If you’re in the middle of applying for a green card right now, I’ve got some news that’s going to sting. USCIS just pulled a policy reversal that nobody saw coming, and it’s going to hit thousands of immigrants right in the wallet.
What Just Happened?
As we kick off 2026, USCIS is completely rewriting the rulebook on medical examinations for green card applications. And by rewriting, I mean they’re literally invalidating medical forms that were perfectly valid just yesterday.
Here’s the deal: Every single person filing for adjustment of status now needs a brand-new I-693 medical examination form. Doesn’t matter if you just got yours done last month. Doesn’t matter if your form was supposed to be good indefinitely under the 2024 rules. If you’re filing now, you need a fresh exam.
The Whiplash-Inducing Timeline
Let me paint you a picture of how crazy this timeline is. Back in April 2024—less than two years ago—USCIS said, “Hey, good news everyone! If your civil surgeon signed your I-693 form after November 1, 2023, you can use it indefinitely. No expiration date. Keep it safe, use it whenever.”
Immigration lawyers breathed a sigh of relief. Applicants saved money. Everyone was happy.
Fast forward to today, and USCIS basically said, “Remember that thing we told you? Yeah, forget all of it.”
The new policy takes effect June 11, 2025, which means by now—January 2026—thousands of applicants have already been caught in this mess. And the confusion is still rippling through the immigration community.
Why Immigration Attorneys Are Losing Sleep
Matt Cameron, an immigration attorney who’s been vocal about this change, pointed out something that’s got legal professionals particularly worried: there was no transition period.
In the past, when USCIS changed the rules, they’d give everyone a heads-up. Maybe a 30-day grace period, maybe 60 days. Time for people to adjust, to prepare, to not get completely blindsided.
Not this time. Applications that were mailed before the announcement but arrived after June 11, 2025? Invalid. Forms that were perfectly acceptable when you paid for them? Now worthless.
Cameron told reporters last year that thousands of Form I-485 applications were being affected. Now, months later, we’re seeing the real impact: families scrambling to redo exams, budgets blown, and application timelines completely derailed.
The Money Problem
Let’s talk dollars and cents, because this isn’t just an inconvenience—it’s expensive.
The I-693 medical examination isn’t something you can do at your regular doctor’s office. You need to see a civil surgeon approved by USCIS. These doctors check for communicable diseases, review your vaccination records, and basically determine if you’re medically admissible to the United States.
The cost? Anywhere from $100 to $500, depending on where you live and which civil surgeon you see. Some urban areas, especially places like New York, San Francisco, and Los Angeles, lean toward the higher end of that range. And with inflation continuing to bite in 2026, some civil surgeons have quietly raised their fees even higher.
For families applying together, multiply that by every family member. A family of four could be looking at $2,000 or more in medical exam costs alone—money that many immigrants simply don’t have lying around.
What Happens If You Withdraw Your Application?
Here’s another kick in the teeth: Under the current policy, if you withdraw your green card application for any reason, your I-693 form becomes invalid. Immediately.
Let’s say you made a mistake on your application and need to withdraw it to fix something. Or maybe your circumstances changed and you need to refile under a different category. Too bad. Your medical exam? Worthless. You’ll need to pay for another one.
This is particularly harsh because immigration applications are complex. Mistakes happen. Sometimes applicants realize they need to switch strategies halfway through. Previously, at least they could keep their medical exam and reuse it. Not anymore.
The Bigger Immigration Mess in 2026
This medical exam fiasco isn’t happening in a vacuum. It’s part of a broader pattern of immigration processing challenges that continue to make life miserable for applicants heading into 2026.
The Department of Labor—which handles labor certifications for certain work visas—dealt with significant delays throughout 2025 due to federal government disruptions. Some visa applicants spent months, even over a year, stuck in limbo because of these backlogs.
Processing times across the board have gotten worse. What used to take 8-12 months is now stretching to 18-24 months for many adjustment of status applications. USCIS offices are understaffed, and the backlog keeps growing.
And if you think it’s bad in the U.S., look north. Canada’s immigration system is still drowning in backlogs, with some humanitarian and economic immigration streams facing wait times that stretch into decades. Yes, decades.
What Does the I-693 Actually Check?
For those wondering what exactly you’re paying for with this medical exam, here’s what civil surgeons look for:
Communicable diseases of public health significance: Things like tuberculosis, syphilis, gonorrhea, and Hansen’s disease (leprosy). Post-COVID, some civil surgeons are also more thorough about respiratory screenings.
Vaccination records: You need to be up to date on vaccines for measles, mumps, rubella, polio, tetanus, pertussis, hepatitis A and B, influenza, rotavirus, meningococcus, varicella, and pneumococcus. Missing vaccines? You’ll need to get them before the exam is complete.
Physical or mental disorders with harmful behavior: Conditions that might pose a danger to others.
Drug abuse or addiction: Current substance abuse can make you inadmissible.
The exam itself usually takes about an hour, though you might need to schedule follow-up appointments if you need additional vaccinations or tests. Some civil surgeons are booking out 4-6 weeks now, so plan accordingly.
What Should You Do Now in 2026?
If you’re in the middle of applying for a green card right now, here’s my honest advice:
Don’t panic, but don’t wait either. If you have an old I-693 form from 2024 or early 2025 and you’re planning to file, know that it won’t work anymore. Budget for a new medical exam.
Talk to an immigration attorney. Yes, they cost money, but so does having your application rejected. A good lawyer can help you navigate this mess and avoid costly mistakes. With Trump back in office and immigration policy changing rapidly, legal guidance is more important than ever.
Get your medical exam done close to filing time. Don’t get it done months in advance “just in case.” Get it done when you’re actually ready to submit your application, ideally within 30-60 days of filing, so there’s less chance of policy changes catching you off guard.
Keep copies of everything. USCIS has a history of losing documents. Keep digital and physical copies of your medical exam, receipts, and all correspondence. Seriously, scan everything.
Book your civil surgeon appointment ASAP. Many civil surgeons are now booked weeks in advance. Don’t wait until the last minute to schedule.
The Trust Problem
Here’s what really bothers me about this whole situation: It erodes trust in the system.
When USCIS tells people, “Your form is good indefinitely,” people make plans based on that. They budget their money accordingly. They time their applications around that promise.
Then, less than two years later, USCIS yanks that promise away without warning. How are immigrants supposed to plan their lives when the rules can change overnight?
Immigration is already stressful enough. The applications are confusing. The wait times are long. The costs add up quickly. Adding sudden, unexplained policy reversals to the mix just makes everything harder.
And let’s be real—this is happening at a time when immigration policy overall is becoming more restrictive. The political climate in 2026 isn’t exactly welcoming. Every additional hurdle feels like another message: “We don’t really want you here.”
What We’re Hearing from the Ground
I’ve been following immigration forums and Facebook groups where applicants share their experiences. The frustration is real:
One applicant from India spent $350 on a medical exam in March 2025, only to have her application delayed for other reasons. By the time she was ready to file in August, her exam was worthless. She had to pay another $375 for a new one.
A family of three from the Philippines had to redo all their exams—$1,200 total—after their attorney advised them to withdraw and refile their application due to a documentation issue.
A software engineer on an H-1B visa told me he’s been “green card ready” for two years but keeps hitting bureaucratic roadblocks. The medical exam policy change was just the latest in a series of setbacks that have cost him thousands of extra dollars.
These aren’t just statistics. These are real people, real families, real dreams being put on hold.
Looking Ahead
Will USCIS reverse course again? Who knows. The agency hasn’t provided a clear explanation for why they made this change in the first place, and given the current political climate, I wouldn’t hold my breath waiting for them to become more lenient.
What we do know is that thousands of green card applicants continue to scramble, adjusting their plans and their budgets. Immigration attorneys are working overtime to help their clients navigate this curveball. And families dreaming of permanent residency in the United States have yet another obstacle thrown in their path.
As we move through 2026, expect immigration policy to remain unpredictable. Stay informed, stay flexible, and if possible, work with professionals who can help you adapt to whatever comes next.
If you’re going through this process right now, I genuinely wish you the best of luck. Stay informed, stay organized, and remember—you’re not alone in finding this frustrating. Thousands of people are in the same boat, and somehow, we all keep pushing forward.
