Doctor won\'t write 504 Letter

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So here is a question for you experts...

My son has never had an ana reaction. He has had hives and lip swelling, but they went away with Benadryl (this was our first sign of allergy). We then got tested and have strictly avoided and carried EPI's ever since. We act as though he could have an ana reaction as this is what we have learned is the correct course of action.

Now, we asked our doctor to write a letter for us supporting our need for a 504 since our son has the potential for anaphylaxsis. He said that since our son has not really had an ana reaction that he couldn't write the letter.

So my question to you all is...Does everyone with a 504 have a child who has had a known ana reaction? Is my doctor misinformed? He may just not want to for other reasons, but am curious.

Thanks for your help.

On Jul 31, 2006

I think I would want to discuss this further with your doc.

He must have a reason why he is reluctant. Perhaps he could explain it to you. (If, of course, you learn that he feels your child's allergy "isn't that bad," well....)

On Jul 31, 2006

Perhaps your doctor is not familiar with the definition of "disabled" under Section 504. Yes, your son has the potential for anaphylaxis, that's why you need to take precautions and carry epi. These are the things that make your child unable to care for himself in the same manner and to the same degree as his peers. He must always have an epi trained adult to supervise him, and adults must see to it that precautions are taken to protect him from exposure. A young child lacks the skills and judgement to protect himself from the allergens.

The fact that he has not suffered severe anaphylaxis--according to Sampson's chart hives and lip swelling would be Grade 1 or 2 anaphylaxis--does not disqualify your son.

Breathing is not the only "major life activity"!

Is your allergist saying that you would have to risk your son's life to see if he will have a severe reaction before qualify? The POTENTIAL for a fatal reaction is there (otherwise, why did the doc prescribe epi?) Why should your son be penalized because you have been able to protect him from a severe reaction?

By the way, my daughter has never ingested more than a trace of peanut (caused hives for 3 days). Her allergy was discovered because she is contact allergic. She has never had a full-blown ana reaction either, and yet she has a 504.

Cathy

------------------ Mom to 7 yr old PA/TNA daughter and 3 1/2 yr old son who is allergic to eggs.

On Jul 31, 2006

Hey there,

I have a friend whose daughter is PA. They found out after a reaction to egg, not peanut. She has since outgrown the egg, however has never had nuts. Her allergist wrote a 504 letter due to the skin prick tests. And the school has taken it very seriously, to the tune of an aide to be with her during lunch and recess, peanut free room, and other things. So in short, the answer is yes.

I think your allergist does not quite get it. You are not asking him to state she had ana, just that the possibility is there due to the peanut allergy.

good luck

On Jul 31, 2006

I would never expect a physician to know what a 504 is and who qualifies. That is not really his job. I just had our doctor write a letter saying that dd had a life threatening peanut allergy, and that these are the accomodations that are needed. That is really more what his job is.

On Jul 31, 2006

Delete

[This message has been edited by NicoleinNH (edited June 09, 2007).]

On Jul 31, 2006

Dd's doctor kind of flipped out when we asked him. I think he thought we were sue crazy!

I got the speech about how none of his other patients has one blah blah blah.....

Sooooooo.....I explained that I am a former teacher. I explained that as a teacher I THOUGHT I understood food allergies and I THOUGHT I was doing everything possible for my students with allergies. Then I became the parent of a child with food allergies and boy was I wrong! NO way did I understand! I wish someone had explained things to me better!

I also explained that it is NOT unheard of to have a student with a 504 for peanut/tree nut allergies because I happened to know from my experiences as a teacher.

No more arguments once he understood my motives. He wrote the letter explaining dd's symptoms, but not stating anaphylaxis. That's fine. I did ask him to state the whole spectrum of POSSIBLE reactions though and I asked him to state that avoidance of the allergens is necessary.

There are outlines that you can use as a guideline for what you'd like him to include in the letter. We gave dd's doctor an outline of what we would like him to say and then asked him to write what HE wanted but to try to cover those topics. Here are some links to help with outlines:

[url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/000431.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/000431.html[/url]

[url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001046.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/001046.html[/url]

Another interesting point.... We needed to get a note from the doctor in order to bring dd's epipen into a Wiggles concert (of all things) because they searched bags at this particular place. This was a year before we asked for the 504 letter.

THAT note stated, "XXXXX is under my care for the treatment of her peanut and tree nut allergies. She has a potentially life-threatening allergy to peanut and tree nuts. Therefore, injectable Epinephrine in the form of an Epipen must be available at all times."

The wording of THAT letter is much stronger than anything he wrote for the 504. So, of course, I brought that into the eligibility meeting as well and it is one of the things that truly helped us.

Funny how he would word things much differently for the school system.

[This message has been edited by Lori Anne (edited August 01, 2006).]

On Jul 31, 2006

I think we need to keep in mind that our doctors don`t go to law school. We really should not expect them to know if our child qualifies for a 504, as most doctors don`t know what one is. We definitely do need a strongly worded letter that the pa is life threatening and the child must have injectible epi available at all times, and avoid all contact with peanut products. But expecting our doctors to do what is really a lawyer`s job is really setting ourselves up for expectations not to be met. Disability law is not a class offerred in medical school. There are so many other things that doctors have to learn, but disability law is not one of them.

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