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Under the Individuals with Disabilities Education Act (IDEA), before a school district may discipline a student with a disability for greater than 10 days, it must first conduct what is referred to as a manifestation determination review (MDR) (20 U.S.C. §1415(k)(1)(E)). During this review process, the current version of the law requires decision makers to address two questions: (1) is the student’s behavior a manifestation of the student’s disability and (2) was the student’s misconduct caused by the district’s failure to implement the student’s individualized education program (IEP), as required by law. This study aims to explore this first question through interviews with school district decision makers and an in-depth analysis of the paperwork associated with manifestation determination review.