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Medical Examination Memo for I-485 Adjustment of Status Case The Report of Medical Examination and Vaccination Record (form I-693), is one of the documents needed to be submitted to the USCIS for the I-485 Adjustment of Status application. The medical examination is required to establish that the applicant is not inadmissible to the United States on public health grounds.* The medical examination needs to be done by a USCIS-designated civil surgeon. Once completed, the surgeon will provide a medical report in a sealed envelope. However, the USCIS often issues Request For Evidence (RFE) regarding an inadequate completion of this important medical report document on the part of the USCIS-designated civil surgeons for certain cases. While these surgeons are designated by the USCIS and are supposed to know all the requirements for the medical exam and report, they sometimes make mistakes or do not keep abreast of new requirements for the medical exam from the USCIS. The RFE will delay the application process and bring unnecessary extra work for the applicant, attorneys and the doctor too. To avoid an RFE, we would like to provide some basic information related to common problems we have seen in the past. Since only immigration officers may open these medical report envelopes, it would be beneficial if the applicant can make sure that his doctor has addressed the following issues during the medical examination and on the medical report: 1) Tuberculosis: Some I-485 cases get RFEs due to the fact that applicants were not administered a tuberculin (TB) skin test when they went for their medical examination. All applicants older than two years of age MUST be administered a TB test, unless certain conditions prevail in which case a chest x-ray examination may be completed in lieu of the TB test. In ALL cases, when an applicant does not receive a TB test, the surgeon MUST submit documentation explaining the reasons as to why a TB test was not administered and submit further documentation evidencing the completion of a chest x-ray. If it is noticed that the doctor is not complying with federal protocol, the applicant should remind the doctor that unless he qualifies as an extenuating circumstance, the applicant must be administered a TB test. Further, the results of the exam are to be recorded on the applicant’s I-693 form. 2) Vaccination Requirements: All applicants must submit documentation showing that they have been vaccinated against various diseases. These include, but are not limited to, being inoculated against measles, mumps, rubella, polio, tetanus and diphtheria toxoids, pertussis, influenza, hepatitis B, haemophilus influenzae type B, varicella, pneumococcal, rotavirus, hepatitis A, meningococcal, human papillomavirus, and zoster. If the applicant has received these vaccinations before, he should bring the record to the doctor. If the applicant has not been vaccinated against one or more of these ailments, he will need to receive the vaccination at the doctor’s office. 3) Pregnancy: Pregnant women or breastfeeding mothers can postpone receiving vaccinations and chest x-ray examinations. Please ask the doctor to document the reason for the omission of the process. Once the applicant is able to fulfill these requirements, please do so and supplement the report to the CIS. In addition, the medical examination results generally are good for a 6 month period. Once it is submitted, it is good throughout the length of the application process. Further, for a complete list of USCIS-designated civil surgeons, please click on the following link: https://egov.uscis.gov/crisgwi/go?action=offices.type&OfficeLocator.office_type=CIV Please note that it is occasionally easier to see a USCIS-designated civil surgeon in a large metropolitan area as opposed to a small-rural region. Therefore, if you are unable to schedule an appointment with your closest USCIS-designated civil surgeon(s), please attempt to schedule an appointment with one in a more heavily –populated area. Keep in mind that it is very important to have a knowledgeable and professional attorney assist you in your green card application cases. As an example of the medical exam report, with an experienced and responsible attorney’s help, your green card application process will avoid unnecessary delays. *The medical grounds of inadmissibility under U.S. immigration laws are divided into four categories communicable diseases o public health significance, lack of required vaccinations, physical or mental disorders with harmful behavior and drug abuse/drug addiction. ------ Special notice: At 10:30am~12:00pm CST on Saturday March 14, 2009, Attorney Jane Xu will hold a seminar in English at our Houston office. She will talk about H-1B, NIW, EB-1, etc. If you are interested in this seminar, please click the following link to register: http://survey.constantcontact.com/survey/a07e2h3x7zifrut90bb/start ------ (03/09/2009) For more immigration news, please click here |
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