Alternate Format Exams
Alternate format is the accommodation that is granted and then not delivered.
Schools say yes, and then the braille arrives after the examination, or the “accessible” file is a scan of a printed page that no screen reader can read, or the lockdown browser will not run with your assistive technology. Late access is denied access, and the way to establish that is a written record of what you asked for and when.
What alternate format covers
- Braille — contracted or uncontracted, and Nemeth or UEB for mathematics and science, which is a different production process and takes longer.
- Large print — specify the point size and the typeface. “Large print” without a number produces 14pt, which is not an accommodation.
- Accessible electronic text — a real text layer, tagged headings, reading order, alt text on figures. Not a scanned image saved as a PDF.
- Audio, or text-to-speech, with the reading rate and voice under your control.
- A human reader or a scribe.
- Tactile graphics and raised-line diagrams, which have the longest lead time of anything on this list.
- Colored overlays or paper, and control over contrast and background.
- Described images and video.
The two failures that produce most of the complaints
A scanned PDF is not accessible text. It is a picture of a page. A screen reader reads nothing from it. When a school says the publisher’s file is all it has, the answer is that the obligation is access to the content, not delivery of a particular file.
The examination platform will not run with your software. Lockdown browsers, proctoring clients and online question banks routinely break screen readers and magnification — and the institution chose those tools. That is the institution’s problem to solve, not yours and not the vendor’s obligation to you. Ask, in writing, what interim arrangement applies while it is fixed, and ask for it in a form you can use this term.
Mathematics, science and diagrams
This is where alternate format is genuinely technically hard, and where schools most often produce something unusable.
Equations rendered as images are inaccessible however good the rest of the document is. Properly marked-up mathematical notation, or Nemeth braille, requires someone who knows how to produce it. Diagrams need either a tactile version or a written description that carries the same information — and a description that says “a graph showing the relationship” carries none of it.
Raise this at the start of the term, not the week of the examination. Ask who produces the materials and what lead time they need, then work backwards.
Timing is the accommodation
Conversion takes time. Braille and tactile graphics take longer. A request made in week one is generally met; the same request in week four is met in week nine, by which point the term is decided.
Two things to put in writing:
- Ask for the reading list, the question formats and the materials as far ahead as the institution can produce them, and keep the request. If the delay happens, it belongs to the school.
- Ask for a date. “As soon as we can” is not a commitment. And ask what you are to do in the meantime.
Where materials arrived late or unusable, say so at the time. A record of dates built during the term is worth more than any argument made after the grade.
What schools say
“You can come and use the computer in the disability office.” Access confined to one room during office hours is not equal access to a course.
“This is the version the publisher supplies.” The institution owes you access to the content. What the publisher supplies is a procurement problem it chose.
“Changing the format would alter what is being assessed.” Occasionally true — and it has to be shown for the specific assessment. Where a school claims it, ask what competency the print format itself is measuring.
“Nobody has needed that before.” Not a legal answer, and it usually means the process does not exist rather than that it cannot.
Board and licensing examinations
Every national testing body runs its own alternate-format process with its own deadlines, and those deadlines fall months before the test. They also weigh prior use heavily.
Establish the format at your institution now, in writing, even if the examination that matters is years away. A first-time request at the bar examination or a board is far weaker than one backed by four years of documented use.
Other accommodations students ask for
Which accommodation fits depends on the barrier, not the diagnosis, and most students need more than one. These pages cover the others most often requested:
- Assistive Technology on Exams
- CART, Captioning and Interpreters
- Clinical and Practical Examination
- Clinical Placements and Technical Standards
- Course Substitutions and Waivers
- Extended Time on Exams: What the Law Requires
- See the full list
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
My accessible textbook arrived in week six. Is that a violation?
Access that arrives too late to use is the standard failure in this area. Document the date you asked and the date it came, and raise it during the term.
The exam software will not work with my screen reader.
The school chose the software and owes you access to the assessment. Ask in writing what alternative applies for this examination.
How large should large print be?
Whatever your evaluator specifies, by point size. Ask them to put the number in the letter.
Can they charge me for braille production?
No. Auxiliary aids and services are provided at the institution’s expense.
What if the format they gave me was unusable?
Write the same day describing exactly what was wrong with it. “Unusable” is an argument; “the equations were images with no alt text” is a fact.
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.
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.