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Wednesday, March 22, 2017

USCIS Guidance to Civil Surgeons Regarding Form I-693 Gonorrhea Testing Requirement


Dear Civil Surgeon,
Effective Aug. 1, 2016, the Centers for Disease Control and Prevention (CDC) issued new Technical Instructions that require gonorrhea testing for most adjustment of status applicants 15 years of age and older who are required to have a full medical examination when they file Form I-485, Application to Register Permanent Residence or Adjust Status.
If the applicant’s Form I-693, Report of Medical Examination and Vaccination Record, was completed before Aug. 1, 2016, they do not need to report results of such testing, and officers should not issue a Request for EvidenceA Form I-693 is considered completed on the date the civil surgeon signs the form’s certification statement. (See USCIS Policy Manual Volume 8--Admissibility, Part B. Health-Related Grounds of Inadmissibility, Chapter 4--Review of Medical Documentation, C.--Documentation Completed by Civil Surgeon, 3.--Signatures.)
Who Must Be Tested for Gonorrhea
While most adjustment of status applicants 15 years of age and older must be tested for gonorrhea, certain applicants are exempt from having to submit a full medical examination and do not need to be tested. (SeeUSCIS Policy Manual Volume 8--Admissibility, Part B. Health-Related Grounds of Inadmissibility, Chapter 3—Applicability of Medical Examination Vaccination Requirements, A. Requirements by Benefit Type.)
The following applicants may submit Form I-693 with only a completed Vaccination Record (and the information/signature sections for the applicant and civil surgeons), provided they had a medical examination abroad in which the panel physician did not identify a Class A condition:
  • Refugees.
  • Derivative asylees who file an adjustment application within one year of becoming eligible to file.
  • K and V nonimmigrants who file an adjustment application within one year of the medical examination abroad.
The chart below summarizes who must be tested and who does not.
If the applicant…
And the applicant is…
Does the applicant need to be tested for gonorrhea?
Is required to receive a full medical examination
15 years of age or older
Younger than 15 years of age
Only if there is a history of gonorrhea or reason to suspect an infection with gonorrhea.
Is not required to receive a full medical examination
Any age
How Do Civil Surgeons Complete Form I-693 to Report Gonorrhea Testing Results?
Civil surgeons will report the results of required gonorrhea testing differently, depending on which version of Form I-693 they use.
Current Version of Form I-693
The Office of Management and Budget recently approved a new version of Form I-693, showing a version date of Feb. 7, 2017, with expiration date of Feb. 28, 2019.
Civil surgeons using this latest version of Form I-693 report the results of gonorrhea testing in new Part 7, Section C.
Previous Version of Form I-693
The previous version of Form I-693 (March 30, 2015, with expiration date of March 31, 2017) did not contain a separate section for reporting results of gonorrhea testing. As a result, the CDC issued Technical Instructions directing civil surgeons to complete the form as follows:
  1. In the Remarks section of Part 5, Civil Surgeon Worksheet, Section C, Other Class A/Class B Conditions for Communicable Diseases of Public Health Significance, civil surgeons should record the type of screening test used and the positive or negative result of the gonorrhea screening.
    a. If the results are negative, check the “No Class A/B Condition” box in Part 5, Section C.
    b.  If the results are positive and the applicant remains untreated, they have a Class A medical condition. After completing treatment, the condition is reclassified as Class B, and civil surgeons should record this on the Form I-693 by writing “Gonorrhea, Class B” in the Remarks section ofPart 5, Section C.
Note: Civil surgeons may use the previous version of Form I-693 only if they sign and date it on or beforeApril 27, 2017. After that date, they must use the current version of Form I-693.
CDC Rescinds Requirement for Documentation of Gonorrhea Testing
When the CDC issued the Technical Instructions requiring inclusion of gonorrhea testing results in Forms I-693 completed on or after Aug. 1, 2016, it also required civil surgeons to attach all medical documentation such as laboratory reports to the Form I-693, regardless of whether the test results were negative or positive. However, on March 15, 2017, the CDC updated the Technical Instructions to say laboratory reports and other medical documentation do not need to be included with Form I-693. This removal of the documentation requirement applies both prospectively and retroactively, as well as to both the new and previous versions of Form I-693.
As a result of the updated Gonorrhea Technical Instructions, USCIS may adjudicate an adjustment application using an otherwise properly filed and completed Form I-693, regardless of whether or not the civil surgeon attached documentation of gonorrhea testing results.

Kind regards,
U.S. Citizenship and Immigration Services