(U.S. Citizenship and Immigration Services) has rolled back the open-ended I-693 validity rule and set tighter guardrails around the immigration medical examination, moving to a “valid-while-pending” standard for most recent medicals. Effective for all cases pending or filed on or after June 11, 2025, a Form I-693, Report of Immigration Medical Examination and Vaccination Record signed on or after November 1, 2023 remains valid only while the connected immigration application is pending with USCIS.
If that benefit request—such as an Form I-485, Application to Register Permanent Residence or Adjust Status—is denied or withdrawn, the medical cannot be reused. A fresh exam and a new Form I-693 must be submitted with any later filing.
Why USCIS changed the rule
USCIS framed the change as a return to a time‑bound, case‑specific approach that supports public health goals. The agency had briefly allowed indefinite reuse of medicals signed on or after November 1, 2023, under a 2024 update; the June 2025 policy reversed that approach after coordination with the Centers for Disease Control and Prevention (CDC).
According to agency guidance, the shift reinforces:
- Timely screening and vaccination follow-through
- Documentation that reflects a person’s current health status rather than a record that may be years old
VisaVerge.com reports that the agency tied the reversal to “public health concerns and the need for timely medical examinations and treatment,” aligning the I-693 validity framework with CDC safeguards.
How the new rules apply
Key points of the updated policy:
- I-693 signed on or after Nov. 1, 2023: Valid only while the linked application is pending with USCIS. If the case is denied or withdrawn, the medical expires for future use and a new exam is required for any later filing.
- I-693 signed before Nov. 1, 2023: Retains the two‑year validity from the civil surgeon’s signature date, unless USCIS asks for a new medical due to concerns or incomplete information.
- Application rejection exception: If USCIS rejects an application for filing errors (e.g., missing fees or signatures), the applicant may resubmit the same
Form I-693with the corrected filing. A new exam is not required in that narrow circumstance. - Edition-date rule (from July 3, 2025): USCIS will accept only the 01/20/2025 edition of
Form I-693. Until July 3, both the 03/09/2023 and 01/20/2025 editions are accepted. The edition date must match the date the civil surgeon signs the form (check the bottom of each page).
The policy update follows improved data sharing with the CDC, which now receives medical data from civil surgeons electronically. USCIS says this coordination strengthens record‑keeping and helps track compliance with vaccine and treatment guidance. USCIS officers retain discretion to request a new exam if records are incomplete or an applicant’s health needs a fresh review, regardless of the signature date.
Practical impact on applicants and stakeholders
For applicants:
– The I-693 validity for recent medicals now hinges on a live, pending application. Timing your exam matters more than ever.
– If you take the medical too early and your case later stalls, a denial or withdrawal will end that medical’s usefulness for future filings.
– Best practice: schedule the exam with a civil surgeon close to when USCIS signals it needs the medical or when you’re ready to file a complete packet.
– Many applicants bring the sealed I-693 to the adjustment interview or respond to a USCIS Request for Evidence (RFE) to reduce the risk that a long wait will outlast the medical’s practical window.
For employers sponsoring workers:
– Pair the medical with the application only if the case is ready to move forward.
– If the underlying job offer or petition may change, waiting to submit the medical until USCIS asks can avoid paying for another exam later.
For families:
– When cases may face delays (visa number backlogs, etc.), consider holding the medical until it’s truly needed.
For civil surgeons and clinics:
– Expect fewer “banked” medicals and more appointments timed to active filings.
– Clinics must manage inventory and staff training so each packet matches USCIS rules on the day the doctor signs.
– Seal the form in the provided envelope and remind patients not to open it.
– Ensure the correct edition date is used: forms signed on or after July 3, 2025 must be the 01/20/2025 edition.
For immigration attorneys:
– Advise clients to hold the sealed envelope until necessary, monitor case status, and avoid submitting the I-693 too early in long queues.
– Responding to an RFE so the medical arrives at the top of the file as an officer prepares to decide can reduce the risk of a new exam being required.
Steps applicants should take now
- Confirm the edition date of the form before your appointment. The official form and instructions are at Form I-693.
- Ask the civil surgeon to review vaccine records closely to avoid later RFEs.
- Keep a copy of the completed vaccination supplement for your records before the envelope is sealed.
- If your application is rejected for a fixable error, you may resubmit the same I-693 with the corrected filing; if it is denied or withdrawn, plan for a new exam.
- If your I-693 was signed before Nov. 1, 2023, check the two‑year window and be ready for a new exam if USCIS requests one.
Important: A rejection is not the same as a denial. If your case is rejected because of missing signatures or fees, you can fix the error and resubmit the same medical form. Once a case is denied or withdrawn, the medical expires and a new exam is required.
Operational and policy context
- The I-693 examines whether a person:
- Has certain communicable diseases of public health significance
- Has required vaccinations
- Has certain disorders tied to harmful behavior that could affect admissibility
- While most exams do not uncover issues that block a green card, timing matters: vaccines may be due, screening standards may change, and a person’s health can change.
USCIS tied the policy reversal to public health concerns and the need for timely medical examinations and treatment, and to improved electronic data sharing with CDC.
Where to find official forms and guidance
- Official form and instructions: Form I-693
- Adjustment of status information: Form I-485
- Policy guidance: USCIS Policy Manual
The revised USCIS policy places more emphasis on timing and case strategy. By tying recent I-693 validity to an active case, USCIS aims to ensure the medical exam reflects current health facts, current vaccine guidance, and current CDC criteria—reducing the risk that an outdated exam will be used in an active adjudication.
Frequently Asked Questions
This Article in a Nutshell
USCIS revised the I-693 validity policy, rescinding the earlier open-ended reuse approach and adopting a ‘valid-while-pending’ standard for medicals signed on or after Nov. 1, 2023. Effective for cases filed or pending on or after June 11, 2025, the update means that if an application is denied or withdrawn, the I-693 cannot be reused and a new immigration medical exam is required for later filings. Medicals signed before Nov. 1, 2023 retain a two-year validity. USCIS coordinated with the CDC and improved electronic data sharing, aiming to ensure timely screening, current vaccination records, and accurate health documentation. Applicants, sponsors, clinicians, and attorneys should time exams strategically, confirm the correct form edition (01/20/2025 required after July 3, 2025), and keep sealed forms until needed. USCIS officers may still request new exams if records are incomplete or health conditions change.
