How Long Is Form I-693 Valid for USCIS Pending Applications (2025)

The federal government has tightened rules on immigration medicals, making timing and paperwork choices more important for thousands of applicants in the United States. As of September 21, 2025, the USCIS medical exam—documented on Form I-693, Report of Immigration Medical Examination and Vaccination Record—is valid only while the associated application is a pending application. If that application is denied or withdrawn, the medical exam immediately loses validity, even if it was completed recently.

This rule applies to any Form I-693 signed on or after November 1, 2023, and became operative for cases filed or pending on or after June 11, 2025, according to the agency’s policy guidance. Applicants who planned to carry one medical across multiple filings will now need a new exam for every new submission after a denial or withdrawal, changing how families, workers, and attorneys plan their cases.

What changed and why it matters

The revised Form I-693 validity framework marks a clear break from past practice.

• For medicals signed before November 1, 2023, the older rule still applies: the form remains valid for two years from the civil surgeon’s signature date.
• For medicals signed on or after November 1, 2023, the clock is tied to the life of the related case: the medical is valid only while the related application is pending. If that application is denied or withdrawn, the medical is no longer valid.

This distinction matters across categories that require a USCIS medical exam: family-based adjustment (<a href="https://www.uscis.gov/i-485">Form I-485</a>), employment-based filings, and other benefit requests. Applicants who once could reuse a recent medical across filings must now obtain a new exam after any denied or withdrawn case.

How the policy evolved

USCIS initially announced on April 4, 2024, that it would accept medicals signed on or after November 1, 2023, with indefinite validity to reduce paperwork and burden. That change was later reversed.

• The agency finalized a narrower approach, effective for applications pending or filed on or after June 11, 2025.
• USCIS cited public health concerns—medical data can become stale during long adjudication times—so the final rule requires a new USCIS medical exam and Form I-693 for any new filing after a denial or withdrawal.

USCIS points readers to its policy guidance, including the Form I-693 instructions and the Policy Manual. For authoritative details see the USCIS Policy Manual.

Final takeaway: the new rule ensures USCIS reviews current medical information during the life of a case, but it also removes former flexibility and changes filing strategy for many applicants.

Policy details and filing discipline

Under the current standard, USCIS treats Form I-693 as valid only if both conditions are met simultaneously:

1. The exam was properly completed and signed by a USCIS-designated civil surgeon on or after November 1, 2023.
2. The related immigration case remains a pending application.

If an applicant withdraws the case to fix errors, changes strategy, or receives a denial, the medical cannot be reused. USCIS expects a fresh medical for any new application after a denial or withdrawal—even if the prior exam was completed only weeks earlier.

Other important procedural points:

• The exam must be performed by a USCIS-approved civil surgeon.
• The Form I-693 must be submitted in a sealed envelope with the benefit request.
• If the sealed envelope is opened or altered, USCIS can refuse the packet.
• USCIS warns that failing to send a valid medical with an initial Form I-485 or other required application can lead to rejection or denial.

Impact on applicants: cost, timing, and risk

The revised rule affects applicants along three main lines:

• Cost: Repeating exams after a denial or withdrawal increases expenses (appointment fees, lab work, travel). Families and employment-based applicants who once reused medicals might now face additional financial and logistical burdens.
• Timing: Medical validity tied to pending status makes scheduling more sensitive. Many applicants will schedule exams close to the intended filing date to minimize the risk of an exam going unused.
• Risk management: People with complex histories (prior denials, multiple filings, shifting eligibility) face higher stakes when deciding to withdraw and refile. Withdrawing now means losing the medical for future filings.

Legal professionals note that the rule nudges applicants to file clean packages and avoid withdrawals when possible. Law firms are building new checklists and recommending a final pre-filing review to ensure forms, fees, and supporting evidence are complete before scheduling a medical.

Practical examples

• Marriage-based applicant: Files Form I-485 with a sealed Form I-693. If approved, no new exam is needed. If denied, the medical cannot be reused for a new Form I-485.
• Employment-based applicant: Files adjustment with a medical signed in December 2024. If the case remains pending in late 2025, the medical remains valid because the case is pending.
• Family that files without a medical: If USCIS rejects the initial filing for missing required documents, the family must start over and include a new sealed Form I-693.

These examples highlight the core point: for medicals signed on or after November 1, 2023, validity is tied to the life of the pending application. Once that life ends in denial or withdrawal, the medical ends with it.

Access issues and equity concerns

Applicant advocates worry about the burden on people with limited access to civil surgeons, work or childcare constraints, or who live in areas with long appointment waits. Scheduling another medical after a withdrawal can be a substantial hardship.

Those with medicals signed before November 1, 2023 still benefit from the two-year validity rule, but by late 2025 fewer applicants fall into that category.

Who may complete the exam

Only USCIS-designated civil surgeons can perform the immigration medical, complete Form I-693, and provide the sealed packet. Applicants should:

• Confirm the doctor is a civil surgeon.
• Ensure the Form I-693 is sealed and not opened before submission.
• Keep personal records of the civil surgeon’s signature date.

Practical steps and timing (recommended checklist)

1. Schedule the medical only after the case is nearly ready to file. Confirm the doctor is a USCIS-designated civil surgeon and that all vaccines, labs, and exam steps can be completed timely.
2. Have the civil surgeon complete and sign the Form I-693. Record the signature date and retain your own copy of ancillary records (labs, vaccination receipts) while keeping the Form I-693 sealed.
3. Include the sealed Form I-693 with the main filing (e.g., include with Form I-485 for adjustment of status). USCIS warns that skipping a required medical can lead to rejection or denial.
4. Track the case status. A medical signed on or after November 1, 2023 remains valid only while the case is pending.
5. If the case is denied or withdrawn, plan to schedule a fresh exam and submit a new sealed Form I-693 with any new filing.
6. If you hold a medical signed before November 1, 2023, verify whether the two-year validity still covers your situation.

Applicants can access official forms and instructions here:
– Form I-693, Report of Immigration Medical Examination and Vaccination Record: https://www.uscis.gov/i-693
– Form I-485, Application to Register Permanent Residence or Adjust Status: https://www.uscis.gov/i-485
– USCIS Policy Manual: https://www.uscis.gov/policy-manual

Key points to remember

• Medicals signed on or after November 1, 2023: valid only while the linked case is pending.
• If the case is denied or withdrawn: the medical becomes invalid immediately.
• New filing after denial/withdrawal: a new exam and a new Form I-693 are required.
• Medicals signed before November 1, 2023: valid for two years from signature date.
• Effective application date for the rule: applies to applications filed or pending on or after June 11, 2025.

The bottom line: for Form I-693 signed on or after November 1, 2023, validity exists only while the immigration case is a pending application. If that filing ends in denial or withdrawal, the medical ends with it; any new filing requires a new exam and sealed form. For older medicals signed before that date, the two-year rule still applies.

USCIS remains the central authority for policy, updates, and form instructions. Applicants and employers should check the USCIS Policy Manual and the form pages above for the latest guidance and plan filings accordingly. Immigration law firms (for example, Pollack, Pollack, Isaac & DeCicco LLP in New York ((212) 233-8100) and Kublan Khan PLC in Virginia ((703) 854-1081)) are advising clients to schedule medicals close to filing dates and to maintain careful pre-filing checklists to avoid wasted exams and avoidable denials.