CAYDAM

Interim Decision 40815

MATTER OF CATDADI

In Deportation Proceedings

A-12681937

Decided by Board November 24, 1961

Where the subject alien was cm-tilled by U.D. Public Health Service medical

officers as afflicted with "Sexual Deviation—Class A" and the underlying

medical-psychiatric "examination" and "certification", as well as the appellate

procedure before the Board. of Medical Examiners, failed to comply with sub-

stantive procedures and regulatiune set forth in the "Manual for Medical

Examination of Aliens" and 42 CER 84 (initial examination not by 2 medi-

cal officers, no evidence . of independent medical examination by Board of

Medical Examiers and 'refusal by the Board to accept into evidence psychiatric

Mons Mend by the alien), bad.' Class A. certification is not binding on the

special inquiry officer on the question of the alien's inadmissibility under

section 212(a) (4) of the Immigration and Nationality Act, as a sex deviant,

in conjunction with an application for adjustment of status under section 245

of the Act, and the case .is remanded for a new and proper examination by

U.S.1'.H.S. medical authorities.

CHARGE :

Order: Act of 1952—Sectlon 241(a) (2) t8 U.S.C. 1201(a) (2) j—Nonimmigrant

visitor—remained longer.

ON Broils OF RESPONDENT: Sidney Bradpiece, Esquire

280 South Beverly Drive

Beverly Hills, California 90212

Respondent appeals from a decision of the special inquiry officer

finding him deportable as charged and ineligible for any form of relief

other than voluntary departure, which has been granted.

Respondent is a 23-year-old married male alien, native and citizen

of Turkey, who was admitted to the United States as a nonimmigrant

student on September 16, 1961. On February 19, 1965, he was married

to Jacqueline Jean Ray, a native born citizen of the United States,

and they have lived together since that time. Her petition for non-

quota status for him was filed on March 3, 1965, together with his

application for adjustment under section 245.

As part of the adjustment procedure, respondent presented himself

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Interim Dicisibn 4E1815

at the United States Public Health Service for examination in May,

1966. Thereafter, on a Form FS498, a report relating to respondent

was issued it was signed by D. A. St. Claire, M.D., Chief of Medicine,

dated May 27, 1966 and in the space left for notation of defect, disease

or disability, the following is typed in :

"Per Dr. Conrad class A—Sex deviant

his statement attached.".

Attached were two sheets of casually handwritten notes, in two differ-

ent handwritings, bearing the signature of S. J. Conrad at two points.

These two pages, together with repOrts of negative results on two

diagnostic medical tests, were attached to a pink printed sheet, num-

bered PHS 4854, indicating that the attached material was an original

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report, with no copies being retained by the Public Health Service.

These papers were received and stamped by the 'Immigration and

Naturalization Service on May 31, 1966. Thereafter, on October 10,

a Board of Medical Examiners, of the Public Health Servide, was

convened, and respondent, his counsel, and Dr. EdWin E. McNiel, a

psychiatrist, appeared before it. By an undated' communication,

labelled "REPORT OF BOARD OF MEDICAL EXAMINERS",

signed by the three doctors who had composed -the board and mailed

to the Immigration and Naturalization Service under date of October

18, 1966, the United States Public Health Service affirmed its earlier

holding that respondent was afflicted' -With "Sexual Deviation—

Class A)' • . . „ , .

On November 7, 1966; the District DirebtOr of the Immigration and

NaturalizatiOn Service; refethig to the proceedings before the Public

Health Service and the results thereof, advised respondent that his

application for adjustment to 'permanent resident status was denied,

for the reason that he was ineligible to receive a. vise and excludable

-

from admission under section 212(a) '(4) as an alien afflicted with

sexual deviation. Respondent was given 15 days froia the' date of the

letter in which to depart voluntarily from the United States.

Respondent remained in the United State s' beyond 'November ,22,

1966 and on February 23, 1967 an 'order to Show cause was' issued,

charging him with being deportable for overstay. IlearingS in the de-

portation proceedings were held on Maich -6 and March 23, 1967.

Respondent admitted the factual "allegations 'contained in the order

to show cause, but did not concede deporiability, and renewed his ap-

plication for adjustment under section 245. The special inquiry officer,

in his oral decision rendered at the close of the second hearing, recited

that respondent had been examined by a medical officer of the United

States Public health,ervice, with a resulting Class A. Medical Cer-

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Interim Decision #1815

tificate as a sex deviant; that on appeal the Board of Medical Ex-

aminers of the United States Public Health Service had affirmed the

Class A Medical Certificate; that the special inquiry officer, in eases

involving admission or adjustment was bound by the decision of the

Board of Medical Examiners and must base his findings upon their

certification (section 236(d), Immigration and Nationality Act) where

there had been compliance with the appropriate requirements (em-

phasis supplied) (citing U.S. ex rel. Johnson v. Shaughnessy, 336 U.S.

806) ; that inasmuch as it appeared there was such compliance in re-

spondent's case, the United States Public Health Service certificate

must be conclusive, and respondent must be found inadmissible under

section 212(a) (4). Since it followed that respondent must, therefore,

be ineligible for adjustment, the special inquiry officer granted volun-

tary departure as the only relief available, with an alternate order of

deportation to Turkey if respondent should fail to depart when and as

,;.equired.

In the situation we have before us, where the decision of the Public

Health Service when made is so binding that there is no appeal from

a denial of adjustment or admission based upon that decision, and

where not only the, alien, but an American citizen wife is affected,

the procedure promulgated by the Surgeon General of the United

States cannot be overlooked, or abridged for the sake of convenience.

From an examination of the record, we are not satisfied that either

the initial "sex deviant" classification, or its affirmance by the medical

board, was made in compliance with the regulations governing such

functions, or with the procedures prescribed by the Public Health

Service itself for the medical examination of aliens. Respondent, on

appeal, attacks not only the procedures used by the Public Health

.$ervice, but the type and sufficiency of evidence relied on in reaching

its conclusion. Mindful of the Congressional intent that the medical

judgment of Public Health Service officers in these situations is to be

conclusive, we address ourselves only to the propriety and sufficiency

of the procedures used by them in reaching their conclusion.

First, it is prescribed that a certification as to a Class A condition

must be issued on a specific form, PHS-124 (FQ), (Manual for Medical

Examination of Aliens, Public Health Service, 1963, hereinafter re-

ferred to as Manual, pp. 4-1, par. 1), and the original of that form is

to be turned over to the Immigration and Naturalization Service

(Manuakpp.; 2 12, par. 2. (5) ). No such form is in the file, nor was

-

it apparently ever filled out. While on its face, this failure to comply

with the rules would appear to be trivial, in actuality it resulted, from

the outset, in the denial of substantive right to respondent, for the

Class A Certificate (with exceptions not applicable here) :

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Interim Decision #1615

"shall be signed by at least two medical officers who have examined the alien.

* • *" (Manual, pp. 4-2, par. 3.b.) (Emphasis supplied.)

Respondent was seen by only one medical officer, and from the notes

appended by that medical officer to the report sent to the Immigration

and Naturalization Service, it cannot be ascertained whether he ac-

tually gave respondent a medical-psychiatric examination. Those notes

bear little resemblance to reports of psychiatric examinations we have

had before us in the past. Further, they do not contain the information

that the Manual specifies as necessary in records of examination : (pp.

2-19, par. 54)

"Examiners shall maintain records of all examinations. When mental conditions

are certified, the record shall contain a statement of the personal and antecedent

history of the individual as far as obtainable, a description of any physieal

abnormalities detected, and a detailed description of the mental signs and

symptoms * "" •

As to the Board of Medical Examiners which was convened, counsel

points out that the doctor who made the initial finding of sexual devi-

ation was not only a member of that board, but that he acted as Chair-

man as well. His is the first signature on the board's report, and he

apparently made the only record of its proceedings (see handwritten

notes above referred to, part of Ex. 3, and entry after date 10/10/66).

That his presence on the board is recognized by the Public Health

Service as an undesirable practice is shown by the following instruc-

tion in the Manual (pp. 2-15, par. 44.d.)

"All practical effort shall be made to mid haying a medical board include in

ite tnemberghip an individual who has previously rendered a decision in the

same case."

It is difficult to believe that another qualified medical officer was not

available, in an area where medical boards may be convened whenever

required (Manual, pp. 2-14, par. 44a.(1) ), and where, therefore, suf-

ficent facilities and personnel for them are presumably on hand at all

times.

As for the procedure to be followed by the medical board, Title 42

CFR, section 34.14, in defining the scope of reexamination by the

board, states:

"(c) Reexamination shall include :

(1) A medical examination by the board. If the mental condition of the

alien is in question and the board does not include at least one officer who has

had special training in the diagnosis of mental defects, diseases and disabilities,

the board shall designate a physician with such training who shall (gee examine

the alien, and his report shall be included in the record." (Emphasis supplied.)

That this medical examination was intended to be something more

than a mere scrutiny of the alien while testimony was being given be-

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Interim Decision #1815

fore the board is made even clearer by a provision of the Manual which

states:

"* • • The alien's counsel shall not be permitted to be present during the board's

independent medical examination • • •." (pp. 2-16, par. 46, last sentence.)

Although the board's report implies that it did make a medical exami-

nation of respondent (see par. 8 of the Report), counsel, who was pres-

ent with the respondent throughout the proceedings, insists there was

no examination of the type required by the regulations. (See respond-

ent's Brief, p. 10.) The file contains no record of an examination, in

accordance with the requirements set forth in the Manual (pp. 2-19,

par. 51) ; there is no statement in the medical board's report as to

when and where the board examined the respondent (as required by

par. V, pp. 2-16, Manual); and the only record of the proceedings,

the handwritten notes referred to above, makes just the following

reference to respondent's participation on October 10, 1966:

"Pt. comes in with atty Sidney Bradpiece. Dr. Edwin E. Me Neil. They deny the

police report . .", etc.

From the above mentioned material, and counsel's statements, it does

not appear that respondent was afforded the independent medical re-

examination which is one of the basic reasons for the convening of

the board.

Counsel claims further error and unfairness in the board's proceed-

ings. Xe states that reports of a psychiatrist and psychologist who

examined the respondent and conclUded that he was not a sexual

deviant were offered in evidence bit were refused by the board and

returned to counsel. (Copies of these reports are in this record as

Exhibit 4.) One of them was a report made by the psychiatrist who

appeared before the board on respondent's behalf. Title 42 CFR, sec-

tion 34.14(e) provides that witnesses before the board shall be given

a reasonable opportunity to all relevant and material evidence,

orally or in writing, and section 34.14 (g) provides that the findings of

the board are to. be hazed on its medical examination of the alien and

on the evidence presented and made a part of the record of its proceed-

ings. That the clalined Material was presented is confirmed by the

October 10, 1966 entry in the handwritten record of the proceedings

referred to above.

Both. 42 CFR 34 and the - Manua/ require that the board's report

give both findings and conclusions. The Mammal, at pages 2-16, para-

graph 47, gives in detail the material that the report should contain,

followed by a • sp'ecinien report. The report in this file contains vir-

tually none of the specified information; it does not show when and

where the respondent was medically examined; it does not indicate

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Interim Decision #1815

the nature of all records submitted, or identify the witnesses heard,

or give the nature of the testimony and evidence; it does not give the

facts on which its finding is based. It merely lists, in vague terms, the

records it reviewed, and then states that on the basis of that evidence

and of its medical examination of respondent, it concludes that he

has: Sexual Deviation—Class A, and the earlier medical certificate is

affirmed.

It is apparent that the regulations and Mama procedures were

given only token recognition, or honored. in the breach, and that re-

spondent did not receive the type of hearing and examination con-

templated. The medical board's finding of the existence of a Class A

condition was not based on its own independent medical-psychiatric

examination, for it did not make one. It did not carefully consider an

of the evidence presented, because it refused to accept and make a part

of the record the reports of a psychiatrist and psychologist who had ex-

amined and tested respondent, which reports were offered by re-

spondent as evidence of his normality. There is no way of knowing

why it reached the decision it did, because its report contains abso-

lutely no findings.

In a situation in which the sufficiency of a Public Health Service

Class A finding was attacked in the courts, in U.S. ere rel. Johnson v.

Shaughnessy, supra, the Supreme Court held that a certificate of a

Class A condition, made by a medical board of review without full

compliance with the applicable regulations and procedures, which

denied the alien the independent review and reexamination which

Congress and the Surgeon General had prescribed, was not binding

on the question of medical admissibility, and remanded the case with

the order that the petitioner be afforded a proper hearing and medical

examination before the appropriate public health authorities.

Here, not only the appellate procedure before the medical board,

but the underlying "examination" and "certification" failed to comply

with the prescribed steps and standards. We hold that because of these

serious omissions and failure to comply with the regulations and pro-

cedures, the Class A. finding in this case is invalid and is not binding

in these proceedings. Therefore, the conclusion of the special inquiry

officer that respondent must be found inadmissible and ineligible for

adjustment on the basis thereof, will not be affirmed. However, as

neither the special inquiry officer nor this Board has the expertise

or the authority to make a determination on respondent's medical ad-

missibility or inadmissibility in these proceedings, we will remand this

case with the direction that respondent be afforded the opportunity

for a new and proper. medical examination , conducted in accordance

with the standards set forth therefor by the Surgeon General of the

533

Interim Decision *1815

United States; and that upon receipt of the results of such examina-

tion, the special inquiry officer shall make a new determination on

respondent's eligibility and application for adjustment of status, and

any or all such other findings and orders as may be proper and neces-

sary at that time.

ORDER: It is ordered that this matter be and the same is hereby

remanded for the purposes se•fortb. above.

It is further ordered that the decision of the special inquiry officer,

made after the above proceedings, shall be certified to this Board for

final review.

534