We have been getting a lot of questions from Adjustment of Status (AOS) Applicants regarding the best time to submit and to complete their Form I-693 Medicals. The U.S. Citizenship and Immigration Service (“USCIS”) effective on November 1, 2018, stated the I-693 medical report will be valid for two years from the date of submission to USCIS. Further, according to USCIS guidance, Form I-693 is valid only when a civil surgeon signs it no more than 60 days before the date an applicant files the application for the underlying immigration benefit.

Do you need to submit Form I-693 medical exam with the initial filing I-485 filing?

The short answer is NO. USCIS policy requires only that the medical exam be submitted any time prior to adjudication. According to the USCIS Policy Manual,

The medical examination report may be submitted to USCIS:

  • Concurrently with the immigration benefit application; or
  • At any time after filing the immigration benefit application but prior to the adjudication of that application; if not filed concurrently with the immigration benefit application, USCIS encourages applicants to wait until USCIS requests the medical examination report before submitting it including a request to bring the medical examination report to an interview.

What is the current best practice for including I-693 medical exams with employment I-485 filings?
For many Applicants, it is a good idea to consider filing the initial I-485 AOS application without including the I-693 medical exam. This is especially true for cases where the visa number cutoff date may retrogress resulting in the total amount of time USCIS takes to adjudicate a case being longer than two years. Our recommendation both for family-based and employment-based, therefore, is to submit the AOS I-485 application without Form I-693 Medical.

When to obtain the Form I-693 medical exam after submission of AOS and before an RFE or Interview is scheduled?
We have clients who have submitted their AOS without the medical but now their priority date is currently wondering whether to wait for USCIS to issue an RFE or to proactively schedule their medicals. USCIS Policy Manual to help answer this inquiry.

When did civil surgeon sign? I-693 retains evidentiary value through
No more than 60 days before applicant filed underlying benefit application with USCIS
 2 years from the date civil surgeon signed I-693
After applicant filed benefit application with USCIS
 2 years from the date civil surgeon signed I-693
More than 60 days before applicant filed benefit application with USCIS
 N/A – I-693 not valid at time applicant submits I-693 to USCIS

The table illustrates three scenarios. The first scenario illustrates if an applicant gets the medical completed no more than 60 days before the applicant files his/her AOS, the medical is valid for two years from the date the civil surgeon signed it.

The second scenario addresses the questions stated above at the beginning of this section. If an applicant has already filed for AOS and subsequently gets a medical completed, then Form I-693 is valid for two years from the date the civil surgeon signed. The last scenario describes the civil surgeon signs off on the medical more than 60 days before the applicant files his or her AOS. In this case, the medical is not valid.

Therefore, clients whose priority date is current and awaiting an RFE requesting a medical may go ahead take an appointment with a civil surgeon and obtain a sealed Form I- 693 in anticipation of the RFE. With that being said, we do not recommend sending the medical to USCIS proactively without the RFE or interview.  USCIS explicitly states they recommend waiting until they request the medicals to send it. Further, from our experience waiting for an RFE or interview would be the only way to guarantee USCIS matches the medical submitted with the pending application. Applicants with AOS pending but their priority date is not current, we recommend getting the medical after their priority date becomes current.

Conclusion
Each application and its circumstances are different so it is impossible to formulate a single recommendation that would apply equally well to all. Our office weighs several 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.

AOS I-693 immigration Immigration Medical Exam