We have recently won a case for a physician working in several rural clinics as well as his private practice within a medically underserved area. We were retained following a denial of the I-140 petition for NIW. We filed an appeal as well as an amended (new) I-140 application to show that the physician had met the 5-year service requirements for an NIW. The applicant had moved from one medically underserved area to another while the original I-140 was pending. The issue was whether an “amendment” could have been filed in this case to notify USCIS of the move without an approved I-140. USCIS issued a request for evidence, but acknowledged the applicant’s prior medical service and credited him the time towards his 5-year requirement. Upon receipt of the request for evidence we responded with additional documentation to show the relationship between the physician (medical service provider) and the rural clinics (contractor). We supplied attestation letters from each of the contractors as well as an affidavit from the applicant indicating a commitment to complete his 5-years of medical service in the underserved area. In order to show “full-time” employment, we provided documentation that described the combined service at each rural clinic as well as time spent with patients at his private practice, which more than met the 40-hour requirement. We also offered a letter from the previous employer to document prior medical service.