The main tenant of the Individuals with Disabilities Education Act (IDEA) reauthorization was improving student outcomes through the use of evidence-based interventions. A particularly interesting aspect that found its way into the legislation was the eligibility process. Current methods of eligibility identification for students with learning disabilities (LD) and emotional and behavioral disorders (EBD) were criticized as being invalid and resulting in overidentification. In the case of LD, a response-to-intervention (RTI) approach was adapted as one of the methods for determining eligibility. In the case of EBD (as well as LD), the recommendation was to use the medical model for making eligibility decisions (i.e., diagnosis by a physician). Although it did not become part of IDEA 2004, it will likely be reintroduced in the next reauthorization. The purpose of this article is to provide a critique of the medical model to make eligibility decisions and point out its potential paradoxical results. A model of RTI is then presented for making EBD eligibility decisions.