Purpose U.S. Citizenship and Immigration Services (USCIS) is issuing policy guidance in the USCIS Policy Manual to remove the requirement that the civil surgeon’s signature on the Report of Immigration Medical Examination and Vaccination Record (Form I-693) be dated no more than 60 days before an applicant files the application for the underlying immigration benefit. Background In general, noncitizens applying for certain immigration benefits while in the United States must use Form I-693 to show they are free from any conditions that would render them inadmissible under the health-related grounds.1 Currently, USCIS considers a completed Form I-693 to retain its evidentiary value for 2 years after the date the civil surgeon signed the form, as long as the date of the civil surgeon’s signature is no more than 60 days before the applicant filed the application for the underlying immigration benefit. This is commonly referred to as the “60-day rule.” Due to the COVID-19 pandemic and ongoing related processing delays, USCIS has experienced delays in all aspects of operations. Applicants have also experienced difficulties beyond their control, including delays with completing the immigration medical examination. In response, USCIS has temporarily waived the requirement that the civil surgeon sign Form I-693 no more than 60 days before the applicant files the underlying application since December 9, 2021. USCIS is now removing this requirement permanently. Applicants, civil surgeons, USCIS officers, federal partners, and other stakeholders have consistently expressed concern that this requirement is confusing and necessitates Requests for Evidence (RFEs) to be issued for otherwise valid Forms I693. While the 60-day rule was intended to enhance operational efficiency and reduce the need to request updated Forms I-693 from applicants, in practice these efficiencies have not been realized.2 This guidance, contained in Volume 8 of the Policy Manual, is effective immediately and applies to all Forms I-693 associated with applications for underlying immigration benefits pending as of 1 See INA 232 and 8 CFR 232 (immigration medical examination). See INA 212(a)(1) (health-related grounds of inadmissibility). 2 See Validity of Report of Medical Examination and Vaccination Record (Form I-693), PA-2018-09, issued October 16, 2018. To provide feedback on this update, email USCIS at policyfeedback@uscis.dhs.gov. PA-2023-11: Removal of “60-Day Rule” for Report of Immigration Medical Examination and Vaccination Record (Form I-693) Page: 2 March 31, 2023, regardless of when the application was filed or when the civil surgeon signed Form I-693. The guidance contained in the Policy Manual is controlling and supersedes any related prior guidance. Policy Highlights • Removes the requirement that the civil surgeon’s signature on Form I-693 be dated no more than 60 days before the applicant files the underlying immigration benefit application. • Clarifies that officers should review Form I-693 for compliance with the procedures and requirements outlined in the Technical Instructions for Civil Surgeons that were in effect as of the date of the civil surgeon’s signature unless otherwise specified by the Centers for Disease Control and Prevention. Officers should not issue an RFE for the applicant to meet the requirements that did not apply as of the date the civil surgeon signed the Form I-693. • Clarifies the process for the civil surgeon and the applicant when responding to a Form I-693- related RFE. Summary of Changes Affected Section: Volume 8 > Part B > Chapter 4, Review of Medical Examination Documentation • In Section A (Results of the Medical Examination), revises paragraphs under “Panel Physicians” and “Civil Surgeons” italicized subheadings. • In Section B (Documentation Completed by Panel Physician), removes second paragraph. • Revises Section C (Documentation Completed by Civil Surgeon) throughout, including, but not limited to: o Revising existing content, including adding new content in Subsection 2 (Complete Form). o Making minor edits throughout Subsection 3 (Signatures), and adding a new paragraph at the end of this subsection. o Renaming Subsection 4 as “Form I-693 Validity and Evidentiary Value,” removing alert box and revising subsection content. USCIS may also make other minor technical, stylistic, and conforming changes consistent with this update. Citation Volume 8: Admissibility, Part B, Health-Related Grounds of Inadmissibility, Chapter 4, Review of Medical Examination Documentation [8 USCIS-PM B.4]