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I-485 RFE: the medical exam, birth certificate and I-864 rules, and the 12-week limit

An I-485 RFE has to be answered by the printed date, which can never be more than twelve weeks away and cannot be extended (8 CFR 103.2(b)(8)(iv)). The regulations behind the three requests people search for are 8 CFR 245.5 (civil surgeon medical exam), 103.2(b)(2) (birth records) and 213a.2 (affidavit of support).

People searching "I-485 RFE medical", "I-485 RFE birth certificate" or "I-485 RFE affidavit of support" have usually opened a notice that lists one or more of those items. Each has its own rule in the Code of Federal Regulations, and each interacts with the same response deadline.

This page sets out those rules as at 9 October 2026, from the eCFR: how an RFE on an adjustment application works (8 CFR 103.2(b)), the medical examination requirement (8 CFR 245.5), the rules for proving a birth or marriage when a record is missing (103.2(b)(2)), and the affidavit of support rules (8 CFR 213a.2). It does not say which request a given applicant will receive, how often any request occurs, or what a given document needs to look like. The form instructions on uscis.gov, the I-693 instructions and the notice itself carry that detail, and a lawyer or accredited representative applies it.

Fees mentioned here: the I-485 is $1,440 for an applicant aged 14 or older (8 CFR 106.2(a)(21)), and there is no USCIS fee for the I-693 medical report form (106.2(a)(39)). Neither is among the four fees changing on 16 October 2026. Check the USCIS fee schedule (Form G-1055) before paying.

The response rules, in short

The general RFE rules in 8 CFR 103.2(b) are covered in our page on the USCIS Request for Evidence. For an I-485 the points that matter:

  • The notice prints a response date. The regulation says "in no case shall the maximum response period provided in a request for evidence exceed twelve weeks" and "additional time to respond… may not be granted" (103.2(b)(8)(iv)).
  • The options are a complete response, a partial response with a request for a decision on the record, or withdrawal (103.2(b)(11)). Everything goes together, with the original notice.
  • If the date passes, the application "may be summarily denied as abandoned, denied based on the record, or denied for both reasons" (103.2(b)(13)(i)).
  • A required biometrics or interview appointment that is missed leads to the request being "considered abandoned and denied" unless a rescheduling request or change of address, received by the appointment time, is accepted by the agency as excusing it (103.2(b)(13)(ii)).
  • Evidence must show eligibility "at the time of filing" and continue "through adjudication" (103.2(b)(1), (b)(12)).

An I-485 RFE can also be the notice that tells the applicant a document is missing from the initial filing (initial evidence) or that the file lacks something extra (additional evidence). The notice has to say which.

Medical examination requests (8 CFR 245.5)

The medical rule is short. 8 CFR 245.5 says: "Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by a designated civil surgeon, whose report setting forth the findings of the mental and physical condition of the applicant, including compliance with section 212(a)(1)(A)(ii) of the Act, shall be incorporated into the record."

Three things in that sentence and the ones after it:

  1. A designated civil surgeon. The regulation requires the examination "by a designated civil surgeon". A report from a doctor who is not designated is not what the rule describes. USCIS keeps the list of designated surgeons on uscis.gov, and the current Form I-693 instructions there govern how the report must be submitted and sealed.
  2. The report is "incorporated into the record". It is part of the application, which is why an RFE can ask for it when it is missing or incomplete.
  3. The K exception. "A medical examination shall not be required of an applicant for adjustment of status who entered the United States as a nonimmigrant spouse… of a United States citizen or the child of such an alien as defined in section 101(a)(15)(K) of the Act and § 214.2(k) of this chapter if the applicant was medically examined prior to, and as a condition of, the issuance of the nonimmigrant visa; provided that the medical examination must have occurred not more than 1 year prior the date of application for adjustment of status."

The regulation also says an applicant "certified under paragraphs (1)(A)(ii) or (1)(A)(iii) of section 212(a) of the Act" may appeal to a Board of Medical Officers of the US Public Health Service under INA §234 and 8 CFR part 235.

Fees. 8 CFR 106.2(a)(39) lists the Report of Immigration Medical Examination and Vaccination Record (Form I-693) with "No fee" for USCIS. That is the USCIS filing fee. What a civil surgeon charges for the examination is set by the surgeon, not by the regulations read for this page, and it is a separate cost.

Timing and validity. How long a completed I-693 stays acceptable, and how it must be submitted, are set in the form instructions and USCIS policy. Check those on uscis.gov for the form edition named in the notice. Do not treat a date from a website or forum as current.

Birth certificate and other civil documents (8 CFR 103.2(b)(2))

The I-485 form instructions ask for a birth certificate and, for a marriage-based case, a marriage certificate. An RFE on this point is usually about a document that is absent, unreadable, untranslated or unobtainable. 8 CFR 103.2(b)(2) is the rule that governs those situations, and it is a ladder with fixed steps.

Step 1: the required document. The default is the primary civil record the form requires.

Step 2: show it cannot be obtained. "If a required document, such as a birth or marriage certificate, does not exist or cannot be obtained, an applicant or petitioner must demonstrate this and submit secondary evidence, such as church or school records, pertinent to the facts at issue."

Step 3: if secondary evidence is also unavailable, the person "must demonstrate the unavailability of both the required document and relevant secondary evidence, and submit two or more affidavits, sworn to or affirmed by persons who are not parties to the petition who have direct personal knowledge of the event and circumstances. Secondary evidence must overcome the unavailability of primary evidence, and affidavits must overcome the unavailability of both primary and secondary evidence."

How to show a record is unavailable (103.2(b)(2)(ii)). Where a record does not exist, the applicant "must submit an original written statement on government letterhead establishing this from the relevant government or other authority", explaining why it does not exist and whether similar records for that time and place are available. Two relaxations: no certification is required "where the Department of State's Foreign Affairs Manual indicates this type of document generally does not exist", and an applicant who could not get the statement "may submit evidence that repeated good faith attempts were made". But "where USCIS finds that such documents or statements are generally available, it may require" them.

The presumption. The first sentence of 103.2(b)(2)(i) is the one to read twice: "The non-existence or other unavailability of required evidence creates a presumption of ineligibility." A person who simply says a record is lost has not met the rule.

Translations. Under 103.2(b)(3), any foreign-language document must come with a full English translation certified as complete and accurate, with the translator's certification of competence.

Name differences. Where a document uses an anglicised version of a name, "the native form of the name may also be required" (103.2(b)(5)).

Original documents. USCIS "may, at any time, request submission of an original document", with a deadline; missing it "may result in denial or revocation" (103.2(b)(5)). An original submitted to USCIS is returned "when no longer required", and the applicant can request it back if it is not returned in a reasonable time.

Affidavit of support (I-864) requests (8 CFR 213a.2)

Our page on the I-864 Affidavit of Support covers the rules in full. The RFE-relevant points from 8 CFR 213a.2 are these.

The income threshold. "The sponsor must demonstrate the means to maintain the intending immigrant at an annual income of at least 125 percent of the Federal poverty line", or 100 percent for a sponsor on active military duty sponsoring a spouse or child (213a.2(c)(2)). The poverty guidelines used are those "in effect" when the evidence is assessed.

Proof of income. The sponsor includes "a photocopy or an Internal Revenue Service-issued transcript of his or her complete Federal income tax return for the most recent taxable year (counting from the date of the signing, rather than the filing, of an affidavit of support)", with all schedules and, if a photocopy is used, the W-2s and 1099s the sponsor relies on. The sponsor may submit returns for the three most recent years at their option (213a.2(c)(2)(i)(A)).

No return filed. If the sponsor "did not file a Federal income tax return for the year for which a transcript or photocopy must be provided", the affidavit "will not be considered sufficient… even if the household income meets the requirements" unless the person proves "by a preponderance of the evidence" that they had no duty to file; if they cannot, it is not sufficient "until" they have filed and provide the return (213a.2(c)(2)(i)(D)).

Joint sponsor and household member. A joint sponsor "must execute a separate affidavit of support" and accept joint and several liability (213a.2(c)(2)(iii)(C)); the joint sponsor "is not required to file a visa petition". A household member's income counts only through an affidavit of support attachment, and that person's tax returns must be for the same year as the sponsor's.

The one-year rule. If "more than one year passes between the filing of the affidavit of support… and the hearing, interview, or examination", the officer may, "in the exercise of discretion", direct the applicant to submit additional evidence. A written request must give "not less than 30 days" (213a.2(a)(1)(v)(B)). Sufficiency is then judged on income "in the year the… officer… makes the request" and the Poverty Guidelines "in effect when the request for evidence was issued". This 30-day-minimum rule applies to that specific request. It does not override the twelve-week ceiling or the no-extension rule in 103.2(b)(8)(iv) for ordinary RFEs.

Verification. The government "may pursue verification of any information provided on or with an affidavit of support", including with employers, institutions, the IRS and the Social Security Administration (213a.2(c)(2)(v)).

Whether a sponsor's income meets 125 percent in a given year, and whether a particular person can serve as a joint sponsor, depends on current guideline tables and facts. Those are advice questions.

Interviews, biometrics and the work permit while an RFE is open

Several things can run alongside an RFE.

Interview and biometrics. USCIS "may require any applicant… to appear for an interview and/or biometric collection" (103.2(b)(9)). A person who cannot attend may, before the scheduled time, appear earlier, "for good cause, request that the biometric services appointment be rescheduled", or withdraw. Missing it without a request means the application is treated as abandoned and denied (103.2(b)(13)(ii)).

Interim benefits. 103.2(b)(10)(ii): "Interim benefits will not be granted based on a benefit request held in suspense for the submission of requested initial evidence, except that the applicant or beneficiary will normally be allowed to remain while a benefit request to extend or obtain status while in the United States is pending. The USCIS may choose to pursue other actions to seek removal of a person notwithstanding the pending application."

Employment authorization. A pending I-485 is the basis for the (c)(9) category. 8 CFR 274a.12(c)(9) says an adjustment applicant "will not be deemed to be an 'unauthorized alien'… while his or her properly filed Form I-485 application is pending final adjudication, if the alien has otherwise obtained permission from the Service pursuant to 8 CFR 274a.12 to engage in employment, or if the alien had been granted employment authorization prior to the filing of the adjustment application and such authorization does not expire during the pendency of the adjustment application." The I-765 fee is $520, or $260 for an applicant who filed the I-485 with a fee after 1 April 2024 and whose I-485 is still pending (106.2(a)(44)).

Since 30 October 2025, a renewal I-765 does not automatically extend an expiring work permit. 8 CFR 274a.13(e), added by the interim final rule at 90 FR 48799, says the document "will expire" on the day after the end validity date for a (c) category. Our page on what happens to a work permit after an I-485 denial has the details. The RFE does not itself stop an EAD from expiring on the date printed on the card.

Processing clock. USCIS's own processing-time limits are "suspended" from the date of an RFE for additional evidence and resume when the response arrives (103.2(b)(10)(i)). Where initial evidence was missing, they "start over from the date of receipt".

Where I-485 RFE responses go wrong, from the rules

Reading the sections above as a checklist of failure points:

  • A medical report from someone who is not a designated civil surgeon, or an I-693 not in the form the notice names.
  • A K-1 entrant assuming the exam is waived when it was done more than one year before the I-485 date, or was not done as a condition of the visa.
  • A birth certificate that is not the civil record, with no showing that the record cannot be obtained, so the presumption of ineligibility stands.
  • Skipping the secondary-evidence step and going straight to affidavits.
  • Affidavits from relatives who are parties to the case rather than non-party witnesses with direct personal knowledge.
  • A certified translation missing, or the translator's competence statement left off.
  • An I-864 where the sponsor's tax return is for the wrong year, lacks schedules or W-2s, or was never filed.
  • A joint sponsor who signs the form but never files the separate affidavit.
  • Household income assessed against an outdated poverty guideline table.
  • Replying to only some items. 103.2(b)(11) treats that as a request for a decision on the record.
  • Missing a biometrics or interview slot during the RFE period.

An abandonment denial ends the pending application, and the (c)(9) work-permit category is tied to a pending application. The consequences make an accurate reading of the notice matter.

Who may help. Deciding whether a document satisfies the rule, or whether to answer in full or ask for a decision on the record, is legal advice. Only attorneys and DOJ-accredited representatives of recognized organizations, and the few other categories in 8 CFR 292.1, may give it before USCIS. Notaries and immigration consultants may not. USCIS says notaries "are not attorneys and cannot represent you in legal matters, including immigration cases".

Finding a licensed attorney or accredited representative

Migratio's directory lists immigration attorneys and DOJ-accredited representatives. Listings are shown in a neutral order with factual filters (state, language, attorney or accredited representative). Migratio does not recommend, rank or match any lawyer, and it is not a lawyer referral service. Check any listing yourself against the state bar or the EOIR roster before you sign anything.

See attorneys and accredited representatives in the directory.

Notaries public, notarios and immigration consultants are not lawyers and cannot give immigration legal advice. Only a licensed attorney or a DOJ-accredited representative can.

Migratio is not a law firm and does not give legal advice. Only a licensed attorney or a DOJ-accredited representative can advise you.

Questions people ask

How long do I have to respond to an I-485 RFE?

By the date printed on the notice. Under 8 CFR 103.2(b)(8)(iv) the response period is never more than twelve weeks (84 days), and additional time may not be granted.

Who can do the medical exam for an I-485?

8 CFR 245.5 requires the examination to be done by a designated civil surgeon, whose report is incorporated into the record. Applicants who entered on a K visa and were examined as a condition of that visa within one year of the I-485 date are excepted. Check the current I-693 instructions on uscis.gov.

What if I cannot get my birth certificate for an I-485 RFE?

8 CFR 103.2(b)(2) requires you to show the document does not exist or cannot be obtained, then submit secondary evidence such as church or school records. If that is also unavailable, two or more affidavits from non-party witnesses with direct personal knowledge are required.

What does an I-485 RFE about the I-864 mean?

It means the affidavit of support is missing or does not show the sponsor can maintain the intending immigrant at 125 percent of the Federal poverty line (100 percent for some military sponsors). The sponsor's most recent tax return, schedules, and where needed a joint sponsor's separate affidavit are the documents the rule describes (8 CFR 213a.2).

Does an RFE stop my work permit from expiring?

No. An EAD expires on the date on the card unless a rule extends it. Since 30 October 2025, 8 CFR 274a.13(e) provides that a renewal request does not automatically extend a (c)-category EAD.

How much is the I-485 filing fee in 2026?

$1,440 for an applicant 14 or older and $950 for a child under 14 filing with a parent's I-485 (8 CFR 106.2(a)(21)). Check the USCIS fee schedule before paying.

Sources

Last checked 2026-10-09.

Related guides

  • USCIS Request for Evidence (RFE): the deadline, your options and what happens if you miss it — A Request for Evidence gives a date to respond, and under 8 CFR 103.2(b)(8)(iv) that response period can never be longer than twelve weeks. Additional time "may not be granted". The regulation lets the applicant send everything, send part and ask for a decision on the record, or withdraw.
  • I-485 denied: what the regulations say about appeals, motions, renewal and your work permit — 8 CFR 245.2(a)(5)(ii) says "no appeal lies from the denial" of an adjustment application. The regulations leave two routes: a motion to reopen or reconsider on Form I-290B within 30 days ($800), and, for an applicant who is not an arriving alien, renewing the application in removal proceedings. A work permit has its own validity date and its own revocation rule.
  • Form I-485 fee 2026: adults, children and add-on forms — As at 9 October 2026 the paper fee for Form I-485 is $1,440 for an applicant 14 or older and $950 for a child under 14 filing with a parent (8 CFR 106.2(a)(21)). A fee waiver is available only to people exempt from the public charge ground, and related forms carry their own fees.
  • Form I-864 Affidavit of Support: who signs, the income test, how long it lasts — The I-864 is a contract in which the sponsor agrees to maintain the immigrant at 125% of the Federal Poverty Guidelines (100% for armed-forces sponsors of a spouse or child). It has no USCIS fee. It ends at citizenship, 40 qualifying quarters, death or departure, not at divorce.
  • Form I-765 fee 2026: $520, $260, $570 or no fee — The standard paper fee for Form I-765 is $520 (8 CFR 106.2(a)(44)). It is $260 with a pending I-485 filed with a fee after 1 April 2024, some groups pay nothing, and a statutory fee applies to initial asylum, parole and TPS work permits, rising from $560 to $570 on 16 October 2026.
  • I-130 RFE: what the regulations require, the 12-week limit and how a response works — An I-130 Request for Evidence asks for proof the regulations in 8 CFR 204.1 and 204.2 require: the petitioner's status, the claimed relationship and, for spouses, proof every earlier marriage ended. The response period is never more than twelve weeks and cannot be extended (8 CFR 103.2(b)(8)(iv)).