What Happens After Your Immigration Medical Exam?

For many green card applicants, the immigration medical exam feels like a big hurdle. You gather documents, come to your appointment, complete lab work, and meet with the civil surgeon. Then the visit ends and a new question shows up: what actually happens after the exam is done?

At Baron Medical Group in Los Angeles, Dr. Daesoon Leem, a USCIS-designated civil surgeon, has completed thousands of I-693 exams. Our team sees the same concerns again and again: how long it takes to get results, what the sealed envelope is for, when to worry, and what to do if something goes wrong.

This guide explains what typically happens after your immigration medical exam, how your sealed I-693 is used in your green card case, and how to avoid the most common post-exam problems so your case can move forward smoothly.

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What Your Civil Surgeon Does After the Exam

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How your I-693 is filled out, signed, and sealed

Once your in-office examination and required lab tests are complete, your civil surgeon moves into the paperwork phase. At Baron Medical Group, this usually includes:

• Reviewing your medical history, exam findings, and vaccination records
• Confirming all required lab results are back and correctly documented
• Completing every relevant section of Form I-693, including the vaccination record
• Signing and dating the form as a USCIS-authorized civil surgeon

After that, the clinic must prepare a sealed I-693 packet. This is the envelope you are told never to open. It is sealed because USCIS wants to know that the contents have not been changed after the civil surgeon signs off.

In our office, you receive:

• One sealed envelope for USCIS use only
• A photocopy of the I-693 and your lab results for your own records

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Typical turnaround times in Los Angeles clinics

Turnaround time depends on lab processing and how quickly your case is reviewed. In many Los Angeles practices, results can take anywhere from 5 to 14 days, especially if outside labs or extra vaccines are needed.

At Baron Medical Group, most patients choose between:

• Standard service (typical completion in about 4 to 7 business days after all labs return)
• Premium express service (many cases completed in about 2 to 3 business days once labs are finalized)

These faster processing options can be helpful if you are working with a filing deadline, dealing with a Request for Evidence, or trying to file your I-485 before a visa bulletin date changes.

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How Your Sealed I-693 Is Used in Your Green Card Case

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Submitting with your I-485 vs responding to a USCIS RFE

Today, for most applicants, USCIS expects Form I-693 to be submitted with Form I-485 rather than later in the process. In practice, that means:

• Your immigration attorney or preparer usually wants your sealed I-693 ready before they mail your I-485 package, or very soon after.
• If you file without a medical exam when one is required, your I-485 can now be rejected or significantly delayed instead of just getting a routine RFE.

There are still limited situations where an attorney may advise filing the I-485 first and submitting the medical later, but for most family and employment based cases, planning to file both together is now the safer default.

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Mailing, tracking, and bringing your I-693 to an interview

Once Baron Medical Group gives you your sealed packet, the next step is logistics:

• If filing a new I-485: your attorney or you will place the sealed envelope inside the main application package and send it to the USCIS lockbox address listed in your I-485 instructions.
• If responding to an RFE: the sealed packet is mailed together with the original RFE letter so USCIS can match it to your existing case.
• If instructed to bring it to an interview: you take the sealed envelope to your green card interview and give it directly to the officer.

In every scenario, you should use trackable shipping and keep a copy of your tracking and delivery confirmation. If USCIS later claims it never received your I-693, you will want proof of when and where it was delivered.

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Understanding Your Results and Possible Outcomes

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What it means when everything is normal

The most common outcome is straightforward: your exam is normal, your vaccinations are complete or properly documented, and your lab tests do not show any Class A conditions. In that case:

• The civil surgeon checks the appropriate boxes confirming you are admissible
• Your I-693 simply becomes one part of your green card file at USCIS
• You will not usually receive a separate notice about the medical exam itself

A normal exam does not speed up the rest of your case, but it removes a major source of delay. When the officer is finally ready to review your file, the medical portion should already be complete.

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Class A vs Class B conditions and when follow-up is required

Some findings require extra steps:

• Class A conditions include active, untreated tuberculosis, certain untreated sexually transmitted infections, and some mental health or substance use issues associated with current harmful behavior. These usually need treatment and sometimes a waiver before USCIS can approve your case.
• Class B conditions are health issues that do not make you inadmissible but are noted for follow-up, such as latent tuberculosis infection that is not active.

If your exam uncovers something that affects admissibility, Baron Medical Group will explain your lab results and next steps in simple language. In many cases, completing treatment and documenting it properly allows your case to move forward.

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Common Post-Exam Problems and How to Fix Them

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When the envelope is rejected, damaged, or expired

Even when your medical exam is fine, paperwork issues can cause trouble:

• Opened envelope: if someone opens the sealed packet, USCIS will treat the form as invalid and usually require a completely new exam. Never open the sealed packet yourself.
• Damaged envelope: if the seal is torn or looks tampered with in transit, the officer can refuse it. If this happens, you may need to redo your exam.
• Using the wrong form edition or old signature date: USCIS only accepts specific editions of Form I-693, and the civil surgeon’s signature must meet current validity rules. If your exam is too old or on an outdated form, USCIS may send you an RFE or ask for a new medical.

To reduce this risk, we stay current with USCIS updates, use the latest form version, and confirm your exam timing with you if your case has been pending for a long time.

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Correcting civil surgeon errors and when you need a new medical exam

Sometimes the problem is not your health, but the paperwork. Common issues include:

• Missing entries or unchecked boxes in required sections
• Incorrect vaccination markings or missing explanations
• Mismatched personal information such as date of birth or A-number
• Signatures or dates in the wrong place

If USCIS flags an error that came from the medical side, the first step is to contact the civil surgeon who completed your exam. In many cases, the clinic can:

• Review the issue
• Correct the form
• Re-seal a new packet without repeating the full exam, as long as the original exam is still valid

If your medical has become invalid under current rules, or if it is tied to an application that was denied or withdrawn, you will need a new exam and a new I-693.

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How to Prepare While You Wait for USCIS to Process Your Case

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Documents and records you should keep

Once your sealed packet is in USCIS hands, your main job is preparation and record keeping. You should keep:

• Your personal copy of Form I-693 and lab results
• Receipts from Baron Medical Group, including any vaccination records
• Shipping receipts and tracking numbers showing when USCIS received your packet
• Any emails or letters from your attorney that summarize what was submitted

These documents are useful if there is ever a question about what was sent, or if you move and need to transfer records to a new attorney or doctor.

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Checking case status and when to contact your attorney or USCIS

While you wait for your green card decision, your medical exam usually stays in the background. Still, there are moments when you should check in:

• Use your USCIS receipt number to monitor your case online and confirm that nothing has been rejected.
• If you get an RFE that mentions your medical exam, contact your attorney and our office promptly so we can review what USCIS is asking for.
• If your case has been pending far longer than normal and you are unsure whether your medical is still valid, ask your attorney and, if needed, contact Baron Medical Group to discuss next steps.

The goal is to avoid surprises. A short call or email now is better than discovering a problem months later when visa numbers or family plans are on the line.

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Conclusion

Your immigration medical exam is not just a one-time visit. What happens afterward can affect how smoothly your green card case moves forward. The civil surgeon’s documentation, the way your I-693 is sealed and submitted, and how you respond to any follow-up requests all matter.

The good news is that most applicants complete this step without major issues, especially when they choose an experienced civil surgeon who follows current USCIS guidance. At Baron Medical Group in Los Angeles, we focus on three things:

• Accurate, thorough exams that meet USCIS technical requirements
• Clear communication about your results and what they mean
• Efficient processing, with standard and express options to match your timeline

If you have completed your immigration medical exam with us and still have questions about what happens next, reach out to our team. We can explain your results, help you understand your paperwork, and work with your attorney to support the medical part of your journey to permanent residency.

Note: This article is for general information only and does not replace advice from your immigration attorney or official USCIS guidance.

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