USCIS Medical Exam Policy Change: I-693 Medical Exams Valid Indefinitely

The U.S. Citizenship and Immigration Service (“USCIS”) have just announced a change in their policy regarding the validity period of a Form I-693, Report of Medical Examination and Vaccination Record, when filed in support of a Form I-485 Adjustment of Status Application.

Effective immediately and for all medical exams signed by the civil surgeon after November 1, 2023, USCIS will consider the I-693 medical exam valid indefinitely.   For medical exams signed before November 1, 2023, the validity term will remain two years from the date of the civil surgeon signature.

Background and Reasons for the Change of Policy

USCIS has changed its policy multiple times over the past years.   The most recent change stems from the way civil surgeons (this is the technical term for the doctors who are authorized to perform USCIS-required medical exams) are required to report tuberculosis data.   Starting November 1, 2023 CDC requires civil surgeons to share data electronically with USCIS.     Additionally, civil surgeons have certain reporting obligations to their local health departments.    As a result, USCIS is now changing their policy that all medical exams signed after November 1, 2023 remain valid indefinitely.

USCIS still reserves the right to still request updated medical exams if they have a reason to believe that the existing I-693 no longer reflects the applicant’s medical condition.   For example, aging applicants or I-485 applicants with long-pending adjustment of status applications may still see requests for evidence for “updated” medicals.

New Policy Allows Flexibility But Still Requires Careful I-485 Planning and I-693 Medical Exam Timing

The additional flexibility means that applicants (especially from backlogged counties such as India or China) no longer have to worry about their medicals expiring before their adjustment of status application can be approved.

Even though medicals no longer have to be submitted in support of I-485 application within 60 days of the civil surgeon’s signature, we still encourage thoughtful planning of the medicals and the submission of the I-485 application.   For example, where an applicant is in a hurry to submit I-485 it may be helpful to start the medical exam process and perhaps include the medical exams with the submission if they are ready in time.   However, some medical exams take longer (to schedule and/or to complete) and under the new guidance,  there should not be material disadvantage in filing the I-485 promptly without medical exams and then submitting them later to USCIS (since under the new policy the medicals would not expire).

We invite you to review our I-485 filing strategies article for additional information and pointers regarding I-693 medical exams including whether to include the medical exam proactively or submit at a later time to USCIS.

I-693 Medical Exam Validity Rules

Below is a table which illustrates the validity of the I-693 medical exams for I-485 cases filed after November 1, 2023. Source: USCIS Policy Manual.

This validity chart makes it clear that an applicant can file their I-485 without the medicals in an effort to submit the application as quickly as possible. Then, after the I-485 is filed, the applicant can secure their medical records and complete their I-693 medical exam.  Since a newer medical exam is valid indefinitely,  the applicant can submit the I-693 sealed medical exam envelope to USCIS during an interview, upon request by USCIS (in an RFE) or (possibly – see below) proactively send to USCIS.

Conclusion

We welcome this policy update which will certainly allow more flexibility during the I-485 application process.   It will also help eliminate the backlogs and, for many long-term I-485 applicants,  decrease the cost of the I-485 process by having to do fewer medical exams.

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