Accommodations for students with diabetes, seizures or allergies

By the IEP Atlas editorial teamLast updated November 1, 2026

Short answer

Medical accommodations at school let a student with diabetes, a seizure disorder or a severe allergy attend class, eat, test and travel safely at the same standard as peers. They sit in a 504 plan or IEP and point to a health plan the school nurse writes from the doctor's orders. Examples include snacks and water in class, test retakes after a low, and trained staff on field trips.

A student with type 1 diabetes, epilepsy or a peanut allergy may need no special instruction at all. What the student needs is a school day arranged so the condition does not block learning or put the student at risk. That arrangement lives in three documents that have to agree: the education plan, the health plan and the emergency plan.

This page is for case managers who coordinate those documents. It lists 24 accommodations written the way they should read in a 504 plan or IEP, checked as accommodation or modification. It does not give medical guidance. Every medical step, such as when to treat a low blood sugar or give rescue medicine, comes from the student's doctor through the school nurse. The general method for writing accommodations is in the pillar on IEP accommodations.

Which plan: 504, IEP or health plan only

Section 504 requires schools to provide a free appropriate public education to students with disabilities, including regular or special education and related aids and services designed to meet their needs.^[1] Many students with diabetes, seizures or severe allergies have a 504 plan. The federal resource guide on Section 504 explains how schools evaluate and plan for these students.^[2]

A student gets an IEP when the condition limits strength, vitality or alertness and affects educational performance enough that the student needs specially designed instruction. That usually falls under other health impairment.^[3] A student with frequent seizures who misses instruction and has memory gaps may need an IEP. A student whose diabetes is well managed may need only a 504 plan.

Document	What it covers	Who writes it	Legal basis
504 plan	Accommodations and services for equal access	504 team	Section 504
IEP	Goals, specially designed instruction, related services, accommodations	IEP team	IDEA
Individualized health plan	Daily care: monitoring, medicine, meals, who is trained	School nurse, from provider orders	State nursing rules and district policy
Emergency action plan	Signs of an emergency and the exact steps staff take	School nurse, from provider orders	State rules and district policy

The 504 plan or IEP should reference the health plan by name rather than copying medical orders into it. Orders change during the year. The plan should say that the health plan is followed in every setting, including buses, field trips and testing.

School health services and the nurse

Under IDEA, school health services and school nurse services are related services when a student needs them to benefit from special education.^[4] The Supreme Court held in Irving Independent School District v. Tatro that a service such as clean intermittent catheterization, which a school nurse or trained layperson can provide, is a related service rather than an excluded medical service.^[5] Districts must provide such services when the student needs them to attend school.

In practice, the nurse trains staff, writes the health plan and keeps the records. The case manager makes sure the plan's accommodations match what the nurse wrote and that every teacher has a copy.

24 accommodations written for the 504 plan or IEP

Diabetes

Accommodation as written in the plan	Type	Effect on grading and testing
1. The student may check blood glucose and use diabetes supplies in any classroom, on the bus and on field trips, as set out in the health plan.	Accommodation	None
2. The student may eat a snack and drink water in class at any time, without asking aloud.	Accommodation	None
3. The student may use the restroom and visit the nurse without a pass limit.	Accommodation	None
4. If blood glucose is outside the range named in the health plan before or during a test, the student may stop and finish the test later the same day or the next school day.	Accommodation	None; follow the state manual for state tests
5. Time spent on diabetes care during a test or timed task is added back.	Accommodation	None
6. Absences and missed instruction for medical appointments are excused, and the student receives notes and a make-up schedule within 2 school days.	Accommodation	None
7. A trained staff member, named in the health plan, accompanies the student on field trips and after-school activities run by the school.	Accommodation	None
8. The student's teachers receive the health plan and a one-page summary of low and high signs by the first day of each semester.	Accommodation	None

Seizures

Accommodation as written in the plan	Type	Effect on grading and testing
9. Staff follow the seizure action plan in all settings. At least 2 staff trained in that plan are on site whenever the student is in school.	Accommodation	None
10. After a seizure, the student may rest in the nurse's office for the time set in the seizure action plan and is not required to return to class work that day.	Accommodation	None
11. The student may retake any test or quiz taken on a day with a seizure, or within 24 hours after one.	Accommodation	None, if the retake covers the same content
12. The student receives a copy of class notes for any class missed or partly missed due to a seizure or recovery time.	Accommodation	None
13. The student has an assigned seat away from hard edges and stairs in labs and shop classes, as named in the health plan.	Accommodation	None
14. Rescue medicine, as ordered, travels with the student or a trained adult on buses and field trips.	Accommodation	None
15. Teachers record any seizure activity they see on the log provided by the nurse and send it to the nurse the same day.	Accommodation	None
16. For students with memory effects after seizures, directions and assignments are given in writing in all classes.	Accommodation	None

Severe allergies

Accommodation as written in the plan	Type	Effect on grading and testing
17. Epinephrine, as ordered, is kept in a location named in the emergency plan and travels with the student on field trips.	Accommodation	None
18. Food used in class activities, parties or lessons is checked against the student's allergen list, or the student receives a safe alternative from home.	Accommodation	None
19. The student eats lunch at a table cleaned before lunch, with peers who agree to the table's food rules, per the health plan.	Accommodation	None
20. Substitute teachers receive the emergency plan and the student's photo in the sub folder.	Accommodation	None
21. Classroom science or art materials containing the allergen are replaced with a safe material for the student's whole group.	Accommodation	None, if the lesson objective is the same
22. The bus driver and any coach or club advisor receive the emergency plan and training before the student rides or participates.	Accommodation	None

When the condition affects learning over time

Accommodation as written in the plan	Type	Effect on grading and testing
23. During a documented medical leave or hospital stay of more than 10 school days, the student receives home or hospital instruction, as arranged by the team.	Service	None; grades follow district policy
24. After extended absence, the student completes a reduced set of make-up assignments covering priority standards only.	Modification	Changes what is graded; note as district policy requires

Item 24 is the only modification. Item 23 is a service decision that the team makes, not a classroom accommodation. Everything else changes the setting, the timing or the steps staff take, so the standard stays the same.

Weak vs better wording

Weak: "Student may have snacks."

Better: "The student may eat a snack and drink water in class at any time, without asking aloud. Snacks are kept in the student's backpack and in the nurse's office."

Weak: "Follow seizure protocol."

Better: "Staff follow the seizure action plan, written by the school nurse from the provider's orders, in all settings. At least 2 staff trained in that plan are on site whenever the student is in school."

The better versions name where, how and who. They also point to the health plan rather than restating medical steps that may change.

A worked example: testing after a low

Alex is a 7th grader (fictional) with type 1 diabetes and a 504 plan. In October, Alex scored 52% on a math unit test taken during a low blood sugar episode the nurse later recorded. On the 3 prior unit tests, Alex scored 84%, 88% and 81%.

The case manager added item 4 and item 5, and gave the math teacher a short note on the process. In January, Alex's glucose was out of range before a science test. Alex went to the nurse, returned 25 minutes later and took the test the next morning, scoring 86%. The teacher logged the delay on the accommodation tracking sheet. The numbers illustrate how the accommodation is used and documented; they are not a benchmark.

Goals for health self-management

Some students, especially in middle and high school, are learning to manage their own care. That can be an IEP goal, such as recording glucose checks or telling an adult about symptoms. The health self-management goal templates have wording, and the school nurse goals page shows goals nurses often support.

Keeping the documents in sync

Review the 504 plan or IEP whenever the health plan changes in a way that affects class, such as a new device or new emergency steps. At least once a year, the case manager, nurse and family should read all three documents side by side. A mismatch, such as a 504 plan that says "snacks in class" and a health plan that lists set snack times, confuses staff when it matters most.

Anxiety often comes along with a chronic health condition; the anxiety accommodations page covers that. For students moving toward college, see high school accommodations. Rules on nursing tasks, delegation and who can give medicine vary by state, so check state guidance and district policy before writing the plan.

Frequently asked questions

Does a student with diabetes get a 504 plan or an IEP?

Most students with well-managed diabetes have a 504 plan with accommodations and a health plan. A student gets an IEP if the condition affects learning enough to need specially designed instruction. The team decides based on an evaluation.

What is the difference between a 504 plan and a health plan?

The 504 plan lists the accommodations and services the student needs for equal access to school. The individualized health plan, written by the school nurse from the doctor's orders, describes daily care and who provides it. The 504 plan should refer to the health plan.

Can a student retake a test after a seizure or low blood sugar?

Yes, if the plan includes that accommodation. Write it with the conditions, such as a test taken on the day of a seizure or while glucose is out of range, and when the retake happens. State test rules for stopping and resuming vary, so check the state manual.

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Sources

34 CFR §104.33: Free appropriate public education, eCFR (National Archives)
Parent and Educator Resource Guide to Section 504 in Public Elementary and Secondary Schools (2016), U.S. Department of Education, Office for Civil Rights
34 CFR §300.8: Child with a disability, Legal Information Institute, Cornell Law School
34 CFR §300.34: Related services, Legal Information Institute, Cornell Law School
Irving Independent School District v. Tatro, 468 U.S. 883 (1984), Library of Congress (U.S. Reports)

Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.