My guess is that they won't want proof, but the actual medical exam itself. The 'proof' in the form of the certificate or the copy may jar them into looking a little harder, but by and large they're going to need the real thing. (Although, of course, they could accept the copy as the real thing - but may need the sealed envelope) Any appeals or legal action would simply extend it beyond the validity of the report anyway. If it's at all discretionary on the part of the IO, it may work, but I wouldn't go beyond the 30 days. But Dale, if your case is in California, the Atlanta office shouldn't be sending you RFE's.