dismissed H-1B Case: Healthcare Administration

identifyf~ data deleted M, 
PUBLIC COPY 
U.S. Department of Homeland Security 
20 Mass, Rm. A3042,425 I Street, N.W. 
Washington, DC 20529 
U. S. Citizenship 
and Immigration 
- -.. & 
FILE: WAC 03 141 50129 Office: CALIFORNIA SERVICE CENTER Date: SEP 2 0 2005 
PETITION: Petition for a Nonimmigrant Worker Pursuant to Section 10 1 (a)(l S)(H)(i)(b) of the 
Immigration and Nationality Act, 8 U.S.C. ij 1 101 (a)(lS)(H)(i)(b) 
ON BEHALF OF PETITIONER: 
INSTRUCTIONS: 
This is the decision of the Administrative Appeals Office in your case. All documents have been returned to 
the office that originally decided your case. Any further inquiry must be made to that office. 
Robert P. Wiemann, Director 
Administrative Appeals Office 
WAC 03 141 50129 
Page 2 
DISCUSSION: The service center director denied the nonimmigrant visa petition and the matter is now before 
the Administrative Appeals Office (AAO) on appeal. The appeal will be dismissed. The petition will be denied. 
The petitioner is a residential care facility that seeks to employ the beneficiary as its medical records 
administrator. The petitioner endeavors to classify the beneficiary as a nonimrnigrant worker in a specialty 
occupation pursuant to 9 lOl(a)(lS)(H)(i)(b) of the Immigration and Nationality Act (the Act), 8 U.S.C. 
§ 1 10 1 (a>( 15)(H)(i)(b). 
The director denied the petition because the beneficiary is not qualified to perform the duties of a specialty 
occupation. On appeal, counsel submits a brief and supporting documents. 
Section 214(i)(2) of the Act, 8 U.S.C. 5 1184(i)(2), states that an alien applying for classification as an H-1B 
nonimmigrant worker must possess full state licensure to practice in the occupation, if such licensure is 
required to practice in the occupation, and completion of the degree in the specialty that the occupation 
requires. If the alien does not possess the required degree, the petitioner must demonstrate that the alien has 
experience in the specialty equivalent to the completion of such degree, and recognition of expertise in the 
specialty through progressively responsible positions relating to the specialty. 
Pursuant to 8 C.F.R. Fj 214.2(h)(4)(iii)(C), to qualify to perform services in a specialty occupation, an alien 
must meet one of the following criteria: 
(I) Hold a United States baccalaureate or higher degree required by the specialty 
occupation from an accredited college or university; 
(2) Hold a foreign degree determined to be equivalent to a United States baccalaureate or 
higher degree required by the specialty occupation from an accredited college or 
university; 
(3) Hold an unrestricted state license, registration or certification which authorizes him 
or her to fully practice the specialty occupation and be immediately engaged in that 
specialty in the state of intended employment; or 
(4) Have education, specialized training, and/or progressively responsible experience 
that is equivalent to completion of a United States baccalaureate or higher degree in 
the specialty occupation, and have recognition of expertise in the specialty through 
progressively responsible positions directly related to the specialty. 
The record of proceeding before the AAO contains, in part: (1) Form 1-129 and supporting documentation; 
(2) the director's request for additional evidence; (3) the petitioner's response to the director's request; (4) the 
director's denial letter; and (5) Form I-290B and supporting documentation. The AAO reviewed the record in 
its entirety before issuing its decision. 
The petitioner is seeking the beneficiary's services as a medical records administrator. The petitioner 
indicated in its initial letter that it wished to hire the beneficiary because she satisfactorily meets the required 
educational qualifications and professional experience required to perform the job of medical records 
administrator, which it indicated as having a bachelor's degree in the medical field. The petitioner stated the 
WAC 03 141 50129 
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beneficiary has the required bachelor's degree and work experience appropriate in performing the job duties. 
In response to the director's request for evidence, counsel stated that the proffered position was not a nursing 
home administrator but similar to that of the description of a medical and health service manager as clescribed 
in the Department of Labor's Occupational Outlook Handbook (the Handbook). The Handbook describes 
medical and health service managers as follows: 
The occupation, medical and health services manager, encompasses all individuals who plan, 
direct, coordinate, and supervise the delivery of healthcare. Medical and health services 
managers include specialists and generalists. Specialists are in charge of specific clinical 
departments or services, while generalists manage or help to manage an entire facility o.r 
system. . . . . 
Large facilities usually have several assistant administrators to aid the top administrator and 
to handle daily decisions. Assistant administrators may direct activities in clinical areas such 
as nursing, surgery, therapy, medical records, or health information. 
The director found that the beneficiary was not qualified for the proffered position because the beneficiary's 
education was found to be the equivalent to the U.S degree of Bachelor of Science in Physical Thera.py. The 
director found that there was no information in the record to establish that the beneficiary has knowledge or 
experience in management principles as stated in the Handbook. The director found that the record did not 
establish that the beneficiary has experience in health information or as a medical records admimistrator, 
which relates to the duties of the proffered position. 
On appeal, counsel states the beneficiary has a degree in physical therapy and has been found to be qualified 
for the position by the petitioner. Counsel contends that that "although candidates in possession of degrees 
dealing with management principles and practices may qualify for the position, those who have completed at 
least bachelor's degrees in health science field, such as the beneficiary, who possesses a degree in physical 
therapy and has sufficient familiarity with administration practices, are also considered eligible for the 
proffered position and thus, H-1B classification." 
Upon review of the record, the petitioner has failed to establish that the beneficiary is qualified to peirform an 
occupation as a health services manager in a medical records administrator position that usually requires a 
bachelor's degree in health information or medical records administration. The beneficiary does not hold a 
baccalaureate degree from an accredited U.S. college or university in the field of study required by the 
specialty occupation. 
The record reflects that the beneficiary obtained the equivalent of a bachelor's degree in physical therapy 
from an accredited university in the United States. 
The Handbook states that the following about training and education for medical and health service mimagers 
who are charged with administering records departments: 
Clinical managers have more specific responsibilities than do generalists, and have training or 
experience in a specific clinical area. For example, directors of physical therapy are 
experienced physical therapists, and most health information and medical record 
administrators have a bachelor's degree in health information or medical record 
WAC 03 141 50129 
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administration. Clinical managers establish and implement policies, objectives, and. 
procedures for their departments; evaluate personnel and work; develop reports and budgets: 
and coordinate activities with other managers (Emphasis added). 
The Handbook indicates the following about training and education for Medical Records Administrator: 
[I]n larger institutions, the director is usually an administrator, with a bachelor's degree in 
medical records and health information administration. 
While counsel contends that the Handbook also indicates that the beneficiary is qualified as a medical and 
health services manager by virtue of her four year degree in a life science, physical therapy, that position is 
not supported in this case, as the petitioner is seeking to place the beneficiary in a position as a medical 
records administrator. 
The record does not reflect that the petitioner has met the terms of 8 C.F.R. 5 214.2(h)(4)(iii)(D)(I) and has 
not established that the beneficiary has the equivalent of a bachelor's degree in the specific specialty required 
by the specialty occupation. The beneficiary's university records indicated that the course of study was 
focused on physical therapy. Finally, the petitioner indicated that the beneficiary has been employed as a 
physical therapist. 
As related in the discussion above, the petitioner has failed to establish that the beneficiary is qualified to 
perform the duties of medical and health service manager who is performing the services of a medical records 
administrator. Accordingly, the AAO shall not disturb the director's denial of the petition. 
The director also found that the position was a health services manager. The AAO disagrees. The A10 does 
not find that the proffered position is a medical and health services manager and does not find that the 
position is a specialty occupation. 
Section 2 14(i)(l) of the Act, 8 U.S.C. 5 1 1 84(i)(l), defines the term "specialty occupation" as an occ;upation 
that requires: 
(A) theoretical and practical application of a body of highly specialized knowledge, and 
(B) attainment of a bachelor's or higher degree in the specific specialty (or its equivalent) 
as a minimum for entry into the occupation in the United States. 
Pursuant to 8 C.F.R. 5 214.2(h)(4)(iii)(A), to qualify as a specialty occupation, the position must meet one of 
the following criteria: 
(I) A baccalaureate or higher degree or its equivalent is normally the minimum requirement 
for entry into the particular position; 
(2) The degree requirement is common to the industry in parallel positions among similar 
organizations or, in the alternative, an employer may show that its particular position is 
so complex or unique that it can be performed only by an individual with a degree; 
WAC 03 141 50129 
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(3) The employer normally requires a degree or its equivalent for the position; or 
(4) The nature of the specific duties is so specialized and complex that knowledge required to 
perform the duties is usually associated with the attainment of a baccalaureate or highei- 
degree. 
Citizenship and Immigration Services (CIS) interprets the term "degree" in the criteria at 8 C.F.R. 
5 214.2(h)(4)(iii)(A) to mean not just any baccalaureate or higher degree, but one in a specific specialty that is 
directly related to the proffered position. 
The record of proceeding before the AAO contains: (1) Form 1-129 and supporting documentation; (2) the 
director's request for additional evidence; (3) the petitioner's response to the director's request:, (4) the 
director's denial letter; and (5) Form I-290B and supporting documentation. The AAO reviewed the record in 
its entirety before issuing its decision. 
The petitioner is seeking the beneficiary's services as its medical records administrator. Evidence of the 
beneficiary's duties includes: the 1-129 petition; the petitioner's letter in support of the petition. According to 
this evidence, the beneficiary would perform duties that entail: maintaining all medical records of patients, 
accurately coding and documenting their diseases, conditions and treatments pursuant to the hteirnational 
Classifications of Diseases (ICD-9) (20% of time); implementing clinical data validation measures and 
analyze abnormal findings, medications and surgical procedures (15% of time); implementing the pe1:itioner's 
health information systems and record keeping procedures that will provide quick data storage (15% of time); 
as custodian of confidential patient information, approving release of medical records submitte'd to the 
department (10% of time); acting as secondary source of information on coding system regulations and any 
changes made by official agencies that affect coding information policies; serving as resources staff to other 
staff on legal issues regarding health information (10% of time); constantly reviewing diagnostic and 
procedural codes on all clinical data such as diseases, therapies, surgeries, laboratory tests, pharmaceuticals, 
treatments, making sure that the petitioner is using the most current ICD-9 diagnostic codes (5% of time); 
requiring coders, transcribers and other medical record-keeping personnel to adhere to accuracy of 
information, concentration and close attention to detail (5% of time); contacting Medicare, Medicaid, Medi- 
cal, health insurance firms and health maintenance organizations (HMOs) on matters pertaining to 
reimbursement regulations and clarify codes, which are unclear to the payors (5% of time); resolving 
consumer concerns/problems relating to record keeping policies of the petitioner (5% of time); implementing 
rules on close confidentiality of medical records and that patientlresident privacy rights are strictly protected 
(5% of time); and analyzing patient data for reimbursement, laboratory planning, quality of patient care, risk 
management, utilization management and research (5% of time). 
Upon review of the records, the AAO finds that proffered position is not a specialty occupation because the 
duties reflect those of a medical records and health information technician. Upon review of the record, the 
petitioner has established none of the four criteria outlined in 8 C.F.R. 5 214.2(h)(4)(iii)(A). Therefore, the 
proffered position is not a specialty occupation. 
The AAO turns first to the criteria at 8 C.F.R. 5 214.2(h)(4)(iii)(A)(l) and (2): a baccalaureate or higher 
degree or its equivalent is the normal minimum requirement for entry into the particular position; a degree 
requirement is common to the industry in parallel positions among similar organizations; or a particular 
position is so complex or unique that it can be performed only by an individual with a degree. 
WAC 03 141 50129 
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Factors often considered by CIS when determining these criteria include: whether the Handbook reports that the 
industry requires a degree; whether the industry's professional association has made a degree a minimum entry 
requirement; and whether letters or affidavits from firms or individuals in the industry attest that such firms 
"routinely employ and recruit only degreed individuals." See Shanti, Inc. v. Reno, 36 F. Supp. 2d 1 1:5 1, 1 165 
(D.Minn. 1999)(quoting Hird/Blaker Corp. v. Sava, 712 F. Supp. 872, 1102 (S.D.N.Y. 1989)). 
The proffered position is similar to that of a medical records and health information technician. The 
Handbook indicates that medical records and health information technicians organize and evaluate medical 
records for completeness and accuracy. They assign a code to each diagnosis and procedure. The}, consult 
classification manuals and also rely on their knowledge of disease processes. Technicians then use computer 
software to assign the patient to one of several hundred "diagnosis-related groups," or DRGs. The DRG 
determines the amount for which the hospital will be reimbursed if the patient is covered by Medicare or other 
insurance programs using the DRG system. The Handbook indicates technicians also use computer programs 
to tabulate and analyze data to help improve patient care, to control costs, for use in legal actions, in response 
to surveys, or for use in research studies. The Handbook further notes that Medical records and health 
information technicians' duties vary with the size of the facility. In large to medium sized facilities, 
technicians may specialize in one aspect of health information, or supervise health information clerks and 
transcriptionists while a medical records and health information administrator manages the department. 
Finally, the Handbook indicates in small facilities, a credentialed medical records and health infc~rmation 
technician manages the department. 
In its Handbook, 2004-2005 edition, the DOL states the following about the training and educational 
requirements for medical records and health information technician positions: 
Medical records and health information technicians entering the field usually have an 
associate's degree from a community or junior college. In addition to general education, 
course work includes medical terminology, anatomy and physiology, legal aspects of health 
information, coding and abstraction of data, statistics, database management, quality 
improvement methods, and computer science. 
Experienced medical records and health information technicians usually advance in one of 
two ways - by specializing or managing. Senior technicians with RHIT credentials may 
become director or assistant director of a medical and health information department in a 
small facility. . . . In larger institutions, the director is usually an administrator with a 
bachelor's degree in medical records and health information administration. 
The proffered position resembles a medical records and health information technician. As the Handbook does 
not indicate that a bachelor's degree or its equivalent is required as a minimum for entry into the occupation, 
the petitioner has not established the first criterion. Additionally, according to the Cal$orrzia Occupational 
Guide (the Guide) the State of California requires certification for those technicians who actually manage 
medical record departments. Furthermore, the Guide notes that Medical Record Administrators rnust be 
certified as registered record administrators (RRAs) by the American Health Information Management 
Association or already be certified Accredited Record Technicians. 
WAC 03 141 50129 
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The record does not include any information regarding parallel positions in the petitioner's industry. The 
record also does not include any evidence from professional associations regarding an industry standard. In 
addition, no documentation to support the complexity or uniqueness of the proffered position was submitted. 
The petitioner has, thus, not established the criteria set forth at 8 C.F.R. 5 214.2(h)(4)(iii)(A)(I) or (2). 
The AAO now turns to the criterion at 8 C.F.R. 5 214.2(h)(4)(iii)(A)(3) - the employer normally requires a 
degree or its equivalent for the position. On appeal, neither the petitioner nor counsel addresses this criterion. 
Therefore, the petitioner has not established the criterion set forth at 8 C.F.R. 5 214.2(h)(4)(iii)(A)(3). 
Finally, the AAO turns to the criterion at 8 C.F.R. 5 214,2(h)(4)(iii)(A)(4) -the nature of the specific duties is 
so specialized and complex that knowledge required to perform the duties is usually associated with the 
attainment of a baccalaureate or higher degree. 
To the extent that they are depicted in the record, the duties do not appear so specialized and complex as to 
require the highly specialized knowledge associated with a baccalaureate or higher degree, or its equivalent, 
in a specific specialty. The duties are those routinely performed by medical records and health infclrmation 
technicians in the industry. The duties described do not reflect those of an administrator of a medical records 
department in a large institution. Therefore, the evidence does not establish that the proffered posi1:ion is a 
specialty occupation under 8 C.F.R. 5 214.2(h)(4)(iii)(A)(4). 
As related in the discussion above, the petitioner has failed to establish that the proffered posit:~on is a 
specialty occupation. Accordingly, the AAO shall not disturb the director's denial of the petition. 
The burden of proof in these proceedings rests solely with the petitioner. Section 291 of the Act, 8 U.S.C. 5 1361. 
The petitioner has not sustained that burden. 
ORDER: The appeal is dismissed. The petition is denied.