Migraines, Medication, and Missed Instruction – Requesting Eligibility

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teen boy with hand on head eyes closedMy middle school son was diagnosed with migraines at 8 years old.  He takes his medication at home only because I don’t have enough to send to school.  The school says his absences are unexcused medically and considers him chronically truant.

School policy says a student will be excused for medical reasons when the parent writes a note.  I have written a letter explaining his condition, his doctor has written a letter, and I’ve written notes for absences, but the school will not excuse him.

First: Tell the doctor you need an additional prescription so one prescription bottle can be left at school. There are legitimate reasons why the school nurse does not dispense medication that is not in its original container.

Second: Write a letter (see sample)… to the nurse and ask for a copy of your son’s medical file. The school nurse keeps a record of all student visits to her office, the reason for the visit, and any medication dispensed.  You want to have the same information about this the school has.

Third: Rewrite this medical plan for migraines instead of diabetes http://www.diabetes.org/living-with-diabetes/parents-and-kids/diabetes-care-at-school/written-care-plans/diabetes-medical-management.html.

  • Have the treating physician approve it and sign it.
  • Deliver signed copies to the principal and school nurse.

If you need help with wording you can look up migraines here. You are going to run it by the doctor when you are finished anyway but this will help you get the wording right. You want the descriptions in the plan to be accurate and useful to those who read it.


Request Eligibility for an IEP Under IDEA

A 504 plan accommodates a disability.

An Individualized Education Program (IEP) provides specialized instruction, such as when a child has a learning difference or when a child cannot attend school as other children do, i.e.,  when a child cannot attend on a regular basis for medical reasons. Other Health Impaired is a disability category under IDEA, the special education law.

Fourth:  There is a sample 504 plan at the American Diabetes website as well as the medical plan that I referred to above. However, I do not recommend preparing the 504 plan from the diabetes website in your situation.

Instead, I recommend that you write a letter similar to the letter below and request an eligibility meeting under IDEA.

Your son needs:

  • the missed instruction
  • any future missed instruction
  • an alternate method of instruction, not just accommodations

Use this letter template  to request an eligibility meeting for special education / specialized instruction:

Jane Smith
500 Oak Lane
Nashua, NH 03060

April 18, 2009

Nathan Weiss, Director of Special Education
SAU #1
1001 Main Street
Nashua, NH 03060

Reference: Mark Andrew Smith
DOB: 01/02/96
School: Grove Middle School

Dear Mr. Weiss:

My son ______________ was diagnosed with ______________ when he was 8 years old. Since then he has had multiple __________ and has often missed school due to ____________.

I am requesting an eligibility meeting to discuss ______________’s diagnosis and need of specialized instruction due to his frequent medically related absences. I would like this meeting to be held as soon as possible. I realize that this is a very busy time of year for all of the staff at the school and your anticipated cooperation and assistance in helping us help ______________ is greatly appreciated.

Please feel free to call me either at my home, 555-555-1212 or my cell phone, 555-666-1212.


[Both parents should sign this and both go to the meeting if at all possible]

Enclosure: another copy of the medical plan

Next Steps: Tell Your Story Well

What you need in the IEP is a plan to provide your son with the instruction he misses when he cannot attend school and a plan for how tests and homework will be made up or adjusted so that he will learn the same information, but so there will be enough flexibility that it can be done around her medical needs.

The plan will be followed by his teachers and administrators. You and your son are the experts on what is working, what has worked in the past, and what is not working.

You told your story well in your letter to me (we used only part of it for this blog post). Use that as a guide to prepare your comments for the meeting.

  • Make copies of your written concerns for everyone at the meeting.
  • Ask, in writing, that a copy of your written concerns be part of the meeting record and part of your son’s school file.
  • Write up a list or plan before the meeting and have enough copies for every one there.

  1. OK, I frequently deal with OCR, which oversees ADAAA compliance including section 504. According to the head of our Chicago office, the letter you should send should say, “I would like my child to be evaluated for special education and related services.” That is all it has to say. If you want to be nice, you can include why. Timelines for IDEA kick in with that letter. Also, OCR highly recommends 504s for medical conditions such as migraines, and if the school continues to dismiss the importance of planning to accommodate his/her needs, you can file a complaint online; it’s not scary and you can continue to amend your complaint during the resolution process. Also, again, straight from the mouth of the head of our OCR, your child can get anything on a 504 that they could get under IDEA; there’s a difference in several areas of format and procedurals, but it would all still be available with a 504, should you choose to go that route.

    Also, to Michelle – there is no reason why a good student who has need of special education and related service due to a medical condition cannot get an IEP. OSERs has written memoranda regarding this, look up “letter to Delisle” and a memorandum written 4/17/15 to State Directors of Special Ed from Melody Musgrove of OSERs.

  2. With the way insurance companies limit the amount of medication they’ll pay for, it might be hard or impossible to get a second prescription for school. I had a hard time convincing the school my son got fevers with his migraines, and he had to be fever free for 24 hours. He spent many a day after a migraine playing outside. I finally found one article and my pediatrician wrote a note saying he can return to school at my discretion.

  3. My 8th grade daughter has a 504 due to migraines.Her school is pushing for her to get out of public school into on-line school. They say that she won’t qualify for an IEP because she is a good student. That it has to be a med condition that affects learning. And that all accommodations are in-class. So, since she misses so much school there is nothing they can do for her. I.E. in her Spanish class, a large % of her grade is an in class participation grade. They can’t make that teacher modify that. Any info or suggestions??

    • Actually, they CAN make the teacher modify it. 504 has to do with making modifications based on the disability. If the student misses a lot of school, and therefore has a low participation grade, the grade could be figured WITHOUT participation.

      • Same thing is happening with my sophomore. She has a 504 but we did not include absences or homework accommodations because I did not foresee her being absent a lot this school year. The AP said I could not include homework or absences in a 504 but i have been hearing different things. They would not accept a chronic illness letter from the doctor to excuse the absences

        • Research your state rules on absences Some states have rules to support students with a lot of absences. . Your state parent training and information center, or disability rights project may be able to assist you.

  4. I agree with the recommendation to consider a 504 plan. Especially with Congress’ recent admonition that 504 plans were intended to be developed for a rather broad range of challenges, erring on the side of providing accommodations rather than refusing them. “Specialized instruction” under IDEA might not be needed. However, no penalty for missed school due to illness, teacher individualizing make-up work that is “essential,” and tutoring if academic performance fall below grade-level expectations, could be part of a 504 plan.

  5. Migraines can be hard for a school to understand in a child. The suggestions the Wrights have given are great. The key is to follow them exactly. When you have documented with a signed medical plan, and asked in writing for specialized instruction, it will probably get the school’s attention. Be polite, be calm and be gently assertive at the meeting. This is a medical problem and should be addressed to your child received an appropriate education. You also can ask how other medical problems are handled by checking with other parents. If they accommodate ADHD, for example, there is no reason they should not accommodate migraines.

  6. You would be requesting an evaluation not eligibility, the school would need to review existing information to see if there is an adverse affect on your daughter’s educational performance. Simple documentation of migraines would not suffice. It seems as though eligibility could occur at the same meeting though.

    Requesting an additional prescription for the school may be beneficial but if your daughter is having to stay home so much and receives her medication at home there may not be any benefit to meds at school.

    I would lean more towards a 504 Plan to examine any environmental triggers for your daughter’s migraines e.g. noises, lights, sounds etc. and possible to set up a place for her to go to recover at school. Perhaps some relaxation training may be beneficial to write in as well. Take a close look at triggers at home as well.

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