United States 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

Health-related reasons for denial of a Green Card application

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

1. Public health threats posed by infectious diseases

If you suffer from certain infectious diseases (such as gonorrhea, syphilis, leprosy, tuberculosis), you will 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. 

2. Abuse of alcohol or drugs

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

3. 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 disorders by USCIS because they harm others. 

4. 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.

5. Fail to provide the list of vaccinations

You may also be considered inadmissible for a green card if you cannot show proof of your vaccinations till current data. 

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 a denial of your application caused by various health reasons;

  • It is necessary to show proof of treatment to USCIS if you have ever suffered from a contagious disease. Your regular doctor might also provide a statement about your treatment that the disease is cured or under control.
  • 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. 

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, and direct refusal to seek treatment could result in USCIS denying your waiver. Only an attorney can help you to waive inadmissibility.

What preparation is required for Immigration Medical Exam?

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

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 green card application, which is called “concurrent filing

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 results are acceptable for two years from the date of the doctor’s signature. 

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 instructions for the examination 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 let you know 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 consisting 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
  • If you are applying from the U.S. for a green card, you must bring Form 1-693 to the medical examination on which the civil surgeon will record your exam results, officially named as Report of Medical Examination and Vaccination Record.
  • While, if you apply from outside the U.S., you must bring NVC (National Visa Center) interview appointment letter because 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 the Medical Exam for Immigration, 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, such as asylum green cards, child green cards, parent green cards, marriage green cards, or any other type.

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

1. Vaccination Screening:

Immigration and Nationality Act (INA) and the Centers for Disease Control and Prevention require the following vaccination of green card applicants;

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

2. Medical History Review

This is also an important step that must 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 severe health condition that makes you unable to work like a normal person.
  • A chronic mental or physical condition.

3. Physical Exam

During your physical exam, these organs are likely to be examined by your doctor;

  • 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 and pregnant women because X-rays are dangerous to an unborn child.

4. 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 currently facing or are likely to occur again.

5. Drug & Alcohol Screening

During the appointment, the doctor will also ask you 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 any addiction. 

6. 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 to by the pregnant patient. The doctor will provide extra protection in the U.S. 


  • https://mhdpakistan.iom.int/immigration-medical-examination-ime-canadian-visa-applicant retrieved on 24th December 2021.
  • https://www.immigrationhelp.org/learning-center/the-complete-guide-to-the-u-s-immigration-medical-exam 24th December 2021.
  • https://www.amcpk.com/amc/medicalexamination.aspx 24th December 2021.
  • https://citizenpath.com/immigration-medical-exam/ 24th December 2021.