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Canadian OT to American OT in 8 Simple Steps

by Natasha Freutel



Are you a Canadian OT wanting to work in the United States, but not sure where to start?

Check out New Grad Occupational Therapy's 8 steps to working in the United States. We break down the process, cost, and time commitment, so you are prepared while looking for a new job and planning your upcoming move.

Step 1: Graduate

There is an essential difference between finishing school and graduating. This may or may not apply to you, but some programs that finish in June or July do not officially graduate until the convocation ceremony in the fall. NBCOT often requires that your degree has been conferred as an internationally educated OT.

Step 2: Apply to take your NBCOT exam as a Canadian OT and receive ATT letter

You can apply to take the NBCOT online or by mail. You will need your Social Insurance Number (SIN), credit card to pay the $555.00 fee, and you must request your school to mail your official transcript to NBCOT. You can find their address on the application.

Once all the information is received you will receive your Authorization To Test (ATT) letter. Once you receive this letter you are officially one step closer to working in the United States.

Step 3: Schedule Exam

All exams are completed at a Prometric testing center. There are multiple locations all over the United States and Canada. Find the closest location to you here and search for dates and availability. Once you write and pass your exam, you may move on to the next step!

Step 4: Apply for your Visa Credential Verification Certification (VCVC)

The U.S. Department of Homeland Security, U.S. Citizenship & Immigration Services (USCIS) requires a health care worker certification (in this case a VCVC) to prove that your credentials are legit. Only occupational therapists who have successfully passed the NBCOT Certification Examination are eligible to apply through the Visa Credential Verification Certificate (VCVC) process. Have your credit card ready again, as this also costs $500. Read more about it here.

Step 5: Finalize your Job Offer

Hopefully, you have a job lined up and can now finalize your job offer. Let them know that you are planning to come as a TN NAFTA professional and will require additional documentation from the company to obtain your immigration papers. According to, this includes a “letter from your prospective employer detailing items such as the professional capacity in which you will work in the United States, the purpose of your employment, your length of stay, and your educational qualifications.” This is a fairly simple letter, but you may want to think about hiring an immigration attorney to assist if your new company is not familiar with the process.

Step 6: Apply for your TN Status

You can do this at any border crossing or port of entry. TN status is not actually a visa, therefore you do not have to apply at the United States consulate. Before applying make sure you have all the required documentation. This is critical as you can easily get denied for missing an item. This application costs $56.00 and is good for three years.

TN NAFTA Requirements Checklist

  • You are a citizen of Canada or Mexico
  • Your profession qualifies under the regulations
  • The position in the United States requires a NAFTA professional
  • You have a prearranged full-time or part-time job with a U.S. employer (but not self-employment)
  • You have the qualifications to practice in the profession in question (VCVC)

Remember, you are a temporary non-resident, and therefore they may also ask you for proof that you are not planning to stay there indefinitely. It is recommended to bring documentation showing Canadian assets, family ties, property owned, car loans, student loans, etc. If they believe that you are going to stay permanently, it is possible that they will deny your application.

Step 7: Apply for your SSN

Woohoo! You are almost there. The next step is to apply for your Social Security Number (SSN). The Social Security Administration recommends waiting 10 days after arriving in the United States to apply for a social security number. This makes it easier for them to verify immigration documents online, speeding up the process.  Find more information here.

Step 8: Apply for your License

Lastly, apply for your OT license. Once you have all the other documents in place, you can apply for your state licensure. Check with the board of occupational therapy in the state you will be working for specific requirements. This process can take anywhere from 2 weeks to a few months and the cost can vary from 50 to 200 dollars. Research this ahead of time to make sure you have completed all the requirements before applying. You can find more information on

Wishing you the best of luck on your job search! Moving to sunny California from Canada was the best decision I ever made. I am beyond grateful for all the opportunities that have been provided to me as a Canadian OT and hope you find a job and place that you love.

**Please note: This is not an all-encompassing list, but rather an illustration of the process, cost, and time commitment. Please consult an immigration professional regarding your specific circumstances.

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