Extreme hardship · Forms I-601 and I-601A
Psychological evaluations for extreme hardship waivers.
A waiver does not turn on what the applicant has been through. It turns on what would happen to the qualifying relative — the U.S. citizen or lawful permanent resident spouse or parent — if the applicant were refused. So that is the person we evaluate.
Every evaluation is completed by a U.S. licensed Doctor of Psychology, virtually, anywhere in the country, in English or Spanish.
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At a glance
- Who is evaluated
- The qualifying relative, not the applicant.
- Fee
- $1,000, with payment plans over up to six months.
- Interview
- Virtual. One session, or two at no extra charge if it is needed.
- Report
- One to two weeks from the interview.
- Languages
- English and Spanish. Interpreters for other languages on request.
That first line surprises people more often than any other thing on this site, and getting it wrong wastes a filing.
What the evaluation establishes
Hardship is always a comparison: this family as it is now, against two futures neither of which they chose.
Separation, and relocation
Both have to be weighed, because the relative faces a choice between them. We set out what staying behind alone would do, and what following the applicant to the other country would do — to health, to care, to schooling, to income and to safety.
The hardship already present
Depression, anxiety, a chronic condition, a child with an individualised education program, an elderly parent being cared for at home. The baseline matters, because extreme hardship is usually an existing vulnerability made worse rather than something that begins on the day of refusal.
How far it would deteriorate
Prognosis is where a clinical opinion earns its place: what would worsen, how quickly, what treatment would be interrupted, and whether the care relied on here exists at all in the country of relocation.
The whole household
Losing a wage earner or the person who does the caring is a psychological event as well as a financial one. We document income, debt, housing, childcare, school continuity and language, and quantify the strain where it can be quantified.
What a hardship waiver has to establish
The waiver turns on a small number of findings. These are the ones an evaluation can reach, and the ones it cannot.
Hardship to the qualifying relative, not to the applicant
This is the distinction the whole waiver turns on, and the one most often got wrong. The hardship that matters is what a U.S. citizen or lawful permanent resident spouse or parent would suffer. The applicant’s own suffering, however severe, is not the test. So the person we evaluate is the qualifying relative. Where a firm sends us the applicant, we say so before any interview is booked.
Both scenarios, not one
The qualifying relative faces two futures: relocating to the applicant’s country, or remaining in the United States separated from them. A waiver is weak when it argues only one. The evaluation addresses both, because hardship that looks tolerable in one scenario is often severe in the other.
Hardship as an accumulation
Individual factors — family ties, health, financial consequence, conditions in the country of relocation, care that is unavailable there — rarely reach “extreme” alone. They are weighed together, and a clinical account is what shows how they compound in one person rather than sitting as a list.
Health, specifically
Where the qualifying relative has a condition, what matters is not the diagnosis but whether treatment exists where they would be going, and what deterioration would follow without it.
What the evaluation does not do
It does not weigh the equities, does not address admissibility, and does not predict the outcome.
PPA is a clinical practice, not a law firm. The standards described above are set out to show where a psychological evaluation fits within them. They are general information, not legal advice, and nothing here creates an attorney–client relationship. What a particular case requires is for the applicant’s attorney to determine.
How it works
Four steps. The qualifying relative needs an hour of privacy and a phone or a laptop; we handle the rest.
A call, at no charge
Tell us about the case and who the qualifying relative is. We explain how the evaluation works, what it can and cannot do, and what it costs. No payment is taken at this stage.
Usually within a few hoursDocuments and scheduling
Counsel sends the declaration, the filing deadline, and the objective records that anchor the findings: treatment notes, school and IEP documents, employer letters, anything about the conditions in the country of relocation.
Priority scheduling when a filing date requires itThe clinical interview
Virtual, with the qualifying relative, in their own language. History, the household as it works now, both futures, and standardised measures. If it becomes too much to finish in one sitting, we stop and take it up again another day — and that second session costs nothing.
One session, or two at no extra chargeThe report
Written, signed and sent to counsel as a PDF, ready to file, with history, observation and opinion kept clearly apart. We answer questions on the findings afterwards at no extra charge.
One to two weeks from the interviewWhat the report contains
Written for an adjudicator, not for a clinician. Its length follows the case rather than a template.
- The qualifying relative's relevant personal, family and medical history
- The household as it functions now, and who depends on whom
- Mental status examination and behavioural observations
- The standardised instruments administered, with scores and what they mean
- Diagnostic impressions, where a diagnosis is warranted
- Separation: the psychological and practical consequences of staying behind
- Relocation: care, schooling, language, employment and safety in the other country
- Children's needs, including education, therapies and continuity of care
- Financial and caregiving impact on the household
- Prognosis, treatment needs, and the barriers to obtaining that treatment
- The evaluator's credentials, licence number and signature
We provide the written evaluation and nothing beyond it. We do not prepare declarations, and we do not appear as an expert witness or give testimony.
We are retained to examine, not to advocate. The report says what we find — which is the only reason it carries weight.
If the clinical picture does not support the claim, we will tell counsel before the report is written rather than after. An evaluation that overstates is worse than no evaluation at all.
Fees
$1,000Complete. No hourly billing.
The fee covers the intake call, the clinical interview, the instruments, the written report, and answering counsel's questions once it is delivered.
A second session costs nothing extra. Sometimes the interview cannot be finished in one sitting. When that happens we stop and finish another day, and the fee does not move. Nobody is put in the position of choosing between stopping and paying more.
Payment plans run over up to six months, and the evaluation goes ahead while payments are running. We take payment only after we have spoken to you and agreed the case is one we can help with. If the case stops before the interview takes place, the fee is returned in full and any remaining payments are cancelled.
Where a filing date requires it, we prioritise scheduling.
Other evaluations we prepare
Questions we are asked
Who exactly do you evaluate?
The qualifying relative — the U.S. citizen or permanent resident spouse or parent whose hardship the waiver depends on. Not the applicant. Where children are central to the hardship, their circumstances are documented through the relative and through the records counsel provides.
Is an I-601A evaluation different from an I-601?
The clinical work is the same, and in both the subject is the qualifying relative. The difference is one of timing: with the provisional waiver the family is facing the prospect of departure rather than living with it already, so the evaluation addresses anticipated hardship and the relative's current state under that prospect. How the framework applies to a particular case is counsel's ground, not ours.
The relative has no diagnosis. Is there any point?
Often, yes. Hardship is not only psychiatric, and a person who is managing now may still face extreme hardship if the household loses its income, its caregiver or its access to treatment. The report will describe what is actually there, including resilience, rather than manufacture a condition that is not.
Is the evaluation ever done in person?
No. Every evaluation we carry out is virtual, and that is deliberate rather than a compromise: it is what allows us to take a case in any state, including for families who live nowhere near a psychologist who speaks their language. The protocol, the standardised instruments and the written report are the same ones we would use in a consulting room.
Who carries out the evaluation?
A U.S. licensed Doctor of Psychology, in every case. You can read about the clinician who carries out the evaluations on our About page.
What if the case does not go ahead?
If the interview has not yet taken place, the fee is returned in full and any remaining payments are cancelled. Once the interview has happened the clinical work has been done, and the fee stands.
Start with a conversation.
Tell us a little about the case and we will call you to explain how the evaluation works and arrange the interview. Nothing is charged for that call.
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