Schedule A (US shortage occupations: nurses and physical therapists)

In 20 CFR 656.5 the Department of Labor (DOL) states that it has determined there are not sufficient United States workers who are able, willing, qualified and available for the occupations on Schedule A, and that employing foreign workers in them will not adversely affect the wages and working conditions of US workers similarly employed. That determination is why these jobs skip PERM recruitment.

Schedule A has two groups:

• Group I: physical therapists and professional nurses.
• Group II: people of exceptional ability in the sciences or arts (including college and university teachers) and in the performing arts.

In December 2023 DOL published a request for information on adding STEM and other shortage occupations. As the regulation reads in October 2026, Group I still lists only professional nurses and physical therapists.

Professional nurses. 20 CFR 656.5(a)(2) covers people who will be employed as professional nurses and who:

• have received a certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS, now TruMerit);
• hold a permanent, full and unrestricted license to practice professional nursing in the state of intended employment; or
• have passed the NCLEX-RN, administered by the National Council of State Boards of Nursing.

Any one of the three is enough. DOL defines a professional nurse as a person who applies the art and science of nursing, generally including clinical judgments in the observation, care and counsel of patients, administering medicines and treatments prescribed by a physician or dentist, and promoting health. The rule does not list licensed practical or vocational nurses.

Physical therapists. 20 CFR 656.5(a)(1) covers people who will be employed as physical therapists and who have all the qualifications needed to take the physical therapist licensing exam in the state where they will practice. Under 656.15(c)(1), the employer files a letter or statement signed by an authorized state physical therapy licensing official confirming the worker is qualified to take that state's written licensing exam.

1. The employer obtains a prevailing wage determination from DOL. USCIS says the wage offered must be at least 100 percent of the prevailing wage.
2. The employer gives notice of filing to a bargaining representative, or posts it at the workplace for at least 10 consecutive business days, between 30 and 180 days before filing.
3. The employer files the uncertified Form ETA-9089, with appendices, a signed Final Determination and the nurse or therapist evidence, together with Form I-140 at USCIS, not at DOL.
4. USCIS decides, usually in the EB-3 category, and the filing date sets your priority date.

USCIS says the nurse must hold the qualifying credential at the time of filing.

• No green card queue jump. You still wait for your date in the Visa Bulletin.
• No appeal to DOL. Under 656.15(e), USCIS's Schedule A decision is final, and under 656.15(f) nurse and physical therapist cases cannot be refiled through basic PERM.
• No license. You still need state licensure and a health care worker certificate such as VisaScreen.

Our NCLEX-RN guide and nurses in the USA page cover the full route.