Employees often wonder whether they absolutely must obtain the required sealed medical exam by a certified U.S. Citizenship and Immigration Services doctor prior to filing their adjustment-of-status application. While it is not absolutely required, we strongly recommend “yes” to getting it done before they file their application.

Many are aware that USCIS guidelines allow for the submission of the medical exam after the filing of the adjustment of status. So there is no compelling legal reason that it must be included – except to stave off an eventual request for one, either in a request for evidence (RFE) or at the green card interview. However, there are a number of very practical reasons for ensuring that the medical exam is completed prior to the adjustment-of-status filing.

A primary reason for doing so is to have more lead time to strategize. Certain medical issues can have immigration impacts. A variety of medical issues could potentially trigger USCIS to question, or outright deny, the green card application. One of them could be a previously undiagnosed disease; another could be a missing vaccination. Why be taken by surprise?

Fortunately, if issues are discovered prior to the submission of the adjustment-of-status application, it is possible to mitigate them by delaying the filing. Individuals who object to vaccinations on religious or moral grounds may apply for a waiver of the vaccination requirement for themselves or their children. Similarly, if tuberculosis is diagnosed, there is time to submit a waiver request and receive required treatment.

While the medical form needs to be provided in a sealed envelope, it is also critical to request a copy of the medical form to ensure that there are no surprises. Even for an individual in perfect health, a box left unchecked in haste by the physician could result in another medical examination needing to be done prior to case approval. Similarly, some physicians may not be using the currently accepted version of the form, which can also lead to USCIS rejection.

Applicants sometimes have insufficient time to obtain a medical examination prior to filing the application. Every month there are certain applications that need to be filed before the end of that month. The priority dates change on a monthly basis, and since the exam can only be done by a doctor approved by USCIS, and vaccination histories must be collected prior to the appointment, there may not be enough time to complete the exam process. If follow-up tests are needed, results could be delayed further. Accordingly, for truly urgent situations, when someone is quite sure they are fully caught up on all medical issues, it might be possible to file without a medical exam.

As noted above, BAL recommends that employees obtain the medical exam in time to file it with the adjustment-of-status application. However, for urgent situations BAL can review submitting without on a case-by-case basis.

The information contained here is meant to be informational, and while BAL has made every effort to ensure the accuracy of the information, it is not promised or guaranteed to be complete. Readers of this information should not act upon any information contained on this alert/blog without seeking professional counsel. This alert does not constitute legal advice or create an attorney-client relationship. Any reference to prior results, does not imply or guarantee similar future outcomes.