevent a full blown outbreak of TB, so the odds are pretty strong she received it if she is over the age of 20.

 

Civil Surgeons have many times have discard the x-ray taken in China stating the quality is too poor and the requirement for a radiologist to read the x-ray means the radiologist would want their own.

 

The requirement for a TST TB test is posted here: Technical Instructions for Civil Surgeons and in the 2008 Tuberculosis Technical Instructions for Civil Surgeons at the CDC it is interesting to find this statement:

Because many BCG-vaccinated applicants have lived in areas of the world where TB transmission frequently occurs, perform a chest radiograph on all such applicants with a skin test reaction of 5 mm or greater of induration.

 

In the past the medical locations in China went directly to the chest x-ray instead of the TST test because it was more authoritative and produced faster results. I'd imagine that with having a large portion of the population being treated with BGC in the past it just made sense.

 

If they give the TST to her and it comes back positive do NOT allow them to bypass the chest x-ray and move on to treatment. Tell them there is a strong chance she was treated with BGC and insist on a chest x-ray, just because she doesn't recall doesn't mean she didn't have a strong chance of being treated with it.

 

My reason for insisting on the x-ray is two fold, first it is cheaper and secondly the treatment for TB can be pretty rough on the body. There is no need to be treated for TB unless there is evidence you have it.

[dale7570]

Thank God we finally got through the visa process and my dear one is here and we are now married. She came on a K-1 Visa.

However, I continue to be absolutely confused as to whether she needs any TB testing to be done here before filing the I-485 (with the I-693 Vaccination Supplement).

She had her medical exam done in GZ in December, 2008. She does not recall having a TB test at the time and does have chest X-ray films in her possession from that exam.

Do we need to do any further TB testing before filing for AOS, or is the vaccination supplement sufficient?

Thanks.

 

this is an excellant question that is still being debated by cfl members. according to the i-485 instructions, if you had the medical exam within the past 12 months then your ok. it doesn't mention anything about a new tb test being done. however, i have seen many posts at vj that were rfe'd for a new medical exam, so the bottom line is that it depends on the uscis person that adjudicates your i-485.

[LeeFisher3]

Thank God we finally got through the visa process and my dear one is here and we are now married. She came on a K-1 Visa.

However, I continue to be absolutely confused as to whether she needs any TB testing to be done here before filing the I-485 (with the I-693 Vaccination Supplement).

She had her medical exam done in GZ in December, 2008. She does not recall having a TB test at the time and does have chest X-ray films in her possession from that exam.

Do we need to do any further TB testing before filing for AOS, or is the vaccination supplement sufficient?

Thanks.

 

this is an excellant question that is still being debated by cfl members. according to the i-485 instructions, if you had the medical exam within the past 12 months then your ok. it doesn't mention anything about a new tb test being done. however, i have seen many posts at vj that were rfe'd for a new medical exam, so the bottom line is that it depends on the uscis person that adjudicates your i-485.

It's a new requirement for AOS: Changes to the Tuberculosis and Vaccination Requirements Required for Adjustment of Status.

The new TB testing and treatment requirements became effective on May 1, 2008. However, CDC allowed a 30 day grace period. Therefore, any medical exam that takes place on or after June 1, 2008 must be performed in accordance with the new TB testing requirements.

[Cathy]

Since every child in China is required to have the BCG vaccinated, the Chinese will turn out positive for the TB skin test (PPD test). So, when the Chinese visits a civil surgeon here, tell them that they have the PPD done before and the result is positive. Then, the Chinese will not, or should not, be asked for the PPD again.

 

To claim be TB-free, the Chinese will be required to show the X-ray film. Some office accept the one done in Guangzhou, some don't. Therefore, the Chinese may be required to take the X-ray at a medical facility here to show the status of the lungs.

 

The vaccination booklet is helpful to finish the medical exam in the States.

[LeeFisher3]

Since every child in China is required to have the BCG vaccinated, the Chinese will turn out positive for the TB skin test (PPD test). So, when the Chinese visits a civil surgeon here, tell them that they have the PPD done before and the result is positive. Then, the Chinese will not, or should not, be asked for the PPD again.

 

To claim be TB-free, the Chinese will be required to show the X-ray film. Some office accept the one done in Guangzhou, some don't. Therefore, the Chinese may be required to take the X-ray at a medical facility here to show the status of the lungs.

 

The vaccination booklet is helpful to finish the medical exam in the States.

The CDC removed the option from the Civil Surgeon to make that determination about BGC and now requires them to do the TB Skin test.

 

The following is from the letter the CDC sent to Civil Surgeons concering the change in the rules.

A chest radiograph is required for all applicants with a tuberculin skin test (TST) reaction of 5 mm or greater of induration, including pregnant (or possibly pregnant) women. Previously, the chest radiograph could be waived for a pregnant applicant if she had a scar or other evidence of BCG vaccination and denied having any TB-related symptoms. This exception is no longer permissible. If the applicant decides to undergo a radiograph during pregnancy, the possible risks of radiation to the fetus should be explained to her and informed consent obtained, confirmed by a signed consent form. If she wishes, the applicant may defer the radiograph until after delivery, but the civil surgeon cannot sign the medical examination form until the radiograph is performed and interpreted, and treatment for Class A pulmonary TB disease, if needed, is completed.

[dale7570]

Thank God we finally got through the visa process and my dear one is here and we are now married. She came on a K-1 Visa.

However, I continue to be absolutely confused as to whether she needs any TB testing to be done here before filing the I-485 (with the I-693 Vaccination Supplement).

She had her medical exam done in GZ in December, 2008. She does not recall having a TB test at the time and does have chest X-ray films in her possession from that exam.

Do we need to do any further TB testing before filing for AOS, or is the vaccination supplement sufficient?

Thanks.

 

this is an excellant question that is still being debated by cfl members. according to the i-485 instructions, if you had the medical exam within the past 12 months then your ok. it doesn't mention anything about a new tb test being done. however, i have seen many posts at vj that were rfe'd for a new medical exam, so the bottom line is that it depends on the uscis person that adjudicates your i-485.

It's a new requirement for AOS: Changes to the Tuberculosis and Vaccination Requirements Required for Adjustment of Status.

The new TB testing and treatment requirements became effective on May 1, 2008. However, CDC allowed a 30 day grace period. Therefore, any medical exam that takes place on or after June 1, 2008 must be performed in accordance with the new TB testing requirements.

 

i wonder if the guz medical facilities are doing the medical exam according to the new tb test standards? we had our medical done in guz on july 25th 2008.

[LeeFisher3]

Thank God we finally got through the visa process and my dear one is here and we are now married. She came on a K-1 Visa.

However, I continue to be absolutely confused as to whether she needs any TB testing to be done here before filing the I-485 (with the I-693 Vaccination Supplement).

She had her medical exam done in GZ in December, 2008. She does not recall having a TB test at the time and does have chest X-ray films in her possession from that exam.

Do we need to do any further TB testing before filing for AOS, or is the vaccination supplement sufficient?

Thanks.

 

this is an excellant question that is still being debated by cfl members. according to the i-485 instructions, if you had the medical exam within the past 12 months then your ok. it doesn't mention anything about a new tb test being done. however, i have seen many posts at vj that were rfe'd for a new medical exam, so the bottom line is that it depends on the uscis person that adjudicates your i-485.

It's a new requirement for AOS: Changes to the Tuberculosis and Vaccination Requirements Required for Adjustment of Status.

The new TB testing and treatment requirements became effective on May 1, 2008. However, CDC allowed a 30 day grace period. Therefore, any medical exam that takes place on or after June 1, 2008 must be performed in accordance with the new TB testing requirements.

 

i wonder if the guz medical facilities are doing the medical exam according to the new tb test standards? we had our medical done in guz on july 25th 2008.

Highly doubtful, I'd imagine they know the results of the TB tests given the usage of BCG vaccine in China and just move on to step 2 instead of wasting everyones time and money with a test that 99% of the time will require the chest x-ray. (99% is just my guess)