An extreme hardship evaluation is a clinical assessment of a qualifying relative — usually a U.S. citizen or permanent resident spouse or parent — that documents the mental health impact they would suffer if the applicant's waiver were denied. It supports I-601, I-601A, and 212(h) waivers. Amrinderjit Singh, LCSW conducts these evaluations by telehealth in 9 states.
Who is evaluated
A hardship waiver is decided on the hardship to the qualifying relative, not to the applicant. For unlawful-presence waivers (Form I-601A and many I-601 filings), the qualifying relatives are a U.S. citizen or permanent resident spouse or parent. For 212(h) waivers, a U.S. citizen or permanent resident son or daughter can also qualify. Hardship to other family members, such as children who are not qualifying relatives, is relevant when it affects the qualifying relative — for example, a spouse left to raise children alone.
Separation and relocation
USCIS looks at hardship in both scenarios: the qualifying relative staying in the U.S. without the applicant, and the qualifying relative relocating abroad with the applicant. Each report addresses both:
- Separation: anticipated emotional impact, loss of support and caregiving, financial stress and its mental health effects, and effects on children in the household.
- Relocation: disruption of mental health treatment, loss of family and community support, and the relative's ties to the U.S.
What the report covers
- Clinical interview with the qualifying relative (and the applicant, where helpful).
- Validated screening instruments for depression, anxiety, and stress.
- Existing mental health history, current treatment, and how it would be affected.
- Family roles, dependency, and caregiving responsibilities.
- DSM-5-TR diagnoses where clinically supported — a diagnosis is not required.
Why direct-language interviews matter here
In many Punjabi- and Hindi-speaking families, distress is described through physical symptoms, family obligation, and shame rather than clinical vocabulary. Interviewing the qualifying relative directly in their language — and recognizing those idioms of distress — produces a more accurate and more persuasive account of hardship.
Available in 9 states
Evaluations are conducted by secure telehealth for clients physically located in any of these states at the time of the session:
Frequently asked questions
Who needs to be evaluated for an I-601A extreme hardship waiver?
The qualifying relative — the U.S. citizen or permanent resident spouse or parent. The applicant may also participate, but the report focuses on the hardship the qualifying relative would face.
Is a formal diagnosis required for a hardship waiver evaluation?
No. The evaluation documents distress, functional impact, and anticipated hardship. DSM-5-TR diagnoses are included only where clinically supported.
Can hardship to children be included?
Yes, to the extent it affects the qualifying relative. For I-601A waivers children are not themselves qualifying relatives, but their needs often shape the hardship a spouse or parent would face.
Does the evaluation address both separation and relocation?
Yes. USCIS considers both scenarios, so every report addresses the impact of the qualifying relative staying in the U.S. and of relocating abroad.
Written by Amrinderjit Singh, LCSW · Last updated September 2026. This page describes clinical services and is not legal advice; eligibility questions should be directed to an immigration attorney.