The 504 Plan: School Accommodations and Protections for Your Concussed Student Athlete

By Alicia Jensen

After student athletes suffer a concussion, the first thing that pops into their heads is, “When can I play again?” What many might not realize at first is that the effects of concussions are way more than just physical in nature. Concussions mentally and cognitively impair that athlete either along with the physical symptoms or even after they have been cleared to go back on the field.

Many student athletes like me who are diagnosed with Post-Concussion Syndrome may notice some cognitive symptoms as they return back to school. Symptoms such as memory loss, confusion, a short attention span, and the terrible list goes on and on.

Cognitive impairments can hold back students with PCS from their true potential. They are no longer normal students. They can’t handle the same workload that every other student in their class might be able to handle. They can easily become mentally fatigued or “brain foggy” after doing what might seem like a simple and normal school task such as reading and writing. Most student athletes just keep going on and push through their symptoms because they don’t really know what else to do about the work load. The doctor’s note they get every 3-4 weeks that states “No gym, extra time on tests and assignments- Please excuse their absences as medical” can only get them so far. They feel bad and like a burden on their teachers and everyone around them if they ask for help.

I know all of this because I was one of those students. That was, until I finally got help through a Medical Accommodations 504 Plan. A 504 plan is an official document that is created by administrators and guidance counselors at the student athlete’s school which entails details of their condition and what accommodations they will need in order to be successful in the classroom. In all public schools, 504 plans are protected by federal statute and school compliance is mandatory.

A few weeks ago, someone found The Knockout Project by searching for answers for their 6-year-old child who had been diagnosed with PCS and needed help with attaining a 504 Plan. After speaking to The Knockout Project founder, Jay Fraga, we decided that we needed to place emphasis on the importance of a 504 Plan for a student athlete returning to the classroom. With the green light from Jay, I decided to ask the person on the front line of 504 Plan management a few questions: my Assistant Principal and 504 Officer of Cherry Hill High School West, Ms. Rebecca Metzger.


Alicia, left, and Ms. Rebecca Metzger

Since I was placed on a 504 Plan back in October 2012, I have seen first-hand the work this amazing woman has done for not only me, but other students with PCS. I sat down with her and asked her some questions to help everybody better understand the process and seriousness of Post-Concussion Syndrome and easing some pain through a 504 Plan.

I first asked her what she would say to other school administrators who do not currently offer a program to their students who have been diagnosed with Post-Concussion Syndrome.

“School districts and staff need to be made more aware of the research that is demonstrating serious long-term side effects of Post-Concussion Syndrome. Both physical and emotional,” Ms. Metzger said.

Ms. Metzger has also recognized, through working with PCS students, that they can be successful in school with the right supports. This could go beyond just making a 504 Plan. The US Department of Health and Human Services along with the CDC wrote in the piece “Returning to School After a Concussion: A Fact Sheet for School Professionals”: “It is normal for students to feel frustrated, sad, embarrassed, and even angry…Talk with the student about these issues and offer support and encouragement.”

Ms. Metzger played Rugby at the collegiate level and for the US Women’s National Team, along with competing in Gymnastics when she was younger. During her time as an athlete, she sustained 3 concussions. She reported post-concussion symptoms such as “Headaches, vertigo, nausea and ringing in my ears.” This experience gives her a better insight into what a student-athlete with PCS is feeling at school.

Many students with PCS seem to need the same accommodations in the classroom: “Additional time, flexible scheduling, assistance with organizing and prioritizing assignments, and empathetic/understanding teachers and staff.”

Another major accommodation that many may not address is the need for “half day schedules and homebound tutoring.” These things provide the student with less classroom exposure for a little while which in turn gives them more time to rest, the most important healing measure.

High school is hard enough, but when you add 24/7 physical and emotional pain to the mix, you could get a complete disaster. When I asked how important a 504 Plan is to a student with PCS, Ms. Metzger did not hesitate to give me an answer. She said, “If symptoms are long lasting and pervasive, students will need a 504 Plan to meet the demands of high school.” For me, I was taking Honors and AP level courses, so I often felt the stress high school could bring. As soon as my physical symptoms became worse and as school went on, I knew I needed help. Once I was placed on a 504 Plan, I felt the immediate attention and care from my teachers. Some better than others, but at least there was an official document stating my problem and the help I would need to achieve academic goals.

Before I was diagnosed with PCS, I had no idea that what I was suffering had a name. Even worse, I had no idea that these accommodations were available to me. “Post-Concussion Syndrome students are more common than many people may think, but ultimately, not every concussion results in PCS,” says Ms. Metzger.

Other factors in the 504 Plan process include: “How much time is the student putting in to completing work? Are there teachers who can speak to student performance prior to the injury? How many days was the student absent/will the student be absent?” she said.

According to Ms. Metzger, I was the “third student with PCS and the most serious” she had seen. When she first read my documentation (neuropsychological testing report and doctor’s notes), she said that she “was hoping you weren’t faking and that I could help.” Neuropsychological evaluation (NPE) is a testing method through which a neuropsychologist can acquire data about a subject’s cognitive, motor, behavioral, linguistic, and executive functioning. My grades were very good, which surprised her and the rest of my 504 team because of how low scored my neuropsychological evaluation was. When asked about the effects that concussions had on me, one of my teachers that had me in class before, during, and after my concussions told my 504 advisor Ms. Metzger that, “She was like a different person. I could see flashes of her from before the concussions, but I couldn’t believe how much she was struggling with basic things like word recall and writing in an organized fashion. I was blown away by how hard it was for her to do things that had once been so easy.” Hearing that really made me more grateful for my 504 Plan. It is now something that I am realizing has helped me get to where I am today academically.

504 Plans are meant to help the student succeed and ultimately help them with laying down the groundwork for their future. As a student with PCS, I can tell you that it is an everyday struggle, but I would not be succeeding to the best of my ability right now if it weren’t for my 504 Plan. It is so important to get student athletes with Post-Concussion Syndrome some type of accommodations.

Through my personal experience, I have come to realize that I can achieve the same amount as I could’ve if I did not have PCS, but I am not sure if I could do it without my 504 Plan. If you are diagnosed with Post-Concussion Syndrome and are having trouble in school, reach out to your school’s 504 Officer or guidance counselor. Every school district follows different guidelines, so it doesn’t hurt to ask if you are eligible. A 504 Plan could change a lot for you – physically, mentally, emotionally, and most importantly, academically. A 504 Plan can be vital in the success of student athletes with Post-Concussion Syndrome, they and their parents just need to be made more aware that the help is available.

Special thanks to Ms. Metzger for helping me out with all of this. You are one of my biggest cheerleaders in this Post-Concussion Syndrome fight and I am very much grateful for everything you do for me. You are more than my 504 Plan Advisor; you are a mentor, a supporter, and a friend. I would not be able to do any of this without you! Thank you.

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