Research & Evidence

The Impact of Psychological Evaluations in Immigration Cases

Peer-reviewed research consistently demonstrates that psychological evaluations dramatically improve outcomes in immigration cases. Applicants who submit professional psychological evaluations are nearly twice as likely to receive favorable decisions compared to those without such documentation.

This page provides immigration attorneys, applicants, and advocates with evidence-based information about the documented impact of psychological evaluations across different case types.

Key Research Findings

The Landmark Studies

Physicians for Human Rights Study (2021)

• Sample: 2,584 cases between 2008-2018
• Result: 81.6% of applicants with forensic evaluations were granted relief
• Comparison: National grant rate was only 42.4% during the same period
• Published: Journal of Forensic and Legal Medicine (Atkinson et al., 2021)
• Links: [PubMed] [Full Text]

Original PHR Study (2008)

• Sample: 746 asylum seekers between 2000-2004
• Result: 89% were granted asylum with evaluations
• Comparison: National average was 37.5%
• Published: Journal of Immigrant and Minority Health (Lustig et al., 2008)
• Links: [PubMed] [Full Text]

What This Means

Why Psychological Evaluations Make Such a Difference

1. They Provide Objective Clinical Evidence

Immigration adjudicators—whether USCIS officers or immigration judges—must make decisions based on evidence. A psychological evaluation transforms subjective experiences into objective, clinical documentation that meets legal evidentiary standards.

As noted in the PHR research: "Forensic medical evaluations can provide scientific evidence that a person has suffered persecution and harm, improving the likelihood that those who seek refuge in the United States will be granted asylum or other forms of life-saving immigration relief."

2. They Fill Critical Evidentiary Gaps

Many immigration applicants lack traditional documentation of their experiences:

• Abuse victims may never have called police
• Asylum seekers fled without medical records
• Trauma survivors avoided hospitals due to fear or shame
• Cultural factors prevented documentation as events occurred

A psychological evaluation provides professional documentation when other evidence is unavailable or incomplete. USCIS explicitly recognizes psychological evaluations as valid evidence, particularly when "prepared by a qualified medical or mental health professional, who treated or thoroughly and adequately evaluated the [applicant] using well-established assessments or tools."

3. They Explain Complex Trauma Presentations

Immigration adjudicators are not mental health professionals. They may not understand why:

• A trauma survivor's story has inconsistencies (trauma affects memory)
• An abuse victim stayed with their abuser for years
• An asylum seeker appears calm when describing horrific events
• Someone can't remember specific dates or details

A licensed clinician translates these complex psychological phenomena into language adjudicators can understand, explaining behaviors that might otherwise undermine credibility.

4. They Establish the Severity of Harm

For many immigration benefits, applicants must prove more than just that something bad happened—they must demonstrate significant psychological impact. Evaluations document:

• Clinical diagnoses (PTSD, Major Depression, Anxiety Disorders)
• Severity of symptoms using validated assessment tools
• Functional impairment in daily life
• Connection between the trauma/hardship and current symptoms
• Prognosis and treatment needs

Case-by-Case Impact

Asylum Cases

The research is clearest for asylum applications:

• 81.6% success rate with evaluations vs. 42.4% without (2008-2018)
• 89% success rate with evaluations vs. 37.5% without (2000-2004)

Asylum evaluations document:

• Past persecution and its psychological effects
• Current PTSD, depression, anxiety symptoms
• Fear of return and its clinical basis
• How symptoms corroborate the applicant's account

VAWA Self-Petitions

For survivors of domestic violence by U.S. citizen or LPR abusers:

• 81.6% grant rate with forensic evaluations vs. 42.4% without
• Evaluations are particularly critical when physical evidence is limited
• They document "battery or extreme cruelty" through psychological impact

VAWA evaluations address:

• The psychological impact of abuse
• How trauma explains behaviors (staying with abuser, not calling police)
• Cultural factors affecting disclosure
• The survivor's good moral character despite trauma responses

Extreme Hardship Waivers (I-601/I-601A)

For applicants seeking waivers based on hardship to U.S. citizen or LPR relatives:

• Attorneys report approximately 90% success rates with quality evaluations (anecdotal)
• USCIS Policy Manual explicitly lists psychological factors among hardship considerations

The evaluation documents how separation or relocation would cause:

• Worsening of existing mental health conditions
• Development of new psychological disorders
• Inability to access adequate mental health treatment abroad
• Cumulative, compounding psychological effects

Cancellation of Removal

For cases requiring "exceptional and extremely unusual hardship":

• This is the highest hardship threshold in immigration law
• Evaluations must demonstrate impact far beyond normal separation
• Focus is on psychological impact to U.S. citizen/LPR qualifying relatives

U-Visa and T-Visa Cases

For crime victims and trafficking survivors:

• Evaluations document psychological harm from the crime/trafficking
• Help explain behaviors that might otherwise seem inconsistent with victimization
• Establish severity meeting statutory requirements

What USCIS Looks for in Evaluations

According to USCIS policy and case law, effective evaluations include:

1. Qualified Evaluator

• Licensed mental health professional (LCSW, Psychologist, Psychiatrist)
• Training in forensic or immigration-related assessments
• Understanding of relevant legal standards
• CV/credentials demonstrating expertise

2. Thorough Assessment Methods

• Clinical interview(s)—multiple sessions preferred
• Validated psychological testing instruments
• Review of relevant records and documentation
• Collateral information when available

3. DSM-5 Diagnostic Framework

• Clear diagnoses using current diagnostic criteria
• Explanation of how symptoms meet diagnostic thresholds
• Differential diagnosis ruling out alternative explanations

4. Legal Nexus

• Connection between psychological findings and legal requirements
• Specific reference to statutory standards (extreme hardship, battery/extreme cruelty, etc.)
• Professional opinion on how findings support the case

5. Cultural Competence

• Understanding of how culture affects trauma presentation
• Recognition of cultural factors in disclosure and help-seeking
• Appropriate use of interpreters when needed

The Cost of NOT Having an Evaluation

Without a psychological evaluation:

• Your case relies solely on personal statements and other documents
• Adjudicators may not understand the psychological basis of your claims
• Credibility issues may arise from trauma-related memory inconsistencies
• The severity and permanence of harm may not be adequately conveyed
• You may receive a Request for Evidence (RFE) delaying your case
• Your case may be denied when it could have been approved

Given that the difference in success rates can be nearly double with an evaluation, the investment typically represents a small fraction of the potential benefit of winning your case.

Research Citations

Primary Studies:

1. Atkinson HG, Wyka K, Hampton K, Seno CL, Yim ET, Ottenheimer D, Arastu NS. (2021). Impact of forensic medical evaluations on immigration relief grant rates and correlates of outcomes in the United States. Journal of Forensic and Legal Medicine, 84:102272. [PubMed] [Full Text]
2. Lustig SL, Kureshi S, Delucchi KL, Iacopino V, Morse SC. (2008). Asylum grant rates following medical evaluations of maltreatment among political asylum applicants in the United States. Journal of Immigrant and Minority Health, 10(1):7-15. [PubMed] [Full Text]

Supporting Sources:

3. USCIS Policy Manual, Volume 3, Part D, Chapter 2 (VAWA eligibility and evidence requirements)
4. USCIS Policy Manual, Volume 9, Part B, Chapter 5 (Extreme hardship considerations)
5. Scruggs E, Guetterman TC, Meyer AC, VanArtsdalen J, Heisler M. (2016). "An absolutely necessary piece": a qualitative study of legal perspectives on medical affidavits in the asylum process. Journal of Forensic and Legal Medicine, 44:72-78.
6. Green AS, Ruchman SG, Katz CL, Singer EK. (2020). Piloting forensic tele-mental health evaluations of asylum seekers. Psychiatry Research, 291:113256.

How I Can Help

I'm Fernando Vázquez, a Licensed Clinical Social Worker with 8 years specializing in immigration psychological evaluations. I've completed hundreds of evaluations for immigration courts, including the Dallas Immigration Court, Houston Immigration Court, Miami Immigration Court, Orlando Immigration Court, Charlotte Immigration Court, and USCIS field offices throughout New Jersey, Florida, Texas, and South Carolina.

Multi-State Licensing:

• New Jersey: LCSW #44SC06146200
• Florida: LCSW #TPSW2497
• Texas: LCSW #115239
• South Carolina: LCSW #TLS.359.CP

Bilingual Services: I conduct evaluations in English, Spanish, Portuguese, or Galician.

Flexible Turnaround: Five turnaround tiers from 24-hour emergency to 15-day standard.

Contact Information

For more information about immigration psychological evaluations or to discuss your specific case:

Phone: (862) 372-2737

Email: info@riverbankbehavioral.com

Office: 78 Fillmore St., Newark, NJ 07105

I respond to all inquiries within 24-48 hours. For attorneys, please visit the For Attorneys page for referral information.

This content is for educational purposes and does not constitute legal advice. Consult with a qualified immigration attorney about your specific case.

Page Last Updated: January 2026 | Fernando Vázquez, LCSW | Licensed in NJ (#44SC06146200), FL (#TPSW2497), TX (#115239), SC (#TLS.359.CP) | MSW, Rutgers University 2018