Oakton Health Center

The United States Citizenship and Immigration Services (USCIS) has recently announced updated guidance concerning immigration medical exam results, specifically Form I-693. Starting from November 1, 2023, any Form I-693 properly completed and signed by an approved civil surgeon will not expire and can be used indefinitely to prove the health status of the applicant. However, some exceptions apply, such as pre-November 1, 2023 forms, which remain valid for only two years after the civil surgeon’s signature.

Importantly, exceptions also apply for Afghan parolees who came through Operation Allies Welcome, as their pre-November 1, 2023 Form I-693 remains valid for three years from the civil surgeon’s signature date. Despite these changes, immigration officers have the authority to request updated medical exams if they believe the applicant’s health status has changed or if the previous form does not accurately represent the applicant’s current condition.

In addition, starting from July 3, 2025, USCIS will only accept the 01/20/25 edition of Form I-693. If a civil surgeon signs the form on or before July 2, 2025, either the 03/09/23 or the 01/20/25 edition must be used.

In a contrasting recent policy reversal, as of June 11, 2025, USCIS stipulates that all new green card applications include a fresh medical examination form, regardless if an applicant had submitted one previously. Should a green card application be withdrawn or denied, its accompanying medical exam form cannot be reused, and a new medical examination with an updated I-693 form will be required for a subsequent application. This comes as a departure from the April 2024 guidance which had made the validity of Form I-693 indefinite. The new policy change is designed to ensure that applicants receive timely and proper medical examinations and treatment, thereby safeguarding public health.

These adjustments represent significant changes to the USCIS medical examinations policy for immigration applicants. Prospective applicants and their representatives are encouraged to familiarize themselves with the new procedures.

The Trump administration announced immediate changes to the green card application process, making renewed medical examination form, known as I-693, a requirement for every new permanent residency application. The move affects immigrants currently applying for status adjustment, who were previously allowed to use forms signed by civil surgeons indefinitely. Under the new guidance, if an application for a green card is withdrawn, the I-693 form is invalidated, and the applicant must retake the medical exam to obtain a new signed form. The exams inspect for health conditions that could potentially cause inadmissibility to the U.S.

In other developments, this announcement comes at a time of heightened scrutiny of immigrants as the Trump administration works hard to crack down on Immigration Law violations. The administration has been known to take a tougher stance on the immigration enforcement measures, including taking actions like revoking green cards possessed by people they view as violators of immigration laws.

Throughout March, immediate changes to several application forms led to confusion and triggered lawsuits from attorneys, forcing USCIS to offer at least two weeks of buffered time for the changes to take effect. The federal government has repeatedly stressed that green cards do not equate to citizenship and that they can be revoked on grounds of national security, immigration law violations or criminal convictions.

To comply with the renewed requirements, applicants need to schedule their medical exam with a USCIS-designated civil surgeon who will then complete and sign Form I-693. Failure to properly submit the forms, I-693 and I-485, which stands as the application to register permanent residence or adjust status, could lead to application rejection. The update is aimed at minimizing the number of Request for Evidence (RFEs) being issued before an I-485 form can be adjudicated.

On a related note, the USCIS warned that failure to include these medical and vaccination report forms with the I-485 Form for adjustment of status could lead to petition denial. This step has been taken in an effort to streamline the immigration process, thus reducing the amount of additional evidence requested before eliminating a Form I-485. USCIS noted that the “Form I-693 and Vaccination Record” would be valid indefinitely, following a properly completed and signed form by a civil surgeon.

The changes, effective from June 11, 2025, have generally been seen as aligning with an ongoing trend of making the immigration process increasingly burdensome. However, commentators also note that the policy change is relatively narrow and may not lead to significant disruption.

The Trump administration is revising a policy on green card requirements that was put in place in 2024. Announced by the United States Citizenship and Immigration Services (USCIS) on June 11, 2025, a medical exam form must now accompany every new application for permanent residency. This new rule applies to all applications filed starting June 11, as well as any current pending applications. If a pending application does not have an associated medical exam form, it will be denied.

This change signifies that the previously indefinite validity of medical exam forms, or Form I-683s, now ceases when an application for permanent residency is withdrawn or denied. Consequently, individuals might have to pay for a medical exam more than once if they reapply. Previously, only applicants required to verify their admissibility on medical grounds needed to file a medical examination form.

For the medical exam, applicants undergo checks for specific conditions or diseases that could otherwise render them inadmissible to the U.S., as well as verifying their vaccination records. The exam is conducted by a civil surgeon and often cost hundreds of dollars.

Simultaneously, President Donald Trump announced the “gold card” initiative. This new website allows people to register their interest in purchasing a green card for $5 million. The initiative is thought to be a part of his plan to replace the EB-5 offers, which grant green cards to those who invest in the U.S., announced in February. Trump suggests this scheme could raise $50 trillion, enough to alleviate the national debt, however current data suggests it would yield between $25 billion to $40 billion.

Legal experts argue that Trump cannot modify or abolish the EB-5 visa program without congressional support, yet the “gold card” program could potentially coexist with the current EB-5. This new rule requiring medical exam forms places significant financial and time-bound pressure on those looking to obtain a green card, reshaping the path to permanent residency in the U.S. The ‘gold card’ proposition, on the other hand, offers an alternate route for affluent hopefuls.