Epilepsy and Seizure Disorder Accommodations

OCR’s epilepsy fact sheet is unusually well organized around the reality of the condition — it separates what happens before, during and after a seizure, and it recognizes that the side effects of anti-seizure medication are themselves a source of academic difficulty.

If your college has refused, delayed, or failed to deliver an accommodation for epilepsy, here is how I handle disability accommodation disputes under Section 504 and the ADA.

How OCR describes it

Drawing on the National Institute of Neurological Disorders and Stroke, OCR describes epilepsy as a chronic brain disorder in which groups of nerve cells send the wrong signals and cause seizures. Some seizures involve loss of consciousness, falls and convulsions; in others consciousness is retained alongside involuntary movements, sensations, emotions or behaviors. Recovery varies: some people recover immediately, others take minutes to hours, and may feel tired, sleepy, weak or confused, with memory affected.

OCR organizes the educational impact by phase:

• Generally — absence for appointments, seizures, the side effects of anti-seizure medication, hospitalisation or care at home; and isolation from peers to avoid activities that risk triggering a seizure.
• Before — difficulty concentrating; ongoing fear or stress about having a seizure.
• During — loss of consciousness, falls, fainting; sudden onset of extreme emotions; sensory experiences that are not real; repetitive behaviors including blinks, twisting, jerks, twitches, mouth movements or walking in a circle.
• After — effects on mental health including depression and anxiety; extreme fatigue, nausea, confusion, headache, or muscle pain; and some degree of memory loss or an inability to concentrate.

Primary source. U.S. Department of Education, Office for Civil Rights, Section 504 Protections for Students with Epilepsy (June 2024). OCR wrote it for elementary and secondary schools; the definition of disability it applies is the same one that governs in college, though the obligations that follow from it differ. OCR keeps an index of its condition-specific guidance.

When it is a disability

According to the Department of Justice, epilepsy will, in virtually all cases, substantially limit neurological function, 28 C.F.R. § 35.108(d)(2)(iii)(I).

OCR names as additionally implicated: walking, learning, concentrating, thinking, and communicating.

Modifications OCR names for this condition

The Office for Civil Rights gives the following as examples of modifications that may be appropriate. This is an illustrative list, not a complete one, and which of these — if any — is right for a particular student is an individualized question.

• Making up work without penalty, and excusing late arrivals and absences when epilepsy-related symptoms or treatment interfere.
• Extra time to complete assignments, access to a quiet space for tests, preferred seating, and periodic rest breaks, and other modifications for a student who has difficulty concentrating or experiences changes in behavior or mood.
• Distance learning or provision of instructional materials for use at home when symptoms or treatment intensify and it is difficult to leave home.
• Carrying medication and self-administering it at prescribed times or if the student senses a seizure may be coming on — the clearest statement in OCR guidance that timing flexibility is part of the accommodation.
• Leaving class to visit a health office to rest following a seizure, or to recover from the debilitating effects of anti-seizure medication.

What schools get wrong

• Ignoring medication side effects. OCR treats them as an independent basis for absence and for accommodation. Students routinely fail to mention them because they seem like a personal problem rather than a disability-related one.
• Photosensitivity and screens. Where screen flicker is a trigger, format is an accommodation — see paper examinations and alternative formats.
• Post-ictal recovery treated as absence. The hours after a seizure are part of the event.
• Harassment, which OCR notes may attach to absences, seizures, or repetitive facial or body movements.

The four rules that decide coverage

Every one of OCR’s condition fact sheets carries the same boxed statement of how the coverage question is decided. It is short, it is favorable to students, and almost nobody reads it:

1. The question should not demand extensive analysis. Whether an impairment substantially limits a major life activity is not meant to be a fight.
2. “Substantially limits” is construed broadly, in favor of expansive coverage, to the maximum extent the statutory language permits.
3. An impairment need not prevent or severely restrict anything. It is enough that it substantially limits the activity as compared to most people in the general population. And an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active.
4. Medication is disregarded. The beneficial effects of mitigating measures — medication above all — must be left out of the assessment. You are evaluated as you would be untreated.

OCR adds one more line to every sheet that is worth committing to memory: a school may always accept that a student has a disability without any documentation or medical tests. Documentation may be requested. It is not a precondition the law imposes.

And this, which answers the most common self-defeating assumption students make: a student may need modifications even if they are not substantially limited in the major life activity of learning. Good grades do not end the inquiry.

Accommodations for other conditions

The legal test is the same whatever the diagnosis — what matters is the functional limitation and the barrier it creates. These pages cover other conditions:

• Food Allergy Accommodations in College
• GERD and Acid Reflux Accommodations in College
• Inflammatory Bowel Disease Accommodations (Crohn’s and Colitis)
• Learning Disabilities & Dyslexia
• Long COVID Accommodations in College
• Migraine Accommodations in College
• See the full list

Why epilepsy is almost always a disability under Section 504

You rarely have to argue this one. The Department of Justice regulation states that epilepsy will, in virtually all cases, substantially limit neurological function — 28 C.F.R. § 35.108(d)(2)(iii)(I) — and neurological function is a major bodily function, which the statute makes a major life activity. 29 U.S.C. § 705(20)(B), incorporating 42 U.S.C. § 12102(2)(B). Epilepsy can separately limit walking, learning, concentrating, thinking and communicating, each of which is a major life activity in its own right.

Three statutory rules do most of the work when a disability services office pushes back:

• Episodic conditions count. An impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active. 42 U.S.C. § 12102(4)(D). This is the answer to the most common objection a student with epilepsy hears — that they seem fine, that they have not had a seizure this semester, that the last event was months ago. The statute was amended in 2008 precisely to stop that reasoning.
• Medication is disregarded. The beneficial effects of mitigating measures must be ignored in deciding whether an impairment substantially limits a major life activity. 42 U.S.C. § 12102(4)(E). Well-controlled epilepsy is still epilepsy for coverage purposes. And note what the rule does not say: it disregards the benefits of medication, not its burdens. Sedation, slowed processing, fatigue or memory effects from an anti-seizure medication are functional limitations you can and should describe in the request itself.
• It is not supposed to be a hard question. Whether an impairment substantially limits a major life activity “should not demand extensive analysis,” and “substantially limits” is to be construed broadly in favor of expansive coverage. The comparison is to most people in the general population — not to your classmates, and not to your own performance before diagnosis.

One more point students are not told: a school may always accept that a student has a disability without documentation or medical tests. Extensive documentation demands are a choice the school is making, not a legal requirement it is obeying.

The postictal window is the accommodation nobody asks for

Most students with epilepsy ask for extended time. Extended time is often not the thing that would have helped.

The Office for Civil Rights describes what actually happens around a seizure. Before: difficulty concentrating, an ongoing sense of fear or stress about the possibility of a seizure, and sometimes behavioral or mood changes in the run-up. During: loss of consciousness, falls, sudden extreme emotion, sensory experiences that are not real, repetitive movements. After: extreme fatigue, nausea, confusion, headache, muscle pain, and — the one that ends examinations — some degree of memory loss or an inability to concentrate, sometimes for hours.

That recovery period is why the useful accommodations for epilepsy are usually about when and whether rather than how long:

• The right to stop and reschedule an examination that falls inside a post-seizure recovery window, rather than to sit it with extra minutes attached.
• Stop-the-clock rest breaks that do not consume testing time.
• A separate or reduced-distraction room, so that a seizure or an aura does not become a public event that ends the sitting.
• Permission to carry and self-administer medication at prescribed times or when an aura begins, and to leave the room to rest afterwards.
• Preferred seating — near an exit, away from strobing screens or fluorescent flicker where photosensitivity is a factor.
• Make-up work without penalty and excused late arrivals and absences for appointments, seizures, medication side effects, hospitalisation, or care at home.
• Instructional materials for home use or remote access during a period when symptoms or treatment intensify.

Ask for the schedule-based accommodations by name. A disability services office working from a standard menu will offer extended time and a quiet room, because that is what the menu holds, and a student who accepts the menu has usually accepted the wrong accommodation.

The remedy students forget to ask for: correcting the record

When OCR describes what a school may have to do after failing a student with epilepsy, one item on the list is doing more work than the rest: excuse absences incurred due to epilepsy and the side effects of seizure medication, and correct student records regarding unexcused absences.

That is a retrospective remedy, and it is frequently the one that matters. A student who has already accumulated unexcused absences, an attendance-based grade penalty, or a professionalism note is not asking for future accommodation — they are asking the school to unwind a record that was created by a disability. The other retrospective remedies OCR lists are the same shape: an opportunity to re-take classes, tests or assignments with appropriate modifications, without penalty or negative consequence.

Frame the request that way. “Please excuse these absences and correct the attendance record” is a different request from “please give me flexibility going forward,” and only one of them repairs the transcript.

Safety-based exclusion, and the individualised-assessment rule

Students with seizure disorders are sometimes told they cannot do a laboratory rotation, a clinical placement, a driving-related component, or a program with equipment or height requirements. Sometimes that concern is real. Often it is a generalisation about epilepsy applied to a student whose seizure type, frequency and control have never been examined.

The governing principle across the disability regulations is individualised assessment: a school must assess the actual student and the actual risk, not act on speculation, stereotype or generalisation about a condition. If a program is restricting your participation, the questions to put in writing are what specific function it believes you cannot safely perform, what evidence it relied on, whether it considered any modification that would remove the risk, and who made the decision. A school that cannot answer those questions has not conducted an assessment; it has applied a label.

Harassment, and being “regarded as”

Section 504 also protects a student who has a record of an impairment or who is regarded as having one. 34 C.F.R. § 104.3(j)(1)(ii), (iii). For epilepsy that matters in two ways. A student whose seizures are now fully controlled retains protection through the record-of prong. And a student who is treated differently because faculty or classmates believe there is a seizure disorder — whether or not that belief is right — is protected too.

Harassment related to absences, to a seizure witnessed by classmates, or to repetitive facial or body movements can require the school to respond. Report it in writing, to the office the school designates, and keep the report.

The law that governs a college accommodation request

Two statutes do the work. Section 504 of the Rehabilitation Act, 29 U.S.C. § 794, reaches every school that takes federal money — which is very nearly all of them. The ADA covers the rest: Title II for public colleges and universities, Title III for private ones as places of public accommodation. In the Eleventh Circuit, which governs Florida, claims under the two are analyzed under the same standards.

The regulation that actually decides most disputes is 34 C.F.R. § 104.44, and it is worth knowing what it says on both sides of the line.

What it requires. A college must modify academic requirements where necessary so they do not discriminate — and the regulation names examples: changes in the length of time permitted to complete a degree, substitution of specific courses, and adaptation of how a course is conducted. It requires modified examination formats so that results measure achievement rather than the disability, unless the disability is what the test is measuring. And it requires auxiliary aids — taped texts, interpreters, library readers, adapted classroom equipment.

What it expressly does not require. The same regulation says a college need not provide attendants, individually prescribed devices, readers for personal use or study, or other devices or services of a personal nature. A student who asks for a personal aide or a personal reader is asking for something § 104.44 does not oblige the school to supply, and it is better to know that at the outset. The regulation also provides that academic requirements the school can demonstrate are essential to the instruction, or to a directly related licensing requirement, are not discriminatory.

“Otherwise qualified” — and where Florida students lose

Protection runs only to a student who is “otherwise qualified.” Under Southeastern Community College v. Davis, 442 U.S. 397 (1979), that means able to meet the program’s requirements in spite of the disability, and the statute does not require substantial modifications to the program itself. The Eleventh Circuit put it plainly in Goldberg v. Florida International University, 838 F. App’x 487 (11th Cir. 2020): a qualified student is one who can meet the program’s academic standards with or without accommodations.

The recent Florida cases show where that bites. In Nehme v. Florida International University Board of Trustees, 121 F.4th 1379 (11th Cir. 2024), a medical student who failed at least eight courses — five of them after being placed on academic probation — was held not to be a qualified individual, and it counted against him that he conceded he had received proper accommodations for four of the failed exams. In J.A.M. v. Nova Southeastern University, 646 F. App’x 921 (11th Cir. 2016), repeated extended leaves of absence, exam rescheduling and excusal of misconduct were held to be accommodations that would fundamentally alter an osteopathic medicine program.

The practical lesson runs the other way, though, and it is the reason timing matters more than almost anything else: accommodations are forward-looking. A request made after a run of failures is fighting the record those failures created. The same request made before them is a different case entirely.

The school has to actually think about it — the strongest student-side rule

Deference to academic judgment is real. Courts will not override a genuinely academic decision unless it is “such a substantial departure from accepted academic norms as to demonstrate that the person or committee responsible did not actually exercise professional judgment” — Regents of University of Michigan v. Ewing, 474 U.S. 214, 225 (1985) — and courts in Florida give the same respect to a school’s judgment about the qualifications its program requires. But deference is earned, not assumed, and that is where cases are won.

Under Wynne v. Tufts University School of Medicine, 932 F.2d 19 (1st Cir. 1991) (en banc) — applied in Florida in Forbes v. St. Thomas University, 768 F. Supp. 2d 1222 (S.D. Fla. 2010), aff’d, 456 F. App’x 809 (11th Cir. 2012) — a school has “a real obligation” to “seek suitable means of reasonably accommodating” a student with a disability, and has to put in a factual record showing that its officials “considered alternative means, their feasibility, cost and effect on the academic program” before concluding that no reasonable accommodation was available. A conclusory assertion, with no evidence of deliberate consideration, is not enough. So the question to ask of any denial is not only “was this decision right?” but “is there any record that anyone actually weighed the alternatives?” Often there is not.

Two further points help. Whether an accommodation would impose an undue burden or fundamentally alter a program is generally a question of fact — Redding v. Nova Southeastern University, 165 F. Supp. 3d 1274 (S.D. Fla. 2016) — which means it is not something a school can simply assert its way past. And to establish fundamental alteration a school has to identify the essential requirement, show that modifying it goes to the core of the program, and show it considered whether any lesser alternative existed.

The interactive process, and a warning about how students lose it

Section 504 and the ADA do not use the phrase “interactive process” for college students the way employment law does, and the Eleventh Circuit has not held in a published decision that failing to engage in one is independently actionable — that remains unsettled. What Florida courts do recognize, from Forbes, is that the process is genuinely two-sided: the student carries the initial burden to identify the disability and make the case for specific accommodations, after which the school must consider the request and make a reasoned decision.

Here is the warning. In Amy v. Florida International University Board of Trustees, 2024 WL 5323717 (S.D. Fla. Nov. 20, 2024), the court found that the student broke down the interactive process by insisting on one particular accommodation and resisting any alternative. Where a school does not obstruct the process and makes reasonable efforts to communicate and to accommodate on the information it has, liability does not follow. Refusing every alternative on offer is a way to lose a case that could have been won — ask for what you need, but engage with what is proposed, and put the reasons in writing.

Technical standards

Published technical standards get real deference. Following Southeastern Community College v. Davis, the Eleventh Circuit treats a school’s academic standards as entitled to deference as the statement of the qualifications its program requires: Wood v. President & Trustees of Spring Hill College, 978 F.2d 1214, 1222–23 (11th Cir. 1992); see also Redding v. Nova Southeastern University, 165 F. Supp. 3d 1274, 1285 (S.D. Fla. 2016). They are not untouchable. The Section 504 regulation shields only the academic requirements a school can demonstrate are essential to the instruction or to a directly related licensing requirement, 34 C.F.R. § 104.44(a), so the showing is the school’s to make. And under Wynne, the school has to show that the people responsible actually considered the alternatives — their feasibility, cost and effect on the program — rather than simply pointing to the standard. Courts will not second-guess curriculum or clinical content on a thin record, but a standard that appears nowhere until the moment it is used to exclude a student is a different matter from one published and applied consistently for years.

Retaliation

Asking for accommodations is protected activity, and so is complaining about how a request was handled. A retaliation claim requires protected activity, the school’s knowledge of it, an adverse action, and a causal link — with but-for causation, and the familiar burden-shifting that follows. Retaliation claims sometimes survive where the underlying accommodation claim does not, because they turn on what the school did after the request rather than on whether the student was qualified.

Where to complain, and what it is worth

There are two routes and they are not alternatives you have to choose between carefully — a student may do both.

The Office for Civil Rights. A complaint to the U.S. Department of Education’s OCR must be filed within 180 days of the discriminatory act. It costs nothing and needs no lawyer, though what you put in it matters.

Court. A postsecondary student does not have to exhaust administrative remedies before suing under Section 504 or the ADA. Filing with OCR is not a prerequisite.

On remedies, be realistic. Injunctive relief — reinstatement, the accommodation itself, correction of a record — and attorney’s fees do not require proof of intentional discrimination. Money damages do, generally shown through deliberate indifference: that the school knew of a substantial risk of discrimination and failed to act.

And one recent development that changes what these cases are worth. In Cummings v. Premier Rehab Keller, 596 U.S. 212 (2022), the Supreme Court held that emotional distress damages are not recoverable under Section 504, because it was enacted under the Spending Clause and funding recipients never consented to that exposure. The Eleventh Circuit extended that to ADA Title II in A.W. v. Coweta County School District, 110 F.4th 1309 (11th Cir. 2024). Earlier Eleventh Circuit authority allowing emotional distress damages, Sheely v. MRI Radiology Network, 505 F.3d 1173 (11th Cir. 2007), no longer holds. For most students this means the value of a case lies in getting the accommodation, the place, or the record put right — not in a damages award for the distress of the fight.

This page describes how these rules work in general. It is not legal advice about your situation, and no outcome can be promised in any individual case.

Common questions

What if I have a seizure during an exam?

Agree the plan in advance: who is told, where you recover, and whether the exam is paused or rescheduled.

Can I be excluded from a lab or clinical placement?

Only on an individualized assessment, not a categorical assumption. That analysis belongs with technical standards.

Do I have to tell my professors?

You do not have to disclose a diagnosis. You may want at least one person in the room to know what to do, which is a practical decision rather than a legal requirement.

This is an individualized, fact-specific inquiry

Every determination described on this page is individualized. The Department of Education’s Office for Civil Rights says so directly: asked whether there is a list of all possible academic adjustments, OCR answers no — adjustments “must be individualized,” and “sometimes the most effective and practical academic adjustment for a given situation is a new solution rather than an off-the-shelf response.”

The lists on this page are examples. They are not comprehensive, they are not a menu, and they are not a ceiling. Two students with the same diagnosis can need entirely different adjustments, and OCR’s own guidance uses paired examples to make that point — one student whose treatment plan calls for supervision, another whose plan calls for privacy, same condition, opposite accommodation. A school that applies a fixed package to everyone with a particular condition has already made an error, whatever the package contains.

Nothing here predicts what any particular school will do, or what any particular student is entitled to. That depends on facts this page cannot know.

This practice is student-side only

A Students’ Lawyer represents students and families. It does not advise, defend, or consult for colleges, universities, testing agencies, or licensing boards. Knowing how a school is supposed to run this analysis is what makes it possible to show when it has not — where the interactive process was skipped, where an essential-requirement finding was assumed rather than made, where a denial rests on a blanket policy rather than on this student’s documentation. The standard reads the same from either chair. The reason to know it cold is to hold the institution to it.

When it is time to call a lawyer

Most accommodation requests should never involve counsel. Register, document, ask, receive. The moments that actually warrant a call are narrower and more specific:

• The denial rests on a policy rather than on you. “We don’t do that” and “that isn’t one of our accommodations” are not individualized assessments, and OCR has said as much.
• An essential requirement is invoked but cannot be found in writing. A technical standard or program requirement that appears for the first time in your denial letter is worth examining.
• The school offers withdrawal, a leave, or a lighter program instead of a modification it never evaluated.
• Something changed after you asked. Requesting a modification is itself protected activity, and a grade, a referral, a schedule, or a tone that shifts afterward raises a separate retaliation question that does not depend on whether the original request was correct.
• A deadline is running. Internal appeal windows are short, an OCR complaint is generally due within 180 days, and a graduation or licensure date does not wait.
• The stakes have escalated. Once probation, dismissal, a conduct referral, or a technical-standards determination is on the table, the matter is no longer an accommodation request.

If any of that describes where you are, two pages go further: accommodation denials under Section 504 and the ADA covers how a refusal is challenged at the school itself, and testing accommodations for standardized exams covers the separate track for exams, where the testing agency rather than your school decides.

These are fact-specific questions, and the answer usually turns on details — what was asked, in what words, to whom, and what the file says. If you are not sure whether your situation is one of these, that uncertainty is itself a reasonable reason to ask.

Get in touch to talk through a specific situation, whether you are a student or a family.

General information about disability law in education. It is not legal advice, it does not create an attorney-client relationship, and it cannot account for the facts of your situation or the law of your jurisdiction. Guidance documents from the Office for Civil Rights are cited throughout; OCR guidance does not itself have the force and effect of law, and OCR states that its enforcement determinations are based on the particular factual circumstances of each individual case.