How Waivers Work

J-1 waivers by themselves do not allow foreign physicians to live and work in the United States.  They simply allow you to apply for a temporary work visa or permanent resident status without first returning to your home country for two years. J-1 physicians must obtain a work visa, in most cases, an H-1B visa in order to work for an employer.

J-1 Waiver Costs

In general, legal fees for J-1 waivers vary from $2,000 to $4,000, depending upon the expertise, experience, and location of the attorney.  Most government agencies do not charge applications fees except the Delta Regional Authority and some state Conrad 30 programs such as Texas, Ohio, and Oregon.  In most cases, either the employer or the physician can pay the fees. However, some states do require the employer to pay the waiver application fee.

Waiver Obligations

The hardship waiver and the persecution waiver are the most “liberating” of the waivers.  Physicians who obtain these waivers are not restricted in terms of employment.  Once these waivers are granted, the physician may work for any employer who wishes to sponsor a work visa for him (usually an H-1B visa) or immediately apply for a green card if married to a U.S. citizen.

By contrast, IGA waivers carry certain obligations that must be fulfilled in order to avoid losing the waiver.  In general, all IGA waivers require the foreign physician to begin work for the sponsoring facility within 90 days of the USCIS approval of the waiver and continue work for a total of three years.  After completing the three years, you are free to work in any location in the United States, provided you obtain the appropriate visa to do so.

Under USCIS regulations, foreign physicians who receive waivers under the Conrad 30 (State Health Agency request) program must work in H-1B status for the three-year contract period, with one exception: they may not complete the permanent residence process until they have completed the third year of the contract. Although there are no USCIS regulations that address other IGA waivers in this regard, the USCIS tends to apply these rules (H-1B status and three year bar on filing for permanent residence). Finally, many state Conrad 30 programs and the ARC, DRA, and HHS have periodic reporting requirements where the physician or sponsoring employer must report the status of employment and in some cases, the number of patients served by the physician.

In our next article we will discuss what happens in the event a foreign physician loses an IGA waiver, as well as alternatives to waivers.