USCIS Now Requires Form I-693 to Be Submitted with Form I-485

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Key Takeaways

Effective Dec 2, 2024, USCIS requires Form I-693 to be submitted with Form I-485 to reduce delays.
Form I-693 must be signed by a USCIS-designated civil surgeon, submitted in a sealed envelope, and correctly completed.
As of Feb 10, 2025, only the 10/24/24 edition of Form I-485 is accepted; older versions face rejection.

On December 2, 2024, the United States Citizenship and Immigration Services (USCIS) introduced a key update concerning the submission of Form I-485, Application to Register Permanent Residence or Adjust Status. Effective immediately upon announcement, certain applicants adjusting their immigration status are required to file Form I-693, Report of Immigration Medical Examination and Vaccination Record, alongside their Form I-485. This requirement, which officially took effect on December 2, aims to reduce processing delays caused by incomplete applications and streamline case evaluations by ensuring that all medical documentation is submitted at the outset.

As of March 12, 2025, the policy has been in place for over three months, enabling USCIS to process adjustment of status applications with greater efficiency. However, for applicants and their representatives, this shift introduces several practical considerations, including the scheduling of medical examinations in advance and addressing costs upfront. Failure to adhere to the updated filing requirements may result in rejection of the application. Below is an in-depth discussion of the newly implemented policy, its specific requirements, and its implications for affected parties.

USCIS Now Requires Form I-693 to Be Submitted with Form I-485

Key Policy Change and Objectives

The recent USCIS policy mandates that applicants required to undergo medical examination submit Form I-693 with their Form I-485. Previously, it was common for applicants to wait for a Request for Evidence (RFE) from USCIS to submit the I-693 form. The agency noted that this prior method introduced significant bottlenecks and delays during adjudication due to incomplete submissions. To address this inefficiency, the updated requirements are meant to expedite application processing while reducing the backlog of incomplete cases that await supporting medical documentation. Importantly, while USCIS has listed “certain applicants” as being subject to this change, most individuals applying to adjust their status within the U.S. are required to comply.

From a procedural viewpoint, the change stems from a desire for efficiency on USCIS’s part. Applicants who submit all required documentation upfront allow the agency to approve cases more swiftly, particularly when there are no other outstanding issues affecting admissibility.

Important Requirements

Under the current policy, compliance requires strict adherence to the following guidelines. These conditions ensure proper submission and minimize the likelihood of application rejection:

Completion and Submission of Form I-693: The form must be filled out accurately and signed by a USCIS-designated civil surgeon. Only those physicians designated by USCIS are authorized to conduct immigration medical examinations. To confirm you are working with an approved physician, USCIS offers an official Civil Surgeon Locator tool, which is available on the USCIS website.
Sealed Envelope: The completed Form I-693 must be provided in a sealed envelope, prepared by the USCIS-designated civil surgeon. Opening or altering this envelope will render the form invalid, leading to rejection.
Updated Instructions: The latest instructions for Form I-485 emphasize the requirement to include Form I-693 when applicable. The revised instructions reflect broader updates to immigration standards, including fine-tuned public charge evaluation questions.
Partial Documentation Cases: Even when only part of Form I-693, such as the vaccination record, is relevant, applicants must still file pursuant to the outlined procedures.

An additional revision worth noting is USCIS’s January 22, 2025, exemption for COVID-19 vaccination documentation in Form I-693 submissions. This adjustment acknowledges updated public health guidelines while simplifying compliance for applicants.

Practical Challenges for Applicants

While the updated policy is anticipated to benefit USCIS operational efficiency, applicants face several immediate hurdles. First, securing an appointment with a USCIS-designated civil surgeon may prove difficult in regions with high demand, potentially delaying I-485 filing timelines. This could be particularly problematic for applicants who need to meet critical deadlines, such as those nearing the expiration of current status categories.

Second, the requirement to pay for the medical examination at the time of filing adds an upfront financial burden for applicants. Previously, applicants who waited for RFEs did not pay until USCIS specifically requested the medical records.

Third, though the requirement may lengthen the initial preparation period, the anticipated reduction in RFEs should alleviate long-term delays. For many applicants, the trade-off of earlier expenses in return for faster USCIS adjudication may be considered worthwhile.

The updated concurrent filing requirement is part of a broader set of reforms and clarifications introduced by USCIS between late 2024 and early 2025. These include modifications to Form I-485 itself, as well as updates affecting evidentiary requirements for adjustment applications.

Indefinite Validity of Form I-693: Effective April 4, 2024, Form I-693 is deemed indefinitely valid if signed by a recognized USCIS civil surgeon on or after November 1, 2023. Applicants no longer need to worry about their form expiring while awaiting adjudication—a notable improvement compared to prior regulations with strict validity timeframes.
Updated Form I-485 Edition: As of February 10, 2025, USCIS only accepts the revised version of Form I-485, dated 10/24/24. Previous editions submitted on or after the cutoff date will be automatically rejected.
Removal of Form I-864W: The updated I-485 form now incorporates options for eligible applicants to request exemption from the Affidavit of Support requirement (Form I-864W) directly within the form itself. This reform eliminates the need for a separate submission, further reducing procedural complexity.
Public Charge Clarification: Additionally, amendments to Form I-485 clearly identify public charge evaluation standards, a development aimed at increasing applicant understanding of the policy.

Advantages and Impacts

The decision to make concurrent submissions mandatory yields several potential benefits for individuals applying for permanent residence:

Reduced Processing Times: By eliminating additional steps like RFEs, USCIS hopes to improve adjudication efficiency.
Lower RFE Incidences: Fewer instances of missing medical documentation should result in less need for case officers to issue RFEs, saving time for both the agency and applicants.
Clarity of Requirements: Updated forms and revised instructions provide greater transparency into USCIS expectations at the outset of the filing process.

While these advantages place emphasis on a smoother processing system overall, some applicants may struggle to adjust to the financial and logistical upfront demands. Therefore, USCIS highlights the importance of early medical examination scheduling and document preparation to avoid unnecessary rejections or delays.

Recommendations for Applicants

For applicants and representatives navigating the transition, certain preparatory actions are vital:

Ensure that the medical examination is conducted well in advance to account for potential scheduling delays. Pay particular attention to the designation of the civil surgeon to confirm compliance.
Use the latest editions of all forms and closely adhere to the revised instructions. Keep in mind that certain older versions are no longer valid for use and will lead to rejection.
Submit all relevant paperwork together, avoiding common errors such as altering the sealed envelope of Form I-693 or arriving unprepared for your medical examination.
For additional questions, applicants can visit USCIS’s official page for further guidance on Form I-485 and related filings.

Final Thoughts

The concurrent filing requirement for Form I-485 and Form I-693 marks a significant procedural change aimed at improving overall agency efficiency. Though the adjustment may necessitate updated practices among applicants, the reduced incidence of RFEs and shorter case timelines will serve the immigration community in the long run. As VisaVerge.com highlights, this shift reflects USCIS’s broader commitment to implementing common-sense changes that de-emphasize procedural redundancy while emphasizing thorough submission at the outset.

By understanding these changes and planning accordingly, applicants can minimize disruptions and ensure compliance with this policy framework. Anyone seeking additional clarification is encouraged to consult USCIS-designated civil surgeons and review up-to-date government resources to maximize the likelihood of a successful filing.

Learn Today

USCIS (United States Citizenship and Immigration Services) → The U.S. government agency managing immigration applications, including visas, green cards, and naturalization processes.
Form I-485 → An application used to adjust immigration status to become a lawful permanent resident within the United States.
Form I-693 → A form documenting medical examinations and vaccination records, required to ensure applicants meet U.S. health standards.
Civil Surgeon → A physician authorized by USCIS to perform immigration medical examinations and complete Form I-693.
Request for Evidence (RFE) → A USCIS-issued notice requiring additional documentation or information to adequately process an immigration application.

This Article in a Nutshell

USCIS’s new policy mandates submitting Form I-693 with Form I-485, effective December 2, 2024. This shift reduces processing delays but requires applicants to schedule medical exams early and handle costs upfront. Though challenging initially, streamlined submissions eliminate RFEs, fostering faster decisions. Proper preparation ensures compliance and benefits applicants navigating a faster immigration process.
— By VisaVerge.com

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