Summary
The Manual Release (MR) #25.20 updates policies and procedures for medical PM/WAG relating to Asylum Applicants and Torture Victims (AATV) as well as Victims of Trafficking, Torture, or Other Serious Crimes (VTTC).
The release outlines new procedures for processing AATV/VTTC cases in the Integrated Eligibility System (IES), and new policies regarding derivative family members (DFM) for VTTC cases and the verification of status for AATV/VTTC. It also clarifies distinctions between state-funded medical coverage and federally funded Medicaid.
The updated requirements for VTTC applications after June 5, 2024, are highlighted in the article. These include: Illinois residency; having a child or other derivative family member; verification that the applicant has filed for a T Visa, U Visa, or asylum; and the meeting of financial eligible factors. The amendments no longer allow for a single adult applicant and require that those preparing or intending to file their visa or asylum applications have already officially filed them.
Also laid out in the release are the updated processes for verifying eligibility for VTTC or AATV, including the necessity for at least one individual in the household to have filed for either types of visas or asylum. It also explains the definition and conditions of Derivative Family Members (DFM) for VTTC cases.
The MR concludes by explaining the application process, including the conditions for backdated eligibility, and reminding of the changes to state-funded medical program eligibility rules that came into effect December 2023. It explains the progression process for a noncitizen who does not qualify for a federally funded medical program, with the HBIA/HBIS programs currently not accepting new applications.
The October 2025 Visa Bulletin has been released as well, providing update on the employment-based green card processing. The bulletin points out two groups of applicants and provides relevant actions to take for each group with regard to processing green card visas. It also breaks down the visa bulletin basics like filing dates vs final action dates.
The bulletin further explains visa bulletin implications and what to do when priority date is current. It provides insight on preparing for I-485 application filing, advising on gathering key evidence, scheduling a medical exam, deciding on filing strategy amongst other things.
For those whose I-485 is pending, the Visa bulletin advises on considerations for litigation if case has stalled, refreshing of medical exam proactively and using “supplement J” for confirmation or portability. It also suggests steps on avoiding common pitfalls during the visa application process.
The Visa bulletin reiterates that being proactive, precise and persistent can help in the smooth processing of green card processing.
Changes have been announced by the U.S Citizenship and Immigration Services (USCIS) regarding the processing of green card applications that are slated to affect a significant number of applicants. The updates chiefly concern Form I-693, a document used to report the immigration medical examination and vaccination record of the applicant, which must be filled out by a civil surgeon as part of the application procedure. As per the newly released rules, effective from November 1, 2023, signed Form I-693 will only stay valid for as long as the related applications are pending.
Previously, a valid Form I-693 could be re-used for further applications if the original application was denied or withdrawn. However, the new policy means that if an application is denied or withdrawn, the previously submitted form becomes invalid and the applicant is required to resubmit a new form along with the subsequent application. This rule applies to all applications that were either filed or still in the pending status on or after June 11, 2025.
One significant implication of this policy change is the cost that comes with it. The cost of a medical examination and filling out Form I-693 typically ranges between $400 and $1,000. Therefore, applicants being forced to redo these steps can feel a significant financial burden, especially if their applications are denied or withdrawn. It is suggested that applicants engage with experienced legal professionals to properly review their application before submission to avoid costly errors that could lead to denial.
In justification of these changes, the USCIS asserts that the purpose behind this update is to ensure that medical examinations are carried out in a timely and accurate manner, thereby maintaining public health. The changes brought about by this policy attracted criticism from various corners for the inconvenience it brings to applicants without substantial lead time to adjust to the new rules.
Further, in light of the Trump administration’s steps towards stricter immigration enforcement, these changes seem to fall in line with a broader trend. Certain actions such as the immediate changes to several application forms announced in March that sparked confusion among applicants and led to USCIS subsequently extending at least a two-week buffer period for changes to take effect have indeed raised eyebrows.
In this considerable shift in green card application procedures and the associated costs, the federal government’s position appears to be clear: while a green card allows for permanent residency in the United States, it does not immediately confer citizenship. The government maintains the authority to revoke these cards on grounds of national security, in case of violations of immigration law, or criminal offenses.
The changes put into effect since principal date imply major adjustments to the green card application procedure and are expected to have far-reaching impacts on thousands of applicants who are currently in the process of adjusting their applications. The changes come into effect on Wednesday, June 11, 2025, and a new version of the form is expected to take effect from July 3, 2025.
