In order to complete the application process for a U.S. green card (lawful permanent residence), you must undergo a medical examination. The purpose is to ensure that you are not inadmissible to the U.S. on public health grounds; in other words, that you don't have a communicable disease or other condition that would impact U.S. health or safety.
However, you cannot simply undergo a medical examination with your regular doctor. Instead, a civil surgeon who has been specially designated by the relevant U.S. immigration authorities must perform the required medical examination. The civil surgeons who are qualified to perform green card medical examinations receive special, ongoing training about immigration issues.
This article will detail how to find such a doctor, and what the doctor will do for you in furtherance of your goal of immigrating to the United States.
Finding a Physician or Civil Surgeon Authorized to Do Immigration Medical Exams
If you are applying for your green card from overseas, through a U.S. consulate or embassy, the consulate will supply you with a list of authorized "panel physicians" not long before you go in for your visa interview. Or, you might be able to access the list through the website of the consulate you'll be visiting.
If you are applying for your green card from within the United States, otherwise known as "adjusting status" (a process that's mostly open only to foreign nationals who are lawfully in the U.S.), you can access the list of qualified civil surgeons from U.S. Citizenship and Immigration Services (USCIS). The easiest way is probably by checking the USCIS Find a Doctor page. Or, you can call the USCIS Contact Center at 800-375-5283.
What to Bring to the Immigration Medical Examination
In preparation for the medical examination, you should gather the following:
- Your valid, unexpired government-issued identity, such as a passport, driver's license, laissez-passer, or other travel document.
- The physician's fee (which varies by doctor; in the U.S., it's usually between $130 and $450). Insurance coverage might also be a possibility if you're in the United States; bring your insurance card along, in case.
- A list of what vaccinations you have already had.
- If you're assisting someone in your immigrating family who has mental retardation or learning disabilities, a report of their condition and any special educational or supervision requirements.
- If you've had a previous positive skin test for tuberculosis (TB), a certificate from your doctor giving the circumstances of the positive test result, indicating any treatment prescribed and how long it lasted. If you have ever been diagnosed with TB, you must present a written certification, signed by your doctor, proving that you were adequately treated. The certificate must include dates and types of medications you took. If you have ever had an abnormal chest X-ray, borrow the last X-ray films taken and bring them to your medical exam. The actual films, not the typed reports, might be required.
- If you have had syphilis, a written certificate, signed by a doctor or public health official, proving that you were adequately treated. If you have ever had a positive VDRL or other blood test for syphilis, and were not treated, bring a written explanation signed your doctor.
- If you have any history of harmful or violent behavior resulting in injury to people or animals, or harm to inanimate objects, information that will allow the doctor to determine whether the behavior was related to a psychiatric or medical problem, or to drug or alcohol use. Harmful behavior is considered to include attempted suicide or self-harm, no matter how minor in nature.
- If you have been treated or hospitalized for psychiatric or mental illness, or alcohol or drug abuse, a written certification including the diagnosis, length of treatment, and your prognosis.
- If you are being treated for a chronic medical condition or taking medication on a regular basis, be ready to explain your conditions and give the names of the medications, perhaps by preparing a written list, or a statement prepared by your doctor.
- If you're coming from overseas and interviewing at a U.S. consulate, bring your interview appointment notice, a copy of your "Immigrant Visa and Alien Registration Application" confirmation page, and if the consulate requests, color photographs that meet the State Department's requirements.
- If you're adjusting status in the United States, a copy of Form I-693, Report of Medical Examination and Vaccination Record, with the top part filled in by you.
What the Doctor Will Do at Your Immigration Medical Exam
The doctor will talk with you, review your medical and vaccination history, and give you a physical examination, a chest X-ray, and blood test.
Children under the age of 15 will normally not be given the X-ray or blood tests.
If you are pregnant, you can ask that the X-ray be postponed, though whether this will be allowed depends on which country you are coming from.
During the physical portion of the examination, the doctor will, at a minimum, look at your eyes, ears, nose and throat, extremities, heart, lungs, abdomen, lymph nodes, skin, and external genitalia.
The doctor will also give you any vaccinations that you are lacking, based on a list of required vaccinations. These include:
- COVID-19 (but because this usually requires a series of two, it's best to do elsewhere)
- Hepatitis A and B
- Influenza type b (Hib)
- Meningococcal disease
- Pneumococcal disease
- Tetanus and diphtheria toxoids
What Types of Illnesses or Conditions Can Make You Inadmissible to the United States
You don't need to worry that if you go into your medical examination with, for example, a head cold or an irregular heartbeat, your green card will be denied. In fact, the doctor is expected to examine you only for conditions that are relevant to the immigration process, so don't expect this to be a complete review of your health.
Only certain medical conditions can make you inadmissible to the United States under the Immigration and Nationality Act (I.N.A.), under Sections 212(a) or 8 U.S.C. Section 1182(a) and I.N.A. Section 221(d) or 8 U.S.C. Section 1201(d). These include:
- A communicable diseases of public health significance. A list of these is kept in the Code of Federal Regulations at 42 C.F.R. Section 34.2. and they can be added to by presidential executive order or by the Centers for Disease Control, which keeps a list of quarantinable diseases. The main ones on the list are active tuberculosis, various venereal diseases, and infectious leprosy. COVID-19 or coronavirus has been added to the list of quarantinable diseases. AIDS (HIV) was once on the list, but no longer.
- A physical or mental disorder and a history of behavior associated with the disorder that may pose or has posed a threat to the property, safety, or welfare of the applicant or others.
- A physical or mental disorder and a history or behavior associated with the disorder that may pose or has posed a threat to the property, safety or welfare of the foreign national or others and which behavior is likely to recur or lead to other harmful behavior. (Note that a conviction for driving while under the influence of alcohol has been interpreted to indicate inadmissibility as a medical disorder and associated harmful behavior.)
- Abuse of or addiction to drugs.
Some of these diseases can be cured or overcome, and some grounds of inadmissibility can be waived (legally forgiven). See a lawyer for a full analysis and help with preparing a waiver application.
Submitting the Results of Your Medical Examination to U.S. Immigration Authorities
If you are applying for your green card from overseas, through a U.S. consulate or embassy, the authorized panel physician will either give you the medical examination results to hand-carry to the visa interview or will send the results directly to the U.S. embassy or consulate.
If you are adjusting status, the doctor will complete Form I-693 and give it to you in a sealed envelope. You must then submit the envelope to USCIS, at your green card interview. The envelope will not be accepted unless it remains sealed.
By U.S. government policy, the results of an immigration examination remain valid for up to one year before you file your application for a green card. However, as a temporary measure to deal with COVID-related delays, USCIS has extended the I-693's evidentiary to two years from the date of the physician's signature.