Gender identity and gender-affirming medical treatment should only be discussed when clinically relevant to the psychological evaluation.

If the applicant has already disclosed this information on the Personal History Statement (PHS) or F-3 and it is not associated with current psychological symptoms or functional impairment, avoid including unnecessary diagnostic or treatment details in the report.

Instead:

• Use brief, factual language.

• Avoid discussing diagnoses or hormone replacement therapy unless clinically relevant.

• Focus the report on current psychological functioning rather than medical history.

• Maintain the applicant's privacy while documenting only information necessary for the psychological opinion.

Psychological reports should remain focused on mental health and occupational functioning rather than medical treatment unrelated to the referral question.

Whenever an applicant reports current or recent psychiatric treatment, psychologists should obtain the appropriate records whenever clinically indicated.

Examples include:

• Current psychiatric medication

• Therapy within the past year

• Recent psychiatric hospitalization

• Ongoing psychiatric treatment

• Significant mental health diagnoses requiring verification

Treatment records help:

• Verify applicant self-report.

• Confirm treatment compliance.

• Assess psychological stability.

• Clarify diagnosis.

• Identify previously undisclosed concerns.

Records should be obtained regardless of whether the evaluator anticipates a Suitable or Not Suitable recommendation. Clinical opinions should be supported by objective documentation whenever possible.

A Not Suitable recommendation should always be supported by clear, objective, and clinically defensible evidence.

Common factors include:

• Active or poorly controlled mental health symptoms

• Recent suicidal ideation or behavior

• Unresolved trauma affecting current functioning

• Substance misuse

• Significant integrity concerns

• Poor judgment

• Persistent interpersonal difficulties

• Emotional instability

• Untreated psychological conditions

• Behavioral patterns likely to impair safe occupational functioning

Historical events alone rarely justify a Not Suitable recommendation.

Instead, evaluators should determine whether the identified concerns remain active, unresolved, or predictive of future occupational impairment.

The recommendation should be based on the applicant's current psychological readiness for the position rather than diagnosis alone.

When applicants demonstrate longstanding interpersonal, communication, or social-perception differences, psychologists should describe observable behaviors rather than assign diagnostic labels that are not necessary to explain occupational functioning.

Examples include:

• Difficulty recognizing subtle social cues

• Reduced facial expressiveness

• Limited emotional reciprocity

• Quiet or concrete communication style

• Need for direct communication

The emphasis should remain on functional workplace implications rather than presumed diagnoses.

Reports should explain how these characteristics may influence:

• Communication

• Teamwork

• Supervision

• Public interaction

• Occupational functioning

without speculating about developmental or psychiatric diagnoses.

Clinically relevant information from prior FMRT evaluations—including previous Fitness-for-Duty Evaluations (FFDEs)—may be considered when it assists in understanding the applicant's current psychological functioning.

When referencing prior FMRT information:

• Focus on clinically relevant historical findings.

• Avoid identifying the previous evaluation type.

• Do not disclose previous recommendations or outcomes.

• Do not identify the referring agency.

• Do not reference specific treatment providers or record sources.

Prior information should only be introduced when necessary to clarify significant discrepancies, omissions, or clinically relevant historical concerns.

Each evaluation should remain an independent clinical opinion based on the applicant's current functioning.

Applicants are expected to cooperate with the evaluation process by providing records that are reasonably necessary for a complete psychological assessment.

Residential treatment records

Residential treatment programs generally do not fall under FMRT's extended records policy for psychiatric hospitalizations because they are typically voluntary rather than involuntary.

However, these records often provide valuable information regarding:

• Treatment participation

• Psychological stability

• Recovery

• Current functioning

Whenever clinically relevant, psychologists should make reasonable efforts to obtain these records.

If an applicant refuses to authorize release of clinically relevant records (such as VA disability records), the evaluator should determine whether the refusal prevents completion of a thorough and defensible evaluation.

A refusal alone does not automatically require a Not Suitable recommendation.

However, it may justify a Not Suitable determination when:

• The evaluation cannot be completed adequately.

• Clinically significant questions remain unanswered.

• The applicant refuses to cooperate with a required component of the evaluation.

The recommendation should focus on the applicant's inability or unwillingness to complete the evaluation—not on speculation regarding the contents of the withheld records.

• Keep reports focused on current psychological functioning.

• Obtain treatment records whenever clinically indicated.

• Base Not Suitable recommendations on objective, defensible evidence rather than isolated historical events.

• Describe observable behaviors rather than unnecessary diagnostic labels.

• Prior FMRT evaluations may inform—but should not determine—the current clinical opinion.

• Maintain applicant privacy by limiting discussion of medically irrelevant information.

• Recommendations should reflect the applicant's current occupational readiness rather than diagnostic labels or historical events.

• Cooperation with the evaluation process is an important component of every psychological assessment.