I-485 filings must include the medical exam (Form I-693) up front; June 2025 update tied each I-693 to a specific application

Since December 2, 2024, most adjustment-of-status applicants must include a completed Form I-693 (medical exam) with their initial I-485 submission. A June 11, 2025 USCIS policy update further tied each I-693 to the specific application it was filed with — submissions for prior or future I-485s are no longer reusable.

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On December 2, 2024, USCIS began requiring most adjustment-of-status applicants to file Form I-693 (Report of Immigration Medical Examination and Vaccination Record) at the same time as the I-485, rather than later in the process. The I-693 must be signed by a USCIS-designated civil surgeon.

A June 11, 2025 update narrowed the rule further: each I-693 is now valid only for the specific I-485 it was filed with. A medical exam submitted with a prior I-485 (later denied or withdrawn) is no longer reusable for a subsequent I-485 filing.

Separately, USCIS now requires separate payments for each form filed concurrently. A single combined check covering an I-485, I-765, and I-131 package will cause the entire package to be rejected. Each form needs its own payment.

Why it matters here

These are two of the most common reasons CasePredictor users see their I-485 packages rejected and have to refile — which resets the receipt-date clock and pushes their predicted decision window forward by months. The I-485 form page now lists both rules in the 'Common rejection reasons' FAQ.

I-485 filings must include the medical exam (Form I-693) up front; June 2025 update tied each I-693 to a specific application

Why it matters here

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