The Application Process For J-1 Visa Waivers In Montana

To apply for the J-1 visa waiver in the state of Montana, the J1 physician must:

  • Obtain a J-1 visa waiver case number from the U.S. Department of State.
  • Identify practice sites in Montana that are eligible to employ J1-physicians.
  • Seek employment at an eligible practice site.
  • Obtaining an employment contract (contingent on securing the J-1 visa waiver).
  • Submit the application for the J-1 visa waiver to the Montana Department of Public Health & Human Services (DPHHS).


Obtaining a J-1 Visa Waiver Case Number

Before anything else, the J-1 physician must obtain a J-1 visa waiver case number from the U.S. Department of State. This must be done before submission of the visa waiver application to Montana DPHHS. It is important to know that Montana DPHHS will not process any application without a J-1 visa waiver case number. Information in regards to how to obtain a J-1 case number can be found online at Alternatively, the application information can also be requested by writing to:

U.S. Department of State
Waiver Review Division
P.O. Box 952137
St. Louis, MO 63195-2137

The J-1 physician should send a completed Waiver Review Application Data Sheet to the Waiver Review Division of the U.S. Department of State to get the J-1 visa waiver case number. Make sure to include the required fee as well as two self-addressed stamped legal-size envelopes.

Once the Waiver Review Division of the U.S. Department of State has received the Application Data Sheet, the applicant will be mailed the J-1 visa waiver case number along with further instructions how to proceed.  Once the case number has been received, it is important that the case number will be affixed to any correspondence and documents in regards to the J-1 visa waiver process. Without this case number, documents will not be processed and will be returned to the applicant.


Identifying Practice Sites In Montana That Are Eligible to Employ J-1 Physicians

J-1 physicians must identify a practice site that must be physically located in a currently designated area within the state of Montana. Those locations are referred to as either federal Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA) or Medically Underserved Population (MUP). A practice site for general psychiatry must be in a designated Mental Health Professional Shortage Area (MHPSA). Usually, those designated areas might be rural areas where there is a shortage with increased demand for physicians.

The applicant can get an up-to-date list of the designated shortage and underserved areas in Montana by visiting the website of the Health Resources and Services Administration of the DPHHS, Shortage Designation Branch. The website’s address is

Note: The designation cycle for the eligible practice areas is always 3 years. It is important that the designation is current on the date the U.S. Department of State reviews the application and on the date when the J-1 visa waiver is approved.


Seeking Employment at Eligible Practice Sites

The J-1 physician will be required to find practice sites that would be willing to employ him or her. Not all practice sites, even in the above mentioned designated areas, will be suitable. A potential practice site must demonstrate that they attempted unsuccessfully to hire US citizens and/or residents for a period of at least six months.

It can be beneficial if the J-1 physician and the potential employer become familiar with the obligations outlined in the Montana State-30 J-1 Visa Waiver Program Guidelines. The work relationship between the J-1 physician and the employer needs to be good. Such a contract is not easily broken and both parties should be pretty confident that this relationship will be successful.


Obtaining an Employment Contract

In the next step, the J-1 physician needs to obtain an employment contract with an approved practice site. This contract will have the following requirements:

1. The contract must be for three years or longer.

2. It must include the full addresses and telephone numbers of the site(s) where the J-1 physician will practice.

3. It must include a statement by the J-1 physician agreeing to meet the requirements set forth in Section 214(k)(1) and (a) of the Immigration and Nationality Act.

4. It must clearly indicate the number of hours per week and the schedule that the J-1 physician will practice. This time must be a minimum of 40 hours/week for at least 4 days not including travel and/or on-call time.

5. The contract must state the the fixed salary.

6. The contract cannot include a non-compete clause preventing or discouraging the J-1 physician from continuing to practice in any federally designated shortage area after the period of obligation has expired.

7. The employment contract can only be terminated for just and proper cause and not simply for the mutual convenience of the parties. In addition, the contract must state that if the physician terminates the contract for any reason other than just and proper cause, he/she shall compensate the employer for any losses and inconveniences in the amount of $100,000 in damages.

Submitting the Application for the J-1 visa waiver to the Montana Department of Public Health and Human Services

In the final steps of the application process, the applicant will submit the application to the Montana Department of Public Health and Human Services.  The original application together with three hard-copies must be submitted. The application must be in writing and cannot be made via email or fax.

The applicant can also use the help of an immigration lawyer to help with the correct submission of the application along with all required documents. However, it is recommended that the J-1 physician does not use the same attorney as the employer in order to avoid possible conflicts of interest.

Requirements for the Employer

1. The employer needs to provide the original and a copy of the employment contract. The contract must be signed by both parties.

2. The employer must provide a letter requesting that Montana DPHHS act as an “interested government agency” and recommend the waiver on behalf of the J-1 physician.

The letter must include:

• The name and medical specialty of the J-1 physician.
• The qualifications of the J-1 physician.
• A detailed work schedule for the J-1 physician along with a statement that he or she will practice primary (or psychiatric or other specialty) care at least 40 hours per week during normal office hours at least 4 days per week (on-call and travel times do not count toward the 40-hour minimum).
• A description why the waiver should be granted and how it will affect the community if the waiver is denied.

3. A completed “Medical Practice Site and Program Description” form (Attachment 1 for existing practice site and/or Attachment 2 for practice site under development);

4. The employer is required to provide proof of prior efforts to hire a U.S. citizen or permanent resident physician for at least six months previously. This proof must consist of documents such as advertisements placed,  agreements with temporary agencies, resumes received, list of applicants interviewed along with the reasons for rejection.

5. Valid Medicaid and Medicare Provider Agreements of the employer.

6. A copy of the sliding fee scale, evidence of charitable care provided or any other verifiable evidence acceptable to Montana DPHHS

7. The employer must provide a retention plan, intended to meet the physician’s professional and lifestyle needs while practicing in this placement.

8. Letters of support from the local medical community and community leaders.

One other requirement is that the employer must not charge patients more than the usual rate prevailing in this particular federally designated shortage area.

In such cases where the practice site is located in a low-income special population HPSA, the employer must also provide the following information,  unless the practice is a Federally Qualified Community Health Center or other FQHC:

• The percentage of patients who are provided health services at a reduced rate
• The percentage of Medicare patients
• The percentage of Medicaid patients.

Requirements for the J-1 Physician

For a complete application, the J-1 physician must provide:

1. A J-1 Physician Assurances form (Attachment 3)

2. His or her current Curriculum Vitae.

3. Three letters of recommendation in support of the waiver applicant’s professional abilities and qualifications;

4. The J-1 physician must provide a copy of a valid license to practice medicine in Montana or must provide of application to obtain a license.

5. Documentation of Board Certification or a letter from the director of the J-1 physician’s residency program attesting to Board eligibility;

6. A copy of the U.S. Department of State letter assigning the case number;

7. A copy of the completed Waiver Review Application Data Sheet, including the applicant’s case

8. Copies of all the Certificates of Eligibility for Exchange Visitor (J-1) Status;

9. Copies of all the IAP-66 sheets issued by the U.S. Information Agency for each year the J-1 physician maintained the J-1 visa status with no time gaps;

10. A copy of his/her passport including all visa entries;

11. Copies of any I-94 Entry and Departure Cards; and

12. An explanation of any period spent in some other visa status, out of status, or outside of the U.S.

Important Notes

The application for the J-1 visa waiver must include all the required documents from the employer and the J-1 physician. The documents must be submitted with tabs in the order presented in Attachment 6. Each supplied document and correspondence must have the J-1 physician’s case number affixed. All documents must be on standard 8.5 by 11-inch white paper.

Mailing Address For the Application

The application must be mailed to:

J-1 Coordinator, Primary Care Office
Montana Dept. of Public Health & Human Services
P.O. Box 202951
Helena, MT 59620-2951

Once the application has been mailed, the applicant can expect a notification about the receipt of the application within approximately 15 working days. This notification will confirm that the application has been received by the Montana DPHHS and will also let the applicant know in case the application should be incomplete.

If the application was received and is deemed complete, it will be forwarded to the U.S. Department of State for review. The practice site and the physician will then be notified in writing that the application has been forwarded. Once the U.S. Department of State recommends the application for approval, it will forward the application to the BCIS with a recommendation for approval. When the application has been approved by BCIS they will send notification directly to the J-1 physician.

In those cases where the application has been rejected , Montana DPHHS will return all documents that were submitted to the applicant.