On 2 December 2024, U.S. Citizenship and Immigration Services (“USCIS”) published an announcement regarding medical reports (I-693 Form).  The USCIS announcement focuses upon the I-693 report filed during the permanent residency (“green card”) application process.  USCIS now requires that applicants file the I-693 medical report at the same time as the adjustment application (I-485 Form).  

What Is an I-693 Report?

During the I-485 adjustment process, U.S. law requires that USCIS determine if any medical problems prohibit granting permanent residency.  The relevant statute, INA § 212(a)(1)(A), identifies the medical reasons why USCIS may find an applicant ineligible for permanent residency.  See 8 U.S.C. § 1182(a)(1)(A).  For I-485 application purposes, USCIS requires an I-693 medical report to allow officers to analyze an applicant’s medical eligibility for residency.     

May a Primary Care Physician or Specialist Prepare an I-693 Medical Report?

No.  For applicants living in the United States, USCIS requires that a civil surgeon conduct the medical exam.  To ease the process for applicants, USCIS maintains a website for adjustment applicants to find civil surgeons in their region. In the past, I-693 medical reports expired after time passed. However, an I-693 medical report prepared by a civil surgeon after 1 November 2023 does not expire.  

May USCIS Deny an I-485 Adjustment Application Based upon a Medical Issue?      

Yes.  When Congress enacted 8 U.S.C. § 1182(a)(1)(A), Congress directed USCIS to find an applicant “inadmissible” due to certain medical conditions.  In an adjustment case, medically inadmissible means that USCIS may not approve an I-485 application.  Stated differently, inadmissible means the applicant may not become a permanent resident due to a medical issue. 

May USCIS Forgive a Medical Condition Harming a Permanent Residency Application?

Yes.  USCIS may review an applicant’s application for a waiver from the medical inadmissibility.  For example, 8 U.S.C. § 1182(g) provides the statutory criteria for USCIS to consider an application for a medical waiver.