USCIS Case Studies & Practical Application 3

Question 1

A civil surgeon discovers during an I-693 exam that a 30-year-old female applicant is pregnant. Several required vaccines (MMR, varicella) are contraindicated in pregnancy. How should the civil surgeon handle the vaccination requirement?

Accepted Answer

Document the pregnancy as a contraindication, defer the contraindicated vaccines, and note them as not administered on the I-693; the applicant can complete vaccination postpartum

Answer

Pregnancy is a recognized medical contraindication; the civil surgeon documents the deferral and USCIS policy allows completion of deferred vaccines after the pregnancy.

Question 2

An applicant who underwent adjustment of status had an I-693 completed by a civil surgeon 3 years ago, but USCIS never adjudicated the case. The applicant is now refiling. Is the original I-693 still valid?

Accepted Answer

No, the I-693 is valid for 2 years from the date the civil surgeon signed it; a new examination is required

Answer

USCIS policy states the I-693 is generally valid for 2 years from the civil surgeon's signature date; an exam performed 3 years ago would require a new examination.

Question 3

A civil surgeon examines an applicant who has HIV that is well-controlled on antiretroviral therapy with an undetectable viral load. The applicant is otherwise healthy. What is the correct I-693 classification under current USCIS policy?

Accepted Answer

Class B notification because HIV is no longer a ground of inadmissibility but must still be documented

Answer

HIV was removed as a ground of inadmissibility in 2010; it is now treated as a Class B condition that must be documented but does not bar admission.

Question 4

During the physical exam, a civil surgeon notes signs of physical abuse on a pediatric applicant (age 8). The parent accompanying the child becomes defensive when questioned. What must the civil surgeon do?

Accepted Answer

Report the suspected child abuse to the appropriate state child protective services authority as required by mandatory reporting laws, regardless of immigration consequences

Answer

Civil surgeons are licensed medical professionals bound by state mandatory reporting laws for suspected child abuse, which supersede immigration process considerations.

Question 5

An applicant seeking adjustment of status is found to have untreated syphilis (reactive RPR, confirmed by treponemal test). The civil surgeon has confirmed the diagnosis. What is the correct I-693 classification and next step?

Accepted Answer

Class A; the civil surgeon must complete treatment before signing the I-693

Answer

Syphilis is a Class A communicable disease of public health significance; the civil surgeon must ensure treatment is completed before certifying the I-693.

USCIS - Medical Exam Practice Test

USCIS - Medical Exam Practice Test

USCIS Case Studies & Practical Application 3