Your CogScreen-AE results came back low. Here's what to do.

Dr. Jordan 'Coach' Keller•
Your CogScreen-AE results came back low. Here's what to do.

Your CogScreen-AE results came back low. Here's what to do.

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

Quick facts
What "low" means LRPV below threshold triggers FAA review — not automatic denial
FAA review timeline 30–90 days typical
Retest availability Yes — timing and eligibility depend on AME guidance
Special Issuance Available pathway for many pilots with low results

This is part 3 of the CogScreen-AE test day series

Part 1 — CogScreen-AE test day: what to expect from start to finish
Part 2 — 5 mistakes pilots make on the CogScreen-AE
Part 3 — Your results came back low. Here's what to do. ← you are here

TL;DR

  • There is no binary pass/fail on the CogScreen-AE
  • A low LRPV triggers additional FAA review — not an automatic denial
  • Your options are additional evaluation, Special Issuance, or retest — and they often run in parallel
  • Many pilots with initially low scores ultimately receive medical certification
  • Your first call should be to a HIMS AME, not a standard AME — that distinction matters more than most pilots realize

Table of contents

  1. First: what "low" actually means
  2. What happens in the first 48 hours
  3. What happens over the next 90 days
  4. Your three options — explained clearly
  5. The HIMS AME: your most important call
  6. If a retest is in your future
  7. What PilotPrep can do from here
  8. FAQ

You just got your CogScreen-AE results. The number is lower than you hoped.

Before anything else: take a breath. The conclusion pilots typically jump to — that a low result means their career is over — is almost never accurate. It's understandable. It's also not what the process looks like in practice.

This article gives you the honest picture: what a low LRPV actually means, what the FAA does next, and what your real options are. Not reassurance for its own sake. Just the accurate account of how this works, because knowing that changes what you do next.

First: what "low" actually means

The CogScreen-AE does not produce a pass or a fail. It produces an LRPV — a Logistic Regression Probability Value. That score compares your cognitive profile on this particular administration to healthy pilots your age. A low score means your profile was less consistent with that reference population on the day you took the test.

That's a narrower statement than it might feel like right now.

A number of factors can produce a lower-than-expected LRPV that have nothing to do with underlying cognitive deficits: poor sleep in the days before the test, test anxiety, format unfamiliarity with specific subtests, illness, or medication effects. If any of those were present — and you'll likely know if they were — document them now while the details are fresh. That context can be included in your AME's submission to the FAA.

What a low score triggers is FAA review, and potentially a request for additional neuropsychological evaluation. Not an immediate denial. The FAA review process is not adversarial. It's a mechanism for gathering more information before a certification decision is made.

For the full explanation of how the LRPV is calculated and what the component scores measure, the understanding CogScreen-AE scores guide is the right starting point.

What happens in the first 48 hours

This is the window where the right moves matter most — and where pilots most often make avoidable errors by acting too quickly or not quickly enough.

Do immediately:

First, document any factors that may have affected your performance. Sleep quality the night before. Any illness in the days prior. Medication changes. Unusual stress. Write it down now, with dates. This information can be part of your AME's submission and your HIMS AME's assessment.

Second, do not schedule anything independently. Don't call a neuropsychologist to arrange a second evaluation. Don't schedule a retest. Don't submit anything to the FAA on your own. Wait for the formal process to tell you what's being requested before you respond to it.

Third, call a HIMS AME before you respond to anything. Not your standard AME — a HIMS AME. That distinction is covered in detail below, but the short version is this: a standard AME cannot navigate the process that's now in front of you. A HIMS AME can, and getting them involved early gives you the strongest possible position before the FAA review begins.

What happens over the next 90 days

Here's the realistic sequence:

Weeks 1–2: The neuropsychologist sends the written report to your AME. Your AME reviews it and submits it to the FAA with their assessment.

Weeks 2–4: The FAA receives the package and opens a review. This is not a hearing. It's an administrative process.

Weeks 4–8: The FAA may request additional evaluation or documentation — a full neuropsychological battery, HIMS AME oversight, or supplementary records. If they do, you'll receive a letter specifying exactly what's needed.

Weeks 8–12: FAA decision. Outcomes at this stage include Special Issuance issued, additional evaluation requested, or — in a minority of cases — denial.

Total: 30–90 days is typical. Complex cases or cases requiring additional evaluation can run longer. If you haven't heard anything after 45 days, follow up with your AME for a status update.

Your three options — explained clearly

These paths are not mutually exclusive. In many cases they run in parallel, and a HIMS AME will help you understand which combination applies to your situation.

Option A: additional neuropsychological evaluation

The FAA may request a more comprehensive evaluation beyond the CogScreen alone — a full neuropsychological battery administered by a qualified neuropsychologist. This gives the FAA additional data points and provides a more complete picture of your cognitive profile than a single CogScreen administration can offer.

This is not a punishment. It's a standard part of the review process for scores that fall below the threshold, and the results of a comprehensive evaluation often provide the documentation needed to support a Special Issuance application.

Option B: Special Issuance

Special Issuance is a medical certificate issued to pilots who don't meet standard certification criteria but can demonstrate they meet the FAA's safety standard. It is not rare — thousands of pilots currently fly on Special Issuance certificates. Many of the conditions that trigger CogScreen review, including ADHD, TBI history, and certain neurological concerns, have established Special Issuance pathways with documented precedent.

Special Issuance requires working with a HIMS AME. If ADHD is part of your picture, the FAA ADHD Fast Track certification guide covers that specific pathway in detail — it's the most comprehensive resource available on the 2026 process.

A complete guide to FAA Special Issuance medical certificates across all conditions is coming to faacogscreen.com. Until then, your HIMS AME is the authoritative source for your specific situation.

Option C: retest

Retesting is possible, but it's not a guaranteed option and the timing is not yours to set unilaterally. The FAA may or may not accept a retest as part of their review process. Confirm with your HIMS AME before scheduling one independently.

If a retest is the right path, more on preparation is in the section below.

The HIMS AME: your most important call

This is the section of this article that matters most if your results have triggered FAA review.

A standard AME — the one who issued your most recent medical certificate — is not equipped to navigate the Special Issuance process. That's not a criticism of standard AMEs. It's a structural fact about how FAA medical certification works. Special Issuance cases require a specialist: a Human Intervention Motivation Study Aviation Medical Examiner, known as a HIMS AME.

HIMS AMEs handle complex certification cases involving neurological, psychiatric, and substance-related conditions. They know the FAA review process from the inside — the documentation requirements, the realistic timelines, the specific language the FAA responds to. A good HIMS AME doesn't just file paperwork. They help you build the strongest possible submission before the FAA review begins.

How to find one: go to faa.gov/pilots/amelocator and filter for Senior AME. Not all Senior AMEs are HIMS-designated, so confirm when you call.

What to bring to that first conversation: your CogScreen report, or the preliminary LRPV if the full written report isn't complete yet. Your complete medical history relevant to the reason for the CogScreen referral. Any documentation of factors that may have affected your performance on test day.

One point worth repeating: don't wait for the FAA letter before making this call. Engaging a HIMS AME now — before the FAA has formalized their request — gives you time to prepare a proactive response rather than a reactive one.

If a retest is in your future

If your HIMS AME confirms that retesting is part of your path, the preparation window matters. Here's how to use it well.

Start by identifying which specific subtests drove the low LRPV. Your neuropsychologist can tell you this from your results — ask them directly. The LRPV is a composite, and a targeted preparation approach focused on your weakest subtests is more effective than running the full battery repeatedly.

From there, address the controllable factors that may have affected your first test. Sleep discipline in the final days before the appointment. Format familiarity with the specific subtests that tripped you up. Anxiety management, which is a trainable skill. The 5 mistakes pilots make on the CogScreen-AE covers all of these in detail — if any of those factors were present in your first test, that's where to focus.

Give yourself a minimum of three to four weeks of structured preparation before retesting. The 4-week CogScreen study plan is built for exactly this window — it includes a proper taper so you arrive rested rather than depleted. The 10 evidence-based preparation strategies covers the cognitive science behind what actually improves performance.

What PilotPrep can do from here

A direct statement first: PilotPrep cannot change your LRPV from the first test. It cannot influence the FAA review process. What happened has happened, and the path forward runs through your HIMS AME and the FAA — not through a preparation platform.

What PilotPrep can do is give you a specific, measurable preparation structure if a retest is part of your path.

The practice modules cover all 13 CogScreen subtests individually. If you know which subtests drove your low LRPV, you can train those specifically rather than working the full battery. Scores are reported against pilot norms — the same normative population used in the CogScreen-AE — so you get a realistic picture of where you stand relative to other pilots, not the general population. Session logs track your performance across time, giving you documented evidence of consistent improvement that you can share with your HIMS AME or neuropsychologist as part of your retest preparation record.

If a retest is not in your immediate future, the modules still build the underlying cognitive skills the CogScreen measures — working memory, processing speed, sustained attention. That foundation is worth having regardless of where the certification process goes.

No account needed to start.

Try 5 free questions →

From the faacogscreen.com resource library

The full CogScreen-AE process — from first appointment to certification decision — is covered here:

FAQ

Can I fly while my case is under FAA review? This depends directly on your certificate class and current status — it's not a question with a single answer that applies to all pilots. Ask your HIMS AME this question in your first conversation with them. Do not assume either way.

Can I appeal a denial? Yes. The appeal process exists and pilots use it. It is lengthy, and a HIMS AME is essential for navigating it. In cases involving formal denial, some pilots also consult an aviation attorney. For most cases that reach the review stage, denial is not the outcome — but if it is, it's not the end of the road.

How long before I can retest? Typically months, not weeks. The timing depends on FAA guidance in your specific case. Confirm with your HIMS AME before scheduling anything.

Will a low CogScreen result affect my future medicals? It becomes part of your medical record. A successful Special Issuance, however, demonstrates that you meet the FAA's safety standard — and that documentation travels with you going forward as a positive data point, not only as a flag.

Do I need a lawyer? For most cases that reach the review stage: no. For cases involving an appeal after formal denial, consulting an aviation attorney who specializes in FAA matters is worth considering.

What if I think my result was affected by illness or other circumstances? Document it now — dates, specifics, anything relevant. Discuss it with your HIMS AME. That context can be included in the FAA submission and may be meaningful in the review process.

Can I get a second opinion on the neuropsychological evaluation? Yes. Discuss this with your HIMS AME before arranging it independently. They can advise on how a second evaluation fits into your specific review process and how to document it appropriately.

More from faacogscreen.com

New guides publish every Tuesday and Friday at faacogscreen.com.

References

  • Kay, G.G. (1995). CogScreen Aeromedical Edition: Professional Manual. Psychological Assessment Resources.
  • Taylor, J.L., O'Hara, R., Mumenthaler, M.S., & Tinklenberg, J.R. (2000). Cognitive ability, expertise, and age differences in following air-traffic control instructions. Psychology and Aging, 15(4), 753–762.
  • Van Benthem, K., et al. (2024). Cognitive screening in aviation: current practice and future directions. Aviation, Space, and Environmental Medicine.
  • FAA Office of Aerospace Medicine. Neuropsychological evaluation requirements. FAA AME Guide. faa.gov/ame_guide
  • FAA AME Locator. faa.gov/pilots/amelocator

Ready to prepare for the CogScreen-AE?

Start training with our adaptive cognitive modules designed specifically for pilots. Get instant access to real-time scoring and performance tracking.

Start Free Trial