dismissed EB-2 NIW Case: Naturopathic Medicine

U.S. Citizenship 
and Immigration 
Services 
MATTER OF G-C-L-
Non-Precedent Decision of the 
Administrative Appeals Office 
DATE: MAY 14, 2019 
APPEAL OF NEBRASKA SERVICE CENTER DECISION 
PETITION: FORM I-140, IMMIGRANT PETITION FOR ALIEN WORKER 
The Petitioner, a naturopathic physician, seeks second preference immigrant classification as a 
member of the professions holding an advanced degree, as well as a national interest waiver of the job 
offer requirement attached to this EB-2 classification. See Immigration and Nationality Act (the Act) 
section 203(b)(2), 8 U.S.C. § l 153(b)(2). After a petitioner has established eligibility for EB-2 
classification, U.S. Citizenship and Immigration Services (USCIS) may, as matter of discretion, grant 
a national interest waiver if the petitioner demonstrates: (1) that the foreign national's proposed 
endeavor has both substantial merit and national importance; (2) that the foreign national is well 
positioned to advance the proposed endeavor; and (3) that, on balance, it would be beneficial to the 
United States to waive the requirements of a job offer and thus of a labor certification. Matter of 
Dhanasar, 26 I&N Dec. 884 (AAO 2016). 
The Director of the Nebraska Service Center denied the Form 1-140, Immigrant Petition for Alien 
Worker, and a subsequent motion, concluding that the Petitioner qualified for classification as a 
member of the professions holding an advanced degree, but that she had not established that a waiver 
of the required job offer, and thus of the labor certification, would be in the national interest. 
On appeal, the Petitioner submits additional evidence and contends that she is eligible for a national 
interest waiver under the Dhanasar framework. 
Upon de novo review, we will dismiss the appeal. 
I. LAW 
To establish eligibility for a national interest waiver, a petitioner must first demonstrate qualification 
for the underlying EB-2 visa classification, as either an advanced degree professional or an individual 
of exceptional ability in the sciences, arts, or business. Because this classification requires that the 
individual's services be sought by a U.S. employer, a separate showing is required to establish that a 
waiver of the job offer requirement is in the national interest. 
Section 203(b) of the Act sets out this sequential framework: 
Matter of G-C-L-
(2) Aliens who are members of the professions holding advanced degrees or aliens of 
exceptional ability. -
(A) In general. - Visas shall be made available ... to qualified immigrants who are 
members of the professions holding advanced degrees or their equivalent or 
who because of their exceptional ability in the sciences, arts, or business, will 
substantially benefit prospectively the national economy, cultural or 
educational interests, or welfare of the United States, and whose services in the 
sciences, arts, professions, or business are sought by an employer in the United 
States. 
(B) Waiver ofjob offer-
(i) National interest waiver. ... [T]he Attorney General may, when the Attorney 
General deems it to be in the national interest, waive the requirements of 
subparagraph (A) that an alien's services in the sciences, arts, professions, or 
business be sought by an employer in the United States. 
While neither the statute nor the pertinent regulations define the term "national interest," we set forth 
a framework for adjudicating national interest waiver petitions in the precedent decision Matter of 
Dhanasar, 26 I&N Dec. 884. 1 Dhanasar states that after EB-2 eligibility has been established, users 
may, as a matter of discretion, grant a national interest waiver when the below prongs are met. 
The first prong, substantial merit and national importance, focuses on the specific endeavor that the 
foreign national proposes to undertake. The endeavor's merit may be demonstrated in a range of areas 
such as business, entrepreneurialism, science, technology, culture, health, or education. In 
determining whether the proposed endeavor has national importance, we consider its potential 
prospective impact. 
The second prong shifts the focus from the proposed endeavor to the foreign national. To determine 
whether he or she is well positioned to advance the proposed endeavor, we consider factors including, 
but not limited to: the individual's education, skills, knowledge and record of success in related or 
similar efforts; a model or plan for future activities; any progress towards achieving the proposed 
endeavor; and the interest of potential customers, users, investors, or other relevant entities or 
individuals. 
The third prong requires the petitioner to demonstrate that, on balance, it would be beneficial to the 
United States to waive the requirements of a job offer and thus of a labor certification. In performing 
this analysis, users may evaluate factors such as: whether, in light of the nature of the foreign 
national's qualifications or the proposed endeavor, it would be impractical either for the foreign 
national to secure a job offer or for the petitioner to obtain a labor certification; whether, even assuming 
that other qualified U.S. workers are available, the United States would still benefit from the foreign 
national's contributions; and whether the national interest in the foreign national's contributions is 
1 In announcing this new framework, we vacated our prior precedent decision, Matter of New York State Department of 
Transportation, 22 l&N Dec. 215 (Act. Assoc. Comm'r 1998) (NYSDOT). 
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Matter of G-C-L-
sufficiently urgent to warrant forgoing the labor certification process. In each case, the factor(s) 
considered must, taken together, indicate that on balance, it would be beneficial to the United States 
to waive the requirements of a job offer and thus of a labor certification. 2 
II. ANALYSIS 
The record indicates that the Petitoner qualifies as a member of the professions holding an advanced 
degree. 3 The remaining issue to be determined is whether the Petitioner has established that a waiver of 
the requirement of a job offer, and thus a labor certification, would be in the national interest. 
At the time of filing, the Petitioner was serving as a naturopathic physician at her private medical 
practice in I I Minnesota. 4 The Petitioner asserted that she intends "to continue to practice 
naturopathic medicine on patients with cancer and other medical conditions or diseases for which 
treatment options have either been exhausted or not yet explored." She also noted that "[a] proximately 
thirty-five active patients currently comprise [her] medical practice." The Petitioner further stated: 
I have my own office located in I I Minnesota, where I see my patients .... 
However, I must also travel to my patents' residences, and I travel with them, which is 
often required, when I refer them to a specialist who will collaborate with me in 
implementing their treatment plans. . . . . My integrative medical practice "fills the 
gap" for an increasingly large cancer population in rural Minnesota that is often elderly, 
of low income, and unable to afford the expensive cancer treatments and follow-up 
regimens needed to manage the severe side effects caused by cancer treatments such as 
chemotherapy, radiation, and immunotherapy. 
The record includes letters of support from patients explaining how the Petitioner provided them with 
quality medical care and improved their health. In addition, the Petitioner presented articles discussing 
healthcare barriers and disparities in rural areas, healthcare access in rural Minnesota, solutions to 
Minnesota's rural healthcare problems, the economic impact of cancer, insurance barriers to medical 
care, and reductions in healthcare costs attributable to naturopathic medicine. She also provided 
articles describing naturopathic doctors' increasing role in oncology care, physician shortages in rural 
areas, and challenges faced by rural cancer patients. Furthermore, the record contains guidance 
regarding naturopathic practice and care from the American Association of N aturopathic Physicians, 
an article in the New York Times about the benefits of integrative medicine, and a report from the 
Integrative Healthcare Policy Consortium entitled "Integrative Health and Medicine: Today's Answer 
to Affordable Healthcare." 
With the motion, the Petitioner submitted information about clinical trials and studies from the 
National Institute of Aging, a research article indicating that screening logs have the potential to 
2 See Dhanasar, 26 T&N Dec. at 888-91, for elaboration on these three prongs. 
3 The Petitioner provided evidence that she received a "Doctor of Naturopathic Medicine" degree from the~I --~ 
1 1<2004). 
4 As the Petitioner is applying for a waiver of the job offer requirement, it is not necessary for her to have a job offer from 
a specific employer. However, we will consider information about her current position to illustrate the capacity in which 
she intends to work in order to determine whether her proposed endeavor meets the requirements of the first prong of the 
Dhanasar framework. 
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Matter of G-C-L-
improve part1c1pation of underrepresented populations in clinical trials, and a published study 
evaluating racial and ethnic differences in clinical trial enrollment. In addition, she presented articles 
discussing cancer prevalence, cancer types based on race and ethnicity, breast cancer integrative 
oncology care and its costs, and productivity losses attributable to cancer-related mortality. 
Furthermore, the record contains published studies describing the cost-effectiveness of naturopathic 
medicine in treating anxiety disorders, chronic low back pain, and cardiovascular disease. The 
Petitioner also offered an article examining naturopathic medicine in primary care practice. 
Regarding the first prong of the Dhanasar framework, the Director concluded that the Petitioner's 
"services appear to only impact a population in Minnesota" and that the evidence was insufficient to 
show that her "work has had an impact beyond her area of practice." While the record demonstrates 
that the Petitioner's proposed work as a naturopathic physician has substantial merit, for the reasons 
discussed below, the evidence is not sufficient to show this endeavor's national importance. 
On appeal, the Petitioner contends that "she submitted numerous articles on the benefits of 
naturopathic medicine and its impact on the cost of healthcare." In determining national importance, 
the relevant question is not the importance of the industry or profession in which the individual will 
work; instead we focus on the "the specific endeavor that the foreign national proposes to undertake." 
See Dhanasar, 26 I&N Dec. at 889. In Dhanasar, we further noted that "we look for broader 
implications" of the proposed endeavor and 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. 
The Petitioner further argues that "while her work as a naturopathic medicine [sic] is situated in 
Minnesota, the integrated medical approach to treatment plans for her patients often requires her to 
travel with them to collaborate with physicians from various medical and clinical research facilities 
throughout the United States." She notes that she "facilitated the enrollment" of one of her patients 
"into an MD Anderson Cancer Center clinical trial" for treatment of his aggressive prostate cancer. In 
facilitating this patient's enrollment, the Petitioner indicates that she "sought the assistance and 
collaboration of doctors at MD Anderson." In addition, the Petitioner asserts that she sought the 
assistance of a colorectal surgeon at the Nebraska Medical Center to perform surgery on one of her 
oncology patients and accompanied that patient to medical appointments in I I The record 
includes letters of support from the aforementioned two patients and copies of their medical records. 
To evaluate whether the Petitioner's proposed endeavor satisfies the national importance requirement 
we look to evidence documenting the "potential prospective impact" of her work. With respect to the 
Petitioner's proposed care and treatment of patients, the record does not establish that her clinical work 
would impact the naturopathic field and healthcare industry more broadly, as opposed to being limited 
to the patients she serves. Accordingly, without sufficient documentary evidence of its broader impact, 
the Petitioner's clinical work as a naturopathic physician does not meet the "national importance" 
element of the first prong of the Dhanasar framework. Similarly, in Dhanasar, we determined that 
the petitioner's teaching activities did not rise to the level of having national importance because they 
would not impact his field more broadly. Id. at 893. 
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Matter of G-C-L-
The Petitioner maintains that her treatment plans improve the medical conditions of her patients and 
reduce the number of treatments they require, thereby decreasing their immediate healthcare costs. In 
addition, she previously stated that by improving the health of her patients, her proposed work broadly 
enhances societal welfare by increasing her patients' "productivity and that of their families and 
employers." The Petitioner further asserted that as her medical "practice grows, she will need staff to 
assist her in patient intake, administrative tasks, and other functions typical of a medical practice." 
The record, however, does not demonstrate that her medical practice has significant potential to 
employ U.S. workers or otherwise offers substantial positive economic effects for our nation. While 
the Petitioner contends that her "administrative time would be mitigated if she hires 1-2 people to her 
staff/' the record does not include sufficient information or evidence regarding any significant projected 
job growth attributable to her medical practice. The Petitioner has not shown that benefits to the regional 
or national economy resulting from expanding her medical practice, reducing her patients' healthcare 
costs, or increasing their job productivity would reach the level of "substantial positive economic effects" 
contemplated by Dhanasar. Id. at 890. Accordingly, the Petitioner's proposed work as a naturopathic 
physician does not meet the first prong of the Dhanasar framework. 
Finally, the Petitioner argues that her "volunteer participation in wntmg questions" for the 
N aturopathic Physicians Licensing Exam (NP LEX) "has potential prospective impact" relating to 
"national interests in healthcare reform and public safety," thereby establishing the national 
importance of her NPLEX work. Her appellate submission includes a November 2018 letter from the 
executive director ofNPLEX stating: 
[The Petitioner] recently spent 13 hours volunteering time and expertise to write items 
for the NPLEX Examinations. We recognize the amount of commitment this requires. 
Construction of the NPLEX Examinations involves the help of more than 90 
individuals, all of whom offer valuable time and invaluable experience to improving 
the quality of the NPLEX. 
As stated above, the Petitioner's proposed endeavor involves serving patients as a naturopathic 
physician at her private medical practice. She has not shown that the amount of time she intends to 
devote writing items for NPLEX is sufficient to meet the first prong of the Dhanasar framework. 
Regardless, the evidence does not demonstrate that the implications of her proposed volunteer service 
for NP LEX and the potential prospective impact of this work rise to the level of national importance. 
Because the documentation in the record does not establish the national importance of her proposed 
endeavor as required by the first prong of the Dhanasar precedent decision, the Petitioner has not 
demonstrated eligibility for a national interest waiver. Further analysis of her eligibility under the second 
and third prongs outlined in Dhanasar, therefore, would serve no meaningful purpose. 
III. CONCLUSION 
As the Petitioner has not met the requisite first prong set forth in the Dhanasar analytical framework, we 
find that she has not established she is eligible for or otherwise merits a national interest waiver as a 
matter of discretion. The appeal will be dismissed for the above stated reasons, with each considered 
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Matter of G-C-L-
as an independent and alternate basis for the decision. In visa petition proceedings, it is the petitioner's 
burden to establish eligibility for the immigration benefit sought. Section 291 of the Act, 8 U.S.C. 
§ 1361; Matter of Skirball Cultural Ctr., 25 I&N Dec. 799,806 (AAO 2012). Here, that burden has 
not been met. 
ORDER: The appeal is dismissed. 
Cite as Matter ofG-C-L-, ID# 3135063 (AAO May 14, 2019) 
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