When Is The Best Time to Complete the I-485 Medicals? I-693 Medical Exam Validity Explained

Among the surge of I-485 applications over the past several months, our office has fielded hundreds (at least) questions as to what is the best time to prepare and submit the required I-693 medical exam documentation to USCIS. More recently, as USCIS is getting ready to approve many I-485s, getting the medical exam ready will certainly give edge and the chance for a faster I-485 approval to those who are able to provide the required medicals quickly.

I-693 Medical Exams Required for Approval of I-485 But Do Not Have to be Submitted With Initial Filing

First, the I-693 medical exam does not have to be submitted as part of the initial I-485 application — an I-485 filing will not be rejected as improperly filed for not including a I-693 medical exam documentation. The medical exam is, however, required before a I-485 can be approved.

As of April 4, 2024, USCIS has waived the expiration of medicals signed after November 1, 2023 (see details).  This is in addition to the March 2023 policy change which waived the requirement that medicals must be filed within 60 days of the doctor’s signature when filing I-485.   As a result, medicals signed after November 1, 2023 do not expire while medicals signed before November 1, 2023 remain valid for a period of two years from the date of signature. 

The applicable technical rules and requirements (for vaccines, etc.) should be applied as of the date of the Civil Surgeon’s signature on an otherwise valid and unexpired medical exam.

If, by the time an immigration officer reviews a pending I-485 application, it has been more than 2 years from the Civil Surgeon’s medical exam signature and if this signature was before November 1, 2023, the immigration officer should request a new and more recent medical exam.   

Should I Send My Medicals Proactively to USCIS?

USCIS policy requires only that the medical exam be submitted any time prior to adjudication.  This means that it is possible to include the medicals with the initial I-485 filing but it is also totally acceptable to provide them at a later time.

Filing I-693 Medicals With Initial I-485

For cases where time permits and where it is possible that the Final Action may be (or remain) current in the near future, our recommendation is to try to submit the I-693 medicals with the initial I-485 filing.   This is USCIS’s recommendation as well and this ensures the fastest possible approval time for an I-485 application.

Filing I-693 Medicals After I-485 Filing

For most cases which do NOT expect to have a current priority date under Final Action in the near future or if obtaining the medicals will take time, in order to avoid delays in the I-485 submission,  it may make most sense to file the I-485 application and then work on obtaining the medicals for submission to USCIS at a later time.    The medicals can be submitted to USCIS proactively or in response to USCIS request.

First, USCIS generally does not like when applicants send documents relating to a case without being asked. As our readers and clients can understand, USCIS is dealing with huge volumes of correspondence and sending the medicals proactively and not in a response to a request increases not only the workload at USCIS but also increases the risk that a piece of correspondence may be lost and not make its way to the proper application file. For example, USCIS is often moving cases between services centers and field offices and it may be hard to know with certainty where a I-485 case file is located at an given time so that the medicals can be sent to that center.

Our general recommendation is to submit the medicals to USCIS only when asked to do so and under clear instructions on where to send. This is a much more efficient way to make sure that the medicals are sent to a specific request and to a specific USCIS office address. The risk of the medicals getting misplaced, delayed, or lost is, in our experience, extremely small. Also, we have found that filing the medicals in response to an RFE is likely to allow the case to be reviewed (and, hopefully, approved) faster.

Getting I-693 Ready and Waiting for Interview/RFE

For many I-485 applicants who have a priority date which is likely to be current in the following months (up to two years), it may make sense to aim to complete the medical exams and obtain the sealed I-693 medical exam envelopes. Subject to the medical exam validity rules discussed above, these applicants will be in a position to provide the medicals to USCIS promptly and ensure their case has the best chance of a faster approval.

Conclusion

Each application and its circumstances are different so it is impossible to formulate a single recommendation which would apply equally well to all.    Our office weighs a number of factors when we consider whether to include I-693 medical exams proactively, but our general recommendation is to consider waiting until either the interview notice is received or USCIS issues an RFE before obtaining the medical exam if they were not included initially.   

Our office is happy and available to assist with I-485 questions or needs.  Please do not hesitate to contact us or consider our consultation options or request I-485 filing quote.  Also, please subscribe to our free weekly newsletter to ensure that you obtain this and related immigration-related news and announcements.