I-693 Expiration and Validity: What the 2025 Rule Changes Mean

If you're adjusting status in the United States, you've probably searched for how long your medical exam is valid — and found contradictory answers. That's because the validity rules for Form I-693 went through multiple revisions in 2024 and 2025, with each change superseding the last. What was true in 2023 is not true today.

This is the current state of the rules as of mid-2026, including the key policy update that took effect June 11, 2025.

The Old Rule vs. The Current Rule

Before November 2023, Form I-693 was valid for two years after the civil surgeon signed it — provided the I-485 was filed within 60 days of signing and the exam was submitted to USCIS within that two-year window.

USCIS then experimented with indefinite validity for exams signed on or after November 1, 2023 — but that policy was walked back. The June 2025 update established the current framework:

Form I-693 is valid only for the specific I-485 application it accompanies. It does not have an independent validity window that floats based on the signing date.

Here's what this means in practice:

• If your I-485 is approved, the I-693 has served its purpose and is no longer relevant.
• If your I-485 is denied or withdrawn, the I-693 is void. You cannot reuse it for a new I-485 filing — you must redo the exam.
• If your I-485 remains pending and the exam results are still clinically current, the I-693 stays valid for the life of that pending application.

The 60-Day Signing Window

The civil surgeon must sign Form I-693 no more than 60 days before you file the I-485. This rule predates the 2025 changes and remains in effect.

If you have your civil surgeon appointment and then wait several months before filing your I-485, you may find that the I-693 signature date falls outside the 60-day window. At that point, USCIS can reject your I-485 package or issue a Request for Evidence (RFE) asking for a new medical.

The timing sequence is:

1. Civil surgeon completes and signs Form I-693
2. You file I-485 within 60 days of the signing date
3. Both are submitted concurrently in the same package

Concurrent Filing Requirement

As of December 2, 2024, applicants are generally required to submit the sealed I-693 at the same time as the I-485 — not separately, not after biometrics, not held for an interview. If you file the I-485 without the sealed I-693, USCIS may reject the package or issue an RFE requiring you to submit the medical within a fixed response window.

There are limited exceptions to concurrent filing — notably for certain visa categories where the medical examination process works differently — but for standard family-based and employment-based adjustment of status applications, concurrent submission is the default expectation.

The Sealed Envelope Rule

The civil surgeon places the completed I-693 in a sealed envelope that they sign across the seal. You submit this sealed envelope to USCIS with your I-485 package. If you open the envelope — even to check whether something was filled out correctly — the I-693 is invalidated. USCIS treats an opened envelope as a compromised exam.

If you're concerned about the contents, ask the civil surgeon to show you the completed form before they seal it. They're permitted to let you review it; they just cannot give you an unsealed copy to take home.

Form Edition Requirement

USCIS also updated the required edition of Form I-693. The edition dated 01/20/25 became mandatory on July 3, 2025. Any I-693 completed on an older edition and submitted after that date is rejected.

Before your civil surgeon appointment, confirm that the clinic uses the current form edition. Established immigration medical clinics update their forms promptly, but smaller or less active civil surgeons may have outdated templates. The current form is always available at uscis.gov/i-693.

What Happens When an I-485 Is Pending Beyond the Exam Date

Under the old rule, there was a two-year validity clock running from the exam signing date. Under the current rule, there's no standalone expiration — but this creates a different problem.

If your application is still pending after 12–18 months, USCIS may determine that the medical results are no longer clinically current and request an updated exam anyway. This isn't governed by the I-693 validity rule per se — it's a discretionary decision by the adjudicating officer. In practice, exams older than 24 months often trigger this kind of request, particularly if there are long processing queues.

USCIS can also request a new medical exam at any point during adjudication if they have reason to believe your health circumstances have changed.

Practical Planning: What to Do With This Information

Don't rush the exam. Scheduling your civil surgeon appointment too early — months before you're ready to file the I-485 — creates signing date problems. Book the appointment once your I-485 package is substantially ready, target filing within 4–6 weeks of the exam, and submit concurrently.

Don't delay the filing after the exam. The 60-day window from signing to I-485 filing is firm. Once you have the sealed envelope, don't sit on it.

Keep the envelope sealed. File it exactly as received. If you need to verify form completion, do that review at the civil surgeon's office before they seal it.

If your I-485 is denied or withdrawn, budget for a new exam. The I-693 cannot be recycled. If you're in a situation where denial is possible (visa category backlog, pending RFE, etc.), plan financially for the possibility of a repeat exam.

COVID-19 is no longer part of the exam. The COVID-19 vaccination requirement was removed on January 20, 2025. Civil surgeons do not need to document COVID vaccination on Form I-693.

Multi-Person Filings

For concurrent I-485 filings in a family — primary applicant plus derivatives — each person needs their own I-693 from a civil surgeon. The validity rules apply independently to each person's form. All sealed envelopes must be submitted together with the family's I-485 package.

If one family member's exam is outside the 60-day window while others are within it, only that person needs to redo the exam. The rest of the package is not affected.

The Immigration Medical Exam Preparation Guide walks through the complete I-693 filing sequence — from booking the civil surgeon appointment to concurrent I-485 submission — with a checklist to verify your timing before you file.