Why it matters

Reversing summary judgment in favor of an employer, the U.S. Court of Appeals, Fourth Circuit, held that the requirement to complete a medical exam may have violated the Americans with Disabilities Act (ADA) as the employer lacked a reasonable belief based on objective evidence that the employee’s medical condition left her unable to perform her job. The Equal Employment Opportunity Commission (EEOC) filed suit on behalf of Cecilia Whitten, a 28-year employee of McLeod Health who was responsible for the company’s internal newsletter. Whitten was born with a physical disability that caused her to struggle with mobility. In 2012, the employer required her to undergo a medical fitness-for-duty exam, which resulted in a discussion of possible accommodations. After placing her on unpaid medical leave, the employer terminated Whitten. She filed a charge of discrimination with the EEOC. A district court judge granted summary judgment in favor of McLeod, but the federal appellate panel reversed. A reasonable jury could find that the employer lacked a reasonable belief based on objective evidence that Whitten’s medical condition left her unable to navigate the employer’s various campuses, particularly as she had been doing so for almost three decades, the Fourth Circuit said.

Detailed discussion

For 28 years, Cecilia Whitten worked for McLeod Health, a company that operates various hospitals and healthcare facilities in South Carolina. As the editor of McLeod’s internal employee newsletter, she was responsible for developing content by interviewing other employees and writing about company events. Whitten typically traveled among McLeod’s various campuses, spread throughout an area of roughly 100 miles.

Whitten was born with a physical disability known as “postaxial hypoplasia of the lower extremity.” Lacking certain bones in her legs, feet and right hand, she has always struggled with mobility, and falling was “a constant” part of her life.

Although Whitten fell multiple times during her almost three decades of employment, she satisfactorily performed her duties for McLeod. However, in 2012, she fell three times in a four-month span (although only one of the falls occurred at work, and it resulted in no harm). Whitten’s supervisor also expressed concern that she looked “sluggish” and appeared flushed and winded after moving short distances.

The supervisor attempted to reduce Whitten’s workload but did not raise any concerns about her health. After her third fall, the supervisor reported the incidents to human resources (HR), and the occupational health department determined Whitten needed to undergo a fitness-for-duty medical exam.

Although “confused about the necessity” of the exam, Whitten underwent the exam. The nurse practitioner concluded Whitten needed a functional-capacity exam, and Whitten was placed on paid administrative leave pending the results. Based on that exam, the occupational therapist recommended that Whitten be restricted to traveling no more than 10 miles from her main office, use an assistive device and be provided with a parking space in an area without a curb.

Whitten, who did not believe she needed any accommodations but thought she was required to submit an accommodation form, responded with a request for a parking space in an area without a curb, help with selecting an appropriate assistive device, a new desk chair with adjustable-height arms, and limitations on walking and standing.

McLeod then informed Whitten that she could not return to her job because her proposed accommodations would prevent her from traveling to the company’s various campuses to collect stories and take photographs, nullifying the purpose of her position. The employer placed Whitten on unpaid medical leave and terminated her six months later.

Whitten filed a charge of discrimination with the EEOC, and the agency filed suit against McLeod for violating the ADA. Specifically, the EEOC alleged that the employer violated the statute by requiring Whitten to undergo a medical exam despite a lack of objective evidence that such an exam was necessary and by discharging Whitten on the basis of her disability.

The district court granted summary judgment to the employer on both claims, and the EEOC appealed. The U.S. Court of Appeals, Fourth Circuit, began with the medical exam.

Pursuant to the ADA, employers may require an employee to undergo a medical exam only where it “is shown to be job-related and consistent with business necessity.” The threshold question for the court: whether navigating to and within McLeod’s campuses was an essential function of Whitten’s job.

The court found evidence supporting McLeod’s position in testimony from Whitten’s supervisor that her job required her to navigate to and from company events and conduct in-person interviews; Whitten agreed in her deposition that her job required her to navigate various locations such as parking lots and grassy areas.

On the other hand, the record contained evidence supporting the EEOC’s position, the court said. McLeod’s own written description of Whitten’s position contained no mention of navigating to and from company events or conducting in-person interviews; Whitten herself did not think that either was a requirement of her job, and the EEOC produced evidence that she was able to conduct interviews and collect other forms of content over the phone.

Given this mixed evidence, “the question is one for the jury, and McLeod is not entitled to summary judgment on the EEOC’s illegal exam claim,” the panel wrote.

“We note that even if it were beyond dispute that navigating to and within McLeod’s campuses was an essential function of Whitten’s job, we would still hold that McLeod is not entitled to summary judgment,” the court added. “A reasonable jury could conclude that when McLeod required Whitten to take a medical exam, the company lacked a reasonable belief—based on objective evidence—that Whitten’s medical condition had left her unable to navigate to and within the company’s campuses without posing a direct threat to her own safety. This, too, makes summary judgment inappropriate.”

Before the employer required Whitten to undergo a medical exam, McLeod knew that Whitten had been able to perform the essential functions of her job—including navigating the campuses—for 28 years, that she had had falls recently and had struggled to handle her workload, and that her manager thought she looked winded, sluggish and groggy.

“[A] reasonable jury, viewing the evidence in the light most favorable to Whitten, could conclude that in the context of Whitten’s employment history, it was not reasonable for McLeod to believe that she had become a direct threat to herself on the job simply because (a) she had fallen multiple times recently and (b) her manager thought she looked groggy and out of breath,” the panel wrote. “This is especially so given that the only one of Whitten’s recent falls to occur at work resulted in virtually no injury.”

The Fourth Circuit reached a similar conclusion on the EEOC’s second claim, that McLeod violated the ADA by discharging Whitten on the basis of her disability. The district court’s reasoning was premised on its analysis of the EEOC’s illegal exam claim, holding that the EEOC could not prove that Whitten was qualified for her job at the time she was fired and that the medical exam indicated that no reasonable accommodation would permit her to navigate the campuses without posing a direct threat to her own safety.

“[I]t is not certain that navigating to and within McLeod’s campuses was essential to Whitten’s job,” the panel said. “By the same token, it is not certain that Whitten’s medical exam was lawful. Since the district court’s grant of summary judgment assumed that those points were not in dispute, we cannot affirm on the basis of the district court’s reasoning.”

The court reversed summary judgment in favor of the employer on both claims and remanded the case to the district court for further proceedings.

To read the opinion in Equal Employment Opportunity Commission v. McLeod Health, Inc., click here.