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Rising demand for nursing staff and a falling supply of nurses has contributed to the largest nursing shortage the U.S. has ever experienced, and is expected to intensify through 2023.(i) According to the U.S. Bureau of Labor Statistics, the job growth rate for registered nurses through 2031 is 6%, which is as fast as the overall average for all occupations. However, the estimated growth rate for nurse practitioners (NPs) is 40%, which is much faster than average.(ii) Fortunately, there is a way for hospitals and health care providers to augment their staff with qualified nurses from abroad through a faster path to a Green Card than is available for other professions.

Typically, when a company sponsors a visa holder or someone outside the U.S. for a permanent role in their organization, they must usually go through three (3) different steps in the employment-based Green Card process and engage with both the U.S. Department of Labor (DOL) and the United States Citizenship and Immigration Services (USCIS). However, two occupations- Nurses and Physical Therapists- enjoy special attention and privileges from the DOL through an expedited form of Green Card processing, called “Schedule A”, found at 20 CFR 656.15.

The Schedule-A process is a “fast-pass” type of Green Card that allows an employer to bypass the DOL’s lengthy PERM or Labor Certification process (thereby saving 12-18 months of time), and make a direct filing with USCIS for a sought-after employee’s Green Card status. We have outlined some details of the process below, but please feel free to contact our firm for a consult if you or a potential employee in your organization may be eligible for this benefit.


To be eligible for a Schedule-A expedited Green Card, a Nurse or Physical Therapist candidate (hereinafter, “Beneficiary”), must have all of the following;

  • A full-time job offer from a U.S. employer;

  • Licensure as a Nurse or Physical Therapist in his or her home country;

  • English language proficiency as demonstrated through TOEFL or IELTS;

  • VisaScreen Certificate or FCCPT for Physical Therapists;

  • U.S. certification for the Schedule-A Profession (NCLEX(iii), sometimes CGFNS, etc.); and

  • Qualification for a State License in the U.S. State where the employee will be working.

While many Nurses and Physical Therapists are sponsored by U.S. employers from abroad (some never having lived or visited the U.S.), many others are sponsored under Schedule-A designation while they are here in the U.S. as F-1 students, or have already graduated and are working as Nurses or Physical Therapists in a temporary capacity under their Optional Practical Training (OPT) work authorization cards. Sponsorship under Schedule-A is possible regardless of whether the Beneficiary is already in the U.S. or abroad. If they are already in the U.S., however, it could lead to continuing work authorization without a break while the Green Card is pending by filing Form I-485 and supplemental applications.


1. Prevailing Wage Determination. In determining how long the process will take from start to finish, the first step in the Schedule-A sponsorship entails filing a Prevailing Wage request with the Department of Labor; this request can take anywhere from 3-6 months or more, depending on processing times. Once issued, a wage request will be valid for up to 180 days. Many organizations that sponsor Schedule-A petitions on a regular basis make sure to always have a valid wage determination on file so as to save many months’ worth of downtime. 2. Post Notice of Filing at Worksite. Once a wage determination is in hand, the next step involves the sponsoring employer posting a Notice in their workplace informing other employees of their intent to sponsor someone for this type of Green Card benefit.

3. File I-140 Immigrant Visa Petition. After this short posting period, the employer will then prepare an I-140 application. Within that filing, the employer will include information about the sponsoring company’s financial solvency; the Nurse or Physical Therapist’s education and credentials (NCLEX, IELTS, TOEFL, etc.); and details about the job offer.

Priority Date. The filing of the I-140 application will also provide the foreign Nurse or Physical Therapist with a “priority date.” This priority date becomes his or her place in line in the immigration queue or “backlog” if the country of birth is subject to a backlog based on supply and demand for U.S. visas for people born in their home country. a. If there is no backlog, the I-140 adjudication could take a few months (depending on processing times, and whether Premium Processing is used). b. If there is a backlog, the timing of the I-140 and subsequent step could take years depending on the specific country of birth. For example, China and India are notorious for years-long backlogs, so most foreign nurses come from countries with no backlog, like the Philippines or Ghana. c. However, if a Nurse or Physical Therapist (even one from China or India) is married to someone whose country of birth is not subject to a backlog, then the Nurse or Physical Therapist applicant can ‘borrow’ their spouse’s country of birth and move up in their Green Card queue under an immigration provision called “cross chargeability”.

4. Embassy/Consulate Interview. Once the I-140 has been approved and a visa number is available for the Nurse or Physical Therapist, the Beneficiary will receive a letter from the National Visa Center to schedule an interview with the U.S. Embassy or Consulate abroad; OR

5. File I-485 Application to Adjust Status. If the Beneficiary is already present in the US on a valid immigration status, he or she will will file an Adjustment of Status application with USCIS (I-485 application). Once the application is approved by USCIS or the US Embassy or Consulate, the Nurse or Physical Therapist will be granted a U.S. Green Card or Lawful Permanent Resident Status.

6. The last step will be for the Beneficiary to obtain a state license where the Beneficiary intends to work upon entry to the U.S.


Once a foreign Nurse or Physical Therapist is eligible to become a Lawful Permanent Resident, his or her immediate family members (spouse and minor children under the age of 21) will also be able to come to the U.S. as Green Card holders, thus furthering the goals of family unification through the employment-based system.


After 5 years as a Lawful Permanent Resident, the Beneficiary and his or her family members are eligible to apply for U.S. Citizenship. Once they become U.S. Citizens, they have the option of sponsoring their elderly parents or adult brothers and sisters from abroad under the family-sponsored immigration provisions.

V. NEXT STEPS To find out whether you qualify for the expedited Green Card process, click here to schedule a complimentary 15-minute consultation with The Grady Firm’s attorneys; call +1 (949) 798-6298; or fill out a Contact Request Form.

ENDNOTES i See, Morris, Gayle. "Nurses Predict Nursing and Healthcare Trends for 2023.” Published November 24, 2022 at https://nursejournal.org/articles/nursing-and-healthcare-trends-for-2023/ ii Id. iii The National Council Licensure Examination (NCLEX) is a test to determine if you can begin your practice as an entry-level nurse in the United States.

The Grady Firm works with dynamic employers and employees across the country to prepare successful employment-based visa and Green Card applications. In addition, we help individuals, families, employees, business owners, and investors obtain non-immigrant and immigrant visas (B-1/B2, H-1B, H-2B, L-1A, L-1B, O-1, TN, E-2, E-3), as well and Green Cards and citizenship based on family relationships, investment, or employment.

This article is for informational purposes only, and does not constitute legal advice or create an attorney-client relationship. This article does not make any guarantees as to the outcome of a particular matter, as each matter has its own set of circumstances and must be evaluated individually by a licensed attorney.


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