TB skin test despite chest x-ray

I

immipassion

Registered Users (C)
It seems of late NSC has started issuing RFEs for TB skin test despite submitting chest x-ray results. I too had skipped the skin test as many people have reported testing positive due to the vaccination given in India. Now I am wondering if I should get it done and submit the results as pre-emptive measure to avoid unecessary delay in I-485 processing. My lawyer is suggesting to wait but I would like to hear from others in the same boat, especially those who had received similar RFE and how long it added to the delay.

Thanks in advance
IP
 
Skin test is a CDC requirement for immigration applications. A negative chest X-ray does not exclude exposure to TB bacteria.

Adjudicators are not doctors and they look at what box is checked. If box says "Not done" for TB skin test then you will get RFE. If box says PPD reaction positive then they will look for chest x-ray......
 
Yeah, what the poster above me said. I suggest you take it anyways. Just don't take any chances or give them any reason to delay the process. My doctor had me take the skin test even though I knew it'd be positive. Just do it. Nike:D
 
thanks

Thank you guys for your input. I will do it asap. Just out of curiosity, docny I am confused by your statement that a negative chest X-ray does not exclude exposure to TB bacteria. I thought if positive skin test and negative chest x-ray implies no TB then x-ray should be the over-riding factor.
 
immipassion said:
Thank you guys for your input. I will do it asap. Just out of curiosity, docny I am confused by your statement that a negative chest X-ray does not exclude exposure to TB bacteria. I thought if positive skin test and negative chest x-ray implies no TB then x-ray should be the over-riding factor.
Click to expand...

Without going into medical details.

A positive skin test (PPD) implies exposure to TB bacteria not necessarily infection.

Positive PPD and a negative chest x-ray mean Latent TB (dormant) which may re-activate in certain patients and therefore prophylactic treatment with one medication as opposed to four (for active TB) is recommended specially in younger population (age 35 or less) to minimize the risk of converting to active TB at a later time. BCG vaccination may convert your PPD to be positive but the effect fades as years goes by and it is recommended to have PPD test even if you have BCG vaccination history in the past (> 5 years). Also BCG does not protect from getting TB infection.

Chest x-ray may be normal (no lung TB - but theoritically one may have other organ TB such as intestine, kidney, spine etc.) OR abnormal (active TB requring treatment with four medications for 6 months or more OR old healed TB scars).

TB is transmitted to through respiratory droplets in the air and hence screening with chest x-ray.

PPD test is for your benefit (to determine if you will need prophylactic treatment). By getting prophylaxis you minimize your chances of converting to an active case and hence no risk to the community if that happens.

Chest x-ray for your benefit and community's benefit - to determine if you have active disease that may be transmitted to others.

The main purpose of Medical exam for USCIS purpose is to ensure that a person does not have communicable disease.

Please see http://www.cdc.gov/ncidod/dq/updates.htm
 
But, to be sure, sounds like the RFE is not suggesting that you have TB, or requesting you to get treatment. It's just about satisfying the procedure, even if it seems unnecessary.
 
Prophylactic treatment is recommended and not enforced. On the other hand treatment for active TB is enforced (at times direct observed therapy also called DOT - where you are directly observed taking pills by dept. of health assigned person everyday).

Positive PPD and negative CXR -> immediate clearance with prophylactic treatment recommendations.

As far as USCIS is concerned, they only look at boxes checked. It is your doctors who will clear you. If your doctor determines that you need some kind of therapy before you can be cleared, then they will tell you so. So don't worry.


There are standard guidelines by CDC to physicians for this.

Please see http://www.cdc.gov/ncidod/dq/civil.htm
 
So I guess my next question would be: "Should I submit the skin test result in advance as additional support document or should I wait to hear back from USCIS. Do they always issue RFE if skin test rsults are missing?" As I said earlier, my lawyer suggests waiting but I know of cases where medical RFE has delayed approval by over 6 months. What, if any, are the drawbacks of submitting it in advance and does it have to be from the same doctor? I got my med exam done during one of my trips since nearest USCIS surgeon to my place is 200 miles away!
 
immipassion said:
So I guess my next question would be: "Should I submit the skin test result in advance as additional support document or should I wait to hear back from USCIS. Do they always issue RFE if skin test rsults are missing?" As I said earlier, my lawyer suggests waiting but I know of cases where medical RFE has delayed approval by over 6 months. What, if any, are the drawbacks of submitting it in advance and does it have to be from the same doctor? I got my med exam done during one of my trips since nearest USCIS surgeon to my place is 200 miles away!
Click to expand...

I suggest you wait. You never know, they may just accept it w/o RFE. And if I understand correctly follow up letters w/o RFE don't necessarily get tagged to your application.
 
cdc website shows NEW skin test can be skipped

cdc website shows NEW skin test can be skipped for the people with positive skin test in the past. Just need chest x-ray.

Are there any situations in which the tuberculin skin test is not required for an applicant 2 years of age or older?

There are two situations in which the TST is not required. Applicants providing written documentation (with a health-care provider's signature) of a TST reaction of 5 mm or greater of induration or applicants who have a history of a severe reaction with blistering to a prior TST may be excluded from this requirement. Applicants in these two groups must undergo a chest radiograph.

http://www.cdc.gov/ncidod/dq/updates.htm
 
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