The Petitioner, a Brazilian-trained physical therapy specialist, proposed to work in the U.S. providing patient care and expert advice/treatment at a healthcare facility, and possibly training new physical therapists.

Prong 1 — national importancenot established · dispositive

“the Petitioner has not offered sufficient information and evidence based on these recommendation letters to demonstrate the prospective impact of her proposed endeavor will rise to the level of national importance, rather than only impacting her employer and patients.”

“the Petitioner's emphasis on the occupational shortage of physical therapists "does not, by itself, establish that [the Petitioner's] work stands to impact the broader field or otherwise have implications rising to the level of national importance."”

“Much of the Petitioner's evidence relates to the importance of the physical therapy profession or field, rather than the national importance of a specific proposed endeavor.”

“this does not appear to have an impact extending beyond her patients.”

“The record does not support that the Petitioner's proposed work as a physical therapy specialist with a healthcare facility stands to have wider implications in the field of physical therapy or the U.S. healthcare industry.”

AAO decision text

How the evidence was treated

• recommendation letter · discounted

  “The letters do not indicate that the Petitioner's work will have national or global implications in the field of physical therapy.”

  AAO decision text
• resume experience · discounted

  “The Petitioner's resume and recommendation letters only address her past accomplishments as a physical therapy specialist impacting her workplaces and patients.”

  AAO decision text
• other · discounted

  “The opinion focuses on the need for physical therapists and how the Petitioner's experience makes her well positioned to fill a physical therapy specialist job, instead of the Petitioner's specific endeavor having a prospective impact.”

  AAO decision text
• media · discounted

  “While the reports and articles demonstrate the field of physical therapy is important, they do not necessarily establish the national importance of the Petitioner's proposed endeavor.”

  AAO decision text
• degree · credited

Where this case turned

• Employer-specific benefit · p1 — "work furthers my company's product" — value accrues to one firm
• Field importance conflated with endeavor · p1 — argues the field matters, not the specific endeavor
• Local, not national scope · p1 — impact confined to clients / a region
• Occupational shortage argument rejected · p1 — argues a labor shortage — the labor-certification question, not Dhanasar

Notable

The Petitioner introduced a new 'endeavor' on appeal (cross-border healthcare business consulting) that the AAO refused to consider as an impermissible material change to the petition, citing Matter of Izummi and Matter of Katigbak.

Authorities this decision leans on

From the doctrinal survivor set — 187 authority tests across 47 distinct authorities cleared the differential-lift gates. Only those appear here.

• 8 C.F.R. 103.2(b)(1)
• 8 C.F.R. 204.5(k)(2)
• Matter of Izummi
• Matter of Katigbak
• Matter of L-A-C-
• Poursina v. USCIS

Cases in adjacent profiles

• The Petitioner, a pharmacist, proposed to work in the United States through her own company providing pharmaceutical reg
• The Petitioner, a Brazilian-trained physiotherapist, proposed to work as a physical therapist and entrepreneur in the Un
• The Petitioner, a resident physician in New York holding a Chinese bachelor of medicine (MBBS) degree found equivalent t
• The Petitioner, a music therapist, proposed to establish and expand music therapy services and community music programs
• The Petitioner, a physical therapist, proposed to work as a physical therapist in the United States while operating his