Was My ADHD Diagnosis Done Properly? Second Opinions

Updated October 13, 2026. Part of the New York Adult ADHD Guide, weigh your options section. Medically reviewed by John C. Shershow, M.D. on October 13, 2026. Editorial policy

Key points

A 2024 review in American Family Physician says diagnosis requires a thorough clinical history, symptom and functional assessment with validated instruments, and collateral information.
Adult criteria require at least five symptoms of inattention and/or hyperactivity-impulsivity, several present before age 12, in two or more settings, with clear impairment.
Even an accurate screener produces false positives: about one in three positive results on the DSM-5 ASRS in the general population was not ADHD on a full interview.
In a 2023 CDC survey, 8.9% of adults with a current ADHD diagnosis had been diagnosed by telehealth only; the medium is lawful in New York.
A meta-analysis of adults 50 and older found 2.18% met criteria on research scales while 0.23% had a clinical diagnosis, a sign that ADHD is also missed.

Doubt about an ADHD diagnosis runs in both directions. Some adults were diagnosed in a single short video visit and wonder whether it would hold up. Others were told "it's just anxiety" after ten minutes and suspect something was missed. In both cases the useful question is the same: what did the evaluation consist of? This article gives a way to answer that, and describes what a second opinion involves.

What a proper evaluation rests on

There is no laboratory test to fall back on. The CDC states that there is no single test to diagnose ADHD, so the quality of a diagnosis is the quality of the clinical evaluation behind it. Three sources describe that evaluation in similar terms.

The criteria. For adults, at least five symptoms of inattention and/or five of hyperactivity-impulsivity, lasting six months or more, with several symptoms present before age 12, in two or more settings such as home and work, causing clear impairment.
The rule-out. The clinician must judge whether another condition explains the symptoms better. The CDC names sleep disorders, anxiety, depression and some learning disabilities as conditions that can look similar.
The method. American Family Physician's 2024 review calls for a thorough clinical history, validated instruments and collateral information. CHADD adds an interview from childhood to the present, input from a partner or parent, screening for co-existing conditions and a medical check for causes such as thyroid problems.

The plain-language version of the criteria is in the diagnostic criteria for adult ADHD.

A checklist for the evaluation you had

Question	Why it matters
Did a licensed clinician talk with you live, at some length?	Diagnosis is a clinical judgment; an AAFP toolkit notes it usually takes two to three visits
Were you asked about childhood, school and early behavior?	Several symptoms must have been present before age 12
Were you asked how symptoms affect work, home and relationships?	Symptoms without significant impairment do not meet criteria
Did you complete a rating scale as part of the visit, not instead of it?	Validated instruments are expected, and screeners alone produce false positives
Was anyone who knows you, or any old record, consulted or requested?	Collateral information is part of the standard
Were sleep, mood, anxiety, substance use and medical history covered?	Other conditions can explain or accompany the symptoms
Do you know the clinician's name, profession and New York license?	The clinician must be licensed here when you are located in New York

A "no" on one line does not make a diagnosis wrong. Collateral information is sometimes unavailable, for instance. Several "no" answers mean the conclusion was reached on thin evidence, whichever way it came out.

If you were diagnosed quickly online

A telehealth diagnosis is not suspect because it was made by video. New York law includes assessment and diagnosis in its definition of telehealth, and in the CDC's 2023 survey 8.9% of adults with a current diagnosis had been diagnosed through telehealth alone. The lawful version and its current rules are laid out in online ADHD diagnosis in New York.

The concern is brevity. A diagnosis built mainly on a questionnaire inherits the questionnaire's error rate. In the general population study of the six-question DSM-5 ASRS, the screener's positive predictive value was 67.3%, so about one in three people who screened positive did not have ADHD when fully interviewed.

Two practical consequences follow. A new prescriber makes an independent judgment and is not obliged to continue a medication on the strength of someone else's diagnosis. Third parties also set their own bar: colleges, campus health services and exam boards publish documentation rules, and some of them ask for far more than a short visit produces. Those rules are compared in what an ADHD evaluation report needs for work, school and exams.

If ADHD was ruled out, or never considered

Missed diagnoses are well documented. In the CDC survey, 55.9% of adults with current ADHD were diagnosed at 18 or older. Among adults 50 and older, a meta-analysis of 20 studies found that 2.18% met criteria on validated research scales, 0.23% had a clinical diagnosis and 0.09% were being treated.

Reasons to ask for another look include being told ADHD is impossible because you did well in school or hold a demanding job, being evaluated only for the condition you first mentioned, or years of treatment for anxiety or depression that has helped only partly. ADHD can also sit alongside another condition, which is why CHADD lists screening for co-existing conditions as part of the evaluation. Finding anxiety or depression does not by itself exclude ADHD.

The reverse is also true. Mood, anxiety and sleep conditions can produce inattention without ADHD, and an evaluator who concludes that after a careful history has done the job properly. How clinicians separate the two is discussed in is it ADHD or anxiety?

What a second opinion covers

A re-evaluation is a new clinical evaluation, with the advantage of a paper trail. Expect the clinician to:

read the earlier report, rating scales and any test scores;
take the developmental and school history again, including what was happening before age 12;
ask for collateral information from a partner, parent or sibling, or old records;
screen for co-occurring conditions and review medical history and current medications;
ask how you responded to any treatment so far.

Neuropsychological testing is an option when the picture stays unclear. The American Family Physician review says it may increase diagnostic accuracy when collateral information is missing or co-occurring conditions confuse the picture. It is not a required step.

Be ready for either result. A second opinion can confirm the first diagnosis, replace it, or add a condition alongside it. A response to stimulant medication does not settle the question; the New York bar examiners' handbook notes that a positive response to medication by itself is not supportive of a diagnosis.

How to ask for one

Request your records from the first clinician, including the evaluation note and any rating scale results, and bring them. Tell the new clinician plainly that you want the diagnosis reviewed, and whether you are currently taking medication. Keep taking prescribed medication as directed in the meantime, and raise any change with the prescriber. If you are changing prescribers at the same time, the timing is covered in switching ADHD prescribers in New York without a gap in medication. What an evaluation involves at this practice is described on the adult ADHD evaluation page.

Questions

Is a diagnosis from a telehealth company a real diagnosis?

It can be. New York law treats assessment and diagnosis by telehealth as health care, provided the clinician is licensed in New York. What decides its quality is whether the clinician took a full history, assessed impairment, used validated instruments and considered other conditions.

How long should an adult ADHD evaluation take?

There is no legal minimum. An AAFP toolkit notes that adult diagnosis usually takes two to three visits. A single brief visit that skips childhood history, impairment and other conditions leaves the conclusion resting on little evidence.

Will a new psychiatrist accept my existing diagnosis?

A new prescriber makes an independent judgment and is not required to adopt a previous diagnosis or continue a previous prescription. Bringing the earlier evaluation report, rating scales and any school or family information makes the review faster and more accurate.

My medication works. Doesn't that prove the diagnosis?

No. Response to a stimulant is not treated as proof of ADHD. The New York bar examiners' handbook, for example, states that a positive response to medication by itself is not supportive of a diagnosis. The diagnosis rests on history and impairment.

I was told I can't have ADHD because I did well in school. Is that right?

Good grades do not rule ADHD out. The criteria ask about symptoms before age 12, symptoms in more than one setting and impairment, and impairment can show up outside report cards. If the history was never taken in detail, a second evaluation is reasonable.

Sources

This article is general information, not medical or legal advice. Rules and coverage change; check the linked sources for the current position, and speak with a clinician or attorney about your own situation.

Was my ADHD diagnosis done properly? When to get a second opinion