If you’re preparing for immigration with U.S. Citizenship and Immigration Services (USCIS), one of the most common questions is: How long is the medical exam documented on Form I-693 valid? The answer has changed recently — and understanding the rules can save you from unneeded re-exams or delays. Here’s what you need to know.
A Short History: I-693 Validity Rules Over Time
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Before 2018, I-693 validity was more restrictive: in many cases the form had to be submitted quickly after the civil-surgeon’s signature. (USCIS)
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As of November 1, 2018, new rules took effect: normally, a properly completed I-693 signed by a civil-surgeon remained valid for two years from the date of signature. This applies when used for immigration benefit applications such as adjustment of status (e.g. filing Form I-485).
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On March 31, 2023, USCIS removed the requirement that the civil-surgeon signature be within 60 days of the benefit application filing — which had caused confusion. Now the 2-year validity from signature became the standard for properly completed forms. (USCIS)
The Latest (2025) — What Has Changed (Again)
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According to USCIS’s April 2024 update: for any I-693 signed on or after November 1, 2023, the form “does not expire” — meaning its evidentiary value no longer has a fixed expiration date. (USCIS)
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However, this indefinite-validity policy was modified as of June 11, 2025. Under the current guidance, an I-693 signed on or after November 1, 2023 is valid only while the associated immigration application remains pending. If that application is denied or withdrawn, the I-693 becomes invalid and cannot be reused for a new application. (USCIS)
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For I-693 forms signed before November 1, 2023, the older rule still applies: they remain valid for 2 years from the date the civil-surgeon signed the form, unless USCIS requests new evidence (for example — if there are concerns about a change in health status). (USCIS)
What This Means for Applicants:
1) I-693 Signed Before Nov 1, 2023
- Generally valid for 2 years from the civil surgeon’s signature (USCIS)
- Might still be valid (if within 2 years and no change of health)
2) I-693 Signed On or After Nov 1, 2023
- Valid only while the associated immigration application is pending — becomes invalid if the application is denied or withdrawn. (USCIS)
- Not valid — new medical exam + I-693 required
Implications:
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Even if your I-693 is “recent,” if your application was denied or withdrawn, you’ll likely need a new exam if you re-apply.
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If you had your medical done recently (on or after Nov 1, 2023), you should submit it with your application as soon as possible, because it only remains valid while that application is pending.
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Always ensure the form is correctly completed, signed, and sealed by a designated civil surgeon — errors or incomplete forms may prompt the agency to require a new exam regardless of the signature date. (USCIS)
Advice for Applicants — and for Clinics Performing I-693 Exams
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Schedule the I-693 close to the time you’re ready to file the immigration application. If you do it too early (especially now under the “while-pending” rule), you risk having the exam become invalid if your case is delayed or re-filed.
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Maintain the sealed envelope until you submit it. The sealed envelope is required for submission to USCIS, and opening or altering it may cause rejection. (USCIS)
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If your application was denied or withdrawn, plan for a new exam. Under current rules, you generally cannot re-use a prior I-693.
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Stay updated on USCIS policy — changes may occur. As seen recently (2023–2025), rules can shift. Clinics should track these updates and inform clients accordingly.
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For clinics like ours: make it clear to patients whether their exam will support a first-time filing, or may need repeating depending on application outcome — transparency helps avoid confusion or extra costs.
The validity of I-693 has evolved over time. As of now (2025), the “valid while pending” rule applies to I-693 forms signed on or after November 1, 2023; older forms continue under the 2-year rule. This underscores the importance of timing your exam appropriately, keeping forms sealed, and verifying eligibility — especially if you anticipate possible delays, denials, or re-filings.
If you have any questions about preparing for the medical exam, scheduling at our clinic, or how these rules affect your immigration application — we’re here to help.