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Question: We have requested an
independent educational evaluation and the school district has agreed
to the doctor we have chosen. The district says it will pay up to
$1000-1200 of whatever our private insurance doesn't cover. I thought
that the IEE was supposed to be at public expense. Do I have to use my
insurance?
Answer:
U.S. District Court, Northern
District of Iowa, Central Division
RAYMOND S. and JANET S. as next friends of JOSEPH S., Plaintiffs
V. Al RAMIREZ, Director, State of Iowa Department of Education, The
CLARION-
GOLDFIELD COMMUNITY SCHOOL DISTRICT and ARROWHEAD AREA EDUCATION
ASSOCIATION V,
Defendants
No. C-95-3027
March 4, 1996
The parents of a child with Down Syndrome obtained an independent
educational evaluation and payment was contested at due process. The
parents had obtained partial reimbursement from their insurance
carrier and an administrative law judge determined that the public
agency was only required to pay for the portion of the IEE not covered
by the private insurance. The parents appealed.
HELD: for the parents.
Also, see the following from the old OSEP Letter to Wilson from 1989
that is only available from the OSEP site or via LRP:
In order to avoid unreasonable charges for IEE's, a district may
establish maximum allowable charges for specific tests. If a district
does establish maximum allowable charges for specific tests, the
maximum cannot simply be an average of the fees customarily charged in
the area by professionals who are qualified to conduct the specific
test. Rather, the maximum must be established so that it allows
parents to choose from among the qualified professionals in the area
and only eliminates unreasonably excessive fees. When enforcing
reasonable cost containment criteria, the district must allow parents
the opportunity to demonstrate that unique circumstances justify an
IEE that does not fall within the district's criteria.
If an IEE that falls outside the district's criteria is justified by
the child's unique circumstances, that IEE must be publicly-funded.
Where an agency does not adopt cost criteria, parents are free to
obtain the services of any qualified evaluator. If, in that
circumstance, the public agency believes the fees charged were
unreasonable, it has two options: (1) pay the fees charged to the
parents, or (2) challenge the right of parents to be reimbursed for
the particular fee in a due process hearing, where the agency would
have to show that the fee was "unreasonably expensive."
Basically, it is my opinion that parents cannot be required to use
their insurance coverage to pay any aspect of an IEE as it may
decrease a life time limit for coverage, and therefore is not "free"
to the parent. My position has been supported by case law, although I
am not sure if it was in the 6th Circuit. On the other hand, many
parents in a spirit of cooperation do agree to only have the school
pay any expense not covered by insurance.
John Brower, JD
Education Law Center, PLLC
www.michedlawcenter.com
Education Law Center, PLLC · 810-227-9850
·
www.michedlawcenter.com
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