If, after a district has evaluated a student, an IEP team suspects she may need occupational or physical therapy for both medical and educational reasons, the team will likely refer her to CCS for an OT or PT assessment. [Cal. Gov. Code Secs. 7572(a) & 7575(a)(1).] Only students who are found to need one of these therapies for medical reasons will receive the services from CCS. If the IEP team does not think there is a medical need for therapy or if CCS does not believe the student needs therapy for medical reasons, the student will receive therapy from the district if it is educationally necessary. Both CCS and the school district must conduct appropriate assessments prior to recommending or rejecting OT/PT services. [Cal. Gov. Code Sec. 7575(a)(2).]
Medical necessity means that the therapy is needed to achieve or prevent further loss of functional skills or reduce the incidence and severity of physical disability. [2 C.C.R. Sec. 60300(n).] In addition to having a medical need for therapy, your child must also meet CCS medical condition eligibility requirements. The most common conditions for special education students are: cerebral palsy, neuromuscular diseases that produce muscle weakness and atrophy, such as poliomyelitis, myasthenias, and muscular dystrophy, and chronic musculoskeletal diseases, deformities or injuries, such as osteogenesis imperfecta, arthrogryposis, rheumatoid arthritis, amputation, and contractures resulting from burns. [2 C.C.R. Sec. 60300(j).] Other conditions eligible for OT or PT treatment by CCS are listed in the regulations. [22 C.C.R. Secs. 41515.1 and following.]
The CCS assessment focus will be on addressing functional life skill deficits or physical limitations, not necessarily on academic or other educational tasks. For some special education students these skills and tasks may often overlap. It is important to first assess and, then, discuss these overlapping skills in an IEP meeting so appropriate annual goals and objectives/benchmarks can be developed by the IEP team including CCS.
Federal and state special education laws have broader eligibility criteria for OT/PT than CCS. Under the so-called “educational necessity” standard, OT/PT shall be provided when required to help a student “benefit from special education.” [34
C.F.R. Sec. 300.34(a).] Physical therapy is simply defined by federal law as services provided by a qualified physical therapist. [34 C.F.R. Sec. 300.34(c)(9).] Occupational therapy is defined by federal law as services provided by a qualified occupational therapist and includes improving, developing or restoring functions impaired or lost through illness, injury, or deprivation; improving ability to perform tasks for independent functioning if functions are impaired or lost; and preventing, through early intervention, initial or further impairment or loss of function. [34 C.F.R. Sec. 300.34(c)(6).]