Key points
- The EEOC says an employer may ask for a letter from your health care provider documenting that you have a mental health condition and need an accommodation because of it.
- CUNY's documentation guidelines ask for an ADHD evaluation from within the past three years; the University at Albany accepts documentation signed within the past five years.
- The New York bar examiners require ADHD documentation no more than five years old, but will consider an evaluation done at age 21 or older even if it is older than that.
- The request form for licensing exams run through the New York State Education Department, including the NCLEX, requires documentation from within the last three years.
- Columbia University's ADHD guideline calls for neuropsychological or psychoeducational assessment and says a clinical diagnosis or a prescription does not necessarily justify accommodations.
An ADHD evaluation serves two purposes that are easy to confuse. One is clinical: deciding what is going on and how to treat it. The other is documentary: proving to an employer, a college or an exam board that you have a disability and need a specific adjustment. A report that is entirely adequate for treatment can fall short of a requester's checklist. Knowing the checklist before you are evaluated saves a second round.
One principle runs through every setting
A diagnosis is where the request starts. The New York State Board of Law Examiners puts it bluntly in its accommodations handbook: "A diagnosis is not enough to establish a disability under the ADA." Requesters want to see how the condition limits you now, in the setting they control, and why the accommodation you are asking for addresses that limit. Albany's disability office says the same thing from the other direction: statements such as "student has X disability and therefore needs Y accommodation" are not sufficient.
Work: a letter is usually enough
Employers are entitled to the least. Under the Americans with Disabilities Act, the EEOC's guidance on mental health conditions says an employer may ask for a letter "from your health care provider documenting that you have a mental health condition" and that you need an accommodation because of it. If you do not want the exact diagnosis shared, a more general description may be enough. Information you give must be kept confidential, even from co-workers.
The EEOC guidance states no age limit for the letter. A useful work letter names the clinician and credentials, confirms a condition that limits specific functions (for example sustaining attention in an open office, or tracking multiple deadlines), and connects each requested change to a limitation. State and city law add their own processes, covered in ADHD workplace accommodations in New York.
College and graduate school: rules differ by campus
Colleges are not required to evaluate you or to pay for an evaluation. The U.S. Department of Education says schools "may set reasonable standards for documentation" and may ask for a diagnosis, the date and method of diagnosis, the evaluator's credentials, and how the disability affects a major life activity and academic performance. A high school IEP or Section 504 plan "is generally not sufficient documentation."
Within that frame, New York campuses differ widely. CUNY's guidelines want a recent evaluation with history and functional limitations. Albany most often accepts a letter from the treating professional. Columbia asks for testing with scores. More campus examples are in ADHD accommodations at New York colleges.
Recency rules compared
| Requester | How recent | What it asks for |
|---|---|---|
| Employer (ADA, per EEOC guidance) | No limit stated | A provider's letter confirming a condition and the need for accommodation |
| CUNY (system-wide guidelines) | Within the past three years, updated as required | Evaluation by a qualified professional; history from onset; functional limitations in the educational setting; rationale for each accommodation |
| University at Albany (SUNY) | Signed within the past five years (ADHD is grouped with learning disabilities) | Letter on letterhead from a licensed treating professional; substantial limitations; how each accommodation addresses them |
| Binghamton University (SUNY) | No limit in years; documentation must date from age 14 or older | Clear confirmation of a diagnosis; chart notes, prescription notes and screening instruments are generally not enough alone |
| Columbia University | Testing within the past five years (two years if under 18) | Neuropsychological or psychoeducational assessment with an appendix of all scores |
| New York bar exam | No more than five years old at application; an evaluation at age 21 or older is considered even if older | Diagnostic interview, third-party information, historical records, DSM diagnosis; testing "may be necessary" |
| MCAT | No more than three years before the anticipated test date | Evaluation with all test scores, including cognitive and academic achievement measures |
| NCLEX and other exams handled by the State Education Department | Within the last three years | Evaluation or diagnosis by a licensed professional on letterhead, stating accommodations as a requirement |
Two cautions. The MCAT rule comes from an AAMC guideline document last modified in December 2019 that is still linked from the live application page, so confirm it with AAMC before relying on it. And every row is one requester's rule as read in October 2026; check the linked source for your own exam or campus.
High-stakes exams ask the most
The bar examiners' handbook shows what a demanding standard looks like. Evaluators need training in differential diagnosis and direct experience with adults. Information "must consist of more than self-report." Checklists alone are not adequate, age-based standard scores must be provided for all normed measures, and the report must explain each accommodation with data. If you never had accommodations before, the evaluator should explain why they were not needed then and are needed now. Applications that do not meet the guidelines are rejected as incomplete, with no right of appeal, and late applications are rejected. Requests are due by October 31 for the February exam and March 31 for the July exam, by receipt.
The State Education Department's form adds that IEPs and Section 504 plans from secondary school "are not acceptable" because they are not evaluations of the candidate as an adult.
Federal guidance pulls the other way. The Department of Justice's testing accommodations guidance says documentation requests "must be reasonable and limited to the need for the requested testing accommodations" and that proof of past accommodations in similar settings is generally sufficient. That document states that it has no legally binding effect. Both positions are quoted accurately here, and neither cancels the other. Exam-by-exam routes and deadlines are in ADHD accommodations on the New York bar exam and other exams.
What a psychiatrist's letter can and cannot cover
A treating psychiatrist's letter or evaluation report can supply:
- the diagnosis, when and how it was reached, and the clinician's license and credentials;
- developmental history, including evidence of onset in childhood;
- current symptoms and the functional limitations they cause at work or in study;
- treatment, including medication, and what it does and does not resolve;
- recommended accommodations, each tied to a limitation.
For an employer, and for campuses that accept a treating clinician's letter, that is the whole requirement. A letter cannot supply what was never measured. Where a requester wants standard scores on cognitive or achievement tests, as Columbia and the MCAT do, those come from psychological or neuropsychological testing, which is a separate service. See clinical evaluation or neuropsychological testing.
A letter also cannot decide the outcome. The requester decides, and a prescription proves little: Columbia's guideline says a clinical diagnosis "or related prescription of medication does not necessarily justify the provision of accommodations."
Before your evaluation
- List every place you may need documentation over the next few years.
- Download each one's current guideline and note the recency rule and deadline.
- Ask the evaluator whether the report will be on letterhead, signed and dated, with license details.
- Ask whether testing is needed for your requester, and who would do it.
- Gather school records and any proof of earlier accommodations.
The preparation steps are in how to prepare for an adult ADHD evaluation, and the evaluation process at this practice is described on the adult ADHD evaluation page. This article is general information, not legal advice; for a disputed request, contact the agency concerned or a lawyer.
Questions
Is a letter from my psychiatrist enough for workplace accommodations?
Usually. The EEOC says an employer may ask for a letter from your health care provider documenting that you have a mental health condition and need an accommodation because of it. A general description of the condition may be enough if you prefer not to share the exact diagnosis.
How old can my ADHD evaluation be?
There is no single answer. CUNY asks for an evaluation within three years, the University at Albany within five, and the New York bar examiners within five unless you were evaluated at 21 or older. Licensing exams handled by the State Education Department ask for documentation from the last three years.
Do I need neuropsychological testing to get accommodations?
Only where the requester asks for it. Columbia's ADHD guideline and the MCAT guidelines call for standardized test scores, and the bar examiners say testing may be necessary. Many employers and several New York campuses accept a clinician's letter or report without testing.
Does having a prescription prove I need accommodations?
No. Requesters look for current functional limitations, and several say so directly. Columbia's guideline states that a clinical diagnosis or prescription does not necessarily justify accommodations, and the bar examiners say a diagnosis is not enough to establish a disability.
Will my high school IEP or 504 plan count?
As supporting history, often; as the only document, usually not. Federal guidance says it is generally not sufficient for college, and the State Education Department does not accept secondary school IEPs or 504 plans for its licensing exams. Keep them, because they show a record of earlier need.
Sources
- EEOC: Depression, PTSD, and Other Mental Health Conditions in the Workplace: Your Legal Rights (December 12, 2016)
- U.S. Department of Education, Office for Civil Rights: Students with Disabilities Preparing for Postsecondary Education (page reviewed October 2, 2026)
- Borough of Manhattan Community College: CUNY Documentation Guidelines
- University at Albany: Register with Disability Access and Inclusion Student Services
- Binghamton University Services for Students with Disabilities: Documentation
- Columbia University Disability Services: Guidelines for documentation of ADHD (revised June 2015)
- NYS Board of Law Examiners: Test Accommodations Handbook (revised March 2025)
- AAMC: Evaluation guidelines for learning disabilities, ADHD and psychiatric disabilities (PDF last modified December 2019)
- NYSED Office of the Professions: Request for Reasonable Accommodations for Testing (revised April 2017)
- U.S. Department of Justice, ADA.gov: Testing Accommodations (last updated February 28, 2020)
