How to Prepare Recommendation Letters

3. Other Evidentiary Considerations

Letters of Support

Many petitions for extraordinary ability classification include support letters. While letters of support carry some weight, they should not be the basis for a successful petition of this classification type. Instead, claims made in the letters should be supported by documentary evidence in the case materials.

Letters should specifically explain why the witnesses believe the applicant meets the level of a person with extraordinary abilities. Letters that merely repeat USCIS definitions or contain general and vague statements about the applicant and their achievements are usually not persuasive.

The relationship or connection between the applicant and the letter author is also a factor considered. Generally, a person who has achieved national or international recognition would be expected to have received a large number of independent mentions extending beyond personal and professional acquaintances.

In some cases, letters from other professionals in the applicant's field may contain only general words, showing merely that the applicant is competent and respected in their field. If clear, documented evidence is absent — such letters may be considered but do not prove extraordinary abilities on their own.

Evaluation of Immigration Petitions from Persons Who Previously Held O-1 Status

Sometimes an officer may receive a petition from a person who previously held an O-1 visa (extraordinary ability) or "extraordinary achievement" status in film and television.

While prior O-1 approval may be considered an important factor, it is not decisive and does not guarantee approval of an EB-1A immigration petition.

Due to the similarity of evidentiary requirements, some courts have asked USCIS to explain why, if a person previously received O-1, they are not recognized as eligible for the EB-1A immigration category. USCIS determined that prior O-1 status does not automatically mean compliance with EB-1A requirements.

Therefore, where possible, the officer should briefly explain in case of denial why, despite former O-1 status, the applicant did not meet the evidentiary burden and did not demonstrate compliance with EB-1A criteria.

Example 1 — Leading / Critical Role (from employer)

Dear Sir or Madam,

I serve as Senior Vice President of Product at Helios Health, a U.S. healthcare technology company with 1,200 employees and FDA-cleared software used by 2,300 clinics. I directly supervised [Name] from 2022–2024 as Director of Data Platforms.

[Name] held a clearly leading and critical role in our Data Platform Division. They owned the roadmap and delivery of the Clinical Insights layer used by all Helios applications (10 product lines, ~41% of company revenue in 2024). Under [Name]'s leadership, the team shipped the "Signals v3" release that reduced model inference costs by 37% and improved diagnostic recall by 9.8% across three indications (IRB study #HH-IRB-2218). These results were material to our FDA De Novo expansion (K232118) and to closing enterprise contracts with Adventist and Mercy totaling $12.4M ARR.

Organizationally, [Name] reported to me, managed three managers and 18 engineers/ML scientists, chaired our Company-wide Model Risk Committee, and had veto power on production model deployments. No other role in the division could approve launches touching protected health data. This scope demonstrates a leadership position in the hierarchy and a critical influence on outcomes.

For verification, please see: press release (Helios Health, 09/14/2023), FDA decision summary (De Novo K232118), and our public case study with Mercy (URL included). I am available to provide further documentation.

Sincerely,

Olivia Carter

SVP Product, Helios Health

Example 2 — Original Contributions of Major Significance (independent expert)

To Whom It May Concern,

I am a full professor and department chair with 120+ peer-reviewed publications (h-index 54). My lab studies clinical decision support and real-world evidence.

[Name]'s contributions are original and field-shaping. Their "Sparse Temporal Fusion" method (see DOI:10.1234/jbi.2023.567890) enables stable predictions under missingness typical of EHR streams. Independent groups have replicated gains of 6–10% AUROC on MIMIC-IV and eICU benchmarks (citations: JBI 2024; AMIA 2024). The method is now used in two NIH-funded consortia (R01-HL-22111; U01-LM-34567) as a default baseline, which is a strong indicator of major significance.

I have no financial relationship with [Name]; our contact has been limited to conference program committees and peer review. My opinions rely on the attached publications, GitHub repository (commit history and releases), and public grant abstracts listed above.

Sincerely,

Prof. Daniel Huang, PhD

Chair, Dept. of Biomedical Informatics, Northridge University

Example 3 — Confirming Scope and Impact Across Industry (editor/organizer)

Dear USCIS Officers,

As Editor-in-Chief of a peer-reviewed trade journal (JCR Q1; Scopus SNIP 1.9), I write to attest to [Name]'s impact on clinical AI deployment. Our 2023 special issue on Model Governance featured [Name]'s invited article (DOI attached), which became the most-read piece of the year (14,300 unique readers; Altmetric 128). Following publication, two hospital systems (ClevelandCare and WestBay Health) cited the framework in their public governance charters (URLs enclosed). In my editorial judgment, [Name]'s work has raised the bar for safe roll-out practices across the sector.

I do not have a personal or supervisory relationship with [Name]. My assessment is editorial and based on objective readership and citation data.

Sincerely,

Maya Rios

Editor-in-Chief, Data & Health