What is an Interested Government Agency (IGA) J-1 Waiver?
For foreign medical graduates (FMGs), the Interested Government Agency (IGA) J-1 Waiver is a critical pathway to avoiding the two-year home residency requirement and continuing your career in the United States.
An IGA waiver is granted when a U.S. federal agency sponsors your application, asserting that your work is vital to one of its projects or serves the public interest. This guide provides an updated, step-by-step overview of the requirements, application process, and key programs available to physicians.
Requirements for the Physician J-1 Waiver
A sponsoring Interested Government Agency (IGA) is a U.S. federal agency that asserts your work is in the public interest. An agency may qualify as your sponsor even if it only provides funding for your project. For example, if your cardiology program receives funds from the Department of Health and Human Services, HHS might qualify as your IGA.
Alternatively, if you work in a Veterans Affairs hospital, the U.S. Department of Veterans Affairs (VA) can be your sponsoring agency, and in that specific case, you do not need to work in a medically underserved area.
For all other IGA physician waivers, you must meet the following core requirements:
- Have an offer for a full-time position (at least 40 hours per week) with a healthcare facility.
- Be willing to work in a facility located in a federally designated Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP).
- Agree to begin employment within 90 days of receiving the waiver approval.
- Commit to working at the designated facility for a minimum of three years.
It is a common misconception that a “no objection” statement from your home country is required for this waiver type. For foreign medical graduates, this is not the case.
A “medically underserved area” is defined as having a shortage of health care professionals. These areas also include mental health professional shortage areas, medically underserved areas or populations, and physician scarcity areas.
The J-1 Waiver Application Process: A Step-by-Step Guide
If the physician qualifies under these requirements, he/she can then be eligible for sponsorship from an Interested Government Agency (IGA).
Step 1: Secure a Qualifying Job Offer
Your first and most important step is to obtain a full-time employment offer from a healthcare facility located in a qualifying underserved area. This employer will be your partner in securing the sponsorship of an IGA.
Step 2: Complete the Online J-1 Waiver Application (Form DS-3035)
You must fill out the J-1 Waiver Recommendation Application, Form DS-3035, on the Department of State’s online portal. After you submit the form electronically, you must print the completed application and the unique barcode page.
Step 3: Mail Your Application Packet
The application process requires documents sent by you and documents sent directly by your sponsoring agency or employer. It is your responsibility to ensure that third parties send all required supporting documents. The Waiver Review Division will not follow up on missing items.
Part A: Documents You Must Mail
You must mail the following items:
- The printed DS-3035 application form with the barcode page.
- The non-refundable application fee of $120. Always verify the current fee on the Department of State’s fee schedule.
- Two self-addressed, stamped envelopes.
- Copy of the data page in your current passport with name and birth date.
To one of the following addresses:
Postal Service
Department of State J-1 Waiver
P.O. Box 979037
St. Louis, MO 63197-9000
Courier Service
Department of State J-1 Waiver
Attn: 979037
3180 Rider Trail South
Earth City, MO 63045
Part B: Supporting Documents Sent by Sponsor
Your sponsoring government agency or employer must email the following supporting documents as PDF attachments directly to the Department of State at [email protected]. These documents cannot be submitted by you:
- Copies of all DS-2019 /IAP-66 forms issued to you.
- Your curriculum vitae (CV).
- A signed personal statement from you with the following exact text: “I, __________ (your name) hereby declare and certify, under penalty of the provisions of 18USC.1001, that: (1) I have sought or obtained the cooperation of_______ (enter name of U.S. Government agency which will submit/is submitting an Interested Government Agency Waiver request on your behalf to obtain a waiver of the two-year home-country physical presence requirement); and (2) I do not now have pending nor will I submit another request to any U.S. Government department or agency or its equivalent, to act on my behalf in any matter relating to a waiver of my two-year home residence requirement.”
- A letter from the head of the sponsoring agency (or a designee) explaining why granting the waiver is in the public interest.
- A signed employment contract for no less than three years and 40 hours per week.
- Evidence that the facility is in a designated HPSA or MUA.
- A statement signed by the head of the facility confirming its location in a shortage area, that it provides care to both Medicare/Medicaid and uninsured patients, and includes the relevant federal location codes (FIPS county code, census tract, or 9-digit zip code).
- Evidence of unsuccessful recruitment efforts to hire a U.S. citizen physician.
- Form G-28 if an attorney is representing you.
Step 4: Track Your Application Status
You can check if supporting documents have been received and view your overall case status on the J-1 Visa Waiver Online webpage. Note that it can take 3-4 weeks for updates to appear online. To check your application status, you will go to the J-1 Visa Waiver Online webpage and click on “Check the status.” Then enter your application case number. The system will let you know if the Department received your application and supporting documents. You will also know if any document is missing.
In some cases, the Waiver Review Division may need additional information from you.
In addition, if you change your address, email address, or phone number after submitting the application, you can update the new information on the webpage. To do this, you can click on “Inform the Department of State of a change to personal data.”
The Waiver Review Division may request additional information and documents. The Division will contact the physician using the information provided in the application (Form DS-3035). If the physician wishes to request information or submit missing documents, all items should be sent to:
Key IGA Programs for Physicians
When it comes to J-1 waiver sponsorship, any U.S. federal government agency can act as an IGA. However, for FMG sponsorship, some agencies have been more involved. They include the:
- Department of Health and Human Services (HHS)
- Department of Veterans Affairs (VA)
- Appalachian Regional Commission (ARC)
- and the United States Department of Agriculture (USDA).
- In some cases, a state health department may also act as an IGA. This is known as the Conrad Program.
Any of the IGAs may request a waiver on your behalf by showing that your two-year absence from the U.S. would be detrimental to a certain activity of significant health importance or of official interest to the agency.
HHS J-1 Waiver program
The HHS is responsible for managing the J-1 visitor program as it relates to health research and clinical care. This explains why the HHS exchange visitor program accepts applications to request a J-1 waiver related to the following two types of work:
- Research performed in an area of significant or priority interest to the HHS
- Health care services in a Health Professional Shortage Area (HPSA) in the U.S. As a J-1 physician, you must agree to provide health care services for three years in a primary health or mental health care HPSA.
The HHS has different waiver requirements for each of the above programs. To apply under the research category, see the Research Waiver Request, Supplement A. And to get a waiver under the clinical care category, see Clinical Care Waiver Request Requirements, Supplement B.
After submitting your application, the HHS will evaluate it and determine if the proposed research program or healthcare services have met the requirements of essential and quality participation. If yes, the HHS will submit its recommendation to approve the request to the Department of State.
Appalachian Regional Commission J-1 Waiver Program
The Appalachian Regional Commission (ARC) is committed to helping residents in the region have access to affordable, quality health care. The commission is a joint federal-state entity, established by Congress in 1965. The ARC is made up of all of West Virginia and parts of Alabama, Kentucky, Georgia, Maryland, South Carolina, New York, North Carolina, Mississippi, Ohio, Pennsylvania, Tennessee, and Virginia.
Your request for a waiver through the ARC must be sponsored by any of the above states. You will have to contact the designated official in the state where you intend to practice to know the required process. This webpage contains the contact information of all ARC states J-1 visa waiver program.
Delta Regional Authority J-1 Waiver Program
There are 240 county or parish areas under Delta Regional Authority in these states: Alabama, Kentucky, Arkansas, Louisiana, Illinois, Mississippi, Missouri, and Tennessee. You must agree to provide full-time primary health care services within the DRA region for at least three years. You will also need to follow all the DRA J-1 waiver program application guidelines and pay the required application processing fee. The DRA program has a liquidated damages clause that you must complete and sign. According to the clause, you must also agree to pay $250,000 to the sponsoring facility if you fail to fulfill any part of your own commitment to the employment contract or pay $6,945 per month for each month you fail to fulfill your requirement.
Conrad State J-1 Waiver Program
The Conrad waiver program for states is similar to that of an IGA. However, the application requirements and program administration vary by state. Under the program, participating states are allowed to sponsor 30 J-1 waiver applications for foreign primary care physicians annually.
To apply for a waiver under Conrad, you must fulfill both the general licensing requirements for physicians in the U.S. as well as the state-specific licensing in the state where you will practice. Your waiver request application must be sponsored by the state where you agree to practice medicine in a designated shortage area for a period of three to four years. You will have to contact the state department to know the required process.
Department of Veterans Affairs (VA)
The VA can sponsor physicians to work in its hospitals.
- VA hospitals do not need to be in a medically underserved area.
- A signed memorandum of agreement is submitted instead of a three-year contract.
Processing Time for J-1 IGA Waiver
The average processing time for a J-1 waiver for physicians based on a request from an IGA is six months, although there may be discrepancies from case to case.
Keep in mind that you will most likely not be permitted to self-petition for your IGA waiver. This means that you will need to get the approval and support from your manager and often a director or executive. These individuals, acting as your employer, will likely need to sign the application for the IGA and give the USCIS information about your work and the program that sponsored you for your J-1 visa.
Other J-1 Waiver Options for Foreign Physicians
Apart from requests through IGAs and state health departments, J-1 physicians may also explore other bases for a waiver. In all, there are five bases through which you can apply for a J-1 waiver, according to the Department of State. The other three bases are:
- No Objection Statement
- Exceptional Hardship to a U.S. citizen or lawful permanent resident spouse or child of a J-1 holder
- Persecution
If your application is denied on one basis, you may reapply under another basis if you think you qualify.
Learn all about J-1 visa and taxes
How VisaNation Law Group Immigration Lawyers Can Help
Getting around the J-1 visa home residency requirement is no easy task. Doing it alone can only increase the probability that your application will be denied. The best way to make sure that you are prepared for any issues or unforeseen obstacles is to have a qualified J-1 visa attorney in your corner.
VisaNation Law Group’s dedicated team of attorneys will take care of everything from filling out your application to helping you collect letters of recommendation and other supporting documents. We’ll also help you determine what qualifies as a medically underserved area so you can be sure that your case is rock solid.
To get in touch with a VisaNation Law Group immigration attorney, just fill out this simple contact form and schedule your consultation with our office today.