Price v. National Bd. of Medical Examiners, Civil Action No. 3:97-0541.

• Decision Date: 06 June 1997
• Docket Number: Civil Action No. 3:97-0541.
• Citation: 966 F.Supp. 419
• Parties: Bryan David PRICE, Brian A. Singleton, and Stephen M. Morris, Plaintiffs, v. THE NATIONAL BOARD OF MEDICAL EXAMINERS, Defendant.
• Court: U.S. District Court — Southern District of West Virginia

966 F.Supp. 419

Bryan David PRICE, Brian A. Singleton, and Stephen M. Morris, Plaintiffs, v. THE NATIONAL BOARD OF MEDICAL EXAMINERS, Defendant.

Civil Action No. 3:97-0541.

United States District Court, S.D. West Virginia, Huntington Division.

June 6, 1997.

COPYRIGHT MATERIAL OMITTED

Kimberly J. Carpenter, Pullin, Knopf, Fowler & Flanagan, Charleston, WV, for Plaintiffs.

Nancy C. Hill, Carey, Hill & Scott, Charleston, WV, for Defendant.

MEMORANDUM ORDER, FINDINGS OF FACT AND CONCLUSIONS OF LAW

GOODWIN, District Judge.

Three Marshall University School of Medicine students seek injunctive relief compelling the National Board of Medical Examiners (Board) to provide each of them with additional time for the United States Medical Licensing Examination (USMLE) and with a separate room in which to take the examination. Plaintiffs claim that these accommodations are mandated by the Americans with Disabilities Act of 1990(ADA), 42 U.S.C. § 12189.¹ The Court has jurisdiction over this matter pursuant to 28 U.S.C. § 1331 because it arises under the laws of the United States. Prior to the injunction hearing, this Court notified the parties that the proceeding would be considered as a trial on the merits, consistent with Rule 65(a)(2) of the Federal Rules of Civil Procedure. Neither party objected.

The ADA is not designed "to allow individuals to advance to professional positions through a back door. Rather, it is aimed at rebuilding the threshold of a profession's front door so that capable people with unrelated disabilities are not barred by that threshold alone from entering the front door." Jamie Katz & Janine Valles, The Americans with Disabilities Act and Professional Licensing, 17 MENTAL & PHYSICAL DISABILITY L. REP. 556, 561 (Sept./Oct.1993). If a court were to grant testing accommodations to persons that do not have disabilities within the meaning of the ADA, it would allow persons to advance to professional positions through the proverbial back door. In so undermining the integrity of the USMLE, that court would hinder the Board's ability to distinguish between qualified students and unqualified students.

Although this Court does not question the good faith of the plaintiffs in this case, the fundamental question in this matter is whether each of the plaintiffs has a disability within the meaning of the ADA. The case turns on the meaning of "substantially limits," a phrase used in the definition of "disability" set forth in § 12101 of the ADA. The parties disagree about when an impairment "substantially limits" a major life activity. After a review of the legislative history, the relevant implementing regulations, and pertinent case law, this Court concludes as follows: An impairment substantially limits a person's major life activity when the individual's important life activities are restricted as to the conditions, manner, or duration under which they can be performed in comparison to most people in the general population. In this case, plaintiffs are able to learn as well as or better than the average person in the general population. Accordingly, judgment is ORDERED in favor of the defendant.

I. Findings of Fact

The Court makes the following findings of fact: Plaintiffs Bryan D. Price, Brian A. Singleton, and Stephen M. Morris are students at the Marshall University School of Medicine. Each of the plaintiffs has completed the equivalent of two years of study. After completing the requirements of the first two years, Marshall medical students must pass Step 1 of the USMLE to continue at Marshall's medical school. The Board administers the USMLE and is the defendant in this action.

Plaintiffs are scheduled to take the USMLE on June 10 and 11, 1997. Each of the plaintiffs has been diagnosed by the National Center of Higher Education for Learning Problems (HELP) with Attention Deficit Hyperactivity Disorder (ADHD). Two of the three plaintiffs have been diagnosed by HELP with Disorder of Written Expression and Reading Disorder, specific learning disabilities. Relying on HELP's diagnoses, plaintiffs seek injunctive relief compelling the Board to provide each of them with additional time for the USMLE and with a separate room in which to take the examination. Plaintiffs claim that these accommodations are mandated by § 12189 of the ADA.

Claiming the aforementioned disorders, plaintiffs sent timely applications to the Board requesting additional time and private rooms when taking the examination. The Board submitted plaintiffs' applications to independent, highly qualified experts in the fields of ADHD and learning disabilities. By separate letters written on May 1 and 7, 1997, the Board denied the requests, asserting that plaintiffs' alleged impairments did not significantly restrict one or more of their major life activities. On May 23, 1997, plaintiffs commenced this action to compel the Board to grant their requests for additional time and separate rooms while taking the USMLE.

Each of the plaintiffs claims to have ADHD. ADHD is a psychiatric disorder. The Court finds that the Diagnostic & Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) accurately explains the symptoms and nature of ADHD. ADHD's essential feature is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. Some hyperactive-impulsive or inattentive symptoms that cause impairment must have been present in the individual before he or she reached seven years of age. Impairment from the symptoms must be present in at least two settings. To be diagnosed with ADHD, an individual must clearly evidence interference with developmentally appropriate social, academic, or occupational functioning. The disturbance experienced by the individual cannot be better accounted for by other mental disorders, which should be ruled out by a differential diagnosis.

Two of the three plaintiffs also claim to have Reading Disorder and Disorder of Written Expression. Reading Disorder and Disorder of Written Expression are specific learning disabilities. Specific learning disabilities are less severe than ADHD, but in order to qualify as a person with a disability under the ADA, persons claiming specific learning disabilities must show that they are substantially limited in one or more major life functions.

In his report submitted to the Board, Mr. Price claimed that he has ADHD of the Predominantly Inattentive Type. Mr. Price's report was signed by Barbara P. Guyer, Ed. D., Debbie Painter, M.A., Charles Painter, M.A., and Sara Barker, M.A. On behalf of the Board, Professor Russell A. Barkley, Ph. D., reviewed Mr. Price's application for accommodations. Professor Barkley concluded that Mr. Price had not provided sufficient documentation to support a clinical diagnosis of ADHD.

This Court finds that Mr. Price has not exhibited a pattern of substantial academic difficulties. Without accommodation, he graduated from high school with a 3.4 grade point average and from Furman University with a 2.9 grade point average. After receiving testing accommodations while taking the MCATs, Mr. Price was admitted to medical school. There is little evidence that Mr. Price's symptoms resulted in significant impairment in home, school, or work functioning. Because a differential diagnosis was never performed on Mr. Price, other disorders that can result in attentional or academic problems were not properly ruled out. Further, Mr. Price had no history of treatment for ADHD until 1994, when he was diagnosed and prescribed medication.

The evidence submitted in support of the claim that Mr. Price has ADHD is less convincing than and is outweighed by the testimony of Professor Barkley. The Court finds that Professor Barkley's clear and consistent testimony renders him the most credible witness regarding the diagnosis of ADHD. Furthermore, Professor Barkley helped draft the DSM-IV, which both parties agree is authoritative in the diagnosis of ADHD. After considering all of the experts' conclusions, the Court finds Professor Barkley's testimony more compelling.

In his report submitted to the Board, Mr. Singleton claimed that he has ADHD of the Combined Type, as well as Reading Disorder and Disorder of Written Expression. Mr. Singleton's report was signed by Barbara P. Guyer, Ed.D., Debbie Painter, M.A., and Charles Painter, M.A. No differential diagnosis ruling out other mental disorders was performed on Mr. Singleton. On behalf of the Board, Professor Michael Gordon reviewed Mr. Singleton's application. Professor Gordon concluded that Mr. Singleton had not provided sufficient documentation to support a clinical diagnosis of ADHD. Dawn P. Flanagan, Ph.D., also reviewed Mr. Singleton's application for accommodation. Ms. Flanagan concluded that Mr. Singleton had not provided sufficient documentation to support the diagnoses of Reading Disorder and Disorder of Written Expression.

Mr. Singleton has not exhibited a pattern of substantial academic difficulties. He was in a gifted program from second grade through his high school graduation. He graduated from high school with a 4.2 grade point average and was the state debate champion. Mr. Singleton earned admittance to the United States Naval Academy. He eventually graduated from Vanderbilt University, earning a degree in physics. Mr. Singleton was then admitted to medical school. All of these accomplishments were attained without any accommodation for his alleged disability.

This Court recognizes that Dr. MacCallum, Mr. Singleton's treating physician, is a competent and accomplished psychiatrist, and that he diagnosed Mr. Singleton as having ADHD. However, the evidence submitted in support of Dr. MacCallum's claim that Mr. Singleton has ADHD, Reading Disorder, and Disorder of Written Expression is less convincing than and is outweighed by the testimony of Professor Gordon and Ms. Flanagan....