Employing Foreign Physical Therapists

Temporary and Permanent Visa Options

The Current Therapist Shortage in the U.S.

The current shortage of qualified Physical Therapists in some regions of the United States has caused many health care providers to recruit foreign Physical Therapists.  Fortunately, U.S. Immigration laws provide several employment visa options for U.S. employers seeking to hire foreign Physical Therapists.

Overall there are two main options for employing foreign Physical Therapists in the U.S:

  1. temporary work visas; and

  2. permanent work visas (green cards).  

 

 

TEMPORARY WORK VISAS FOR PHYSICAL THERAPISTS

 

Most foreign Physical Therapists have bachelor’s degrees in physical therapy (or physiotherapy) and thus qualify for the versatile 6-year H-1B status.  Canadian and Mexican Physical Therapists can be employed in the U.S. in TN status under the NAFTA treaty.

 

  • H-1B Status for Physical Therapists

Most foreign Physical Therapists qualify for professional H-1B status.   Physical Therapists with bachelor’s degrees (or  equivalent) in physical therapy qualify.  The H-1B status authorizes a total stay of 6 years and is issued in increments of 3  years.  INS processing time is generally 15 to 120 days.

·         TN Status for Canadian Physical Therapists

Canadian Physical Therapists can work in the U.S. in TN status pursuant to NAFTA.  Physical Therapists are one of the many professional occupations listed on the NAFTA Annex.

TN status is valid for one year and may be extended each year.  The TN status can be obtained upon the day of entry into the U.S.  The TN Therapist’s spouse and children may reside in the U.S. in TD status.  Of course, the TN Physical Therapist must also meet all state licensure requirements.

The H-1B status is superior to TN status and most U.S. health care providers should pursue H-1B status.  However, there is no $1000 H-1B filing fee associated with the TN status.

  • TN Status for Mexican Physical Therapists

Mexican Physical Therapists can work in the U.S. in TN status pursuant to NAFTA.  The TN status is valid for one year and may be extended each year.  The Mexican Physical Therapist’s dependents may reside in the U.S. in TD status. 

The procedure for obtaining the Mexican TN status differs from the Canadian TN status.  Employers must offer Mexican TN Physical Therapists the higher of the “prevailing wage” or actual wage.  Also, the U.S. employer must first petition the INS Service Center and obtain TN approval before the Mexican Physical Therapist can obtain the required TN visa in the passport.  Processing time can range from 15 to 90 days. Canadians are visa-waived and do not have such requirements.

 

Permanent Visas (Green Cards) for PHYSICAL THERAPISTS: A 2-Step Process

 

Physical Therapists may obtain employment-based immigrant visas (lawful permanent resident status) through a 2-step process that takes approximately 6-12 months to complete. Most foreign professionals must undergo a 3-step process that includes an arcane and time-consuming “labor certification” process through the U.S. Department of Labor. However, Physical Therapists are “Schedule A” employees and are pre-approved for labor certification by the U.S. Department of Labor. Since the labor certification process is bypassed, Step One of the immigrant visa process is the filing of the immigrant visa petition with the INS Service Center .

  • Step One: Filing the Immigrant Visa Petition (Form I-140 with the INS)

The immigrant visa process for Physical Therapists commences with the preparation and filing of the Form I-140 immigrant visa petition. We will prepare the immigrant petition for your signature. The petition contains information about the sponsoring employer and the foreign physical therapist.

 

A separate I-140 immigrant visa petition must be filed for each therapist. The INS filing fee for each application is $115.00.  In addition, U.S. Department of Labor Forms ETA 750 Parts A and B (in duplicate original) together with a company support letter, a posting notice of the job offer (posted on site for 10 working days or supplied to the therapists’ bargaining representative) and the Physical Therapist’s credentialing documentation must accompany the form I-140 petition. The Form ETA 750 Part A are signed by the employer and the Forms ETA 750 Part B are signed by the selected therapist.

 

The INS Service Center processing time for I-140 Immigrant Visa Petitions is a range between two to seven months.  The INS Service Centers, when operating efficiently, process I-140 petitions for Physical Therapists in two to four months.

 

Upon approval of immigrant visa petition, the Physical Therapist may apply for adjustment of status (Form I-485) if he or she is working in the U.S. (e.g. in H-1B or TN status). Alternatively, the Physical Therapist may apply via “consular processing” in which case the INS Service Center will forward the file to the National Visa Center for further processing at the U.S. Embassy or Consulate in the foreign therapist’s home country or country of residence.

  • Step Two:  Adjustment of Status or Consular Processing

Upon INS approval of the I-140 immigrant visa petition, the file is forwarded to the National Visa Center (NVC) to initiate “consular processing”. The NVC is a clearinghouse and serves as the liaison between the INS and Department of State (U.S. Embassy or Consulate).  In some cases, Registered Nurses currently in the U.S. are eligible to “adjust status” and complete the green card process inside the U.S.   Many Physical Therapists working in the U.S. with H-1B or TN status elect to adjust status by filing Form I-485 with the INS Service Center.  Processing time of the I-485 application may take 8 to 15 months.

 

Consular processing is often quicker but requires the Therapist to appear at a scheduled interview at the U.S. Consulate/Embassy in his or her home country. It usually takes a few weeks ( three to six ) for the INS to forward the case to the NVC. Once the NVC receives the approved I-140 petition from the INS, it issues “Packet 3", a group of State Department forms including the visa application (Form DS-230, Part I) and a checklist (Form DS-169) of documents the Physical Therapist will need to present to the consular officer at the required Embassy interview.

 

The Form DS-230, Part I should be completed immediately and forwarded to the U.S. Embassy or Consulate. Once the Physical Therapist has obtained all of the necessary documents (see below) listed on the Form DS-169 checklist, the checklist must then be mailed to the U.S. Embassy or Consulate. Upon receipt of the Form DS-230, Part I and the checklist, the Embassy or Consulate will then issue “Packet 4" including the scheduled interview appointment letter.

 

“Packet 4" contains the visa appointment letter (time/date of interview), Form DS-230, Part II, IRS Form 9003, the medical examination form and the affidavit of support form (Form I-864). The Therapist must appear at the designated physician’s office for the required medical examination. The Therapist should present his or her vaccination records (if available). Upon completion of the examination, the physician will seal the results in an envelope. With respect to the I-864 affidavit of support, the Therapist must complete one for his or her accompanying immediate family members (spouse and children under 21). The affidavit is submitted as evidence that the accompanying family members will have adequate means and support.

 

At the required Embassy interview, the Physical Therapist (and accompanying immediate family members) will present their Forms DS-230, Part II, completed medical examinations, the visa processing fees (approximately $400 per person), employment support letters and the required documentation (e.g. police clearance, PT licenses and certifications) listed below. If the consular officer is satisfied that the Physical Therapist meets the qualifications for the immigrant visa, an immigrant visa stamp will be placed in the Therapist’s passport at the close of the interview. The accompanying family members will also be issued their visa stamps. Accompanying family members may opt to apply later in a “following to join” case.

 

 

 

 

DOCUMENTS REQUIRED FOR APPROVAL OF I-485 APPLICATION TO ADJUST STATUS

  • Visa Screen Certificate

All foreign health care workers (including Physical Therapists) are required to obtain a Visa Screen certificate from an approved credentialing agency. The approved agency for Physical Therapists is the Foreign Credentialing Commission for Physical Therapists (FCCPT).   The Visa Screen certificate verifies that the foreign Physical Therapist’s education, training, license and experience is comparable to a U.S. Physical Therapist and that the foreign Physical Therapist is fluent in English and has the appropriate license.

One of the requirements for obtaining the Visa Screen certificate for Physical Therapists from countries in which English is not the official language is passage of the Test of English as a Foreign Language (TOEFL).

Although the INS Service Center will accept the filing of an I-485 application without the required Visa Screen Certificate, the I-485 application will not be approved unless and until the Physical Therapist submits the required Visa Screen Certificate.

  • Physical Therapy License

The foreign Physical Therapist must be registered in the country where he or she received physical therapy education. Proof of the foreign Physical Therapist’s licensure/registration must be submitted with the I-140 immigrant visa petition.

With respect to U.S. licensure (state of intended employment), temporary or interim licenses (if required by the state) may be obtained once the foreign Physical Therapist enters the U.S.  Each state has its own requirements for obtaining temporary and permanent licenses, some states having additional requirements.  

 

DOCUMENTS REQUIRED AT THE EMBASSY INTERVIEW

  • Visa Screen Certificate

All foreign health care workers (including Physical Therapists) are required to obtain a Visa Screen certificate from an approved credentialing agency. The approved agency for Physical Therapists is the Foreign Credentialing Commission for Physical Therapists (FCCPT).   The Visa Screen certificate verifies that the foreign Physical Therapist’s education, training, license and experience is comparable to a U.S. Physical Therapist and that the foreign Physical Therapist is fluent in English and has the appropriate license.

One of the requirements for obtaining the Visa Screen certificate for Physical Therapists from countries in which English is not the official language is passage of the Test of English as a Foreign Language (TOEFL).

  • Physical Therapy License

The foreign Physical Therapist must be registered in the country where he or she received physical therapy education. Proof of the foreign Physical Therapist’s licensure/registration must be submitted with the I-140 immigrant visa petition.

With respect to U.S. licensure (state of intended employment), temporary or interim licenses (if required by the state) may be obtained once the foreign Physical Therapist enters the U.S.  Each state has its own requirements for obtaining temporary and permanent licenses, some states having additional requirements.  

  • Police Certificates

Each foreign Physical Therapist applying for the immigrant visa abroad (as opposed to filing for adjustment of status in the U.S.) must obtain a police certificate from each country he or she has resided since becoming age 16. Police certificates are not available in some countries.  Police certificates can take several months to obtain.