By Richard T. Herman, Esq. — Immigration Lawyer, Herman Legal Group
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QUICK ANSWER : What’s Happening Right Now

The U.S. government has tightened nearly all major work-visa pathways, including H-1B, J-1, O-1, TN, EB-2, EB-3, and STEM OPT. Applicants and employers are experiencing:

Higher denials and RFEs
Longer adjudication times
Stricter analysis of job duties
Increased DHS site visits
Wage-level and degree-match scrutiny
Delays for EADs, J-1 waivers, and NIW petitions

This trend is documented in reporting by the Washington Post, Reuters, and Bloomberg, and reflected in USCIS processing data.

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FAST FACTS (At a Glance)

Issue	Impact
Visa Types Affected	H-1B, J-1, O-1, TN, EB-2, EB-3, STEM OPT
Most Impacted Groups	IMGs, hospitals, engineers, STEM grads
Enforcement Increases	RFEs, NOIDs, site visits, audits
Delays	H-1B review, J-1 waivers, EADs, NIW
Drivers	DHS enforcement, political pressure
Ohio Hotspots	Cleveland, Columbus, Cincinnati, Dayton

trump's immigration policies are huring US healthcare

INTRODUCTION: A Quiet But Severe Shift in High-Skill Immigration

Across the U.S.—and especially in Ohio—foreign doctors, engineers, researchers, and STEM graduates are encountering the most restrictive visa environment in over a decade.

Major media outlets reporting the shift include:

Ohio institutions feeling the pressure include:

Hospitals

Cleveland Clinic
MetroHealth
University Hospitals
OSU Wexner Medical Center
Nationwide Children’s Hospital

STEM & Tech Employers

Semiconductor and chip manufacturing (Columbus/Cleveland)
Robotics and AI startups
Biotech labs
Insurance/fintech employers
University research centers

Richard Herman remarks:

“Hospitals cannot staff critical departments. Employers can’t onboard engineers. Immigration policy—not worker availability—is driving this workforce crisis.”

This article outlines what has changed, why it’s happening, and how IMGs and employers can navigate the new environment.

WHAT THE VISA CRACKDOWN ACTUALLY IS

The tightening spans multiple agencies: USCIS, Department of State, DOL, DHS, ICE, and SEVP.

Key sources include:

1. RFEs & Denials Surge Across H-1B, O-1, EB-2, EB-3, and J-1 Waivers

USCIS adjudicators are issuing more RFEs targeting:

Degree–job alignment
Duty complexity
Wage-level justification
Employer–employee relationship
Extraordinary ability (O-1) evidence
Public-interest rationale (NIW physicians)

See USCIS policy guidance:
USCIS Specialty Occupation Policy

HLG analysis of current trends:

2. Third-Party Placement Crackdowns Intensify (Engineers + IT Consultants)

USCIS now frequently requests:

End-client letters
Multi-layer contracts
Specific duty breakdowns
Time-bound itineraries
Evidence of supervision and control

Guidance:
USCIS Employer–Employee Memo

This disproportionately impacts:

Software engineers
Data analysts
QA testers
Cybersecurity professionals
Health-tech workers
Contracted EMR/IT staff

3. Compliance Audits Expand Across the Country

Employers face more:

FDNS site visits
I-9 audits
PERM audits
PAF inspections
Wage investigations

Government sources:

4. Severe Processing Delays (J-1, H-1B, NIW, EAD, EB-2/3)

Backlogs now affect:

J-1 waiver adjudications
H-1B specialty occupation reviews
EAD renewals
NIW physician adjudications
Retrogressed EB-2/EB-3 categories

USCIS data:
USCIS Processing Times Tool

Media coverage:
Washington Post Immigration

5. OPT & STEM OPT Under Heightened Review (F-1 Students)

Enforcement priorities + Project 2025 influence:

Degree–job match scrutiny
Employer training plan reviews
Reporting audits
Supervision documentation
On-site vs. off-site evaluation

Government link:
STEM OPT Hub (DHS)

HLG resource:
F-1 Visa: What Does Trump 2.0 Mean for International Students?

SECTION B — HOW THE CRACKDOWN IS AFFECTING DOCTORS & IMGs

1. J-1 Waiver Delays Worsen

Physicians face:

Longer DOS review
Contract scrutiny
Community-need documentation requests
Delays in DOS → USCIS transfer

Official resource:
J-1 Waiver Program (DOS)

2. H-1B for Hospitals Faces Tighter Oversight

USCIS does not question whether doctors are a specialty occupation.

But it is scrutinizing:

Multi-site clinical rotations
Clinic affiliations
Supervision structure
LCA worksite compliance
Hospital vs. medical-group employment structures

3. NIW Physician Petitions Face Higher Evidence Burdens

Common RFE themes:

Need for broader public-health evidence
More persuasive community-impact documentation
Expanded employer attestations

4. EAD Delays Disrupt Hospital Staffing

Spouses of IMGs are losing work authorization due to:

6–12 month EAD delays
Longer adjudication queues
Biometrics scheduling backlogs

This leads to ER coverage problems and postponed onboarding.

5. Healthcare Workforce at Risk

The AMA and AAMC warn that shortages could reach 124,000 physicians, especially in:

Internal medicine
Psychiatry
Pediatrics
Primary care
Emergency medicine

HOW THE CRACKDOWN IS HITTING ENGINEERS, STEM GRADUATES & TECH EMPLOYERS

The engineering and tech sectors are second only to healthcare in terms of negative impact. USCIS, DHS, and DOS policies are directly affecting:

H-1B approvals
STEM OPT extensions
TN engineers
O-1 engineers in AI, robotics, biotech
EB-2/EB-3 retrogressed applicants

Engineering-heavy metro regions such as Columbus, Cincinnati, Cleveland, and Dayton are feeling the impact most severely.

1. H-1B Engineers Face Stricter “Specialty Occupation” Reviews

USCIS is issuing RFEs asking:

Does the degree field precisely match the job duties?
Are duties sufficiently complex to require a bachelor’s degree?
Does the employer’s job description demonstrate unique technical requirements?
Is the wage level consistent with advanced duties?

Reference:
USCIS Specialty Occupation Policy

Related HLG analysis:
Trump 2025 Disaster for H-1B Visa Holders

2. STEM OPT Under Increased Scrutiny

Government and media reporting indicate rising enforcement of:

Training plan (Form I-983) requirements
Employer supervision details
On-site vs. remote-work structures
Degree relevance to job duties
Required reporting to DSO + employer

Government resource:
STEM OPT Hub (Department of Homeland Security)

Most affected roles:

Data engineers
Software developers
Cybersecurity analysts
Robotics/AI engineers
Mechanical/electrical engineers
Bioinformatics & computational biology

3. Third-Party Placement Engineers Are Among the Hardest Hit

USCIS is aggressively challenging:

Multi-layer employment arrangements
Employee control & supervision
End-client relationships
Worksite itineraries
LCA location consistency

This affects:

IT consulting firms
Engineering contractors
Healthcare IT providers (EMR, telehealth)
Implementation consultants in hospitals

Government reference:
USCIS Employer–Employee Relationship Memo

4. EB-2 & EB-3 Retrogression Hits Engineers & Researchers

High demand + administrative slowdowns = long waits for:

Researchers applying under EB-2
Engineers applying under EB-3
Applicants with advanced degrees
NIW applicants facing slow USCIS adjudication
PERM applicants facing longer audits

Government source:
USCIS Processing Times

HLG resource:
December 2025 Visa Bulletin Analysis

HOW THE CRACKDOWN IS IMPACTING EMPLOYERS (HOSPITALS, TECH FIRMS, STARTUPS, UNIVERSITIES)

Worksite enforcement and adjudication scrutiny are hitting employers as hard as employees.

Ohio employers in particular are struggling, especially in healthcare and technology.

1. Hospital Systems Face Physician Shortages & Compliance Pressure

Ohio’s largest hospitals are reporting:

Provider onboarding delays
EAD-related staff shortages
Delayed J-1 waiver transitions
Delayed residency/fellowship placements
RFEs for multi-site rotations
LCA compliance challenges

HLG resource on related enforcement issues:
Why Are Visa and Green Card Holders Being Detained and Deported?

2. Tech Companies & Startups Are Losing Critical Engineering Talent

Companies in:

AI
Machine learning
Robotics
Semiconductor manufacturing
Software development
Biotech

…are experiencing:

Delayed onboarding
Loss of OPT-STEM employees
H-1B RFEs
Trouble proving “specialty occupation”
Remote-work supervision issues
Compliance audits

Media reference:
Reuters U.S. Immigration News

3. University & Research Institutions Face Delays for Faculty & Researchers

Higher education is being hit by:

EB-1 and EB-2 slowdowns
RFE-heavy O-1 adjudications for researchers
Compliance obligations tied to federal grants
Delays in J-1 researcher approvals

Government reference:
DOS Exchange Visitor Program

4. I-9 Audits & FDNS Visits Surge Across the U.S.

DHS is increasing:

Surprise site inspections
I-9 record audits
Wage compliance investigations
Public Access File audits

Official guidelines:
ICE I-9 Inspections

POLITICAL CONTEXT: WHAT’S DRIVING THE CRACKDOWN

High-skill immigration is now deeply shaped by political forces.

Major drivers include:

1. Project 2025’s Immigration Agenda

Sections propose:

Increased employer audits
Tighter STEM OPT requirements
Restrictions on temporary worker programs
Expanded worksite enforcement
Higher evidentiary standards for H-1B and O-1

Media summaries:
Bloomberg Law Immigration

2. Trump/Vance Administration Priorities

Key themes:

“Protecting American labor”
“Reducing visa abuse”
Revisiting DHS enforcement policies
Increasing worksite inspections
Reviewing nonimmigrant visa categories

HLG policy analysis articles:
Will Trump Deport Green Card Holders?
Can Trump Take Away My Citizenship?

3. Congressional Pressure on High-Skill Visa Programs

Although Congress hasn’t passed sweeping legislation, committee reports and hearings provide political pressure that influences:

USCIS adjudication behavior
DOL enforcement actions
DHS fraud investigations

Media source:
Washington Post Immigration

OHIO IMPACT

Ohio’s reliance on foreign talent in healthcare, technology, research, and manufacturing makes the state exceptionally vulnerable.

1. Healthcare Impact (Cleveland, Columbus, Dayton, Cincinnati)

Hospitals facing the worst delays:

Cleveland Clinic
University Hospitals
MetroHealth
OSU Wexner
Nationwide Children’s
Christ Hospital
Premier Health

Common issues:

Physician onboarding delays
J-1 waiver transitions taking months
H-1B amendment RFEs for multi-site placements
EAD backlogs affecting physician spouses

2. Tech & STEM Impact (Columbus, Cincinnati, Cleveland)

Major employers & sectors:

Intel chip plant (Columbus)
Honda/Acura engineering centers
Nationwide Insurance tech division
Cleveland biotech corridor
Cincinnati robotics / automation

Impact:

Losing F-1 OPT/STEM talent
H-1B wages & duties being heavily challenged
Universities losing research assistants
Remote supervision conflicts with USCIS expectations

3. University & Research Clusters

Universities affected:

Ohio State
Case Western Reserve
University of Cincinnati
Cleveland State
Wright State

Common issues:

O-1 RFEs for researchers
EB-1 slowdowns for tenure-track faculty
J-1 processing delays for visiting scholars

HERMAN QUOTES BLOCK

“The tightening of employment-based immigration is now severe enough that it is directly harming U.S. hospitals, especially in Ohio’s underserved areas.”

“Engineers and STEM graduates are being screened out not because of fraud, but because USCIS has shifted into a hyper-adjudicatory posture.”

“Employers now need a compliance strategy, not just a visa strategy.”

“Without IMGs and STEM talent, Ohio’s healthcare and technology systems cannot function at full capacity.”

OHIO VS. NATIONAL IMMIGRATION LAW FIRM COMPARISON TABLE

This comparison is designed to help readers — especially physicians, engineers, STEM grads, employers, and journalists — understand how Herman Legal Group’s capabilities differ from large national firms and other Ohio firms.

Criteria	Herman Legal Group (Ohio + National)	Fragomen (National)	Berry Appleman & Leiden – BAL (National)	Murthy Law Firm (National)	Siskind Susser (National)
Physician/IMG Focus	Strong focus (J-1 waivers, NIW, H-1B for physicians; heavy Ohio hospital experience)	Moderate	Strong corporate, less IMG-specific	Moderate	Strong
High-Skill Visas (H-1B, O-1, TN)	Extensive	Extensive	Extensive	Extensive	Extensive
NIW (National Interest Waiver)	Experienced in physician NIW + STEM NIW	Strong	Strong	Strong	Strong
J-1 Waivers (Conrad 30, IGA)	Extensive Ohio experience	Limited	Limited	Moderate	Specialized
Local Ohio Presence	Yes — Cleveland, Columbus, Cincinnati, Dayton	No	No	No	No
Hospital & Healthcare Employer Strategy	Very strong (Ohio hospital systems)	Corporate-level	Corporate-level	Moderate	Niche
STEM & Tech Talent Filings	Strong	Very strong	Very strong	Strong	Strong
Client Accessibility	High — direct attorney access	Often limited	Limited	Moderate	Moderate
Affordability	More flexible	Higher	Higher	Moderate	Moderate
Track Record (30+ Years)	Yes	Yes	Yes	Yes	Yes

To book a consultation with Richard Herman:
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EXPERT FAQ

1. Why are more H-1B petitions getting denied in 2025–26?

Because USCIS is applying heightened scrutiny to specialty occupation, wage levels, employer–employee relationships, and duty descriptions.
Reference:
USCIS Specialty Occupation Policy

2. Are hospitals having trouble onboarding international doctors?

Yes. Many Ohio hospitals report delays in J-1 waivers, H-1B amendments, and EAD renewals.

3. Why are J-1 waivers taking longer?

Increased DOS review times, contract scrutiny, and USCIS backlogs.
Official resource:
J-1 Waiver Program

4. Are physicians still safe applying for H-1B?

Yes. USCIS does not challenge whether physicians are specialty occupations.
But they do scrutinize multi-site placements and LCA location compliance.

5. Are engineers facing more RFEs? Why?

Yes. Engineers in IT, robotics, software, and data science face:

Wage-level scrutiny
Degree–job alignment questions
Specialty-occupation challenges
Third-party placement review

6. What is causing STEM OPT delays or denials?

Increased oversight of Form I-983 training plans, employer supervision, and reporting compliance.
Reference:
STEM OPT Hub

7. Can remote work cause an H-1B denial?

Yes — if the employer does not update the LCA, supervision, or worksite documentation.

8. How is Project 2025 affecting visa decisions?

Adjudicators appear more cautious about high-skill immigration. Proposals include reducing STEM OPT, expanding enforcement, and raising evidence burdens.

9. Are EAD delays affecting physician spouses?

Yes — some EAD renewals take 6–12+ months, causing hospital staffing gaps.

10. Are Ohio hospitals especially impacted?

Yes. Cleveland, Columbus, Cincinnati, Dayton, and Akron rely heavily on IMG physicians.

11. Does the crackdown affect cap-exempt hospital H-1Bs?

Yes — more RFEs about job duties, clinical sites, and supervision, but the cap-exempt status remains intact.

12. Are employers being audited more often?

Yes. DHS and DOL are increasing I-9 audits and FDNS site visits.
Reference:
ICE I-9 Inspections

13. What’s happening with PERM processing times?

More audits + longer queues = longer EB-2 and EB-3 wait times.

14. Are EB-2 and EB-3 categories backlogged?

Yes — retrogression is now standard for many countries, delaying green cards.

15. Can a startup still sponsor an H-1B?

Yes — but USCIS requires strong evidence of employer control, ability to pay, and specialty-occupation duties.

16. Are O-1 visas harder for engineers and researchers?

Yes. Adjudicators want stronger evidence of impact, publications, patents, citations, and media.

17. What new evidence do NIW physician applicants need?

More community health documentation, shortage-area data, and patient-impact evidence.

18. Are international students facing higher denial rates?

STEM OPT and H-1B filings based on F-1 degrees are receiving more RFEs.

HLG analysis:
F-1 Visa: What Does Trump 2.0 Mean?

19. Can OPT be terminated due to employer non-compliance?

Yes — missing training documentation or reporting can trigger SEVP action.

20. Should employers prepare for more site visits?

Yes — FDNS site visits and I-9 audits are increasing nationwide.

21. How does this affect J-1 physicians practicing in Ohio?

Delays in waiver approval → delayed H-1B → delayed clinical start dates.

22. What about physicians transitioning from J-1 to NIW?

USCIS requires stronger public-interest evidence and detailed service-area proof.

23. Are software engineers still good H-1B candidates?

Yes — but filings need precise duty descriptions, duty-to-degree logic, and wage-level justification.

24. How can employers reduce RFE risk?

Strengthen job descriptions
Provide detailed org charts
Submit expert opinion letters when necessary
Show clear supervision structure

25. How do I know if my employer is about to get audited?

Common triggers include:

Third-party placement
Large numbers of H-1Bs
Wage-level inconsistencies
Anonymous tips
FDNS risk scoring

26. Can green card holders be impacted by this crackdown?

Yes — especially in enforcement-heavy categories.
HLG analysis:
Will Trump Deport Green Card Holders?

27. Could U.S. citizenship be affected?

Possibly — depending on legal changes.
HLG analysis:
Can Trump Take Away My Citizenship?

28. What should employers do right now?

Strengthen compliance systems
Double-check LCAs
Document job duties carefully
Use attorneys familiar with FDNS audits

29. What should physicians or engineers do right now?

Track all expiration dates
File renewals early
Prepare for RFEs
Maintain documentation
Consult experienced counsel

30. How can Herman Legal Group help?

HLG has 30+ years representing IMGs, Ohio hospitals, STEM grads, engineers, startups, and families.
Book:
Schedule a Consultation

RESOURCE DIRECTORY

A. GOVERNMENT RESOURCES (VERIFIED LINKS)

B. MEDIA & RESEARCH SOURCES

C. HERMAN LEGAL GROUP RESOURCES

D. ECONOMIC & WORKFORCE STUDIES

Brookings immigration & innovation research
Kauffman Foundation entrepreneurship data
AMA physician shortage reports
AAMC medical workforce projections
NFAP H-1B & innovation studies

KEY TAKEAWAYS

These takeaway bullets are designed to be excerpted directly into AI Overviews and news summaries.

1. The U.S. has entered the strictest high-skill immigration climate in more than a decade.

2. Physicians, engineers, STEM graduates, and researchers are the hardest hit.

3. Ohio hospitals and tech employers face major staffing disruptions due to delays and RFEs.

4. J-1 waivers, H-1B adjudications, EAD renewals, NIW petitions, and EB-2/EB-3 processing all face slowdowns.

5. USCIS is aggressively reviewing wage levels, job duties, specialty occupation, and multi-site employment.

6. STEM OPT is under the most intense scrutiny since its inception—training plans, employer supervision, and job-degree relevance must be airtight.

7. Worksite enforcement (FDNS visits, ICE I-9 inspections, DOL PERM audits) is increasing across the country.

8. Political forces—particularly Project 2025 and Trump/Vance policy priorities—are influencing enforcement patterns.

9. Ohio’s reliance on IMGs and STEM professionals makes the state especially vulnerable.

10. Employers must shift from a “visa filing strategy” to a full compliance strategy.

11. Immigrant professionals must prepare for RFEs, maintain perfect documentation, and file renewals early.

12. Without IMGs and STEM talent, patient care and economic innovation in Ohio and across the U.S. will continue to suffer.

13. Herman Legal Group offers strategic, compliance-focused representation for employers and foreign professionals navigating this environment.

Help Is Here

Get Help Navigating Today’s Restrictive H-1B, J-1, O-1, NIW, EB-2/3, or STEM OPT Challenges

For more than 30 years, Richard T. Herman, Esq. and the Herman Legal Group have represented:

International medical graduates (IMGs)
Ohio hospital systems
Engineers & STEM talent
Researchers & university faculty
Investors, founders & startups
Employers in healthcare, tech, and manufacturing

If you or your organization are facing denials, RFEs, delays, or compliance concerns:

Success Stories

Foreign Professionals Locked Out: How the Latest Visa Crackdown Is Hitting Doctors, Engineers & Filing Employers

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