New Medical Exam Requirement for Green Card Applications

Effective immediately, applicants for a U.S. Green Card (Form I-485, Application to Register Permanent Residence or Adjust Status) are now required to submit their medical examination report (Form I-693) at the same time as their initial application. This marks a notable shift from previous policy, where applicants could often submit the medical report later, typically in response to a Request for Evidence (RFE) or during an interview.

U.S. Citizenship and Immigration Services (USCIS) has implemented this change to streamline the application process and reduce potential delays. Failure to include the completed and signed Form I-693 with the initial Form I-485 submission may result in the rejection of the application.

November 2025 Visa Bulletin: Key Movements

The U.S. Department of State's November 2025 Visa Bulletin, released on Thursday, October 16, 2025, indicates forward movement in several employment- and family-based visa categories. This advancement means more applicants may become eligible to file for adjustment of status or receive final approval.

For family-sponsored preferences, some categories have seen modest progress in their Dates for Filing (DOF). For instance, the F2A category (spouses and children of permanent residents) for China, India, Mexico, and the Philippines moved forward by one month, from September 22, 2025, to October 22, 2025. However, many employment-based categories have shown little to no movement in their Final Action Dates (FADs) and Dates for Filing (DOFs) between the October and November updates.

Processing Times and What to Expect

While USCIS aims to make the process smoother with the new medical exam requirement, overall processing times for some common forms have seen slight increases in Fiscal Year 2025, which began in October. Despite this, processing times generally remain close to pre-pandemic levels, signaling steady, albeit sometimes slow, progress.

For family-based adjustment of status, processing times in 2025 have been observed around 8-10 months for many applicants, though this can vary based on the local field office workload and visa availability. Employment-based adjustment of status timelines are heavily influenced by Visa Bulletin movement and the history of underlying PERM/I-140 petitions.

Impact on Kenyan Applicants

Kenyans constitute a significant and growing diaspora in the United States. In 2022, the number of Kenyans relocating to the US increased by 9.6% from 2021, reaching 168,915 immigrants. This surge reflects increasing opportunities for skilled and semi-skilled labor in the US, as well as a shrinking job market in Kenya.

Many Kenyan immigrants obtain lawful permanent residence through immediate relative petitions from U.S. citizens or through the Diversity Visa Program. The new medical examination requirement underscores the need for meticulous preparation of all application documents to avoid rejections and further delays.

Navigating the Application Process

Applicants are advised to schedule an appointment with a USCIS-designated civil surgeon to complete Form I-693, which includes a health assessment and vaccination record. The civil surgeon will provide a sealed report to be submitted with Form I-485.

It is crucial for applicants to regularly check the U.S. Department of State's website for the monthly Visa Bulletin to track priority date movements and understand eligibility for filing. Consulting with an immigration attorney can also help ensure compliance with the latest requirements and navigate the complexities of the immigration process.

Unanswered Questions and Future Outlook

While the new medical exam policy aims for efficiency, its long-term impact on overall processing times, especially for applicants in countries with limited access to USCIS-designated civil surgeons, remains to be fully seen. Additionally, the consistency of forward movement in future Visa Bulletins will be a key factor for many aspiring immigrants.

What to Watch

The U.S. Department of State is expected to release the December 2025 Visa Bulletin around mid-November. This will provide further insights into the availability of immigrant visas and potential shifts in priority dates, which are critical for thousands of Kenyan applicants.