How Should Immigration Attorneys Handle Cases With Abnormal Lab Results?

What Abnormal Lab Results Mean for Form I-693

The immigration medical examination includes laboratory testing for tuberculosis (TB), syphilis, and gonorrhea. Abnormal results on any of these tests are documented by the civil surgeon on Form I-693 and may affect the adjudication of the I-485.

The significance of abnormal results depends on the specific finding. Some findings — such as latent TB — are common and do not prevent approval, though they may require treatment documentation. Others — such as active TB or untreated syphilis — are more serious and may constitute grounds of inadmissibility.

The Civil Surgeon's Role

When abnormal lab results are found, the civil surgeon documents the findings on Form I-693 and classifies them as Class A (serious, potentially inadmissible) or Class B (less serious, not inadmissible but requiring follow-up).

Class A conditions include communicable diseases of public health significance, such as active TB or untreated syphilis. Class B conditions include conditions that are less serious or that have been treated, such as latent TB or a history of substance use disorder in remission.

Treatment Requirements and Documentation

For Class A conditions, treatment is typically required before the I-485 can be approved. The civil surgeon may require documentation of treatment completion before finalizing Form I-693.

For Class B conditions, treatment may be recommended but is not always required for approval. However, USCIS may request documentation of follow-up care or treatment as part of the adjudication process.

Waiver Considerations

Some Class A conditions are waivable with Form I-601. The availability of a waiver depends on the specific condition and the applicant's qualifying relationships. Attorneys should evaluate whether a waiver is appropriate and, if so, begin gathering the necessary documentation.

Not all Class A conditions are waivable. For example, active TB that has not been treated is not waivable until treatment is completed. Consult with a physician experienced in immigration medical matters to understand the options.

Timeline Impact

Abnormal lab results can significantly delay the adjudication of an I-485. Treatment for some conditions — such as latent TB — can take 3–9 months. Attorneys should advise clients of potential delays and set realistic expectations for case timelines.