Physically Impaired (PI)

Based on information in the Evaluation Report and the student file, the student must meet the requirements in 1 and 2 below.

1. Documentation of a Physical Impairment

_____ There must be documentation of a medically diagnosed physical impairment.

Physical Impairment: _______________________________________

2. Evaluation

At least one of the following must be documented in the evaluation report: 

Functional Skills

_____ The student’s need for special education instruction and service is supported by a lack of functional level in organizational or independent work skills as verified by a minimum of two or more documented systematic observations in daily routine settings, one of which is completed by a physical and health disabilities teacher.

Motor Skills

_____ The student’s need for special education instruction and service is supported by an inability to manage or complete motoric portions of classroom tasks within time constraints as verified by a minimum of two documented systematic observations in daily routine settings, one of which is completed by a physical and health disabilities teacher.

Educational Performance

_____ The student’s physical impairment interferes with educational performance as shown by an achievement deficit of 1.0 standard deviation or more below the mean on an individually administered, nationally normed, standardized evaluation of the student’s academic achievement.

Achievement test _____________   Standard deviation ______________

Review of Eligibility Determination

To determine compliance with eligibility determination, one of the following must be checked. 

_____ The documentation supports the team decision.
_____ The documentation does not support the team decision.

For complete information regarding disability criteria requirements, refer to Minnesota Rule 3525.1337.