Why You Got MCAT Accommodations But Not Extended Time

I often hear from students and parents for the very first time only after an MCAT accommodations decision has already been issued. In many of those cases, the student was approved for certain accommodations, but denied extended testing time. The decision letter can be confusing, especially when it acknowledges real difficulties with attention, processing, or comprehension.

In most of these situations, the denial has little to do with the diagnosis itself. Instead, extended time was denied because the application did not include objective testing that demonstrated functional impairment under timed conditions.

Understanding this distinction early can make the difference between a smooth accommodations process and one that becomes constrained by deadlines.

Diagnosis is not the same as functional impairment

The AAMC distinguishes clearly between having a diagnosis and demonstrating functional impairment. A diagnosis identifies a condition. It does not, by itself, establish how that condition affects performance compared to most people in the general population under the specific demands of the MCAT.

Extended testing time is considered when there is evidence that a student’s performance on timed cognitive or academic tasks is significantly limited in a way that is directly relevant to a long, speeded, reading-intensive exam. That evidence typically comes from standardized testing. It doesn't come from narrative reports, prior accommodation documents, or mental health care provider treatment summaries.

Why denials occur even when letters are supportive

Many applications include detailed clinician letters that describe longstanding difficulties and treatment history. Those letters may completely reflect a student’s experience and clinical presentation.

However, when extended time is requested, the AAMC generally expects objective data showing how the student performs under timed conditions relative to appropriate norms. Without that data, reviewers can conclude that the documentation does not meet their threshold or extended time, even when the diagnosis is well supported.

The partial approval pattern

Some students are approved for certain accommodations but denied extended time. Families often interpret this as an indication that extended time might be reconsidered later or that the decision was close.

In practice, partial approvals usually reflect the type of evidence submitted. Accommodations that rely more on diagnostic history may be granted, while extended time is denied because it requires direct demonstration of slowed or inefficient performance under timed conditions.

Once this distinction becomes clear, the remaining issue is often logistics rather than eligibility. I outline common MCAT accommodations timelines in more detail, including why extended time decisions often hinge on lead time, in a separate post on planning ahead for MCAT accommodations.

Why timing becomes the limiting factor

MCAT accommodations decisions involve multiple steps, and deadlines are firm. When a denial is issued, there may be limited opportunity to pursue additional testing, prepare updated documentation, and resubmit materials before a planned test date. This is why accommodations planning is most effective when it begins well before an application is submitted.

What to consider if you have not applied yet

If you are early in the process and considering requesting extended time, it is worth clarifying in advance what type of documentation is likely to be required. My MCAT accommodations page walks through how this planning process typically unfolds and what documentation is commonly reviewed. That usually means thinking beyond diagnosis alone and considering whether there is objective evidence of functional limitations under timed conditions that are relevant to the MCAT.

Addressing this question before submitting an application is often much easier than trying to correct it after a decision has already been made.

A final note

Denial of extended time does not mean that a student’s difficulties are not real or that the diagnosis is invalid. In most cases, it reflects a mismatch between the documentation submitted and the criteria used to evaluate extended time requests.

If you are early in the planning process and want to better understand what documentation is typically needed for extended time, a brief consultation can help clarify next steps before deadlines become limiting.