Dr. Nick Nelson walks through busy Highland Hospital to a sixth-floor exam room, where he sees patients from around the world who say they have fled torture and violence.

A few times each week, he and his team conduct medical evaluations of people who are seeking asylum in the United States. The doctors listen to the patients’ stories. They search for signs of trauma. They scrutinize injuries, including electrocution scars, bullet wounds and unset broken bones.

As the Trump administration looks to reduce the number of asylum applicants, citing loopholes and fraudulent claims, this clinic — and others like it in San Diego, Los Angeles, New York and Chicago — seeks evidence that can help determine whether someone should gain asylum in the U.S.

The Highland clinic opened in 2001 as a place for asylum seekers and refugees to get care. Five years later, the staff started offering forensic exams that aim to discern whether there is evidence of torture or abuse. Nelson, who took over as director in 2012, says his team does between 80 and 120 evaluations each year.

Nelson et al. diagnose physical and psychological ailments and, in many cases, substantiate these patients' claims about how they were hurt. Sometimes the asylum seekers have health coverage that pays for the exams, but the county covers the cost for those who don’t.

Nelson has had some medical training on what to expect to see in cases of torture. He also applies his general expertise as a doctor in knowing how to interview and examine patients and has learned something about the countries these asylum seekers are fleeing and the injuries they may have endured.

Nelson also addresses the asylum seekers’ health needs, sometimes diagnosing cases of tuberculosis or HIV that were previously undiagnosed. Nearly all of the patients he sees need mental health referrals, he said, because of years of torture or abuse in their native countries.

The harsher federal policies, including detentions at the border, have generated anxiety and uncertainty among those seeking asylum and their advocates and immigration lawyers.

When applicants are examined at the Highland clinic, Khonsari said, it “definitely makes a difference for judges.” Gaime said the clinic’s reports frequently help corroborate her clients’ experiences in a way that their testimony alone cannot. “Sometimes a traumatized person is not able to relay what happened to them in a way that tells the full story,” she said.

Ira Mehlman which favors stricter controls on immigration noted that there are limits to a doctor’s ability to interpret these cases. Doctors may be able to determine if somebody suffered an injury, he said, but not necessarily the circumstances that led to it. “And they can’t determine if it was because of political persecution,” he said.

Getting asylum doesn’t take away the trauma, but it relieves these people of the fear of returning to a country where they are not safe, Nelson said. “When someone who has got a real basis for an asylum claim gets granted, and you were part of demonstrating why that should be the case,” he said, “that feels really good.”