Back to Blog
CitizenshipSan DiegoUpdated: January 1, 20269 min read

N-648 Medical Disability Waiver in San Diego: English & Civics Test Exemption

Citizenship test waivers for those with medical disabilities

SoCal Immigration Services
Reviewed by: Maria Santos, DOJ Accredited Representative

Quick Answer

For San Diego residents with medical conditions that prevent them from learning English or civics, the N-648 medical waiver offers a path to citizenship. Our Arabic-speaking team helps applicants understand and prepare for this important exemption.

Reviewed for accuracy by

Maria Santos

DOJ Accredited Representative • 15+ years experience

For San Diego residents with medical conditions that prevent them from learning English or civics, the N-648 medical waiver offers a path to citizenship. Our Arabic-speaking team helps applicants understand and prepare for this important exemption.

What is the N-648 Medical Waiver?

The N-648 is a medical certification form that allows naturalization applicants to be excused from the English and/or civics test requirements due to a physical or developmental disability or mental impairment.

This waiver recognizes that some applicants cannot learn English or U.S. history and government due to medical conditions beyond their control.

Who Qualifies for N-648?

To qualify for the N-648 medical waiver, you must have:
  • A physical or developmental disability or mental impairment
  • The condition must have lasted or is expected to last at least 12 months
  • The disability must directly prevent you from learning English and/or civics
  • The condition cannot be solely due to age or lack of education

Common Qualifying Conditions

  • Alzheimer's disease or dementia
  • Stroke with lasting cognitive effects
  • Traumatic brain injury
  • Intellectual disabilities
  • Severe mental health conditions (schizophrenia, severe PTSD)
  • Developmental disabilities
  • Hearing loss (for English requirement)
  • Severe learning disabilities

N-648 vs. Age-Based Exemptions

The N-648 is different from age-based exemptions:
Exemption TypeRequirementsWhat's Waived
50/20 Rule50+ years old, 20+ years as LPREnglish (civics in native language)
55/15 Rule55+ years old, 15+ years as LPREnglish (civics in native language)
65/20 Rule65+ years old, 20+ years as LPREnglish + simplified civics
N-648 WaiverMedical disabilityEnglish and/or civics entirely

Who Must Complete the N-648?

The N-648 must be completed by a licensed medical professional who has examined you. Acceptable medical professionals include:

• Medical Doctor (MD)
• Doctor of Osteopathy (DO)
• Clinical Psychologist
• Licensed Nurse Practitioner (in some states)

The doctor must explain how your condition prevents you from learning the required material.

What the Doctor Must Certify

  • Clinical diagnosis of your condition
  • How long the condition has lasted or will last
  • How the condition affects your ability to learn English
  • How the condition affects your ability to learn civics
  • Whether the disability prevents learning, not just makes it difficult
  • That the opinion is based on medical examination

Common Reasons N-648s Are Denied

  • Form not fully completed by the doctor
  • Doctor doesn't explain the connection between disability and inability to learn
  • Condition listed doesn't typically prevent learning
  • USCIS believes applicant could learn with accommodation
  • Doctor's credentials not properly documented
  • Form is older than 6 months at interview

Preparing for Your Interview

  1. 1
    Find a Qualified Doctor

    Choose a doctor who understands immigration medical requirements

  2. 2
    Complete Medical Evaluation

    Undergo thorough evaluation documenting your condition

  3. 3
    Review the N-648

    Ensure form is complete and clearly explains your limitations

  4. 4
    Gather Supporting Documents

    Collect medical records, test results, and treatment history

  5. 5
    Prepare for Questions

    USCIS may still ask basic questions about your condition

FAQFrequently Asked Questions

Q:How much does the N-648 cost?

A: There is no USCIS fee for the N-648 form itself. However, you will need to pay for the medical evaluation from your doctor, which varies by provider.

Q:Can PTSD from war trauma qualify?

A: Severe PTSD can qualify if it affects cognitive function and ability to learn. Many refugees from conflict areas like Syria, Iraq, and Yemen may qualify.

Q:What if my N-648 is denied?

A: If denied, you may need to take the tests or submit a new N-648 with better documentation. You can also appeal or request a new interview.

Q:Do I still need to attend the interview?

A: Yes, you must still attend the naturalization interview. The officer may ask questions about your application and verify your disability.

Q:Can I waive just English or just civics?

A: Yes, the N-648 can be used to waive English only, civics only, or both, depending on how your condition affects each ability.

Disclaimer: This article provides general information about immigration services in San Diego and does not constitute legal advice. SoCal Immigration Services is a document preparation company, not a law firm. For legal advice specific to your situation, please consult with a licensed immigration attorney.
Published: January 1, 2026Last Updated: January 1, 2026

Need N-648 Help in San Diego?

Our team helps applicants understand the N-648 process and prepare complete documentation for their citizenship applications.

Serving San Diego and all of Southern California

Related Articles

Customer Support

How can we help you today?