Some parents and students have a perception that there is a non-negligible number of people who do not have an actual need who unfairly get extra time on tests. And that is upsetting - both for those people and the students who feel judged.
This concern appears to be most pronounced with students who are competing for the most selective schools.
I don’t know one way or the other to what extent this is a legit concern overall but I can contribute my own experience in case it makes some of those people less aggravated.
One of my nearest and dearest (ND) was diagnosed at a young age with ADHD, inattentive type. Unlike some others, his neurodivergence is clear to people who interact with him. His testing showed it, every teacher raised it. Now a young adult, he has not outgrown his diagnosis and deals with its challenges daily.
Even though his family has means, and some level of expertise (helped friends navigate the IEP process); even though he is significantly impacted by his neurodivergence, he was never given extra time. Not on class tests or on standardized testing. Not in college.
This was true when ND attended public school and private.
That is because you have to demonstrate a substantial limitation in timed testing relative to most peers. If you are compensating to allow you to do pretty well, even if it is not up to your personal full potential, you don’t qualify for extra time. Because, compared to most peers, you have not demonstrated your disability is substantially disadvantaging you.
In other words, from my experience (I don’t have data), a student with a documented disability with a 1520 is unlikely to get time to enable them to get up to the 1580+ apparently needed at the most selective schools.
(Two notes - if this sounds somewhat familiar, I posted earlier but did not express what I meant to - I got all caught up in the realities of day-to-day living for ND. Second, I am not suggesting ND should have gotten extra time.)