What If You’ve Never Had Accommodations Before?
Understanding How Testing Boards Like the AAMC and LSAC Review Requests
It’s increasingly common for bright, capable adults to seek accommodations for exams like the MCAT or LSAT even if they’ve never received them before. Maybe you were never formally diagnosed with ADHD, or perhaps you always managed to do well in school by studying longer or over-preparing.
But now, facing a long, high-stakes, timed exam, you find yourself wondering:
If I’ve never had accommodations before, will my request be denied?
The short answer is: not necessarily, but testing boards will expect a very strong and well-documented case.
Why Testing Boards Look at Accommodation History
When reviewing requests, boards like the AAMC (MCAT) and LSAC (LSAT) ask an important question:
“If this condition has been lifelong, why weren’t accommodations needed before?”
That question doesn’t mean they doubt your experience, but it’s about establishing consistency. The burden of proof is higher if there’s no record of previous accommodations, because testing boards need to confirm that:
A disability or condition is truly present,
It creates a functional limitation under standardized testing conditions, and
The accommodation requested is reasonable and necessary to provide equal access.
If you’ve performed well academically in the past, it’s crucial that your evaluation explains why your coping strategies worked before but no longer suffice under the intensity of exams like the MCAT or LSAT.
The MCAT: The Most Stringent Process
The AAMC, which oversees the MCAT, is known for being particularly rigorous. They require:
A recognized diagnosis (e.g., ADHD, learning disorder, anxiety disorder)
Objective test data demonstrating functional impairment
A clear connection between the data and the specific exam demands
Recency matters:
Evaluations must generally be within 3 years of your test date.
Common reasons for MCAT denials:
No prior history of accommodations
Evaluation lacks data on timed tasks (like processing speed or fluency)
Report doesn’t explain how the diagnosis leads to functional impairment during the exam
Recommendations seem generic rather than tailored to the MCAT format
Even if you’ve never had formal accommodations, including detailed qualitative evidence can help such as having to study longer than peers, running out of time on past exams, or needing extra breaks to maintain focus.
The LSAT: Rigorous, But More Flexible
The Law School Admission Council (LSAC), which manages the LSAT, has become more flexible in recent years, especially after ADA-related legal cases. They now focus more on access and equity rather than proof of disability severity.
LSAC requires:
A recent evaluation (within 5 years)
A diagnosis with supporting data
A functional rationale for why the accommodation is necessary
You don’t have to have received accommodations before, but the evaluation must clearly show why you need them now. For example, maybe you previously used extended study sessions to compensate, but the pace and structure of the LSAT make that impossible.
How to Strengthen an Application Without Prior Accommodations
If you have no prior history of accommodations, the documentation needs to be especially strong. Here’s how to build that case:
1. Document a Longstanding Pattern
Describe how symptoms have been present for years, even if undiagnosed.
Examples include:
Needing extra time to complete tests
Losing focus or energy during long tasks
Having to reread or rewrite work repeatedly to get it right
2. Show Objective Data Gaps
Demonstrate measurable differences between ability and performance:
High reasoning or vocabulary scores but low processing speed or fluency
Evidence of fatigue or attention decline over time.
3. Connect It Directly to the Exam
For instance, your evaluator might write:
“Although her reasoning skills are superior, her timed reading fluency is below average, suggesting she cannot fully demonstrate her knowledge within the time constraints of the MCAT.”
4. Address the Lack of Prior Accommodations Head-On
Your evaluator should include a paragraph explaining this directly:
“Although Mr. X did not receive accommodations previously, he maintained high performance through compensatory strategies such as extended preparation and untimed study settings that are not available during standardized testing. As the time and cognitive load of the MCAT have increased, these strategies no longer offset his attentional inefficiency.”
5. Keep Reports Specific and Tailored
Boards are skeptical of generic reports. The best evaluations are data-rich, concise, and clearly linked to exam demands.
Summary
You don’t need a lifelong record of accommodations to qualify but you do need a comprehensive, well-documented evaluation that shows why the accommodation is necessary now. A thorough neuropsychological evaluation with timed, performance-based measures can make all the difference in bridging that gap between potential and performance.
If You’re Considering Accommodations
If you’re unsure whether your current documentation meets the MCAT or LSAT standards, it may be worth reviewing it with a psychologist familiar with high-stakes testing requirements. A targeted evaluation can clarify whether additional testing or documentation would strengthen your request.
