Disability Rights



As many teachers may know, students with chronic illnesses are at risk for discrimination, and sometimes they need access to special education programs. Fortunately, laws are in place that allow these students to receive accommodations and extra services in school, if warranted.  Based on the student's health condition and its impact of school functioning, students may qualify for services under the Other Health Impairment (OHI) category of the Individuals with Disabilities Education Act (IDEA, sometimes referred to as IDEIA), or they may receive protection under section 504 of the Rehabilitation Act. The differences in the services received through IDEA and Section 504 are described below.

Individuals with Disabilities Education Act (IDEA)

IDEA includes 13 categories of disabilities. Teachers are often more familiar with the Specific Learning Disability (SLD) and Speech-Language Impairment (SLI) categories than the OHI category. Nonetheless, students who qualify under any category are afforded the same rights and protections.

The purpose of IDEA is to:

  • Ensure that all children with disabilities are provided a free and appropriate public education (FAPE) designed to meet their unique needs and prepare them for employment and independent living.
  • Ensure that the rights of children with disabilities and their parents are protected.
  • Assist states, localities, educational service agencies, and federal agencies in providing for the education of all children with disabilities.
  • Assess and ensure the effectiveness of efforts to educate children with disabilities, which includes the creation of an individualized educational program (IEP).

* IDEA covers children from ages 3 to age 22 years.

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Other Health Impairment (OHI)

As mentioned earlier, OHI is an IDEA category available to students with chronic illnesses. Research, however, demonstrates that this category is rarely used, at least in some schools. OHI services are intended to help address students' unique health-related educational needs.  

OHI is defined by IDEA as follows (local state definitions may vary slightly):

  • Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—(i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and (ii) Adversely affects a child’s educational performance. [§300.8(c)(9)]

Among the most common pediatric diagnoses associated with OHI use are:

ADHD Leukemia
Diabetes Nephritis
Epilepsy Rheumatic Fever
Heart Conditions Sickle Cell Anemia
Hemophilia Tourette Syndrome
Lead Poisoning  

EdMedKids provides a link to the National Dissemination Center for Children with Disabilities, which provides more information about OHI.

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Individualized Educational Plan (IEP)

Teachers are often familiar with the fact that IDEA mandates an IEP for all elligible students.  Each IEP is designed for one student and must be individualized to meet his or her specific needs. This is also true for students who are OHI service recipients. IEPs for students with OHI should address instructional needs and related services (such as access to a resource teacher or classroom accommodations) as well as school health service needs and school nurse services.

Teachers, parents, and other school staff must work together to develop, review, and revise IEPs. Cooperation is important. In addition, the classroom teacher's observations and suggestions may be especially critical for generating an IEP for students with chronic illness. The EdMedKids section entitled Teacher Toolbox provides support (e.g., structured observation forms) to teachers in gathering information that may be needed for IEPs.  

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The Rehabilitation Act and Section 504

If students with chronic illnesses fail to qualify for services under IDEA (typically when their medical condition does not impact their educational performance), they may be be eligible for accommodations and/or services under Section 504 of the Rehabilitation Act of 1973. Section 504 ensures that children with disabilities have equal access to education.

To qualify for services under section 504, a child must first be determined to have a disability that substantially limits one or more major life functions, including education, learning, and behavior. Services provided to the child might include:

  • Education in regular classrooms
  • Education in regular classrooms with supplementary services, modification and/or accommodations
  • Special education and related services
  • Any combination of the above

Accommodations for students with health problems have come under recent scrutiny. As a result, the court system has ruled on what schools must do to accomodate these students. For example, courts have concluded that schools are obligated to allow students with OHI to participate in non-academic and extra-curricular activities (e.g., field trips). In addition, it now appears that schools are obligated to provide health-related services during transport to and from school. For students with diabetes, in-class glucose monitoring has been ruled to be a reasonable accommodation. Additional details on court rulings about students with chronic illnesses can be found in a document prepared by Schmitt and colleagues in 2010 doi10.1002/pits.20505. Services received under section 504 are outlined in a child’s 504 plan, as described below. 

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504 Plan                                                                        

Similar to an IEP, a 504 Plan is a legal document. It falls under provisions of the Rehabilitation Act of 1973 that includes accommodations and modifications offered to a child.  Once a 504 plan is developed, teachers and staff must comply with the listed accommodations and modifications. The circumscribed purpose of 504 Plans is to provide a student with disabilities both equal access and fairness in general education; it is not designed to enhance student performance per se.

Below are links to examples of 504 plans, which include medical and academic accommodations:

Differences between an IEP and a 504 Plan


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 Americans with Disabilities Act (ADA)

ADA, enacted in 1990, provides the same legal protections to students with disabilities as section 504. ADA tracks Section 504 and explains that the remedies, procedures and rights under the ADA are the same as under the Rehabilitation Act. Unlike IDEA, Section 504 and ADA protect students of all ages. 

EdMedKids provides a link to Wright's Law, which provides more information on Section 504, ADA, and IDEA.