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If you file Form I-485, Application to Register Permanent Residence or Adjust Status, you typically must undergo an immigration medical examination and receive vaccinations against vaccine-preventable diseases. The examination must be done by a doctor who is designated by U.S. Citizenship and Immigration Services. USCIS designates certain doctors (known as civil surgeons) to perform the immigration medical examination required for most green card applicants. The civil surgeon that conducts your medical examination and review of your vaccination records will then prepare a Form I-693 which will serve as evidence of your compliance with this requirement. A NEW USCIS POLICY requires that an applicant for permanent residency submit a completed Form I-693 WITH their Form I-485 application for adjustment of status or the application will be rejected. WHO CAN PERFORM AN IMMIGRATION MEDICAL EXAMINATION AND COMPLETE THE FORM I-693? Immigration medical examinations conducted inside the United States must be performed by a civil surgeon who has been designated by USCIS. (Immigration medical examinations conducted outside the United States must be performed by a panel physician who is authorized by the Department of State.). For more information on immigration medical examination, see Form I-693, Report of Medial Examination and Vaccination Record and USCIS Policy Manual Guidance on Health- Related Grounds of Inadmissibility. HOW CAN I FIND A CIVIL SURGEON IN MY AREA to PERFORM THE MEDICAL EXAMINATION AND COMLETE THE FORM I-693? USCIS has a excellent tool on their website which allows you to search for civil surgeons by location and language spoken, so you can find a designated civil surgeon to complete your medical examination who is not only close to you but speaks your language. Further, you can narrow your search down by gender. This is a really great feature they added as it makes the unpleasant task of going to the doctor much more comfortable when you can pick a doctor in your neighborhood who you can communicate with easily…it’s a trip to the amusement park but it makes the process less uncomfortable. To find a designate civil surgeon in your area use the tool on the top of this webpage. What Exactly is the Examination? The immigration medical examination entails a review of your medical history and a physical examination. The civil surgeon will review your medical history and then perform a basic physical examination. As part of the physical examination the civil surgeon will test for communicable diseases such as tuberculosis, syphilis, and gonorrhea, depending on age, as required by the Centers for Disease Control and Prevention (CDC). After the immigration medical examination, the civil surgeon will complete the Form I-693 and seal the form in an envelope for you to submit to USCIS. They usually stamp the envelope across the fold to ensure the seal is not broken before it is submitted to USCIS. Be careful with the sealed envelope and before you leave the office ensure that it is completely sealed shut. USCIS will not accept the form if the envelope has been opened or altered. It is strongly recommended that you ask the civil surgeon for an extra copy of the completed Form I-693 for your personal records before the civil surgeon seals the original in the envelope. You can review that copy prior to submitting the sealed envelope, so if you notice the civil surgeon made any mistakes (spelling of your name, date of birth, etc.) you can go have it corrected so it will not delay your application. You can find all the details about the Form I-693 on the USCIS website at uscis.gov/i-693. WHAT TO BRING TO YOUR EXAMINATION Bring the following to your medical examination: Vaccination Requirements These Questions and Answers provide basic information about the general vaccination requirements for immigrants (this page does not address the vaccination assessments conducted by panel physicians overseas). For refugees applying for adjustment of status, health department physicians may complete only the vaccination record portion of Form I-693, Report of Medical Examination and Vaccination Record, as blanket-designated civil surgeons. WHAT VACCINATIONS AM I REQUIRED TO GET? Under the immigration laws of the United States, a noncitizen who applies for an immigrant visa abroad, or who seeks to adjust status to that of a lawful permanent resident while in the United States, is required to receive vaccinations to prevent the following diseases: NOTE: If a noncitizen applies for an immigrant visa abroad, that individual has to undergo an immigration medical examination conducted by a panel physician authorized by the U.S. Department of State (DOS). CDC issues separate instructions to panel physicians designated by DOS to conduct immigration medical examinations abroad. For more information about panel physicians, please consult CDC’s and DOS’s websites: Technical Instructions for Panel Physicians | CDC & Medical Examinations FAQs (state.gov). CDC publishes the vaccination requirements and immigration medical examination instructions (including a detailed table listing all required vaccines) at www.cdc.gov/immigrant-refugee-health/hcp/civil-surgeons/index.html. WILL IMMIGRATION FORCE ME TO GET ALL OF THESE VACCINATIONS? No. No Government agency will force you to get any vaccinations. It is your decision whether or not you wish to get vaccinated, however, should you choose not to get the required vaccinations then you will not be admitted to the US as a legal permanent resident–your application will be denied. HOW CAN MY APPLICATION BE DENIED BECAUSE OF VACCINATION RECORDS? Under the Immigration and Nationality Act (INA) section 212(a)(1)(A)(ii), a noncitizen who seeks admission as an immigrant or who seeks adjustment of status to that of a lawful permanent resident, who fails to show proof that they were vaccinated against vaccine-preventable diseases, is inadmissible and therefore ineligible for admission or adjustment of status. LEGAL AUTHORITY FOR IMMIGRATION VACCINATION REQUIREMENTS The legal foundation for this authority is found in Title 8: Aliens and Nationality and Title 42: The Public Health and Welfare of the U.S. Code (USC), and relevant supporting regulations at Title 42 Public Health in the Code of Federal Regulations (CFR). Title 8 of the U.S. Code: Aliens and Nationality Title 42 of the U.S. Code: The Public Health and Welfare Title 42 of the
Conditional Parole Conditional parole is also known as release from custody. This is a separate and distinct process from parole and does not meet the “inspected and paroled” requirement for adjustment eligibility. Evidence of Parole Evidence of parole includes: Special Immigrant Juvenile Status (SIJS) Parole INA § 245(h) states “a special immigrant described in section 1101(a)(27)(J) of this title…such an immigrant shall be deemed, for purposes of subsection (a) [adjustment of status], to have been paroled into the United States.” The Regulations at 8 C.F.R. § 1245.1(a) goes farther, noting that regardless of how they entered the United States, a young person designated a special immigrant juvenile has been paroled: such a person is “deemed, for the purpose of applying the adjustment of status provisions of section 245(a) of the Act, to have been paroled into the United States, regardless of the actual method of entry into the United States” (emphasis added). A Respondent cannot be found inadmissible or removable for being present in the United States without having been paroled when, under the law, he has been deemed to have been paroled. So this would serve as grounds for a motion to terminate removal proceedings if the the respondent is being charged only as inadmissible INA § 212(a)(6)(A)(i). INA §245(h) (h) Application with respect to special immigrants In applying this section to a special immigrant described in section 1101(a)(27)(J) of this title- (1) such an immigrant shall be deemed, for purposes of subsection (a), to have been paroled into the United States; and (2) in determining the alien’s admissibility as an immigrant- (A) paragraphs (4), (5)(A), (6)(A), (6)(C), (6)(D), (7)(A), and (9)(B) of section 1182(a) of this title shall not apply; and (B) the Attorney General may waive other paragraphs of section 1182(a) of this title (other than paragraphs (2)(A), (2)(B), (2)(C) (except for so much of such paragraph as related to a single offense of simple possession of 30 grams or less of marijuana), (3)(A), (3)(B), (3)(C), and (3)(E)) in the case of individual aliens for humanitarian purposes, family unity, or when it is otherwise in the public interest. INA § 245(h) is clear and unambiguous, as “a special immigrant described in section 1101(a)(27)(J) of this title…such an immigrant shall be deemed, for purposes of subsection (a) [adjustment of status], to have been paroled into the United States.” The Regulations at 8 C.F.R. § 1245.1(a) goes farther, noting that regardless of how they entered the United States, a young person designated a special immigrant juvenile has been paroled: such a person is “deemed, for the purpose of applying the adjustment of status provisions of section 245(a) of the Act, to have been paroled into the United States, regardless of the actual method of entry into the United States” (emphasis added). The Respondent cannot be found inadmissible or removable for being present in the United States without having been paroled when, under the law, he has been deemed to have been paroled. 8 USC § 1101(a)(27)(J) (J) an immigrant who is present in the United States— **(i)**who has been declared dependent on a juvenile court located in the United States or whom such a court has legally committed to, or placed under the custody of, an agency or department of a State, or an individual or entity appointed by a State or juvenile court located in the United States, and whose reunification with 1 or both of the immigrant’s parents is not viable due to abuse, neglect, abandonment, or a similar basis found under State law; **(ii)**for whom it has been determined in administrative or judicial proceedings that it would not be in the alien’s best interest to be returned to the alien’s or parent’s previous country of nationality or country of last habitual residence; and (iii) in whose case the Secretary of Homeland Security consents to the grant of special immigrant juvenile status, except that— **(I)**no juvenile court has jurisdiction to determine the custody status or placement of an alien in the custody of the Secretary of Health and Human Services unless the Secretary of Health and Human Services specifically consents to such jurisdiction; and **(II)**no natural parent or prior adoptive parent of any alien provided special immigrant status under this subparagraph shall thereafter, by virtue of such parentage, be accorded any right, privilege, or status under this chapter; When is Parole NOT Parole for Purposes of Adjustment of Status? See **Matter of Olty CABRERA-FERNANDEZ, 28 I&N Dec. 747 (BIA 2023);** MATTER OF CABRERA FERNANDEZ (1) Release on conditional parole under section 236(a)(2)(B) of the Immigration and Nationality Act, 8 U.S.C. § 1226(a)(2)(B) (2018), is legally distinct from release on humanitarian parole under section 212(d)(5)(A) of the INA, 8 U.S.C. § 1182(d)(5)(A) (2018). Matter of Castillo-Padilla, 25 I&N Dec. 257, 258–63 (BIA 2010), followed. (2) Applicants for admission who are released on conditional parole rather than humanitarian parole have not been “inspected and admitted or paroled,” and accordingly are not eligible for adjustment of status under the Cuban Refugee Adjustment Act of November 2, 1966, Pub. L. No. 89-732, 80 Stat. 1161, as amended.
ADMISSION A noncitizen is admitted if the following conditions are met: A noncitizen who meets these two requirements is admitted, even if the person obtained the admission by fraud. Likewise, the noncitizen is admitted, even if the CBP officer performed a cursory inspection. As long as the noncitizen meets the procedural requirements for admission, the noncitizen meets the inspected and admitted requirement for adjustment of status. Any type of admission can meet the inspected and admitted requirement, which includes, but is not limited to, admission as a nonimmigrant, an immigrant, or a refugee. See INA 101(a)(13)(A) (“The terms ‘admission’ and ‘admitted’ mean, with respect to an alien, the lawful entry of the alien into the United States after inspection and authorization by an immigration officer.”). Legislative history does not elaborate on the meaning of “lawful.” Evidence of Admission An Arrival/Departure Record (Form I-94), including a replacement when appropriate, is the most common document evidencing a noncitizen’s admission. The following are other types of documentation that may be accepted as proof of admission into the United States: When inspected and admitted to the United States, the following nonimmigrants are exempt from the issuance of an Arrival/Departure Record: False Claim to Citizenship Cannot be an Admission/Inspection A noncitizen who gains admission to the U.S. upon a knowing false claim to U.S. citizenship cannot be deemed to have been inspected and admitted. See Matter of Pinzon (PDF), 26 I&N Dec. 189 (BIA 2013). Deferred Admission Deferred inspection is a form of parole. A noncitizen who is deferred inspection is paroled into the United States for the period of time necessary to complete the inspection. See 8 CFR 235.2(c). For more information on deferred inspection, see Subsection 3, Parole [7 USCIS-PM B.2(A)(3)].
Bars to Adjustment of Status Noncitizen INASection Entries and Periods of Stay to Consider Exemptfrom Bar Crewman 245(c)(1) Only most recent permission to land, or admission prior to filing for adjustment VAWA-based applicants In Unlawful Immigration Status on the Date the Adjustment Application is Filed OR Who Failed to Continuously Maintain Lawful Status Since Entry into United States OR Who Continues in, or Accepts, Unauthorized Employment Prior to Filing for Adjustment 245(c)(2) All entries and time periods spent in the United States (departure and return does not remove the ineligibility) VAWA-based applicantsImmediate relativesCertain special immigrants245(k) eligible Admitted in Transit Without a Visa (TWOV) 245(c)(3) Only most recent admission prior to filing for adjustment VAWA-based applicants Admitted as a Nonimmigrant Without a Visa under a Visa Waiver Program 245(c)(4) Only most recent admission prior to filing for adjustment VAWA-based applicantsImmediate relatives Admitted as Witness or Informant 245(c)(5) Only most recent admission prior to filing for adjustment VAWA-based applicants Who is Deportable Due to Involvement in Terrorist Activity or Group 245(c)(6) All entries and time periods spent in the United States VAWA-based applicant Seeking Adjustment in an Employment-based Immigrant Category and Not in a Lawful Nonimmigrant Status 245(c)(7) Only most recent admission prior to filing for adjustment VAWA-based applicantsImmediate relatives and other family-based applicantsSpecial immigrant juveniles245(k) eligible Who has Otherwise Violated the Terms of a Nonimmigrant Visa OR Who has Ever Engaged in Unauthorized Employment 245(c)(8) All entries and time periods spent in the United States (departure and return does not remove the ineligibility) VAWA-based applicantsImmediate relativesCertain special immigrants245(k) eligible EXEMPTIONS FROM BARS TO ADJUSTMENT Congress has provided relief from particular adjustment bars to certain categories of immigrants such as VAWA-based adjustment applicants, immediate relatives, and designated special immigrants. Furthermore, INA 245(k) exempts eligible applicants under the employment-based 1st, 2nd, 3rd and certain 4th preference categories from the INA 245(c)(2), INA 245(c)(7), and INA 245(c)(8) bars. Specifically, an eligible employment-based adjustment applicant may qualify for this exemption if the applicant failed to maintain a lawful status, engaged in unauthorized employment, or violated the terms of his or her nonimmigrant status (admission under a nonimmigrant visa) for 180 days or less since his or her most recent lawful admission. See also exceptions for being admitted or paroled.
Exceptions to Being Admitted or Parole VAWA & INA 245i SIJS See INA 245(h)(1), which states that SIJ-based applicants are considered paroled into the United States for purposes of INA 245(a). Special immigrant juveniles (SIJ) and other special immigrants are not exempt from this requirement. However, statutory provisions expressly state that these special immigrants are considered paroled for adjustment eligibility purposes. Accordingly, the beneficiaries of approved SIJ petitions meet the inspected and admitted or inspected and paroled requirement, regardless of their manner of arrival in the United States. See INA 245(g), which holds that certain special immigrants, as defined under INA 101(a)(27)(k), are considered paroled into the United States for purposes of INA 245(a).
AOS Statute INA 245(a) Adjustment of Status Eligibility Requirements The applicant must have been: The applicant must properly file an adjustment of status application. The applicant must be physically present in the United States. The applicant must be eligible to receive an immigrant visa. An immigrant visa must be immediately available when the applicant files the adjustment of status application. and at the time of final adjudication. The applicant must be admissible to the United States for lawful permanent residence or eligible for a waiver of inadmissibility or other form of relief. The applicant merits the favorable exercise of discretion. §1255. Adjustment of status of nonimmigrant to that of person admitted for permanent residence (a) Status as person admitted for permanent residence on application and eligibility for immigrant visa The status of an alien who was inspected and admitted or paroled into the United States or the status of any other alien having an approved petition for classification as a VAWA self-petitioner may be adjusted by the Attorney General, in his discretion and under such regulations as he may prescribe, to that of an alien lawfully admitted for permanent residence if (1) the alien makes an application for such adjustment, (2) the alien is eligible to receive an immigrant visa and is admissible to the United States for permanent residence, and (3) an immigrant visa is immediately available to him at the time his application is filed. (b) Record of lawful admission for permanent residence; reduction of preference visas Upon the approval of an application for adjustment made under subsection (a), the Attorney General shall record the alien’s lawful admission for permanent residence as of the date the order of the Attorney General approving the application for the adjustment of status is made, and the Secretary of State shall reduce by one the number of the preference visas authorized to be issued under sections 1152 and 1153 of this title within the class to which the alien is chargeable for the fiscal year then current. (c) Alien crewmen, aliens continuing or accepting unauthorized employment, and aliens admitted in transit without visa Other than an alien having an approved petition for classification as a VAWA self-petitioner, subsection (a) shall not be applicable to (1) an alien crewman; (2) subject to subsection (k), an alien (other than an immediate relative as defined in section 1151(b) of this title or a special immigrant described in section 1101(a)(27)(H), (I), (J), or (K) of this title) who hereafter continues in or accepts unauthorized employment prior to filing an application for adjustment of status or who is in unlawful immigration status on the date of filing the application for adjustment of status or who has failed (other than through no fault of his own or for technical reasons) to maintain continuously a lawful status since entry into the United States; (3) any alien admitted in transit without visa under section 1182(d)(4)(C) of this title; (4) an alien (other than an immediate relative as defined in section 1151(b) of this title) who was admitted as a nonimmigrant visitor without a visa under section 1182(l) of this title or section 1187 of this title; (5) an alien who was admitted as a nonimmigrant described in section 1101(a)(15)(S) of this title,1 (6) an alien who is deportable under section 1227(a)(4)(B) of this title; (7) any alien who seeks adjustment of status to that of an immigrant under section 1153(b) of this title and is not in a lawful nonimmigrant status; or (8) any alien who was employed while the alien was an unauthorized alien, as defined in section 1324a(h)(3) of this title, or who has otherwise violated the terms of a nonimmigrant visa. (d) Alien admitted for permanent residence on conditional basis; fiancee or fiance of citizen The Attorney General may not adjust, under subsection (a), the status of an alien lawfully admitted to the United States for permanent residence on a conditional basis under section 1186a of this title. The Attorney General may not adjust, under subsection (a), the status of a nonimmigrant alien described in section 1101(a)(15)(K) of this title except to that of an alien lawfully admitted to the United States on a conditional basis under section 1186a of this title as a result of the marriage of the nonimmigrant (or, in the case of a minor child, the parent) to the citizen who filed the petition to accord that alien’s nonimmigrant status under section 1101(a)(15)(K) of this title. (e) Restriction on adjustment of status based on marriages entered while in admissibility or deportation proceedings; bona fide marriage exception (1) Except as provided in paragraph (3), an alien who is seeking to receive an immigrant visa on the basis of a marriage which was entered into during the period described in paragraph (2) may not have the alien’s status adjusted under subsection (a). (2) The period described in this paragraph is the period during which administrative or judicial proceedings are pending regarding the alien’s right to be admitted or remain in the United States. (3) Paragraph (1) and section 1154(g) of this title shall not apply with respect to a marriage if the alien establishes by clear and convincing evidence to the satisfaction of the Attorney General that the marriage was entered into in good faith and in accordance with the laws of the place where the marriage took place and the marriage was not entered into for the purpose of procuring the alien’s admission as an immigrant and no fee or other consideration was given (other than a fee or other consideration to an attorney for assistance in preparation of a lawful petition) for the filing of a petition under section 1154(a) of this title or subsection (d) or (p) 2 of section 1184 of this title with respect to the alien spouse or alien son or daughter. In accordance with regulations, there shall be only one level of administrative appellate review for each alien under the previous sentence. (f) Limitation on adjustment of status The Attorney General may not adjust, under subsection (a), the status of an alien lawfully admitted to the United States for permanent residence on a conditional basis under section 1186b