How Abnormal Results Are Handled

If any of your laboratory results come back abnormal, our civil surgeon will review the findings with you privately and professionally. The civil surgeon will explain what the result means in plain language, whether it has any bearing on your immigration application, and what — if any — follow-up steps are required.

Our team is experienced in handling sensitive medical findings with discretion and compassion. You will never be left wondering what a result means or what to do next.

Common Abnormal Results and What They Mean

The most common abnormal results in the immigration laboratory panel and their typical implications:

• Reactive syphilis RPR: Requires confirmatory treponemal test; treated syphilis is generally not a ground of inadmissibility
• Positive gonorrhea NAAT: Treatable with antibiotics; completing treatment typically resolves the finding
• Positive IGRA (QuantiFERON-TB Gold): Requires chest X-ray to distinguish latent from active TB; latent TB is not a ground of inadmissibility
• Abnormal chest X-ray: Requires further evaluation; findings vary widely in significance

Documentation on Form I-693

The civil surgeon is required to document all relevant laboratory findings on Form I-693, including abnormal results. The documentation will reflect the nature of the finding, any treatment or follow-up completed, and the civil surgeon's clinical assessment.

Accurate and complete documentation is essential for your application. The civil surgeon will not finalize and seal your Form I-693 until all required follow-up has been completed and documented.

When Additional Testing May Be Required

Some abnormal results require confirmatory testing before a final determination can be made. For example, a reactive syphilis screening test (RPR) requires a confirmatory treponemal test. A positive IGRA TB test requires a chest X-ray to evaluate for active disease.

Our civil surgeon will order any necessary follow-up testing and explain the process. In most cases, follow-up testing can be completed on-site or with minimal additional appointments. We will keep you informed throughout the process.

When Treatment Is Required Before I-693 Can Be Completed

If your abnormal result indicates an active communicable disease — such as active syphilis or active TB — treatment will be required before your Form I-693 can be finalized. The civil surgeon cannot seal and complete the form until the condition is treated and documented.

Our civil surgeon will advise you on appropriate treatment options and, if necessary, refer you to a specialist or your local health department. Once treatment is completed and documented, your Form I-693 can be finalized.

Abnormal Results and Immigration Inadmissibility

Not all abnormal laboratory results constitute grounds of inadmissibility under U.S. immigration law. Many findings are treatable or do not meet the legal threshold for inadmissibility. The civil surgeon will clearly explain whether your specific finding has any impact on your immigration application.

Conditions that may constitute grounds of inadmissibility include active TB disease, active infectious syphilis, and active gonorrhea. In each case, completing treatment resolves the inadmissibility finding. Latent TB infection, treated syphilis, and treated gonorrhea are generally not grounds of inadmissibility.

Your Privacy and Confidentiality

All medical information, including laboratory results, is handled with strict confidentiality in accordance with applicable privacy laws, including HIPAA. Results are discussed privately with you and shared with USCIS only as required by the immigration medical examination process. Our team is committed to treating every patient with dignity and respect.