May Need a New Medical Exam If the Civil Surgeon is No Longer Listed

This is a situation where the reviewing officer’s discretion plays a significant role. USCIS has a tool on its website that lists all the civil surgeons in the US who are authorized to complete the I-693 medical exam. Applicants would go to the online tool, search for a civil surgeon near where they live, set up an appointment, and complete the medical exam. The sealed medical exam report (I-693) will then be submitted to USCIS as part of the Green Card application package.

When adjudicating the I-693, the reviewing officer also checks the same tool. The problem here is that sometimes the civil surgeon who was authorized and listed on the USCIS website during medical exam completion may have left his practice and is no longer listed on USCIS’s website at the time of adjudication. So then, is the completed medical exam considered valid?

The policy manual states the following:

“The physician must be designated as a civil surgeon at the time of the completion of the medical examination.”

https://www.uscis.gov/policy-manual/volume-8-part-b-chapter-4

The focus therefore should be on whether the civil surgeon was authorized at the time of completing the medical exam.

However, the same policy manual also gives wide discretionary power to the officer to request a new exam at any time, stating:

“If an officer reviewing Form I-693 has a concern about the sufficiency of an immigration medical examination performed by a physician who was designated at the time of the medical exam but subsequently had his or her designation revoked, the officer may reorder the medical exam to be performed by a civil surgeon to address the concern.”

https://www.uscis.gov/policy-manual/volume-8-part-b-chapter-4

To be clear, the officer does not have to reveal what the concern was when reordering a new medical exam as shown in the sample RFE below. In practice, they may ask for a new I-693 without cause based solely on not finding your civil surgeon on their website.

In conclusion, if your civil surgeon notifies you about his/her retirement, there’s a chance that you may be requested to do a new medical exam. You may consider getting a new medical exam and just send it even before getting an RFE. But keep in mind that in addition to incurring additional cost, the new medical exam may not be linked to your green card application as documents filed without the RFE notice often get misplaced. The prudent approach is to wait for an RFE to arrive first.