EB-2 NIW Case Study: Approval for Medical Doctor and Radiologist from Peru Peru Medical Doctor and RadiologistColombo & Hurd secured approval of an EB-2 National Interest Waiver (NIW) petition for a medical doctor and radiologist from Peru who specializes in musculoskeletal health. USCIS approved the petition with Premium Processing following the firm’s response to a Request for Evidence (RFE). Osteoarthritis is the most common form of arthritis and one of the leading causes of physical disability among adults in the United States. The condition causes chronic joint pain and limits mobility, which makes it harder for people to stay active and keep working. Obesity is one of its main risk factors, and prevention through healthy weight, regular physical activity, and joint protection remains a priority for federal health agencies. Our client’s work as a musculoskeletal radiologist has given him firsthand experience with the effects of osteoarthritis and other joint conditions. His proposed endeavor focuses on preventing and mitigating osteoarthritis in young adults through training, education, and workshops for health professionals and vulnerable populations. His work aims to reduce work-related disability and lower the economic burden this disease places on the U.S. healthcare system. The initial petition was led by Partner Sal Picataggio, and the RFE response was led by Senior Attorney Roshn Vazel, Director of the firm’s RFE Department. Evaluate my Profile Client ProfileA Radiologist Focused on Joint Health and PreventionEB-2 NIW VisaOur client holds a medical degree and a specialization in radiology. His career began with a residency in radiology at a national cancer institute in Peru, where he interpreted imaging studies, assisted in image-guided procedures, and took part in clinical research. After his residency, he continued working at the institute as a radiologist, supervising diagnostic imaging and advising other physicians on complex cases. For over a decade, he has led the musculoskeletal radiology unit at a private clinic in Lima, a role that combines clinical work with management of policies, staff, and quality assurance. Over more than 16 years in practice, he has developed deep knowledge of sports injuries and degenerative joint conditions. He has taught radiology to medical students and postgraduate physicians, helped develop curricula, and authored peer-reviewed publications in musculoskeletal imaging. His training also includes a visiting scholar appointment at a U.S. university radiology department, an observership at a U.S. radiology institute, and an imaging internship in Chile. In the United States, he plans to apply his clinical knowledge to osteoarthritis prevention, helping people recognize and address risk factors before significant joint damage occurs. His proposed program includes educational campaigns, workshops, and training sessions focused on healthy weight management, nutrition, and physical activity. The program will reach young adults, parents, and health professionals through in-person workshops, online webinars, social media content, and one-on-one counseling. By addressing obesity and other risk factors early, his work aims to lower osteoarthritis rates and help people who already have the condition stay mobile and active. The Challenge Showing the Broader Impact of a Prevention-Focused Endeavor USCIS issued an RFE questioning all three parts of the EB-2 NIW standard. Specifically, the RFE requested a more specific description of how the client’s work would affect the field and the economy as a whole beyond just the individuals he would serve directly. USCIS also questioned whether our client was well positioned to advance his endeavor and asked for additional evidence of the client’s record of success, his plan for the endeavor, and interest from U.S. entities or individuals. The petition therefore needed to clearly show how a prevention program built on education and workshops produces measurable benefits at a national level, and how the client’s clinical, teaching, and research background makes him the right person to carry it out. Strategic Response Connecting Osteoarthritis Prevention to Federal Health Priorities The legal team focused on showing how the client’s prevention program could benefit communities and healthcare providers beyond those participating directly in his workshops. The response connected his proposed work to federal efforts to prevent chronic disease, promote physical activity, and reduce the impact of musculoskeletal conditions on the workforce. The response cited the Centers for Disease Control and Prevention (CDC)’s guidance on physical activity, healthy weight, and joint protection, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Osteoarthritis Initiative, and research on the economic and employment effects of joint conditions. The response also referenced the executive action establishing the Make America Healthy Again Commission and explained how the endeavor reduces costs for the healthcare system and employers, not only for the people who attend his workshops. To address USCIS’s questions about the client’s ability to carry out the endeavor, the response included a professional plan that laid out the services, target population, location, and funding for the endeavor. Updated letters of recommendation, his publication and citation record, and a personal statement on his conference presentations, awards, and professional memberships showed a record of success in the field. A statement on the innovative aspects of the endeavor explained how his approach differs from existing programs and how it can scale beyond a single region. Finally, the response showed that our client’s contributions benefit the United States even if other qualified workers are available, and that the need for osteoarthritis prevention is urgent given the condition’s effect on disability and employment. Read More The Result EB-2 NIW Approval with Premium Processing After RFE Response USCIS approved the EB-2 NIW petition with Premium Processing on October 5, 2026. The approval followed the RFE response, confirming that the client’s prevention-focused endeavor meets the national importance standard and that he is well positioned to advance it. This approval positions our client to pursue his osteoarthritis prevention programs in the United States. Once permanent residency is obtained, he will be able to launch his workshops, training sessions, and online resources for young adults, families, and health professionals. Why This Case Succeeded A Clinician Who Sees the Problem and Teaches the Solution The strength of this case came from how naturally the client’s background connects to his endeavor. As a musculoskeletal radiologist, he has spent his career reading the images that reveal joint damage, often after the condition has already set in. That daily exposure gives him a clear understanding of which risk factors matter most and which habits protect joints over time. His years of teaching medical students and postgraduate physicians showed he can translate that knowledge into programs others can follow. The petition also showed reach beyond his own practice. Training health professionals creates a multiplier effect, since each person he educates can carry prevention strategies to their own patients and communities. Paired with a concrete plan that identified where the endeavor would start, whom it would serve, and how it would be funded, the record gave USCIS a specific, verifiable picture of national impact. The evidence spanned federal health guidance, peer-reviewed work, and independent letters, so no single piece carried the argument alone. Case Overview Category Details Visa Classification EB-2 National Interest Waiver (NIW) Nationality Peru Professional Field Medicine and Radiology Education Medical Degree; Specialization in Radiology Request for Evidence (RFE) Yes Premium Processing Yes Attorneys Partner Sal Picataggio and Senior Attorney Roshn Vazel Outcome I-140 Petition Approved Date of Approval October 5, 2026 Read More