If you’ve been asked to complete an immigration medical exam for your green card or visa application, it’s natural to have questions about what’s involved. This is one of the most common questions patients bring into the clinic. Here’s what you can expect during the process.
Why a Chest X-Ray Is Required at All
Tuberculosis screening has been a part of the immigration medical examination process for decades in order to verify that applicants meet specific health-related standards. For candidates two years of age and older, the exam often begins with a blood test known as an IGRA to ascertain whether you have previously been exposed to tuberculosis (TB) bacteria. A chest x-ray is the next necessary step to ascertain whether there is evidence of any active disease in the lungs rather than just previous exposure if that test is positive.
Usually, adults are the ones who require the actual x-ray. Imaging is only included if the first screening suggests it, and younger children typically go through the blood or skin test component first.
What the Exam Actually Looks Like
At a civil surgeon’s office like ours in Las Vegas, the appointment usually covers more than just the x-ray. Your appointment typically includes a review of your medical history, a general physical exam, a check of your vaccination records, and whatever lab work applies to your specific case, TB screening included when it’s required. The x-ray itself takes only a few minutes. Completing the required paperwork, including Form I-693, usually takes longer than the X-ray itself.
What a Normal Result Means
If the chest x-ray comes back clear, no further TB-related evaluation is usually required. The civil surgeon documents the result, and assuming everything else on the exam is in order, the I-693 form gets completed and sealed for submission with the rest of the immigration application. No further TB-related steps are needed.
What Happens If the X-Ray Is Abnormal
This is frequently the section that causes the greatest confusion; therefore, it is important to break it down in a way that makes it easier to comprehend what comes next.
Active tuberculosis is not always indicated by an abnormal chest x-ray. It implies that additional testing is required to rule it out. Following a referral to the local health department, three sputum samples are typically taken, separated by at least 24 hours. In order to completely confirm or rule out active disease, those samples undergo a culture procedure that usually takes six to eight weeks. This is the conventional procedure to obtain a conclusive answer, but the testing process is time-consuming because TB cultures take several weeks to yield accurate findings.
Depending on what the sputum results show, applicants are generally classified into one of several categories. If active, infectious TB is confirmed, that’s classified as Class A, and treatment has to be completed before the immigration medical clearance can move forward. If the x-ray showed something suggestive of TB but the sputum cultures come back negative, that typically falls under Class B1, and while follow-up care is strongly advised, it doesn’t necessarily block the medical exam from being completed. A positive blood test with a completely normal x-ray usually is generally classified as Class B2, a latent TB infection, which means no active disease and no immediate barrier to moving forward, though treatment after arrival is generally recommended.
The civil surgeon can’t sign off on the I-693 while an applicant is still waiting on sputum results for suspected active TB. That part of the process simply has to run its course first.
Does an Abnormal Result Mean You Won’t Get Approved?
Not necessarily, and many applicants worry about this the moment they hear “abnormal.” Latent TB, meaning exposure without active disease, doesn’t block someone from immigrating as long as the required testing and any recommended treatment protocols are followed. Active TB does require treatment to be completed first, but the focus is on completing the required medical treatment, not a permanent disqualification.
What This Costs in Las Vegas
At our clinic, a chest x-ray and TB screening are included as part of the standard immigration exam package, which runs $199 and also covers a full medical exam, blood and lab testing, and completion of Form I-693. For applicants who need things moving faster, the Premium package at $299 adds same-day priority scheduling and 24-hour report turnaround, which can be helpful for applicants working within USCIS processing timelines.
Getting Started
If you’ve received a request for a medical exam as part of your immigration case, understanding the process in advance can help make the experience much less stressful. Our office is located at 6889 W Charleston Suite A in Las Vegas, and our team can explain the requirements that apply to your immigration case before your appointment, including whether TB screening applies to your situation.
You can reach us directly at +1 (702) 373-3923 or through our contact page to schedule. And if you’re currently waiting on sputum results or unsure what your TB classification means for your case, that’s exactly the kind of question worth asking your civil surgeon directly rather than guessing, since the right next step depends on the specific details of your exam.