Oakton Health Center

The Trump administration has made immediate and substantial changes to the green card application process within the US. Now, all new permanent residency applications ration will require a renewed medical examination form. If an applicant’s file lacks the necessary medical examination form, it will be denied automatically. Previously, these forms had an unlimited validity period, now they expire if an applicant’s green card application is withdrawn or denied.

This amendment means that those seeking a green card will potentially need to pay for multiple medical exams. Had their application is denied or withdrawn and they wish to reapply, they will need a new medical exam – a costly hurdle for many applicants. These medical check-ups, performed by civil surgeons, can cost hundreds of dollars and involve tests for specific conditions that could make a person ineligible for US residency, in addition to vaccination records.

The Trump administration, on the same day, also announced plans for a new “gold card” program. This scheme would enable applicants to buy a green card outright for a sum of $5 million. This idea appears to be part of Trump’s proposed overhaul of the EB-5 visa program, which currently grants green cards to investors in the US. However, legal experts have noted that the existing EB-5 visa scheme can’t be abolished or amended without congressional approval. Therefore, the new “gold card” program may be intended to coexist alongside it.

Elsewhere, manual updates for medical PM/WAG for Asylum Applicants and Torture Victims (AATV) and Victims of Trafficking, Torture, or Other Serious Crimes (VTTC) have been released. This reveals new procedures for processing AATV and VTTC cases in IES, new policies regarding the categorisation of ‘Derivative Family Members’ for VTTC cases, and clarification of state-funded medical coverage versus federally funded Medicaid.

The manual updates bring legislative changes to the eligibility criteria for VTTC benefits. This includes changes to eligibility for a single adult applicant and those intending to file for a T visa, U visa, or asylum. The revised procedures provide detailed guidelines for verifying immigrant applications status, including Derivative Family Members and the application process. It provides the framework for handling different scenarios based on the pending applications and changes in applicant status.

1. Changes to Permanent Residency Applications in the United States
The United States Citizenship and Immigration Services (USCIS) has implemented changes to its permanent residency application process for immigrants. As part of the change, applicants are now required to include Form I-693, Report of Immigration Medical Examination and Vaccination Record, when filing Form I-485 to adjust their status. The Form I-693 must be completed and signed by a civil surgeon to verify the applicant’s health conditions and vaccination status. This procedure aims at streamlining the application process, reducing the number of Requests for Evidence (RFEs), and ensuring health-related eligibility for permanent residency. Failure to submit the form could result in application rejection.

2. Cost and Accessibility Challenges for Immigrant Medical Exams in Kansas City
A report highlights the challenges immigrants face when securing medical examinations necessary for immigration status adjustments in Kansas City. The medical examination, conducted by physicians accredited by Immigration Services, includes a medical history review, physical examination, chest x-ray, and blood tests, amongst others. However, only 17 locations within the city’s metro area are listed as having civil surgeons – doctors designated to perform these examinations. Coupled with the city’s increasing immigrant population, this leads to long waiting lists. Additionally, the examinations are not covered by most insurance plans, with costs varying wildly – up to $1,400 in some cases. Many immigrants, like Priyanka Raeburn, are discovering cost-effective options at community health centers like KC CARE Health Center, which offers examinations at a base cost of $250.

3. USCIS Requires Medical and Vaccination Reports in Green Card Applications
USCIS has announced new requirements for green card applicants, necessitating the inclusion of their medical and vaccination reports in Form I-485 for status adjustment. Applicants must complete an Immigration Medical Examination, receive all required vaccinations, and a submit correct Form I-693 outlining their health condition, signed by a civil surgeon, to demonstrate that they do not have health-related inadmissibility. Noncompliance with this might result in the applicant’s form I-485 being rejected. The reason for this change is to streamline the immigration process and reduce the amount of Request for Evidence sent by USCIS.

These changes affect various immigration benefits including immigrant visa applicants applying to the United States Department of State (DOS), such as immediate relatives, spouses, and work-based applications, among others. Also affected are applicants for status adjustments such as immediate family members of a U.S. citizen, through refugee or asylum status, victims of crimes or human trafficking with U and T Visas. To avoid mistakes, applicants are recommended to consult with immigration attorneys or organizations accredited by Immigration before submitting applications to USCIS. USCIS advises that additional information about civil surgeons conducting the examinations, alongside detailed requirements, is available on their website.

In the January 2025 Visa Bulletin Reaction with Charina Garcia, the primary highlights include no changes in filing dates for employment-based visas and stricter enforcement of medical documentation requirements by USCIS. Adjustment of status applications will now be rejected if they lack a completed medical examination.

Final action dates saw some encouraging movements, as several categories saw progression. For instance, EB-2 and EB-3 Rest of World, after a seven-month hold, saw movement. China witnessed advanced progression in EB-2 by one month and a significant jump in EB-3 from April to June, indicating reduced demand in earlier dates for China’s EB-3 category. EB-2 in India advanced from August to October, with steady progression observed in EB-3, but no change in EB-1 since July 2024.

The family-based visa categories also saw mixed movements. Notably, the F1 and F2B categories progressed after six months of no movement, while the F4 category remained stagnant for seven consecutive months. F2A remained popular but saw little movement due to high demand.

Looking ahead, gradual changes in employment-based visas are anticipated from January to April 2025. EB-1 Rest of World will likely remain current with moderate advancements expected in EB-2 and EB-3. Family-based categories look to see steady forward movement starting from February 2025, despite potential backlogs. The employment-based limit for 2025 is projected to be around 150,000.

Despite changes in administration set for 2025, visa limits, which are established by law, aren’t likely to be negatively impacted. Final thoughts encourage applicants to stay hopeful and informed, and to prepare early by completing their medicals and gathering all necessary documents.