What Type of FAA Letter Did You Get? A Pilot's Guide to Deferral, Additional Records Requests, and Denials

Author: Dr. Jordan "Coach" Keller
Platform: faacogscreen.com
Version: 1.0
Date: April 2026
Primary Keyword: FAA deferral letter
Secondary Keywords: FAA additional records request, FAA medical denial pilots
Title Tag: What Type of FAA Letter Did You Get? Deferral vs. Records Request vs. Denial (58 chars)
Meta Description: Got a letter from the FAA after your medical exam? Learn what deferral, additional records requests, and denials actually mean—and what to do next. (155 chars)

TL;DR: The FAA sends three fundamentally different types of letters after a medical exam. Each one means something different, requires a different response, and has different consequences for your flying status and future applications. Many pilots confuse them — sometimes with serious results.

You left your AME's office without a certificate in hand. A few weeks later, a letter shows up from Oklahoma City.

Here's where I see pilots make their first mistake: they assume they know what it means.

Some think any letter from the FAA is a denial. Others assume it's just paperwork, set it aside, and miss a response deadline. A few don't realize that the letter type itself determines what they should do next — and how urgently.

The FAA communicates through several distinct letter types, and they are not interchangeable. Getting clear on which one you have is the first step in your response strategy.

The landscape changed in January 2025

Before getting into the letter types themselves, there's important context: starting January 1, 2025, when an applicant's FAA medical application is deferred by an AME, the FAA now issues an initial denial letter rather than the previous informational request letter.

The FAA explained the change this way: "If we don't have everything that we need, instead of sending a letter, an information request letter, we're going to send a denial, with a reconsideration letter."

That's a significant shift. It means what used to be called an "informational request" now arrives under the formal heading of a denial — even when the intent is simply to gather more documentation. Pilots are strongly advised to ensure all medical documentation is complete and discuss medical issues with their AME before applying for a medical certificate.

Why does this matter? Because if you receive an initial denial of your FAA medical application, you will have to forever report that denial on your FAA medical application at question 13. The paperwork implications follow you.

Letter type 1: The deferral (at the AME level)

Before you ever hear from Oklahoma City, there's the deferral that happens at your AME's office.

If the AME determines the applicant is clearly ineligible for certification, the AME gives the applicant a signed and dated Letter of Denial. Otherwise, when certification is uncertain, the AME defers — transmitting the exam to the FAA without issuing a certificate.

In practice, whenever you do not meet the criteria to be issued a medical certificate at the exam, your case is usually deferred to the FAA for further review. The AME rarely outright denies applicants — the FAA prefers that the AME defer the case and let them confirm the situation.

So if your AME said something like "I need to send this to Oklahoma City" and you left without a certificate, that's a deferral. It's not a denial. The two are different, though the 2025 policy changes have made the terminology murkier.

What triggers a deferral? Common reasons include undisclosed or recently disclosed medical conditions, ADHD or SSRI history, head injury, substance-related history, or any situation where the AME feels additional FAA review is warranted. Typically, when a medical application is deferred to the FAA, it's because the airman has or had a medical condition, takes a disqualifying medication, or has had an alcohol or drug-related arrest or conviction which the examining AME feels warrants a closer look by the FAA physicians.

Letter type 2: The additional records request (now repackaged as an "initial denial")

Under the old system, this was often the first letter pilots received from the AMCD directly: a request for more documentation. It gave you 30 to 90 days to respond and wasn't technically a denial.

Under the 2025 system, the initial denial letter will deny the applicant's application for medical certification, but will further include a list of any additional information that the FAA may require for reconsideration of the application.

Think of it this way: the letter says "denied" at the top, but what it really means in many cases is "send us what we're asking for and we'll reconsider." The changes to the FAA medical deferral process will not change the fact that if you submit documentation supporting your eligibility for certification, the FAA may still issue a medical certificate.

What kind of documentation might they request? It depends entirely on your disclosed history. The deferral/denial letter from the FAA will explicitly state it. If it calls out SSRI, HIV, ADHD, or substance use, the required test battery will be specific to those areas.

For cognitive concerns specifically, neuropsychological evaluations are required when head trauma, stroke, encephalitis, multiple sclerosis, other suspected acquired or developmental conditions, or medications used for treatment may produce cognitive deficits that would make an airman unsafe to perform pilot duties. In those cases, the letter will specify a full neuropsychological evaluation including, typically, CogScreen-AE as part of the battery.

The practical guidance here: read the letter carefully, note every item requested, and do not respond piecemeal. Submitting incomplete medical records or records that do not demonstrate a resolved medical issue will either lead the airman to a denied medical application or otherwise keep the airman in the FAA's queue for months on end.

Letter type 3: The substantive denial

This is the one pilots fear most — and with reason. A substantive denial is not a request for more information. It's a determination that, based on what the FAA has reviewed, you do not currently meet the medical standards.

When the AME concludes that the applicant is clearly ineligible for certification, the applicant is denied using the AME Letter of Denial, which provides the applicant with the reason for the denial and appeal rights and procedures.

At the AMCD level, a General Denial functions similarly. The AMCD processes nearly 7,000 General Denials annually, averaging 75 cases per workday requiring special handling and review.

If you receive a substantive denial, you have specific appeal rights. A Petition for Reconsideration must be filed within 30 days of the date of the letter and is only effective if you are providing new, previously unconsidered information to the FAA.

Miss that window, and things get worse. Under 14 CFR §67.409, if the person does not ask for reconsideration during the 30-day period after the date of the denial, they are considered to have withdrawn the application for a medical certificate.

How to identify which letter you have

Open the letter. Read the first paragraph. Here's a rough guide:

If it references your application and lists specific documents, records, or evaluations it needs — that's the new initial denial/records request. It looks like a denial but functions more like a conditional hold. Respond with everything requested, together, before the deadline.

If it uses language like "you do not meet the medical standards" without offering a reconsideration pathway based on new records — that's a substantive denial. Engage an aviation attorney or HIMS AME immediately. The 30-day clock is running.

If you're unsure, the AMCD uses non-physician legal reviewers who check incoming medical applications and write eligibility letters for approved conditions or request additional medical information for incomplete applications. You can call the AMCD in Oklahoma City directly at (405) 954-4821 to ask which category your letter falls into.

The cognitive evaluation pathway

If your letter requests neuropsychological testing — which it will specify — that evaluation will typically include CogScreen-AE as part of a broader battery. A full FAA neuropsychological evaluation can take 6 to 12 hours depending on the questions that need to be answered.

CogScreen-AE is the FAA's benchmark computerized assessment of attention, working memory, and psychomotor speed. It's administered in a controlled setting by a qualified examiner — you cannot take it at home, and you cannot self-administer it.

What you can do beforehand is familiarize yourself with the test mechanics. PilotPrep was built for exactly this purpose: 13 adaptive modules that replicate the structure, timing, and scoring logic of CogScreen-AE subtests, so the format isn't unfamiliar when you sit down for the real evaluation. Reduced test anxiety matters when the stakes are this high.

The one thing that trips pilots up most

You get the letter. You're relieved it's "just" a records request. You gather some documents, send them over, and wait.

Months pass. Then another letter arrives — this time less favorable.

This happens more than it should. Some things can only be adequately assessed with lab testing, specific examination techniques, and radiographic studies. If you had multiple issues and one of them has a mandatory waiting period, the FAA may initially only address that issue in their letter and ignore the others — until the primary barrier is resolved.

Think of it as a gatekeeper. The FAA isn't going to process your cardiologist's report if they're still waiting to see whether your head injury clears a five-year waiting period. Know the full picture of your case before you start submitting documentation.

Where to go from here

If you've received any letter from the FAA after a medical exam, the next step isn't Google — it's a HIMS AME or aviation attorney who can read the letter with you and map your specific situation.

For pilots who are heading into neuropsychological testing as part of their reconsideration pathway, the FAA maintains a list of qualified neuropsychologists on the FAA AME Guide neuropsychology page. Start there.

And if CogScreen-AE is part of what lies ahead for you, spend some time on faacogscreen.com. Familiarity with the test structure won't change your underlying cognition — but it will help you perform at your actual ability level rather than losing points to format confusion and anxiety on test day.

That distinction, sometimes, is the whole ballgame.

Dr. Jordan "Coach" Keller is an aviation neuropsychology educator and the educational voice behind PilotPrep (faacogscreen.com). This article is for informational purposes only and does not constitute legal or medical advice. Consult a HIMS AME or aviation attorney for guidance specific to your certification situation.

What Type of FAA Letter Did You Get? Deferral vs. Records Request vs. Denial