Understanding the Role of TB Testing in Immigration

Tuberculosis (TB) testing is a critical component of the U.S. immigration medical examination. The United States Citizenship and Immigration Services (USCIS) requires all applicants for permanent residence (green card) to undergo a medical exam, which includes screening for communicable diseases like tuberculosis. This requirement ensures that immigrants entering the country do not pose a public health risk. Screening for tuberculosis (TB), a contagious disease that mostly affects the lungs, is essential to preserving national health security. During the immigration exam, a TB test—either a TB blood test (interferon-gamma release assay or IGRA) or a chest X-ray—is used to identify potential infections.

Many people wonder, “What happens if a TB test is positive for immigration?” The answer isn’t as alarming as it may seem at first. A positive TB test doesn’t automatically mean you’ll be denied entry or residency. Instead, it signals that further evaluation is needed. 

What Does a Positive TB Test Result Mean?

When a TB test comes back positive during your immigration physical, it means your body has been exposed to the tuberculosis bacteria at some point. However, this doesn’t confirm whether the infection is active or latent. A positive TB result from an IGRA test or skin test (although the skin test is less commonly used for immigration) typically leads to a follow-up chest X-ray to assess whether you have active TB disease, which is contagious, or latent TB infection, which is not contagious but still requires attention.

If your chest X-ray appears normal and there are no symptoms like chronic cough, weight loss, or night sweats, then the positive TB test may indicate latent tuberculosis infection (LTBI). In that case, the civil surgeon performing your immigration medical exam will document this appropriately on Form I-693 and may refer you for further evaluation or treatment. Although a latent TB infection alone won’t prevent you from receiving a green card, you must adhere to all advised follow-ups to prevent immigration delays. 

Next Steps After a Positive TB Test for Immigration

After a positive TB test result, the next step is a chest X-ray, which helps distinguish between latent and active TB. If the chest X-ray shows abnormalities consistent with tuberculosis or if you are showing symptoms of active TB, you will be referred to your local health department or a specialist for further evaluation. This may include a sputum test and additional clinical assessments. USCIS requires the civil surgeon to defer clearance until the individual is cleared of active TB or has started appropriate treatment.

If active tuberculosis is confirmed, you must begin a treatment regimen under public health supervision. The course of treatment usually lasts six to nine months, and meticulous documentation is required. Once treatment is successfully underway or completed, and you are no longer considered a public health risk, your immigration paperwork can resume. The length of time it takes to verify your status and whether you adhere to all medical advice will determine when your green card is approved.

This process, while time-consuming, is essential for public health and does not usually result in denial of your immigration application unless you fail to comply with required evaluations or treatments.

Can You Still Immigrate With a Positive TB Test?

One of the most common concerns among green card applicants is whether a positive TB test can block their immigration approval. The short answer is no—it typically doesn’t lead to automatic disqualification. Immigration authorities understand that TB is a treatable condition, and the policies are designed to manage public health risks, not to penalize applicants.

If you have a positive TB test but show no signs of active disease, you may be asked to start preventive therapy, especially if you’re under the age of 35 or have certain medical conditions. The civil surgeon will note this on your Form I-693, and the form will be submitted to USCIS as part of your immigration application. You will still be able to proceed with your green card process, assuming all other parts of your application are in order.

However, if you fail to follow up with recommended tests or treatments after a positive result, your medical examination may be deemed incomplete. In such cases, USCIS could delay your application or even request that the entire exam be redone. To avoid this, it’s crucial to remain in contact with your designated healthcare providers and comply with all medical guidelines.

How Long Does It Take to Clear a Positive TB Result for Immigration?

The duration of the follow-up process after a positive TB test depends on whether you have latent or active TB. If further evaluation determines you have latent TB, your immigration paperwork can typically proceed with minimal delays. However, if active TB is diagnosed, treatment must begin immediately, and immigration clearance is deferred until you’re no longer contagious.

Treatment for active TB usually lasts several months and includes a combination of antibiotics. You must complete a significant portion of this treatment and demonstrate compliance before the civil surgeon can issue a clearance. In some cases, a certificate from a health department or a designated TB clinic may also be required.

On the other hand, if the chest X-ray and follow-up testing rule out active TB, the civil surgeon can complete your immigration medical form relatively quickly. In either case, delays in obtaining necessary documents or failing to attend appointments can significantly slow down your immigration timeline. Therefore, the best course of action is to act promptly and responsibly.

Final Thoughts:

Navigating the immigration medical process can be overwhelming, especially when unexpected issues like a positive TB test arise. However, the system is designed to support your health and ensure public safety—not to hinder your immigration goals. At A2Z Pediatrics, we are committed to providing compassionate and accurate medical evaluations for families going through immigration procedures. Whether your child tests positive for TB or you’re preparing for the exam yourself, we’re here to help you through every step with clarity and care.

If you’ve tested positive for tuberculosis during your immigration exam, stay informed, follow medical guidance, and trust the process. With proper follow-up and cooperation, your path to lawful residency remains well within reach.

FAQs:

Will a positive TB test prevent me from getting a green card?

No, a positive TB test alone does not prevent you from obtaining a green card. As long as you complete all required evaluations and, if necessary, treatment, you can still be approved for immigration.

What follow-up tests are required after a positive TB result?

After a positive result, a chest X-ray is the next required step. If there are signs of active TB, further testing such as sputum cultures and clinical exams may be conducted to confirm the diagnosis.

Do I have to take medication if I test positive for TB?

If you are diagnosed with active TB, you are required to start treatment under medical supervision. If you have latent TB, treatment may be recommended but is not always mandatory for immigration purposes unless directed by a health authority.

How long will the immigration process be delayed if I test positive for TB?

The delay depends on the type of TB. For latent TB, the delay is usually minimal. For active TB, you may experience a delay of several months while undergoing treatment.

Can children test positive for TB and still immigrate?

Yes, children can test positive for TB and still proceed with immigration. The process is similar, involving chest X-rays and follow-ups. Pediatric cases are handled carefully, especially by clinics experienced in immigration evaluations like A2Z Pediatrics.