dismissed EB-2 NIW Case: Healthcare

U.S. Citizenship 
and Immigration 
Services 
Non-Precedent Decision of the
Administrative Appeals Office 
Date: MAR. 03, 2025 In Re: 37172763 
Appeal of Texas Service Center Decision 
Form 1-140, Immigrant Petition for Alien Workers (National Interest Waiver) 
The Petitioner seeks employment-based second preference (EB-2) immigrant classification as either a 
member of the professions holding an advanced degree or an individual of exceptional ability, as well 
as a national interest waiver of the job offer requirement attached to this classification. See 
Immigration and Nationality Act (the Act) section 203(b )(2), 8 U.S.C. § 1153(b )(2). 
The Director of the Texas Service Center denied the petition, concluding that the record did not 
establish the Petitioner's eligibility for the requested national interest waiver. The matter is now before 
us on appeal pursuant to 8 C.F.R. § 103.3. 
The Petitioner bears the burden of proof to demonstrate eligibility by a preponderance of the evidence. 
Matter ofChawathe, 25 I&N Dec. 369, 375-76 (AAO 2010). We review the questions in this matter 
de novo. Matter of Christa's, Inc., 26 I&N Dec. 537,537 n.2 (AAO 2015). Upon de novo review, 
we will dismiss the appeal. 
I. LAW 
To qualify for the underlying EB-2 visa classification, a petitioner must establish they are an advanced 
degree professional or an individual of exceptional ability in the sciences, arts, or business. Section 
203(b )(2)(A) of the Act. 
An advanced degree is any U.S. academic or professional degree or a foreign equivalent degree above 
that of a bachelor's degree. 8 C.F.R. § 204.5(K)(2). A U.S. bachelor's degree or foreign equivalent 
degree followed by five years of progressive experience in the specialty is the equivalent of a master's 
degree. Id. 
If a petitioner establishes eligibility for the underlying EB-2 classification, they must then demonstrate 
that they merit a discretionary waiver of the job offer requirement "in the national interest." 
Section 203(b )(2)(B)(i) of the Act. Matter ofDhanasar, 26 l&N Dec. 884, 889 (AAO 2016), provides 
the framework for adjudicating national interest waiver petitions. Dhanasar states that U.S . 
Citizenship and Immigration Services (USCIS) may, as matter of discretion, 1 grant a national interest 
waiver if the petitioner demonstrates that: 
• The proposed endeavor has both substantial merit and national importance; 
• The individual is well-positioned to advance their proposed endeavor; and 
• On balance, waiving the job offer requirement would benefit the United States. 
Id. 
II. ANALYSIS 
The Director determined that the Petitioner qualified for the underlying EB-2 classification as an 
advanced degree professional, but did not establish eligibility for a national interest waiver under the 
Dhanasar framework. For the reasons set forth below, we agree that the Petitioner has not established 
eligibility for a national interest wavier, and will dismiss the appeal. 
The first prong, substantial merit and national importance, focuses on the specific endeavor that the 
individual proposes to undertake. Matter of Dhanasar, 26 I&N Dec. at 889. The endeavor's merit 
may be demonstrated in a range of areas such as business, entrepreneurialism, science, technology, 
culture, health, or education. Id. In determining whether the proposed endeavor has national 
importance, we consider its potential prospective impact. Id. 
The record reflects that the Petitioner has experience working as a clinical nurse specialist abroad and 
most recently as a caregiver within a senior living facility in the United States. The Petitioner intends 
to operate a home health care services company, ___________ to provide 
individualized care to various patients, including seniors, pregnant women, adults, and children. She 
asserts that her company would be positioned to offer a personalized approach to fit each patient's 
needs, health conditions, and preferences in a home setting. In addition, she claims she will offer 
physical therapy, occupational therapy, and speech therapy. And she also asserted that her company 
would provide continuous training and education to its staff and patients to ensure they follow industry 
best practices. Some of the specific health care offerings will include assistance with childbirth and 
postpartum care as well as health monitoring and medication administration for elderly individuals. 
Accordingly, by responding to the aging population and accompanying healthcare needs, the Petitioner 
asserted that her company would address a critical and growing need in the healthcare market. In 
addition to medical care, the company will also assist with day-to-day activities, including maintaining 
personal hygiene, clothing, and recreational activities, as well as emotional support services. And the 
company also intends to offer specialized training to nursing homes and assisted living facilities. 
In support of the endeavor, the Petitioner initially submitted a five-year business plan, which included 
a summary of the company's services, a market analysis, and five-year employment and financial 
projections. In addition to the business plan, the Petitioner submitted letters of recommendation, an 
expert opinion letter, and articles discussing the nursing field and shortage of nurses in the United 
States, as well as articles providing an overview of the home health care field and current trends within 
1 See Flores v. Garland, 72 F.4th 85, 88 (5th Cir. 2023) (joining the Third, Ninth, Eleventh, and D.C. Circuit Courts of 
Appeals in concluding that USCIS' decision to grant or deny a national interest waiver is discretionary in nature). 
2 
the field. She also provided articles discussing the impact of immigrant entrepreneurs on the U.S. 
economy. In response to the Director's request for evidence (RFE), the Petitioner submitted a revised 
five-year business plan for her company along with additional articles discussing the home health care 
industry and immigrant entrepreneurs. 2 
Upon review, the Director concluded that, while the Petitioner established the substantial merit of her 
endeavor, the record did not demonstrate its national importance because the prospective impact of 
her endeavor would not sufficiently extend beyond her patients to lead to broader implications within 
the industry or field. Moreover, the Director concluded the Petitioner did not establish that her 
endeavor has significant potential to employ U.S. workers or otherwise result in substantial positive 
economic effects as contemplated in Dhanasar. 
On appeal, the Petitioner generally disagrees with the Director's conclusions, asserting that the 
Director did not adequately consider the national importance of her proposed endeavor, and incorrectly 
concluded that the benefits of her endeavor would be limited to her prospective patients, "overlooking 
the critical and growing role that the home care industry plays in the United States' broader healthcare 
system." Notably, however, beyond generally disagreeing with the Director's conclusions, the 
Petitioner does not identify a legal error in the Director's decision. And, instead of addressing the 
Director's specific conclusions regarding the limited impact of her endeavor, she continues to reiterate 
the same claims previously made before the Director by relying primarily on the importance of the 
field. The reason for filing an appeal is to provide an affected party with the means to remedy what 
they perceive as an erroneous conclusion of law or statement of fact within the unfavorable decision. 
See 8 C.F.R. § 103.3(a)(l)(v). By presenting only general disagreement with the Director's 
conclusions, without identifying a specific erroneous conclusion of law or statement of fact, the 
Petitioner has failed to sufficiently identify a basis for her appeal. See Matter of Valencia, 19 I&N 
Dec 354, 354-55 (BIA 1986). Nevertheless, we have reviewed the record in its entirety, and for the 
reasons discussed below, we conclude that the Petitioner has not established her eligibility for a 
national interest waiver. 
The standard of proof in this proceeding is preponderance of the evidence, meaning that a petitioner 
must show that what is claimed is "more likely than not" or "probably" true. Matter of Chawathe, 25 
I&N Dec. at 375-76. To determine whether a petitioner has met the burden under the preponderance 
standard, we consider not only the quantity, but also the quality (including relevance, probative value, 
and credibility) of the evidence. Id.; Matter ofE-M-, 20 I&N Dec. 77, 79-80 (Comm'r 1989). Upon 
de novo review of the record, we conclude the record establishes the substantial merit of the 
Petitioner's endeavor, but does not demonstrate, by a preponderance of the evidence, that the 
Petitioner's proposed endeavor of operating a home health services company has national importance 
as contemplated under the Dhanasar analytical framework. 
The Petitioner dedicates a significant portion of her appellate brief discussing the importance of the 
clinical nurse specialist role within the U.S. healthcare industry, and the vital role nurses play in the 
U.S. healthcare industry relating to patient care, preventative care, and post-surgical care. And the 
Petitioner discussed several statistics and data related to the benefits and impact of the home health 
2 While we do not discuss each piece of evidence contained in the record individually, we have reviewed and considered 
each one. 
3 
care field. Yet, in Dhanasar, we said that, in determining national importance, the relevant question 
is not the importance of the field, industry, or profession in which a petitioner may work; instead, we 
focus on "the specific endeavor that the foreign national proposes to undertake." Dhanasar at 889. 
Accordingly, we "look for broader implications" resulting from the proposed endeavor, noting that 
"[a ]n undertaking may have national importance for example, because it has national or even global 
implications within a particular field." Id. We also stated that "[a]n endeavor that has significant 
potential to employ U.S. workers or has other substantial positive economic effects, particularly in an 
economically depressed area, for instance, may well be understood to have national importance." Id. 
at 890. 
On appeal, the Petitioner contends that her company will result in broader implications to her field, 
because she will place a strong emphasis on training and professional development, will set industry 
standards, and she will develop training programs in nursing homes and assisted living facilities. 
Moreover, she asserts that her company's alignment with federal priorities, including home healthcare, 
and access to health care services in economically depressed regions establishes its national 
importance. Additionally, the Petitioner asserts that her company will result in substantial economic 
benefits, including the creation of 30 jobs by its fifth year of operation, as well as the generation of 
$115,905 in tax payments in that same time. However, the record does not support the Petitioner's 
assertions that her company will result in broader implications to the field, or otherwise result in 
substantial economic effects rising to the level of national importance as contemplated in Dhanasar. 
A petitioner must support assertions with relevant, probative, and credible evidence. See Matter of 
Chawathe, 25 I&N Dec. at 376. 
Here, although the Petitioner claims on appeal that, by offering "personalized home care services, 
[her] company will not only impact local communities but also contribute to addressing nationwide 
challenges in the healthcare system," and will alleviate the burden on hospitals and nursing facilities, 
the record does not establish that her company will meaningfully impact the industry as claimed. 
While the Petitioner's statements reflect her intention to provide valuable services to her future 
patients, she has not provided sufficient information and evidence to demonstrate that the prospective 
impact of her proposed endeavor rises to the level of national importance. For example, she asserts 
that her company is committed to raising the standard of care in the industry by introducing innovative 
practices and relying on technological advancements, but she does not provide further explanation of 
what if any innovative practices or technological advancements she intends to introduce, and how they 
will be implemented in the industry such that they can be considered to extend beyond her company 
and individual patients. And, without this information, we are unable to determine whether her 
company's practices would indeed be analogous to the "improved manufacturing processes or medical 
advances" contemplated in Dhanasar. Dhanasar at 889. Generalized conclusory statements that do 
not identify a specific impact in the field have little probative value. See 1756, Inc. v. US. Att'y Gen., 
745 F. Supp. 9, 15 (D.D.C. 1990) (holding that an agency need not credit conclusory assertions in 
immigration benefits adjudications). 
Similarly, while the Petitioner claims that her endeavor is aligned with national initiatives to improve 
the accessibility and quality of healthcare, she has not shown how her endeavor would meaningfully 
impact these broad initiatives, beyond the immediate benefits to her prospective patients. The 
company's alignment these policies relates more to the substantial merit of her endeavor rather than 
its prospective impact. In Dhanasar, we determined that the petitioner's teaching activities did not 
4 
rise to the level of having national importance because they would not impact his field more 
broadly. Dhanasar at 893. Here too, while we agree with the Petitioner that her company may offer 
benefits to her patients, including allowing them to avoid hospitalizations, and access home health 
care in rural areas, the record does not show how her proposed endeavor stands to sufficiently extend 
beyond her patients to lead to "national or even global implications," or otherwise meaningfully impact 
these broad initiatives at a level commensurate with national importance. Id. at 889. 
We also reviewed the testimonial evidence in the record, including the expert opinion letter and 
multiple letters of recommendation in the record and conclude they provide little additional probative 
value in establishing the national importance of the Petitioner's proposed endeavor. First, the expert 
opinion letter focuses primarily on the Petitioner's education and professional experience, as well as 
the importance of the field and public health. And, while Dr. T-K- states that the Petitioner's company 
"has significant potential to improve public health and quality of life," they do not provide specific 
examples regarding how the individual services the Petitioner will offer to her patients would 
meaningfully impact the field, or otherwise improve public health at a level commensurate with 
national importance. As discussed, while we recognize the growing importance of home health care, 
the expert opinion does not establish the endeavor would result in broader implications. USCIS may, 
in its discretion, use as advisory opinions statements from universities, professional organizations, or 
other sources submitted in evidence as expert testimony. Matter of Caron Int'l, 19 I&N Dec. 791, 795 
(Comm'r. 1988). However, USCIS is ultimately responsible for making the final determination 
regarding a foreign national's eligibility. The submission of letters from experts supporting the 
petition is not presumptive evidence of eligibility. Id., see also Matter ofD-R-, 25 I&N Dec. 445, 460 
n.13 (BIA 2011) (discussing the varying weight that may be given expert testimony based on 
relevance, reliability, and the overall probative value). 
Similarly, while the letters of recommendation commend the Petitioner for her experience in the field, 
including her coordination of public health initiatives and excellent patient care, the letters do not 
establish the broader implications of her proposed endeavor. A petitioner's expertise and record of 
success are considerations under Dhanasar' s second prong, which "shifts the focus from the proposed 
endeavor to the foreign national." Id. at 890. The issue here is whether the Petitioner has demonstrated 
the national importance of her proposed endeavor. 
Additionally, we agree that the Petitioner has not demonstrated that her proposed endeavor has 
significant potential to employ U.S. workers or otherwise result in substantial positive economic 
effects. On appeal, she relies on her company's projected employment and tax payments to support 
the national importance of her endeavor. However, while any basic economic activity has the potential 
to positively impact a local economy, the Petitioner has not demonstrated with credible and probative 
evidence how the economic activity directly resulting from her company and its operations would rise 
to the level of national importance contemplated in Dhanasar. First, the record contains inconsistent 
information pertaining to the Petitioner's employment and financial projects. In the Petitioner's first 
business plan, she indicated that, by the fifth year of operations, she anticipated generating annual 
revenue of $1,289,752 while employing 20 individuals in various roles. Subsequently, in her revised 
business plan submitted in response to the Director's RFE, the Petitioner indicated that, in that same 
5 
time, she anticipated generating $2,333,784 in revenue, and intended to employ 30 individuals 3. The 
Petitioner did not address these changes, and beyond providing the costs of services, neither business 
plan provides sufficient explanation for the basis of these financial and employment projections. Yet, 
even if the endeavor's revenue and job creation projections were sufficiently explained and supported, 
they do not establish that her company would operate on a scale rising to the level of national 
importance contemplated in Dhanasar, nor has the Petitioner explained how her proposed employment 
numbers and revenue would impact her company's areas of intended operations. 
And, while we recognize the Petitioner's claims that her company will be able to address the shortage 
of nurses and health care professionals by providing internships and apprenticeship programs, ongoing 
training, and attractive benefits packages, she has not explained to what extent these benefits, even if 
implemented, will meaningly address the claimed nationwide shortage on a broader level. Nor has 
the Petitioner explained how she intends to recruit eight registered nurses and nursing technicians as 
well as four certified nursing assistants given the stated shortage in the record, as the articles in the 
record indicate that there is a shortage of individuals to fill these roles, not a shortage of available 
positions. 
For the reasons discussed, the evidence does not establish the national importance of the proposed 
endeavor as required by the first prong of the Dhanasar precedent decision. 
III. CONCLUSION 
As the Petitioner has not met the requisite first prong of the Dhanasar analytical framework, we 
conclude that she has not established she is eligible for or otherwise merits a national interest waiver 
as a matter of discretion. Since the identified basis for denial is dispositive of the Petitioner's appeal, 
we decline to reach and hereby reserve the Petitioner's eligibility and appellate arguments under 
Dhanasar's second and third prongs. See INS v Bagamasbad, 429 U.S. 24, 25 (1976) (per curiam) 
(holding that agencies are not required to make "purely advisory findings" on issues that are 
unnecessary to the ultimate decision). 
ORDER: The appeal is dismissed. 
3 While the revised business plan indicated the Petitioner's plans to hire 30 employees, sections of the business plan 
remained unchanged and still referenced the claimed economic impact of employing 20 individuals. 
6