USCIS doctors: Civil surgeons for immigration physicals

Applicants for US immigration and citizenship have to apply for an adjustment of status (Form I-485) and go through a medical examination.

This medical examination cannot be done by regular medical doctors, but by a doctor designated by the United States Citizenship and Immigration Services, which is a component of the United States Department of Homeland Security.

The immigration form used for the green card medical examination by the USCIS doctor is called an I-693 Form.

Why a USCIS doctor?

USCIS doctors must have years of experience practicing as medical doctors before they can be appointed as USCIS-approved doctors.

Only they can perform immigration medicals because they understand the standards of each exam. It can be a nerve-wracking process where no one can afford to make a mistake as proper completion of this paperwork is an essential prerequisite for green card approval.

An Immigration medical exam is, therefore, one area where expertise and experience matter a lot.

Difference between a civil surgeon and a panel physician

Depending on the immigration benefit sought by the immigrant, he or she may be required to undergo a medical examination.

If the immigration applicant resides outside the US, they can go to an immigration doctor inside their country. These doctors are called panel physicians. Panel physicians are designated by the Department of State.

If the immigration applicant resides inside the US, they have to go to a USCIS-designated doctor in the country. These USCIS-designated and approved immigration doctors are called civil surgeons. Civil surgeons are designated by the USCIS.

Responsibilities of USCIS Civil Surgeons

Civil surgeons have to perform the immigration medical examination according to the Technical Instructions for Civil Surgeons published by the Centers for Disease Control and Prevention in Atlanta, Georgia. These technical instructions as described on the USCIS website, include:

• The Technical Instructions for Medical Examinations of Aliens in the U.S. (1991)
• The Tuberculosis (TB) Component of the Technical Instructions for the Medical Examination of Aliens in the U.S. 2008 (effective May 1, 2008)
• Adjustment of Status for U.S. Permanent Residence Requirements: Technical Instructions for Vaccinations 2009 (effective Dec.14, 2009)
• 2010 Technical Instructions for Mental Disorders and Substance Abuse for Civil Surgeons (effective June 1, 2010)
• 2013 Technical Instructions for Syphilis and Hansen’s Disease (effective January 1, 2013)
• Any updates to the documents listed above as published on CDC’s website (Gonorrhea update effective August 01, 2016).

Each of these documents and updates to the USCIS civil surgeon’s responsibilities can be obtained from the CDC’s website.

Failure to comply with any of the Technical Instructions may result in USCIS revoking the civil surgeon’s designation.

Form I-693: Report of medical examination and vaccination record

All immigration and naturalization applicants filing for adjustment of status to get a green card or a lawful permanent resident status must submit the valid versions of form I-693 completed by a USCIS civil surgeon. USCIS doctors use the form I-693 to report the results of the immigration exam to USCIS.

As per the USCIS regulations, anyone who wishes to be a US citizen or long-term permanent resident must have the same level of immunization and protection from diseases that US citizens in America have. This means, even if you have had your vaccines in other countries, you’ll need to ensure that you have the vaccines required by the United States.

The medical examination is required to establish that an applicant isn’t inadmissible to the United States on public health grounds. A list of those health grounds can be found in section 212(a)(1) of the Immigration and Nationality Act.

Important things to remember:

• You have to use the most recent form I-693 version.
• You don’t need to print or bring a form to your green card medical exam appointment.
• Once you arrive in a civil surgeon’s office, you’ll be asked to fill out the top part of the form.
• Don’t sign until the USCIS civil surgeon asks you to.
• The USCIS doctors will use the form to document your medical history, your vaccination status, and the results of your medical exam. They’ll then complete, sign, and seal the form and any supporting documents in an envelope.
• You’re responsible for submitting the sealed envelope to USCIS as directed in the Form I-693 instructions
• Don’t break the seal! Any unsealed envelope won’t be accepted by USCIS.

To ensure the results of the medical examination are still valid at the time USCIS adjudicates the associated benefit application, applicants should schedule the medical examination as close as possible to the time they file for adjustment of status, respond to a Request for Evidence, or attend an interview (if applicable).

Applicants should, however, also provide sufficient time for getting the results of laboratory testing or additional testing required under CDC’s technical instructions.

Where to file the form I-693

As per the USCIS, the applicant has to submit Form I-693 to USCIS, not the civil surgeon.

If you’re applying for adjustment of status, you may submit the immigration medical exam forms in one of the following ways:

• Mail the form I-693, together with your Form I-485, Application to Register for Permanent Residence or Adjust Status, to the location specified for your Form I-485
• Mail the form I-693, after filing your Form I-485, to the location specified in your most recent communication with USCIS (for example, a Request for Evidence letter from USCIS)
• Submit the form I-693 in person during an interview at a USCIS field office (if an interview is required)

Other applicants: Follow the instructions on or included with the application or the instructions given to you by the office requesting the medical examination.

Get checked by a USCIS doctor near you

If you desire to become a US permanent resident, green card holder, or US citizen, you need to follow these rules. If you refuse or lack an immigration medical exam, your application may be denied or even terminated.

You mustn’t take shortcuts with your immigration paperwork. When you plan to do your immigration and naturalization to the US, the USCIS requires you to be well enough to protect yourself and others from life-threatening health conditions. 

As much as you need to comply with these regulations, the USCIS civil surgeon, too, has to comply with these guidelines.