Oakton Health Center

On the USCIS Immigration Medical Exam Guidance front, the U.S. Citizenship and Immigration Services (USCIS) updated its guidance on how long an immigration medical exam report (Form I-693) remains valid as evidence. For all forms correctly completed and signed by an approved civil surgeon after November 1, 2023, they will not expire and will be used indefinitely. Before this date, those forms are valid for two years from when they were signed, with an exception for certain Afghan parolees, whose forms are valid for three years. Officers can, however, request new exams if they believe the applicant’s health status has changed.

In the Manual Release #25.20 Medical PM/WAG Updates regarding Asylum Applicants and Torture Victims (AATV) and Victims of Trafficking, Torture or Other Serious Crimes (VTTC), there were updates on processing these cases. New policies included details regarding Derivative Family Members (DFM) for VTTC cases and how to verify status for AATV/VTTC. Notably, applicants must now verify that they have filed for a T Visa, a U Visa, or asylum, rather than just preparing to file. Additionally, the applicant must have a child or other derivative family member to qualify for VTTC benefits. Asylum seekers must prove they either have a pending asylum application, an appeal regarding a decision of asylum, or are receiving treatment from a federally funded torture center to qualify for AATV assistance.

Lastly, the U.S. Department of Homeland Security (DHS) published a final rule regarding ‘public charge’ on September 9, 2022, taking effect on December 23, 2022. This rule enhances clarity around how they’ll determine if a noncitizen is likely to become a public charge, i.e., someone who could be denied visa, green card, or entry into the U.S. For more information, those interested are advised to visit USCIS’s resources page on public charge.

1. Immigration Bureau Reverses Ban on Harvard Student Visas
Harvard University-associated individuals can now proceed with scheduling and processing of visa applications as the U.S. Department of State reinstated the processing of F, M, and J visas, which previously got canceled due to security concerns. The termination of the Cuban, Haitian, Nicaraguan, and Venezuelan (CHNV) parole programs, following a Supreme Court ruling, implies that affected persons must prepare for revocations of their work authorizations to ensure compliance. The USCIS’s recent update mandates that any I-693 medical exam form must be submitted while its associated application remains pending. A fine forgiveness program for individuals self-deporting through the CBP One Home App can waive up to $1000 daily imposed for failing to depart on time after removal orders have been issued.

2. Challenges Associated with Immigration Medical Exams in Kansas
In Kansas City, getting a medical examination to gain permanent residency can be a long, costly process. Priyanka Raeburn, a resident of Kansas City and immigrant from New Delhi, discussed her struggle with the immigration medical exam process. These examinations must take place with a USCIS-approved physician and can cost up to $1400, which most insurance plans do not cover. However, Raeburn found a more affordable solution at the KC CARE Health Center, where the cost of exams is as low as $250. Regardless, many advocates suggest that the exam process and the associated costs need regulation and potential subsidy to alleviate the one-time financial burden.

3. Changes to Green Card Applications Can Impact Immigrants
The Trump administration has made significant changes to green card applications, including requiring a new medical examination form, announced by the USCIS. The previous policy was over a year old, enabling applicants to use medical forms indefinitely, but according to the new rule, the I-693 medical exam form becomes invalid if a green card application is withdrawn. Consequently, applicants must retake the exam to obtain a new, signed copy. This policy change impacts thousands of applicants attempting to file their adjustment of status applications, also known as Form I-485.

The USCIS implemented the change to preserve public health within the country. Prior to December 2024, only immigrants who needed to demonstrate they were not inadmissible presented a medical examination form. Now, all green card applicants must file one. The decision follows a series of attempts by the Trump administration to crack down on immigrants violating immigration laws.

Attorneys noted the lack of notice for the sudden policy change. USCIS usually allows a lead time for preparing applicants and immigration attorneys but made this change effective immediately. The hasty decision may result in invalid forms mailed in the same week.

Furthermore, the Trump administration has taken a harsher stance on immigrants, even revoking green cards from individuals considered to have violated the U.S.’ immigration or other laws. Immigrants can lose their green cards on national security grounds, for violation of immigration laws, or due to criminal convictions.

The newly implemented policy took effect on June 11, 2025. A fresh edition of the I-693 form became effective on July 3, 2025.

Starting from December 2, 2024, it became a procedural mandate for certain applicants planning to alter their status to permanent residency in America to submit Form I-693, Report of Immigration Medical Examination and Vaccination Record, along with Form I-485. The objective of this change is to verify health-related admissibility and reduce the number of Request for Evidence (RFEs) issued during the examination procedure. As a result, this would streamline the application procedure and limit delays.

Failing to include Form I-693 when submitting Form I-485, Application to Register Permanent Residence or Adjust Status, may result in the rejection of the I-485 application. Generally, applicants are obliged to undergo an immigration medical test and receive all necessary vaccinations to ensure their eligibility for status adjustment. A civil surgeon needs to affirm that the applicant doesn’t have any health conditions that could lead to them being inadmissible based on health-related factors by signing and completing Form I-693.

The new rule emphasizes that all applicants must submit Form I-693 or a partial Form I-693, like the Vaccination Record, with their Form I-485. Noncompliance could result in the Form I-485 being rejected. Form I-485 instructions have been revised to include this new requirement. The aim of this procedural modification is to cut down the number of RFEs issued before a Form I-485 can be passed. Form I-693, properly completed and signed by a civil surgeon post-November 1, 2023, is indefinitely valid.

To prevent their application from being rejected, applicants must book a medical appointment with a USCIS-designated civil surgeon who will finalize and sign Form I-693.The I-485 application needs both forms, I-693 and I-485, to be properly submitted.

The Trump government reversed a fairly new green card policy, where now, every new permanent residency application necessitates a renewed medical examination form, effective immediately from June 11, 2025. The rule applies to all applications for permanent residency filed, including the ones already pending from the defined date. To reiterate, every I-485 (Application to Register Permanent Residence or Adjust Status) filed needs an accompanying Form I-693 (Report of Immigration Medical Examination and Vaccination Record). If an application is pending but doesn’t have a related medical examination form, it will be declined.

The legacy policy stated indefinite validity for Form I-693s if appropriately completed, which became effective from April 2024. Now, the forms expire if a person’s permanent resident application is withdrawn or denied.

Medical tests, performed by a civil surgeon, may cost hundreds of dollars. They contain checks for specific conditions or diseases that could cause a person to be inadmissible in the U.S, alongside vaccination records. This change could mean green card seekers could wind up paying for a test more than once if their permanent residency application is declined or withdrawn and they wish to apply once more.

President Donald Trump, on the same day, proclaimed the initiation of a new website where people can express their interest in a “gold card” purchase for a green card that costs $5 million. Trump anticipates the “gold card” sales could yield around $50 trillion, funds enough to retire the national debt. However, the existing data proposes the scheme would instead raise approximately $25 billion to $40 billion.

Legal professionals indicate that President Trump can’t modify or eradicate the EB-5 visa program without acquiring congressional approval. Alternatively, a new “gold card” program could hypothetically coexist with the existing EB-5.