Oakton Health Center

Starting June 11, 2025, the United States Citizenship and Immigration Services (USCIS) has revised its policy on medical examination forms, requiring all green card applicants to submit a fresh examination form, regardless of previous submissions. This modifies a policy introduced more than a year prior, which allowed the indefinite reuse of Form I-693, provided that it was completed and endorsed by a certified civil surgeon.

Under the new policy, Form I-693 is only valid while the application it is associated with is active. A denied or withdrawn application invalidates the corresponding Form I-693, and any subsequent applications will demand a new medical examination and updated I-693 form.

The previous policy from April 2024, which granted indefinite validity to Form I-693, was deemed by USCIS as “overly broad” and a potential threat to public health in the US. Limiting the validity time to the current immigration benefit application or request will ensure that aliens get proper and timely medical examinations and treatment, thus securing public health.

The change will significantly impact immigrants applying for permanent residency, who until June 10, were permitted to use a previous form signed by a civil surgeon. It also affects those aspiring to file their application for adjustment of status, known as Form I-485. Medical exams that usually cost between $100 and $500 involve checking for specific conditions that could render an applicant inadmissible to the US. With the policy change requiring a renewed medical examination form for each application, prospective green card holders could end up paying for an exam more than once.

The Trump administration also introduced an immigration scheme, a “gold card” option, allowing successful applicants to purchase a green card for $5 million, touted to collect $50 trillion and pay off the national debt, although existing data suggests a forecast of around $25 billion to $40 billion.

The consistent changes to application processes and enforcement of immigration laws across the board have amplified the scrutiny faced by immigrants. However, the USCIS has made this move for health-related reasons and not necessarily to make the process more difficult.
Meanwhile, the position of green card holders remains delicate, with incidents of detentions and denials of reentry following travel abroad despite the status of permanent residency.

President Trump, who has taken a hard stance on immigration violations, cannot amend or abolish the EB-5 visa program allowing green cards to investors without congressional approval. However, the new gold card plan can potentially coexist with the current EB-5.

On July 3, 2025, a new version of the form will take effect, meant to uphold proper medical examinations and treatment for immigrants and to safeguard public health. However, the frequent changes to immigration policies have led to confusion and lawsuits that forced USCIS to reverse decisions or provide buffer time for changes to become effective. The new policy will have implications for potentially thousands of applicants, making it tougher to navigate the US immigration system.

The United States Citizenship and Immigration Services (USCIS) now requires certain applicants seeking to adjust their status to permanent residency to submit Form I-693, Report of Immigration Medical Examination and Vaccination Record, alongside Form I-485. This requirement, effective from December 2, 2024, aims to ensure that applicants do not possess health conditions that would make them inadmissible based on health-related grounds, thus streamlining the application process and reducing the number of Requests for Evidence (RFEs) issued.

Applicants must undergo an immigration medical exam and receive all necessary vaccinations, with a civil surgeon required to complete and sign Form I-693. Failure to include Form I-693 or a partially completed Form I-693 (for example, a Vaccination Record), may result in the rejection of the Form I-485 application. USCIS has consequently updated Form I-485’s instructions to reflect this change.

To prevent application rejection, applicants must schedule a medical exam with a USCIS-designated civil surgeon, who will complete and sign Form I-693. A properly completed Form I-693, signed by a civil surgeon on or after November 1, 2023, will remain valid indefinitely. This change has been enforced by USCIS to reduce the need for additional evidence gathering before adjudicating a Form I-485, as well as to streamline the immigration process.

Intercountry adoptions also have specific health guidelines. Each year, more than 5,000 children from all over the world are adopted by parents in the United States. As children born in other areas may face different health problems than those raised domestically, knowing as much as possible about a child’s health is integral for adoptive parents. Apart from the standard paperwork, medical examinations, vaccinations, and information gathering, adopters are also advised to be aware of the child’s health conditions.

CDC recommends that parents try to collect all relevant health information before traveling to bring the child home. The medical examination process for the adopted child usually begins overseas with a visit to a panel physician. An overseas medical exam’s purpose is to identify applicants, including adopted children, with Class A conditions. Children should also receive a medical exam once they enter the United States to determine the presence of any other health issues not screened during the visa medical exam.

Each child’s first medical visit in the United States might include checking their growth and development, testing hearing and vision, and screening for diseases like HIV/AIDS, Syphilis, Hepatitis B, illnesses caused by parasites, and Tuberculosis. Parents are required to get their children vaccinated within 30 days of arrival. The final verdict for waivers requested for Class A conditions is made by the Department of Homeland Security’s U.S. Citizenship and Immigration Services (USCIS).