Starting June 11, 2025, the U.S. Citizenship and Immigration Services (USCIS) has implemented a crucial update to the medical examination process for individuals applying for a green card (U.S. lawful permanent residency). This rule directly impacts thousands of Indian nationals either already in the U.S. or preparing for immigration through family-based, employment-based, or diversity visa categories.
If you’re an Indian citizen planning your journey toward a U.S. green card, it’s essential to understand how these new rules affect you and what steps you should take to remain compliant.
Before we explore the rule change,, let’s understand the purpose of the USCIS medical exam:
A Form I-693, Report of Immigration Medical Examination and Vaccination Record, must be submitted by all applicants for adjustment of status (green card applicants) in the U.S. It ensures that the applicant is not inadmissible on public health grounds. The exam is conducted by a civil surgeon authorized by USCIS.
USCIS has now finalized a rule making the validity of Form I-693 (medical exam report) fixed at two years from the date the civil surgeon signs it. This rule is effective from June 11, 2025, and applies to all new and pending adjustment of status applications.
Before the rule change on June 11, 2025, USCIS allowed for the indefinite reuse of the Form I-693, Report of Immigration Medical Examination and Vaccination Record, as long as it was properly completed and signed by a civil surgeon after November 1, 2023. This meant applicants could reuse the same medical form for different applications or if an application was denied or withdrawn. The new policy requires a fresh medical exam for each new green card application, regardless of prior submissions.
According to USCIS, the revised regulation aims to:
India is consistently one of the top countries with the highest number of green card applicants. Here’s how this change directly impacts Indian nationals:
You now have to strategically plan the timing of your medical exam so that it does not expire before your green card is approved. If your I-485 (adjustment of status) takes longer than expected—common in cases involving backlogs—you may need to redo the exam, increasing cost and delays.
Since you may need to submit new medical reports if adjudication takes longer than two years, it could lead to additional medical examination fees, vaccine charges, and administrative costs.
If the exam expires, USCIS will likely issue an RFE, halting your green card process until you comply. Given the high number of green card applications from India and existing processing delays, this adds further complexity.
Many Indian nationals apply under employment-based categories (EB-2 and EB-3), which often have long wait times due to visa retrogression. These applicants are most likely to experience I-693 expiration before adjudication.
The new rule from June 11, 2025, marks a significant shift in how green card applicants should plan their medical examinations. For Indian nationals facing visa backlogs and long waiting periods, timing and documentation are now more critical than ever.
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