Over the past two weeks, U.S. Citizenship and Immigration Services (USCIS) has transferred a large volume of pending EB-5-based Form I-485 adjustment of status applications from the California Service Center (CSC) to the Texas Service Center (TSC). Immediately following transfer, some applicants are receiving Requests for Evidence (RFEs) seeking Form I-693 medical examinations and providing 30 days to respond. Some of the impacted cases are for EB-5 investors, as previously the CSC adjudicated all Form I-485 applications under that category.

All applicants for adjustment of status must undergo a medical examination with a designated USCIS civil surgeon and submit the results on Form I-693. The examination confirms that the applicant has undergone the required physical and mental health screening, does not have certain communicable diseases, and has received required vaccinations. Because each family member must submit a separately completed Form I-693, the cost and time may be significant for families filing together, especially where additional testing or vaccines are ordered.

Historically, Form I-693 medical examinations remained valid for the duration of a pending adjustment application. Since 2023, however, USCIS has limited the validity period to two years from the date the civil surgeon signs the form.

Some recent RFEs have requested updated medical examinations even where fewer than two years have elapsed since the original Form I-693 was completed and submitted, raising questions about why replacement medicals are being requested in cases where the prior examination should still be valid.

At the same time, these RFEs are being issued with abbreviated response periods. GT’s Immigration & Compliance Practice has observed numerous RFEs of this type providing 30 days to respond, rather than the more typical 87-day response period.

The practical impact is significant. EB-5 investors who do not act quickly, or who assume USCIS will accept a previously submitted medical examination without further action, may face denial of their adjustment application at the final stage of the green card process.

This trend also comes against the backdrop of USCIS’s August 2026 policy guidance emphasizing stricter evidentiary review, greater officer discretion to deny deficient filings without first issuing a Request for Evidence or Notice of Intent to Deny (NOID), and the agency’s authority to set response deadlines that are shorter than the maximum period allowed by regulation.

EB-5 investors may wish to review any USCIS transfer notices, RFEs, or other correspondence relating to a pending Form I-485 application. Applicants who receive a request for a new Form I-693 might wish to schedule a civil surgeon appointment as soon as possible and begin gathering any required supporting documentation, including evidence of updated vaccinations where applicable.