Changes Made to Validity of Medical Examinations for Immigrants


Foreign nationals who apply to immigrate in the United States or at U.S. Consulates or Embassies overseas are required to undergo a medical examination. For adjustment of status applicants, the validity of the medical exam results is generally one year from the date of receipt by the United States Citizenship and Immigration Services (“USCIS”). In past years, when there have been delays in processing adjustment of status applications, USCIS has – out of convenience – automatically extended the validity of the medical exam results. In 2014, USCIS ceased granting these automatic extensions. What effect does this change in policy have on those seeking to immigrate to the United States?

Purpose of the medical examination

First, it is important to understand the primary purpose of the medical examination, which is to determine whether the applicant is subject to a health-related ground of inadmissibility.

A foreign national is inadmissible to the United States if he has a communicable disease of public health significance; has failed to present documentation of having received vaccinations against vaccine-preventable diseases;[1] or if it has been determined that he has a physical or mental disorder and behavior that may pose a threat to the property, safety, or welfare of others.[2] The foreign national is also inadmissible if it has been determined that he is a drug abuser or addict.

The results of the medical examination may also be used to consider whether the foreign national is likely to become a public charge; that is, whether the applicant’s disease or disability would be likely to render him unable to care for himself, attend school or work, or would require extensive medical care or institutionalization.

Adjustment of status applicants

For an adjustment of status applicant, the medical examination is to be performed by a “designated civil surgeon,” who is selected by the Immigration Service (“USCIS”) to conduct medical exams. The USCIS website[3] provides information on how to locate designated civil surgeons by geographic region. The doctor completes the Form I-693 Report of Medical Examination and Vaccination Record and reports on the medical exam and laboratory results. The report is placed in a sealed envelope and is usually submitted with the immigration application. The medical report will remain valid as long as no more than one year has passed since the report was received by USCIS. Due to long delays in the processing of “green card” applications, the medical report may no longer be valid at the time of adjudication.

In June 2014, USCIS instituted a change in policy: instead of extending the validity of the exam until the processing was completed, it announced that the exams are valid for just one year from date of receipt. As a result, applicants whose applications have been pending beyond the one-year validity period of the medical exam will now have to submit new medical exams. They may receive a Request for Evidence (RFE) asking for new medical reports.

For foreign nationals who have not yet filed their adjustment of status application, the revised USCIS Policy Manual provides that the medical exam report can still be filed concurrently with the adjustment of status application; or, if not filed concurrently, one can wait until a medical examination report is requested before submitting one.

The advantage of filing the medical exam with the application could be prompter adjudication of the application without the delay of receiving an RFE. Also, if there is a medical issue, the applicant would be made aware of it before the immigration application is filed. The only disadvantage is the need to retake or update the medical exam if more than one year elapses from the date of the exam. Note, if visa numbers are available, most adjustment applications are processed within one year. Unlike employment-based applications that are processed by mail without a personal interview, in the case of other types of applications requiring a personal interview, the medical results can simply be taken to the scheduled interview.

Immigrant visa applicants Processed at American Embassies Overseas

The change in USCIS policy affects only those who are seeking to adjust status in the United States. The Foreign Affairs Manual (“FAM”), a State Department Manual used by consular officers, provides the guidelines on the validity of medical examinations for immigrant visa applicants.

Similar to the procedure within the United States, the medical exam overseas is conducted by physicians approved by the Consular Officer. The U.S. State Department website[4] posts listings of physicians that have been approved by each U.S. Consulate or Embassy abroad. The validity of the medical examination is determined by the Centers for Disease Control and Prevention (“CDC”). If the applicant does not have any medical conditions, the validity period is six months. In some cases, the validity period is three months.[5]

Consular officers are instructed to limit the validity of the immigrant visa to the validity of the medical exam. Thus, if an applicant’s medical examination is valid for only four months at the time of visa issuance, the immigrant visa will be valid for only four months. Applicants who fail to travel to the United States within the validity period of the medical examination will need to undergo a new medical examination.[6]

Effect of change in USCIS policy for adjustment of status applicants

In sum, just when one thinks that the big day has finally arrived, and a visa number is now available to allow one to gain the coveted green card, don’t be surprised to receive a Request for Evidence (RFE) asking for an updated medical exam. However, the good news is that this means that USCIS has concluded its review of your case and will rapidly grant permanent residency after receipt of the updated medical exams.

[1] The vaccination requirement may be waived in certain circumstances (e.g. certification by a civil surgeon, panel physician, or medical officer that it is not medically appropriate, or if the vaccination requirement is contrary to the applicant’s religious beliefs or moral convictions). See INA §212(g)(2).

[2] The foreign national is inadmissible if he or she has had a physical or mental disorder, and a history of behavior associated with the disorder…[that]…has posed a threat to the property, safety, or welfare of himself or herself, or others, and which behavior is likely to recur and lead to other harmful behavior. See INA §212(a)(1)(A)(iii)(II) (emphasis added).

[3] Please refer to the following link for how to locate a civil surgeon:

[4] Please see the following link:

[5] If the applicant is found to have a Class B tubercular pulmonary or extra-pulmonary condition, or an HIV condition (with or without a TB class), the medical examination will be valid for only three months. 9 FAM 40.11 Exhibit I lists the medical examination validity periods for corresponding Class A and Class B medical conditions.

[6] See 9 FAM 40.11 N.6.

Reprinted with permission.

About The Author

Josie GonzalezJosie Gonzalez is a partner of Stone Grzegorek & Gonzalez LLP, in Los Angeles, CA. She is recognized nationally as an expert in employment-based immigration, I-9 compliance and worksite enforcement. She has served in AILA committee leadership positions in the areas of worksite enforcement and labor certification (PERM), and served on the AILA Board of Governors for nearly twenty years. She received her undergraduate, masters and law degree from U.C. Berkeley. She has published numerous articles for legal and business journals.

Jennifer LinJennifer Lin is an associate at Stone Grzegorek & Gonzalez LLP, in Los Angeles, CA. She counsels clients in obtaining permanent resident status, and has experience working on nonimmigrant petitions. She earned her undergraduate degree from Bryn Mawr College, and her law degree from the UCLA School of Law.

The opinions expressed in this article do not necessarily reflect the opinion of ILW.COM.