Language proficiency assessment (LPA) serves as a gatekeeper to accessing language services for English learners (ELs) with and without disabilities. Moreover, research suggests that EL services are often deemphasized compared with special education services for students with significant cognitive disabilities (SCDs). We highlight the intersectional nature of educational inequities faced by ELs with SCDs by briefly examining the implications of current legal requirements and offering a critique of LPAs, particularly those designed for students with SCDs. The difficulty of identifying the relative contributions of both limited English proficiency and disability to perceived deficits in English language proficiency is especially salient for students with SCDs, as their communication challenges may be misunderstood as primarily stemming from their underlying disability. This issue raises concerns about how English language proficiency should be understood for ELs with SCDs. A failure to understand this in turn may lead to inaccurate results in diagnostic testing, in addition to inequitable access to appropriate EL services. Finally, a case is made for alternative processes that could increase access to appropriate educational programs and foster increased educational equity.