The United States Citizenship and Immigration Services (USCIS) has issued a significant update to its policies regarding the validity of Form I-693, the Report of Immigration Medical Examination and Vaccination Record. According to the revised guidance in Volume 8 of the USCIS Policy Manual, any Form I-693 signed by a civil surgeon on or after November 1, 2023, will now only be considered valid while the immigration application it was filed with is pending.
USCIS clarified that if the associated immigration application—most commonly Form I-485, Application to Register Permanent Residence or Adjust Status—is either withdrawn or denied, the medical examination form will no longer be valid. This policy takes immediate effect and applies to all applications pending or submitted on or after June 11, 2025.
Under the updated framework, applicants who previously submitted a Form I-485 alongside a Form I-693 and later had their I-485 application withdrawn or denied, must provide a new, freshly completed Form I-693 for any future Form I-485 submission. This ensures that the medical documentation reflects the applicant’s most current health status at the time of their new immigration request.
“Most aliens subject to health-related grounds of inadmissibility must have an immigration medical examination to demonstrate they are not inadmissible,” USCIS stated. Generally, individuals applying to adjust their immigration status in the United States must include Form I-693 to certify they do not have any medical conditions that would render them inadmissible on health-related grounds.
Furthermore, USCIS reserves the right to request a Form I-693 even from individuals who might not typically be required to undergo a medical examination, should circumstances suggest a potential public health issue. “We may require an alien who would otherwise not be required to undergo an immigration medical examination to submit a Form I-693 as a matter of discretion, if the evidence indicates that there may be a public health concern,” the agency noted.
This recent policy adjustment marks a reversal from the stance USCIS adopted on April 4, 2024. At that time, USCIS had updated its manual to state that any Form I-693 signed by a civil surgeon on or after November 1, 2023, would remain valid indefinitely. The idea behind that change was to enable applicants to use the same form for any future immigration benefit application, streamlining the process and reducing the need for repeated medical examinations.
The April guidance, however, has now been reassessed. “We have since determined that the April 4, 2024, policy is overly broad and could potentially threaten public health in the United States,” USCIS explained. The agency’s concern is that granting indefinite validity to medical exams could allow outdated or inaccurate health information to be used in immigration decisions, particularly in situations where an applicant’s health may have changed significantly over time.
As a result, USCIS is rolling back the indefinite validity policy and opting for a stricter rule that ties the medical form’s validity specifically to the application it supports. “By limiting the validity period to only the current immigration benefit application or request, we ensure that aliens get timely and proper medical examinations and treatment, which safeguards public health,” the agency emphasized.
Another significant development took place on December 2, 2024, when USCIS issued a separate requirement mandating that Form I-693 be submitted at the same time as Form I-485. This rule aimed to simplify the adjudication process by ensuring that medical documentation is available when an officer evaluates an application. Previously, applicants often waited to submit Form I-693 until after receiving a request for evidence (RFE), potentially delaying processing.
The current change complements that December rule by reinforcing the importance of up-to-date medical information. It underscores USCIS’s renewed focus on timely, accurate, and case-specific health assessments rather than relying on outdated records for future applications.
The updated policy is especially relevant for civil surgeons—licensed medical professionals authorized by USCIS to perform immigration medical examinations. These professionals must ensure that the Form I-693 is accurately completed, signed, and dated to be deemed acceptable. With this revised guidance, civil surgeons and applicants alike will need to pay close attention to when and how the form is submitted, knowing it is now restricted to the lifespan of the accompanying application.
In practical terms, applicants considering adjustment of status should be prepared to undergo a new medical exam if they are resubmitting Form I-485 after a prior attempt failed. Even if they previously submitted a Form I-693 deemed valid at the time, that form cannot be reused for a new application.
This shift places added importance on the timing of medical exams. If an applicant schedules the exam too far in advance, and their application is denied or withdrawn for any reason, they may need to repeat the exam, leading to additional time, effort, and financial costs. However, USCIS believes this tradeoff is necessary to protect public health and maintain the integrity of the immigration system.
The move also aligns USCIS policy with broader public health priorities, especially in a post-pandemic context where health monitoring remains a critical consideration in international travel and migration.
With these changes, USCIS continues to refine its approach to balancing efficient immigration processing with the need to ensure that applicants meet health-related eligibility standards. As the agency put it, “By limiting the validity period to only the current immigration benefit application or request, we ensure that aliens get timely and proper medical examinations and treatment, which safeguards public health.”
This new guidance highlights USCIS’s evolving understanding of the role of medical exams in immigration adjudication and affirms its commitment to using current medical data when determining admissibility.
In summary, USCIS now requires that Form I-693 signed on or after November 1, 2023, be valid only while the associated immigration application is pending. Once the application is withdrawn or denied, the medical exam form becomes invalid. This policy is effective immediately and applies to all applications pending or submitted on or after June 11, 2025. This move replaces the previous indefinite validity policy and reaffirms the agency’s focus on current, accurate medical assessments as a cornerstone of public health protection in immigration processing.