(SOUTH AFRICA) — South Africa’s Department of Home Affairs dropped the medical report requirement for several visa and residency categories on July 8, 2026, after Minister Leon Schreiber issued Ministerial Directive 10 of 2026 to waive a step that had long added cost and waiting time for applicants.

Leon Schreiber, South Africa’s minister of Home Affairs, said the change was intended to provide “welcome relief” and “simplify South Africa’s immigration processes.” The waiver applies to Temporary Residence Visas filed within South Africa and Permanent Residence Permits filed both inside the country and abroad.

The move removes a medical report requirement that had forced many visa applicants to arrange private examinations before they could complete their files. Home Affairs also had already waived radiological reports in 2023, cutting out another health document from the application process.

That leaves South Africa and the United States moving in opposite directions on medical paperwork for immigration cases as of July 9, 2026. South Africa has waived the medical report in the covered categories; the United States still requires most green card applicants to file a medical examination record with the initial application.

In the United States, U.S. Citizenship and Immigration Services requires most adjustment of status applicants to submit Form I-693, the Report of Immigration Medical Examination and Vaccination Record. Since December 2, 2024, USCIS has required applicants to file that form together with Form I-485, the application to register permanent residence or adjust status.

USCIS states: “You must submit Form I-693 with your Form I-485 application package. USCIS may reject an I-485 if the I-693 is missing”. That filing rule remained in place on July 9, 2026, even as South Africa removed the comparable step for covered applications.

USCIS also changed the validity rule for the medical exam on June 11, 2025. A Form I-693 now remains valid only for the specific application with which it was submitted, meaning an exam cannot be reused if the application is denied or withdrawn.

One U.S. relief measure did take effect on January 22, 2025, when USCIS waived the COVID-19 vaccination requirement for all adjustment of status applicants. That removed one item from the civil surgeon’s checklist, but it did not eliminate the broader medical report requirement.

The South African directive carries the clearest immediate effect in preparation time. Applicants in the covered categories no longer need to schedule a doctor’s visit, pay for a medical report, and wait for the document before filing, a change that cuts both expense and delay at the front end of the process.

That matters most in application systems where missing paperwork can stall a case before it begins. In South Africa, the new rule reduces the number of documents Home Affairs requires at filing. In the United States, the paperwork burden still falls on applicants before the first package goes out, because the medical exam must be completed before the adjustment filing reaches USCIS.

South Africa’s waiver is also broader than a small procedural tweak. It removes the medical report for temporary residence applications lodged inside the country and for permanent residence permit applications lodged both domestically and abroad, covering two of the most common routes that require substantial document collection.

The earlier 2023 decision to waive radiological reports had already narrowed the health documentation attached to those applications. With the new directive in force, applicants in the covered South African categories are now largely exempt from health-related paperwork that once formed a routine part of the submission.

Home Affairs did not announce a matching change for every visa type, and the directive described the affected classes specifically. That distinction matters because immigration systems often apply document waivers to one set of categories while keeping older requirements for others.

U.S. policy works the other way. Most adjustment applicants still need an immigration medical exam from a designated civil surgeon before filing, and the timing rule leaves little room to submit the form later if it was omitted from the initial packet.

The practical effect is not limited to the exam itself. Applicants must first secure an appointment with a civil surgeon, complete the exam, obtain the sealed Form I-693, and include it with Form I-485. If that packet arrives without the form, USCIS says it may reject the application.

That upfront rule changed the sequence of filing in the United States after December 2, 2024. Before then, some applicants could file adjustment paperwork first and submit the medical exam later. The current policy requires the medical step before the filing date, which can add planning pressure and fresh costs at the start of the case.

The South African announcement stands out because it cuts an administrative requirement rather than modifying a validity period or one item on a vaccine checklist. Schreiber presented the measure as part of a broader effort to simplify immigration processing through Home Affairs, with the waiver framed as immediate relief for applicants who had been paying private providers for mandatory reports.

Applicants seeking permanent residence permits from abroad also fall within the South African change, an uncommon feature in document waivers that often stop at domestic filings. That means the directive reaches both people already in South Africa and some applicants preparing files from outside the country.

The official source for the South African change is Directive 10 of 2026, issued by Home Affairs on July 8, 2026. U.S. policy remains set out through USCIS guidance on Form I-693, including the current I-693 instructions and updates posted through the USCIS newsroom.

Those two systems now present a stark split for visa applicants and residency applicants dealing with medical paperwork. In South Africa, Home Affairs has removed the medical report requirement for the covered categories and reduced the preparation burden further after the earlier radiological waiver. In the United States, the medical report requirement remains mandatory, tied to the initial filing and backed by the risk that USCIS may reject a case if the form is missing.

The contrast leaves one set of applicants gathering fewer documents and another still arranging a medical exam before they can file at all.