USCIS Case Studies & Practical Application 4

Question 1

A 55-year-old applicant needs a hepatitis B vaccine series as part of the I-693 requirements, but has documented anaphylaxis to a prior hepatitis B vaccine dose. How should the civil surgeon handle this?

Accepted Answer

Document the severe allergic reaction as a medical contraindication on the I-693 and do not administer the vaccine

Answer

A history of anaphylaxis to a vaccine component is a contraindication recognized by the CDC; the civil surgeon documents this on the I-693 rather than administering the vaccine.

Question 2

An applicant for adjustment of status has a positive gonorrhea NAAT result discovered during the I-693 exam. The applicant received a single-dose azithromycin and ceftriaxone treatment in the civil surgeon's office. Can the I-693 be signed the same day?

Accepted Answer

No, gonorrhea is a Class A condition; the civil surgeon should confirm treatment was given and note it, then sign the I-693 after confirming treatment completion

Answer

Gonorrhea is a Class A communicable disease; the civil surgeon must document treatment and confirm it was administered before certifying the I-693.

Question 3

A civil surgeon's USCIS designation is about to expire in 30 days. An applicant schedules an exam for a date after the expiration. The civil surgeon's designation lapses before the appointment. What happens if the civil surgeon completes the I-693 after the designation expires?

Accepted Answer

USCIS will reject the I-693 as invalid because only currently designated civil surgeons may sign the form

Answer

The civil surgeon must be currently designated by USCIS at the time of signing; an expired designation invalidates the I-693 and requires a new exam from an active civil surgeon.

Question 4

An applicant's overseas panel physician exam identified a Class A tuberculosis condition. The applicant was treated abroad and arrives in the US with documentation of completed treatment. Which agency conducts the domestic follow-up evaluation?

Accepted Answer

The local or state health department conducts the required follow-up under CDC's domestic medical examination program for refugees and immigrants with Class A conditions

Answer

The CDC's Division of Global Migration Health coordinates with state and local health departments to conduct follow-up evaluations for arriving immigrants with Class A conditions.

Question 5

During an I-693 exam, an applicant discloses they were hospitalized involuntarily for a psychiatric condition 15 years ago after a single episode, have had no recurrences, and are currently employed and stable. How does the civil surgeon most appropriately handle this?

Accepted Answer

Evaluate the current mental health status; if there is no current mental disorder associated with harmful behavior, no Class A finding is warranted

Answer

The inadmissibility standard requires a current mental disorder associated with harmful behavior; a remote single episode with full recovery does not automatically result in a Class A finding.

USCIS - Medical Exam Practice Test

USCIS - Medical Exam Practice Test

USCIS Case Studies & Practical Application 4