Cognitive or mental impairment
What the FAA's documents say about cognitive or mental impairment, in plain words, with the FAA's own words one press away.
FAA term: Cognitive or Mental Impairment or Dysfunction, Cognitive DisorderCovers: All classes
Show the FAA's words: which classes the FAA's table covers
COGNITIVE OR MENTAL IMPAIRMENT OR DYSFUNCTION COGNITIVE DISORDER All Classes
Alzheimer's disease or dementia
The FAA's Item 46 Neurologic list names Mild Cognitive Impairment (MCI) in the titles of two tables, this one and the table for Alzheimer's disease, mild cognitive impairment or dementia, which has its own page. The text of this table does not name MCI, and this page does not say which of the two a case belongs to.
Short version
The disposition table has one row.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AA neurological finding, or its cause unknown | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Cognitive or mental impairment
- Row A · Special Issuance
A neurological finding -- cognitive impairment/dysfunction, mental impairment/dysfunction, confusion, delirium or encephalopathy -- or when the cause of the neurological finding is unknown. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Block 60.
A. Neurological finding Cognitive impairment/ dysfunction Mental impairment/dysfunction Confusion Delirium Encephalopathy OR When the cause of the neurological finding is unknown Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Block 60.
The FAA pathways for cognitive or mental impairment
Your step-by-step plan
Step 1: The neurological evaluation
From your treating neurologist, within 90 days of the exam.Within 90 days before the examA current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation, from a clinic visit with your treating neurologist no more than 90 days before the exam.
Show the FAA's words: The neurological evaluation
1. A current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam.
FAA source: Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
A. Neurological finding Cognitive impairment/ dysfunction Mental impairment/dysfunction Confusion Delirium Encephalopathy OR When the cause of the neurological finding is unknown
FAA source: Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Step 2: The neuropsychological evaluation
To the FAA's specifications, within 90 days of the exam.Neuropsychological (NP) evaluation
Within 90 days before the examA neuropsychological (NP) evaluation that meets the FAA's specifications, from a clinic visit with your treating neuropsychologist no more than 90 days before the exam.
The report must include, at a minimum
- A review of all available records, including academic records, records of prior psychiatric hospitalizations, and records of periods of observation or treatment
- A thorough clinical interview, with a detailed history
- A mental status examination
- Interpretation of a full battery of neuropsychological and psychological tests, including but not limited to the core test battery
- An integrated summary of findings with an explicit diagnostic statement, and the neuropsychologist's opinions and recommendations on clinically or aeromedically significant findings and the potential impact on aviation safety consistent with the Federal Aviation Regulations
The clinical interview's history covers
- Psychosocial or developmental problems
- Academic and employment performance
- Legal issues
- Substance use/abuse, including treatment and quality of recovery
- Aviation background and experience
- Medical conditions, and all medication use
- Behavioral observations during the interview and testing
Score reports and score summary sheet
With the neuropsychologist's report: copies of all computer score reports, and an appended score summary sheet with all scores for all tests administered.
The score summary sheet
- Pilot norms, when available
- If pilot norms are not available for a test, the normative comparison group is specified
- Percentile scores, when available
Show the FAA's words: The neuropsychological evaluation
2. A Neuropsychological (NP) evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment from a clinic visit with the treating neuropsychologist no more than 90 days before the AME exam.
FAA source: Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Who may perform a neuropsychological evaluation? Neuropsychological evaluations should be conducted by a qualified neuropsychologist with additional training in aviation-specific topics. The following link contains a list of neuropsychologists who meet all FAA quality criteria. See FAA Neuropsychologist List
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
What must the neuropsychological evaluation report include? At a minimum: A review of all available records, including academic records, records of prior psychiatric hospitalizations, and records of periods of observation or treatment (e.g., psychiatrist, psychologist, or pediatric neuropsychiatrist treatment notes). Records must be in sufficient detail to permit a clear evaluation of the nature and extent of any previous mental disorders. A thorough clinical interview to include a detailed history regarding: psychosocial or developmental problems; academic and employment performance; legal issues; substance use/abuse (including treatment and quality of recovery); aviation background and experience; medical conditions, and all medication use; and behavioral observations during the interview and testing. A mental status examination. Interpretation of a full battery of neuropsychological and psychological tests including but not limited to the core test battery (specified below). An integrated summary of findings with an explicit diagnostic statement, and the neuropsychologist's opinion(s) and recommendation(s) regarding clinically or aeromedically significant findings and the potential impact on aviation safety consistent with the Federal Aviation Regulations.
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
Recommendations should be strictly limited to the psychologist's area of expertise.
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
What must be submitted? The neuropsychologist's report as specified in the portal, plus : Copies of all computer score reports; and An appended score summary sheet that includes all scores for all tests administered. When available, pilot norms must be used . If pilot norms are not available for a particular test, then the normative comparison group (e.g., general population, age/education-corrected) must be specified. Also, when available, percentile scores must be included.
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
You should make records available to the neuropsychologist prior to the evaluation, to include: Copies of all records regarding prior psychiatric/substance-related hospitalizations, observations or treatment not previously submitted to the FAA. A complete copy of your agency medical records. You should request a copy of your agency records be sent directly to the psychiatrist and psychologist by submitting a Request for Airman Records (FAA Form 8065-2)
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
Why is a neuropsychological evaluation required? Head trauma, stroke, encephalitis, multiple sclerosis, other suspected acquired or developmental conditions, and medications used for treatment, may produce cognitive deficits that would make an airman unsafe to perform pilot duties. This guideline outlines the requirements for a neuropsychological evaluation.
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
What is required in the core test battery? To promote test security, itemized lists of tests comprising psychological/neuropsychological test batteries have been moved to a secure site. Authorized professionals should use the portal at FAA Neuropsychology Testing Specifications . For access to the portal, email a request to 9-AMC-AAM-NPTesting@faa.gov .
For questions about testing or requirements, email 9-AMC-AAM-NPTesting@faa.gov .
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
What else does the neuropsychologist need to know? The FAA will not proceed with a review of the test findings without the above data.
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
The data and clinical findings will be carefully safeguarded in accordance with the APA Ethical Principles of Psychologists and Code of Conduct (2002) as well as applicable federal law. The raw neurocognitive testing data may be required at a future date for expert review by one of the FAA's consulting clinical neuropsychologists. In that event, authorization for release of the data by the airman to the expert reviewer will need to be provided.
FAA source: Neurocognitive Impairment. FAA date 26 June 2024; checked by Crosscheck 14 October 2026.
Step 3: Other testing
Testing already performed or deemed necessary by your treating physician.Any other testing already performed or deemed necessary by your treating physician.
Show the FAA's words: Other testing
3. Any other testing already performed or deemed necessary by the treating physician.
FAA source: Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Note: If the cause of the cognitive impairment is known (due to another condition - e.g., stroke, traumatic brain injury, substance abuse, multiple sclerosis, neurodegenerative disease, mood disorder, a specified medical illness, or specified medication effect) – see that section for any additional evaluation data requirements.
FAA source: Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI). FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
Row ADefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Block 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
A neurological finding -- cognitive impairment/dysfunction, mental impairment/dysfunction, confusion, delirium or encephalopathy -- or when the cause of the neurological finding is unknown. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and annotates the elements or findings in Block 60.
A. Neurological finding Cognitive impairment/ dysfunction Mental impairment/dysfunction Confusion Delirium Encephalopathy OR When the cause of the neurological finding is unknown Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance Annotate (elements or findings) in Block 60.
If the examiner defersSpecial Issuance
The table marks Row A, a neurological finding or a neurological finding whose cause is unknown, DEFER.
What the FAA lists to send
- Item 1. A current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation, from a clinic visit with the treating neurologist no more than 90 days before the exam.
- Item 2. A neuropsychological (NP) evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, from a clinic visit with the treating neuropsychologist no more than 90 days before the exam.
- Item 3. Any other testing already performed or deemed necessary by the treating physician.
- Item 4. With the neuropsychologist's report, as the specifications page lists, copies of all computer score reports and an appended score summary sheet that includes all scores for all tests administered.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row A, a neurological finding or a neurological finding whose cause is unknown, DEFER.
A. Neurological finding … OR When the cause of the neurological finding is unknown … DEFER Submit the information to the FAA for a possible Special Issuance
What the FAA lists to send
- Item 1
A current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation, from a clinic visit with the treating neurologist no more than 90 days before the exam.
1. A current, detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam.
- Item 2
A neuropsychological (NP) evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, from a clinic visit with the treating neuropsychologist no more than 90 days before the exam.
2. A Neuropsychological (NP) evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment from a clinic visit with the treating neuropsychologist no more than 90 days before the AME exam.
- Item 3
Any other testing already performed or deemed necessary by the treating physician.
3. Any other testing already performed or deemed necessary by the treating physician.
- Item 4
With the neuropsychologist's report, as the specifications page lists, copies of all computer score reports and an appended score summary sheet that includes all scores for all tests administered.
The neuropsychologist's report as specified in the portal, plus : Copies of all computer score reports; and An appended score summary sheet that includes all scores for all tests administered.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
The two documents describe the neuropsychologist differently
The table asks for the NP evaluation from a clinic visit with the treating neuropsychologist no more than 90 days before the exam. The specifications page says neuropsychological evaluations should be conducted by a qualified neuropsychologist with additional training in aviation-specific topics, and it gives no time. This page shows both as published.
Show the FAA's words: good to know, 1
2. A Neuropsychological (NP) evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment from a clinic visit with the treating neuropsychologist no more than 90 days before the AME exam.
Neuropsychological evaluations should be conducted by a qualified neuropsychologist with additional training in aviation-specific topics.
The specifications the table names
The table's NP evaluation must meet FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment. That is the heading of the FAA's Neurocognitive Impairment page, which this page quotes.
Show the FAA's words: good to know, 2
that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment
Disease Protocols - Neurocognitive Impairment Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment
The specifications page names a psychiatrist and a psychologist
The specifications page is about a neuropsychologist's evaluation. It says to request a copy of the agency records be sent directly to the psychiatrist and psychologist, and that recommendations should be strictly limited to the psychologist's area of expertise. Both are shown as printed.
Show the FAA's words: good to know, 3
You should request a copy of your agency records be sent directly to the psychiatrist and psychologist by submitting a Request for Airman Records (FAA Form 8065-2) … Recommendations should be strictly limited to the psychologist's area of expertise.
A known cause has its own section too
The table's note says that if the cause of the cognitive impairment is known (due to another condition, for example stroke, traumatic brain injury, substance abuse, multiple sclerosis, neurodegenerative disease, mood disorder, a specified medical illness, or specified medication effect), see that section for any additional evaluation data requirements.
Show the FAA's words: good to know, 4
Note: If the cause of the cognitive impairment is known (due to another condition - e.g., stroke, traumatic brain injury, substance abuse, multiple sclerosis, neurodegenerative disease, mood disorder, a specified medical illness, or specified medication effect) – see that section for any additional evaluation data requirements.
The FAA will not proceed without the above data
Under its last heading, What else does the neuropsychologist need to know?, the specifications page says the FAA will not proceed with a review of the test findings without the above data. It comes after the page's lists of records, report contents and what must be submitted, and the page does not say which of that data it means.
Show the FAA's words: good to know, 5
What else does the neuropsychologist need to know? The FAA will not proceed with a review of the test findings without the above data.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI)Open to print: Cognitive or Mental Impairment or Dysfunction, Cognitive Disorder, Mild Cognitive Impairment (MCI), a PDF at the FAA, in a new tab
Special Issuance
- Open at the FAA: Neurocognitive Impairment, a page at the FAA, in a new tab
Related conditions
Each has its own page, with what the FAA's documents say about it.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.