Recent Changes to Submission Requirements

As of December 2, 2024, USCIS has updated its policy to require that Form I-693, Report of Immigration Medical Examination and Vaccination Record, be submitted along with Form I-485, which is the Application to Register Permanent Residence or Adjust Status. Previously, applicants could submit the medical examination results later in the process, often in response to a Request for Evidence (RFE) or during the I-485 interview. Now, failing to include Form I-693 with the initial I-485 filing may result in the application being rejected. For sponsoring employers, such failure could mean additional expense, delays and burdens associated with re-filing the I-485.

What is Form I-693?

Form I-693 is the document used to record the results of the medical examination and is required to become a permanent resident in the United States. The medical examination, which is completed and signed by a USCIS-designated civil surgeon, ensures that applicants do not have any health conditions that would make them inadmissible to the United States on public health grounds. This includes checking for communicable diseases and mental health issues, as well as ensuring that all required vaccinations are up to date.

Steps to Complete the Medical Examination

  1. Find a Civil Surgeon: Locate a USCIS-designated civil surgeon in your area. You can find a list of approved civil surgeons on the USCIS website.
  2. Schedule an Appointment: Make an appointment for your medical examination. Be sure to bring any vaccination records and medical history information to the appointment.
  3. Complete the Examination: The civil surgeon will conduct a thorough medical examination, including a review of your vaccination records. If you need additional vaccinations, the civil surgeon can administer them.
  4. Submit Form I-693: Once the examination is complete, the civil surgeon will complete Form I-693 and place it in a sealed envelope. Do not open this envelope. Submit it along with your Form I-485 to USCIS.

Impact to I-485 Applicants and Sponsoring Employers

Since the medical examination is now required for I-485 applicants in the initial filing, applicants should review the list of CDC’s vaccination requirements and medical requirements prior to becoming eligible to file the I-485 application. The window to file the I-485 can be extremely narrow, and obtaining the required vaccinations can take several months. Applicants should also review the list of required I-485 documents to avoid unnecessary delays and increase their chances of a successful adjustment of status.  For sponsoring employers, an applicant’s failure to secure Form I-693 could mean additional expense and burden associated with re-filing the Form I-485.