Do IEP Teams have to honor Doctors’ Notes?

I won’t ever forget the interaction I had with one of Kevin’s neurologists. We had a regular appointment/checkup. And he was a baby, like 2 years old. We knew he was autistic and I wanted him in an ABA program.

The neurologist said to me, “Just tell them that he needs ABA.” And he offered to write me a letter stating as much. I still have it. And I was sure that I had struck gold! I had an IEP letter from a doctor! Score!

doctor writing a note for an IEP

All I had to do was present this to his coordinator…and those services would just start flowing our way. Right?

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Now when I look back on that incident and my naivete, I want to face palm. (And, no need to email me about ABA–this article is now over 12 years old, things are different now)

Are there IEP laws about Doctors’ Notes?

So, the short answer here is…there is no short answer. When it comes to some accommodations, such as those for life-threatening food allergies, seizure plans, and Type 1 Diabetes, yes, a doctor’s note will get you those accommodations.

In fact, it is best practice to bring in said allergy or seizure plan from your doctor and present it to your team. My son’s school actually requires that his seizure plan be updated by his neurologist every year.

To give you some framework, try to think of it this way. If my son has a seizure and the seizure plan is not followed, what may happen? If your child has a life-threatening allergy, comes into contact with an allergen, and the plan is not followed, what may happen? What will happen if a child does not receive insulin?

They may die. So before you think about trying to sway your IEP team toward adding something to your IEP, ask yourself that question. “Will they die if they do not receive this?”

Chances are, no. Also ask, is this a medical or educational support/service/accommodation?

Even still, believe it or not….I have seen many schools refuse to honor doctor-requested accommodations for life-threatening food allergies. I know! It’s crazy! But it does happen.

Do IEPs have to Honor Doctor’s Notes?

Most of what I hear from clients and in our Facebook group is not life and death situations.

Parents often (mistakenly) think that a doctor’s note will secure them:

And that’s not how this works. At least not in a direct cause/effect fashion.

An IEP Letter from a Doctor?

IEP teams are required to consider outside evaluations. So, I would treat this as such.

However, that will require that your child’s doctor’s office write more than a few sentences. I would ask that the doctor, the PA or whoever is assisting them, fill out comprehensive visit notes. Many practices then have this available for caregivers online, and you can just print them out. This should include:

  • Brief history of the child
  • What they were seen/evaluated for on that particular visit
  • Recommendations

Then, it can be treated an an outside evaluation and submitted to the IEP team for consideration. Like any other IEE, the team does only have to “consider” the information. But, should you choose to use your Procedural Safeguards, this evidence will strengthen your request.

Doctors Orders on an IEP

No, schools do not have to follow doctor’s orders.

IEPs are needs-driven. If you want something added to the IEP, you have to demonstrate need.

This happens either through evaluations, or team decisions based upon the IEP progress monitoring that is being done. If a child is not making adequate progress toward IEP goals, and can reasonably be expected to do so, then you’d add more in to address that specific need.

The three steps to follow are pretty simple:

  1. Parent makes a written request for said support or service.
  2. Team discusses it; school ultimately makes final offer to parent.
  3. Parent receives that decision on PWN and decides whether or not to use her procedural safeguards.

It’s also very common when a child has a medical diagnosis of autism or ADHD, but the school does not feel the child needs an IEP. You still must go through the process and request IEP evaluations.

a doctor writing a note asking for services on an IEP

Modifying an IEP Based on Doctor Recommendations

In the IEP process, for most situations, a doctor’s note is considered an outside evaluator’s report. And, per IDEA, they only have to “consider” the information presented to them in such a report. Whatever you submit to your IEP team should demonstrate an educational need.

A doctor’s note supporting your IEP request may work, but it is not the slam dunk that many parents think it is.

Whenever you make a request, you want to have as much supporting data as you can. A doctor’s note stating that your child needs a 1:1 or more OT is just one piece of data in the big picture.

If it works or has worked for you, great. I mean that. If it was up to me, all of kids would have their needs met and this website would disappear. But just because it worked for you doesn’t mean that it’s a slam dunk for every other child. And, parents need to have reasonable expectations.

I have heard from many parents who got a doctor’s note, demanded something on the IEP because of it, and then were furious and/or disappointed when it didn’t happen. Fact is, it shouldn’t happen.

Imagine the chaos in the IEP system, if all parents had to do was get a doctor’s note! We really don’t want doctors dictating what happens in the IEP process.

Again, use the IEP process and use your Procedural Safeguards. As always, ask in our Facebook group if you have further questions.

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