Washington v. HCA Health Services of Texas, Inc.

Decision Date03 September 1998
Docket NumberNo. 97-20310,97-20310
Citation152 F.3d 464
Parties8 A.D. Cases 1044, 13 NDLR P 117 Kelvin WASHINGTON, Plaintiff-Appellee, v. HCA HEALTH SERVICES OF TEXAS, INC., doing business as HCA Spring Branch Medical Center, Defendant-Appellant.
CourtU.S. Court of Appeals — Fifth Circuit

Joseph Y. Ahmad, Ahmad & Zavitsnaos, Houston, TX, for Plaintiff-Appellee.

Nancy Lynne Patterson, Littler Mendelson, Mark E. Edwards, Houston, TX, for Defendant-Appellant.

Barbara L. Sloan, Washington, DC, for Equal Employment Opportunity Commission, Amicus Curiae.

Appeal from the United States District Court for the Southern District of Texas.

Before POLITZ, Chief Judge, and GARWOOD and BARKSDALE, Circuit Judges.

GARWOOD, Circuit Judge:

In this interlocutory appeal, we are asked to decide whether a court should consider the plaintiff's medicated or unmedicated condition to determine whether the plaintiff has a "disability" under the Americans with Disabilities Act (ADA).

Facts and Proceedings Below

Plaintiff-appellee Kelvin Washington (Washington) brought a claim under the ADA against his former employer, defendant-appellant HCA Health Services of Texas, Inc. (the Hospital), alleging that he was discriminated against in violation of the ADA due to the fact that he suffers from Adult Stills Disease.

Washington began working for HCA Health Services of Texas, Inc. d/b/a the Spring Branch Medical Center, on September 26, 1991, as a senior accountant. Prior to this he was employed at another HCA facility from July 3, 1989, until September 1991. In July 1989, Washington was diagnosed with Adult Stills Disease, a degenerative rheumatoid condition affecting his bones and joints; as a result of this disease, he also suffers from Membranous Glomerulonephritis, a related kidney disease.

Washington is able to control the effects of this disease through medication. He regularly takes four prescription medications that control the pain and other symptoms associated with the disease. Thanks to this medication, he is able to lead a relatively normal life; without such treatment, Washington would be bedridden and unable to work.

In 1993 the demands of Washington's job increased and he often worked sixty to eighty hour weeks. In May 1993 Washington collapsed at work and his doctor recommended that he limit his work to ten hours per day and fifty hours per week. The doctor believed that this work restriction was necessary because Washington's disease activity had increased as a result of the twelve to sixteen hour days that he had been working.

Washington informed his supervisor about his doctor's advice and through a lawyer he requested that, as a person with a disability under the ADA, he be accommodated. Washington asserts that the requested accommodation was refused, but he nevertheless limited his work hours to fifty hours per week, in accordance with his doctor's advice. Shortly thereafter, the Hospital eliminated one of the two senior accountant positions during a work force reduction, and Washington was terminated. He filed this suit alleging that he was terminated in violation of the ADA.

The suit was initially filed on April 13, 1994, in Texas state court, but the Hospital filed a Notice of Removal and the case was subsequently removed to the United States District Court for the Southern District of Texas, Houston Division.

On March 17, 1995, the Hospital filed a motion for summary judgment claiming that it had a nondiscriminatory reason for terminating Washington's employment. The court granted the motion on May 18, 1995. In response, Washington filed a motion for new trial; the motion was denied, and Washington appealed. This Court reversed the summary judgment, finding a triable issue of fact regarding the Hospital's motive for laying off Washington, and remanded the case back to the district court. See Washington v. HCA, No. 95-20628, 95 F.3d 45 (5th Cir.1996) (unpublished).

On remand, the Hospital filed another motion for summary judgment, arguing that Washington was not "disabled" under the ADA since this disease was effectively controlled by medication. The court denied the motion, ruling that Washington's condition should be considered in its unmedicated state and as such constituted a disability under the ADA. The court, however, recognized that the question whether an individual must be assessed in his medicated or unmedicated state is a novel question in this Circuit and certified it for appeal to this Court pursuant to 28 U.S.C. § 1292(b). 1 Thus, the sole question before us is whether a court must assess an individual's condition with or without regard to mitigating measures, when determining whether that individual is "disabled" under the ADA.

Discussion
I. The ADA

The ADA provides that "[n]o covered entity shall discriminate against a qualified individual with a disability because of the disability of such individual in regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment." 42 U.S.C. § 12112(a). Thus, to establish a claim under the ADA, a plaintiff must demonstrate that:

(1) he is disabled within the meaning of the ADA;

(2) he is qualified; and

(3) the employer discriminated against him based on his alleged disability.

See Rizzo v. Children's World Learning Centers, Inc., 84 F.3d 758, 762 (5th Cir.1996); Daugherty v. City of El Paso, 56 F.3d 695, 696 (5th Cir.1995). This appeal is concerned only with the first prong.

To satisfy the first prong of an ADA cause of action, a plaintiff must demonstrate that he is disabled by satisfying one of the prongs of the ADA's definition of disability. Under the ADA, a disability is defined as:

"(A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual;

(B) a record of such an impairment; or

(C) being regarded as having such an impairment." 42 U.S.C. § 12102(2)(A)-(C).

The only question before us is whether Washington satisfies subparagraph (A). Under subparagraph (A), a plaintiff must demonstrate that: (1) he has an impairment, and (2) that impairment substantially limits a major life activity. 2 The ADA does not specify whether the existence of an impairment or the determination of whether an impairment substantially limits a major life activity should be made with regard to medication or other mitigating measures. Because the text of the ADA is not unambiguously clear on this matter, we turn to other sources for guidance. The two main sources that guide our decision are the EEOC's Interpretive Guidelines and the legislative history of the ADA. 3

II. The Legislative History

The EEOC's interpretation is consistent with much of the legislative history of the ADA. The House Education and Labor Committee Report discusses the three-pronged definition of disability. With regard to the first prong ("a physical or mental impairment that substantially limits one or more of the major life activities of such individual," 42 U.S.C. § 12102(2)(A)) the Committee Report explains that:

"Whether a person has a disability should be assessed without regard to the availability of mitigating measures, such as reasonable accommodations or auxiliary aids. For example, a person who is hard of hearing is substantially limited in the major life activity of hearing, even though the loss may be corrected through the use of a hearing aid. Likewise, persons with impairments, such as epilepsy or diabetes, which substantially limit a major life activity are covered under the first prong of the definition of disability, even if the effects of the impairment are controlled by medication." H.R. REP. No. 101-485(II) at 52 (1990), reprinted in 1990 U.S.C.C.A.N. 303, 334.

The House Judiciary Committee Report uses similar language to describe the breadth and meaning of the first prong of the definition of disability:

"The impairment should be assessed without considering whether mitigating measures, such as auxiliary aids or reasonable accommodations, would result in a less-than-substantial limitation. For example, a person with epilepsy, an impairment which substantially limits a major life activity, is covered under this test, even if the effects of the impairment which substantially limits a major life activity, is also covered, even if the hearing loss is corrected by the use of a hearing aid." H.R. REP. No. 101-485(III) at 28, reprinted in 1990 U.S.C.C.A.N. 445, 451.

The Senate Labor and Human Resources Committee Report, however, is somewhat inconsistent with these two House Reports. Like the House Reports, the Senate Report states that "whether a person has a disability should be assessed without regard to the availability of mitigating measures, such as reasonable accommodations or auxiliary aids." S. REP. No. 101-116, at 23 (1989). But, the Senate Report then goes on to describe the purpose of the third prong ("being regarded as having such an impairment" 42 U.S.C. § 12102(2)(C)):

"Another important goal of the third prong of the definition is to ensure that persons with medical conditions that are under control, and that therefore do not currently limit major life activities, are not discriminated against on the basis of their medical conditions. [Examples include:] individuals with controlled diabetes or epilepsy ... [or individuals who] wear hearing aids ...." S. REP. No. 101-116, at 24 (1989)(emphasis added).

The Senate Report is thus to some extent inconsistent with the House Reports in its treatment of individuals with controlled disabilities. While the House Reports indicate that individuals with epilepsy, diabetes, or hearing impairment should be assessed without regard to mitigating measures and therefore considered to be "disabled" under the first prong, the Senate Report suggests that these individuals ought to be assessed in their medicated state and thus are not disabled because the...

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