Facts You Should Know About the Process 

In certain situations (for example, if an occupational therapy practitioner has not practiced for a certain period of time), regulatory laws in some states/jurisdictions require individuals who have obtained OCCUPATIONAL THERAPIST REGISTERED OTR® (OTR), and/or CERTIFIED OCCUPATIONAL THERAPY ASSISTANT COTA® (COTA) certification to take the NBCOT examination for state regulatory purposes only. Such state requirements must be met in order to obtain a limited permit or license to practice in that state/jurisdiction. Candidates taking the examination for this purpose are eligible as State Re-activation candidates. These individuals must be pre-approved by the state regulatory entity to sit for the examination. 

Since the formation of the National Board for Certification in Occupational Therapy, Inc. (NBCOT), in 1986, NBCOT has worked closely with state regulatory entities to administer the certification examinations (OTR/COTA) to individuals for State Re-activation purposes. The NBCOT has done so in order to assist the states/jurisdictions who have this requirement written into their statutes and/or regulations.

Currently, jurisdictions known to require NBCOT’s examination for State Re-activation purposes include: Alabama, Arkansas, California, Connecticut, Florida, Iowa, Illinois, Indiana, Kansas, Massachusetts, Michigan, Montana, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Texas, and Washington.  It is extremely important for each individual to contact the state agency directly to determine whether examination under the State Re-activation provisions would be a requirement in order to obtain a limited permit or license to practice in that jurisdiction.

If you are required by the state to examine for State Re-activation purposes:

You will need to apply for licensure as an occupational therapy practitioner using application forms available from the state/jurisdiction. The application must be submitted to the appropriate state occupational therapy regulatory entity (e.g., board/advisory committee), not NBCOT.

The state regulatory entity then sends NBCOT a completed form entitled, Eligibility Application for NBCOT Examination for State Regulation/State Re-activation Purposes for each State Re-activation candidate.

Once the Eligibility Application for NBCOT Examination for State RegulationState Re-activation Purposes form has been completed by the state and returned to NBCOT, NBCOT will mail you an NBCOT Candidate Handbook and paper application. A letter of instruction will be included for applying. State Re-activation only candidates are required to apply using the paper application only. You may not apply online.

If you fail the examination for “State Re-activation purposes,” you will be sent another NBCOT Candidate Handbook and application so you may re-take the examination for State Re-activation purposes. 

For further information about the “State Re-activation” process, please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it