Curran & Berger

Mary, an Indian national, graduated from a nursing school in Kerela, India. The school had only opened a few years before, but provided a good academic and clinical experience in a three-year program, with all courses and clinics in English. Upon graduation, she obtained her license and began looking for work. Good, fulltime positions with decent salaries were hard to come by. Mary, however, was determined to pursue a career in nursing, so she found a volunteer position for her first year, and eventually found a position in a small hospital working in acute care. The job paid very little (approximately $30 per week in U.S. dollars).

Most of Mary’s fellow nursing school graduates were unable to find jobs in India, and she knew several nurses who had taken jobs in Saudi Arabia, the United Arab Emirates, and the United States. A few of these nurses recommended that she look into the possibility of working abroad. Mary occasionally used an internet café to send email to friends and to access the internet. She began to research nursing abroad, and found the CGFNS website (www.cgfns.org), Upon learning that the CGFNS Certificate was required for most state licenses in the US, and that the cost was very high, ($368.00 for the CGFNS Certificate, $140.00 for the language test (IELTS), and as much as $425.00 for state licensure) Mary researched and chose a nurse recruitment company that would pay her fees.

Mary signed up for the CGFNS Certification program, which verifies that an RN’s nursing education and foreign license are comparable to those of a “First Level, General Nurse.” After this credentials review was completed, CGFNS would allow Mary to sit for the CGFNS examination. This examination is very similar to the NCLEX examination that all U.S. nurses must pass to obtain a state nursing license. It is designed to predict which nurses are likely to pass the NCLEX examination.

Mary also signed up for a private English class to brush up on her spoken English skills. Even though she had been educated in English, Mary was concerned about her accent and she knew that she would need to pass both spoken and written English tests within 2 years of passing the CGFNS exam before she could receive the CGFNS Certification.

When Mary felt more comfortable with her English skills, she signed up to take her English test with the International English Language Testing System (www.IELTS.org), and passed the written and spoken sections. Mary could have used a different testing service, such as Test of English as a Foreign Language (www.ETS.org/TOEFL), but she had heard that the British-based IELTS exam was preferred by Indian nurses.

Mary passed the CGFNS examination, and was granted a CGFNS certificate. The recruiter Mary had hired arranged for her to interview with several of their client hospitals. Mary was offered sponsorship and a full time position for 24 months at the “prevailing wage”, in Boston, Massachusetts. In return for her 24-month commitment, Mary would be provided with all necessary licensing fees, legal fees, airfare to the US and transitional housing. The recruiter also promised to pay for her NCLEX examination, now being offered in India.

The nurse recruiter and the hospital regularly worked with a respectable Immigration Law Firm, who they contacted to begin work on Mary’s case. A lawyer from the firm called Mary, explained the process, clarified his role as attorney for both the nurse and the employer (dual representation), and requested her:

• Nursing diploma
• Nursing transcripts
• Nursing license
• CGFNS certificate
• Copy of passport

The lawyer also sent Mary two copies of uncertified form ETA-9089, asking her to sign page 8 and return them to him with the other documents. In addition, he sent her a packet of information regarding the consular process, including form DS-230, a copy of the Foreign Affairs Manual section on Indian document requirements and instructions for documentation that would be required later in the visa procedure.

The lawyer then contacted the hospital’s HR generalist to obtain details of the (non-union) job offer, including the salary, a letter from a financial officer of the hospital stating that they employed over 100 workers, and either an annual report, a federal tax return, or an audited financial statement. He also requested confirmation of the hospital’s:

• Number of employees
• Tax ID number
• Nursing supervisor
• Gross and net income

The attorney ordered a Prevailing Wage Determination from the state labor office to officially determine the minimum hourly wage that the hospital must pay this entry-level nurse. The lawyer already knew what that amount would be because the information is available on-line (www.flcdatacenter.com). Even though many foreign nurses come to the U.S. with years of previous experience, the hospital’s attorney normally classified the positions as (level one) entry positions because even experienced foreign nurses required training and orientation before they were able to effectively work in U.S. hospitals.

Registered nurses are a “Schedule A” occupation under DOL rules, based on the continuous shortage of nurses. Therefore, petitioners are not required to go through the typical “labor certification” advertising process to show that there is a labor shortage. Register nurses fall into the third employment-based category (EB-3), which is normally backlogged several years. However, Congress had recently offered temporary relief to this backlog by allocating an addition 50,000 “EX” immigrant visas for Schedule A workers and their families.

Based on the information received, the lawyer prepared a Department of Labor Notice of Filing and asked the HR generalist to post it in a conspicuous location for 10 consecutive business days (not including weekends or holidays). The hospital did not make use of in-house media to advertise job openings, so no additional notice was required. Sixteen days after posting the notice, the HR generalist removed, signed and returned the Notice to the attorney, along with the required signed forms previously mailed to the HR generalist (uncertified ETA 9089 page 9, I-140, G-28). The lawyer was required to wait thirty days after the Notice was removed, then he filed the following with the United States Citizenship and Immigration Service [USCIS], Texas Service Center by Federal Express:

• G-28, signed by the petitioner (hospital officer) and attorney
• Cover letter to USCIS, listing the enclosures and requesting that the approval of this “Schedule A” petition be cabled to the U.S. Consulate in New Delhi, India
• Form I-140 (immigrant visa petition)
• Fee check to Department of Homeland Security ($475)
• Uncertified form ETA 9098 in duplicate signed by attorney, alien and employer
• Prevailing Wage Determination statement (unexpired)
• CGFNS Certificate {Note:An NCLEX pass letter or state nursing license is an acceptable alternative}
• Nursing Diploma/Degree
• Nursing license from country of nursing education
• Nursing education transcripts
• Notice of Filing (after 10 business day posting and additional 30 calendar day wait)
• A letter from a financial officer of the hospital stating that the hospital employed over 100 workers (note that the hospital was a private organization and did not wish to share it’s sensitive financial or tax records, so they asked the lawyer to just use the letter from the financial officer, as they had done in past cases)

Two weeks after filing, the attorney received a receipt notice from USCIS. He entered the receipt information in the USCIS on-line system so he would be notified immediately of any USCIS action by email.

While the attorney was working on the visa petition, the nurse recruiting company was assisting Mary with her VisaScreen application (www.ichp.org). A Visascreen Certificate is required before a permanent residence application can be approved. The Certificate, which confirms the nurse’s credentials and English fluency, can only be obtained from a CGFNS subsidiary company (ICHP). Since Mary already had her credentials evaluated by CGFNS, and had passed the (EILTS) English tests, she had already met all the Visascreen requirements and merely had to pay CGFNS/IHCP $398 for the Certificate.

The Visascreen certificate was mailed to Mary two months after the nurse recruiter sent in the fee.

After the I-140 immigrant visa petition had been pending for three months, the attorney received a Request for Evidence (RFE) from the USCIS, requesting additional proof that the employer had the ability top pay the nurse’s salary. The hospital was a very well known and prestigious facility with thousands of employees, including hundreds of registered nurses, and never had any difficulty paying any of those salaries. Both the attorney and the HR generalist assigned to the case were perplexed at the request, but a review of the regulations confirmed that financial documents such as an annual report, a federal tax return, or an audited financial statement were required to prove the employer could in fact pay the foreign worker’s salary. The lawyer assured the hospital that the financial information would be held in the strictest confidence, and the hospital reluctantly provided the previous year’s federal tax return, which the lawyer forwarded to the government.

Five months after the original filing of the I-140 petition, the attorney received email and written notification of its approval, and the case was forwarded to the National Visa Center [NVC] in Portsmouth, New Hampshire.

Three weeks later he received notification of the NVC case number, with a “fee bill” requesting a $380 money order to proceed with Mary’s case. The lawyer quickly returned the fee bill to NVC with the $380 money order. {Note: if Mary was married or had any children, the NVC would have taken the information about her family from the I-140 petition and requested an additional $380 money order for each eligible family member}.

Anticipating the next stage of the process, and knowing that plenty of special “EX” visas were available for Schedule A nurse applicants, the lawyer asked Mary to send him the documents he had requested months before, including a completed forms DS-230 Part I and Part 2, signed on page two (not on page four) and began organizing the papers required by the U.S. consulate.

Approximately three months after sending the $380 money order and the fee bill to the NVC, Mary called the attorney to announce that she had just gotten married and wanted her husband, Rajesh, to accompany her.

Mary scanned a copy of her marriage certificate, Rajesh’s birth certificate, and a copy of the biographic page from his valid passport and sent them to the attorney, who forwarded these documents via email (with her NVC case #) This e-mail address is being protected from spam bots, you need JavaScript enabled to view it , notifying the NVC of the new family member. NVC responded by email the next day, and two weeks later the attorney received a feebill for Rajesh, which he quickly returned to NVC with the $380 money order.

Because this was the first marriage for both Mary and Rajesh, there was no need for a divorce certificate, or death certificate to show termination of prior marriages.

Rajesh in the meantime completed and signed his DS-230 Part I and Part 2 and sent them to the attorney.

A few weeks later, the attorney received the Instruction Packet (formerly known as Packet 3) for the Immigrant Visa Applicants

The lawyer then forwarded the following to the NVC by FedEx:

• National Visa Center - Barcode Sheet
• Forms DS-230, Part 1, signed by each applicant
• Clear copies of the biographic pages of each applicant’s passport [Please note, the NVC case # was clearly written in the top left hand corner of every document submitted]

The lawyer then made a note in his calendar, reminding him to check the New Delhi Embassy website, which publishes all the cases scheduled for visa interviews each month (http://newdelhi.usembassy.gov/visa_interview_dates.html). This is a useful service offered by the U.S. embassies in India, especially considering that the lawyer and applicant sometimes do not receive written interview notification from these embassies.

[Note that India is “Standard Review” country, for which the NVC does not require originals of documents in advance. If Mary had planned to process her case in an “Appointment Review” country (Philippines, Turkey, Canada, Lebanon, UAE, and all African countries), they would also have been required to submit and unsigned DS-230 Part II, along with their original police certificates, birth certificates, marriage certificate, and any military or prison records.]

After receiving the completed Instruction Packet, the NVC then sent Mary and Rajesh’s file to the U.S. Embassy in New Delhi.

Since the NCLEX examination was now being offered in India, Mary decided to sign up for it and take it. Each U.S. state has its own procedure for granting authorization to take the NCLEX exam for nurse licensure. Mary’s CGFNS Certificate qualified her to apply for authorization to test (ATT) in Massachusetts. With the assistance of her recruitment agency, Mary submitted her CGFNS Certificate and her application to the Massachusetts board of nursing along with the $225.00 fee. Two weeks later Mary received her ATT, which would be valid for 60 days. Mary contacted the testing agency “Pearson Vue”, paid $200.00 and scheduled her NCLEX exam in Bangalore, India. Mary’s results were posted in on the internet 48 hours after taking the test. She passed the test, and was licensed to practice as a registered nurse in Massachusetts within the week.

Three months after her lawyer filed the DS-230 forms, the consulate post sent the Interview Notice (also known as Packet Four) to Mary. She was expecting it because she saw her case number listed on the embassy website the previous week. Had she not received the Interview Notice, she would have been advised by the attorney to contact the U.S. consulate for instructions.

The lawyer obtained and sent Mary a notarized letter from the sponsoring hospital verifying the offer of employment.

Mary and Rajesh read the Interview Notice instructions carefully, went to physician’s office down the street from Embassy for their medical examinations, and went to their visa appointment together with the following documents (originals in English, or with certified English translations):

• Interview Notice
• Hospital letter
• Passports
• Forms DS-230 Part II for each (unsigned)
• Two passport-style photographs each
• Visascreen Certificate
• Sealed Medical Examinations
• Birth certificates
• Marriage Certificate
• Police Clearance Certificates

[Had this been an “Appointment Review” interview, the consular officer would already have the original birth, marriage and police certificates.]

After a lengthy wait at the Embassy, Mary and Rajesh were interviewed by a consular officer. They were asked if they had committed any crimes or violated any visa rules, and were advised that their cases were approved. Two days later their passports were returned to them with Immigrant Visa stamps, valid for 6 months, and sealed envelopes to give to the U.S. immigration inspector at the airport.

Two weeks later Mary flew to the U.S. Her nurse recruiter met her at Logan Airport and took her to her temporary apartment (shared with two other nurses, one from India, one from the Philippines). The recruiter also showed her where the hospital was, introduced her to the Nurse Director, explained the bus systems, got her a cell phone, showed her several local Indian restaurants and food stores, and even helped fill her refrigerator with Indian food. The next day, Mary’s second cousin from Connecticut came to visit Mary and took her on a tour of Boston.

Mary entered the hospital orientation and training program a few days later. After six weeks, Mary began to feel comfortable with her work and settled into a routine. Soon after, Rajesh also entered the U.S. in permanent residence status. Because he checked “yes” to numbers 33a and 33b on the DS-230 Part 2, Rajesh’s social security card was automatically processed and mailed to him several weeks after he arrived. Rajesh was quickly able to find employment as an electrical engineer on Route 128. Mary and Rajesh are now dedicated Red Sox fans and look forward to raising a family in Boston.