Afghan Doctor's Green Card 2026: Stuck in Immigration Limbo

Ali (a pseudonym) wakes up at 5:30 a.m. every day, drives 35 minutes through the West Virginia mountains, and starts caring for some of the sickest patients in the country. Last year, he treated more than 1,600 people — over 80% of them on Medicare or Medicaid. Some drove two hours just to see him. But this fall, he may not be allowed to keep working, even though he has done everything right.

What happened to his green card application?

Ali came to the US on an H-1B visa (a work visa for highly skilled foreign workers) and later applied for a green card (permanent US residency). Under normal rules, people who have applied for a green card can stay in the country while their case is reviewed. But in January 2026, the Trump administration told US Citizenship and Immigration Services (USCIS) to pause processing of green card applications and other immigration benefits for people from 39 countries — including Afghanistan. Ali's application froze. His visa expires this fall. If USCIS does not approve his green card or renew his visa status by then, he will lose his job — even though his two US-born children and his wife can legally stay in the country.

A federal court recently ruled that USCIS must stop suspending immigration benefit processing for nationals of those 39 countries. The judge said the policy showed "anti-immigrant sentiments" that the agency is not allowed to act on. But USCIS is appealing that decision. In the meantime, the agency says it will comply with the court order — but lawyers say they are seeing very slow movement. Of 21 foreign doctors interviewed for this story, only one had their application processed. Ali and 19 others are still waiting. The Trump administration also imposed a $100,000 fee on new H-1B visas for people applying from abroad — though a separate federal judge struck down that fee on June 8, 2026. That ruling is also being appealed.

Ali's situation is not unique. Doctors from Sudan, Libya, Iran, Nigeria, and other affected countries face the same freeze. Many work in rural or underserved areas where hospitals have struggled for years to recruit physicians. West Virginia has the second-highest cancer death rate in the US and one of the lowest life expectancies. More than 50% of its residents live in areas without easy access to basic medical care. Hospital leaders say losing foreign-born doctors would directly reduce the number of patients they can treat — one hospital executive said kidney transplants at his facility dropped from about 150 to about 80 this year because of limited physicians.

What to do

• If your green card application or work permit (Form I-765, the Employment Authorization Document) is on hold because of the USCIS pause, contact an immigration lawyer right away. The recent court ruling may give you grounds to push USCIS to process your case — but you may need to be part of a lawsuit or file a mandamus action (a legal request asking a court to force a government agency to act).
• If your H-1B visa or status expires soon, ask your employer's HR or legal team to file an H-1B extension (Form I-129, the petition for a nonimmigrant worker) as early as possible. The current filing fee for Form I-129 is $730. Do not wait until the last minute.
• Track the court cases. The federal ruling against the USCIS pause is being appealed. Decisions in these cases can change your options quickly. Sign up for updates from organizations like the American Immigration Lawyers Association (AILA) or follow immigration news outlets.
• Document everything. Keep copies of all your visa approvals, work authorization documents, application receipts, and employer letters. If your status is questioned, this paperwork is critical.