Should I Submit the Medical Exam with My Employment-Based I-485 Filing?

We are thrilled that dozens of our clients can file the I-485 application for adjustment of status as of October 1, even though the priority date is not yet current (see this post).

Many of our clients are wondering if they should submit the medical exam now, or wait until they receive an RFE for it. We cannot make this decision for the client; every person must decide for themselves how they want to handle this. However, we can outline some of the pros and cons of each option:

If you submit the medical exam now with your I-485 filing:

  1. The current USCIS policy is that the medical exam is valid for one year. Therefore it is entirely possible that the exam would expire before the priority date actually becomes current (and therefore before the time USCIS is ready to approve your I-485 application). If that happens, USCIS would issue an RFE asking for an updated medical exam, which you would need to submit.
  2. On the other hand, it’s possible, depending on the case, that the priority date would become current before the medical exam expires. If that happens, it’s possible USCIS would approve the case right away, without having to issue the RFE for the updated medical exam (though they could issue an RFE for another reason).

If you do not submit the medical exam with the I-485 filing now:

  1. There is a chance that USCIS would erroneously reject your application because it does not contain the medical exams. This should not happen; USCIS should accept the filing even without the exam, and should just send an RFE asking for it later. However, we cannot control erroneous rejections. If the “filing date” priority dates retrogress, it may mean you do not have the opportunity to simply re-submit with the medical exam. Again, this should not happen, but we cannot make guarantees that it would not.
  2. If you chose to not complete the medical exam now, but rather to wait for the RFE asking for it, you could save yourself from having to have two medicals done (see appoint 1 in the section above).
  3. On the other hand, if the priority dates becomes current and the medial exam is still valid, USCIS could possibly approve the application without delay (though they could issue an RFE for another issue, such as confirming the original job offer is still valid). But if you have not yet submitted the medical exam and the priority date becomes current, you will receive an RFE for the medical and will have to submit that before USCIS can approve the case. If the priority date retrogresses between the time you receive the RFE and the time that you submit the medical and USCIS gets around to your case again, your case will be put back in the queue until the priority date becomes current again. In other words, you could miss a narrow window of opportunity to have the case approved for lack of a valid medical exam (this could still happen even if you submit a medical exam with the initial filing; that exam could expire before the priority date is current in which case you would need to obtain a new medical anyway).

As outlined above, there is no clear answer as to the best option to take regarding when to submit the medical exam. The above information is for educational purposes only and cannot be relied on as legal advice. It is ultimately your decision as to when to submit the medical exam.

Do you need assistance with an employment-based AOS (I-485) filing, or other employment-based or family-based immigration matter? Please contact our office 804-396-3412 or We look forward to hearing from you!