"IS there a way that a person can extend a visit in the U.S. because of medical reasons? My friend traveled from Ireland last month and was planning to stay for a few weeks. She has a visa. She has had medical problems at home, and I feel the best place for her to take care of them is here. She also has insurance which would be of great benefit to her in paying the bills. Can she stay here because of her condition? Are there procedures she has to follow?"

YOU say that your friend entered the U.S. on a visa and was planning on staying here for a few weeks, so we'll assume she's in possession of a B tourist visa. This will be very important should she decide to extend her stay in the U.S.

Why? Only those who entered the U.S. with a visa are permitted to do this. Visitors who travel to the U.S. under the visa waiver program, which allows for visa-free stays of up to 90 days, cannot apply to extend or change status while in the U.S. under any circumstances.

As a visa holder your friend can apply to the U.S. Citizenship and Immigration Service (USCIS) to extend her non-immigrant status. These extensions are usually granted provided all guidelines for doing so are met, chief among them the filing of the appropriate paperwork prior to the expiration date on the I-94 arrival/departure card that every non-immigrant receives upon entry. (The card is stapled into the visitor's passport.)

The form to complete for an extension of stay is I-539 (application to extend/change non-immigrant status.) It's available for downloading on the USCIS website, www.uscis.gov. The filing fee is $300, and the paperwork comes complete with detailed instructions.

Again, it's important that your friend start the process prior to the expiration date on the I-94 - in fact, USCIS recommends that the paperwork be filed 60 days in advance. And the agency doesn't look kindly on those who fail to stick to the rules.

According to USCIS, "If your status expired before you filed an application with USCIS to extend your stay in the U.S. or if you have otherwise violated the terms of your status, such as by working without authorization, then you are out of status. If you have fallen out of status, except in certain limited instances related to circumstances beyond your control, we cannot extend your nonimmigrant stay.

"Staying longer than the period of time for which you were granted admission may also have a negative effect on your ability to get other benefits or to return to the U.S. at a later time. If you fall out of status, we recommend you leave the U.S. as soon as possible to avoid, or at least minimize, the possible impact on your ability to come back to the U.S. at a later time."

Having said that, it's probable that your friend would fall out of status while waiting for an answer from USCIS on the extension. The agency's Vermont Service Center, which processes I-539s for the East Coast of the U.S., is currently handling applications filed on or before August 13, 2007.

Being out of status during the processing time is permissible, as long as the I-539 was received before status expired. USCIS will grant an extended stay for 240 days, or until a decision on the application is made, whichever comes first.

Obviously, if an extension is denied, your friend would have to leave the country immediately. But this shouldn't be a problem if all the t's are crossed and the i's are dotted.