The Americans with Disabilities Act: A Brief Overview

Disclaimer;  This is a brief overview which cannot possibly set forth everything about the ADA and which, for purposes of brevity or as part of an effort to state legal concepts simply and in plain English, may describe the law in a manner which is not necessarily precise and/or accurate in every respect.

Signed into law on July 26 1990, the Americans with Disabilities Act is a wide-ranging legislation intended to make American Society more accessible to people with disabilities.

It is divided into five titles:

1. Employment (Title I) Business must provide reasonable accommodations to protect the rights of individuals with disabilities in all aspects of employment. Possible changes may include restructuring jobs, altering the layout of workstations, or modifying equipment. Employment aspects may include the application process, hiring, wages, benefits, and all other aspects of employment. Medical examinations are highly regulated.
2. Public Services (Title II) Public services, which include state and local government instrumentalities, the National Railroad Passenger Corporation, and other commuter authorities, cannot deny services to people with disabilities participation in programs or activities which are available to people without disabilities. In addition, public transportation systems, such as public transit buses, must be accessible to individuals with disabilities.
3. Public Accommodations (Title III) All new construction and modifications must be accessible to individuals with disabilities. For existing facilities, barriers to services must be removed if readily achievable. Public accommodations include facilities such as restaurants, hotels, grocery stores, retail stores, etc., as well as privately owned transportation systems.
4. Telecommunications (Title IV) Telecommunications companies offering telephone service to the general public must have telephone relay service to individuals who use telecommunication devices for the deaf (TTYs) or similar devices.
5. Miscellaneous (Title V) Includes a provision prohibiting either (a) coercing or threatening or (b) retaliating against the disabled or those attempting to aid people with disabilities in asserting their rights under the ADA.

The ADA's protection applies primarily, but not exclusively, to "disabled" individuals. An individual is "disabled" if he or she meets at least any one of the following tests:

1. He or she has a physical or mental impairment that substantially limits one or more of his/her major life activities;
2. He or she has a record of such an impairment
3. He or she is regarded as having such an impairment.

Other individuals who are protected in certain circumstances include 1) those, such as parents, who have an association with an individual known to have a disability, and 2) those who are coerced or subjected to retaliation for assisting people with disabilities in asserting their rights under the ADA.

While the employment provisions of the ADA apply to employers of fifteen employees or more, its public accommodations provisions apply to all sizes of business, regardless of number of employees. State and local governments are covered regardless of size.

EEOC Enforcement Guidance on the Americans with Disabilites Act and Psychiatric Disabilities [BROKEN LINK TK

Sets forth the Commission's position on the application of Title I of the Americans with Disabilities Act of 1990 to individuals with psychiatric disabilities

U.S. Supreme Court Actions [OUT OF DATE LINK TK]

Long-term Disability; ERISA; Arbitrary & Capricious; MI; ADA Title I

The Tenth Circuit affirmed that an administrator's decision to limit and, thus, terminate an employee's long-term disability (LTD) benefits because he had a mental, rather than a physical, disability was not arbitrary and capricious under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. S1001 et seq., nor did it violate the Americans with Disabilities Act (ADA) Title I, 42 U.S.C. SS12111-12117. Kimber v. Thiokol Corp., 196 F.3d 1092 (10th Cir. 1999).

Ivan Kimber, a materials clerk at Thiokol Corp., was placed on a medical leave of absence and awarded LTD benefits due to diabetes. Upon further review, his disability benefits were terminated. Kimber appealed. He offered the opinions of three physicians, including a psychologist, Dr. Williams, who opined that Kimber had depression and perhaps mild dementia secondary to his diabetes. John Hancock Managed Care Group, which was retained by the plan administrator to review disability claims, arranged for a psychological evaluation. The psychologist agreed with Dr. Williams, and the plan administrator reinstated Kimber's disability benefits, finding that he was totally disabled "due, at least in significant part to a mental condition." As a result, Kimber was awarded the past benefits he had lost, but no future benefits due to a plan provision that disability benefits end after 24 months if the disability is due to a mental condition. Kimber sued Thiokol, alleging the plan administrator's decision to deny benefits was arbitrary and capricious, and that the plan violated Title I by establishing different levels of benefits for disabilities caused by physical or mental conditions. The district court dismissed the case.

The Tenth Circuit affirmed. First, a one-time determination of eligibility for benefits under the plan does not foreclose a subsequent principled review. Here, John Hancock reviewed Kimber's claim as part of a periodic review, determined that there was insufficient evidence of total disability in the file, and requested additional medical evidence. Regardless of its initial determination, Thiokol had the right to review Kimber's file and request continuing evidence of a total disability. Second, Thiokol did not act arbitrarily and capriciously by finding there was a lack of objective evidence of total disability based upon diabetes. Although the letter from Dr. Williams states that Kimber is "totally disabled secondary to diabetes, hypertension and the problems associated with this," it does not include any reference to clinical data. A rational plan administrator could find this document insufficient because it does not contain supporting data for the conclusions reached. Third, the plan administrator was not required to look at all of Kimber's relevant medical records in making its determination. Specifically, Kimber points to the neuropsychological evaluation report, which the administrator did not read. The court held that the plan administrator did not have a duty to read every single piece of raw data. The administrator employed John Hancock to review medical records and provide professional opinion as to their contents, and relied upon its analysis of the report in making his final decision.

Further, the court held that the administrator did not act arbitrarily and capriciously in interpreting the phrase "due to a mental condition" to mean "due, at least in significant part, to" a mental condition. The phrase "due to" is ambiguous. When a plan administrator is given authority to interpret the plan's language and more than one interpretation is rational, the administrator can choose any rational alternative. See Naugle v. O'Connell, 833 F.2d 1391 (10th Cir. 1987). The plan administrator's decision that the mental condition need not be the sole cause of the disability before benefits can be limited is a rational interpretation.

Finally, Thiokol did not violate the ADA by employing a disability plan that distinguished between mental and physical disabilities. This issue has been argued extensively in other circuits. See Ford v. Schering-Plough Corp., 145 F.3d 601 (3d Cir. 1998), 22 MPDLR 491, cert. denied, 119 S. Ct. 850 (1999). The ADA does not require equal coverage for every type of disability. Such a requirement would destabilize the insurance industry in a manner not intended by Congress when it passed the ADA. So long as every employee is offered the same plan regardless of that employee's contemporary or future disability status, no discrimination has occurred even if the plan offers different coverage for various disabilities. See Lewis v. Kmart Corp., 180 F.3d 166 (4th Cir. 1999); Parker v. Metropolitan Life Ins. Co., 121 F.3d 1006 (6th Cir. 1997), 21 MPDLR 644