Summarized User Experiences
Medical RFE for not taking the Tuberculin Skin Test (TST)
There might be various reasons as to why one would not have taken TB test for the USCIS medical exam, at the time of filing for I-485/Adjustment Of status. For example, pregnancy. Hence the subsequent information is based on this premise. There may be other reasons as to one would not have taken a TB test at the time of filing.
It depends on the doctor you are consulting to get the medical exam, some doctors say that it is OK to take a TB test during the pregnancy and some just give you a blanket waiver as soon as they realize that you are pregnant.
So it is your discretion ultimately to get the test or not. If you decide not to take the test its highly recommended that you call in advance of the medical exam visit to check if they give a blanket waiver, in case you are pregnant. If one wants to play it safe, they can go for a blanket waiver, afterall, mom and baby's health are paramount.
Before and After RFE
Usually when the Immigration Officer opens your I-485 application he/she checks for all the requirements defined as per the USCIS medical exam. If there are any requirements that are missing or if the IO determines that he/she needs more information inorder to process your case for medical exam compliance, an RFE could be issued.
Ok, if you have a lawyer representing you, you probably would have signed the G-28 form. In this case usually, an RFE is sent to the lawyer. The applicant may not get a copy of it. However some IV members reported getting a copy of as well. It is highly recommended that the applicant registers for online case status and enable emails for any changes on the application, so they would be aware if there is any status change on their pending I-485 application.
When you get a TB Test Medical RFE, you get back the whole sealed and signed envelope you initially sent to USCIS for submitting the Medical Exam. The applicant should not open it, it has to be taken to USCIS civil surgeon, where the applicant goes to get the TB test.
Now, some doctors do not do just administer the TB test, they insist on redoing the whole exam. It is perfectly normal to just get the TB test done, remember this RFE is for TB test not for the whole medical exam. So call the doctor before you schedule an appointment and ask, if they say NO just to TB Test, move on to next nearest doctor in your area. You could also call a couple of doctors and compare the fees if you want to.
Based on the guidelines (refer to link # 4) set by USCIS, you may have to take the Chest X-ray if your TB Skin test turns out to be positive. Per USCIS regulation, do not take the Chest X-ray directly unless there is a reason.
USCIS states "the civil surgeon must administer the TST, unless one of the exceptions listed in the Technical Instructions applies. If the civil surgeon performs a chest x-ray without giving the applicant the TST, the reason for omitting the TST must be noted on Form I-693."
Once the X ray report is ready the Radiologist sends the X ray report to the Civil Surgeon and the report is attached to the I-693 form.
Make sure when you get the RFE, always use the current I-693 form. Check all the appropriate fields are filled and signed.
Send the RFE material/documents in the envelope that is provided by USCIS. Its highly recommended to send the package via Express mail (USPS) or atleast a 2 day delivery with confirmation.
1) Link to download the I-693 form
Link for the USCIS Online Case Status
USCIS Changes Vaccination Requirements To Adjust Status To Legal Permanent Resident
Questions & Answers:Changes to the Tuberculosis and Vaccination Requirements Required for Adjustment of Status
Medical RFE for not sending X-Ray
Medical RFE for physician not being in the list of USCIS approved list
Further Info and Discussions
Medical exam costs