Which FAA evaluation is it: psychiatric, psychological, or neuropsychological?
The letter is usually short, and somewhere in it is one sentence that decides the next several months of your life. The FAA requires a current psychiatric evaluation. Or a psychological evaluation. Or a neuropsychological evaluation. Most pilots read all three the same way, as the FAA wanting them to go see a mental health person, and then they book whoever can see them soonest.
Those are three different credentials. The FAA publishes a separate specification document for each one, and each specification names who is allowed to perform it. A report written by the wrong discipline does not get partial credit. It gets returned, and you start over, months later, with the money already spent.
I'm Corinne, a licensed psychologist, FAA/HIMS trained aviation psychologist, and former pilot. I complete FAA psychological evaluations, and a fair share of my consultation calls end with me telling a pilot that the appointment they called to book is not the one their letter asks for. Here is how to tell them apart before you spend anything.
Each of those three words names a credential the FAA will check
The Guide for Aviation Medical Examiners is the FAA's working manual for aeromedical certification, and it carries separate specifications for psychiatric evaluations, psychological evaluations, and neuropsychological evaluations, with further specifications for substance-related cases and for ADHD. The current guide was updated at the end of October 2026.
Each specification does two things. It states who may perform the evaluation, down to degree, license, and in some cases board certification. Then it lists what the report has to contain. When your package reaches the FAA's Aerospace Medical Certification Division, a physician there reads your report against the specification that matches the request, item by item. Clinical quality does not substitute for that structure, and good clinicians produce failing reports all the time.
So start with the letter rather than with a provider search. Find the exact phrase the FAA used and write it down, and note whether the letter names more than one evaluation, because plenty of them do.
One source of confusion worth naming: pilots searching for help usually type "FAA psychiatric evaluations" no matter which of the three they were sent for, because that is the phrase that sounds like the whole category. It is a reasonable search term and a terrible scheduling instruction.
FAA psychiatric evaluations are done by psychiatrists, and the FAA wants one who knows aviation
A psychiatric evaluation is performed by a physician, an MD or a DO, and no other credential will do. The FAA's specifications point to board certification by the American Board of Psychiatry and Neurology or the American Board of Osteopathic Neurology and Psychiatry, and the agency advises using a psychiatrist with aerospace experience or at least a working familiarity with aviation medical standards. Where the case involves substance use, the specifications add board certification in addiction psychiatry or HIMS training.
The report generally rests on a records review, a clinical interview, a mental status examination, and an integrated summary that states a diagnosis explicitly and gives the psychiatrist's treatment and monitoring recommendations.
No psychologist can write this one. I cannot write this one, and neither can any other PsyD or PhD, regardless of how much aviation work we do. If your letter says psychiatric, you need a physician.
There is usually a reason the FAA asked for a physician specifically, and medication is the common one. Psychotropic medication is disqualifying for certification purposes until the FAA says otherwise, which is why an AME who sees it defers the application and forwards the records rather than issuing. When a prescription is at the center of your file, the agency wants the discipline that prescribes to account for it. The antidepressant pathway runs on the same logic.
An FAA psychological evaluation means a doctoral psychologist and a battery of tests
The psychological specification calls for a clinical psychologist with a doctoral degree, a state license to practice independently, and expertise in psychological assessment. The report rests on a review of all available records, a clinical interview, and the interpretation of a full battery of psychological tests, ending in a clear diagnostic statement.
This is the evaluation I complete, and it is the one most often requested after a pilot discloses a mental health history on a medical application, or when a special issuance pathway calls for documentation of current psychological status. Details are on the FAA psychological evaluation page.
Two things pilots get wrong about it. The first is that testing is optional if the clinician feels confident. It is not. The specification asks for interpretation of a battery, and a report built on conversation alone invites a request for more. The second is treating it as a therapy intake with FAA paperwork stapled to it. The purpose is different. This is an assessment with one defined audience, a federal physician who has never met you and who will decide something about your certificate from the document in front of them.
An FAA neuropsychological evaluation is the long one, and the FAA keeps a list of who can do it
This one looks at cognition rather than mood. The specification for potential neurocognitive impairment opens by naming why it exists: head trauma, stroke, encephalitis, multiple sclerosis, other suspected acquired or developmental conditions, and medications used in treatment may produce cognitive deficits that would make an airman unsafe to perform pilot duties.
The requirements are tighter than for the other two. The FAA asks for a qualified neuropsychologist with additional training in aviation-specific topics, and it publishes a list of neuropsychologists who meet its quality criteria. The battery is standardized and generally includes the CogScreen-AE, a test built for aviators. Where pilot norms exist for a measure, the specification requires that they be used, and where they do not, the report has to say which comparison group was used instead, with percentile scores included when they are available. The itemized test lists are not public, for test security reasons; clinicians request access to them through the FAA's neuropsychological testing mailbox.
In practice this is commonly one to two days of testing and several thousand dollars. It is also the version of these three that pilots most often arrange without realizing a list exists, and a battery administered by someone not on it is a battery you may be asked to repeat.
If your history involves ADHD, this is the territory of the Standard Track, which is a full neuropsychological evaluation from an FAA HIMS-qualified neuropsychologist, as distinct from the interview-based Fast Track.
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Letters that ask for two at once are normal, and the order matters
Substance-related cases often draw a psychiatric evaluation and a neuropsychological evaluation together, which is why the FAA keeps a combined specification for them. That pairing shows up throughout the HIMS process.
Where more than one is requested, sequence saves time. The psychiatric or psychological interview can usually be scheduled quickly; the neuropsychological battery takes a slot on a specialist's calendar and produces a long report afterward. Starting the long one first, and gathering the records both clinicians will need while you wait, is usually the difference between one submission cycle and two.
Requirements also move. For renewals of an antidepressant special issuance, the FAA concluded in a late 2022 policy that a neuropsychologist evaluation and routine CogScreen-AE administration were no longer necessary except where clinically indicated. If you went through this years ago, do not assume your file looks the same this time, and do not let a well-meaning clinician work from an old checklist.
Do not buy testing before the FAA asks for it
The guide says this plainly in its own guidance to examiners: additional testing should not be obtained until requested by FAA physicians. It is good advice for pilots too, and it goes against instinct. Waiting feels passive when your certificate is sitting in Oklahoma City.
Testing done early tends to be testing done wrong. It gets administered under a protocol that does not match what the FAA will eventually specify, or without pilot norms, or by a clinician not on the relevant list. You then have two problems instead of one: the evaluation still has to be done properly, and there is now a prior result in your history that the agency can see and will ask about.
A returned report usually means the checklist went unanswered
The specification is a checklist, and the FAA reads the report as an answer to that checklist. A thoughtful four-paragraph letter from a clinician who has known a pilot for years, concluding that they are doing well and should be able to fly, can be clinically sound and still fail, because it does not address the items.
This is the part that catches pilots who take the letter to a trusted general clinician. There is nothing wrong with that clinician. They have never read the specification, they do not know that a particular item has to be addressed in a particular way, and nobody tells them until the request for more information arrives. When you call someone about an FAA evaluation, the useful question is not whether they treat pilots. It is whether they have read the specification your letter cites and will write to it.
How to read your letter in ten minutes
- Find the exact words. Psychiatric, psychological, or neuropsychological, and whether more than one is named.
- Note every supporting item requested: treatment records, hospitalization records, prescription history, letters from treating providers. Those usually take longer to collect than the evaluation takes to complete.
- Note any deadline, and note whether the letter asks for a current evaluation, which means recent, not one you already have.
- Match the word to a credential. Psychiatric means a physician. Psychological means a doctoral psychologist with assessment expertise. Neuropsychological means a neuropsychologist from the FAA's list.
- Ask the clinician you call whether they have read that specification. If the answer is unclear, keep calling.
If all of that is more than you want to sort out alone, bring the letter to a consultation call and we will read it together, including when the answer is that you need a physician or a neuropsychologist rather than me.
The bottom line
Three words, three credentials, three specifications. Which word appears in your letter is not a formatting detail, and the costliest delays in aeromedical certification are usually administrative: careful work, done sincerely, by the wrong discipline, in the wrong format, at the wrong point in the process. Pilots clear these evaluations all the time. They clear them faster when the first appointment is the correct one.
If you have a letter in front of you and are not sure what it is asking for, bring it to a free consultation and we will work out which evaluation you need before you book anything. If you also want to talk about the flying part of your life rather than only the paperwork, that is a conversation I am glad to have.
Frequently Asked Questions
What is the difference between an FAA psychiatric evaluation and an FAA psychological evaluation?
A psychiatric evaluation is performed by a physician, an MD or DO, and the FAA's specifications point to board certification in psychiatry, with aerospace experience preferred and addiction psychiatry or HIMS training where substance use is involved. A psychological evaluation is performed by a clinical psychologist with a doctoral degree, independent state licensure, and expertise in psychological assessment, and its report rests on the interpretation of a full battery of psychological tests. They are not interchangeable, and a report from the wrong discipline is generally returned.
Who can perform an FAA neuropsychological evaluation?
The FAA asks for a qualified neuropsychologist with additional training in aviation-specific topics, and it publishes a list of neuropsychologists who meet its quality criteria. The battery is standardized and includes the CogScreen-AE, and where pilot norms exist for a test, the specification requires that those norms be used. An evaluation performed outside those requirements may have to be repeated.
Why did the FAA ask for a psychiatric evaluation instead of a psychological one?
Medication is the most common reason. Psychotropic medication is disqualifying for certification purposes until the FAA says otherwise, which is why an AME who sees it defers the application rather than issuing, and when a prescription sits at the center of a file the agency generally wants a physician to account for it. Your letter should name which evaluation is required; if it does not, your AME can tell you what was requested.
Should I get testing done before the FAA asks for it?
Generally no. The FAA's own guidance to examiners says additional testing should not be obtained until requested by FAA physicians. Testing arranged early is often administered under the wrong protocol, without pilot norms, or by a clinician outside the FAA's requirements, which means it has to be repeated and the earlier result is still part of your history.
Can my own therapist write the report?
Only if they hold the credential the specification requires and are willing to write to that specification. A clinically sound letter from a trusted provider still fails if it does not address every item the FAA listed. Before scheduling, ask whether the clinician has read the specification your letter cites.
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