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ADA Policy

Policy & Procedures for Testing Accommodations for Exam Takers with Disabilities

Download the accommodation request form

The American Board of Ophthalmology (ABO) supports the principles of and complies with its obligations under Title III of the Americans with Disabilities Act (ADA), as amended, and the implementing regulations of the U.S. Department of Justice, including those at 28 CFR §36.309, to ensure non-discrimination in ABO examinations. Under these requirements the ABO must offer its examinations in a place and manner accessible to persons with disabilities and to make reasonable accommodations in examination procedures for persons with disabilities. Candidates or Diplomates with disabilities may request modifications in the administration of the examination, appropriate auxiliary aids, alternative accessible arrangements or other reasonable accommodations. The ABO will provide these accommodations unless they would place undue burden on the ABO or fundamentally alter the measurement of the knowledge and skills the examination is intended to assess. This document outlines the process for requesting examination accommodations.

ADA Requirements

The ADA provides protection for persons with disabilities. Under the ADA persons with disabilities may be entitled to accommodations if they have a (i) a physical or mental impairment that (ii) substantially limits one or more major life activities within the meaning of the ADA. The ABO recognizes that under the ADA Amendments Act a broader class of now qualifies as persons with disabilities who may need accommodations in testing.

The ABO is required to take steps in selecting and administering its examinations so as to best ensure that when the examination is administered to an individual with a disability that impairs sensory, manual or speaking skills, the examination results accurately reflect the individual's aptitude or achievement level, or whatever other factors the examination purports to measure, rather than reflecting the individual's impaired sensory, manual or speaking skills.

The ABO is obligated to: (i) ensure that its examinations are administered in facilities that are accessible to individuals with disabilities, or alternative arrangements are made; (ii) provide auxiliary aids and services for persons with impaired sensory, manual or speaking skills; and (iii) make other modifications or accommodations in the examination (e.g. changes in the length of time permitted for completion of the examination, or adaptation of the manner in which the examination is given).

There are several limits to these obligations. The ABO is only obligated to make accommodations to otherwise qualified candidates or diplomates with disabilities who, because of a substantially limiting impairment, cannot take an examination under standard conditions. ABO is not obligated to make any modification or provide any accommodations that would fundamentally alter the measurement of the skills or knowledge the examination is intended to test, or would jeopardize exam security. ABO is also not obligated to make any modification, provide any auxiliary aid or service or provide other accommodations that would impose an undue burden on ABO.

Deadline for Requests

Candidates or diplomates with disabilities who believe they may need accommodations in the place or manner in which examinations are administered should submit the request to the Board office. The request should identify the nature and extent of the disability and the accommodations that the applicant is requesting. Candidates or diplomates must include in their requests any accommodations that may be needed for both the written examination and the oral examination, because of the limited time between the results of the written examination and the next schedule oral examination. The candidate or diplomate should include appropriate documentation. (See guidelines below). All requests and any supporting documentation or questions should be sent to the attention of the Administrator; ABO, PO Box 1887, Doylestown, PA 18901. All subsequent communications or supplemental information should be sent to the Administrator unless the Administrator directs otherwise.

Requests and supporting documentation can be submitted with the candidate's or diplomate's application up to one year in advance of the exam the candidate or diplomate wishes to take. The ABO requests that all documentation be received by four (4) months prior to the exam the candidate or diplomate wishes to take. Please see the table below.


Exam Date(s)

Registration Deadline

ADA Accommodations Request Deadline (with supporting documentation)

Quarterly Questions January - December 31 annually Rolling 1 month prior to engagement in activity, but no later than October 1

Candidates or diplomates who anticipate the need for accommodations should contact the ABO office in advance of the applicable deadline to allow sufficient time for submitting required documentation that may not be readily available, or for supplying additional documentation. Substantial planning and resources are necessary for ABO examinations, which is why it is crucial all supporting documentation is received by the dates posted above.  The ABO may also contact the candidate or diplomate for additional information. Please note, the ABO may not consider supporting documentation that is not received by the deadline.

ABO Review of Documentation, Decisions, Appeals

The ABO will do an initial review and will notify the candidate or diplomate within four (4) weeks after receipt of the request whether the request is granted. If the ABO does not find appropriate and sufficient evidence on which to base a decision to grant a requested accommodation, the ABO will advise the candidate or diplomate what is deemed insufficient and what additional information the ABO requires. Candidates or diplomates will be notified of the deadline by which they must submit any supplemental documentation, which is typically no more than eight (8) weeks prior to the desired exam date. If additional documentation is submitted, the candidate or diplomate will be promptly notified of ABO's decision, including the nature of any accommodations that will be provided and the deadline for appeals of an adverse decision. Any candidate or diplomate whose request for accommodations is denied may submit a letter of appeal. The ABO Admissions Committee or its designees will review the relevant materials and make a final decision.

The ABO reserves the right, at its own expense, to have the candidate's or diplomate's documentation reviewed by an expert of its choosing. Such an expert may perform an independent assessment of the candidate's or diplomate's needs based upon the documentation submitted. Candidates or diplomates may be asked to give permission for the ABO or its outside professional to consult with the professionals who conducted assessments or provided reports. The ABO reserves the right in unusual situations to request that a candidate or diplomate be examined by a medical provider, at the ABO's expense.

Guidelines for Documentation

The ABO requires candidates or diplomates to provide only the documentation that is reasonable and necessary to establish that the candidate or diplomate (i) has a physical or mental impairment that substantially limits one or more major life activities; and (ii) how any such impairment limits the candidate's or diplomate's ability to take ABO examinations under standard conditions and what accommodations are needed.

The nature and extent of documentation that is necessary will depend on the nature of the disability and the specific modification or aid requested. Certain requests, such as those involving accessibility of testing facilities for persons with mobility impairments or auxiliary aids or services for persons with hearing or speech impairments, may involve less documentation than requests for modifications in the administration of the test for persons with cognitive impairments.

Examples of appropriate documentation substantiating the need for desired testing accommodations may include, but are not limited to:

  • The nature of the disability giving rise to the need for accommodation along with recommended accommodations and for why each requested accommodation is needed. A description of the functional limitations due to the disability would be useful in evaluating the request.
  • A report written by a professional appropriately qualified to evaluate the disability and related need for accommodation. Such a report must appear on the professional's letterhead (including address and telephone number) with his or her credentials stated in the letterhead or title. The report must include the name of the candidate or diplomate and the date of testing, and must be signed by the professional writing the report.
  • A history of any previous settings in which accommodations have been granted (e.g., OKAP, MCAT, USMLE, etc.). Candidates or diplomates may also submit documentation of past modifications, accommodations, or auxiliary aids or services received in similar testing situations, as well as such modifications, accommodations, or related aids and services provided in response to an Individualized Education Program (IEP) provided under the Individuals with Disabilities Education Act, a plan describing services provided pursuant to section 504 of the Rehabilitation Act of 1973 or the ADA, or accommodations provided in any other special education program.
  • Any reports or assessments submitted in support of a request should include the date and location; copies of evaluation reports with scores or ratings for each standard instrument or assessment methods used; and a full description of any nonstandard instruments and assessment methods used.
  • Other examples of relevant information that may support a candidate's or diplomate's request would be the results of psycho-educational or other professional evaluations; a candidate's or diplomate's history of diagnosis; or observations by educators.
  • The ABO recognizes that some candidates or diplomates may not have received a diagnosis of a condition until later in life. In such situations the ABO will consider bona fide, reasonably supported reasons for the late diagnosis, as well as academic or other objective evidence related to the asserted disability and need for accommodations.

The ABO will consider all information provided, but some information carries particular weight. The ABO will give considerable weight to documentation of past modifications, accommodations or auxiliary aids or services received in similar testing situations or by other standardized testing agencies, as well as such modifications, accommodations or related aids and services provided pursuant to the IDEA, ADA or the Rehabilitation Act. The ABO will also carefully consider evaluations from qualified professionals who, based upon their personal treatment or observations (and not just a review of records) have determined in their clinical judgment, and in accordance with generally accepted diagnostic criteria, that the candidate or diplomate has a disability and needs the requested test accommodations in order to demonstrate the applicant's ability and achievement level.