Applicants
Does the Form I-693 Medical Exam Expire? What Applies in 2026
A reader asked whether an I-693 signed after November 1, 2023 never expires. The answer has changed twice since then. Here is what applies now, in plain language, and what to check before you file.
A reader asked a question that many people have after an EB-1A or EB-2 NIW approval: if my medical exam was signed after November 1, 2023, does it never expire?
It is a fair question, because the answer was true for a while and then changed. This post walks through the timeline calmly, so you can see what applies to you now.
This is general information, not legal advice. Check your own facts with the current USCIS instructions or an immigration attorney.
The short answer
A Form I-693, the Report of Immigration Medical Examination and Vaccination Record, signed by a civil surgeon on or after November 1, 2023 does not expire on a set date. But since June 11, 2025 USCIS treats it as valid only for the application it was submitted with, and only while that application is pending.
So the safer way to say it is not "never expires". It is "stays valid for that one I-485 while it is pending".
How the rule changed
- 2018. A civil surgeon had to sign within 60 days before you filed, and the case had to be decided within two years of the signature.
- March 31, 2023. USCIS removed the 60 day rule. A form could be accepted for up to two years after signature.
- April 4, 2024. USCIS announced that forms signed on or after November 1, 2023 would not expire.
- December 2, 2024. USCIS began expecting the I-693 to be filed together with the I-485 and may reject a filing that is missing it.
- June 11, 2025. USCIS issued a new policy that replaced the April 2024 one. The I-693 is now valid only while the application it was submitted with is pending.
What this means in practice
- Your I-485 is pending. The form you submitted with it should stay valid for that case. USCIS can still ask for an updated medical if it has a reason to believe the report no longer reflects your condition.
- Your I-485 is withdrawn or denied. That I-693 is no longer valid. If you file again you need a new exam and a newly signed form.
- Your exam was signed before November 1, 2023. Earlier exams were tied to the older two year rule. Check the signature date with an attorney before relying on it.
- You are processing through a consulate. The above is for adjustment of status inside the United States. Applicants abroad see an embassy panel physician and follow the embassy instructions.
Should you do the exam before your priority date is current?
It depends on your timing, and it is worth talking through with your attorney. One law firm note suggests that if your priority date is not expected to be current soon it may be reasonable to file first and submit the medical when USCIS asks. If your date is current or about to be, completing the exam in advance can save time. The December 2024 filing expectation makes the second case more common.
Practical checks before the exam
These come from a law firm guide to the 2026 rules, so confirm them with the current USCIS instructions:
- Only a USCIS designated civil surgeon can sign the form. Check the doctor on the USCIS locator first.
- For a paper filing, send the sealed envelope unopened. For an eligible online filing you open it, upload the completed form and keep the original and envelope until USCIS decides.
- Required vaccines follow CDC guidance. Past doses can be documented or a titer test can be ordered.
- Applicants age 2 and older need a blood test for tuberculosis, not the skin test, as the first screen.
- Common mistakes are a broken seal, a doctor not on the list, an outdated form edition and a missing I-693 at filing.
How this fits with evidence preparation
A missing medical is one of the easiest reasons for a delay, and USCIS can now deny a filing that lacks required initial evidence without first sending a Request for Evidence (guidance issued August 5, 2026). The medical is not the most exciting part of a green card journey, but it is one of the simplest to get right.
If you want to see where the rest of your evidence stands, the free assessments are at meritocrat.us for EB-1A, EB-2 NIW and O-1.
Sources
- Immigration Policy Tracking, USCIS revises requirements for the I-693 (timeline of 2018, 2023, 2024 and 2025 policies)
- BAL, USCIS Policy Manual update regarding Form I-693 (June 12, 2025)
- Visaserve, USCIS update: Form I-693 validity now tied to a specific application
- Capitol Immigration Law Group, USCIS I-693 medical exam policy (December 2024)
- Modern Law Group, I-485 medical exam in 2026
Meritocrat is not a law firm and this is general information, not legal advice.
Frequently asked questions
- Does an I-693 signed after November 1, 2023 never expire?
- Not quite. It does not expire on a fixed date, but USCIS now ties it to the specific application it was submitted with. It stays valid while that application is pending. If the application is withdrawn or denied the form is no longer valid.
- My I-693 was signed before November 1, 2023. Is it still usable?
- Older exams were subject to the earlier two year validity from the civil surgeon signature. Check the signature date and ask an immigration attorney or the USCIS instructions before relying on an older form.
- Do I need a new exam if I refile my I-485 after a denial?
- Yes in general. The earlier I-693 becomes invalid when that application is denied or withdrawn, so a newly completed form is needed with the new filing.
- Does this apply if I am processing through a consulate abroad?
- No. Applicants abroad have their medical exam with an embassy designated panel physician and follow the embassy instructions. The I-693 rules above are for adjustment of status in the United States.
Prepare your case in one connected workspace
Case Studio helps EB-1A, EB-2 NIW, and O-1 applicants organize evidence and review what supports each claim.