USCIS 2026 Alert: Green Card Applicants Face Medical RFE Surge After Case Transfers

Over the past two weeks, USCIS has transferred a significant 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). Almost immediately following these transfers, affected applicants began receiving Requests for Evidence (RFEs) requiring updated Form I-693 medical examinations — with only 30 days to respond, far shorter than the typical 87-day window. The medical examination requirement applies to all adjustment of status applicants, regardless of visa category. Form I-693 must be completed by a USCIS-designated civil surgeon and confirms that applicants have undergone required health screenings and vaccinations. Since 2023, USCIS has limited the validity of these examinations to two years from the date of signing — a significant change from prior policy, under which they remained valid for the duration of the pending application. What is drawing particular attention is that some RFEs are requesting updated medical exams even in cases where the original Form I-693 was completed within the last two years — meaning it should still be valid under current policy. This raises concerns that the Texas Service Center may be applying a stricter or inconsistent standard following the case transfers. This trend aligns with USCIS's August 2026 policy guidance, which emphasized stricter evidentiary review, broader officer discretion to deny applications without issuing an RFE, and the agency's authority to set response deadlines shorter than regulatory maximums. Together, these developments signal a more aggressive adjudication posture that employment-based green card applicants across all categories should be aware of. Applicants with a pending Form I-485 — particularly those who may have recently received a transfer notice — are advised to review all USCIS correspondence carefully. Those who receive a medical RFE should schedule a civil surgeon appointment immediately and begin compiling vaccination records and any required supporting documentation, given the compressed response window.