Effective Date: June 11, 2025
The U.S. Citizenship and Immigration Services (USCIS) has implemented a significant policy revision concerning the validity of Form I-693, Report of Medical Examination and Vaccination Record. This update, which affects both current and future applicants for adjustment of status, reflects a refined approach to immigration adjudication and public health oversight. The revision ensures the timely and case-specific evaluation of medical records submitted in connection with immigration benefits.
At Immigration Fleet, we remain committed to providing accurate and timely guidance to our clients and stakeholders in response to evolving regulatory standards to promote procedural compliance and minimize application risks.
Summary of Key Changes
1. Revised Validity Framework for Form I-693
Effective immediately, USCIS has updated the policy for Form I-693s signed by civil surgeons on or after November 1, 2023:
- A Form I-693 will now be considered valid only while the associated immigration application remains pending.
- If the related application—most commonly Form I-485, Application to Register Permanent Residence or Adjust Status—is withdrawn or denied, the accompanying Form I-693 becomes invalid as a matter of law and policy, regardless of the date of the civil surgeon’s signature.
- Consequently, Form I-693 now functions as a single-use document tied exclusively to a specific benefit request. If the applicant refiles or submits a new application, they must undergo a new medical examination and provide a newly completed Form I-693.
2. Applicability
This updated guidance applies to:
- All immigration benefit applications filed on or after June 11, 2025, and
- Any pending application as of June 11, 2025, that includes a Form I-693 signed on or after November 1, 2023.
Context and Rationale for the Policy Revision
Previous Guidance: April 4, 2024
On April 4, 2024, USCIS issued a policy update stating that Forms I-693 signed on or after November 1, 2023, would be valid indefinitely, permitting reuse for subsequent immigration applications. The intent was to reduce redundancy and applicant burden.
However, upon further analysis, USCIS has determined that this approach was overly broad and posed potential risks to public health. By limiting the validity of Form I-693 to the pendency of the original immigration application, the agency seeks to ensure that medical evaluations reflect an applicant’s most current health status, thereby maintaining the integrity of adjudications and promoting public health protection.
December 2, 2024 Requirement: Submission at Time of Filing
Additionally, on December 2, 2024, USCIS mandated that applicants must submit Form I-693 concurrently with Form I-485. This procedural requirement remains in effect and is intended to streamline case processing and reduce delays caused by Requests for Evidence (RFEs).
Validity of Forms Signed Before November 1, 2023
USCIS has confirmed that Forms I-693 signed by civil surgeons before November 1, 2023, remain subject to the prior policy framework:
- Such forms retain their two-year validity from the date of the civil surgeon’s signature, provided they meet all other evidentiary criteria.
- This distinction is based on changes in procedural requirements; specifically, newer versions of Form I-693 include mandatory electronic reporting of health data to the Centres for Disease Control and Prevention (CDC), a requirement not present in earlier forms.
Practical Implications for Adjustment Applicants
The updated policy has substantial implications for applicants whose Form I-485 may be denied, withdrawn, or delayed. Specifically:
- If Form I-485 is denied or withdrawn, any Form I-693 signed on or after November 1, 2023, and submitted with that application becomes immediately invalid.
- In such cases, a new medical examination and a newly signed Form I-693 must accompany any future immigration benefit request.
- Applicants may no longer rely on a previously submitted Form I-693, even if it was completed recently or within prior validity timeframes.
USCIS Discretion and Health-Related Grounds of Inadmissibility
Most applicants seeking adjustment of status are required to submit Form I-693 to establish that they are not inadmissible under health-related grounds, pursuant to INA §212(a)(1). Furthermore, USCIS retains the discretion to request a Form I-693 in cases where the applicant would otherwise be exempt, if there is evidence indicating a potential public health concern.
This discretionary authority enables USCIS to proactively address issues that may affect the health and safety of the U.S. population.
Recommended Best Practices for Applicants
In light of these changes, Immigration Fleet strongly advises applicants to:
- Schedule their medical examination in close coordination with the expected application filing date.
- Submit complete, accurate, and timely filings to minimize the risk of denial or withdrawal.
- Maintain thorough records of all immigration filings, including medical documentation.
- Monitor application status carefully and prepare to obtain a new Form I-693 if necessary.
- Seek legal or professional guidance prior to refiling or in response to application denials.
Conclusion: A Shift Toward Precision and Public Health Accountability
This policy revision marks a deliberate shift by USCIS toward a more targeted, timely, and medically accountable adjudication framework. By ensuring that medical records are both current and application-specific, USCIS enhances the reliability of health-based eligibility determinations and reinforces public health safeguards.
While the updated policy may present logistical challenges for some applicants, it reflects a balanced approach to maintaining both immigration integrity and public health priorities.
Immigration Fleet is fully prepared to assist clients in navigating these regulatory changes. Our experienced professionals are available to review documentation, offer strategic filing advice, and ensure ongoing compliance with USCIS requirements.
For further information or to schedule a consultation regarding Form I-693 or your adjustment of status application, please contact Immigration Fleet.
Your journey is important—Immigration Fleet is here to help you navigate it with confidence and care.
