USCIS Policy Update – I-693 Medical Exams

Safe Passage, July 18, 2016

Great news from our district office. In short, attorneys can help their clients obtain their medical and not worry the results will expire. Safe Passage Project is also seeking confirmation from DHS Headquarters in D.C.

Recently Safe Passage Project learned that the USCIS is sending Request for Evidence (RFE) letters to attorneys and youth who filed for adjustment of status without submitting the medical exam, Form I-693. The medical exam is required of all people seeking adjust of status to lawful permanent resident. The exam must be conducted by a physician authorized by the federal government to certify that the applicant meets all of the medical standards required of new immigrants. [There is  typically a $150 fee or greater for this exam and this is fee is paid to the physician not the USCIS. There is no waiver for this fee.]

The Form I-693 advises that the results of the medical exam are valid for one year. Safe Passage Project was concerned that some of the young people who only recently filed for special immigrant juvenile status on Form I-360 (the visa petition form) would find that their medical expired before they could complete the adjustment of status process. When you file the I-360 petition, the USCIS issues a receipt and the date of the receipt becomes the young person’s “priority date” or place in line for a visa number.

The State Department has predicted a shortage of visas for children born in El Salvador, Guatemala, or Honduras because each country has a visa cap of 672 children per year. Safe Passage Project will know more about the future backlogs in early September when the State Department sets the new cutoff dates for Special Immigrant Juveniles for the opening of the new fiscal year on October 1. It is Safe Passage Project’s best guess that children who filed the I-360 in 2016 will not complete their adjustment of status process within the next few months and the wait may be much longer.  Therefore, staff worried the medical exams would expire and children would have to return to the doctor for a second exam and pay the fee twice.

Safe Passage Project reached out to the USCIS District Office and a senior officer said it is current USCIS policy to request the medical and to complete all of the necessary evaluation of the young person’s application even though no visa numbers are currently available. In other words, USCIS will “work the cases” as if there are able to grant permanent resident status now and if a case is fully approvable they will issue a letter informing the young person that he or she does qualify for permanent residence and as soon as visa numbers are available for the young person’s priority date, they will grant permanent residence and send the “green card.”

USCIS will not require a second medical even if more than one year has passed since the original exam.

If you have more questions about the process or how to help your client schedule a medical exam or have other questions about responding to the RFE letters, please contact your mentor attorney at Safe Passage Project or write to us at