When Schools Punish Sick Children Who Miss School: A Game Plan

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(Moved from Community Helpline)

My child has an IEP. She has chronic health problems documented by three medical specialists and she has a Health Plan. Chronic health problems and medical appointments forced her to miss many school days this year. She made up all her work and has no incomplete assignments. Her grades are A’s and B’s.

The school told her that if she doesn’t make up the time she missed, she will not get credit for these classes. Can they do that? She would gladly give up her sick days for school days.

The purpose of laws that require children to attend a certain number of school days is to deter truancy. A law that is intended to deter truancy must include exemptions for children who have chronic illnesses or who are injured, not truant. Your child passed her classes with flying colors but the school is threatening to withhold credit for these classes because she was ill and unable to attend school.

Public schools are required by law to accommodate the health needs of students. The plan to accommodate health needs may be called a health plan or a 504 plan. Your child has a health plan but the school is not following it.

Call your State Department of Education. (You will find contact information for your state in the Directory of State Education Departments) Ask about your state’s attendance requirements and exemptions for children who have documented illnesses and health plans. Please let us know what you learn.

I spoke with the state department of education about the school’s punishment of my child for truancy when she has a chronic illness. Because the chronic health issues are noted in her IEP, and because her IEP states she will need special accommodations, her absences are excused. The representative thought our district is just not familiar with the laws that protect students with chronic illnesses.

Thanks for letting us know that you were able to resolve this problem. In our opinion, the school should give your daughter an award for courage and perseverance, despite the obstacles she faced.

For readers who have sick children, the American Diabetes Association has prepared excellent model 504 plans and health plans. These model plans can be modified to cover other health or medical problems that affect a child’s school performance. Download the model plan and revise it so it describes your child’s medical condition and needs related to that condition. Consult with your child’s doctor to make sure the plan is complete and covers all your child’s health needs.

To learn more about helping children with chronic illnesses, read My Child Has Health Problems, the School Reports Him Truant by Suzanne Whitney. Sue writes about creative advocacy strategies in Doing Your Homework. Review the legal and advocacy information and resources from the American Diabetes Society. This information is useful in advocating for children with other health problems.

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245 Comments on "When Schools Punish Sick Children Who Miss School: A Game Plan"

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My Daughter is 13 years old and when starting middle school, the Hereditary disease struck. Immune system weak from stress and she had full Blown IBS D&C. A severe form. She has a GI dr. but there is nothing to stop it that works prescription wise. my daughter is in the 5th percentile for growth and weight. She weighs about 68 lbs will be 14 in July. The threats to her by truancy brought on an anxiety disorder she hyperventilates. Please help! She has a 504 not helping.

My daughter has missed 19.5 days of school this year and are all excused. Is this okay?

My son has a 504 in place. Tonight I read up on the Texas Educational Code and they do not excuse the missed days. He is required to make up 1 hr per day above 18. My issue is he is at school and sent home for keystones over 10 times this year! How can I control that? How can he? It doesn’t seem right.

My 6 year old Grandson has missed school when he had severe Flu. He missed total of five days not in a row. My Daughter took Dr. notes and they STILL want a truancy meeting.

My son had cancer at age 3, stage 3 Wilms tumor with 18 weeks of Chemo. And he lost a kidney. He’s suffered from chronic stomach pains a th the drop of a hat periodically since age 3, he’s now 9 and in third grade.
He has missed 20 days of school from doctor appointments and these belly pains.
The school sent me a letter stating if he misses anymore school they will call the district attorney on us if we do not have a doctors note.
We’ve been to a specialist and his doctors and the ER several times in the past and they don’t really know what is causing it without doing exploratory surgery, which they don’t want to do.
The doctor has given us a medicine that helps his belly pains but since they can’t do anything for him when he has the pains we just ride it out. what should I do?

Homeschool. My son is in gr 11 and it is an ongoing battle and source of frustration. He is so close to getting a high school diploma now and wants it although i am not sure he will b able to go enough to get it. I wish i had homeschooled him right off the bat and at 17 done the ged. He says if he doesnt get the diploma now he will feel like a failure. I feel i failed him by not pulling out if this crazy system that just made his stress worse and probably made him sicker.


hi there my 14 year old daughter had the same thing except hers in actually a chronic illness if thats what your sons is to he can can a 504 like my daughter so that he can be homebound well at least here in texas

My daughter has missed 20.5 days of school, with 2 ER visits and multiple doctor visits. The first time she was very sick and that was the first ER vist. She missed 7-ish days of school. After she came back she got a concussion and missed several days of school. She came back to school for a bit and then this past Thursday had serve chest pain in her chest (left side) and stomach. So mcuh pain she couldn’t move, 2nd ER vist. With all of these problems she has missed a lot of school work and the school is requiring her to take the mid-term exams. Thoughts on this? Should they have offered a 504 plan?

They never offer a 504. You have to request it and fight for it.

My 9 year old had to have knee surgery due to an infection. He missed a lot of school in December and a couple days this month due to pain. The school says he can miss no more days without a doctors excuse but recovery is slow. Would a 504 help?

Is there a reason that you cannot obtain a doctor’s excuse for the days he has missed and possible days he will miss due to the medical condition?

I actually do have doctor’s notes for the missed days due to pain, they just seem to continue to be condescending about the entire thing. I had to tell his teacher to stop bringing up his absences to him as it was very upsetting to him. I am hoping we are at the end and this will all blow over. Thanks for replying.

Every yr we have a teacher like this and there is no way to really stop it because of tenure. I have tried. Wish i had homeschooled my now 17 yr old from the start. Public school really messed up his self esteem with this stuff that was not his fault!

My friend has a son who has a immune disorder which requires him to not attend public school due to his high risk of infection. He is also on the spectrum. His IEP meeting was just a few days ago and the school is going against his doctors order and no longer paying for placement in a less populated school setting. Can the school do that? The school says that if he is not in school they will report to DCS and truancy court.

My daughter has a medical excuse for HighSchool. taking her out until Dec 30th and the school id insisting she return next week. She has mental issues that the Doctors feel need to be addressed before returning. She has a tutor through the school, bt can they force her back to school before the Doctor releases her?

I’m 16 years old and I have a 504 because I broke my spine and have had a couple surgeries. But my teaches are generally noncompliant with the 504 terms. I missed around three and a half or four months of school because of my back and I am still considered a truant because they didn’t put my absences under medical leave. I had a home bound teacher that came once every couple weeks

I’m 16 and I’ve been an A honor roll student my whole life until this year. I’m a junior in high school and I’ve suffered migraines for years that the school had not worked with until this year when I got a 504, but it was still very hard to get the teachers and school to comply with my issues. However this year I learned they aren’t migraines, I instead need brain surgery. The school and my teachers have said this is my “tough luck” and they are refusing to give me extra help and time which is causing me to struggle more since finals are coming up in a few weeks. I dont know what to due surely the school is not allowed to say that. Brian surgery is pretty serious. Can the school really treat me this way? I’m having to drop out of school now because it has become too overwhelming.

Every district is to have a 504 coordinator. When contacting staff as Richelle suggests, find out who this person is, & write to them. Also your state parent training & information center can assist you. http://www.parentcenterhub.org/find-your-center

My daughter has chronic migraines, and we’ve had to fight for a 504 plan, and had to threaten to get an attorney because of the harassment of the attendance clerk. Don’t give in and drop out, that’s the easy way out for the school. They are required to provide equal opportunity for all students under the 504 plan. Go straight to the top and demand a 504 plan. Get as much documentation from your physician as possible, and you and your parents should go to whoever is the liaison for attendance for your district and demand that they work with you. Hang in there, don’t give in and get well soon.

I’m 17 years old in my senior year of high school and I came down with CMV Mono. I have to be taken out of school for 2-6 weeks because of it and the school is telling me that I can’t graduate this year. Would something like this work for me? I don’t know who to turn to I’m so stressed out. Any advice is greatly appreciated.

My friend pass a new law that protects kids with chronic illness from being unlawful truancy,please read, you can all do the same .

My son was marked as absent for quite a few days and he was receiving ST and OT services from Heartspring because the school refused to give him these services. They sent me a warning about how he had missed too many days. If he was gone an hour early or came in an hour and a half late these were counted as an entire absence. Is there something that could have taken place to protect him from having a truancy issue?? It just didn’t seem right to me…

I’m 16 years old. I have a number of medical issues including a heart condition. My Doctor thinks I have Marfan Syndrome. I have to go see a genetic Doctor at Riley Childrens Hospital. I have missed 16 days of school because I’m always sick. My joints always hurt. And I have severe scoliosis. I’m in high school and am having issues with my Physical ED teacher. I have a 504 plan due to my health issues in general. My absences don’t count against me because of my medical conditions. And my gym Teacher is saying he is going to kick me out of his class! My mom called the school and spoke with the assistant principle and they said he had the rights by law to kick me out of his class for being absent. Is this true considering its in my 504 plan it says all my absences are excused. Also have IEP

U should get tested for lyme disease and related co infections. These affect the heart, the joints and can cause hypertonia and spine problems.

This is my senior year in HS and I am having a very hard time with my school. I tore my ACL and meniscus in football before school started this year and had to get surgery for it. I missed the first 3 or 4 weeks of school. They never sent me any work until week 3 and expected me to be able to do all of it. My work load is huge now and I dont know how to do any of it. I tried to get them to excuse some of the work but it never happened. I have been given every thing i missed and a lot of my classes dont use books its all discussion. I am afraid I will not be able to pass this quarter and i may not be able to graduate because of it. Can the school just not excuse my work like that? what should I do? I am very over whelmed and have been left to do it all on my own.

My granddaughter has EDS and Dysautonomia and we live in Texas. Her school sites the 90% rule and even though she is passing her Honors/AP courses they failed her because she was out more than 10% of her days. She is in constant pain and spends weeks vomiting and dealing with dislocations of her joints. The school is also trying to kick her out of her Honors courses because she is absent so much. We have been trying to obtain information that we can use to force the school to allow her to stay in those Honors courses and amend the 90% rule. She is in Special Education for OHI on her Chronic Illness but they say the IEP team can not amend the district policy. Help!

Nancy: Look at the information and resources on the 2e page concerning students in accelerated/honors programs who have disabilities. You may find it applies to your granddaughter.


OCR says that if schools “condition” participation in accelerated classes or programs for qualified students with disabilities by requiring these students to forfeit their necessary special education or related aids and services, it amounts to a denial of FAPE under Part B of the IDEA and Section 504.

“The term related aids and services as used here is intended to include…program modifications…”

Does the IEP include program modifications based on your granddaughters chronic illness?

As the original blog post advised, have you called your State Department of Education to see if the prohibition against disability-based discrimination applies to your granddaughter’s situation. The school may be unaware of responsibilities they may have (in spite of the “district policy”.)

Find your State DOE Contact: http://www.yellowpagesforkids.com/help/seas.htm
Find your Parent Training and Information Center Contact: http://www.yellowpagesforkids.com/help/ptis.htm

the 90% rule is actually a state mandate. However, there is a provision in the law that allows an attendance committee of the school to look at each student individually to see if they are academically ready for the next grade and to basically “override” the provision. I would contact the school and ask for an attendance committee hearing. i would be ready with scores etc that show she is ready for the next grade level. Unless, they can provide something to counteract the grades, I would require them to let her pass – with an attorney if need be…..just my thoughts….

I suggest the same on the 90 Percent rule, although I would not follow the last portion of advice “”require them to let her pass”.

My son lost oxygen to the brain and had to learn every thing over again. he was tested by psychologist and needed small classes w students. never got that. it was hard for him. never received Physical Education. since 4 grade self learner and wanted to be in reg class. he tried and fought alot of acusement. now he wants to finish school, but not allowed. please help me. he needs his education, guide me please.

My son has a 504 plan. During his 10th grade year he missed a great deal of school due to illnesses, which caused him to fail 2 classes. He has always maintained good grades and had a 3.5 gpa end of 9th grade, before that, he maintained a4.0 gpa K-8. He is in 11th grade and has gotten his health under control somewhat; his grades are back to normal. In Georgia, is there a way to have those 2 grades expunged? He has retaken both classes and passed, but those F’s have hurt his GPA. The school was a nightmare to deal with at the time; he transferred to a different school. He is going to college, but this will hurt his chances of scholarships…all because he was sick. During his illness, I didn’t think there was anything to be done.

Hello, I have Celiac disease and i am getting used to the gluten free diet… My school has a policy that states if a student misses 10+ days they must obtain a C+ or better on all exams to receive credit for that semester. Does anyone think a 504 plan could cover this?
Thank You

yes, my son has Celiac Disease and is on a 504 plan/

My DAGHTER is 17 & has always been an honor student , this year she’s been out due to a car accident,and a sports injury,and she also has to see a doctor once a month,forA.D.D.MEDS SO DUE TO MEDS FOR A.D.D. It’s hard for her to make the regular school day now they are making her stay 4- hrs extra to make up for DR’s excused absences,their telling us that DR’s excused notes don’t matter,so why do we spend our money to take them to get the notes,IF IT DOESENT MATTER ANYWAY….IF ANYONE HAS ANY HELP TO GUIDE US PLEASE LET ME NO,ALSO HOW DO YOU GET A 504 plan,thanks

Greetings Ronnie,
You can request a Chronic Illness document to be signed by your attending physicians to cover absences. A child who is undergoing medical interventions should not be required to “make up” hours or work that has been interrupted by medical needs. The 504 falls under the disabilities act. If your child is being penalized for her medical disability (even if the disability is chronic or temporal) then it is a violation of her civil rights. You will need a Medical Certification signed by your physicians and her medically related absences should be deemed as exemptions. It is the school’s legal responsibility to accommodate her medical disabilities. I hope this helps.

Hi! My 16 yr old daughter suffers from IBS and has missed a great deal of school. The School administration has been heartless and teachers demand she finish all missed work by the next day which as overwhelmed her and worsened her condition. Further they called us into their office the day before prom and told my daughter she was not allowed to attended the prom due to her poor academic standing. I signed her out because I was so angry and they still refused to allow her to go with her date who was also a student in the school. This is unacceptable and I am furious with the school for their contributing to making my daughters condition worse! Is there anything I can do?

So sorry to hear about this Vicki, if you daughter has diagnosis of IBS, then the school should have drafted a 504 to accommodate her medical needs. Accommodations should be within reason of the student’s condition and suitable for success. You can request a 504 hearing if you do not already have one. In the 504 you need to request a more reasonable amount of make up time for assignments and days and missed instruction. Please see my comments on Ronnie’s post as it is applicable to you.

As you know IBS can be triggered by stress and any school receiving any Federal Funding are obligated under FAPE is an educational right of children with disabilities in the United States that is guaranteed by the Rehabilitation Act of 1973[1] and the Individuals with Disabilities Education Act (IDEA). WIth a 504 plan, FAPE is identified as the process of “the provision of regular or special education and related aids and services that are designed to meet individual needs of handicapped persons as well as the needs of non-handicapped persons are met and based on adherence to procedural safeguards outlined in the law.” So your medical needs stipulates the school’s response (not the other way around).

So additional time for make up work is a Appropriation that is proportional to your daughter obtaining her education. Restricting a student from a school function that is not GPA governed (such as sports, or STUGO) could be considered discriminatory. You should take your case to the OCR (office for civil rights) in your city and see if there are grounds for legal action. Unfortunately you may have to play hard ball on these matters. But before you turn legal ask the school to give you their official responses in writing. Such as the policy on why she was refused access to the dance. Then you will have legal documentation of any misappropriations or discrimination.

I am 16 and I used to attend normal HS but about 2 years ago I got an illness called endometriosis and it affects my attendance because not only does it cause me to have horrible cramps to the point I can’t move or walk but it also doesn’t just hurt when I’m on my period. The pains can come at all times randomly. This second year was the worst year of the illness every month I would miss about 3 days or 4 because I couldn’t deal with the pain, I have always been an honors student and have always been in advanced classes but now with this illness my grades where going down super fast and I couldn’t control it. My teachers where becoming very mean and pushy and even though I had an excused note from the doctor and another one informing I was ill, they are still sending me to court.

Greetings Diana,
So sorry to hear about your endometriosis, but please see my previous posts on situations similar to your. You need a Medical Certification or a Chronic Illness document from your doctors stating the tenets of your conditions and your needs for absences. A certified medical condition will make you exempt from any absences related to your chronic illness. Truancy court will not be applicable to you as your absences are related to your conditions. I pray for your healing and hope this helps.

I am a 15 year old in high school. I’m currently sick with just general symptoms, fatigue, headaches, coughing, stuffiness, and head pressure. But because I have truancy issues due to a mess of things involving mental health issues and trouble waking up that I’m working to fix, I can’t stay home sick from school without a doctor’s note. So even if I were to throw up, my parents would have to bring me to a doctor, have them sign a note, and then give it to the school for me to stay home. So that’s why I was at school today and yesterday, pale enough that friends noticed (and I normally have paler white skin so that’s saying something), coughing up mucus into Kleenexes and hoping that I don’t get any of my friends sick because they have an AP test this Friday.

I have 4 kids. The school year is over on 4 weeks. My kids have been sick a lot this year, stomach flu, my kindergartener had mono, my 11 year old has missed the past month due to a yet to be diagnosed digestive issue. I have brought in 3 Dr notes alone in the past month for him. He had to see a specialist in Omaha and we live in western SD. My oldest daughter has anxiety and goes to counseling. They have all had gastrointestinal illnesses this year and strep throat. A truant officer came to my home last week, very rude, no understanding, saying she is turning us over to the states attorney. Apparently Dr notes don’t do anything.

During allergy season my son does not just get hay fever. He gets full blown allergy attacks that cause congestion, coughing, sneezing, itchy eyes, irritated throat, shortness of breath, and fatique. When the attacks are severe, and he misses schools, the school marks him truant. They say are no excuse to miss school.

I’m 13, and I suffer from migraines. My main trigger for a migraine is anxiety, and/or stress. I have chronic anxiety, so that is just a perfect combination. *note extreme sarcasm* Even though I have a 504 plan, my school still isn’t helpful. I realize they have a quota to fill, but I need them to understand that I would much rather be at school then at home, suffering horrible pain, light sensitivity, and other symptoms. I hate how my classmates and teachers ask prying questions. We always give them doctors’ notes, and make sure they are well informed of what the next step is. I don’t know what we could be doing better! I love school, and always have, but now I’m starting to be turned off from it.

I’m also 13, and suffer for the same thing. I’ve missed about 20 days and have a court date coming up. I don’t know if that will be a good excuse to tell the judge and I don’t know if they’ll end the case there but hopefully everything goes well.

I have a 13 year old who is a strep throat carrier, and the least little germ sends it into full blown strep. My son has doctors excuses for all the days he missed. For some reason the attendance clerk refused to accept a few of the excuses and my son was reported truant. Now, we have to go to court. I don’t understand why. The doctor even put on the notes to call if needed to verify.

I’m 16. I just recently got over from having Hodgkin’s Lymphoma, so I don’t have an immune system yet so I have to do have breathing treatments. Well I just found out I have strep throat and got told I would be able to go to school which wasn’t the truth I tried to go to school and felt really light headed and throw up so the nurse took my temperature and it was 99.7 so she was going to send me home but the principle said I couldn’t go home because I missed to many days.
I don’t know what to do because the school has all the records and doctors note yet they keep trying to punish me for being sick.

Im 18. I am autistic (High end with an IEP) and suffer from chronic diarrhea. The meds I’m on only help if I’m on the highest dose allowed. The side effects compound with panic attacks- making it impossible to do work. Nothing registers.

Ive missed a lot of school. This is my senior year. I failed one year and have caught up to my peers. The school wants to expel me. I need my dr. to sign paperwork that will let me stay eligible to graduate. He says its all in my head and won’t sign it.

What do I do? I like school and I don’t want to fail or be forced to drop out.

Sorry this will be not complete… limited characters which is fine…son was deaf for 2 yrs and daughter was sick for 2 yrs. Son had IEP, school said daughter didn’t need a 504. Ended up taking both out of school due to lack of help, wrong help…it could be a book…..today we home educate them both. Happy ending. Happy family.

School insisted my child had adhd. by 1st grade i tried to tell them i didn’t think that was the problem. by 2nd grade vyanse was making her throat hurt and throw up so i refused to give it to her. then they threatened to fail her. i refused so i feel they just put her in the back of the class and did not even try to educate her. by 4th grade they put her in special ed and psychiatrist put her on amitriptyline. she was not eating lunch. by the end of 4th grade she had severe stomach aches. now in 5th grade she has had a burning stomach. i requested at iep she have a water bottle and snack and was told “no food or drinks allowed in class.” now GI doc says GERD. did qeeg which shows bipolar, ocd & adhd! she missed unexcused days which really were excused so i had to sign the paper, no more late’s or tardy’s.

My son lost all credits for his classes last semester. He is being asked to do 65 hours of community services, all because of Texas compulsory attendance laws. He is in 504 for Migraines and misses a lot of school, is under neurologist’s care, and even has to get infusions at hospital often. This is discrimination — has this area of law gone anywhere since this article was written? I have calls into the area OCR and TEA but no one is calling me back. He is in all pre-AP and AP classes and has managed to keep all A’s because he works his butt off when he is healthy. And now this —– it is punitive! Are there any published opinions from hearings or court proceedings or maybe official letter opinions on the issue?

I dealt with the Dallas OCR office for years. They will not act. Save your time. The same applies for TEA. TEA will ALWAYS defend school districts. Most school districts simply don’t care about the laws and/or they don’t know the laws. My advice: learn the laws and go to work on the school. You may need to hire an advocate.

I’m in Tarrant County. This is disheartening. Then at the federal level, will they help?

This is a great article and thread My heart goes out to you all. My son is on special ed due to cerebral palsy. And developmental delays. He stayed home for almost a year due to back pain which led to a need for surgery finally.He had a chair pulled away while attempting to sit down at an after school program. We kept informing the vice principal of his absences and why and provided MD documentation but we were referred to ACS. After their investigation the case was deemed unfounded but the whole process was very stressful. After we were followed by preventive services. Though we could have benefitted from other services no help was ever given. Only visits. Though I am disabled with several chronic pain illnesses I took care of my son. Home teaching was put in place for only two months total though once we knew about it and we were finally given an application it took forever. I live in NYC.
I am glad to read about 504 and what our and others’ rights are.

Do private schools have to abide by these laws as well?

My grandson has missed school because he has chronic sinus infections even though he has already had sinus surgery. The school reports him truant. they want to expel him. We need help.

my daughter who has perfect grades not one disciplinary issue her intire life suffers from type one diabetes was dragged in to a truant officers office and ask if she was sexualy abused on drugs and in a street gang because I my wife refused too sign a paper that said she would never be late or absent again she only missed 4 days in 6 months from sugar to high in the morning she couldn’t function correctly the school retaliated because I stood up to them with her 504 plan this is how schools roll

My daughter 8yrs ago had a brain mass we had it removed successfully thank goodness but scince then she has been having chronic migraines and has been missing alot of school because of them and we have taken her to specialists and they verified that she does have them. This last year was the first time we had srs called on us for her missing school so we went to court and I guess won and thats when we first heard of a 504 plan which we stuck to and so did that school. Now shes in a different school same 504 plan but from what our daughter tells us there not following it and not believing her that she has headaches shes being forced to stay in school when she’s crying from pain as parents what our our options.At the end of my rope.

Going through similar with my son — see above. Try to resolve with your 504 coordinator by having a 504 meeting. Other than that — a complaint? I finally had good luck with them believing my son when I wrote a lengthy email to all the teachers in which I detailed my son’s medical history, told them these things are real, and told them an action plan for when he gets them. I also just yesterday heard that I can maybe add a “medical plan” to the 504. I am going to look into this — that might help with the believing part too!

My son suffers from EDS Dyspraxia dyslexia anxiety. Due to this he has only 50 percent attendance for this term. e has attended many hospital and doctors appointment which the school knows about. they do nothing to help him they don’t want to understand his problems. we have had nothing but grief from them and now they are threatening us with board of governors

My child was throwing up at school and was refused the right to call me. I had picked him up the day before because he was out of uniform when we arrived home he was sick so I did not take him back to school. The principal had told him to be back at school by a certain which of course did not happen. I called the school to tell them this. The principal told my son he had lost his trust. Also I was told that unless he had a dr excuse he would be expelled. I am not sure how to handle this situation but I am upset.

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