The Japan Medical Services Visa

Step 1

Confirm that the proposed work in Japan is consistent with the activities permitted for the holder of a Japan Medical Services Visa.

The activities permitted under a Medical Services Visa are medical treatment services that are required to be undertaken by those with the following qualifications.

1. Physician.
2. Dentist.
3. Pharmacist.
4. Public health nurse.
5. Birthing assistant.
6. Registered nurse.
7. Assistant nurse.
8. Dental hygienist (shikaeiseishi).
9. X-ray technician.
10. Physical therapist (rigakuryouhoushi).
11. Occupational therapist (sagyouryouhoushi).
12. Eye specialist (shinoukunrenshi).
13. Clinical technician (rinshoukougakugishi).
14. Artificial limb technician (gishisougushi).

Note that, depending on the specific situation, there are a range of other requirements that may need to be met by some applicants. These additional requirements include:

1. That the Applicant will receive no less remuneration than would a Japanese national undertaking comparable work.
2. That the activities in Japan must take place within a certain period of time after the Applicant has received her qualifications (for example within four, six, or seven years).
3. That the Applicant will work in an area where it is difficult to secure certain medical services.

Step 2

Assemble the documents required to support a Japan Medical Services Visa application.

Once an Applicant has confirmed that her proposed activities in Japan are consistent with those outlined above in Step 1, supporting documentation needs to be prepared.

In the case of a Medical Services Visa, the authorities require the following documents:

1. Documents certifying that the Applicant is qualified to undertake one of the activities described in Step 1 above.
2. Documents that certify:
   1. The actual activity to be undertaken by the Applicant,
   2. The proposed duration of the activity,
   3. The position to be held by the Applicant, and
   4. The Applicant’s remuneration.

Although not technically required, our experience is that providing Japanese translations enhances the quality of an application. This may minimize delays in obtaining final approval.

Japan Visa’s certified immigration specialists are able to assist in the preparation and translation of all documentation required for a Medical Services Visa.

Note regarding Japan Tax Planning Opportunities for Medical Services Visa applicants.

Typically, there are quite limited tax planning opportunities for the holder of a Medical Services Visa. But, items such as employer provided housing, commuting allowance, and employer funded home leave can result in significant individual tax savings. In some circumstances, off-shore payment of compensation can result in tax savings if the holder of the Medical Services Visa will spend time outside Japan on business. All these matters should be negotiated with the employer prior to finalizing the documentation needed for the Medical Services Visa COE application (see Step 4 below). The following article provides more information about this important issue Japan Taxes: Tax Planning for Foreigners Working in Japan.

Step 3

Submit an application for a Japan Medical Services Visa Certificate of Eligibility (“COE”).

Once the Applicant’s activities have been confirmed and the appropriate documents assembled per steps 1 and 2 above, the next step in most cases will be to apply for a Certificate of Eligibility (abbreviated as “COE”).

A COE is a document issued by the Japanese immigration authorities. It certifies an Applicant’s eligibility to undertake specific employment in Japan – in this case, the position associated with the Medical Services Visa application.

An application for a Medical Services Visa COE must be submitted in person at a regional immigration office in Japan. The COE application cannot be submitted by mail or at a Japanese embassy outside Japan.

Where the Applicant is not personally available (for example because she is not in Japan or due to a busy schedule) Japanese law allows a certified immigration specialist to submit a Medical Services Visa COE application on behalf of the Applicant.

Japan Visa’s certified immigration specialists are able to handle all the procedures associated with preparing and submitting an application for a Medical Services Visa COE.

Step 4

Await Approval of the Medical Services Visa COE.

The processing time for a Medical Services Visa COE is generally four to six weeks.

Once approved, a notice is sent to an address in Japan advising that the COE is ready for collection at the regional immigration office where the COE application was originally submitted.

Where Japan Visa is handling the Medical Services Visa application, the notification from the immigration authorities is sent to our office. Japan Visa’s certified immigration specialist then collects the COE from the regional immigration office and either forwards it to the Applicant or prepares a change of status application (see Step 5 below).

Step 5

Obtain Legal / Accounting Services Status of Residence (SOR).

Once an Applicant has the Medical Services Visa COE in hand, the next step is for her to exchange the COE for Medical Services “Status of Residence” (usually abbreviated as “SOR”).

Technically speaking, it is the Medical Services SOR that will form the basis of the Applicant actually living and working in Japan.

There are two methods for converting the COE to Medical Services SOR:

1. Exchange the Medical Services COE at a Japanese embassy or Consul outside Japan.

This is the traditional route for obtaining Medical Services SOR.

The Applicant first exchanges the Medical Services Visa COE for a Medical Services Visa at a Japanese embassy or consul outside Japan. The process generally takes two to three business days.

The Applicant then travels to Japan and is granted Medical Services SOR at the port of entry.

2. Undertake a Change of Status to Medical Services SOR in Japan.

In some cases, an alternative may be for the holder of a Medical Services COE to enter Japan under the Japan Visa Waiver Program or some other form of short-term entry. The Applicant then applies for Medical Services SOR via a change of status at a regional immigration office in Japan.

A change of status takes approximately two weeks. During that time, it is not possible for the Applicant to travel outside Japan.

Where the change of status route is utilized, Japan Visa’s certified immigration specialists can undertake the necessary procedures at the regional immigration office in Japan.

Japan Residence Card

Whether you receive your Medical Services SOR at the airport upon entering Japan or via a change of status application filed at a regional immigration office in Japan (see Step 5 above), you will receive a Japan Residence Card.

This is an official identification card that includes an IC chip. The Residence Card contains personal information such as your name, address, birth date, residence status (in this case, Medical Services SOR), period of stay, etc.

You are required to carry your Residence Card at all times.

Step 7

Consider applying for a Japan Re-entry Permit.

Up until July 2012, if you held Medical Services SOR and wished to temporarily leave Japan (e.g., for vacation, business, etc.) it was necessary to obtain a Re-entry Permit for Japan in advance of travelling.

However, it is now possible to leave Japan for up to 12 months without a Re-Entry Permit.

If there is any possibility that a trip outside Japan will last for more than 12 months, an individual holding Medical Services SOR should ensure that they have a Re-entry Permit. This can be obtained at regional immigration office in Japan.

1. Japanese Tax for holders of Medical Services SOR

People living in Japan under Medical Services SOR will typically be working for an institution that handles at least part of their Japan tax matters on their behalf. This is done by way of withholding tax deducted each month and a year-end adjustment as part of the December payroll.

However, if some income is being paid outside Japan, you may need to submit a Japanese tax return by 15 March each year. It is very important that you understand your Japan tax obligations since no extensions are available.

Complying with your Japanese tax obligations is essential in order to renew your visa.

2. US Tax for holders of Medical Services SOR

If the holder of Medical Services SOR is a US citizen or green card holder, they will continue to have US tax obligations even while living in Japan.

The US rules applicable to Americans living overseas are complex and constantly changing. In order to avoid possible penalties, anyone with a US tax filing obligation should seek specialist advice to ensure that they fulfill their US tax obligations.

3. Taxes when the holder of Medical Services SOR leaves Japan

Before leaving Japan, the holder of Medical Services SOR is required to fully settle her taxes or appoint a tax agent.

It should also be noted that Japanese local tax is assessed based on where you live on 1 January each year. As a result, departing Japan prior to 1 January can result in significant tax savings.