Doctor won\'t write 504 Letter

Posted on: Mon, 07/31/2006 - 11:09am
Beldin's picture
Offline
Joined: 01/28/2006 - 09:00

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.

Posted on: Mon, 07/31/2006 - 11:21am
Corvallis Mom's picture
Offline
Joined: 05/22/2001 - 09:00

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....)

Posted on: Mon, 07/31/2006 - 11:44am
Momcat's picture
Offline
Joined: 03/15/2005 - 09:00

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.

Posted on: Mon, 07/31/2006 - 12:09pm
anonymous's picture
Offline
Joined: 05/28/2009 - 16:42

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

Posted on: Mon, 07/31/2006 - 12:11pm
Carefulmom's picture
Offline
Joined: 01/03/2002 - 09:00

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.

Posted on: Mon, 07/31/2006 - 1:35pm
NicoleinNH's picture
Offline
Joined: 06/21/2003 - 09:00

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

Posted on: Mon, 07/31/2006 - 1:44pm
Lori Anne's picture
Offline
Joined: 07/13/2005 - 09:00

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).]

Posted on: Mon, 07/31/2006 - 1:56pm
Carefulmom's picture
Offline
Joined: 01/03/2002 - 09:00

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.

Posted on: Mon, 07/31/2006 - 11:21am
Corvallis Mom's picture
Offline
Joined: 05/22/2001 - 09:00

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....)

Posted on: Mon, 07/31/2006 - 11:44am
Momcat's picture
Offline
Joined: 03/15/2005 - 09:00

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.

Posted on: Mon, 07/31/2006 - 12:09pm
anonymous's picture
Offline
Joined: 05/28/2009 - 16:42

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

Pages

Peanut Free and Nut Free Community

Click on one of the categories below to see all topics and discussions.

Latest Discussions

Latest Post by MoRich Mon, 06/01/2020 - 10:06am
Comments: 6
Latest Post by Sarah McKenzie Fri, 05/22/2020 - 12:57pm
Comments: 6
Latest Post by JRM20 Wed, 05/20/2020 - 9:30am
Comments: 5
Latest Post by justme Mon, 05/18/2020 - 12:36pm
Comments: 45
Latest Post by krisztina Thu, 02/20/2020 - 4:49pm
Comments: 1
Latest Post by chicken Thu, 02/20/2020 - 4:45pm
Comments: 3
Latest Post by lexy Tue, 01/28/2020 - 12:21am
Comments: 6
Latest Post by JRM20 Sun, 01/26/2020 - 11:15am
Comments: 6

Peanut Free Store

More Articles

It Is Easy To Buy Peanut Free Chocolate Online

Ask any parent of a child with a potentially life-...

Peanuts can cause one of the most serious allergic reactions of all food products. Researchers speculate...

Tree nuts and peanuts are distinctly different. An allergy to one does not guarantee an allergy to the other. Peanuts are considered legumes and...

Whether you have a child with a peanut allergy or you are sensitive to packing a nut-free lunch out of concern for other people’s children, it is...

The most frightening thing about a severe allergic reaction to a new food is that it can happen so fast. If parents are not looking for allergic...

Those with severe peanut allergies soon learn to look for the 'peanut-free sign' on any packaged food purchase. This is a notation found on a wide...

Cakes are a central part of many celebrations, from kids' birthdays to weddings. For those with severe ...

For many people with peanut allergies, baked goods present one of the most significant risks. Even if...

A recent study published in the Journal of American College of Nutrition by Mahnaz Rezaeyan Safar and a number of her colleagues has found some...

Chronic Obstructive Pulmonary Disease (COPD) is an overarching term for a number of progressive lung diseases, including emphysema, chronic...

For individuals suffering from chronic obstructive pulmonary disease (COPD), managing the symptoms and avoiding exacerbations can be a full-time...

Psoriasis is a chronic skin condition that causes itchy patches of inflammation and scale on your skin. The severity of psoriasis symptoms varies...

Kim Kardashian, an immensely famous reality star and the wife of acclaimed rapper Kanye West, has spoken out about her struggle with psoriasis....

Paul Wilson, a long-term marathon runner and asthma sufferer, is urging other people with asthma to support a new campaign aimed at raising...

Psoriasis is a common skin condition that causes a buildup of cells on the skin surface, resulting in dry, red patches on the body and/or face....

Sufferers of Rheumatoid Arthritis (RA) will tell you that the most difficult symptom to deal with is morning stiffness. With nearly 90 percent of...

Knowing which medication is right for you can often be a confusing and overwhelming process. The specific type of asthma medication you require...

Psoriasis is a chronic autoimmune condition that causes painful scaly patches on the skin. Although psoriasis is a very common skin condition,...

Although there are multiple treatments available for rheumatoid arthritis (RA), those suffering from the condition can still find themselves...

Patients undergoing biologic treatment for psoriasis, a relatively common inflammatory skin condition, have seen a reduction in arterial plaque...