What Happens at the Immigration Medical Exam (I-693) and How Can I Prepare for Success?

When it comes to the family-based green card (or K-1 fiancé(e) visa) application process, the U.S. government has several methods of assessing whether the non-citizen spouse/fiancé(e) is inadmissible to the United States. In simple terms, inadmissibility is a fancy way of saying "you cannot immigrate to the U.S." There are various grounds of inadmissibility, that form the basis for the government denying your entry or admission to the U.S., including criminal-related, health-related, national security-related, immigration history-related and more. In this blog, we will explore the health-related inadmissibility grounds, what happens during the I-693 medical exam, the roles of civil surgeons and panel physicians, and offer some valuable tips for ensuring a successful examination.

HEALTH-RELATED GROUNDS OF INADMISSIBILITY ADDRESSED BY THE MEDICAL EXAMINATION

According to the Immigration and Nationality Act (INA), if the U.S. government determines that any of the below are applicable to you, you are considered inadmissible and therefore cannot be granted immigration benefits (unless a waiver is available to you):

Communicable Diseases: If you are determined to have a communicable disease of public health significance (the list of applicable diseases can be found here), you are deemed inadmissible.
Lack of Mandatory Vaccinations: If you have failed to present sufficient documentation of having received vaccination against vaccine-preventable diseases, which includes at least the following: mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, influenza type B and hepatitis B, COVID-19, and any other vaccinations recommended, you are deemed inadmissible.
Physical or Mental Disorder: If you are determined to currently have or have a history of a physical or mental disorder and behavior associated with the disorder that may pose, or has posed, a threat to the property, safety, or welfare of the non-citizen or others, you are deemed inadmissible.
Drug Abuser/Drug Addict: If you are determined to be a drug abuser or drug addict, you are deemed inadmissible.

UNDERSTANDING THE USCIS/DEPARTMENT OF STATE IMMIGRATION MEDICAL EXAMINATION

The immigration medical exam is designed to determine whether an applicant poses any health risks to public safety or national security, as well as to identify any medical conditions that might render an applicant inadmissible to the United States. The doctor that you visit is specifically designated and authorized by the U.S. government to perform a medical evaluation of the non-citizen. Below are some basic details about who conducts the medical exam, where to find a designated doctor, what happens at the exam and how best to prepare for the exam:

Civil Surgeons vs. Panel Physicians

In order to complete the immigration medical exam, applicants must seek the services of a designated medical professional. Two types of medical practitioners can perform this examination: civil surgeons and panel physicians. The only difference between the two doctors, other than their titles, is where they are located. Civil Surgeons are U.S. licensed physicians designated by U.S. Citizenship and Immigration Services (USCIS) to conduct immigration medical exams within the United States. Whereas, Panel Physicians are authorized by the U.S. Department of State to perform medical exams outside the United States for individuals applying for immigrant visas at the U.S. Consulate/Embassy in their home country.

For adjustment of status cases, the medical exam should be completed prior to submitting your application packet. For consular processing matters, the medical exam cannot be completed until the case moves from the National Visa Center to the U.S. Consulate/Embassy abroad.

To find a Civil Surgeon in your area, you can visit the following link and input your zip code to obtain a list of doctors designated by USCIS: https://www.uscis.gov/tools/find-a-civil-surgeon

To find a Panel Physician, you will need to visit the website for the specific U.S. Consulate/Embassy in your home country. A list of Embassies can be found here: https://www.usembassy.gov

What Happens at the Immigration Medical Exam

The medical exam itself is actually quite straightforward. The doctor will conduct a physical examination similar to what you can expect during an annual physical, and ask you questions about your vaccination history, medical history and also inquire about your mental health and use of alcohol or controlled substances. Remember, this is NOT your doctor and they are not necessarily looking out for your best interests. You should answer questions with yes or no answers whenever possible, and avoid giving long drawn out responses to simple questions. The doctor's goal is to find any information that would suggest that you are inadmissible based on the grounds listed above.

Preparing for a Successful Immigration Medical Exam

Here are some tips to help ensure a smooth and successful immigration medical examination:

Print out the I-693 Form: Bring a copy of the I-693, Report of Immigration Medical Examination and Vaccination Record, with Part 1 pre-filled out;
Pay for the Cost of the Exam: Inquire about the cost of payment for the exam and be sure to bring the correct amount to pay at the time of your appointment;
Gather Your Medical History: Before the exam, compile a detailed medical history, including any previous diagnoses, treatments, and vaccination records. Being organized will expedite the process.
Bring Vaccination Records: Ensure that you have vaccination records for required immunizations. Applicants should be up-to-date on all vaccines as per U.S. vaccination guidelines. Failure to do so can result in delays or additional expenses.
Expect a Physical Examination: The medical exam typically includes a physical examination, blood tests, and a chest X-ray (if applicable). Dress comfortably and be prepared for these procedures.
Communicate Honestly: Be truthful about your medical history, including any past or current medical conditions. Providing accurate information is crucial for the examiner's assessment. However, you should be cautious in volunteering information that is not asked of you.

Sealed Envelope:

After completing the examination, the civil surgeon or panel physician will provide you with a sealed envelope containing your medical exam results. In some instances, they will send the sealed envelope directly to USCIS or the U.S. Embassy/Consulate. If the doctor hands you the sealed envelope, DO NOT open it as it must be submitted to USCIS or presented at your consulate interview. Opening the sealed envelope will invalidate the exam and you will be required to complete another exam and pay the associated costs.

Ultimately, the immigration medical exam is an important step in the U.S. immigration process. Understanding the grounds of inadmissibility, the roles of civil surgeons and panel physicians, and following the tips provided can help ensure a successful examination. If you are interested in filing a family-based green card petition or K-1 fiancé visa, please do not hesitate to give us a call at (212) 547-8857 or schedule a consultation online and we'd be happy to work with you to apply for the benefits you are seeking. Our experienced immigration attorneys are here to provide the advice you need.

Disclaimer: This blog post and similar posts are not to be considered as providing legal advice. The discussion here is meant for educational and informational purposes only and shall not create an attorney-client relationship with the readers of this content.