In December 2024, the U.S. Citizenship and Immigration Services (USCIS) implemented a significant policy change affecting the I-485 adjustment of status application process. Under the updated guidelines, the I-693 medical exam is now a mandatory component of the initial filing. Previously, applicants could choose to submit the I-693 exam later in response to a Request for Evidence (RFE), typically issued near the final adjudication stage. As long as the exam was provided when requested, the application could proceed. However, with the new policy, failure to include the I-693 exam at the time of the initial application may result in outright rejection, marking a notable shift in how adjustment of status applications are handled.

Applicants anticipating that their priority date may become current in the near future are encouraged to prepare by scheduling their medical exam early. Depending on the need for additional vaccinations or other requirements, completing the exam can take several weeks. Under USCIS’s latest policy, any I-693 medical exam signed by a civil surgeon on or after November 1, 2023, remains valid indefinitely. As a result, obtaining the exam early minimizes delays and ensures readiness, as the completed exam can be used whenever the applicant’s priority date becomes current.

Applicants with pending I-485 applications who previously submitted medical exams signed before November 1, 2023, and whose priority dates later retrogressed, can take similar proactive steps. I-693 forms signed before November 2023 are valid for two years from the date of the civil surgeon’s signature. If this validity period expires before the applicant’s priority date becomes current and their I-485 application reaches final adjudication, USCIS will require a new, valid exam. In such cases, obtaining an updated medical exam in advance allows applicants to respond promptly to a Request for Evidence (RFE), helping to expedite the final adjudication of their adjustment of status application.

By: Rebecca Chen

Rebecca Chen is a Partner at Reddy & Neumann. Her representation includes advising clients throughout the non-immigrant and immigrant visa application process, from initial filing, responding to various requests for evidence, and processing at overseas consulates. Her years of experience in the immigration field have made her a knowledgeable resource for complex business immigration matters.