Oakton Health Center

Summary:

The medical policy manual has been revised to include updates related to ‘Asylum Applicants and Torture Victims’ (AATV) and ‘Victims of Trafficking, Torture or Other Serious Crimes’ (VTTC). The new policy includes changes in processing methods of AATV/VTTC cases, derivative family members (DFMs) in VTTC cases, and the way AATV/VTTC statuses are verified. Additionally, clarification has been provided on the distinction between state-funded medical coverage and federally funded Medicaid. The legislation amendments stipulate new requirements for VTTC eligibility, including having a child or other DFMs and verifying their filing status related to T Visas, U Visas, or asylum.

From December 2, 2024, some applicants submitting Form I-485 for a change in their status to permanent residents in the US are required to submit Form I-693, the documentation of a medical examination and vaccination record. They have to be checked and signed off by a civil surgeon. This procedural change is expected to reduce the number of Requests for Evidence (RFEs) made during applications, streamlining the application process and reducing delays in processing times.

Despite multiple educational qualifications, immigrants face a lengthy wait for a mandatory medical examination necessary for gaining permanent U.S. residency. The exams must be conducted by a USCIS-approved doctor, called a civil surgeon, and include a medical history review, physical examination, chest x-ray, and blood tests. The scarcity of civil surgeons, the high costs of the exams not covered by insurance, and a lack of governmental controls on exam prices make seeking US permanent residency particularly challenging for immigrants. Dr. Craig Dietz of KC CARE Health Center in Kansas City highlights the importance of these exams serving dual purposes of meeting regulatory requirements and offering immigrants a first point of health system contact. The center conducts exams at a base cost of $250. Despite potential future immigration policy changes, demand for these services is expected to continue due to the large number of residents in need.

Starting from December, the United States Citizenship and Immigration Services (USCIS) has instituted a mandatory rule, requiring Green Card applicants to submit their medical and vaccination reports along with their Form I-485 for adjustment of status. This step is a significant shift from the prior procedure in which these requirements could be fulfilled at a later stage of the application process.

USCIS has made this change aiming to streamline the immigration process and decrease the amount of additional evidence solicited prior to adjudicating a Form I-485. Under the old system, USCIS used to send Requests for Evidence to applicants, leading to a significant workload. As such, certain adjustments to the processes have been undertaken, which involve extending the validity of certain documents and requiring the completion of necessary information from the initial stages of the immigration process.

Effective from April 2024, a properly completed Form I-693 that has been signed by a civil surgeon on or after 1st November 2023 will not expire. In other words, it can be used indefinitely to prove that an applicant is not inadmissible due to health-related concerns.

However, USCIS advises all applicants to consult an immigration attorney or a USCIS-accredited organization that provides immigration services before submitting any application to avoid errors. The medical and vaccination requirements vary according to the immigration benefit an applicant is seeking.

USCIS has also mentioned that there are certain immigration categories that may not require a medical examination. Non-immigrants, for instance, and applicants who are not subject to health-related grounds of inadmissibility. Yet, an officer can order a medical examination if there is evidence to suggest possible public health concerns.

In addition, there are certain benefits that necessarily require both the medical report and vaccinations. These include applicants for immigrant visas who pertain to the United States Department of State, such as petitions for immediate relatives, spouses, fiancés, employment-based applications, orphan adoption etc., and applicants for status adjustments like immediate family members of a US citizen, refugees, or asylum status, victims of crimes or human trafficking with U Visa or Visa T among others.

Information about civil surgeons designated to perform medical examinations and vaccinations, and how to locate one in your area is available on the USCIS website.

Finally, USCIS has issued policy guidance in the USCIS Policy Manual, clarifying that a naturalization applicant must demonstrate they have been lawfully admitted for permanent residence, and this applies only to their initial admission as a lawful permanent resident (LPR) or adjustment to LPR status. USCIS will consider whether a naturalization applicant was lawfully admitted for permanent residence or lawfully adjusted to permanent resident status at the time of their initial admission or adjustment, regardless of whether they were lawfully admitted for permanent residence at any later re-entries to the United States.

Overall, USCIS’s new rules around the medical and vaccination report submissions aim to streamline the immigration process and ensure the health safety of those seeking permanent residence. The shift in policy represents a significant development, signaling the department’s consistent commitment to making the immigration procedure more efficient, and ensuring applicants are in good health.

In the monthly “Chatting with Charlie Visa Bulletin Reaction” hosted by Charina Garcia and Charles Oppenheim, the duo provided a comprehensive review and interpretation of the January 2025 Visa Bulletin. Here are the key findings:

The January Bulletin made it apparent that there were no alterations to the dates for employment-based filing. Minor changes are projected to happen in the summer of 2025 and significant ones with the October bulletin; aimed to generate demand for FY 2026.

USCIS announced stricter enforcement of medical documentation requirements, instructing applicants to complete exams early and submit all mandatory documentation with their applications for a smoother adjudication process.

Regarding employment-based visas, Charlie lauded the Final Action Dates movement. After a seven-month stall, EB-2 Rest of the World resumed progress. EB-3 Rest of the World demonstrated consistent, albeit gradual, growth. EB-2 China leaped ahead by a month, with EB-3 making an even larger jump, while India’s EB-2 moved from August to October, showing consistent progress.

As for family-based visa categories, movements were noticed apart from the F4 category, which remained unchanged for seven straight months. The F1 and F2B categories finally resumed progress after a six-month stall, albeit demand has slightly slowed down in the F2A category.

Predictions for January through April 2025 anticipate gradual developments in both employment-based and family-based categories. EB-1 Rest of the World is predicted to remain current, while both EB-2 and EB-3 will see moderate advancements.

The report shared that visa limits, which are established by federal law, are expected to not be affected by the new incoming administration in 2025. The employment-based visa limit estimate for 2025 is around 150,000.

Overall, this report encouraged visa applicants to keep their hopes alive despite gradual progress, prepare their documentation early, and pay close attention to updates to calibrate their anticipations.