Green Card, I-693 Form, Immigration Exam, Immigration Medical Exam, Medical Exam, U.S. citizenship, USCIS Naturalization

Immigration Medical Exam for Permanent Residents

U.S. Citizenship and Immigration Services (USCIS) requires the medical exam for permanent residents to protect public health. You are in the slab of medical inadmissibility if you have a health condition or a history of health problems. To obtain a green card, you must undergo a medical examination conducted by a government-authorized doctor. It includes;

  • Physical and mental examination 
  • Review of immunization records 
  • Testing for drugs and alcohol 
  • Evaluation for illness and disease

Reasons for denial related to health:

You can be denied a green card application by USCIS based on the following five different health reasons. The list includes;

  • Public health threats posed by infectious diseases

If you suffer from certain infectious diseases (such as gonorrhea, syphilis, leprosy, tuberculosis), you will likely need to receive immediate treatment. If you do not cure yourself and are likely to spread the infection among others, USCIS may deny you a green card. 

  • Abuse of alcohol or drugs

It may be impossible for you to get a green card if your medical exam reveals that you are abusing illegal drugs, or alcohol. In case of history of substance abuse, you may be asked to take a drug test or provide documentation of your participation in a drug treatment program. 

  • Reactions to harmful behavior (mental or physical disorders)

USCIS may deny you a green card if you have an illness that might make you violent. Drinking and driving are considered as disorders by USCIS because it can harm others. 

  • Unable to work

USCIS may consider you ineligible to get a green card if your health condition prevents you from working and supporting yourself financially. This could include life-threatening diseases as well. Eligibility will depend on the likelihood of becoming dependent on government assistance.

  • Fail to list the vaccinations you’ve since had

You may also be considered inadmissible if you cannot show proof of your vaccinations until now. 

How to avoid “Medical Inadmissibility”?

It is not necessary that USCIS deny you a green card if you have a cold, a well-managed chronic condition such as diabetes, or have previously been diagnosed with an infectious disease but no longer have it. You can take the following measures to prevent receiving a denial of your application for health reasons;

  • It is necessary to show proof of treatment to USCIS if you have ever suffered from a contagious disease (gonorrhea, syphilis, leprosy, or tuberculosis). Your regular doctor might also provide a statement saying that your disease is cured or under control. Moreover, you may bring copies of your medical records showing your treatment and test results. 
  • You should bring proof of treatment if you have a history of drug abuse. 
  • You should bring proof that your mental health is well managed if you have a history of mental illness. 
  • Your regular doctor should provide a statement explaining how you manage any other severe conditions you have. Furthermore, your illness should describe how it affects your behavior, work, and family.

When USCIS denies your health-related application, you have an option to apply for a government waiver or a waiver of inadmissibility to enter the United States.

Your waiver may be approved subject to specific health conditions. In the case of infectious disease, you may require immediate medical attention in the United States; direct refusal to seek treatment could result in USCIS denying your waiver. Only an attorney can help you to get waive inadmissibility.

What preparation is required for Immigration Medical Exam?

A government-approved doctor will perform your immigration medical exam. Depending on your location, you may need to schedule an appointment beforehand, or you may not. 

1. If you’re applying from inside the United States:

If you live in the United States, you can schedule your appointment using two different options; 

  • Option 1: Schedule it before applying for a green card

Medical exam results can be submitted concurrently with the rest of your application, which is called “concurrent filing. In this case, you must have your medical results signed by a doctor within sixty days of filing. 

If you are applying for a green card, you should wait to submit your medical form until after sending it to the U.S. Department of Homeland Security (DHS), or you should bring it to your interview. It will be necessary to retake the exam if you do not. You can submit your medical records within two years after filing your green card application. 

  • Option 2: schedule it once you begin the green card application process

Your medical exam results can either be mailed to USCIS or brought to your green card interview. Medical exam forms are acceptable for two years from the date of the doctor’s signature. The USCIS website has a list of authorized doctors to schedule an appointment.

2. If you’re applying from outside the United States:

Once you receive an appointment letter from the National Visa Center (NVC) for your green card interview, you can schedule your medical examination. Applicants outside of the United States can apply for green cards through NVC. Moreover, you need to contact your local embassy or consulate before receiving your appointment letter.

Their exam instructions will include a list of qualified and authorized doctors within your country, which you can select for your medical exam. Your exam results could expire in three to six months, depending on your medical condition. Your doctor should inform you about the expiry of medical exam results.

What to bring in Immigration Medical Exam?

To get your medical exam smoothly, you should prepare your documents in advance consist of;

  • Records of your vaccinations
  • Your health history
  • X-Ray reports (if applicable)
  • In case of any health concerns, a letter from your doctor stating your treatment plan
  • A government-issued photo identification
  • Payment evidence for medical exam fees

1. If you are applying from inside the United States

The civil surgeon will record your exam results on Form I-693, officially named as Report of Medical Examination and Vaccination Record. You must bring this form with you for your medical examination. Form I-693 (updated) can be obtained from the USCIS website, but you are advised to bring a copy of the revised form from your doctor’s office. Once the doctor has completed their portion of the form with duly signed, you will need to sign.  

2. If you are applying from outside of the United States

You should bring your National Visa Center (NVC) interview appointment letter with you to the doctor’s office as immigration medical examination is not possible without this letter. The doctor will verify whether your green card application is active with this letter or not. 

During Immigration Medical Exam , what do they check for?

During the medical exam, several different tests will be conducted. If you are applying for adjustment of status, the screening process may be different. While, the general screening categories for all other types of green cards are the same, whether asylum green cards, child green cards, parent green cards, marriage green cards, or any other type.

As part of the screening, patients will have tuberculosis tests, vaccination screenings, medical history reviews, physical exams, mental exams, drug and alcohol screenings, and blood tests.

Tuberculosis Test:

If you are inside or outside the United States, you must follow different tuberculosis test guidelines.

  • If you are applying from the United States

To receive a green card, all applicants who fall in the age group of two and older must undergo an “interferon-gamma release assay” (IGRA). A chest X-ray and further testing will be needed in case of positive results of IGRA test.

Note: United States Citizenship and Immigration Services (USCIS) no longer accepts green card applicants’ tuberculin skin tests (TSTs). Verify that the test you receive is the correct one. 

  • If you are applying from outside the United States

If you are fifteen-year-old and a resident of a country considered “heavily tuberculosis-burdened,” you must have a chest X-ray taken by the CDC.

If you experience any signs of tuberculosis based on the X-rays or other medical examinations, you will have to go for further testing. 

Note: Contact your U.S. embassy or consulate for further tuberculosis exam instructions.

Vaccination Screening:

Immigration and Nationality Act and the Centers for Disease Control and Prevention require the following vaccines;

  • Measles, rubella, and mumps
  • Tetanus and diphtheria toxoids
  • Poliovirus
  • Pertussis
  • Hepatitis A
  • Hepatitis B
  • Influenza
  • Varicella
  • Pneumococcal Pneumonia
  • Meningococcal
  • Rotavirus

Medical History Review:

This is also an important step to be conducted during Immigration Medical Exam in the following conditions;

  • If you’ve ever been hospitalized or experienced any significant health events.
  • A disability or high health condition rendered you unable to function as a normal member of society. 
  • A chronic mental or physical condition that confined you to an institution.

Physical Exam:

These are likely to be examined by your doctor during your physical exam;

  • Throat, eyes, nose, heart, lungs, extremities, abdominal area, skin, lymph nodes, genitalia, and lymphatic system.

You’ll also be tested for syphilis with chest X-rays and blood tests. USCIS will waive this requirement for children seeking green card applicants.

If you are pregnant, you may request a postponement during your medical examination because X-rays are dangerous to an unborn child. 

Mental Exam:

Your doctor also performs a mental examination to evaluate your intelligence, judgment, mood, behavior, and comprehension. Special attention will be paid to;

  • Psychiatric disorders, psychological disorders, violent behavior, and other related disorders. 
  • Mental or physical illnesses associated with dangerous or violent behavior recently or are likely to occur again.

Drug & Alcohol Screening:

During the appointment, the doctor will also ask you about whether you take any prescription drugs, when you last took a drug or drank alcohol, and whether you have had a history of substance abuse.

A green card cannot be granted to someone currently abusing substances, but you are still eligible if you have recovered from your addiction. 

Blood & Urine Screening:

You will receive a syphilis blood test and a gonorrhea urine test if you are older than fifteen. These tests are given regardless of your geographical presence. 

Note: You still need to undergo a medical exam if you have a menstrual period. Whereas, a chest X-ray must be consented by the pregnant patient.

The doctor will provide extra protection. Additionally, you can wait until after birth to get your chest x-ray. If you are living abroad, you must complete it before arriving in the U.S.  Alternatively, you must do so before completing your green card application or Form I-485 if you submit your application during your stay in the U.S.

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