Can physicians get an EB-2 NIW? What 191 AAO decisions say
Published AAO non-precedent decisions, 2017–2025 · updated 2026-10-16
Between 2017 and 2025 the AAO published 191 EB-2 NIW appeal decisions from medicine petitioners; 14 were sustained and 160 dismissed. The most common ground for dismissal: proposed endeavor not shown to have national importance (108 of the 154 merits dismissals, 70%). Second: advanced degree or exceptional ability not established (24, 16%). What the sustained decisions had: endeavor tied to a documented national priority or broad population; independent, specific expert letters. These are appeals of denials, not all adjudications, so the dismissal rate is not an initial-filing approval rate; it shows which arguments the AAO rejected on appeal and which it accepted.
What the decisions say
Grounds for dismissal, by frequency
- 108 of 154 Proposed endeavor not shown to have national importance
“The AAO found that the petitioner did not establish that her proposed endeavor, practicing naturopathic medicine, had the requisite 'national importance' under the Dhanasar framework, as its impact was limited to her direct patients rather than the broader…” AAO, 2020
- 24 of 154 Advanced degree or exceptional ability not established
“The petitioner did not possess an advanced degree and admitted to not having the required five years of progressive, post-baccalaureate experience when the petition was filed.” AAO, 2024
- 23 of 154 Not well positioned to advance the endeavor
“The Director denied the petition, and the AAO dismissed the appeal, because the evidence did not establish that the petitioner was well positioned to advance his proposed endeavor.” AAO, 2022
- 20 of 154 Balance of factors did not favor waiving the job offer
“The Director determined the petitioner only established the substantial merit of her proposed endeavor but failed to demonstrate she was well-positioned to advance it or that a waiver would benefit the United States on balance.” AAO, 2023
- 19 of 154 Proposed endeavor too vague or too local
“The petitioner did not provide a sufficiently specific proposed endeavor, instead offering only vague claims about pursuing work in research and medicine, and therefore did not demonstrate the endeavor's substantial merit and national importance.” AAO, 2021
What the 14 sustained decisions had
- 11 of 14 Endeavor tied to a documented national priority or broad population
“The AAO concluded that the beneficiary's proposed endeavor in epidemiological and psychiatric research had substantial merit and national importance.” AAO, 2023
- 5 of 14 Independent, specific expert letters
“Furthermore, his advanced degree, publications, and letters of support established that he is well-positioned to advance his proposed endeavor.” AAO, 2018
- 2 of 14 Record of achievement and a concrete plan
“Evidence such as the petitioner's publications, development of surgical techniques, peer review activity, and strong letters of endorsement demonstrated a significant record of success.” AAO, 2023
Outcomes by Year
| Year | Dismissed | Sustained | Remanded | Total |
|---|---|---|---|---|
| 2025 | 7 (—) | 0 | 0 | 7 |
| 2024 | 58 (93.5%) | 2 | 2 | 62 |
| 2023 | 38 (80.9%) | 2 | 7 | 47 |
| 2022 | 11 (—) | 1 | 2 | 14 |
| 2021 | 18 (75.0%) | 2 | 4 | 24 |
| 2020 | 3 (—) | 3 | 1 | 7 |
| 2019 | 6 (—) | 1 | 1 | 8 |
| 2018 | 10 (—) | 1 | 0 | 11 |
| 2017 | 9 (—) | 2 | 0 | 11 |
Criteria Breakdown
| Criterion | In Dismissed | In Sustained | Total | Dismissal Rate |
|---|---|---|---|---|
| Prong 1: Substantial merit and national importance | 166 | 9 | 192 | 86.5% |
| Prong 2: Well positioned to advance the endeavor | 132 | 11 | 157 | 84.1% |
| Prong 3: On balance, waiver benefits the U.S. | 126 | 12 | 152 | 82.9% |
| Advanced degree | 29 | 3 | 43 | 67.4% |
| Exceptional ability | 23 | 0 | 31 | 74.2% |
| Motion to reopen/reconsider | 16 | 0 | 16 | — |
Example Decisions
Sustained2023-11-16The appeal was sustained because the AAO found that the petitioner had established the beneficiary's eligibility under the Dhanasar framework. The AAO concluded that the beneficiary's proposed endeavor in…
Sustained2017-04-10The director denied the petition, finding the petitioner had not established that an exemption from the job offer requirement would be in the national interest. The AAO sustained the appeal, determining that the…
Sustained2024-10-16The appeal was sustained because the AAO found that the petitioner, contrary to the Director's decision, met all three prongs of the Dhanasar framework. The AAO determined the petitioner's work in ultrasound imaging has…
Sustained2018-08-31The appeal was sustained because the AAO found the petitioner, a surgeon and researcher, met the three-prong test for a national interest waiver under the Dhanasar framework. The petitioner demonstrated that his…
Sustained2022-10-19The appeal was sustained because the AAO, upon de novo review, found the petitioner eligible for a national interest waiver under the Dhanasar framework. The AAO concluded that her proposed research into developing…
Dismissed2024-08-13The appeal was dismissed because the petitioner failed to demonstrate that her proposed endeavor in medical sales and marketing had national importance, a key requirement under the first prong of the Dhanasar framework.…
Dismissed2024-07-10The motion to reopen was dismissed because the petitioner did not present new facts or supporting documentary evidence. The motion to reconsider was dismissed because the petitioner failed to establish that the prior…
Dismissed2024-06-17The appeal was dismissed because the petitioner failed to establish the 'national importance' of his proposed endeavor, which is part of the first prong of the Dhanasar framework. The AAO found that the petitioner did…
Dismissed2024-04-11The appeal was dismissed because the petitioner failed to establish the 'national importance' of her proposed endeavor. While her plan to create a dental services organization (DSO) had substantial merit, she did not…
Dismissed2024-03-27The appeal was dismissed because the petitioner failed to establish the national importance of her proposed endeavor, the third prong of the Dhanasar framework. Although the Director found her endeavor had substantial…
In sustained EB-2 NIW appeals for Medicine petitioners, the AAO credited evidence such as patents or proprietary contributions; competitively awarded research funding. Dismissed cases most often lacked a clearly defined proposed endeavor with specificity beyond a general field of work; evidence that benefits extend beyond the petitioner’s own work or employer; non-speculative evidence (claims were conclusory or unsupported).
NYSDOT-era decisions (pre-2017)
Outcomes by Year
| Year | Dismissed | Sustained | Remanded | Total |
|---|---|---|---|---|
| 2016 | 12 (—) | 3 | 0 | 15 |
| 2015 | 14 (—) | 1 | 1 | 16 |
| 2014 | 35 (94.6%) | 2 | 0 | 37 |
| 2013 | 21 (87.5%) | 3 | 0 | 24 |
| 2012 | 28 (96.6%) | 1 | 0 | 29 |
| 2011 | 31 (100.0%) | 0 | 0 | 31 |
| 2010 | 6 (—) | 0 | 0 | 6 |
| 2009 | 9 (—) | 1 | 0 | 10 |
| 2008 | 1 (—) | 1 | 1 | 3 |
| 2007 | 2 (—) | 1 | 1 | 4 |
| 2006 | 3 (—) | 2 | 0 | 5 |
| 2005 | 14 (66.7%) | 5 | 2 | 21 |
| 2004 | 1 (—) | 0 | 1 | 2 |
| 2003 | 0 (—) | 0 | 1 | 1 |
| 2001 | 1 (—) | 1 | 1 | 3 |
Criteria Discussed
| Criterion | In Dismissed | In Sustained | Total |
|---|---|---|---|
| Intrinsic merit (NYSDOT) | 133 | 18 | 153 |
| National in scope (NYSDOT) | 129 | 18 | 151 |
| Substantially greater degree than U.S. worker (NYSDOT) | 114 | 18 | 134 |
| Exceptional ability | 33 | 2 | 36 |
| Procedural/filing | 13 | 0 | 15 |
| Advanced degree | 10 | 1 | 13 |
| Prong 3: On balance, waiver benefits the U.S. | 9 | 2 | 11 |
| Motion to reopen/reconsider | 5 | 0 | 5 |
| Prong 1: Substantial merit and national importance | 0 | 1 | 1 |
| Prong 2: Well positioned to advance the endeavor | 0 | 1 | 1 |
| Fraud/misrepresentation | 1 | 0 | 1 |
Sample: published AAO non-precedent decisions collected from uscis.gov. EB-2 NIW statistics reflect the Dhanasar framework era (2017–2025); the prior NYSDOT framework applied different legal standards. These are appeals, not all USCIS adjudications; approval rates here are not initial-filing approval rates. Read our full methodology.
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