Document accessibility · PDF/UA proofs
Proof of work · Pennsylvania public documents

The form a nurse with a disability uses to request a testing accommodation failed nine accessibility rules. It now fails none.

Fourteen documents published by the Pennsylvania Office of Administration, the Pennsylvania Department of Health, the Pennsylvania State Board of Nursing, and the Erie County Department of Health, downloaded from the agencies' own pages and measured with veraPDF against PDF/UA-1 (ISO 14289-1). Each was repaired, measured again, and compared against the original page by page - by raster where the fix was structural, and word by word where a font had to be embedded. Seven now pass with zero failed rules, including the Board’s own Request Form for Testing Accommodations, the Commonwealth’s own Digital Accessibility Policy, and the Board’s own meeting agenda from September 11, 2026. The other seven are published here with exactly what remains and why, because that gap is the honest part of this work.

Documents measured
14
69 pages, four Pennsylvania issuers
Failed rules before
85
veraPDF, PDF/UA-1 profile
Failed rules after
30
Seven files at zero, fully conforming

Seven files conform

These seven carry the PDF/UA-1 identifier because veraPDF independently passed them first, 106 rules out of 106. The identifier is written by hand at sign-off, never by the tool, and never before the file has earned it.

Pennsylvania State Board of Nursing

Meeting Agenda, September 11, 2026

Before FAIL 8 rulesAfter PASS 0 / 106Rendering 7/7 pixel-identical

The agenda the Board published four days before the meeting. Eight rules failed: no document title, a silent Department of State logo, a Teams link that announced no destination, and a roster table whose rows did not line up. But the finding that mattered is one no validator reports. The agenda had fifty-five headings, and thirty-four of them were empty — no text, no image, nothing. veraPDF passes a file with thirty-four blank headings; there is no rule against it. A nurse moving through the agenda by heading, which is the normal way to read an agenda, stopped thirty-four times at something that announced “heading” and then said nothing. They are a Word export artifact, so the same defect is in every document built from that template. Twenty more headings sit on address lines; those contain real text, so they were left exactly as published — whether a street address belongs in the outline is the Board’s editorial call, not mine.

Conforming PDF

Pennsylvania Office of Administration

Digital Accessibility Policy (effective November 12, 2025)

Before FAIL 6 rulesAfter PASS 0 / 106Rendering 4/4 pixel-identical

This is the policy that sets WCAG 2.1 Level AA as the standard for every Commonwealth agency, and it was six rules short of PDF/UA-1 itself. In fairness it was the closest file on this page: tagged, marked, titled, declared as English, with real alternative text already written for the Office’s logo. Somebody did that work. What remained was small — six links with no accessible name, one horizontal rule four points wide tagged as a picture, four empty spaces left unmarked, and one font carrying a stale character set. Nothing about what the document says changed, and all four pages render identically.

Conforming PDF

Pennsylvania State Board of Nursing

Request Form for Testing Accommodations (rev 06/2025)

Before FAIL 9 rulesAfter PASS 0 / 106Text 397/397 words unmoved

Fourteen horizontal rules were tagged as figures, so a screen reader stopped at each one expecting a description. They are decoration, so they are now artifacts. Two headings skipped levels. Five fonts were named but not carried, which is why it is the one file here whose pages are not pixel-identical — see the note below.

Conforming PDF

Pennsylvania State Board of Nursing

Nurse Licensure Compact Act

Before FAIL 2 rulesAfter PASS 0 / 106Rendering 16/16 identical

Sixteen pages, tagged but with no document title and two table headers with no scope. Both fixed; the file now validates clean.

Conforming PDF

Pennsylvania Department of Health

Parent / Guardian Scoliosis Notification

Before FAIL 2 rulesAfter PASS 0 / 106Rendering 1/1 identical

A one-page letter sent home to parents after a school screening. It had no title, so a screen reader announced the filename instead.

Conforming PDF

Pennsylvania State Board of Nursing

Professional Nursing Law (Feb 2023)

Before FAIL 8 rulesAfter PASS 0 / 106Rendering 26/26 identical

Twenty-six pages of the statute that governs every nurse in the state, published with no tag structure at all, no title, and no language. A screen reader had nothing to work with. Now tagged, titled, and conforming, with every page unchanged.

Conforming PDF

Pennsylvania Department of Health

Medical Certificate · School Immunization Card

Before FAIL 5 rulesAfter PASS 0 / 106Text 204/204 words unmoved

Untagged and unmarked on arrival, with three fonts named but not carried. Tagged, then the same three typefaces embedded from the names the file already used.

Conforming PDF

About the fonts, because it is the one claim on this page that needs a caveat. The accommodations form names Arial and Times New Roman but does not carry them, so what a reader sees today depends on which fonts that reader’s machine happens to have. That is the defect the rule exists to prevent. The remediated file embeds the same typefaces the document already names, subset to the glyphs actually drawn, after checking each font’s own embedding-permission bits. Every one of the 397 words sits in the same place to within half a point; what changes is that the letterforms are now fixed rather than guessed. The same was done for the Medical Certificate and the School Dental Form. The other three conforming files needed no font work and are byte-for-byte pixel-identical, including all twenty-six pages of the Professional Nursing Law.

Every file, measured

DocumentPagesBeforeAfterWhat is still failing, and why
Pennsylvania Office of Administration
Digital Accessibility Policy (eff. 11/12/2025)460Nothing. Conforming, signed off.
Pennsylvania Department of Health — school health forms
Parent / Guardian Scoliosis Notification120Nothing. Conforming, signed off.
Certificate of Immunizations122Two rows of the vaccine grid span a different number of columns than the rest, because the serology boxes are merged cells with no span declared. Which cell was merged is readable off the page by eye and not off the file, so it stays a human decision.
Medical Certificate250Nothing. Conforming, signed off.
School Dental Form252All four fonts now embedded and all 59 table headers given scope. Three rows still disagree on column count — same merged-cell judgment as the immunization card.
Parent / Guardian Hearing Screening Notification185It is a scan. The only machine-readable text on the page is the footer “Reviewed 10/2025”. A deterministic pass cannot OCR a page; that is human work.
School Health Record48799 table rows contain non-cell content and 6 rows disagree on column count (7.2). Four pages of clinical grid; the correct structure is a judgment call.
Pennsylvania State Board of Nursing
Nurse Licensure Compact Act1620Nothing. Conforming, signed off.
Professional Nursing Law (Feb 2023)2680Nothing. Conforming, signed off.
Request Form for Testing Accommodations (rev 06/2025)290Conforming, signed off. It still has zero form fields, so it must be printed to be completed — that is a design decision for the Board, not a validator failure.
Erie County Department of Health
Tuberculosis (TB) Referral17347 form fields with no accessible name (7.18.4) and 64 pieces of content neither tagged nor marked as artifact.
Animal Bite Report Form17571 unnamed form fields, 56 untagged content items, one unembedded font.
Communicable Disease Referral18652 unnamed form fields, 64 untagged content items, one link with no description.
What is left is not a queue of easy wins. Four of the seven fail on table structure or on a scan. The other three are interactive forms whose fields carry no accessible name, so a screen reader announces the field but not what it asks for; naming those means reading each label off the page and deciding which field it belongs to. Deciding that a row’s last cell was merged across two columns, or re-typing a scan, changes what the document says. A script that decides those things produces a file that passes a validator and misreads to the person using a screen reader, which is worse than the honest failure. Those stay on this list until a person does them.
Every “after” count above still includes one rule that is failing on purpose. Clause 5 is the PDF/UA conformance identifier. This pipeline refuses to write it. A file gets that identifier only after a validator has independently passed everything else, which is why seven of these thirteen are published as failing rather than stamped and called done.

How to read these

See the translated-document proofs — four state files where translation broke the tagging.