Applicants for Employment-Based Adjustment of Status are required to submit a completed medical exam in order to be approved for lawful permanent residence status (the green card). The purpose of the medical exam is to establish that an applicant is not inadmissible on public-health grounds. USCIS currently recommends that Employment-Based applicants submit their completed medical exam (Form I-693) along with their I-485 application for efficient processing. Questions often arise regarding how long a medical exam remains valid, and this depends on whether the civil surgeon completing the exam signed it before or after the AOS application is filed.

If the medical is signed by the civil surgeon before the AOS application is filed, the civil surgeon’s signature date cannot be more than 60 days (i.e., 61 days or more) before the AOS filing date. In other words, when filing the medical exam along with the I-485 application, the medical must have been signed within the past 60 days. If it was signed more than 60 days before the I-485 application is received by USCIS, the medical is not valid and a new medical exam will be requested by USCIS before the green card can be approved.

Assuming a valid medical exam was submitted with the I-485 application (ie it was signed no more than 60 days prior to the receipt date of the AOS), then the medical exam remains valid for two years from the date of the civil surgeon’s signature while the adjustment application is pending with USCIS. In this way, as long as the adjustment is approved within 2 years of the date the medical exam was signed, USCIS can utilize the exam to confirm admissibility and adjust the applicant’s status, assuming all other requirements are met.

In some situations, it may be necessary to file the I-485 application without first obtaining the medical exam, such as when it is impossible to obtain a timely appointment with a civil surgeon like we saw during the COVID-19 pandemic, or when an applicant’s priority date will not remain available long enough to wait for an appointment in the event of retrogression or inability to use the Filing Dates Chart in the monthly Visa Bulletin. In the case where the I-485 application is filed and the medical exam is completed after filing, the exam remains valid for 2 years from the date of the civil surgeon’s signature. The medical exam can be submitted in response to a Request for Evidence, by bringing it to an interview appointment, or by interfiling. Note that even if the medical is obtained after the AOS application is filed, if the application is not adjudicated within the medical’s two-year validity period, the applicant would have to obtain another medical, which would require additional time, effort, and expenses.

By: Emily Neumann

Emily Neumann is Managing Partner at Reddy Neumann Brown PC with over 15 years of experience practicing US immigration law providing services to U.S. businesses and multinational corporations. Emily has helped transform the firm from a solo practice to Houston’s largest immigration law firm focused exclusively on U.S. employment-based immigration.  She received her Bachelor’s degree in Biology from Central Michigan University and her Juris Doctorate degree from the University of Houston Law Center. Emily is a frequent speaker and has been quoted in Bloomberg Law, U.S. News & World Report, Inside Higher Ed, and The Times of India on various hot topics in immigration. She is a member of the American Immigration Lawyers Association and Society for Human Resource Management.