Medical Exam (I-693) Validity Policy Change Discussion

[justvisiting]

USCIS is about to announce a new policy - they will stop renewing expired Medical Exams. They have started sending out RFEs for those who had their medical exam > 1 year ago. This will likely impact the I-485 processing times further. If you become Current this year after June 1, you will probably have an RFE. It looks like USCIS is doing their best to waste visa numbers this year. Hopefully DOS responds by aggressively moving dates forward to increase use of CP numbers. This however has very little impact on EB-2 consumption. I now fully expect visa numbers to be wasted this fiscal year.

[imdeng]

Oh Well... if folks get RFEs for EVL, Medical etc starting June - you have a very small window of for getting everything done right. I hope they will start the process early enough.

OTOH - there is the whole industry out there that does Medicals for immigration. Urgent Care for our case here in WI. They have a very fast turnaround - usually just a couple of days. So folks can get reply to a Medical RFE in like a week or two. So it is manageable.


USCIS is about to announce a new policy - they will stop renewing expired Medical Exams. They have started sending out RFEs for those who had their medical exam > 1 year ago. This will likely impact the I-485 processing times further. If you become Current this year after June 1, you will probably have an RFE. It looks like USCIS is doing their best to waste visa numbers this year. Hopefully DOS responds by aggressively moving dates forward to increase use of CP numbers. This however has very little impact on EB-2 consumption. I now fully expect visa numbers to be wasted this fiscal year.

[Spectator]

USCIS is about to announce a new policy - they will stop renewing expired Medical Exams. They have started sending out RFEs for those who had their medical exam > 1 year ago. This will likely impact the I-485 processing times further. If you become Current this year after June 1, you will probably have an RFE. It looks like USCIS is doing their best to waste visa numbers this year. Hopefully DOS responds by aggressively moving dates forward to increase use of CP numbers. This however has very little impact on EB-2 consumption. I now fully expect visa numbers to be wasted this fiscal year.justvisiting,

It certainly appears to be the case. AILA are hearing rumours and an extension memo is already overdue, if there was going to be one.

TBH, it doesn't make much sense to me from a health perspective - if the person did not have a reportable Class A or B medical condition at the time of the original medical examination, they are unlikely to develop one in the intervening time. If they did, then the medical examination was only valid for a year anyway.

A totally unnecessary reversal of policy IMO, if that is indeed the case.

If USCIS and the CDC have concerns about the time that has elapsed since 2007, then they could have assessed that by selecting a proportion of cases from higher risk Countries to see if their concerns have any basis in fact or not. If it turns out to be a "one size fits all" approach, where everyone receives an RFE, I can't agree with it.

Perhaps they are considering raising the initial validity from one year to a more sensible period.

[EB2-03252009]

So this will make eb2-I dates to move into 2009 or they wont move at all?


USCIS is about to announce a new policy - they will stop renewing expired Medical Exams. They have started sending out RFEs for those who had their medical exam > 1 year ago. This will likely impact the I-485 processing times further. If you become Current this year after June 1, you will probably have an RFE. It looks like USCIS is doing their best to waste visa numbers this year. Hopefully DOS responds by aggressively moving dates forward to increase use of CP numbers. This however has very little impact on EB-2 consumption. I now fully expect visa numbers to be wasted this fiscal year.

[Jagan01]

USCIS is about to announce a new policy - they will stop renewing expired Medical Exams. They have started sending out RFEs for those who had their medical exam > 1 year ago. This will likely impact the I-485 processing times further. If you become Current this year after June 1, you will probably have an RFE. It looks like USCIS is doing their best to waste visa numbers this year. Hopefully DOS responds by aggressively moving dates forward to increase use of CP numbers. This however has very little impact on EB-2 consumption. I now fully expect visa numbers to be wasted this fiscal year.

Would they not assign the visa numbers to applications in this FY to avoid wastage. The approvals might come in Oct or Nov 2014 but the visas will still be counted against FY2014. Is that not the case ?

[bzabza]

USCIS is about to announce a new policy - they will stop renewing expired Medical Exams. They have started sending out RFEs for those who had their medical exam > 1 year ago. This will likely impact the I-485 processing times further. If you become Current this year after June 1, you will probably have an RFE. It looks like USCIS is doing their best to waste visa numbers this year. Hopefully DOS responds by aggressively moving dates forward to increase use of CP numbers. This however has very little impact on EB-2 consumption. I now fully expect visa numbers to be wasted this fiscal year.

Where Did you get this info from? Can you share the source?

[justvisiting]

Where Did you get this info from? Can you share the source?

AILA Website:

Practice Alert: RFEs for Expiring Medical Exams
AILA practice alert notifying members that effective June 1, 2014, certain Forms I-693 submitted to USCIS in connection with adjustment of status applications more than one year prior will no longer be valid. RFEs are being sent out in anticipation of a change in policy.
AILA Doc. No. 14042146.

Oh Law Firm has the details.

[justvisiting]

So this will make eb2-I dates to move into 2009 or they wont move at all?

In a perfect world with perfect communication between USCIS and DOS, this should lead to DOS advancing dates further. Unfortunately we do not live in that world. That's why I suspect visa numbers may go to waste.

[Spectator]

In a perfect world with perfect communication between USCIS and DOS, this should lead to DOS advancing dates further. Unfortunately we do not live in that world. That's why I suspect visa numbers may go to waste.As much as a pain it is, if USCIS issue RFEs for new medicals in a timely fashion, there is no need for it to disrupt anything regarding processing and visa use.

As far as EB2-I goes, the dates aren't likely to move forward until July at the earliest (although I think it will more likely be August). If the RFEs are issued and replied to in a timely fashion, there will be nothing to stop approval on the same timescale as without the RFE.

It is a problem if USCIS wait to the last minute to issue RFEs, so it is actually encouraging to hear about them so early.

If USCIS are no longer going to extend the validity of the I-693 on a yearly basis, they really need to up the acceptable validity period to at least 2-3 years by way of a new Memo or regulation. People (especially in EB2-I) can become Current multiple times, just over a year apart (or just over year since the date of the last I-693) before their case is adjudicated. It really would not be fair to expect a new I-693 every year under those circumstances.

As best I can tell, the I-693 RFEs have so far only been received by EB3 applicants who first filed in 2007.

[shekhar_kuruk]

Spec,
I do know a Chinese girl at work who received this RFE and discussed this with me. Her priority date is Sep 2009 and she is an EB 2 candidate. She sounded a little worried but I did mention that she could get current soon.


As much as a pain it is, if USCIS issue RFEs for new medicals in a timely fashion, there is no need for it to disrupt anything regarding processing and visa use.

As far as EB2-I goes, the dates aren't likely to move forward until July at the earliest (although I think it will more likely be August). If the RFEs are issued and replied to in a timely fashion, there will be nothing to stop approval on the same timescale as without the RFE.

It is a problem if USCIS wait to the last minute to issue RFEs, so it is actually encouraging to hear about them so early.

If USCIS are no longer going to extend the validity of the I-693 on a yearly basis, they really need to up the acceptable validity period to at least 2-3 years by way of a new Memo or regulation. People (especially in EB2-I) can become Current multiple times, just over a year apart (or just over year since the date of the last I-693) before their case is adjudicated. It really would not be fair to expect a new I-693 every year under those circumstances.

As best I can tell, the I-693 RFEs have so far only been received by EB3 applicants who first filed in 2007.

[Kanmani]

This is how the memo on extension of validity of Form I-693 reads ......

"Policy
Even if more than one year has elapsed since the civil surgeon’s endorsement of a Form I-693 submitted in support of an I-485 or I-687 application, the Form I-693 should be considered valid in any case in which:

• The Form I-693 shows that the applicant had no Class A or Class B medical condition (other than a Class B Other Medical Condition) at the time
of the medical examination; and

• USCIS adjudicates the Form I-485 or Form I-687 on or before May 31, 2014.

By June 1, 2014, USCIS anticipates that it will issue a new policy in regards to the sufficiency of Form I-693 endorsements. USCIS is currently working with CDC on developing the new policy"

http://www.uscis.gov/sites/default/files/files/nativedocuments/I-693_Extension_PM_REVISION_Effective_9-4-13.pdf

[qesehmk]

Thanks Kanmani!

This to me looks like
A) The current policy anyway was only until 31st May 2014. And hence USCIS must renew the current policy or come up with new one.
B) Unless fundamentally landscape has changed CDC has no reason to not support current policy extension - which means in all likelihood current policy will continue to be in force unless CDC sees increased need to renew medical exams.

From administrative perspective - increased exams/RFEs add more headache rather than solve anything. So I think more than 50% I would believe the current policy should be extended as is.

This is how the memo on extension of validity of Form I-693 reads ......

"Policy
Even if more than one year has elapsed since the civil surgeon’s endorsement of a Form I-693 submitted in support of an I-485 or I-687 application, the Form I-693 should be considered valid in any case in which:

• The Form I-693 shows that the applicant had no Class A or Class B medical condition (other than a Class B Other Medical Condition) at the time
of the medical examination; and

• USCIS adjudicates the Form I-485 or Form I-687 on or before May 31, 2014.

By June 1, 2014, USCIS anticipates that it will issue a new policy in regards to the sufficiency of Form I-693 endorsements. USCIS is currently working with CDC on developing the new policy"

http://www.uscis.gov/sites/default/files/files/nativedocuments/I-693_Extension_PM_REVISION_Effective_9-4-13.pdf

[Spectator]

Thanks Kanmani!

This to me looks like
A) The current policy anyway was only until 31st May 2014. And hence USCIS must renew the current policy or come up with new one.
B) Unless fundamentally landscape has changed CDC has no reason to not support current policy extension - which means in all likelihood current policy will continue to be in force unless CDC sees increased need to renew medical exams.

From administrative perspective - increased exams/RFEs add more headache rather than solve anything. So I think more than 50% I would believe the current policy should be extended as is.Q,

I do sense something is afoot.

Here's the history of the previous Extension Memos and their publication dates (as far back as I am going to look anyway):

July 23, 2003 - extended until January 1, 2004
January 8, 2004 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/Archives%201998-2008/2004/i693extmem10804.pdf) - extended until January 1, 2005
December 2, 2004 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/Archives%201998-2008/2004/i693extn120204pub.pdf) - extended until January 1, 2006
January 11, 2006 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/Archives%201998-2008/2006/i693medext011106.pdf) - extended until January 1, 2007
January 3, 2007 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/i693medext010307.pdf) - extended until January 1, 2008
January 7, 2008 (http://www.uscis.gov/sites/default/files/files/pressrelease/I-693_extension_ja708.pdf) - extended until January 1, 2009
December 10, 2008 (http://www.avlawoffice.com/NeufeldMemo.htm) - extended until January 1, 2010
December 30, 2009 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static%20Files%20Memoranda/Extension%20of%20Validity%20of%20Medical%20Certifi cation%20on%20Form%20I-693_123009.pdf) - extended until January 1, 2011
December 16, 2010 - extended until January 1, 2012
December 29, 2011 (http://www.uscis.gov/sites/default/files/USCIS/Outreach/Feedback%20Opportunities/Interim%20Guidance%20for%20Comment/Ext_ValidityMedical_Cert_I693_2.pdf) - extended until January 1, 2013
December 20, 2012 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/I693_Extension_PM_Approved_Final122012.pdf) - extended until September 30, 2013
September 4, 2013 (http://www.uscis.gov/sites/default/files/files/nativedocuments/I-693_Extension_PM_REVISION_Effective_9-4-13.pdf) - extended until May 31, 2014

In recent years, apart from the last extension, they have been published well before the previous extension expired.

The last 2 extensions have been for a period of less than a year.

Even though the last extension was published very close to the expiration of the previous extension, I do not remember USCIS issuing RFE requests, or AILA suggesting the policy might change.

I can see 2 possibilities:

a) USCIS will (eventually) publish a Memo with a fixed validity period from the original examination that they will accept.

b) USCIS will no longer extend the validity and fall back to the 1 year expiration date.

My bet is on (a).

[qesehmk]

Spec that's a great observation and data!

As per possibility #2 - why do you think USCIS will opt for that at all? It doesn't bring USCIS any revenue does it?
Q,

I do sense something is afoot.

Here's the history of the previous Extension Memos and their publication dates (as far back as I am going to look anyway):

July 23, 2003 - extended until January 1, 2004
January 8, 2004 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/Archives%201998-2008/2004/i693extmem10804.pdf) - extended until January 1, 2005
December 2, 2004 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/Archives%201998-2008/2004/i693extn120204pub.pdf) - extended until January 1, 2006
January 11, 2006 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/Archives%201998-2008/2006/i693medext011106.pdf) - extended until January 1, 2007
January 3, 2007 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/i693medext010307.pdf) - extended until January 1, 2008
January 7, 2008 (http://www.uscis.gov/sites/default/files/files/pressrelease/I-693_extension_ja708.pdf) - extended until January 1, 2009
December 10, 2008 (http://www.avlawoffice.com/NeufeldMemo.htm) - extended until January 1, 2010
December 30, 2009 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static%20Files%20Memoranda/Extension%20of%20Validity%20of%20Medical%20Certifi cation%20on%20Form%20I-693_123009.pdf) - extended until January 1, 2011
December 16, 2010 - extended until January 1, 2012
December 29, 2011 (http://www.uscis.gov/sites/default/files/USCIS/Outreach/Feedback%20Opportunities/Interim%20Guidance%20for%20Comment/Ext_ValidityMedical_Cert_I693_2.pdf) - extended until January 1, 2013
December 20, 2012 (http://www.uscis.gov/sites/default/files/USCIS/Laws/Memoranda/Static_Files_Memoranda/I693_Extension_PM_Approved_Final122012.pdf) - extended until September 30, 2013
September 4, 2013 (http://www.uscis.gov/sites/default/files/files/nativedocuments/I-693_Extension_PM_REVISION_Effective_9-4-13.pdf) - extended until May 31, 2014

In recent years, apart from the last extension, they have been published well before the previous extension expired.

The last 2 extensions have been for a period of less than a year.

Even though the last extension was published very close to the expiration of the previous extension, I do not remember USCIS issuing RFE requests, or AILA suggesting the policy might change.

I can see 2 possibilities:

a) USCIS will (eventually) publish a Memo with a fixed validity period from the original examination that they will accept.

b) USCIS will no longer extend the validity and fall back to the 1 year expiration date.

[Spectator]

Spec that's a great observation and data!

As per possibility #2 - why do you think USCIS will opt for that at all? It doesn't bring USCIS any revenue does it?Q,

In truth, I don't think (b) is at all likely, but more because it would serve no health benefit. I'm pretty certain USCIS would resist that option because it would place an increased processing burden on them.

I just think it is even less likely USCIS will return to one year extensions.

It's pretty amazing that in over a decade, USCIS and CDC have not been able to formulate a final policy (or maybe it isn't). Disappointing is probably a better description.

I was quite surprised the extensions have been going on for so long. Prior to having a look, I had assumed it was a result of July 2007 creating large backlogs.

[qesehmk]

Agree Spec. I think that for AOS cases - they should do it once. Once a person is cleared - s/he is no more or less likely to acquire any new disease than anybody else in US. So why bother retesting!


It's pretty amazing that in over a decade, USCIS and CDC have not been able to formulate a final policy (or maybe it isn't). Disappointing is probably a better description.

[Spectator]

A little more info on medical examination validity.

Murthy (http://www.murthy.com/2014/04/23/uscis-issuing-rfes-on-i-485s-for-updated-medical-exams/) reports


Now, however, it appears that the USCIS will not be granting these blanket extensions again, which means that all I-693s completed more than a year prior to May 31, 2014, are scheduled to expire.

......

The USCIS provided confirmation to the American Immigration Lawyers Association (AILA) that, as of June 1, 2014, medical examinations that are more than a year old will no longer remain valid. The USCIS will release a notice on this topic in the near future. RFEs have already begun being issued to applicants with expired I-693s.

I'm not sure it adds too much, since Murthy sometimes add their own spin with the the words they use.

[ROCK72]

FYI...
http://www.murthy.com/2014/04/23/uscis-issuing-rfes-on-i-485s-for-updated-medical-exams/

[sreddy]

Murthy law firm posted something on the RFE subject. See the link below.
http://www.murthy.com/2014/04/23/uscis-issuing-rfes-on-i-485s-for-updated-medical-exams/

I booked tickets for India trip first weekend of June. So I will have only 5 working days in June before start. Any advise on how to respond to RFEs without effecting my trip?

[vizcard]

Realistically what does this mean ?

I have a copy of what the doc sent to USCIS (and he probably has my medical records too). I just go back to him show him that and he signs off on a new one ?

[Spectator]

Realistically what does this mean ?

I have a copy of what the doc sent to USCIS (and he probably has my medical records too). I just go back to him show him that and he signs off on a new one ?Realistically, I think it would mean that the results of the previous Medical Exam are no longer valid and you would have to undergo a new Medical Examination.

Assuming your vaccinations are up to date, there should be relatively little to repeat (TB and Syphilis tests perhaps).

There is very little evidence so far of any EB2 applicants receiving an RFE for a new I-693. The vast majority of EB2-I applicants left underwent their Medical Exam less than 2 years ago.

That leads me to think (hope) that the new guidance will set a defined number of years as the validity of the I-693 that USCIS will accept and that almost all current EB2-I applicants will fall within the revised validity period at the present time.

[justvisiting]

I was wondering, what happens if USCIS sends the RFE to everyone with an expired exam? You are required to respond the RFE, right? What if you are nowhere close to becoming current? Do you still have to go, get your medical exam, spend the (at least) $100, and then wait until it happens again the year after that?
This is a ridiculous policy change.

[sreddy]

I spoke to my law firm people yesterday. The lady who I spoke to me indicated they already started getting RFEs, most of them that they received so far are for expired I-693s. She could not tell me more details on what priority dates received RFEs so far. I will follow-up again after couple of weeks to get more info.

[primus]

I applied for 485 on Aug 1st 2013. And I included my medical exams done on July 3rd 2013. Does that mean, this year, if they work on my application, say on Sept 1st 2014, then will they issue me RFE that time as it would be past 1 year from July 3rd 2013?

[edisonguy]

My wife is leaving to India by May month mid. My PD is early 2009. We have another 2 weeks of time to do the medicals before she leaves. I checked the current I693 form which is valid until 01/15.

Let us say if we do the medicals before she leaves, can we use the same sealed envelope to address the medical RFE [if the RFE is before Sep 30].

I know the medical report is valid for 1 year. Will this plan workout. This will help us to not change the planned schedule which is Aug-4 back to USA.

Gurus, kindly pour your thoughts/ideas ASAP.

[sreddy]

My wife is leaving to India by May month mid. My PD is Feb 2009. We have another 2 weeks of time to do the medicals before she leaves. I checked the current I693 form which is valid until 01/15.

Let us say if we do the medicals before she leaves, can we use the same sealed envelope to address the medical RFE [if the RFE is before Sep 30].

I know the medical report is valid for 1 year. Will this plan workout. This will help us to not change the planned schedule which is Aug-4 back to USA.

Gurus, kindly pour your thoughts/ideas ASAP.

According to my conversation with my employer's law firm, yes. You can go to the same doctor that you visited before to make it more simpler, and submit paper work well in advance. I think you should talk to your law firm once . They are the ones receiving RFE, and responsible for responding the same.

Other thing to note, they will have 80 days to respond to the RFE. So if she is coming back in June/July, no harm in waiting.

Other option that I can think of, USCIS has approved medical practitioners all over the world. You can get it done in India as well, and send it to your law firm directly in FedEx.

[JJcalifornian]

Is there a way we can send out the medicals to USCIS even before we receive an RFE, so that by the time they pull out the file they ll see a valid medical report for adjudicating I485; if so any idea to which address we will be sending out the I693 as it's not telling where we can send it out. I guess we should be able to send out the same po box as I765 renewal.

[sreddy]

I think you should never overfeed them, and buy trouble. if you have a situation where you are not going to be in US around June/July, provide info to your law firm in advance, and let them respond. That's my take.


Is there a way we can send out the medicals to USCIS even before we receive an RFE, so that by the time they pull out the file they ll see a valid medical report for adjudicating I485; if so any idea to which address we will be sending out the I693 as it's not telling where we can send it out. I guess we should be able to send out the same po box as I765 renewal.

[JJcalifornian]

Thanks Sreddy

[triplet]

Looks like Medicals are set to expire, it is official. (Not sure if this has been already been posted on the forum)
http://www.uscis.gov/policymanual/Updates/20140530-I-693Validity.pdf#
(from http://immigration-law.com)

[smuggymba]

Poor lawyers worked very hard lobbying this. Just another feather in our misery cap.

[helpful_leo]

Qs to those knowledgeable here. The new USCIS memo here says:
"The revised policy becomes effective on June 1, 2014, and applies to any Form I-693 supporting a benefit application adjudicated on or after that date."

Is it possible that the new medical policy is not applicable to cases that have already been pre-adjudicated before May 30, 2014?

Also, can I get the medical exam done before receiving the RFE on a pending application, so that I have it ready to submit as soon as I get the RFE? There is the risk of wasting money, but are there any technicalities that prevent such a I-693 from being accepted?

Thanks!




Looks like Medicals are set to expire, it is official. (Not sure if this has been already been posted on the forum)
http://www.uscis.gov/policymanual/Updates/20140530-I-693Validity.pdf#
(from http://immigration-law.com)

[MATT2012]

Qs to those knowledgeable here. The new USCIS memo here says:
"The revised policy becomes effective on June 1, 2014, and applies to any Form I-693 supporting a benefit application adjudicated on or after that date."

Is it possible that the new medical policy is not applicable to cases that have already been pre-adjudicated before May 30, 2014?

Also, can I get the medical exam done before receiving the RFE on a pending application, so that I have it ready to submit as soon as I get the RFE? There is the risk of wasting money, but are there any technicalities that prevent such a I-693 from being accepted?

Thanks!

All pre-adjudicated applications will go through the final adjudication process. So it will be applicable to almost all EB2I pending cases. Don't do the medical exam before receiving the RFE, unless you want to do the whole form again. Some Surgeons prefer only to add to the existing form.

[Spectator]

Qs to those knowledgeable here. The new USCIS memo here says:
"The revised policy becomes effective on June 1, 2014, and applies to any Form I-693 supporting a benefit application adjudicated on or after that date."

Is it possible that the new medical policy is not applicable to cases that have already been pre-adjudicated before May 30, 2014?

Also, can I get the medical exam done before receiving the RFE on a pending application, so that I have it ready to submit as soon as I get the RFE? There is the risk of wasting money, but are there any technicalities that prevent such a I-693 from being accepted?

Thanks!My opinion.

Pre-adjudication is not adjudication. One results in permanent residency being granted, the other doesn't and the inadmissibility only related to the ability to approve the case and use a visa number.

According to the policy (http://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html), the I-693 should not be more than one year old at the time USCIS receives it


The medical examination report was submitted to USCIS less than one year after completion of the examination;[22]

Footnote 22 says:

USCIS will use the date the Form I-693 was signed by the civil surgeon (including blanket-designated health departments and military physicians) to determine whether the report was submitted less than one year after completion of the examination.

It then also says:


The benefit application[23] is adjudicated no more than one year after the date the medical examination report was submitted to USCIS;[24]

Footnote 24 says:

USCIS will use the date that USCIS received the Form I-693 to determine whether the medical examination report is more than one year old at time of adjudication of the benefit application. Although the medical examination report is generally valid for adjudicatory purposes up to one year after filing, the officer may order an additional immigration medical examination at any time if he or she has concerns as to an applicant’s inadmissibility on health-related grounds. For more information, see Chapter 11, Inadmissibility Determination, Section C, Other Information.

There are actually 2 one year clocks in play - one for validity of the submission to USCIS, then one for validity from when USCIS receive the form.

To answer your question, yes, you can get the Medical Exam and I-693 completed prior to any RFE. The I-693 must be submitted to USCIS within one year of the examination to remain valid. The I-693 will remain valid for USCIS adjudication purposes for one year from when USCIS receive it. In an extreme case, the I-693 could be almost 2 years old and still be valid.

[helpful_leo]

Thanks Spec for the response.

My understanding is that the surgeon gives me the completed and sealed I-693, and I can post it to USCIS as soon as I get the RFE.

I am December 2008 PD. I know its not a given yet - but likely - that I may be current this time around. If I obtain the I-693 before the RFE, I risk the possibility that I am not current this time and wasted the money and effort, as the I-693 will likely be invalid when I am current the next time around.

Am I reading the situation correctly or are there other issues involved?




To answer your question, yes, you can get the Medical Exam and I-693 completed prior to any RFE. The I-693 must be submitted to USCIS within one year of the examination to remain valid. The I-693 will remain valid for USCIS adjudication purposes for one year from when USCIS receive it. In an extreme case, the I-693 could be almost 2 years old and still be valid.

[helpful_leo]

Thanks Matt for the response.

I didn't entirely understand you. As long as the date is within 1 year, why should USCIS have a problem if I obtained the I-693 before receiving the RFE? And the part about surgeons - add to which existing form (since the expired I-693 is not with us anymore)?


All pre-adjudicated applications will go through the final adjudication process. So it will be applicable to almost all EB2I pending cases. Don't do the medical exam before receiving the RFE, unless you want to do the whole form again. Some Surgeons prefer only to add to the existing form.

[MATT2012]

Thanks Matt for the response.

I didn't entirely understand you. As long as the date is within 1 year, why should USCIS have a problem if I obtained the I-693 before receiving the RFE? And the part about surgeons - add to which existing form (since the expired I-693 is not with us anymore)?

From USCIS side, all that they would care about is whether I-693 is issued within a year. When USCIS issues an RFE for I-693, the old I-693 will be in that packet.(This was the case atleast until this new set of RFEs started). The surgeon will just administer appropriate tests and add results to the same form and sign next to be new additions together with the new date.

I once had a medical RFE, and I wanted my surgeon to fill in a new form. Surgeon was particular about just adding the new test in the old form. Infact my Surgeon even asked about the Gold Sheet as she was fully aware of the process.

[Spectator]

Thanks Spec for the response.

My understanding is that the surgeon gives me the completed and sealed I-693, and I can post it to USCIS as soon as I get the RFE.

I am December 2008 PD. I know its not a given yet - but likely - that I may be current this time around. If I obtain the I-693 before the RFE, I risk the possibility that I am not current this time and wasted the money and effort, as the I-693 will likely be invalid when I am current the next time around.

Am I reading the situation correctly or are there other issues involved?helpful,

Perhaps, but not necessarily.

The policy says:


Timing of the Submission of the Medical Examination Report

The medical examination report may be submitted to USCIS:


Concurrently with the immigration benefit application; or


At any time after filing the immigration benefit application but prior to the adjudication of that application; if not filed concurrently with the immigration benefit application, USCIS encourages applicants to wait until USCIS requests the medical examination report before submitting it.



Note it only says:


if not filed concurrently with the immigration benefit application,USCIS encourages applicants to wait until USCIS requests the medical examination report before submitting it.

rather than the I-693 can only be submitted once an RFE has been received. I don't really see that there is any difference between not filing concurrently (which will now be an option for new filers) and the filing of a new I-693 because the existing one has expired.

Hypothetically, if you didn't receive an RFE, you could wait nearly 12 months after the examination date to send the I-693 to USCIS. It would then have a further 12 months validity once received by USCIS, so you could get nearly 2 years of validity for the I-693. That would cover FY2014 if sent fairly soon and the FY2015 adjudication period if sent later, but wouldn't stretch quite to the end of FY2016.

I'm not suggesting that approach. I have seen posts from the past that suggest that USCIS do not like the I-693 sent when they have not sent an RFE so YMMV if you chose that approach.

[vizcard]

From USCIS side, all that they would care about is whether I-693 is issued within a year. When USCIS issues an RFE for I-693, the old I-693 will be in that packet.(This was the case atleast until this new set of RFEs started).

I don't think the old 693 is being included in the RFE notice (atleast wasn't in mine). I did have a copy of the previous one so that served as my vaccination records.

[whythewait]

Received RFE text/email. If it turned out to be I-693 related, then is there something one need to know for pregnant women?

[Spectator]

Received RFE text/email. If it turned out to be I-693 related, then is there something one need to know for pregnant women?whythewait,

I have just taken this reply from Trackitt.



Does a pregnant AOS applicant usually have to wait until after pregnancy to clear medicals related to this RFE?
Which would mean forever since the dates will retrogress before TB & other tests can be retaken.

Or do they use common sense in such situations?


http://www.uscis.gov/news/questions-and-answers/vaccination-requirements


Q. I am pregnant and do not wish to receive any vaccinations. Do I still have to get them to be able to obtain permanent resident status in the United States?

A. If you are pregnant, the CDC's Technical Instructions direct the civil surgeon how to evaluate the vaccines you are able to receive during pregnancy. If the civil surgeon cannot safely administer a required vaccine, he/she will annotate the Form I-693 by marking the vaccine as contraindicated. See link to the right for information on pregnancy and vaccinations in general.

CDC link referenced above http://www.cdc.gov/vaccines/pubs/preg-guide.htm

Also see http://www.uscis.gov/archive/archive-news/questions-and-answers-2009-update-tuberculosis-screening-required-adjustment-status but note this is now fairly old and I do not know if the chest x-ray requirement below has changed. I doubt it - not much has changed since November 1, 2009.


Q. When is a chest x-ray required?

A. Every applicant is required to undergo a chest x-ray if one of the following applies:

The applicant has a TST reaction of 5mm or greater of induration (including pregnant or possibly pregnant individuals)

The applicant has a positive IGRA result (including pregnant or possibly pregnant individuals)

The applicant was not required to undergo the TST or IGRA testing because of the exceptions specified in the TB Component of the Technical Instructions for the Medical Examination of Aliens in the United States (May 2008), and its update, applied to the applicant

The applicant has signs or symptoms of TB (regardless of the initial testing result)

The applicant is immunosuppressed (regardless of the initial testing result)

Q. If a chest x-ray is required, will USCIS accept Form I-693 without the full and formal chest x-ray report?

A. No. If a chest x-ray is required, the TB Component of the Technical Instructions for the Medical Examination of Aliens in the United States (May 2008), and its update require the civil surgeon to submit a full and formal chest x-ray report. The instructions for Form I-693 direct the civil surgeon to give the applicant a copy of the results of any testing conducted in relation to Form I-693 and a copy of the Form I-693, as submitted to USCIS.

Pregnancy per se does not stop the I-693 from being completed. If the applicant refuses a test that is deemed safe by the CDC, the I-693 cannot be completed and the I-485 could not be approved at that time.

It would be the applicant's choice to wait until later, if that is their preference.

[Spectator]

Some notes taken from today's teleconference on the I-693 policy change that were posted on Trackitt by H1bguru.


I registered for the nationwide teleconference today and thought I will share some updates from it regarding I-693 change:

It looks like if you already applied for I-485 before May 30, 2014, you medical is not valid anymore (if it lost its 1 year validity). Everyone who filed I-485 in 2012 or beyond can expect RFE from their service centers.

• USCIS is making this change as per the request from CDC and they are also planning to change the I-693 form in Jan 2015.

• We have been asked to wait for the RFE and schedule a new medical exam and re-submit the medicals with other evidence as requested.

• Sending a medical exam before RFE is no way going to help them link your new I-693 medical with Alien number.

• There was a question from a person regarding RFE response and Retrogression: What happens if you receive RFE on the last day when the date is current and if you had already completed medical and had no time to respond to RFE before it retrogresses. Are they going to work on your case after it retrogresses or Is the medical submitted for RFE is going to be valid??? This person was asked to email USCIS.

[imdeng]

Did the trackitt poster mean May 30, 2013? That would account for them being more than 1 year old and hence not valid anymore.

Some notes from today's teleconference on the I-693 policy change that were posted on Trackitt by H1bguru.

[Spectator]

Did the trackitt poster mean May 30, 2013? That would account for them being more than 1 year old and hence not valid anymore.I think what they meant was:

After May 31, 2014 (when the last I-693 extension expired), any Medical that is more than one year old (since submission to USCIS) will no longer be valid for adjudication purposes.

A new I-693 will be required.

[Spectator]

Another answer to a question in the teleconference confirmed that the Medical Examination for AOS applicants I-693 can only be performed by a USCIS designated Civil Surgeon while physically present in the USA.

It cannot be performed abroad by a DOS designated Panel Physician.


One of the question is regarding: what happens if my wife and kids are visiting their parents or some medical emergency and if primary applicant is in US and got RFE in hand. Should the spouse and kid of the primary applicant visit nearest Consular processing and get their medical done through consulate abroad. Answer is No. They have to be physically present in US to get their medical done.
http://www.trackitt.com/usa-discussion-forums/i485-eb/1260285081/matt-s-forecast-xls-is-updated/page/27

[krookbond]

It may be possible that they will go back to extending medicals every one year from next year.

[vizcard]

It may be possible that they will go back to extending medicals every one year from next year.

possible. As I understand it, its not completely up to the USCIS to determine that. The CDC has a major say in that.

[smuggymba]

Why are they sending medical RFEs is anyone's guess.

The lawyer lobby must have met with USCIS and requested them to do something so the money gods smile on them. simple.

there is no rhyme or reason for medical RFE's - people are already here and can care of TB or other stuff via their medical insurance.

[NewHope]

Hi Gurus,

I am new member, I have a question on medical validity, my PD 09/2009, I received RFE for Medical & EVL in the month of july, took test during july, 2014 and responded RFE in the first week of August, 2014, will my new medical expire in july or August? I am now worried that i may have to redo medical next year same time.

Please advise.

[Spectator]

Hi Gurus,

I am new member, I have a question on medical validity, my PD 09/2009, I received RFE for Medical & EVL in the month of july, took test during july, 2014 and responded RFE in the first week of August, 2014, will my new medical expire in july or August? I am now worried that i may have to redo medical next year same time.

Please advise.Your medical will expire (for adjudication purposes) one year from the date USCIS received the I-693 (i.e. August 2015).


[24] USCIS will use the date that USCIS received the Form I-693 to determine whether the medical examination report is more than one year old at time of adjudication of the benefit application. Although the medical examination report is generally valid for adjudicatory purposes up to one year after filing, the officer may order an additional immigration medical examination at any time if he or she has concerns as to an applicant’s inadmissibility on health-related grounds. For more information, see Chapter 11, Inadmissibility Determination, Section C, Other Information [8 USCIS-PM B.11(C)].

http://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html

[feedmyback]

I have a question. Suppose if the dates move past May 1' 2010 in the next year. Should the people with PDs after May 1' 2010, file I-693 form as part of the 485 application process? Or is it now removed from the initial 485 filing process and required only on an RFE?

[Spectator]

I have a question. Suppose if the dates move past May 1' 2010 in the next year. Should the people with PDs after May 1' 2010, file I-693 form as part of the 485 application process? Or is it now removed from the initial 485 filing process and required only on an RFE?Applicants now have the choice to file the I-693 with the application, or wait for it to be requested via an RFE.

For those likely to be adjudicated some time in the future, it might make sense to skip the I-693 when initially filing the I-485.


Timing of the Submission of the Medical Examination Report

The medical examination report may be submitted to USCIS:


Concurrently with the immigration benefit application; or

At any time after filing the immigration benefit application but prior to the adjudication of that application; if not filed concurrently with the immigration benefit application, USCIS encourages applicants to wait until USCIS requests the medical examination report before submitting it.


http://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html

[Immigo]

From Nov 1, 2018 - I-693 valid for 2 years from date of surgeon signing it. However, form needs to be submitted within 60 days of surgeon signing it.

Per https://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html :

In 2018, USCIS revised its policy regarding the extent to which a Form I-693 retains its evidentiary value. This policy is effective November 1, 2018. Before November 1, 2018, the validity period policy provided Form I-693 retained its evidentiary value as long as it was submitted to USCIS within 1 year of the civil surgeon’s signature and USCIS issued a final decision on the underlying immigration benefit application within a year of the Form I-693 submission to USCIS. This policy contained a maximum 2-year period during which Form I-693 retained its evidentiary value.

Due to increasing caseloads and more complex adjudications, USCIS observed an increasing number of cases where benefit applications could not be decided within 1 year from the date the Form I-693 was submitted. In these cases, USCIS would have to request a new Form I-693, further delaying processing the underlying application and inconveniencing the applicant.

The new policy, effective November 1, 2018, addresses these issues by realigning the existing 2-year period (during which Form I-693 retains its evidentiary value) to require applicants to complete their immigration medical examination closer in time to the filing of the underlying benefit application. This revised policy is intended to reduce the need for USCIS to request an updated Form I-693, thereby streamlining case processing and minimizing inconveniences to applicants.

Related USCIS policy announcement: https://www.uscis.gov/policymanual/Updates/20181016-I-693Validity.pdf

[march1612]

From Nov 1, 2018 - I-693 valid for 2 years from date of surgeon signing it. However, form needs to be submitted within 60 days of surgeon signing it.

Per https://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html :

In 2018, USCIS revised its policy regarding the extent to which a Form I-693 retains its evidentiary value. This policy is effective November 1, 2018. Before November 1, 2018, the validity period policy provided Form I-693 retained its evidentiary value as long as it was submitted to USCIS within 1 year of the civil surgeon’s signature and USCIS issued a final decision on the underlying immigration benefit application within a year of the Form I-693 submission to USCIS. This policy contained a maximum 2-year period during which Form I-693 retained its evidentiary value.

Due to increasing caseloads and more complex adjudications, USCIS observed an increasing number of cases where benefit applications could not be decided within 1 year from the date the Form I-693 was submitted. In these cases, USCIS would have to request a new Form I-693, further delaying processing the underlying application and inconveniencing the applicant.

The new policy, effective November 1, 2018, addresses these issues by realigning the existing 2-year period (during which Form I-693 retains its evidentiary value) to require applicants to complete their immigration medical examination closer in time to the filing of the underlying benefit application. This revised policy is intended to reduce the need for USCIS to request an updated Form I-693, thereby streamlining case processing and minimizing inconveniences to applicants.

Related USCIS policy announcement: https://www.uscis.gov/policymanual/Updates/20181016-I-693Validity.pdf

The article does not clarify how pending 485's will be handled? All pending 485s should continue to expect RFE for medicals?

[Immigo]

The article does not clarify how pending 485's will be handled? All pending 485s should continue to expect RFE for medicals?

We need to look at I-693 submission date rather than pending I-485. There are 2 tables at the end of https://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html which explain this - one is for submissions prior to Nov 1, 2018 and one for submissions after Nov 1, 2018.

[march1612]

We need to look at I-693 submission date rather than pending I-485. There are 2 tables at the end of https://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html which explain this - one is for submissions prior to Nov 1, 2018 and one for submissions after Nov 1, 2018.

I sent my medicals along with 485 around March 2012 and I fall into category 2 of the table.

Will USCIS continue to request medicals redone and resent via RFE?

[Immigo]

I sent my medicals along with 485 around March 2012 and I fall into category 2 of the table.

Will USCIS continue to request medicals redone and resent via RFE?

Since the medicals were filed in 2012, the validity of the medicals has expired for all categories (including category 2). Therefore, I believe you will get an RFE.

Just to be doubly sure, I do have a related question for the experts. See the language below in https://www.uscis.gov/policymanual/HTML/PolicyManual-Volume8-PartB-Chapter4.html - hope it will not become a ground for straight denials in light of the new policy if medicals are not submitted at the time of filing I-485 or if the medicals expire (By new policy, I am referring to https://www.uscis.gov/news/news-releases/uscis-updates-policy-guidance-certain-requests-evidence-and-notices-intent-deny)

In general, if any one of the above criteria is not met, the applicant has not met the burden of proof required to establish that he or she is free of a medical condition that would render the applicant inadmissible to the United States on health-related grounds. In this case, the officer should follow standard operating procedures regarding issuance of a denial or an RFE or Notice of Intent to Deny (NOID) to address the deficiency.