Immigration Medical Exam: Overview

What Is The Immigration Medical Examination?

The green card medical examination is a crucial stage in the U.S. permanent immigration process and is required in most cases. The requirement for immigrant medical examinations has increased since the COVID-19 pandemic. 

The medical examination may consist of a review of vaccination and immunization records and a physical and mental evaluation by a civil surgeon or a panel physician (depending upon the type of green card application). You may also have to undergo some tests like an X-ray or a blood test. The basic idea behind a medical examination is to make sure that the prospective immigrant will not be a public healthcare concern, which would make them inadmissible for entry into the U.S. 

Is A Medical Examination Similar To A Checkup By My Physician?

The medical examination conducted for immigration purposes is quite different from a health checkup. The panel physician/civil surgeon will only test you in terms of the requirements of the USCIS, and it is not a substitute for a health checkup with your regular physician. 

The civil surgeon/panel physician will annotate any other medical condition that he discovers during your examination. However, if a condition is annotated in this section, that does not directly render you inadmissible on health-related grounds of inadmissibility.

Who Is Required To Undergo Medical Examination?

If you are applying to acquire a green card or permanent residence status in the U.S., then you are mandatorily required to undergo an Immigrant Medical Examination by a designated civil surgeon/panel physician. However, in some cases, the requirement is waived by the USCIS.

Here’s a list of the categories of immigrants who are exempt from undergoing a medical examination:

1. Refugees and Asylees Seeking Permanent Residence- If you are a refugee or an Asylee and have undergone a medical examination as a part of your application, before your arrival to the U.S., you usually do not need to undergo a medical examination when you apply to become a permanent resident and adjust your status.
2. K and V Nonimmigrant Visa Holders- If you hold any of these visas you may not be required to undergo a medical examination if you had a medical examination by a designated panel physician/civil surgeon as part of your visa application.
3. Special Immigrant Juveniles (SIJs)- If you are designated as a Special Immigrant juvenile who is a minor you will not be mandatorily required to undergo medical examination if you had a medical examination by a designated panel physician/civil surgeon as part of your visa application.
4. Children of Returning Residents Entering the U.S.- A child of a U.S. resident or U.S. national re-entering the U.S. is not required to undergo medical examination or vaccine requirements. 

In all the above cases, except for children of returning residents, the USCIS may require you to show proof of your immunizations/vaccines.

Which Doctors Can Complete The Medical Examination Process?

The category of medical physicians who can conduct an immigration medical examination will depend upon the type and location of the application.

Medical Examination Within The U.S.

If you are applying for adjustment of status and your medical examination is conducted within the U.S., then only medical professionals who have been designated as civil surgeons are competent to conduct the medical examination. 

The physician must be designated as a civil surgeon at the time of the completion of the immigration medical examination. It must be remembered that if you are physically present within the U.S. but pursuing a visa application abroad you must have the medical examination conducted by a panel physician approved by the U.S. Embassy/Consulate and the medical examination will not be conducted in the U.S. 

To find a civil surgeon, you may refer to the list of USCIS-designated civil surgeons. On the “Find a Doctor” page you may also shortlist a civil surgeon by selecting your address, and zip code which will locate doctors near you. You can also select language preference and the preferred gender of the physician. After selecting a doctor you can contact their office with the number provided on the website and schedule an appointment for a medical examination. 

Medical Examination Outside The U.S. 

In case you apply for permanent legal immigration by consular proceedings through a U.S. Embassy or U.S. Consulate, you will be required to undergo a medical examination by a medical professional who has been designated by the U.S. Department of State (DOS) as a “panel physician”. As per the U.S. Center for Disease Control (CDC), more than 760 medical professionals working overseas have been trained, licensed, and designated as panel physicians, who are solely responsible for conducting the medical examination as per the procedures prescribed by the U.S. DOS. 

When you are immigrating from outside the U.S. and require a medical examination, you may find a list of panel physicians near you by approaching the concerned U.S. Embassy or Consulate which is processing your application for permanent immigration. You may also visit the website of the DOS to find contact information for the Embassy/Consulate.

What Do I Do With The Report Of The Panel Physician/Civil Surgeon?

The integrity of the medical examination report is crucial and must be maintained by the medical professional and the prospective immigrant. If the USCIS suspects that the medical examination report has been tampered with, you may have to undergo the medical examination again. Further, it may lead to rejecting your petition for permanent immigration. 

Medical Examination Within The U.S.

The medical examination report prepared by a civil surgeon is created in Form I-693. You are only supposed to fill out Part 1 of the Form. The rest is to be filled by the panel physician. Once the report has been filled, you must sign it in the presence of the panel physician and deliver it to the USCIS. It has to be ensured that the report is sealed and the seal has not been tampered with or broken in any way.

Medical Examination Outside The U.S.

In case your medical examination is conducted by a medical professional designated by the DOS as a panel physician, then the panel physician is responsible for testing and reporting the results of the tests and consultation to the U.S. Embassy/Consulate. The panel physician will after conducting the prescribed test, directly deliver the report to the consular officer. 

If you are unsure about which medical examination is right for you, then you can take a free eligibility test on FileRight.com and answer simple questions before paying any fees to the USCIS or the Physician. 

How To Prepare For The Medical Exam?

If you are planning to immigrate to the U.S. you must meet the vaccination requirements as prescribed by the USCIS and CDC. Here’s a list of mandatory vaccinations:

1. Measles, Mumps, and Rubella (MMR): Two doses of MMR vaccine are required, and it should be in such a manner that the first dose should be given on or after your 1st birthday and the 2nd dose should be administered at least after 28 days of the first vaccine.
2. Polio: An inactivated polio vaccine (IPV) or, in some cases, an oral polio vaccine (OPV) is required.
3. Tetanus and Diphtheria Toxoids: The primary series of tetanus and diphtheria toxoids are required and also a booster dose within the last 10 years is mandatory
4. Pertussis (Whooping Cough): A single dose of the Tdap vaccine.
5. Haemophilus influenzae Type B: It is required for children under 5 years of age.
6. Hepatitis A: Required for children aged 12 months to 18 years.
7. Hepatitis B: All applicants must receive the Hepatitis B vaccine.
8. Rotavirus: Required for infants aged 6 to 32 weeks.
9. Meningococcal Disease: Required for applicants aged 2 months to 55 years.
10. Varicella (Chickenpox): Applicants who do not have proof of immunity from a previous infection or vaccination must receive the varicella vaccine.
11. Pneumococcal Disease
12. Seasonal Influenza- Only required during flu season typically October 1-March 31.
13. COVID-19
14. Any other vaccine-preventable diseases recommended by the Advisory Committee for Immunization Practices (ACIP)

Vaccination requirements may be exempt in certain cases such as if the child is 10 years or younger, the child is classified as an orphan, or a Hague Convention adoptee. 

What Should I Bring To My Medical Examination?

In case you are applying for a green card through consular proceedings, the embassy/consulate office will provide you with a list of documents that you will be required to carry to the examination. However, here is a general list of items you may be required to carry:

1. Copy of the Appointment Letter 
2. Government-issued photo identification or passport
3. Records of your vaccination/immunization
4. Copy of medical history
5. Printed copy of Form I-693 (only applicable in case of adjustment of status)
6. Passport size photos (number depending upon the form type)
7. List of medication and prescriptions. 
8. Certificate of clearance in case you were previously diagnosed with a “Class A” Condition which may render you inadmissible and now you are cured.
9. Health Insurance Card and payment for the medical examination

If you have any questions or concerns about the medical examination, feel free to reach out to the Immigration Experts at FileRight.com. Additionally, here’s a quick guide on the 5 essential things you need to know about the green card medical exam.

What Is USCIS Form-I-693?

USCIS Form I-693 (Report of Medical Examination and Vaccination Record) is the form and format of the medical examination report used by the USCIS to determine whether you are inadmissible to immigrate to the U.S. on health-related grounds. You, as the applicant are required to fill out Part 1 either with black ink or print in black ink. The rest of the sections will be filed by the civil surgeon. 

After the examination, you must sign the form in the presence of the civil surgeon and deliver the medical examination report in a sealed envelope to the USCIS.  Learn more about Form I-693 here. 

What Is The Cost Of The Medical Examination? 

The cost of the medical exam may vary depending upon the type of test you are required to undergo, and the fees of the panel physician/civil surgeon, and it may range from $100-500 or more. You may have to bear a big chunk of the cost as many physicians do not accept insurance and many portions of tests/examinations are not covered by insurance. You should check with the panel physician/civil surgeon beforehand what the cost would be and whether they accept your insurance. 

However, the USCIS has provided some relief as there is no filing fee for Form I-693. The medical exam usually takes around an hour. But in some cases, it may extend to 2 hours as well. 

What Is The Validity Of The Medical Examination Report?

The USCIS on April 4, 2024, increased the validity of Form I-693, Report of Immigration Medical Examination and Vaccination Record, so that it can be used indefinitely as evidence to show that the immigrant applicant is not inadmissible on health-related grounds. However, this policy is only applicable for a medical examination that was undertaken and signed by a civil surgeon on or after November 1, 2023.  

However, the USCIS officers may still ask for a new form or additional information if they think your health condition might have changed since the form was completed or if they believe it isn’t accurate to ensure that the information is still current and correct.

For all other medical examinations that were conducted and signed by a civil surgeon before November 01, 2023, the validity shall be two years from the date of conducting and signing of the medical examination by a designated civil surgeon. 

What If I Don’t Pass My Medical Examination?

If, in some case, you are unable to pass your medical examination then you will be unable to procure a green card and will be inadmissible for entry into the U.S. If you believe that the behavior and/or the action of the civil surgeon who conducted the medical examination was concerning, you may report the same to the concerned state medical board or connect with the USCIS Contact Center. 

Appeal And Motion To Reopen:

If you are found inadmissible for entry and you believe that the decision was unfavorable or unjust then you may appeal within 30 days of the decision. 

You may file the appeal either with the USCIS Administrative Appeals Office (AAO) or the Board of Immigration Appeals (BIA) by using USCIS Form I-290B, Notice of Appeal, or Motion to Reopen. However, in most cases (except revocation of approved USCIS Form I-140, Immigrant Petition for Alien Worker), only the application or petitioner can file the appeal and not the beneficiary. 

The USCIS would provide details about the appeal process and inform you of the authority where you may appeal the decision in the notice of denial or revocation. You may also refer to the FAQs on appeals and motions to reopen available on the USICS website. 

What Are The Common Reasons For Denial Of My Immigration Petition?

The USCIS published a Policy Manual which lists the health grounds of inadmissibility. As per Volume 8- Part B, the medical examination may reveal the following public health threats to the residents of the U.S. which may render you inadmissible to enter the U.S.:

Class “A” Conditions 

1. Communicable Diseases- This includes present and untreated Gonorrhea, Hansen’s Disease (Leprosy), Syphilis (infectious stage), and Active Class A Tuberculosis (TB). While earlier Human Immunodeficiency Virus (HIV) was included as a communicable disease, however, since January 04, 2010, it has been removed from the list. However, if the disease is treated/cured you will be eligible to apply for a green card.
2. Failure to present vaccine documents against the disease where it is compulsory- Under the Immigration and Nationality Act, a person seeking a permanent resident status or a green card, who fails to show proof that they were vaccinated against vaccine-preventable diseases, is inadmissible. 
3. Present or past physical or mental disorder associated- This includes past physical or mental disorders and harmful behavior that is likely to recur. However, to render a person inadmissible there must be the presence of both physical or mental disorder and harmful behavior. Further, alcohol use while driving is treated to be a physical or mental disorder.
4. Drug or Alcohol Abuse/Addiction- If you are abusing alcohol or prescription/non-prescription drugs then you will be considered ineligible for acquiring a green card. To remove the defect, you may have to undergo a blood/drug test to show that you are no longer abusing the substance. 
5. Harmful behavior- If annotated by the panel physician/civil surgeon on your medical examination report, it may make you inadmissible to apply for a green card. 

Class “B” Conditions

1. A physical or mental disorder without associated harmful behavior or harmful behavior that is now in remission.
2. A substance use disorder for a non-controlled substance without associated harmful behavior.

While Class “A” conditions are conclusive evidence to render a person inadmissible for immigrating to the U.S., however, Class “B” conditions do not compulsorily make a prospective immigrant inadmissible and include any physical or mental abnormality, disease, or disability serious in degree or nature amounting to a substantial departure from well-being. 

Conclusion 

Medical examination is an important step in the immigration process. You must select the right medical physician and take the prescribed vaccination to not be deemed inadmissible for entry to the U.S. It is important both for you and the civil surgeon/panel physician conducting your medical examination to provide true, correct, and accurate information to the USCIS. This is essential to about green card medical exam as any misinformation, misrepresentation, or withholding of information may lead to delays in the immigration process and rejection of the immigration application.  

FAQ’s

I am applying for a green card with my dependent children. Are they required to undergo a medical examination? 

While children are required by USCIS to be medically examined by a physician and immunized before immigrating to the U.S, however, the USCIS has relaxed the requirement of chest X-rays and blood tests for children under 15 years. 

What should I expect at the medical examination?

The medical examination may include X-rays, blood and urine tests, verification of immunization records, and tests for physical or mental disorders and harmful behavior. Along with this, the panel physician/civil surgeon will examine the eyes, ears, throat, nose, heart, lungs, skin, lymph nodes, etc. The physician may also run tests to determine if you are addicted to or abuse drugs or liquor. 

If I am pregnant then am I required to undergo an X-ray during the medical examination? 

In case a woman is pregnant and is required to undergo a medical examination then as per the CDC, the woman would have to provide consent to the panel physician before conducting the X-ray. Further, for the protection of the woman and the unborn child, pelvic protection with a double layer would be provided. 

If I have diabetes or heart problems will I be able to apply for a green card or will I be inadmissible?

If you have chronic diabetes and/or heart problems and you can show that the disease is well-managed you would not be disqualified. Further, if you had a communicable disease that has since then been cured, or if you have a cough and cold on the day of the medical exam, this would not deem you inadmissible to apply for a green card.