A medical resident with Asperger’s Disorder was unable to meet his burden, in his ADA lawsuit against his hospital employer, that he was “otherwise qualified” for his position. The 6th U.S. Circuit Court of Appeals upheld summary judgment in favor of the hospital, because the resident’s requested accommodation - that the hospital physician and staff be educated on the symptoms and triggers of Asperger’s - did not address the key obstacle preventing him from performing a necessary function of his job, or resolve his inability to fulfill his responsibilities as a hospital resident. Jakubowski v. Christ Hosp. Inc., 6th Cir., No. 09-4097, December 8, 2010.

Martin Jakubowksi graduated from the University of Medical Sciences in Poznan, Poland in 2003. In July 2005, he began a medical residency at St. Elizabeth Hospital in Youngstown, Ohio. In October, he was placed in a remediation program to improve performance weaknesses, but his contract at that hospital ultimately was not renewed. He then enrolled at the New York Medical College for a year-long supervised clinical training. He received mixed reviews there, with the negative comments focused largely on his lack of communication skills.

In July 2007, Jakubowski found a second residency, this time at Christ Hospital in Cincinnati. During the first month of that residency, he received mixed reviews. While his “medical knowledge” scores were high, he scored poorly on an emotional intelligence exam, and was evaluated as deficient in self-awareness, social competence, and relationship management. One attending physician observed that Jakubowski had poor organizational skills, skipped standard procedures in his examinations, and performed procedures incorrectly. While Jakubowski never caused actual harm to any patient during his residency, his supervising physicians noted his inability to communicate effectively with nurses, and certain unclear orders made by Jakubowski for medication and treatment of patients.

On August 25, 2007, Jakubowski was formally diagnosed with Asperger’s. On that same day, but before formal notification to the hospital of that diagnosis, the director of the residency program (Dr. Diller) informed Jakubowski that he would be terminated from his residency on September 30, 2007. On September 11, Jakubowski’s attorney sent a letter to the hospital proposing that the hospital accommodate the diagnosed Asperger’s by increasing the “knowledge and understanding” of the physicians and nurses working with Jakubowski. The hospital responded that it did not have sufficient resources to comply with the proposal by Jakubowski, but offered to help him in finding a residency in pathology, a field that required little or no patient interaction.

Jakubowski sued the hospital, alleging that he had been let go because of his Asperger’s Disorder, and claiming that the hospital failed to accommodate that disability. The lower court granted summary judgment in favor of the hospital, and that decision was upheld by the Sixth Circuit on appeal. In its analysis, the Sixth Circuit pointed out that effective communication with colleagues and patients was an essential function of a resident’s job. Whether or not Jakubowski was a “qualified” resident in spite of his Asperger’s depended on whether his proposed accommodation would improve his communication and interactions with others. Because the proposal to increase the “knowledge and understanding” of his co-workers about Asperger’s did not directly improve Jakubowski’s ability to communicate effectively, because the proposed accommodation was involved an indefinitely period of time and indefinite frequency, and because Jakubowski’s inability to communicate could have an adverse effect on patient safety, the Sixth Circuit upheld the lower court’s dismissal of the case.

While the ADA prevents an employer from discriminatorily terminating an otherwise qualified individual on the basis of a disability, Jakubowski was unable to prove that he was “otherwise qualified” to successfully complete his residency, because his proposed accommodation did not directly improve his ability to communicate with co-workers and patients. According to the Sixth Circuit, a plaintiff has the burden of proving that he will be “capable of performing the essential functions of the job with the proposed accommodation,” and Jakubowski was unable to do that. Therefore, he could not proceed with his ADA claims.

This holding does not excuse employers from participating in the interactive process by engaging in a reasonable discussion of accommodations proposed by a disabled employee. It does, however, indicate that unless an impaired individual can describe and request an accommodation that allows him or her to undertake the essential functions of the job, that individual cannot support a lawsuit under the ADA.