Traumatic Brain Injuries Documentation Guidelines

The Accessibility Resource Center provides academic accommodations and services to students with documented disabilities. Students are required to provide comprehensive documentation to verify that a diagnosed disorder meets the legal definition of disability covered under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act, as amended (ADAAA, 2009).

The ADAAA defines disability as a “physical or mental impairment that substantially limits one or more major life activities”. Merely submitting evidence of a diagnosis is not sufficient to warrant academic accommodations. Nonspecific diagnoses, such as individual attention problems, academic problems, and test difficulty/anxiety in and of themselves do not constitute a disability.

The guidelines below are intended to provide guidance for the assessment process, including the areas that must be assessed in order for ARC staff to make appropriate decisions. ARC also has a Disability Assessment Form that needs to be filled out by a qualifying professional.  Please contact ARC at (414) 229-6287 with questions.

Students submitting documentation of physical and/or cognitive sequelae related to a traumatic brain injury (e.g., head trauma, CVA’s, tumors, other medical conditions) must submit evidence of a disabling condition with associated functional impairment in major life activities relevant to the classroom.  Such documentation should include:

  1. DSM-V or ICD Diagnosis (text and code): Detailed background information– including information obtained in diagnostic interviews, relevant hospital and/or rehabilitation records, history of premorbid functioning (including prior academic history and developmental history), any pertinent medical and psychological history, and a discussion of dual diagnosis, if present; this includes a history of any coexisting disorders that could affect functioning. As above, all testing/evaluation reports should be current and signed by a qualified professional.  Qualified professional should not be related to the individual being assessed.
  2. Evaluation: Comprehensive neuropsychological evaluation– conducted after the injury, which includes, but is not limited to, the domains described above for learning and communication disorders.
  3. Functional Limitations: Evidence of current impairment, including behaviors that significantly affect functioning, and how these relate to academics should be provided. A discussion of estimated premorbid functioning should also be included. Detailed information regarding residual physical or medical impairments– current treatment regimens, including current medications. Functional limitations should be determined WITHOUT consideration of mitigating measures (i.e. medication, etc.).  If condition is episodic in nature, level of functioning should be assessed based on active phase of symptoms.
  4. Accommodations: Suggested recommendations, modifications and/or accommodations.

The diagnostic report must include the name and title, and license number of the evaluator. Report should be on letterhead.

General Guidelines for all Disabilities
It is understood that accommodation needs can change over time and are not always identified during the initial diagnostic process. A prior history of accommodation, without demonstration of current need, does not in and of itself warrant provision of accommodations. ARC will make the final determination on eligibility for services based upon the documentation and an interview with the student.

Documentation submitted to ARC is considered confidential and maintained separately from the student’s educational record.

Documentation should be sent to the following address:

Accessibility Resource Center
University of Wisconsin Milwaukee
P.O. Box 413 Milwaukee, WI. 53201

Fax to: (414) 229-2237
Email to: archelp@uwm.edu

Reviewed:  August 2017