Yes on both counts. We do manual underwrites on FHA (and on conventional and VA), and FHA allows a cash-out refinance on a manual underwrite. A manual underwrite happens when a loan does not get an automated approval, most often because of a credit issue the automated system will not clear. A human underwriter reviews the full file under FHA's manual guidelines, which are tighter than an automated approval: ratios start at 31/43 and can stretch to 40/50 with documented compensating factors. Some scenarios, like keeping a non-occupant co-borrower on a cash-out, actually require the downgrade to manual underwriting. On the cash-out question specifically, FHA permits it on a manual underwrite, subject to those manual DTI ceilings, compensating factors, and reserve requirements. The catch is lender appetite. Individual lenders layer their own overlays on top of FHA's rules, and many are more conservative about manually underwritten cash-out files. That is why a single no from one shop is not the answer everywhere. A broker with access to many lenders knows each one's overlays and where a file like yours actually fits. That is the kind of loan we shop across nearly 100 investors, and we can talk yours through on the free Roadmap conversation (about 20 minutes) where we run your real numbers.