The growing number of high-functioning adults seeking accommodations from testing agencies and postsecondary institutions presents an urgent need to ensure reliable and valid diagnostic decision making. The potential for this population to make significant contributions to society will be greater if we provide the learning and testing accommodations to allow them access to knowledge, as well as the means to demonstrate their extraordinary abilities. The criteria and decision making used to identify high-functioning adults with learning disabilities (LD) must be robust yet flexible enough to account for individual differences, measurement fallibility, and examiner expertise. The purpose of this article is to explore legal, measurement, and clinical issues surrounding the provision of accommodations to high-functioning individuals with LD.