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New Public Charge Rule Takes Effect Sept. 18, 2026 - File Your I-485 Now Under Current Standards »
The I-485 medical examination is an important part of the Adjustment of Status process for many green card applicants in the United States. If you are filing Form I-485 to become a lawful permanent resident, you may need to complete an immigration medical exam and submit Form I-693, Report of Immigration Medical Examination and Vaccination Record.
This exam does not decide whether your green card will be approved. USCIS makes that decision after reviewing your full application. The purpose of the medical exam is to help USCIS determine whether you meet the health-related requirements for adjustment of status.
For applicants, understanding when the exam is needed, who can perform it, what happens during the appointment, and how Form I-693 should be handled can help reduce delays and avoid unnecessary Requests for Evidence.
The I-485 medical examination is the immigration medical exam required for many applicants who are applying for a green card from inside the United States.
The results are documented on Form I-693. This form records the applicant’s medical history, physical examination, required lab testing, and vaccination record. Once completed by a USCIS-authorized civil surgeon, Form I-693 is submitted to USCIS as part of the applicant’s adjustment of status case.
USCIS uses the form to confirm that the applicant does not have certain health-related grounds of inadmissibility, such as specific communicable diseases, missing required vaccinations, certain physical or mental health conditions associated with harmful behavior, or drug abuse or addiction concerns.
The key point is simple: Form I-693 connects the medical exam to the green card process. Without a properly completed form, USCIS may not be able to finish reviewing the medical portion of the I-485 application.
Many applicants filing Form I-485 need an immigration medical examination. This often includes people applying for lawful permanent residence through:
Some applicants may have special rules. For example, refugees and asylees may have different requirements depending on their prior medical exam history, vaccination documentation, and USCIS instructions. Applicants should review the current Form I-485 and Form I-693 instructions carefully and follow attorney guidance if they are working with an immigration lawyer.
The immigration medical exam is required because U.S. immigration law includes health-related grounds of inadmissibility. USCIS needs medical documentation to determine whether an applicant has a health condition that affects eligibility for adjustment of status.
The I-485 medical examination helps screen for several health-related areas, including:
A properly completed Form I-693 can help USCIS review the medical portion of the case more efficiently. If a required Form I-693 is missing at filing, USCIS may reject Form I-485. An incomplete, incorrectly signed, or improperly submitted medical form may lead to delays or a Request for Evidence.
Common problems include:
The I-485 medical examination is usually straightforward, but it includes several required steps. The exact process may vary based on age, medical history, vaccination records, and lab results.
The civil surgeon will review your medical history and may ask about:
Applicants should answer questions honestly and bring supporting documentation when available.
The physical examination is a basic health evaluation. It may include checking vital signs and reviewing general health findings. The civil surgeon follows CDC technical instructions and records required information on Form I-693.
The immigration medical exam is not the same as a full annual physical. It is focused on the health-related areas required for immigration purposes.
As part of Form I-693, the civil surgeon will review your vaccination history and determine whether you meet the CDC's vaccination requirements based on your age and medical history.
Commonly required vaccines may include:
If vaccination records are missing, the civil surgeon may recommend receiving missing vaccines or, when appropriate, performing titer testing to document immunity. Some applicants may qualify for medical or other USCIS-recognized exceptions. Because vaccination requirements can change, applicants should follow the most current CDC and USCIS guidance.
Certain Adjustment of Status applicants must submit Form I-693 with Form I-485. When the medical form is required at filing, including it with the application can help avoid rejection, Requests for Evidence, and unnecessary delays.
In some situations, USCIS may request Form I-693 later. Because filing requirements can change, applicants should always follow the latest USCIS instructions or guidance from their immigration attorney.
Being prepared for the I-485 medical examination helps the appointment go more smoothly.
Bring:
If you are not fluent in English or the language used by the office, ask ahead about translator requirements. Some offices require an in-person translator and do not accept phone apps or electronic translation tools for the immigration medical exam.
The I-485 medical examination is an important part of the Adjustment of Status process for many green card applicants. It involves more than a physical exam. Applicants must also meet current testing and vaccination requirements and ensure Form I-693 is completed correctly by a USCIS-authorized civil surgeon.
Small errors, such as missing records, incomplete signatures, using a non-authorized doctor, or opening the sealed envelope, can lead to delays or a Request for Evidence. Proper preparation can help prevent many of these setbacks.
If you are preparing to file Form I-485 or have been asked to submit Form I-693, Steven Wittenberg Gordon, MD can help you complete the required immigration medical examination in accordance with current USCIS protocols.
Schedule an appointment with Dr. Gordon, and move forward with clarity and confidence.
