Many parents and families have trouble understanding how their child can have a medically diagnosed disability, but not be considered eligible for special education at their school. The purpose of this document is to explain the relationship between medical diagnosis and special education eligibility, and why having one does not guarantee having the other.
What is it?
Medical Diagnosis: A medical diagnosis is the determination and identification of a disease, disability, or other condition that is causing a patient’s symptoms.
IDEA Eligibility: If a student is eligible under the Individuals with Disabilities Education Act (IDEA), the student is entitled to special education services and supports in his or her school.
Who decides?
Medical Diagnosis: A medical diagnosis is always made by a doctor or specially trained clinician.
IDEA Eligibility: Eligibility under the IDEA is determined by a student’s IEP team, which must include the student’s parents, one regular education teacher (if the student is in the regular education environment), one special education teacher, and a school representative who is knowledgeable about and has authority to commit the school’s resources.
What are the requirements?
Medical Diagnosis: A doctor or trained clinician uses background knowledge and clinical criteria to determine the existence of a certain medical condition or disability.
IDEA Eligibility: A student’s IEP team must determine that the student has a disability that fits within one of the 13 categories specified in the IDEA. This team must also determine that, because of this disability, the student needs special education and related services in order to benefit from education.
What are the benefits?
Medical Diagnosis: A medical diagnosis does not establish IDEA eligibility and is not required for IDEA eligibility, but a medical diagnosis may help a student’s IEP team decide that the student has one of the 13 disability types under the IDEA. If a student is not eligible for special education under the IDEA, a medical diagnosis may cause the student to qualify for protections under Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act. A medical diagnosis may also be helpful or necessary to receive non-educational government benefits, such as social security or developmental disability services.
IDEA Eligibility: If a student is found eligible under IDEA, the student’s IEP team will develop an Individualized Education Program (IEP) for the student. An IEP will provide the student with the services and accommodations he or she needs to make progress in school.
Examples
- Jose suffers from a stroke. He recovers from the stroke but is left with severely slurred speech which causes him to struggle in school. Jose’s doctor has diagnosed him with dysarthria. Jose has a hard time communicating with teachers because his speech is severely slurred. He is only able to communicate with his mother who can understand some of his speech. Jose’s speech impairment likely means he fits under Speech-Language Impairment (SLI), one of the 13 qualifying disability categories recognized by the IDEA. Additionally, this disability affects Jose’s ability to access the general curriculum, so Jose is likely eligible to receive special education and/or related services under IDEA. Jose’s mother can request that his school evaluate Jose to determine his IDEA eligibility, and if Jose is found eligible by his IEP team, the team can develop an IEP that is tailored to meet Jose’s unique needs. Jose’s IEP may include speech therapy, an interpreter, or other services and accommodations to make sure Jose is able to access and engage in school. What is included in Jose’s IEP will be a decision made by the IEP team, which must always include Jose’s parents.
- Truc’s doctor diagnosed her with lymphedema, a condition that can cause her arms and legs to swell. Truc’s lymphedema results in mild discomfort, but the symptoms usually only occur at night before she goes to bed. Truc’s lymphedema has not impacted her ability to access and benefit from school. Although Truc has received a medical diagnosis and might fit the IDEA’s definition of someone with an Other Health Impairment (OHI), Truc is probably not eligible for special education and related services under the IDEA as her lymphedema does not affect her ability to make progress at school. However, Truc’s disability likely means she is protected by Section 504 of the Rehabilitation Act. If Truc’s disability were to cause her to need disability-related accommodations, such as excusal from certain physical education activities or on-demand access to the school nurse for the administration of medication related to her lymphedema, such accommodations could be documented for her in a 504 Plan. Additionally, Truc is protected from discrimination on the basis of her disability under Section 504 of the Rehabilitation Act. Updated 12/2/2021 4
- Nicholas was involved in a car accident and suffered a traumatic brain injury (TBI). Because of his brain injury, it is hard for him to focus on one mental task for more than a few minutes. His brain injury causes him to repeatedly lose focus during tests and assignments at school. TBI is one of the 13 recognized disability categories under the IDEA, and this TBI impacts Nicholas’ progress in the general education curriculum, so Nicholas is likely eligible to receive special education and related services under the IDEA. Nicholas’s parents can request that his school evaluate Nicholas to determine his IDEA eligibility, and if Nicholas is found eligible by his IEP team, the team can develop an IEP that is tailored to meet Nicholas’s unique needs. Nicholas’s IEP might include accommodations such as extra time for him to complete tests and assignments, and services such as assistance developing executive functioning skills. What is included in Nicholas’s IEP will be a decision made by the IEP team, which must always include Nicholas’s parents.
- Angel has a medical diagnosis of Autism Spectrum Disorder (ASD). Her ASD causes extreme sensitivity to certain sounds and severe social anxiety when she is in large groups. Angel is a bright and capable student. Angel is able to excel in her academics when she is working on assignments alone or working one-on-one with an instructor. However, in classroom settings and other group activities, Angel is unable to focus on her academics and will instead stare at the floor or engage in repetitive self-soothing behaviors. Autism is one of the 13 recognized categories of disabilities under the IDEA, and Angel’s disability makes it difficult for her to make progress in school, so Angel may be found eligible to receive special education and related services under the IDEA. Angel’s parents can request that her school evaluate Angel to determine her IDEA eligibility, and if Angel is found eligible by her IEP team, the team can develop an IEP that is tailored to meet Angel’s unique needs. Some services and accommodations that might be appropriate for Angel include specially designed instruction to help Angel improve self-regulation and coping strategies when faced with uncomfortable sounds or social situations, or the ability to wear noise-canceling headphones in class or complete assignments in alternative environments. What is included in Angel’s IEP will be a decision made by the IEP team, which must always include Angel’s parents.
The following are the 13 Disability Categories under the IDEA
- Autism
- Deaf-blindness
- Deafness
- Serious Emotional Disturbance (emotional disability)
- Hearing Impairment (including deafness)
- Intellectual Disability
- Multiple Disabilities
- Orthopedic Impairment
- Other Health Impairment
- Specific Learning Disability
- Speech or Language impairment
- Traumatic Brain Injury
- Visual Impairment (including blindness)
