There is a widespread, dangerous belief: that having a U.S. citizen child with a health condition guarantees a judge will stop a deportation. It does not, and a September 1, 2026 decision shows why.
At Campos Law Firm, we closely monitor developments in U.S. immigration policy to protect our clients’ rights and future. Below, we explain what the court decided, what the real standard is, and what evidence makes the difference.
What is happening?
On September 1, 2026, the First Circuit Court of Appeals decided Espinoza Benitez v. Blanche (No. 25-2029), in an opinion by Judge Lynch, with Judges Rikelman and Aframe on the panel. The court denied the petition for review, leaving the denial of cancellation of removal in place.
The facts, per the decision: the petitioner is Salvadoran, entered in 2000, and overstayed his visa from 2001. Removal proceedings began in 2018. He has two U.S. citizen children; one has asthma, treated with medication including an inhaler, and was hospitalized in 2014 for an asthma attack.
The problem was not the illness but the proof. The court noted there was no precise testimony or corroborating evidence about the cost of asthma medication in El Salvador, its actual availability there, or the family’s ability to afford it. According to the opinion, the petitioner acknowledged he did not know the costs.
The court also made clear that a lower standard of living is not enough on its own, and that the immigration judge weighed all factors cumulatively.
What does cancellation of removal require?
Cancellation of removal for non-permanent residents (section 240A(b)(1) of the Immigration and Nationality Act) requires four things at once:
- Ten years of continuous physical presence in the country immediately preceding the application.
- Good moral character during that period.
- No disqualifying criminal convictions.
- That removal would cause “exceptional and extremely unusual hardship” to a spouse, parent, or child who is a U.S. citizen or lawful permanent resident.
That fourth requirement is where most cases are lost. The applicant’s own hardship does not count — only the qualifying relative’s. And even when all four are met, the grant remains discretionary.
There is also a cap almost no one mentions: the statute allows a maximum of 4,000 cancellations per fiscal year. Once it is exhausted, judges must reserve grants for the following year, while denials issue without restriction.
What does “exceptional and extremely unusual hardship” mean?
It is a deliberately high standard. The Board of Immigration Appeals defined it in Matter of Monreal-Aguinaga (2001): the hardship must be substantially different from, or beyond, what would normally be expected from the deportation of someone with close family here. It need not be unconscionable, but it must clearly exceed the ordinary.
Two later decisions mark the boundaries. Matter of Andazola-Rivas (2002) denied the case of a mother with two citizen children, because fewer educational and economic opportunities in the home country is precisely the normal result of a deportation. Matter of Recinas (2002) granted relief, but the Board itself warned that the case sat at the outer limit of the narrow spectrum that meets the standard: a single mother of six, with no support, no family in the home country, and children who did not speak Spanish.
For medical cases, Matter of J-J-G- (2020) governs, with a two-part test: the qualifying relative has a serious medical condition, and, if they accompany the applicant, adequate medical care is not reasonably available there. It warns that applicants lack medical and firsthand knowledge, so they must present reliable corroborating evidence; an uncorroborated internet search is not enough.
That explains this outcome: there was a serious, documented condition, but no corroborated proof that treatment was unavailable or unaffordable.
What evidence actually builds a medical hardship case?
This is the actionable part, and it is worth spelling out:
- Treating physician’s declaration: specific diagnosis, medications and dosages by name, prognosis, and above all what concretely happens if treatment is interrupted. Note: a U.S. physician generally knows nothing about the home country’s health system; that proof comes from elsewhere.
- Medication cost in the home country: price listings from the national regulator or pharmacy chains, dated, set against the family’s realistic income there. A price alone proves nothing; affordability is what matters.
- Availability of treatment: State Department country reports, the local public system’s essential medicines list, Pan American Health Organization publications, peer-reviewed medical literature, and — the most powerful and least used — a letter from a physician in the home country.
- Distance and access: where the family would live versus where treatment is actually offered, available transport, and the cost and time of travel.
- Financial capacity and insurance: tax returns, a household budget, the current policy, and bills showing what insurance covers and what comes out of pocket.
- Expert testimony: a country-conditions expert and, where relevant, a psychological evaluation of the impact of separation or relocation on the child.
And a tactical warning: the Supreme Court held in Wilkinson v. Garland (2024) that applying the hardship standard is reviewable on appeal. But as this case shows, that review is deferential, and the court accepts the facts the immigration judge found. In short: the case is won or lost in the record built before the immigration judge.
Protect Your Case with Campos Law Firm
No one can promise an outcome in a cancellation case, and anyone who does should worry you. What can be done is to build the record to the depth the standard demands, and to start early: gathering medical reports, prices, country conditions evidence, and expert opinions takes months.
At Campos Law Firm we assess whether your case meets all four requirements and build the hardship evidence with the documentation courts are now demanding. Do not leave your immigration status to chance. Call us today at +1 (844) 922-6767 to schedule a free, confidential consultation in English or Spanish. Campos Law Firm: Legal Solutions in All Areas of Law.
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