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Roger N. Meyer "...of a different mind "
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I Take on a patently "Overly Broad on its Face" Policy

Copyright 1998 Roger N. Meyer



     [The document below is from information provided to students by the University of Iowa.]


    "This is the current version of our documentation requirements:


    Requirements for Medical Reports Documenting the Accommodation Needs of Students with Chronic Health Disabilities


    The office of Student Disability Services (SDS) is responsible for verifying the eligibility of students requesting accommodation on the basis of disability. Accommodations are adjustments to the environment provided to "level the playing field" with respect to the current functional limitations of an enrolled student. They are not remedial in nature, nor do they change or reduce the academic standards of a course or degree program.


    A student who plans to request accommodations must first disclose his or her disability to SDS by submitting a report that documents his or her needs.  After the report has been submitted and reviewed, the student will be contacted and notified whether he or she may proceed to schedule an appointment to begin services, or whether more information is yet needed.


    All documentation reports must be type-written and signed on professional letterhead bearing the physician's address, phone, and clinical affiliation


1) The physician's license number certifying his or her status as a practicing medical doctor (M.D.) or doctor of osteopathy (D.O.) and any additional information about specialty credentials should be contained in, or accompany, the report. The physician must hold qualifications that are recognized by the State of Iowa as affirming his or her eligibility to render a medical diagnosis.


2) The report should describe the type and severity of the individual's symptoms at the time of first diagnosis, and state the approximate date of their onset. It should describe the subsequent progress and treatment of the condition.


3) The report should contain a description of type and severity of the individual's current symptoms.


4) The report should detail any currently prescribed or recommended treatment, care, or assistive devices. Examples include: medical treatment, physical therapy or other therapies, dietary requirements, mobility devices or other assistive devices, and full or part-time attendant care.


Current Functional Impact of the Disability:


5) The report should describe the manner and level of severity with which the disability currently impacts general functioning.


6) The report should describe manner and level of severity with which the disability currently impacts academic functioning, e.g., reading, memorizing, writing, note-taking, test-taking, etc.


7) The report should indicate any types of activity that might be a typical part of a college program that are specifically contraindicated by the student's disability.


Recommendations for the Student's College Program:


8) The report should contain recommendations for specific reasonable accommodations that are needed to address the current and substantial impact of the disability on the student's academic functioning.


9) The report should contain recommendations for reasonable accommodations pertaining to the individual's campus board, room, or transportation needs."





     This is a patently broad and patronizing policy.


     The amount of information being sought of a third party -- here, a doctor -- is impermissably broad.  Even if a physician could answer the questions, the real point is whether the student's physician should answer them.


     The information submitted by physicians on such forms is confidential, and while Universities and other institutions of higher learning are held to the same standards of confidentiality and privacy as are K-12 institutions under FERPA, there is a lot of potentially damaging information being requested of the physician, rather than of student himself or herself which could get into the wrong hands very easily.  The basis for all requests regarding disability conditions, as with health conditions, must be justified by the requester's overweaning need to know such information.


     "Just because we say so" doesn't cut it."


     Unless the physician modifies or alters the information being requested, the amount of information being asked for could be considered an unwarranted intrusion into doctor-patient confidentiality.  I could understand this kind of information being asked for by an entitlement program, such as SSI or SSD.  Those programs have very strict privacy and confidentiality protections.  Those are federal protections, governed by federal law and regulations.


     I find it personally offensive for a college student to have to have this much information reported by a physician for purposes of being considered an applicant for disability accommodations through the office of disabled student's services.


     If I were a college student with a disability, I would personally challenge the invasive character of the information being sought, and the right of the University to go so thoroughly into these kinds of issues.


     What this form does is perpetuate the medical model of a disability.  By the time a disabled person is ready for college, s/he can and should be sufficiently strong self-advocate to provide this information directly, and only as much as s/he wishes to provide.  In cases like this, the university has the burden of proving its need for such detail and only once the student is negotiating for reasonable accommodations, not before, and not as a condition of even being allowed to access the Disabled Students Services office, let alone use its services.  Much of the information being sought here is information which an employer cannot legally request of a disabled employee even once the employee is hired, and a university is no different.


     Employees who are disabled do not check their civil rights at the door of a business.  Students who are disabled also don't check their civil rights at the university gates, or at the door of the Disabled Student Services Office.  The information being sought is onerous inasmuch as the university's need for this information has yet to be determined by the character of the student's use of the university's Disabled Students Services , if s/he is to seek them at all.  This information, being sought prior to the student's own approach to that office could be potentially damaging to the student's entire career and educational opportunities on that campus or beyond.


     The disabled student knows more about his own limitations as well as strengths, and doesn't need anyone else to "attest" to the extent of his disability, or to verify his needs or to negotiate as the student's absentee proxy as to how those needs should be met.  This is the individual's responsibility, and if the individual is of legal age, he should find it impermissibly offensive to be spoken of in the third person, as this form does.


     Universities and other post-secondary institutions that have a high percentage of mature adults or returning adult students would be hard pressed to defend the patronizing approach found in this policy, which assuredly was developed by insensitive administrators used to dealing with students coming directly from K-12.


     The normal process for arranging accommodations under ADA, and to assure non disparate and nondiscriminatory treatment under Section 504 is a process of negotiation, conducted between the student or the employee, and the university or the employer.  To demand of either an employee or student that they lay all of their possible demands out prior to that point is unconscionable.  If this information was being sought by an employer prior to, or even following disclosure, it would be subject to intense scrutiny as to the employer's need for such detail.  A university and its programs should be no less subject to the same scrutiny.  This holds true even if the university of college has a student health program whose professionals might need such information in treating their patients.  But with a request this broad, the university is asking for information in excess of what even student health providers might ask of a student's own private medical providers.


     Since it is an education issue, the government entity has even LESS of a right to ask such questions since the government institutional policy prohibitions and mandates of ADA don't allow them to be interposed in advance of a a specific accommodation being sought at a specific time for a specific reason, and by the individual himself, not a third party.


     It may have been some time since the physician or specialist has seen the student.  Even though Disabled Students Offices often require recent or current health information, information regarding initial onset date of a disabling condition is irrelevant to the university's needs, since the student is either likely to declare a certain condition as disabling or limiting at this moment, and not necessarily with reference to past times.


     No physician could anticipate all such circumstances where his patient might request future accommodations, and the invasive character of the questions asked and answers being sought cut directly to the heart of the doctor-patient confidentiality and trust relationship.


     Furthermore, it is the student, not the physician, who is navigating the educational system.  The demands of K-12 are considerably different than those imposed on students in post-secondary education.  Most K-12 students aren't legal adults.  Most college students are.  Furthermore, students in post-secondary education are expected to behave more independently, have more advanced executive function skills, and, as legal adults, speak and advocate for themselves, on their own behalf, and in furtherance of their civil rights as adults.  No physician, nor any student advocate, for that matter, is a better judge of the student's needs at any given time, than the student himself or herself.


     The university is skating on extremely thin ice in asking for information relating to as yet unrequested accommodations by a student who may or may not wish to avail himself of the services of its disabled students services office.


     Universities forget as easily as K-12 systems that they don't play an automatic parents patrae role for disabled students, and that they don't have a right to ask for all information because they have release to ask for some information.  Nor should professionals being approached by a University feel obligated to honor the institution's request.  A doctor's refusal may occur to protect the student's rights as a patient, to say nothing of the student's rights as a legal adult to act as his own advocate in disability matters.  If the student is incapable or incompetent in this regard, the question of what information can be requested and of whom it can be asked should be deferred until the issue of who is to represent the student or advocate on behalf of the student's interests has been fully resolved.


     There is no medical need for a medical doctor to verify or provide much of the information being asked.  Whatever policy needs drive this request form, they do not supervene the civil rights protections accorded to disabled students, whether as legal adult, or still as minors at the time of enrollment at the University.  Provision of much of the information being sought acts only to further strip the student of his or her dignity, and perpetuates the infantalization of disabled persons into adulthood.


     Were I a student being asked to submit this request to my doctor through a medical release form, I would object, ask to have an attorney present in a meeting with the ADA compliance officer of the University, and ask not a few pertinent questions of the inquisitors.  The tone of the university policy is patronizing.  It assumes the disabled person is not capable or competent to act as his own advocate -- in advance --  in matters of even choosing to use a public institution's services, disclosing his or her  disability  (on whatever terms the person feels comfortable), and negotiating for reasonable accommodations on their own behalf.



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