Passport Photo Guide for People with Disabilities (U.S. Rules & What You Need to Know)

Jasmine F

Jasmine F

— 5 min read
Passport Photo Guide for People with Disabilities (U.S. Rules & What You Need to Know)
Photo by Romain Virtuel / Unsplash

May 25, 2025

Complete guide to passport photo requirements for people with disabilities, including official accommodations, medical exemptions, and how to avoid wrongful rejections.

Taking a passport photo can already be stressful — and for people with disabilities, chronic conditions, or medical needs, the process sometimes feels confusing or unfair. This guide breaks down exactly what the U.S. Department of State allows (and what it doesn't), including accommodations, medical exemptions, and how to avoid common rejections.

Why This Guide Matters

Most passport photo rules were written with able-bodied people in mind, and photographers or postal clerks often misunderstand what's actually allowed. Many applicants with disabilities get rejected for reasons that should not be grounds for rejection — such as assistive devices, medical headgear, involuntary facial expressions, or posture limitations.

This guide clarifies the official rules so you can submit a valid, compliant passport photo without unnecessary stress.

1. General Passport Photo Requirements (For Everyone)

For step-by-step instructions, see the How to Take a Passport Photo at Home guide. You can also use our passport photo generator to automatically create compliant photos with proper sizing and background requirements.

Before we get into disability-specific rules, the basics still apply:

  • Photo size: 2 × 2 inches
  • Face size: 1 – 1 3/8 inches from chin to top of head
  • Neutral expression (if medically possible)
  • Both eyes open (unless medically unable)
  • No glasses (unless a doctor's note is provided)
  • White or off-white background
  • Head facing directly toward the camera
  • No filters, smoothing, retouching, or altered features
  • Taken within the last 6 months

2. Accommodations & Exceptions for People with Disabilities

This is where most people get conflicting answers.

Here are the real, State-approved exemptions.

Note: If you've had significant weight loss from surgery and are wondering if you need a new passport photo, see our guide on passport requirements after weight-loss surgery.
Note: If you've had significant weight loss from surgery and are wondering if you need a new passport photo, see our guide on passport requirements after weight-loss surgery.

A. Facial Expression Limitations

If someone cannot maintain a neutral expression due to disability, neurological condition, or involuntary muscle movement, the photo must still be accepted.

Examples:

  • Facial paralysis
  • Seizure disorders
  • Muscle spasms
  • Developmental disabilities
  • Stroke-related asymmetry

Allowed: Any involuntary expression

Not grounds for rejection.

B. Eyes Not Fully Open

If an applicant cannot keep one or both eyes open, the photo may still be accepted if a medical condition prevents it.

You should include a doctor's note, but even without one, the State Dept's own examples show accepted photos where one or both eyes are partially closed due to disability.

C. Head or Neck Support

Applicants who cannot hold their head up may:

  • ✔ Use medical neck braces
  • ✔ Use a headrest
  • ✔ Lean against a plain white backdrop
  • ✔ Use a caregiver to steady them as long as the assistant's hands are not visible

If head support is visible, the image may be rejected — but you can use pillows, rolled towels, or support objects hidden behind the person.

D. Posture Limitations

If someone cannot sit upright or face forward due to:

  • Scoliosis
  • Mobility impairment
  • Chronic pain
  • Wheelchair seating needs

…the photographer must work with their natural posture, not force alignment.

Facing the camera straight is required only if physically possible.

E. Assistive Devices

Allowed in the photo if they cannot be removed:

  • Hearing aids
  • Insulin pumps
  • Feeding tubes
  • Cochlear implants
  • Oxygen nasal cannula
  • Wheelchairs

These do not cause rejection.

Not allowed:

Items that obstruct the face when removable, such as:

  • Removable oxygen masks
  • Removable splints/cervical collars (if they can be taken off safely)
  • Anything covering the chin, jaw, cheeks, or forehead unnecessarily

F. Medical Head Coverings

Head coverings for medical reasons are allowed if they do not cast shadows on the face.

Allowed:

  • Bandages
  • Temporary medical wraps
  • Scar-reduction coverings
  • Protective helmets (if medically required)

A note is recommended but not always required.

Not allowed:

  • Hats
  • Fashion scarves
  • Hoods
  • Anything worn only for comfort or preference

3. For People With Severe Disabilities or Infants With Disabilities

If you're taking pictures of children with disabilities, the baby passport photo guide may also help. For information on common rejection reasons and how to avoid them, see our guide on why passport photos get rejected.

If the applicant absolutely cannot sit, hold their head, or face the camera:

You may photograph them lying down on a white sheet.

Rules:

  • No shadows
  • The face must be fully visible
  • No caregivers or hands in the frame

This is how newborn passport photos are also taken — and the same method applies to disabled adults.

4. When the State Dept Should Not Reject Your Photo (But Sometimes Does)

These are the most common wrongful rejections reported by disabled applicants.

  • ❌ "Your expression isn't neutral."If the applicant cannot control their expression, it must still be accepted.
  • ❌ "Your eye is closed; we can't accept this."False — medically necessary eye closure is allowed.
  • ❌ "The wheelchair can't be visible."Untrue — wheelchairs are allowed.
  • ❌ "Your head isn't straight."If the disability prevents this, it's acceptable.
  • ❌ "You must remove your medical device."If removal is unsafe or medically impossible — it stays.

If you want backup, attach a simple note:

"Medical condition prevents neutral expression/upright posture/etc."

That's enough.

5. What Is Not Allowed (Even With Disabilities)

These rules apply universally:

  • ❌ Filters or AI face changesNo smoothing, contouring, sharpening, enlarging eyes, etc.
  • ❌ Changing facial structureNo jaw realignment, cheek slimming, nose editing.
  • ❌ Digital removal of medical devicesAltering reality is considered identity manipulation.
  • ❌ Shadows across the faceEven if disability requires equipment, lighting must keep the face clear.
  • ❌ Caregiver hands or support visibleEven slight finger tips will cause rejection.

6. How to Take an Accessible Passport Photo at Home

If you're using your own app (GetPassportReady), this is a great place to link it.

Step-by-step:

  1. Place the person in front of a bright, white wall
  2. Use natural daylight from the front
  3. Ensure no shadows on face or background
  4. Support head/neck using hidden props
  5. Take the photo from 4–6 feet away
  6. Keep the camera at eye level
  7. Upload and crop to 2×2 requirements
  8. If needed, attach a short medical note
  9. Print with correct DPI if mailing in
Make a compliant passport photo instantly →
Our AI-powered tool helps ensure your photo meets all requirements, including proper sizing and background compliance.

7. If a Clerk or Photographer Argues With You

You can calmly say:

"The U.S. Department of State allows medical exemptions for expression, posture, devices, and eye positioning. Their website confirms this."

Most clerks simply don't know.

If they refuse, go somewhere else.

The acceptance is done by the State Dept not the clerk.

8. Documentation You Can Include (Optional But Helpful)

  • Doctor's note supporting a physical limitation
  • Short explanation statement
  • Copy of a relevant ADA guideline
  • Printed screenshots from travel.state.gov

Most people never need these — but they help prevent rejections.

9. Quick Checklist (Copy/Paste Friendly)

✔ Allowed

  • Mobility devices
  • Medical head coverings
  • Eye partially or fully closed
  • Involuntary expressions
  • Head tilt due to disability
  • Neck braces (if required)
  • Tubes, implants, hearing aids

❌ Not Allowed

  • Filters / beauty edits
  • Caregiver hands visible
  • Incorrect background
  • Shadows across face
  • Removable devices used for comfort only
  • Hats or fashion items

10. Final Tips

  • Take several photos to choose the cleanest one
  • Keep lighting simple
  • Don't overthink the "perfect" neutral expression
  • If a condition is visible, it's still valid
  • The goal is identity accuracy, not perfection
Generate My Passport Photo →
Our AI-powered tool helps ensure your photo meets all requirements, including proper sizing, background compliance, and accessibility accommodations.

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