If you’re applying for a U.S. Green Card, there’s an important change you should know about. USCIS has updated the rules for how long your Form I-693 stays valid. What does that mean in simple terms? If your green card application gets denied or you withdraw it, your medical form expires too. So you’ll need a new exam and a new Form I-693 before you reapply.
This update took effect June 11, 2025, and it replaces the older rule that gave the form indefinite validity. The goal is to make sure every applicant’s medical results are recent and reliable, keeping both you and the community safe.
What exactly changed
USCIS made a clear rule change about Form I-693, the paper your civil surgeon fills out after your immigration medical exam.
This is the simple version: if your I-693 was signed on or after November 1, 2023, it now only works while the immigration application you filed with it is still open. If that application is withdrawn or denied, the I-693 is no longer valid, and you will need a new medical exam and a new I-693 before you file again
A few important facts to make this plain:
- The rule change took effect immediately and applies to applications pending or filed on or after June 11, 2025.
- Before this change, USCIS had said (in April 2024) that I-693 forms signed on or after November 1, 2023, could be used indefinitely. USCIS later decided that was too broad and could risk public health, so they tightened the rule.
- I-693 forms signed before November 1, 2023 are still governed by the old guidance (they generally carried evidentiary value for two years from the surgeon’s signature), so check the signature date on your form.
If you have understood these facts, let’s go over who this affects and what you should do to avoid delays or extra exams.
Who This Affects
This policy change affects anyone applying for a green card (Form I-485) or another immigration benefit that requires Form I-693, the official immigration medical exam report.
In short, it matters to:
- Adjustment of Status Applicants: If you’re applying for a green card inside the U.S., you must submit Form I-693 to prove you meet the health requirements. Under the new rule, your I-693 is valid only while your current application is pending. If that case is denied or withdrawn, you’ll need a brand-new exam before refiling.
- People Refiling or Reopening a Case: If you previously submitted an I-485 with an I-693 that’s now tied to a denied or withdrawn case, you can’t reuse that medical exam. Even if it’s only a few months old, USCIS won’t accept it for your new application.
- Applicants with Delayed or Complex Cases: Those whose cases take longer than usual (due to extra background checks, requests for evidence, or immigration category backlogs) must make sure their I-693 stays connected to their active application.
- Civil Surgeons and Clinics: USCIS-designated doctors now need to clearly explain the new rule to patients, so they understand when their I-693 can and cannot be reused. It’s also important for clinics to date and store these forms properly since they’re valid only for that specific case.
This change aims to keep all immigration medical exams up to date. It ensures applicants are medically cleared at the time their case is under review, not months or years later. Once you have learned this, you should know why USCIS decided to make this change and what it means for your health and immigration process.
What This Means for You
If you’re applying for a green card or any immigration benefit that needs Form I-693, this rule means your medical exam results are no longer reusable for future applications. Your I-693 is now linked directly to the case it was filed with, nothing more, nothing less.
So, if your application is denied, withdrawn, or you decide to reapply later, you’ll need to get a brand-new medical exam from a USCIS-approved civil surgeon. Even if your last exam was recent or your health hasn’t changed, USCIS won’t accept the old one.
Here’s how this might affect you in real life:
- Filing a new I-485: You’ll need to schedule another medical exam and get a new I-693 signed.
- Delays in your case: If your current case drags on, you don’t need to worry about the exam expiring; it stays valid as long as that application is pending.
- Changing lawyers or moving to a new state: Your old I-693 won’t move with you if you file a fresh application.
- Peace of mind for public health: USCIS wants to make sure medical information is current and accurate for every active case. This helps prevent outdated results from being used years later.
The key takeaway: your I-693 lives and dies with your specific application. If that application ends, the form is no longer valid.
How to Stay Prepared
This new rule doesn’t have to catch you off guard. With a little planning, you can make the Form I-693 process simple and stress-free. Here’s how to stay prepared and avoid extra costs or delays.
1. Check the date on your Form I-693.
Look for the date your civil surgeon signed it. If it was signed on or after November 1, 2023, it’s valid only while your application is active. If your case is denied or withdrawn, you’ll need to schedule a new medical exam before refiling.
2. Keep copies of everything.
Always make a copy of your I-693 and vaccination records before sealing the envelope. You can’t open the original sealed form, but keeping a copy helps if USCIS asks for more information or if you need to reapply later.
3. Don’t delay your exam too long.
If USCIS sends you a Request for Evidence (RFE) asking for your medical exam, get it done as soon as possible. Submitting it quickly can prevent your case from being delayed or denied.
4. Choose an experienced civil surgeon.
Only a USCIS-designated civil surgeon can complete and sign Form I-693. Make sure the doctor follows the latest CDC and USCIS technical instructions. If you’re in New Jersey, you can schedule your exam at a local clinic like ours that specializes in immigration medical services.
5. Stay updated on policy changes.
Immigration rules change often. Check the USCIS website or speak with your civil surgeon if you’re unsure about your form’s validity or next steps.
The bottom line: plan ahead, keep records, and work with a civil surgeon who understands the latest USCIS requirements. That way, your I-693 won’t become a roadblock on your path to getting your green card.
FAQs
- Why did USCIS change the validity period for Form I-693?
USCIS made this change to protect public health. Under the old rule, medical exams signed after November 1, 2023, were valid forever, even if someone reapplied years later. Now, USCIS wants every applicant to have an up-to-date exam that reflects their current health. This helps make sure diseases like tuberculosis, syphilis, or gonorrhea are properly checked before immigration benefits are approved.
- What if my green card case was denied or withdrawn?
If your case was denied or withdrawn, your previous I-693 is no longer valid — even if it was signed recently. When you file again, you’ll need to complete a new immigration medical exam and submit a new Form I-693 signed by a civil surgeon.
- How do I know if my Form I-693 is still valid?
It’s valid as long as your immigration application is still pending. Once USCIS makes a final decision (approved, denied, or withdrawn), that same I-693 can’t be reused for a future application.
- What if I submitted my I-693 before November 1, 2023?
The new policy applies to forms signed on or after November 1, 2023. If your form was signed before that date, it’s covered under the old rules and may still be valid for the case it was submitted with. However, if you reapply, you’ll still need a new medical exam.
- What if I’m not sure when to submit my I-693?
It’s usually best to submit your I-693 with your main immigration application (Form I-485). This ensures it’s matched correctly to your case and avoids extra back-and-forth with USCIS. - Can I still use my old I-693 for a new application if nothing has changed with my health?
Unfortunately, no. Even if you’re in perfect health, the new rule says that once your old application is withdrawn or denied, that I-693 expires with it. You’ll need a new one for any new application.