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Medical exams by an authorized physician are a key part of any application for an immigrant visa or green card. This is done to evaluate the applicant’s health-related inadmissibility grounds. During the medical exam, the doctor will make sure you have all the required vaccines and perform a physical exam. He or she will also review your test results and complete the required forms for the government. While many common ailments are not an issue for obtaining a green card, having a highly communicable disease or being a drug addict may pose a problem, for instance:

  • Tuberculosis (active)
  • Syphilis (infectious stage)
  • Chancroid
  • Gonorrhea
  • Granuloma Inguinale
  • Lymphogranuloma Venereum
  • Hansen’s Disease (Leprosy, infectious)

You may also be denied your benefit if you do not have the required vaccines or if you have a mental disorder that may cause you to be harmful to yourself or others. This is why it’s important to bring your immunization record with you to your medical appointment. If you don’t have of the required vaccines, a medical professional can administer them unless it’s not medically needed.

In most adjustment of status cases, applicants will receive their medical exam (Form I-693) in a sealed envelope. It is crucial to not open the envelope! The results are to be opened by USCIS only. However, you should request a copy of the results as it is important for your records. The results are only valid for a limited period of time, so it is often best to have the medical exam after receiving the adjustment of status interview notice and before the interview. Medical exams must be filed with USCIS within 60 days after being issued and they are only valid for two years. Regardless if you are applying for an immigrant visa abroad or adjustment of status in the United States, remember that this is a normal part of the process and should not be cause for concern for most applicants.

A proposed rule by the federal government would deny asylum to foreign nationals if they come from, or recently passed through, certain countries. Immigration officials say the rule would protect national security by slowing the spread of communicable diseases like COVID-19. But the American Medical Association is criticizing the proposal, calling it a form of discrimination against asylum seekers.

‘Legalize discrimination’

In a statement on the subject, the AMA quotes a letter that the group’s executive vice president and CEO, Dr. James L. Madara, wrote to federal officials. “The AMA is concerned that the proposed rule would legitimize discrimination against vulnerable asylum seekers,” Dr. Madara wrote. He also said the rule would base the determination of whether an asylum seeker is eligible on border agents who are “uninformed” about medical matters, and overall make it much more difficult for people seeking a stay of removal based on a credible fear of torture or persecution in their country of origin.

Normally, the AMA does not involve itself in political matters, especially ones that do not have to do with medicine. But Dr. Madara’s letter states that the fact that the rule is based on public health concerns justifies his comments. He believes that the process of determining if a would-be asylee has a communicable disease should be determined by health officials on a case-by-case basis.


On July 29, a federal court had ruled that the government could not enforce the public charge rule during the pandemic. This was a much welcomed announcement since many immigrant families are being severely affected by the COVID-19 pandemic. The new rules would effectively hinder their changes to obtain a legal immigration benefit for which they would otherwise quality. Under the rule, and while assessing the applicant’s eligibility, the government can take into account the individual’s past use of public benefits, age, medical issues, education, and work history, among other aspects, in evaluating the person’s likelihood of becoming a public charge.

On August 12, however, the Second U.S. Circuit Court of Appeals ruled that the prior ruling should only apply to states in the Second Circuit (New York, Vermont, and Connecticut). There are still many unanswered questions on this issue, including what will happen to applicants who did apply between the window of time after July 29 and before the ruling was narrowed. Meanwhile, the I-944 form, Declaration of Self Sufficiency, which is used to demonstrate eligibility under the public charge rules, is not available on USCIS’ website.

It is final! USCIS announced today they are increasing many application fees starting on October 2, 2020. Some of these fees are increasing significantly, including the fee for Naturalization applications, which is going from $640 to $1,160. Asylum applicants, who historically did not have to pay any fees for their applications, will now have to pay $50 in order for their cases to be considered. See our chart below for some examples of these changes.

In addition, a new fee structure will significantly increase the cost for adjustment of status applicants. Under the current rules, most adjustment applicants pay a fee of $1,140 (with an added $85 biometric fee for most individuals). The fee is lower, at $750, for children under 14 year old applying with a parent. Along with their green card applications, applicants can currently request their work and travel permits, which are renewable as long as the application is pending, for no extra fee. Under the new rules going into effect on October 2, the new fee structure will change dramatically and instead require separate fees for each application, as well as increase the fee for children. The new fee will be $1,130 for all applicants, regardless of age, plus a $550 fee for work authorizations and $590 for travel permits.

ProcessCurrent FeeNew Fee starting on October 2, 2020
I-192 Application for Advance Permission To Enter as Nonimmigrant (USCIS)$930$1,400
I-212 Application for Permission to Reapply for Admission into the U.S. After Deportation or Removal$930$1,050
I-589 Application for Asylum and for Withholding of Removal$0$50
I-601A Provisional Unlawful Presence Waiver$630$960
I-751 Petition to Remove Conditions on Residence$595$760
I-929 Petition for Qualifying Family Member of a U-1 Nonimmigrant$230$1,485
N-400 Application for Naturalization$640$1,170

USCIS receives most of its funding from fees paid by applicants, but the lower number of applications submitted during the pandemic and budget cuts have significantly affected the agency. The last time USCIS increased its fees was in December of 2016.


Are you requesting a green card and you are being told you need an Affidavit of Support? You’re not alone! An Affidavit of Support is a requirement for most immigrants seeking a green card and it serves to show that they have adequate financial support and are not likely to become a public charge. The document is a binding contract between the sponsor and the government to financially support the immigrant in the case that he or she is unable to support himself or herself.

Now, don’t panic! Most affidavits of support are never enforced. An affidavit of support could be enforced, however, if the immigrant requests and receives certain means-tested benefits, such as TANF (cash assistance), Medicaid, or SSI (Supplemental Security Income). Even if the immigrant meets the income requirements for these benefits, please note most would not be eligible for at least 5 years after they get their green card. Please see page 11 of this report for more information on the 5-year bar).

The affidavit of support would become effective at the time the green card is granted and is valid until one of the following conditions are met:

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