rfe I-693

Request For Evidence RFE I-693 During Adjustment of Status

Did you receive a request for evidence RFE I-693 during the I-485 adjustment of status processing? Well, don’t panic. It’s actually really easy to comply with this RFE and means that USCIS wants a new updated medical examination.

There are several reasons for receiving an RFE for the I-693:

  • Your medical examination has expired.
  • The medical form wasn’t completed properly.
    • As of August 2016, USCIS requires that any civil surgeon completing the I-693 test applicants over the age of 15 for gonorrhea. This policy change went into affect without notice to the public.

Case Example:

Margaret applied for adjustment of status by submitting form I-485 and I-130 after marrying a U.S. citizen. After a few months of not hearing anything from USCIS, she receives an RFE for the medical examination (I-693).

Turns out that it has now expired and she will be required to make an appointment with a civil surgeon who will complete the medical report.

In the case above, Margaret could have avoided the RFE I-693 if she had looked at when her original report was expiring. Sometimes, it’s best to just redo the medical exam and pay the extra fee to avoid further delays in case processing.

Sample RFE I-693 Medical Examination

Below is an example of a request for evidence received by a K1/K2 applicant. The letter outlines what USCIS is missing and needs to be submitted before the I-485 can be adjudicated.

Request for Additional Evidence (I-485):
This office is unable to complete the processing of your Application to Register Permanent Residence or Adjust Status, (Form I-485) without additional information. Please submit the information requested.

Medical Examination (Form I-693):
Note: All medical examinations and vaccinations must be conducted and administered by a physician who is on the list of Civil Surgeons approved by the USCIS. All medical examinations MUST be submitted in an envelope that has been sealed by the Civil Surgeon.

A review of the record indicates that you entered the United States pursuant to a valid K-2 nonimmigrant visa. All USCIS records relating to you have been reviewed. The U.S. Department of State medical forms DS-2053, DS-3024, DS-3025 and DS-3026 are not in any of those records.

I-693 Medical Examination:
Please submit a properly completed and signed Form I-693, Medical Examination of Aliens Seeking Adjustment of Status. The medical examination must be conducted by a physician who is on the list of Civil Surgeons approved by USCIS. Current regulations now require that the tuberculin skin test be completed by all applicants 2 years of age and older. A chest X-ray is required only when the reaction to the skin test is 5 millimeters or more.

Immunization Form:
Please submit a properly completed Supplemental Form to I-693, Adjustment of Status Applicant’s Documentation of Immunization. The supplemental must be completed and signed by a designated Civil Surgeon.”

Submit Form I-693, Medical Examination

If you’re applying to adjust status inside the U.S., it’s likely you’ll be required to submit form I-693 medical examination.

The reason USCIS needs this form completed is to be sure that you (the beneficiary) is not inadmissible based on public health grounds.

The medical exam must be completed by a USCIS-designated civil surgeon and follow these guidelines:

  • The medical examination report must be completed correctly;
  • The medical examination report must be submitted to USCIS within one year after completion of the examination;
  • The immigration application must be adjudicated no more than one year after the date the medical examination was submitted to USCIS; and
  • The medical examination report must establish that the applicant does not have a Class A medical condition that can result in inadmissibility.

Note: If you submitted the I-485 adjustment of status without the medical examination form I-693, it’s best to wait until you receive an RFE.

Sending it after the initial petition will cause unnecessary delays so avoid doing this if it hasn’t been

rfe i-693

Responding To An RFE I-693 From USCIS

First thing you need to do is figure out what USCIS needs. If it’s simply that the medical exam has expired you should set an appointment with an approved civil surgeon.

If, however, you initially submitted an unexpired I-693 but USCIS has lost your documents, it may just be easier to get another medical examination completed.

USCIS will not accept a copy of the original medical exam.

If the civil surgeon made a mistake on the medical exam, you will likely be required to get this corrected or resubmit a new medical examination.

In most cases, once the civil surgeon corrects their mistake your case should continue to be processed as usual.

Lastly, if the I-693 was not signed by the civil surgeon you are likely to receive an RFE I-693. This is something that you wouldn’t notice since the medical exam results are always sealed. If this happens, you’ll need to redo the medical exam as well.

Calling USCIS Customer Service For More Info.

Sometimes the RFE I-693 isn’t clear on why you are getting it or what needs to be submitted. If this is the case for you, call customer service (1-800-375-5283) and see if they can clear some things up.

If you don’t get any useful information from customer service, schedule an infopass with the local field office that may be processing your case.

Case Example:

Toby received an RFE I-693 for his medical examination because there was an error on it. The civil surgeon did not complete it properly so USCIS will not approve the I-485 until a complete medical exam is resubmitted.

Toby decides to see a different civil surgeon to complete the medical exam correctly. He quickly resubmits the new I-693 to USCIS. 

If you are concerned that the civil surgeon that is completing the form could make a mistake, you may ask them to review the documents with you. Some doctors will be willing to allow you to review what was written before sealing the document.

Final Thoughts On RFE I-693 For I-485

The medical examination is pretty straightforward. Be sure to bring your vaccination records as well as medical history details.

You will be required to submit to an X-ray and possibility blood work.

If your vaccination records are incomplete, you will be asked to get these shots at your own expense. Once the medical exam is complete, you will receive a sealed envelope that says “do not open”,

This is what you need to submit with your adjustment of status and should be unexpired when you send it off.

For those of you who have had your I-693 complete overseas, try to submit the I-485 adjustment of status within one year of this medical exam. If it’s been longer than one year, it’s best to complete the medical exam again inside the U.S. and send a brand new report to USCIS.

At the end of the day, it’s your responsibility to know when your medical exam expires. So to avoid further delays, keep track of when this form was completed and when you’ll be required to resubmit the medical exam.

Have you received an RFE I-693 medical exam? How did you respond to it? Was your adjustment of status approved after responding?


  1. Jorge

    I do have this situation right now, I just respond and send the package with the RFE i693 to USCIS and they will get it by Monday Jun 24th. My question, dose anyone know about how long the USCIS will take to approve my adjustment of status after I submit the RFE? when should I expect my Green Card?

  2. Hi Jorge! That is a million dollar question! Usually after submitting the RFE, it can take several more months. Each service center differs with respect to how long it will take to process and approve your green card. Good luck!

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