The required US Citizenship and Immigration Services Medical Exam for Green Card Application

Who is Required to Take the US Citizenship and Immigration Services (USCIS) Medical Examination and What Does It Involve?

The Medical examination is required to anyone filing a green card application with the USCIS. It is given to individuals looking for admission into the United States (green card application or visa application). In other words, the medical examination is required by the US Citizenship and Immigration Service for individuals seeking to either adjust their status or to enter the US as visa holders. Medical examinations for adjustment of status; ie through the process of the green card application with the USCIS, and application of visas verify good health and admissibility to the United States on medical grounds. The US Citizenship and Immigration Services examination can identify medical conditions that require follow-up medical care after emigration to the U.S. or adjustment of status to permanent residence after green card application is approved.

Requirements of the US Citizenship and Immigration Services medical examinations for green card applications:

All examinations include:

Civil Surgeons and Panel Physicians are required to provide pre-test counseling to all applicants who take the HIV test. If you are found to have HIV infection, the Civil Surgeon must provide you with post-test counseling.

• Vaccinations: Most applicants need to show that they are current with all vaccinations recommended by US public health officials to be able to satisfactorily file their green card application. See our complete list of recommended vaccinations.

Who has to have a US Citizenship and Immigration Services medical examination?

Adjustment of Status applicants (those filing green card applications) and immigrant visa applicants. Anyone applying for adjustment of status (green card application) in the United States, or for an immigrant visa at a U.S. Consular post abroad, must undergo an Immigration Services medical examination including a vaccination assessment.

Note: If the individual is applying for registry based on his or her entry before January 1, 1972, and has been in continuous residence in the United States since that date, a medical examination is not required.

K and V nonimmigrant (temporary) visa applicants. Individuals applying for a K nonimmigrant visa as the fiancee or the spouse of a U.S. citizen or for a V nonimmigrant visa as the spouse or child of a lawful permanent resident (LPR) (including those applying for V status in the United States with the US Citizenship and Immigration Services) must undergo a medical examination, but are not required to comply with the vaccination requirements at that time. They will be required to comply with the vaccination requirements when they eventually apply for adjustment of status.

Refugees. Individuals outside of the United States applying for admission as refugees must undergo a medical examination, but they are not required to comply with the vaccination requirements at that time.

Refugee adjustment applicants. Refugees become eligible to apply for adjustment of status 1 year after their initial refugee admission. When they apply for adjustment of status, they will not be required to repeat the medical examination they had overseas, unless a medical ground of inadmissibility was discovered. But, a refugee who is not required to repeat the medical examination must still comply with the vaccination requirements and submit the vaccination sign-off in support of the adjustment of status application. Contact your state refugee health coordinator or local refugee resettlement agency to find out whether it is possible for you to have the vaccination sign-off done by a state or local health department.

Asylees. Individuals already in the United States who are applying for asylum are not required to have a medical examination.

Asylee adjustment applicants. Individuals granted asylum become eligible to apply for adjustment of status 1 year after the date of approval. When they apply for adjustment of status, they are required to undergo the entire medical examination, including the vaccination assessment.

Note: A US Citizenship and Immigration Services medical examination is not required for other nonimmigrant visa applicants and nonimmigrants arriving at a port of entry, but the Consular officer overseas or the inspector at the port of entry has can require you to undergo an exam if there are reasons to believe that you might be inadmissible on medical grounds.

What if I am pregnant?

If you are pregnant, you are required to have a medical examination, but some parts of it may be postponed until after delivery of your baby, depending on the circumstances of your case. If you have any concerns, you should discuss them with your family doctor before the medical exam, with the Civil Surgeon, or with the Panel Physician.

What are the vaccination requirements of the US Citizenship and Immigration Services medical examination?

• Mumps
• Measles
• Rubella
• Polio
• Tetanus
• Diphtheria toxoids
• Pertussis
• Influenza type B
• Hepatitis B

If you are unable to submit all your vaccination records at the time of the medical examination, or if you have never had certain vaccines, the Civil Surgeon or Panel Physician can administer them to you.

Important: Do not try to fulfill your vaccination requirements before you meet with the Panel Physician or Civil Surgeon, in case it is not medically appropriate for you to have one or more of the required vaccines.

What if vaccinations are contrary to my religious beliefs or moral convictions?

If you have firmly held religious or moral beliefs that do not permit vaccinations, you may still be eligible for adjustment of status. You will need to apply for a waiver of vaccination requirements.

What happens after the US Citizenship and Immigration Services medical examination?

After the US Citizenship and Immigration Services medical examination is complete, the Panel Physician (if you are abroad) or the Civil Surgeon (if you are in the United States) will certify the results on the appropriate forms and place them in a sealed envelope. DO NOT OPEN THE SEALED ENVELOPE. Turn in your envelope with your immigration application.

Who gives the US Citizenship and Immigration Services medical examination?

The US Citizenship and Immigration Services medical examinations are given by licensed and experienced doctors called Civil Surgeons (in the U.S.A.) and Panel Physicians (outside of the U.S.A.). Doctors who qualify as Civil Surgeons or Panel Physicians receive special and on-going immigration oriented medical training and policy updates. Note: A medical exam performed by a doctor NOT approved by the US Citizenship and Immigration Services will not be recognized.

How do I find a designated Civil Surgeon in my area of the United States?

What form is needed for the US Citizenship and Immigration Services medical exam?

If you are applying for adjustment of status in the United States, Form I-693, Medical Examination of Aliens Seeking Adjustment of Status, is used to report the results of the medical exam to the US Citizenship and Immigration Services. If you are applying for a visa at a U.S. Consular post overseas, Form DS 2053 (Formerly Form OF 157) will be given to you. The Consular officer will supply this form and the accompanying supplements, and will give you the names and telephone numbers of Panel Physicians in your area. There is also a vaccination supplement which your Civil Surgeon or Panel Physician will provide. It is used to record the results of the vaccination assessment.

What is a “medical waiver” and what does it do?

A medical waiver permits an immigration applicant to be allowed into, or remain in the United States despite having a health condition identified as medical grounds of inadmissibility. Terms and conditions can be applied to a medical waiver on a case by case basis.

You are eligible for a waiver if:

What are “medical grounds of inadmissibility”?

Are all physical or mental disorders “medically-related grounds of ineligibility”?

No. The Civil Surgeon or Panel Physician must determine that there is no harmful behavior associated with the disorder in question. If you have a history of a physical or a mental disorder, there must be a harmful behavior that is likely to recur in order for it to make you ineligible. If your condition has no associated harmful behavior, then you can proceed with your application process.

What happens if I have a disorder with associated harmful behavior?

If you have a physical or mental condition with associated harmful behavior, you may still be eligible for adjustment of status. You may apply for a waiver according to the terms and conditions established by the USCIS, in consultation with the CDC. If you are applying for adjustment of status in the United States, you must file an Application for Waiver of Grounds of Excludability, including fee payment, with the USCIS office considering your adjustment of status application.

If you are applying for an immigrant visa at a U.S. Consular post abroad, you must submit your waiver application to the Consular post that is considering your immigrant visa application. The Consular post will send your waiver application to the overseas USCIS office in that jurisdiction for a decision. If you are applying for admission as a refugee, or for adjustment of status 1 year following your initial admission as a refugee or the grant of asylum, you may be granted a waiver for humanitarian reasons, to assure family unity, or when it is otherwise in the public interest.

What is a communicable disease of public health significance?

A “communicable disease of public health significance” is defined in the HHS regulations that cover the required medical exam for immigration purposes and includes the following 9 infectious medical conditions:

If the medical examination tests positive for a communicable disease:

Most communicable diseases are easily treatable. If the medical tests are positive for a communicable disease, the Civil Surgeon will recommend a course of treatment. Some medical conditions are not easily treatable. However, you may still receive adjustment of status by filing a waiver application. You are eligible for a waiver if:

The waiver may be granted according to the terms and conditions (which can include posting a bond) determined necessary by the US Citizenship and Immigration Services in consultation with public health officials, based on the nature of the medical condition. If you are applying for adjustment of status in the United States, you must file an Application for Waiver of Grounds of Excludability, including payment of fee, with the US Citizenship and Immigration Services office considering your adjustment of status application.

If you are applying for an immigrant visa at a U.S. Consular post abroad, you must submit your waiver application to the Consular post that is considering your immigrant visa application. The Consular post will send your waiver application to the overseas bureau citizenship and immigration services-USCIS office in that jurisdiction for a decision.

If you are applying for admission as a refugee, or for adjustment of status at least 1 year following your initial admission as a refugee or the grant of asylum, you may be granted a waiver for humanitarian reasons, to assure family unity, or when it is otherwise in the public interest.

What happens if I test positive for HIV?

In the case of testing positive for the HIV virus, you must file a waiver application according to the above instructions. You must also show that your admission to the U.S.:

Note: Individuals seeking admission as refugees from outside the United States are not required to submit documentation of individual eligibility for HIV treatment or health care coverage with Form I-602. They are already considered to have the required consent based on their eligibility for Federally funded programs and the assurances provided to USCIS by HHS.