The U.S. Citizenship and Immigration Services has announced that medical examinations required in connection with green card applications will no longer have to be performed 60 or fewer days before the green card application is filed.


An essential part of filing an I-485 application for permanent resident status in the United States (green card) is a medical examination by a civil surgeon designated by the USCIS. The purpose of the medical examination, including proof of the requisite vaccinations, is to allow the USCIS to determine whether the applicant has a medical condition that might preclude admission to the United States and make the applicant ineligible for permanent resident status.

The USCIS had a longstanding “60-day rule” that was suspended during the COVID-19 pandemic. The rule was that the I-693, Report of Immigration Medical Examination and Vaccination Record, filed with the I-485 Application, had to be signed and dated by the civil surgeon no more than 60 days before the I-485 was filed. If not, the USCIS would issue a Request for Evidence, and the applicant would be required to have a new medical examination and to provide an updated Form I-693 signed by the civil surgeon.

The USCIS has now ended the 60-day rule for good. From now on, the I-693 Report no longer has to be signed and dated by the civil surgeon 60 or fewer days before the filing of the green card application. However, as a point of caution, applicants and their employers should be aware that an I-693 will be valid only for up to two years after the date that it is signed by the civil surgeon. Therefore, an applicant may be required to go through the medical examination process again if the I-485 Application is not approved within two years (because of delays in filing by the applicant or adjudication by the USCIS).

Good news for applicants, doctors, . . . and everybody else

The removal of the 60-day rule is welcome news not only for applicants, but also for civil surgeons, USCIS officers, federal partners, and other stakeholders. Although applicants will need to be mindful that a signed I-693 is valid only for two years, the new timeline will reduce the need for repeat examinations by civil surgeons, making the green card process operate more efficiently and providing more flexibility to both applicants and the civil surgeons.

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