FAA ADHD Standard Track vs Fast Track: Which One Applies to You

By Dr. Jordan 'Coach' Keller | Published March 11, 2026 | Updated August 1, 2026

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Quick facts

Pathways	Fast Track (Row A) and Standard Track (Row B) of the FAA ADHD Disposition Table
What decides it	Time since your last ADHD medication dose, plus three other conditions
Fast Track threshold	4+ years clear on all four criteria
Standard Track washout	90 days off medication minimum before neuropsychological testing
CogScreen-AE	Required in Standard Track. Not required in Fast Track

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TL;DR

• There are two tracks, and you do not choose between them. The FAA's Disposition Table assigns you one.
• The four-year clock runs from your last medication dose, not from your diagnosis.
• Ninety days off medication does not make you Fast Track eligible. That is the Standard Track washout, and confusing the two is the single most common mistake pilots make with this pathway.
• Fast Track can end in same-day issuance by your AME. Standard Track goes to Oklahoma City and typically ends in a Special Issuance with ongoing monitoring.
• The CogScreen-AE is a required part of the Standard Track battery. It is not a required part of Fast Track.

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Table of contents

1. The two tracks, named correctly
2. The decision tree
3. Pathway A: Fast Track
4. Pathway B: Standard Track
5. The mistake that sends pilots down the wrong track
6. Side by side
7. Where the CogScreen-AE fits
8. FAQ

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The two tracks, named correctly

The naming causes real confusion, so let us fix it first.

Fast Track is the expedited pathway, introduced in August 2023. It is Row A of the FAA's ADHD Disposition Table. A doctoral-level psychologist or neuropsychologist reviews your records, completes a form called the FAA ADHD Summary, and if every item comes back clean your AME can issue the certificate at your exam. The evaluator does not have to be HIMS-certified.

Standard Track is the comprehensive pathway. It is Row B. It requires a HIMS neuropsychologist, in person, running a full battery. Your AME cannot issue. The file goes to the FAA's Aerospace Medical Certification Division in Oklahoma City for a decision.

"Standard" sounds like the default and "Fast" sounds like an upgrade you apply for. Neither is true. Most pilots with any recent ADHD history land in Standard Track, and the table decides, not you.

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The decision tree

Work through these in order. Answer honestly, because the FAA has access to pharmacy benefit records and your complete medical history.

Step 1: Are you currently taking ADHD medication?

Yes. You cannot be evaluated on either track while medicated. You must discontinue under your prescribing physician's supervision and complete a 90-day washout before neuropsychological testing. Expect a urinalysis within 24 hours after testing to confirm you are medication-free. After the washout you are in Standard Track, not Fast Track. Return to Step 2 only if your last dose was over four years ago.

No. Continue to Step 2.

This includes stimulants (Adderall, Ritalin, Vyvanse, Concerta, Dexedrine) and non-stimulants prescribed for ADHD (Strattera, Intuniv, Kapvay, Qelbree). It also includes Wellbutrin when it was prescribed for ADHD. If the same medication was prescribed for a different condition, documentation matters and AME discretion applies.

Step 2: Was your last dose more than four years ago?

No, it was within the past four years. You are Standard Track. Stop here. This is the step most pilots get wrong, and it is worth being blunt: being off medication for six months, or a year, or three years does not qualify you for Fast Track.

Yes, more than four years. Continue to Step 3.

Step 3: Have you been symptom-free for those same four years?

The FAA is asking about symptoms, not prescriptions. Ongoing difficulty with attention, organisation or impulse control that you have simply stopped treating still counts.

No. Standard Track. Yes. Continue to Step 4.

Step 4: Has your academic, occupational and social functioning been stable for four years?

Course failures, performance-related job terminations, or academic accommodations within the window all count as instability.

No. Standard Track. Yes. Continue to Step 5.

Step 5: Do you have any other psychiatric diagnosis, current or historical?

This is the criterion that catches the most people, because it is not limited to the four-year window. It asks about your history, full stop.

There is one exception. A history of anxiety or depression does not automatically disqualify you from Fast Track if you also qualify under the FAA's Anxiety, Depression and Related Conditions Fast Track Pathway. Any other psychiatric history outside that exception sends you to Standard Track regardless of your medication timeline.

Yes, and it falls outside that exception. Standard Track. No. You are a Fast Track candidate.

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Pathway A: Fast Track

Realistic timeline: four to eight weeks from starting the process to holding a certificate.

What happens:

1. You gather documentation: medical records, pharmacy records, academic transcripts, employment records.
2. A doctoral-level psychologist or neuropsychologist conducts a records review and clinical evaluation. HIMS certification is not required for this pathway, though familiarity with the FAA protocol helps.
3. The evaluator completes the FAA ADHD Summary, a structured form. Every item needs to land in the "no" column.
4. You bring the completed packet to your AME appointment.
5. If the summary is clean and your AME has no independent concerns, the AME issues at the exam. No deferral to Oklahoma City.

On the CogScreen-AE: a full cognitive battery is not required for Fast Track. This is the pathway's main advantage. Some evaluators do request cognitive testing at their discretion, particularly when records raise questions about current function, so confirm with yours before assuming it is off the table.

The critical sequencing rule: do not visit your AME before your Fast Track packet is complete. Arriving without it is the most common way a qualified Fast Track candidate ends up deferred, and a deferral costs months you did not need to spend.

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Pathway B: Standard Track

Realistic timeline: four to eight months, and longer if the FAA requests additional documentation.

What happens:

1. Ninety-day washout if you were medicated, supervised by your prescribing physician and documented.
2. A HIMS neuropsychologist, in person. Virtual evaluation is not permitted for this pathway.
3. A full neuropsychological battery, typically seven to nine hours across one or two days. At minimum that means the CogScreen-AE, testing of memory, executive function and processing speed, emotional and personality screening (usually the MMPI-2 or PAI), a records review and a clinical interview.
4. Urinalysis within 24 hours of testing.
5. Your AME defers. The file goes to Oklahoma City.
6. FAA review, commonly three to six months.
7. Special Issuance if the evaluation supports certification, usually with annual HIMS AME check-ins and periodic neuropsychological retesting, often every four years. Your authorisation letter spells out the specifics. Read it and keep a copy.

Cost: community-reported figures for the full ADHD battery cluster just under $3,800, with the wider range running roughly $2,000 to $5,000 depending on geography and case complexity. Most health insurance treats aeromedical evaluation as occupational testing and does not cover it.

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The mistake that sends pilots down the wrong track

Two numbers govern this pathway and they do different jobs.

Ninety days is a washout. It is how long you must be off medication before a neuropsychologist can test you meaningfully. It is a Standard Track requirement.

Four years is an eligibility threshold. It is how long your history must be clear before the FAA will consider the expedited route.

Reading the 90-day figure as an eligibility threshold is the error, and it is an easy one to make because both numbers appear in the same FAA documents. A pilot who stopped medication eight months ago, completed a washout, and walks into an AME appointment expecting Fast Track treatment is going to be deferred. Not because anything is wrong with their case, but because they were never in Row A to begin with.

The four-year clock also starts from your last dose, not from your diagnosis. Diagnosed at nine, medicated until nineteen, currently twenty-five: your clock started at nineteen, so you are six years clear and Step 2 passes.

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Side by side

	Fast Track (Row A)	Standard Track (Row B)
Time since last dose	More than 4 years	Any time within 4 years, or currently medicated
Symptom-free period	4 years	Not applicable
Other psychiatric history	None, outside the anxiety/depression exception	Evaluated case by case
Evaluator	Doctoral-level psychologist or neuropsychologist	HIMS neuropsychologist, in person
CogScreen-AE	Not required	Required
Full battery	No	Yes, 7 to 9 hours
Who issues	Your AME, potentially same day	FAA Oklahoma City, as a Special Issuance
Realistic timeline	4 to 8 weeks	4 to 8 months
Ongoing monitoring	None	Annual HIMS AME, periodic retesting

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Where the CogScreen-AE fits

If you are in Standard Track, the CogScreen-AE is not optional and it is not a formality. It is a 13-subtest computerised battery measuring working memory, processing speed, attention, executive function and spatial reasoning, scored against pilot normative data rather than the general population.

The part worth understanding: the neuropsychologist and the FAA see your score, not your potential. Task formats like Backward Digit Span and Dual Task are deliberately unfamiliar, and pilots encountering them for the first time in a testing room routinely perform below their actual ability. That gap is not a cognitive finding. It is a familiarity finding, and it is one of the few variables in this entire process you can control in advance.

If you are in Fast Track, you probably will not face it, but confirm with your evaluator rather than assuming.

PilotPrep provides adaptive practice across all 13 subtests, scored against pilot norms, so the evaluation reflects your cognitive ability rather than your first encounter with the software.

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FAQ

I have been off medication for two years and I feel fine. Am I Fast Track? No. Two years is inside the four-year window, so you are Standard Track. Feeling fine is not one of the criteria.

I was diagnosed as a child but never medicated. Which track? If you have been symptom-free and functionally stable for four years with no other psychiatric history, you may qualify for Fast Track. A childhood diagnosis alone does not disqualify you, but you must still disclose it on MedXPress Item 18.

Can I choose Standard Track to be safe? You do not need to choose. The Disposition Table assigns your row. If you genuinely qualify for Row A, going through a full HIMS battery costs months and thousands of dollars for no benefit.

What if my evaluator says I need a CogScreen for Fast Track? Some do request cognitive testing at their discretion. That is within their remit. It does not mean you have been moved to Standard Track.

Does the four-year clock restart if I take one dose? Treat it as yes. The clock runs from your last dose. Discuss any exception with a HIMS AME before you rely on it.

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Sources

• FAA Guide for Aviation Medical Examiners, ADHD disease protocol
• FAA ADHD Disposition Table (PDF), last updated 30 October 2024
• FAA ADHD Document Checklist, Personal Statement Guidelines, and Fast Track Report Requirements
• 14 CFR Part 67, Medical Standards and Certification

Related reading: the Disposition Table explained line by line and the complete ADHD certification guide.

Requirements change. Verify current guidance at faa.gov/ame_guide and consult a HIMS AME before submitting your MedXPress application. This article is informational and is not medical or legal advice.