Understanding Abnormal Lab Results

An abnormal lab result means that a test value falls outside the normal reference range or indicates the presence of a condition. In the context of the immigration medical exam, abnormal results are evaluated by your Civil Surgeon in the context of USCIS communicable disease classifications — not simply as a pass/fail determination.

Class A vs. Class B Conditions

USCIS classifies communicable diseases into two categories that determine the impact on your immigration case:

Class A conditions are grounds of inadmissibility under INA § 212(a)(1)(A)(i). Active, untreated Class A conditions must be addressed before Form I-693 can be completed. Class A communicable diseases include: active tuberculosis disease, active syphilis (primary, secondary, or early latent), active gonorrhea, and active Hansen's disease (leprosy).

Class B conditions are communicable diseases of public health significance that are not grounds of inadmissibility. They are documented on Form I-693 but do not prevent green card approval. Examples include latent TB infection, treated syphilis, and hepatitis B carrier status.

What Happens After an Abnormal Result

Step 1 — Review: Your Civil Surgeon reviews the abnormal result in the context of your medical history and physical examination findings.

Step 2 — Confirmatory Testing: For some tests (such as a reactive RPR for syphilis), confirmatory testing is required to determine whether the result represents true infection or a false positive.

Step 3 — Treatment (if required): If a Class A condition is confirmed, treatment must be initiated and documented before Form I-693 can be finalized. Your Civil Surgeon will advise on treatment options and timeline.

Step 4 — Documentation: All findings, confirmatory test results, and treatment documentation are recorded on Form I-693 in the appropriate sections.

Specific Abnormal Results and What They Mean

Here is how the most common abnormal results are handled:

• Reactive RPR (syphilis): Requires confirmatory treponemal testing. If confirmed, treatment documentation is required for active syphilis.
• Positive gonorrhea NAAT: Treatment required before I-693 completion. Gonorrhea is highly treatable with a single antibiotic injection.
• Positive QuantiFERON-TB Gold: Requires chest X-ray. Latent TB (LTBI) is not a ground of inadmissibility. Active TB requires treatment.
• Positive chest X-ray: Evaluated for active TB disease. Findings documented in Part 3 of Form I-693.

Does an Abnormal Result Delay Your Case?

For Class B conditions (latent TB, treated syphilis, hepatitis B carrier), there is typically no delay — your Civil Surgeon documents the findings and completes Form I-693 on the standard timeline.

For Class A conditions requiring treatment (active gonorrhea, active syphilis), there may be a brief delay while treatment is completed and documented. Most treatments are rapid — gonorrhea, for example, is treated with a single injection.

Confidentiality of Lab Results

Your lab results are protected by HIPAA and are confidential. They are documented on Form I-693, which is sealed and submitted directly to USCIS. Results are not shared with employers, family members, or other parties without your consent.