I-693 Medical Exam Validity
This post explains the validity of an I-693 medical exam, a topic that confuses a lot of people (particularly receptionists at the USCIS "approved physician" offices)!
If a person is in the United States and is seeking a green card (U.S. permanent resident status), there are two general procedural routes to complete the green card process. One route is through the I-485 adjustment of status process with the U.S. Immigration Service (USCIS); the other route is through immigrant visa processing at a U.S. consulate abroad.
If a person is filing an application for adjustment of status (Form I-485), one of the requirements is a medical exam.
To be clear, the medical exam is a requirement to get an I-485 application approved; it is NOT a requirement for filing an I-485 application and there are many, varied instances where it may be prudent to NOT file the I-693 medical exam results at the same time as the initial I-485.
The medical exam must be completed by an “approved physician.” The list of USCIS-approved physicians is here. The “approved physicians” are also called “civil surgeons” which is a very strange name since they are not involved in surgery.
The USCIS-approved physician must complete Form I-693 and provide a completed Form I-693 in a sealed envelope, then the sealed envelope is provided to USCIS. Anyone can review Form I-693 here.
One PRO TIP is that if you are doing your I-693 medical exam, you can ask for two sets of exam results and then open one set (if you want) to see what the exam results say. There is no reason you cannot have a 2nd set of exam results and review the results. You paid for this!
Another reason to request two sets of sealed exam results is because you want to submit one set of results to USCIS and hold the second set of results back in case you receive a RFE (Request for Evidence). This tactic can be useful for an EB (Employment-Based) I-485 applicant, for example, who is very worried that his priority date will not be current for long and wants to get his sealed exam results matched to his pending I-485 application as quickly as possible and is not sure whether the quickest option is pro-actively filing the I-693 medical exam, or waiting for a RFE. By getting two sets of results, the I-485 applicant can do both - submit the first set to USCIS and hold back the second set for a possible RFE.
Another PRO TIP related to I-693 medical exams:
The USCIS medical exam is generally NOT covered by employer medical insurance. In some instances an employer might cover the cost of the exam process for an EB I-485 applicant but not always. The I-485 applicant may have to pay for the examination ‘out of pocket.’ It is potentially permissible to do some of the required vaccinations or other tests through a physician that IS covered by medical insurance/health insurance and then present the results obtained by the “in network physician” to the USCIS-approved physician. What I mean here is that the “USCIS-approved physician” must sign the I-693 form but the “USCIS approved physician” is not required to do all the exams and tests that support completion of the form. Coordinating all this can take time but if the I-485 applicant is married and has children, the cost of completing the medical exams for the whole family can really add up and finding ways to save on the cost can be very useful.
The rest of this post will discuss the validity period of I-693 exam results, a topic which is surprisingly misunderstood.
The I-693 exam results have limited validity. The theory is that you might end up having a disease or otherwise being inadmissible for health reasons. So you have to provide a relatively recent I-693. Basically the exam results are valid for 24 months from the date the physician signs the exam results.
If you obtain the exam results PRIOR to filing your I-485, then you must submit the I-693 exam results with the I-485 within 60 days of the physician signing the form. So there is a “60 day rule” - but it only applies for people who are completing the exam PRIOR to filing their I-485.
If you obtain the exam results AFTER filing your I-485, then the exam results are valid for 24 months. So that means that during the 24 months after the physician signs the I-693 form, you must submit the I-693 exam results and your case must be adjudicated; or you have to do the exam again.
So, the 60-day rule only applies in certain situations. If the 60-day rule applies to you, and you do your I-693 exam prior to filing your I-485, then your I-485 must be filed with USCIS with the I-693 sealed exam results and then those results are valid for 2 years.
The reason I am elaborating on this particular point is that there may be circumstances where you anticipate that an I-485 application may be pending more than 2 years. If you have reason to believe an I-485 application will be pending more than 2 years, then it does not make sense to do the I-693 upfront with the initial I-485 filing, or you might have to do the exam again which is an annoying waste of time and money.
Further, another situation might arise that if you are racing to file an I-485 application during a certain limited window when a priority date is current, it may not be logistically possible to complete the I-693 medical exam in time to include the exam results with the initial I-485 filing. There is no prejudice or real ‘issue’ with doing the I-693 later after the I-485 filing.
USCIS should NOT reject an I-485 application that is filed without an I-693 medical exam. It is perfectly permissible to do the I-693 exam later.
The following chart is taken from the USCIS Policy Manual and helps to clarify what I have written in this post. You can find the relevant section of the USCIS Policy Manual here.
It has been my anecdotal experience that often the staff who work at the USCIS-approved physician offices, and sometimes the physicians themselves, do NOT actually understand the rules related to the validity of the exam results and they will insist that the exam results are only valid for 60 days and you need to file them with USCIS within 60 days. But as noted here, that is not true. If you do your I-693 exam after your I-485 filing, then you can submit your exam results at any time up to 2 years.
It is of course unfortunate that something as seemingly straightforward as a medical exam is so convoluted; but that is just how U.S. immigration law works. And thankfully, you read my posts so now you know the rule!
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