Thanks for your question on HCM. I can understand your situation and problem. Tuberculosis after treatment produce healing either by fibrosis or calcification or both. These are permanent scar lesions. They are inactive, hence no treatment is required. But they will remain as it is and appear on chest x ray through out the life. For your work permit, we need to prove that these lesions are inactive and you are not suffering from any infectious disease. For this you need to consult pulmonologist and get done 1. CT thorax 2. Bronchoscopic evaluation and BAL (bronchoalveolar lavage) analysis. CT thorax is far superior then chest x ray in diagnosis of inactive scar. BAL is much better then sputum to rule out infections like tuberculosis. If both of these are negative then you can argue with visa authority about not having active, infectious disease. And your x ray spots are old, healed, scar lesions.