Most individuals seeking to adjust status to legal permanent residence (LPR) in the United States are required to submit an immigration medical examination and vaccination report. The medical examination report is used to determine the admissibility of the applicant based on medical grounds. One cannot obtain an immigrant visa or adjust status without a medical examination and vaccination report. Therefore, it is important to know the requirements for the medical examination.

The medical examination report submitted to the United States Citizenship and Immigration Services (USCIS) must be prepared by a physician who has been designated as a “civil surgeon” by USCIS. Therefore, an applicant must find a civil surgeon in the area he or she is living and make an appointment for a medical examination. The current list of civil surgeons can be found on the USCIS web site at the Civil Surgeon Locator Link. In addition, the civil surgeon list can be obtained by calling USCIS National Customer Service Center at 800-375-5283.

Required Medical Exams

Once the applicant finds a civil surgeon, an appointment should be made for a medical examination. When going for the medical examination, the applicant must bring his or her passport or other form of government-issued photo identification and any written documentation of vaccination history. The civil surgeon conducting the medical examination can require the applicant to take any or all of the following tests, if there is a reason to suspect the possibility of infection:

  • Tuberculosis;
  • Syphilis (for applicants 15 years or older);
  • HIV (blood test);
  • Gonorrhea;
  • Mental defect;
  • Narcotic drug addiction;
  • Psychopathic personality;
  • Chancroid;
  • Lymphogranuloma venereum; and
  • Granuloma inguinal.


In addition, certain vaccinations included on the Centers for Disease Control and Prevention's (CDC) list are required. As of July 1, 2008, the following additional vaccinations are required for certain age groups:

  • Rotavirus
  • Hepatitis A
  • Meningococcal
  • Human papillomavirus
  • Zoster


During the examination, the civil surgeon will review the vaccination history of the applicant and will determine whether certain vaccinations are necessary and/or appropriate. USCIS has revised the Report of Medical Examination and Vaccination Record (Form I-693) to include these new vaccination requirements listed above. The June 5, 2008 edition of the I-693 must be used for any medical examination completed on or after August 1, 2008.

After the medical examination is completed, the applicant must sign the Form I-693 in the presence of the civil surgeon. The civil surgeon will certify the results on the appropriate forms. The applicant must not open the sealed envelope. The sealed envelope containing the medical examination report should be submitted together with the immigration application to USCIS.

Exemptions

Although most applicants for adjustment of status are required to submit a medical examination report, there are exemptions under certain circumstances. An immigration applicant, who is pregnant or is trying to get pregnant, is exempted from taking the TB test, even if the skin test results are positive. In addition, certain vaccines cannot be given to these applicants. Therefore, under certain circumstances, the civil surgeon may postpone the medical examination until after the baby is delivered.

Moreover, children under the age of two (2) are required to have the tuberculin skin test only if there is evidence that the child has had contact with a person known to have TB or if there are other reasons to suspect TB.

Medical examination results are generally valid for 12 months. Individuals that are legal residents but changing status to U.S. citizens may be required to retake the immigrant medical exam if the examination was previously taken more than 12 months ago. Therefore, it is recommended that the applicant schedule the medical examination as close to the date he or she plans to submit the application.

Agencies Involved

To obtain further information regarding the immigration medical examination, one can contact the following agencies:

  • USCIS (United States Citizenship and Immigration Services) – An immigration applicant can find a designated civil surgeon in the area by calling the USCIS National Customer Service Center at 800-375-5283, or by going to the USCIS website at www.uscis.gov and clicking on the Civil Surgeon Locator link.
  • CDC (Center for Disease Control) – CDC publishes and regulates specific guidelines for civil surgeons conducting the medical examination of aliens in the USA. The Technical Instructions, guidelines and periodic updates are available on the CDC website at http://www.cdc.gov.
  • ACIP (Advisory Committee for Immunization Practices) – ACIP recommends required vaccines for the medical examination.
  • HHS (Department of Health and Human Services) – In consultation with the civil surgeon and/or USCIS, HHS determines if any of the following applies to the applicant: 1) whether a vaccine supplement is medically appropriate; 2) whether the applicant has a physical or mental disorder; or 3) whether the applicant suffers from drug addiction or abuse.


Conclusion

Individuals planning to adjust their status in the United States should know that his or her petition requires a medical examination report prepared by a designated civil surgeon. . Therefore, the applicant should plan the examination so that when he or she files the petition, an examination report prepared within twelve (12) months of the filing date may be submitted with the petition.

Please note: Immigration laws and regulations are constantly changing and this article is provided for informational purposes only and is not to be construed or relied upon as legal advice under any circumstance. Please refer to our legal disclaimer for additional details.

 

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