Extended time is frequently recommended for students with disabilities (SWD) with an intent to remove barriers to accurate measurement of their underlying knowledge and skills. However, empirical findings have varied in terms of whether extended time conditions are an appropriate method for doing so, raising questions of whether frequent recommendation is warranted. Existing score comparability studies have not carefully attended to whether students for whom the extended time accommodation has been recommended truly need, use, and benefit from extended time. In the current study, math test process data from the National Assessment of Educational Progress were used to explore and compare score comparability, as determined via analysis of differential item functioning, for SWD specifically deemed by school teams to need extended time. Score comparability was evident regardless of whether or not the students actually used extended time, begging the question of whether, for many SWD, extended time is truly necessary for score comparability to be achieved. Implications for practice, including methods for more specifically identifying who indeed needs extended time, as well as options for alternative accommodations and interventions that may better target the needs of students who don't truly need and/or use it are offered.