Guide to POTS

Hoping this makes a confusing chronic illness diagnosis easier

504 vs IEP

Disclaimer: I am not a medical professional or a lawyer, the information on this page is for your knowledge but please consult a professional if you need help. 

With POTS there is a major medical problem but also there might be a cognitive problem. When you are in school and struggling either medically or academically you should be offered 1 of 2 types of legal services, an IEP or a 504. Below I’m going to break down the difference between the two and highlight the benefits of both. Then I’ll break down what I find most beneficial for myself in school and what I would recommend for students with POTS as someone with POTS and as a teacher. 


This is the most common of the 2 documents. IEP stands for individualized education plan. It is commonly used for students with learning disabilities (such as dyslexia, ADHD, etc.) to give teachers and students a guide to what the student needs. This is a legally binding document and your student will get any services on that document. If they are not getting the services they need then you should bring that up to the school immediately. They can get a lot of fines for not providing what is needed so they will respond and your student will get the services they need. IEP are normally reevaluated every 2 years.


A 504 is also a legally binding document but it is a civil document that falls under the American Disabilities Act. This document can follow you your whole life. A 504 tends to be for medical issues, it can be a short term or long term thing.  I’ve seen 504 for a 1 month period for a concussion and I’ve seen one that last a whole life for hearing loss. Like an IEP you can receive accommodation with a 504 but in general you do not receive services.

Services vs Accommodations

Generally accommodations are done in the classroom. Most commonly I see time and a half on tests and quizzes,  this means if a test is an hour the student gets another half hour.  With an IEP you generally get services as well such as additional support in reading. This is not always the case with IEP but it is common. 

Accommodations vs Modification 

An accommodation allows students equal access to curriculum. For example size 18 font on a test for a student who has trouble seeing while all over students get size 12. Accommodations are about making things equitable across the curriculum without changing the curriculum.

Modifications change the curriculum. Modifications can remove books, change unit, and get rid of certain aspects of the curriculum. This is useful for some students but the majority of students do not need a modified curriculum.

Okay so which is most beneficial for POTS?

Personally I would think a 504. POTS is a medical condition not a learning disability. A 504 is also a civil document and can be useful later in life in a job or college.

Some accommodations that you can ask for in a 504 for POTS are:

  • Being able to put feet up when needed
  • Able to eat and drink when they need
  • Carry pain medication on them
  • Time and a half for all projects, test and quizzes
  • Extensions on all long term assignments
  • No busy work only curriculum necessary work
  • Able to leave classroom to go for a walk as needed
  • Breaks in the nurse’s office to lay down as needed
  • Alternative assignments to group work with extended absences 

There are many more than that and your 504 provider will suggest some that might be beneficial. 

Further Reading

“Classroom Accommodations for Children with Dysautonomia.” Dysautonomia International, Accessed 4 April 2023.

“IEP vs. 504 Plan: What’s the Difference?”, Accessed 4 April 2023.

JONES, CAROLYN. “Parents’ guide to 504 plans and IEPs: What they are and how they’re different.” EdSource, 29 March 2022, Accessed 4 April 2023.

“School and College Accommodations.” Standing Up To POTS, Accessed 4 April 2023.

“What kinds of accommodations and services can my child get?” MassLegalHelp, Accessed 4 April 2023.

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