The path to permanent residency involves navigating a series of requirements and documentation, and one question we frequently hear from our clients is whether they can file Form I-485 (Application to Register Permanent Residence or Adjust Status) without first completing the required medical examination. Our team of civil surgeons is here to provide clarity on this important question and help you make informed decisions about your immigration journey.
The Short Answer: Yes, But…
Let’s start with the direct answer: Yes, you can file Form I-485 without including the medical examination results (Form I-693). USCIS allows applicants to submit their adjustment of status application without the medical examination documentation and provide it later in the process. However, this approach comes with both advantages and potential drawbacks that you should carefully consider.
Understanding the Medical Examination Requirement
Before we dive deeper into the strategy of filing without the medical exam, let’s clarify what this requirement involves. USCIS requires most green card applicants to undergo a medical examination conducted by a USCIS-designated civil surgeon. This examination is documented on Form I-693 (Report of Medical Examination and Vaccination Record) and includes:
- A review of your medical history
- A physical examination
- Mental health assessment
- Tuberculosis (TB) testing
- Blood tests for syphilis and other conditions as needed
- Vaccination verification
- Screening for drug and alcohol disorders
The purpose of this examination is to ensure that applicants don’t have health conditions that would make them inadmissible to the United States on public health grounds. It’s an essential part of the green card process, even if you choose to submit it after your initial I-485 filing.
Why Some Applicants Choose to File Without the Medical Exam
There are several strategic and practical reasons why applicants might choose to file their I-485 without including the medical examination results:
1. Limited Validity Period
One of the primary reasons for delaying the medical examination is its limited validity period. Form I-693 is valid for only two years from the date the civil surgeon signs it. However, many I-485 applications take longer than two years to process, especially for applicants from countries with significant backlogs or during periods of increased USCIS processing times.
By waiting to complete the medical examination until later in the process, you can maximize the form’s validity period and reduce the risk of needing to repeat the examination (and incur additional costs) if your case takes longer than expected to adjudicate.
2. Securing Your Place in Line
Filing your I-485 as soon as possible secures your place in the processing queue and establishes your priority date (if applicable). For applicants from countries with significant visa backlogs, this can be critically important. By filing without waiting for the medical examination, you can submit your application sooner.
3. Work and Travel Benefits
Filing Form I-485 makes you eligible to apply for accompanying benefits, including:
- Form I-765 (Application for Employment Authorization), which provides work authorization while your green card application is pending
- Form I-131 (Application for Travel Document), which allows you to travel internationally without abandoning your pending application
These benefits can be crucial for maintaining your livelihood and family connections during the often lengthy adjustment of status process. Filing your I-485 promptly, even without the medical examination, allows you to apply for these benefits sooner.
4. Unexpected Filing Windows
Sometimes, visa bulletin movements create unexpected filing windows that applicants need to take advantage of quickly. In these situations, waiting to complete the medical examination might cause you to miss a critical filing opportunity.
5. Time to Address Health Issues
If you have health concerns that might need to be addressed before the medical examination, filing without the exam gives you time to resolve these issues while your application is already in processing.
The USCIS Policy on Filing Without Medical Examination
USCIS officially acknowledges and accommodates the strategy of filing Form I-485 without the medical examination. According to USCIS policy, applicants have three options for submitting Form I-693:
- Submit it together with your Form I-485 application package
- Bring it to your adjustment of status interview (if an interview is scheduled)
- Submit it in response to a Request for Evidence (RFE) if USCIS sends one
This flexibility allows applicants to choose the timing that works best for their specific situation.
Potential Drawbacks of Filing Without the Medical Exam
While filing without the medical examination offers advantages, there are also potential drawbacks to consider:
1. Guaranteed Request for Evidence (RFE)
If you file without Form I-693, USCIS will eventually issue an RFE requesting it. This adds an additional step to your process and temporarily pauses the adjudication of your case until you respond. While this is a normal part of the process if you choose this strategy, it does create an additional procedural hurdle.
2. Potential Processing Delays
Responding to an RFE takes time – both for you to complete the medical examination and submit the response, and for USCIS to process your response and resume adjudication. This can potentially add weeks or months to your overall processing time.
3. Risk of Missing the RFE Response Deadline
USCIS typically gives applicants 87 days to respond to an RFE. If you’re traveling or otherwise unavailable when the RFE arrives, you might face challenges in completing the medical examination and submitting your response within the deadline. Missing the deadline could result in your application being denied.
4. Confusion About Process Timing
Some applicants find it stressful not knowing exactly when USCIS will issue the RFE for the medical examination. This uncertainty can make it difficult to plan the timing of your medical examination and may create additional anxiety during an already stressful process.
Strategic Considerations for Your Specific Situation
The best approach – whether to include the medical examination with your initial filing or wait for an RFE – depends on your specific circumstances. Here are some factors to consider:
Current Processing Times
Check current USCIS processing times for I-485 applications in your category and field office. If processing times are relatively short (less than 2 years), including the medical examination with your initial filing might make sense to avoid the additional step of responding to an RFE.
However, if processing times are approaching or exceeding two years, waiting to submit the medical examination later in the process may be more strategic to ensure the form doesn’t expire before your case is adjudicated.
Your Immigration Timeline and Goals
Consider your personal timeline and goals. If you anticipate needing to travel internationally or change jobs soon, filing as quickly as possible (even without the medical examination) may be a priority to secure your pending status and apply for accompanying benefits.
Health and Vaccination Status
Assess your current health and vaccination status. If you know you’re missing several required vaccinations or have health concerns that might need to be addressed before the examination, filing without the medical exam gives you time to address these issues while your application is already in process.
Visa Bulletin Considerations
For employment-based and some family-based categories, check the visa bulletin to determine if your priority date is current or close to becoming current. If you have a narrow window of opportunity to file, submitting without the medical examination might be necessary to take advantage of that window.
Our Recommendations Based on 27 Years of Experience
As civil surgeons with nearly three decades of experience helping immigrants through the medical examination process, we’ve seen how various filing strategies play out in real-world scenarios.
For Most Applicants:
If you have time to complete the medical examination without delaying your filing significantly, including Form I-693 with your initial I-485 submission can simplify your process by potentially eliminating the need to respond to an RFE later. This “one and done” approach has the advantage of simplicity and reduces the number of interactions with USCIS.
At our Los Angeles clinic, we offer both standard service (results in 7-9 days) and rush service (results in 3-5 days) to accommodate different timing needs, making it possible to complete your medical examination efficiently before filing.
For Applicants Facing Long Backlogs:
If you’re from a country with significant visa backlogs (such as India or China for certain employment-based categories) where processing times regularly exceed two years, filing without the medical examination is often more strategic. This approach allows you to secure your place in line while maximizing the validity period of your eventual medical examination.
For Applicants with Urgent Filing Needs:
If you need to file urgently to take advantage of a visa bulletin movement, maintain your status, or apply for work or travel authorization, filing without the medical examination allows you to submit your application more quickly. You can then address the medical requirements when USCIS issues the RFE.
How We Can Help With Your Medical Examination Needs
Whether you decide to include the medical examination with your initial filing or respond to an RFE later, our clinic is here to support you throughout the process. With 27 years of experience as civil surgeons in Los Angeles, we understand the nuances of immigration medical examinations and the importance of accurate, thorough documentation.
Our Comprehensive Immigration Medical Exam Pricing
Both our standard service ($350, results in 7-9 days) and rush service ($450, results in 3-5 days) include everything you need for a complete I-693 examination:
- Full physical examination by our experienced civil surgeons
- Quantiferon TB Gold Blood Test (more accurate than the traditional skin test)
- RPR/Syphilis blood test
- Gonorrhea & Chlamydia urine test
- Professional completion of your I-693 form
- Proper sealing of the form in an envelope for USCIS submission
- A copy of your results for your personal records
Why Choose Our Clinic for Your Medical Examination
As the highest-rated immigration medical exam office in Los Angeles (by Yelp & Google) and the most referred by immigration attorneys, we pride ourselves on accuracy, efficiency, and compassionate care. Our civil surgeons are experienced in handling complex medical histories and ensuring that your examination meets all USCIS requirements.
Whether you’re preparing for your initial I-485 filing or responding to an RFE, we can typically accommodate appointments within days of your call, helping you meet your immigration timeline needs.
The path to permanent residency has many steps, and the medical examination is one we’re honored to help you complete. By understanding your options and making informed decisions about your filing strategy, you can navigate this process with confidence and move closer to achieving your immigration goals.
