1. H. Ronald Klasko, Esq. Klasko, Rulon, Stock & Seltzer, LLP Philadelphia New York 1800 John F. Kennedy Blvd., 17 th Floor317 Madison Ave., Suite 1518 Philadelphia, PA 19103 New York, NY 10017 215.825.8600 212.796.8840 rklasko@klaskolaw.com www.klaskolaw.com Permanent Residence and Waiver Options for Clinicians and Researchers

2. Klasko, Rulon, Stock & Seltzer, LLP Ron Klasko is the Managing Partner of Klasko, Rulon, Stock & Seltzer, LLP. Ron and his firm were chosen by clients and peers as one of the top five immigration firms in the country for five consecutive years and “the strongest in the country in representing clients in the university research and medical sectors.” (Chambers Global) Ron is a former National President of the American Immigration Lawyers Association. He has been a featured invited speaker for the American Association of Medical Colleges (AAMC) and the Educational Commission for Foreign Medical Graduates (ECFMG). He has been Adjunct Professor of Immigration Law at Villanova University Law School and is a frequent author and lecturer on immigration law issues related to academic healthcare institutions. Ron is selected annually for inclusion in Best Lawyers in America. Mr. Klasko is the founder and co-chair of NAFSA’s Healthcare Interest Group. His practice emphasizes representation of universities, hospitals and research institutions and their students, scholars, staff and employees. H. Ronald Klasko, Esq.

3. Klasko, Rulon, Stock & Seltzer, LLP J-1 Waiver Options No objection statement Exceptional hardship Persecution Interested government agency

4. Klasko, Rulon, Stock & Seltzer, LLP No Objection Statement Researchers only Usually not helpful if U.S. or international organization funding Quickest and easiest waiver Attitudes of different countries

5. Klasko, Rulon, Stock & Seltzer, LLP Exceptional Hardship Waiver Hardship to U.S. citizen or LPR spouse or child Hardship must be “exceptional” Very difficult

6. Klasko, Rulon, Stock & Seltzer, LLP Persecution Waiver Individualized persecution Similar to asylum

7. Klasko, Rulon, Stock & Seltzer, LLP Interested Government Agency Waivers General  Choosing between research track and clinical track  Research track Usually through HHS Peer review process – unlike CIS filings Do not need 3 years in H-1B?

8. Klasko, Rulon, Stock & Seltzer, LLP HHS Waivers Key Issues  Importance of research program Does not have to be NIH funded  Essentiality and uniqueness of foreign national Recruitment (unavailability of U.S. researchers)  Future of program and future of foreign national  Bench research (at least 30 hours per week) vs. clinical research  Excellence of foreign national’s research

9. Klasko, Rulon, Stock & Seltzer, LLP Obtaining a J-1 Waiver Clinical Track  Choosing state vs. federal agency  Choosing between states  Cannot file more than one  HPSA or MUA or FLEX 10 or V.A.  Must be 3 years in H-1B “Extraordinary circumstances” to change employers

10. Klasko, Rulon, Stock & Seltzer, LLP Obtaining a J-1 Waiver Timing issues  Vary by state  Vary by federal agency  3 steps  When to start  Options if J-1 expiring O-1 J-1 extension? Leave U.S. (cont’d)

11. Klasko, Rulon, Stock & Seltzer, LLP Conrad 30 Waivers Must be HPSA or MUA  Except FLEX 10 Agree to begin employment within 90 days of receiving waiver  Can delay if still in training program  Can expedite by filing H-1B before CIS approves waiver

12. Klasko, Rulon, Stock & Seltzer, LLP Conrad 30 Waivers Differences between states  Timing  Recruitment required  When/how choose 30?  Primary care? Specialty? Subspecialty?  Use of FLEX 10 (cont’d)

13. Klasko, Rulon, Stock & Seltzer, LLP Federal Government Agency Waivers Issues in common  40 hours in HPSA or MUA Except VA  Primary care General practice, family practice, internal medicine, psychiatry, pediatrics, OBGYN Except VA and DRA

14. Klasko, Rulon, Stock & Seltzer, LLP Federal Government Agency Waivers  Recruitment  Facility must provide medical care to Medicaid/Medicare-eligible and indigent uninsured patients  No non-compete clauses (cont’d)

15. Klasko, Rulon, Stock & Seltzer, LLP Federal Government Agency Waivers V.A. Waivers  3 levels of approvals  National and internal recruitment  At least 5/8 appointment  O-1 must wait 2 years (cont’d)

16. Klasko, Rulon, Stock & Seltzer, LLP Federal Government Agency Waivers Appalachian Regional Commission Waivers  Rural counties in 13 states  File with state Need state concurrence Some states will transfer Conrad 30 to A.R.C. Some states do not allow specialty training  Recruitment within last 6 months  Cannot be out of status more than 6 months  HPSA only (cont’d)

17. Klasko, Rulon, Stock & Seltzer, LLP Delta Regional Authority Waivers Part of 8 states HPSA or MUA No limitation to primary care Specialty training allowed Recruitment for 60 days, including national Site surveys every 6 months

18. Klasko, Rulon, Stock & Seltzer, LLP HHS Waivers HPSA of 7 or higher Need state DOH support letter Must file within 12 months of completion of primary care residency Limited to rural health clinics, certain native American facilities and HRSA-grant health centers Very long process – not user friendly

19. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Family Investment Asylum Lottery Employment

20. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Employer-sponsored or self-sponsored Labor certification or extraordinary/national interest/exceptional Multiple petitions

21. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Quotas  Visa Bulletin (www.travel.state.gov)www.travel.state.gov  Per country of birth, per preference category, per fiscal year  Filing date is “priority date”  EB-1 (extraordinary ability, outstanding researcher) No quota wait (cont’d)

22. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Quotas  EB-2 National interest waiver Labor certification requiring  Masters degree  Bachelors degree plus 5 years progressive experience, or  Exceptional ability No quota wait, except China and India  EB-3 Labor certification requiring bachelors or 2 years experience Long quota wait for all countries (cont’d)

23. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Self-Sponsored  Extraordinary ability EB-1 Standard  National or international reputation  “One of few at the top of peers”  Key is defining field of expertise specifically Extensive documentation required Reference letters critical (cont’d)

24. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment  National Interest Waiver EB-2 Standard  Exceptional ability or advanced degree  National priority  National impact Extensive documentation required Reference letters critical (cont’d)

25. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Employer-Sponsored  Outstanding Researcher EB-1 “Permanent position” Similar to extraordinary ability (cont’d)

26. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Evaluating Eligibility CV Evaluation  1 st listed author publications In process; submitted; accepted; published; cited  Impact factor?  Citations Footnote Text  Presentations 1 st listed abstracts Oral vs. poster (cont’d)  Book chapters  Honors and awards  Manuscript reviewer  Media  Memberships  Patents

27. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Evaluating Eligibility Evaluation Outside of CV  Importance/narrowness of field of expertise  Ability to explain importance  Significant contributions to field First, only, best, new discovery? Impact on field and other researchers New? Old? Sustained?  Referees (cont’d)

28. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Choosing Referees  How many?  Good C.V.’s  Prestigious institutions  Geographical diversity One per institution  Impartiality (cont’d)

29. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Other Factors  Not a peer review process  Importance of job title?  Importance of employer sponsorship?  File now, or wait?  Choice of attorney; role of attorney (cont’d)

30. Klasko, Rulon, Stock & Seltzer, LLP EB-1 for Clinicians General  Why more difficult than researchers  Can be done for residents?  Still need waiver for I-485

31. Klasko, Rulon, Stock & Seltzer, LLP EB-1 for Clinicians How prove extraordinary ability as a clinician?  Rare expertise in sophisticated procedures or technologies  Complicated diagnoses missed by other specialists  Unusual success rate  Novelty of procedures  “Wow” cases  Prestige of institution (cont’d)

32. Klasko, Rulon, Stock & Seltzer, LLP EB-1 for Clinicians  Difficult surgical procedures  Prestigious fellowships  Significance of Board certification or “Diplomate”  Judge of medical students, residents, or nurses  Grand round presentations  High salary (cont’d)

33. Klasko, Rulon, Stock & Seltzer, LLP Special Handling Labor Certification (PERM) Employer-sponsored Must be “some classroom teaching” Nationwide competitive recruitment  At least one print ad “Selected” within last 18 months EB-2

34. Klasko, Rulon, Stock & Seltzer, LLP Can apply to attendings and other clinicians if “some classroom teaching”  Can be very small percentage  Can be teaching of residents in a classroom Choice if selection more than 18 months ago  “Reselection” One national print ad  Regular recruitment Most qualified standard still applies Special Handling Labor Certification (PERM) (cont’d)

35. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Labor Certification Application (PERM)  Employer Sponsored  Recruitment  Prevailing wage  Legal issues  Timing  First of 3 steps (cont’d)

36. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Timing  Electronic filing  Possibility of audit  First of three steps  Importance of filing before end of 5 th year in H-1B status (cont’d)

37. Klasko, Rulon, Stock & Seltzer, LLP Clinical National Interest Waivers Credentialing examination required except graduates of US medical school or non-clinical medical practice Available for physicians working full time in HPSA or MUA or for a VA facility for a minimum of five years  Can switch locations  Can count time before filing, but not J time before H-1B Can be specialist

38. Klasko, Rulon, Stock & Seltzer, LLP Clinical National Interest Waivers Physicians can apply for permanent residence (when EB-2 available) before completing five years, but cannot be approved until completion Requires letter from state or federal agency attesting that the physician’s work furthers the public interest (cont’d)

39. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment I-140 Petition  1 st step for EB-1 and national interest waiver  2 nd step for PERM Employee documents education and experience  If adjustment of status, file concurrently with I-485 if quota current  If consular immigrant visa processing, approval sent to National Visa Center (cont’d)

40. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment I-485 (Application for Adjustment of Status to Permanent Resident)  Cannot file until quota is current  Importance of filing Do not need to maintain visa status Can file for spouse and child Can get Employment Authorization Document (EAD) (cont’d)

41. Klasko, Rulon, Stock & Seltzer, LLP Permanent Resident Status Employment Can get advance parole travel document  Eliminate need to obtain visas  Can still maintain and extend H-1B status Can leave employer if  I-140 approved  I-485 pending 180 days  Similar occupation Permanent resident upon approval Timing and delay issues (cont’d)

42. Klasko, Rulon, Stock & Seltzer, LLP Questions?

43. For Further Information H. Ronald Klasko, Esq. Klasko, Rulon, Stock & Seltzer, LLP E-mail: rklasko@klaskolaw.com Telephone: 215-825-8600 (Philadelphia) 212-796-8840 (New York) Websites: www.klaskolaw.com www.eb1immigration.com www.worksite-compliance.com www.eb5immigration.com Blog: http://blog.klaskolaw.com