As of November 1, USCIS will change its policy on the validity period of the I-693 medical exam forms which much be submitted for Adjustment of Status applications.
There will now be a requirement that the I-693 has been required within two months of the date of filing (which has historically been the case most of the time anyway, in our experience), and there will be a two-year validity period from the date the form was signed by the Civil Surgeon completing the exam.
With the slowing of processing time for Adjustment of Status cases beyond a year in many instances, we were often seeing exams submitted with the initial filing expire by the time of interview resulting in costly repeated medical exams. We had been hesitant until relatively recently to file without these exams, as USCIS had in the past rejected filings that did not include a sealed I-693 medical exam form.
As processing times continued to slow, we would occasionally have cases where the exam had expired by time of interview. While we will need to be mindful of the two-month limit and get the case filed no later than two months from date of exam, we can now again begin to submit these with the initial filing.