If your Aviation Medical Examiner or an FAA letter has asked for a neurological evaluation, this page explains what happens and what you leave with. Dr. Achillefs Ntranos, MD, a board-certified neurologist, performs the evaluation himself, in person, usually the same or next business day.
We are neurologists, not Aviation Medical Examiners
We do not issue, defer, or deny medical certificates. We examine you and write the neurological report your AME and the FAA use to make that decision. If you still need an AME, the FAA's designee locator is the place to start.
When the FAA asks for one
The request arrives one of three ways: your AME defers your exam and asks for a neurologist's report, the FAA sends a letter listing what it needs, or you know from your history that a report will be required and want it ready before you see the AME.
Conditions that commonly trigger it:
- Seizures or epilepsy, including a single seizure years ago
- Stroke or transient ischemic attack
- Concussion or head injury, especially with loss of consciousness
- Migraine with aura, or frequent headaches
- Tremor, multiple sclerosis, or other demyelinating conditions
- White matter lesions or other unexplained brain MRI findings
- Cognitive symptoms or memory concerns
- Neuropathy affecting sensation or strength
- Fainting or unexplained loss of consciousness
The FAA specification requires the evaluation to have been performed within the last 90 days. If your letter states a shorter window, follow the letter. Tell us your deadline when you call and we book around it.
Visual guide
A neurological report for aviation review
- Assess: review your history and examine you in person.
- Document: include the findings and required supporting tests.
- Submit: your AME and the FAA use the report in certification decisions.
How the evaluation works
Before the visit
Send us the FAA letter or AME request, prior neurology, hospital, and emergency records, imaging and EEG reports, and a medication list. Images upload through our patient tools page. Dr. Ntranos reviews everything before you arrive and plans for any test the letter names.
The history
When the condition started, how often events occur, when the last one was, what treatment you have had, what you take now, and what has changed since your last certificate.
The examination
Mental status, cranial nerves, strength, sensation, reflexes, coordination, and gait. Cognitive testing is added when the condition or the FAA request calls for it.
Testing, if the FAA asks for it
MRI, EEG, or laboratory tests are ordered near you and run through your insurance, with our office handling the prior authorization. The report waits for the results, because a report without them usually draws a follow-up request.
The report
You receive the signed report and supporting documents and take them to your AME, who submits them. If the FAA comes back with a question, we answer it in writing. If the outcome is a Special Issuance with a yearly report attached, we schedule those follow-ups so the certificate does not lapse.
Visual guide
Bring the evidence the request calls for
- Request: send the letter and tell us your deadline.
- Evidence: bring prior notes, imaging, EEG reports and medications.
- Testing boundary: a formal FAA neuropsychological battery requires an aviation-trained neuropsychologist.
What the FAA specification asks the report to contain
The FAA publishes a specification sheet for neurological evaluations, and the report is written to it. It requires the evaluation to be performed by a board-certified physician who holds current certification from the American Board of Psychiatry and Neurology or the equivalent. It asks for a detailed account of a recent neurological examination; the history of the condition with dates of events and treatment; the results of any imaging, EEG with activating procedures, or laboratory tests the condition warrants; and a mental status assessment. For the cognitive screen the FAA accepts the Montreal Cognitive Assessment (MoCA), the Kokmen Short Test of Mental Status, or the St. Louis University Mental Status exam (SLUMS), and it asks for the score sheets. It does not accept the Folstein Mini-Mental State Examination. A screen is not required when a current comprehensive neuropsychological assessment is already on file. Writing to the specification is what keeps a report from coming back with a request for more.
What you leave with
| What you get | What we do not provide |
|---|---|
| A signed report on letterhead for your AME and the FAA, following the FAA's published neurological evaluation specifications | FAA Form 8500-8, which your AME completes |
| Copies of the imaging, EEG, and laboratory reports behind the opinion, so the FAA need not request them | A medical certificate, or any decision to issue, defer, or deny one |
| A duplicate set for your file, since renewals ask for the same documents again | Any assurance of the outcome. We write what we find |
| A written answer if your AME or the FAA follows up | Aviation Medical Examiner services of any kind |
Cognitive testing versus a formal neuropsychological evaluation
Pilots are often unsure which they have been asked for.
In-office cognitive testing is part of the neurological evaluation when the condition warrants it, for example after a head injury or when memory is in question. It measures memory, attention, processing speed, and executive function, and the results go into the report. Our neuropsychological testing page describes the tests and how to prepare.
A formal FAA neuropsychological evaluation is a separate, longer battery the FAA specifies in detail, administered by a neuropsychologist with aviation-specific training. The FAA publishes a list of neuropsychologists who meet its criteria, and the required test battery is held on a secure FAA portal. If your letter asks for that, we help you find one and coordinate so both reports are submitted together.
Fees, and booking your evaluation
We are a direct-pay practice. One flat fee covers the evaluation and the report, with no facility charges, and the office confirms it when you book. Insurance does not cover visits for medical certificates, so plan on paying out of pocket. We can provide a superbill on request, though claims for this kind of visit are usually denied. Any MRI, EEG, or laboratory testing runs through your insurance. HSA and FSA cards are accepted, and details are on our billing page.
Appointments are usually available the same or the next business day, Monday to Friday, 9am–6pm Pacific. No referral is needed. Book an FAA neurological evaluation or call (310) 774-7025, mention it is for the FAA, give us your deadline, and send your records ahead. If the request is from the California DMV instead, see our DMV evaluation page.