USCIS has updated how it treats Form I-693 (Report of Immigration Medical Examination and Vaccination Record). Two separate shifts matter for applicants and practitioners: (1) USCIS permanently removed the previous “60-day rule” requiring that a civil surgeon’s signature be dated no more than 60 days before filing the underlying benefit application, and (2) in June 2025 USCIS revised its validity rules for I-693s signed on or after November 1, 2023 and announced a new edition requirement in mid-2025.
What practitioners should know in plain terms: USCIS removed the 60-day signature limit in 2023, which eased timing pressures on applicants and civil surgeons and reduced RFEs tied only to the timing of the signature. That change remains in force and is the reason many clinics stopped insisting on the 60-day window.
Then, effective June 11, 2025, USCIS clarified that any Form I-693 signed by a civil surgeon on or after November 1, 2023 is only valid while the underlying application (most commonly Form I-485) with which it was submitted remains pending; if that underlying application is withdrawn or denied, the I-693 tied to it is no longer valid and a new medical will normally be required for a later filing. USCIS also issued an edition requirement (the 01/20/2025 edition becomes mandatory starting July 3, 2025). These are operationally important: they mean you must track signature dates, edition dates, and the status of the related application to know whether a previously completed I-693 remains usable.
For forms signed before November 1, 2023, USCIS guidance and practitioner summaries indicate the older two-year practical validity rule continues to apply (counting from the civil surgeon’s signature date), so verify the signature date on the form. Always confirm the edition/date printed on the form and whether USCIS is still accepting that edition at filing.
By Brian D. Lerner — Practical summary of USCIS policy updates affecting Form I-693 timing, validity, and edition requirements (2023–2025).
Quick reference — I-693 timing & edition rules
| Rule / date | What it means | Action for clinic / counsel |
|---|---|---|
| 60-day rule removed (March 31, 2023) | Civil surgeons no longer must date the signature within 60 days of filing. | Clinics can stop scheduling strictly around a 60-day window, but still note signature dates in client files. |
| Forms signed on/after Nov 1, 2023 | Valid only while the related application is pending (effective June 11, 2025); invalid if underlying application withdrawn/denied. | Track underlying application status; if I-485 is denied/withdrawn, expect to order a new medical for any later filing. |
| Form edition requirement — Jan 20, 2025 edition | USCIS will require the 01/20/2025 edition beginning July 3, 2025 (older editions accepted only until that date). | Use the correct edition on or after July 3, 2025; clinics should stock the current edition and note edition/date on each completed form. |
| Forms signed before Nov 1, 2023 | Practitioner guidance treats many of these as valid for two years from signature, but verify on a case-by-case basis. | Confirm signature date and edition; document the two-year window in the client file if applicable. |
Intake & triage checklist
- Record civil surgeon signature date and the printed edition date on Form I-693 immediately when you receive it.
- Note the underlying application type and receipt number (usually Form I-485) and track its adjudication status.
- If an I-693 is signed on/after Nov 1, 2023, flag the file: it will be invalid if the associated I-485 is later withdrawn or denied.
- If the underlying application is denied or withdrawn, schedule a new medical exam using the current accepted edition before refiling or advise client about timing and costs.
- If filing near or after July 3, 2025, confirm you are using the 01/20/2025 edition; do not submit older editions after that date.
- Keep the sealed I-693 envelope (if applicable) and scan a front/back copy; log the civil surgeon’s name and clinic contact for verification if USCIS questions the form.
Frequently asked questions
Does the 60-day rule still apply?
No — USCIS permanently removed the 60-day signature requirement in 2023, so civil surgeons do not need to date signatures within 60 days of filing. The removal reduced routine RFEs tied solely to signature timing.
If my I-693 was signed after Nov 1, 2023, is it valid forever?
No. For I-693 forms signed on or after Nov 1, 2023, USCIS has said the form is valid