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Immigration Process | Access Therapies

What are different ways for me to live and work as therapist in the USA ?

There are two major requirements that you will have to fulfill:
For Physical Therapist:
1. You have to apply for credential evaluation to FCCPT/ICD/ICHP and if you pass you may apply to take the NPTE with FSBPT, after arranging for the visitor visa, you can now take the exam in any testing sites in the US. You must also pass the Test of English as a Foreign Language (TOEFL) exam (Countries whose primary language is not English) with a score of 220 or more. Once FCCPT receives passing scores for the TOEFL they will then issue a certificate (Visa Screen Certificate).

For Occupational Therapists:
1. you have to apply for credential evaluation to NBCOT and if credentials are approved based on US standard of education you can proceed to take the exam. The State Board exam can be taken on the country where NBCOT has a testing site. After passing the exam you must also pass the Test of English as a Foreign Language (TOEFL) exam (Countries whose primary language is not English) with a score of 220 or more. Once NBCOT receives both passing scores they will then issue a certificate (Visa Screen Certificate).

I-140 - Employment-based Permanent Residency (Green Card)
The immigration method with the fewest requirements on the therapist and employer is to apply for an employment-based green card. This allows a therapist to work in the U.S. indefinitely, as long as the green card is renewed every ten years.

Therapy is one of the few professions that does not require a labor certification to be filed before applying for an I-140 (unlike physicians), so I-140`s can be approved in three to six months.

H-1B - For Positions Requiring at Least a Bachelor's Degree
The H-1B visa can be used to hire skilled professionals that have at least a bachelor's degree and are filling a position that requires the same level of education.

Most registered nurses and nursing jobs do not meet this requirement, but if the US employer is hiring foreign nurses for supervisory or management positions, or for subspecialty areas that require a bachelor's degree, an H-1B might be an option.

Additionally, if your facility hires nurses with bachelor's degrees almost exclusively, it is possible to make a case for using the H-1B to bring in international nursing talent.

Depending on where your facility is located, approval of an H-1B visa can take anywhere from two to six months.

H-1B`s last for three years, and can be renewed for another three.

Read more on:
Difficulties in Obtaining H1B Status for RNs
Who is the employer when a consulting company sponsors the H1B visa?
Can a consulting company hire nurses on an H1B Visa stating that the minimum requirement for the job is an bachelor's?

See if you qualify for an H-1B

TN - For Canadian or Mexican Nurses
Registered nurses who are Canadian or Mexican citizens can work in the U.S. on the TN visa, as long as they have a state or provincial nursing license. The TN visa typically takes from one to six weeks to approve, and is good for one year. It may be renewed in yearly increments an unlimited number of times.

H-1C - For Facilities in Underserved Areas
The H-1C visa was created in 1999 specifically for hospitals in areas with low primary care physicians-to-patient ratios, typically in rural or inner-city locations. Facilities must meet additional stringent standards, so stringent, in fact, that the U.S. Department of Labor identified only 14 hospitals that qualified to hire nurses on H-1C visas. These 14 hospitals face additional restrictions: only 500 H-1C visas will be issued each year by the INS, and the program limits the number of H-1C`s issued in each state to either 25 or 50, depending on the state population.H-1C visas are valid for three years, and usually take two to six months to approve.

What is an H1B visa

The foreign worker:

A nonimmigrant in the H-1B category is an alien who is coming temporarily to the U.S. to perform services in a "specialty occupation". The alien is qualified through the appropriate degree, or through a combination of education and experience equivalent to that degree. The worker may be entering the U.S. for the first time or may already be working in the U.S., but pursuing a change of employer.

The foreign worker must prove that he or she is qualified for the specialty occupation and the particular job offered. One method is to obtain a credentials evaluation of their foreign university degree, to show that it is equivalent to that of a U.S. degree.

If the worker is already in the U.S. and holds a valid nonimmigrant status, the H-1B visa can be extended and revalidated in the U.S. If, on the other hand, the worker is not in lawful status, or resides abroad, the H-1B visa must be obtained through a U.S. Consulate.

Since the H-1B visa is considered a temporary visa, there is a limitation on periods of stay. The initial periods of stay may be approved for up to 3 years (usually depending on the occupation and/or the needs of the employer). And after that, another 3 years are available, by filing forms for and extension of stay. After the six years, the worker must spend one year outside the U.S. before being entitled to another H-1B visa. However, many workers take steps to obtain permanent residence (the Green Card) during their initial stay.

Dependents of H-1B workers (spouses and children under 21) may be granted an H-4 visa. Dependents with an H-4 visa are not permitted to work in the U.S.

The employer of a foreign worker:

To qualify as a U.S. employer, the employer must have a U.S. taxpayer identification number.

When hiring an H-1B worker, the employer must file a Labor Condition Application (LCA) with the Department of Labor (DOL). This application requires the employer to describe the position and the salary, as well as attest to facts concerning the wage, working conditions, labor conditions and the giving of notice of the employment.

Once the LCA is approved, the employer then submits an I-129 Petition for nonimmigrant worker, along with related forms and supporting documents, to the Immigration and Naturalization Service (INS). This form documents that the job requires the services of a person in a "specialty occupation", and provides documentation that the worker does, indeed, qualify for the job offered.

The employer of an H-1B worker has certain responsibilities to meet. Once the I-129 is approved, the employer must maintain wage and hour records, as well as information concerning working conditions for similarly situated employees. Upon request, these records must be provided to DOL's Wage and Hour Division. If the appropriate records are not maintained, the employer could be liable for substantial penalties and fines, even lose the right to apply for immigrant and nonimmigrant visas for up to one year.

If the worker is terminated any time during the approved period of stay on the I-129, the employer is responsible for paying for the worker's return transportation to his or her foreign residence. 

What are the steps and the time involved in the H-1B process?

Answer: Approximately 6 - 10 weeks, if all goes well!

As soon as the prospective employer suspects they will be hiring a new foreign worker, or need to extend an H-1B visa, the completion of the Prevailing Wage Determination and Labor Condition Application can begin. Depending on the state, obtaining the Prevailing Wage Determination varies in difficulty and time involved (from a few days to 2 weeks or more).

In order to begin the Prevailing Wage Determination and the Labor Condition Application, we will need the following information:

  1. Kind of the profession
  2. Job title and requirements (educational & experience) for the job
  3. Salary to be paid
  4. Employer's name and address
  5. The physical address where the foreign worker will actually perform the job
  6. Type of setting where job will be performed

What information/documentation is required to begin the processing of an H-1B visa?

1. Information/Documentation needed from the foreign worker‚ this is what we need from the foreign worker in order to process his/her H-1B visa. There may be items that the foreign worker does not have or is not familiar with. Those items are not applicable and can be ignored/skipped.

If Spouse and Children are residing in the U.S. at the time we file for the foreign worker's H-1B visa: items listed are needed in order to process their H-4 visas.

If Spouse and Children are overseas when we file the H-1B, there is not paperwork for us to file here in the U.S. Spouse and Children must appear at a U.S. Embassy to apply for an H-4 Visa.

2. Information/Documentation needed from the Employer‚ this is what we need from the employer in order to process an H-1B visa. Once an employer is established with us, we only need the information specific for each potential new employee such as job title, detailed job description, salary offered, etc.

Once the Prevailing Wage Determination is obtained...the ETA 9035 - Labor Condition Application (LCA) can be completed and posted at the work site (to be left up for 10 consecutive days in two conspicuous places). As soon as the LCA (or a notice of the filing) has been posted, we can then file the LCA with the Department of Labor. In approximately 10 - 14 business days, the approved (certified) copy of this form will arrive in our office. We will fax a copy of the filed form to the employer, with instructions about giving a copy of the LCA to the (prospective) employee.

As soon as we receive all the information/documentation from the foreign worker and the employer, and while we wait for the approved LCA, the paperwork for the petition can begin. When the all information has been transferred onto the INS (Immigration and Naturalization Service) forms, authorized signatures are obtained. When all forms are signed and the certified LCA arrives, all is packaged and sent to INS.

Credentials Evaluation (Education/Work):

If an education credentials evaluation was not obtained as a part of a licensure requirement (as in the rehab professions), many times, the INS requires that an evaluation of the foreign workers credentials be performed and added as supporting documentation to the visa application. This evaluation is done to make sure that the foreign worker's degree is equivalent to a U.S. degree. If an evaluation has not already been completed, we must have good, readable copies of the foreign worker's degree certificate(s), transcripts or mark sheets, any professional development course certificates and translations of any documents that are not in English.

The more information provided to us, the faster the education evaluation may be performed. Usually the cost for an education evaluation is approximately $125.00, however in some cases it may cost more.

The credentialing process usually takes approximately 2 weeks to complete and is customarily performed at the same time that the Department of Labor is processing the LCA. Therefore, the credentialing process normally does not delay a file.

Approximately 4 - 8 weeks:

In approximately 14 - 21 days after mailing the I-129 Petition to INS, a "Receipt Notice of Action", form I-797, is received in our office. This means that INS has received the file and is beginning to process it. If this notice is not received in at least 21 days after mailing, we will investigate. If INS is satisfied with the file, they will send an "Approval Notice of Action", form I-797, usually within 14 - 36 days of the Receipt Notice. If we do not hear anything after 36 days, we will investigate!

Occasionally, between the Receipt Notice and the Approval Notice, a letter from INS may be received requesting more information or clarification of a fact. With the employer's cooperation and/or the cooperation of the foreign worker, we simply comply with their request. If this happens, it can delay the process another 10 -14 (or more) days.

Additional information that may be helpful during the hiring process:

General questions that may be asked of the foreign workers during an interview to qualify a potential employee's immigration status.

General immigration terms that may be encountered during the immigration process.

When the Approval is received - Final Step!

If the foreign worker is residing in the U.S. and has maintained valid immigration status, he or she may now go to work for the new employer.

If the foreign worker is outside the U.S., they may now go to the U.S. Embassy listed on the I-129 Petition to have the visa issued and stamped, after which, they may enter the U.S.

Please note that there are many, many situations and types of visas that a person could experience. The above information will hopefully give you a brief overview of the most common things you will need to know before applying for the H-1B visa. Anytime you have questions about a particular situation, contact an immigration attorney.

What is a Green Card?

Permanent residence status, symbolized to many people by the so-called "green card", which is actually pink, confers on foreign nationals the right to live and work in the U.S. without time limitations.
The two most common ways to obtain permanent residence is by close family ties to a U.S. citizen or permanent resident, or through employment with a U.S.-based employer. For purposes of this discussion, the employment based visa will be our focus. There are two main phases to the process.
Phase I: The alien must be sponsored by the employer, who files a petition with INS to have the alien classified as a person qualified to immigrate.
Phase II: Once the alien is found qualified to immigrate, he or she may proceed to apply for permanent resident status. This can been done through Consular Processing or by Adjustment of Status.
Once the immigrant visa is issued, the permanent resident may then travel freely on the visa, and may accept employment without restrictions. It is not clearly stated, but we recommend that the foreign worker remain employed by the sponsoring employer for at least six (6) months after the visa is issued to show good intent regarding the employment relationship. The above information has been taken from immigration related sources, readily available to the public and should not be conceived as legal advice or legal direction. Information shown is greatly condensed. If an H-1B visa is in your future, be sure to contact an immigration specialist to assist in the process.