Deane v. Pocono Medical Center/Opinion of the Court

[p140] OPINION OF THE COURT

BECKER, Chief Judge.

This is an appeal by Stacy L. Deane from an order of the district court granting summary judgment to her former employer, Pocono Medical Center ("PMC"), on Deane's claim under the Americans with Disabilities Act ("ADA" or the "Act"), 42 U.S.C. § 1201 et seq. In enacting the ADA, Congress intended that the scope of the Act would extend not only to those who are actually disabled, but also to individuals wrongly regarded by employers as being disabled. Deane, a registered nurse, sued PMC under the ADA as such a "regarded as" plaintiff to redress PMC's failure to accommodate her in a manner that would enable her to retain her position following a work-related injury that affected her ability to do heavy lifting. The case came before the en banc court to settle the question that divided the original panel -- whether "regarded as" plaintiffs, in order to be considered qualified under the ADA, must show that they are able to perform all of the functions of the relevant position or just the essential functions, with or without accommodation. The panel decided that they must be able to perform all of the functions. Before the en banc court, neither party supported that position, and we now reject it, concluding that the plain language of the ADA requires proof only of a plaintiff 's ability to perform a position's essential functions.

This conclusion forces us to determine whether Deane has adduced sufficient evidence to create a genuine issue of material fact with respect to two elements of her prima facie case: (1) whether PMC misperceived Deane as being disabled; and (2) whether Deane is a "qualified individual", a decision that turns on whether lifting is an essential function of nursing at PMC. Because we conclude that Deane has adduced sufficient evidence regarding both of these matters, we hold that summary judgment was inappropriate. Accordingly, the judgment of the district court will be reversed and the case remanded for further proceedings.

The panel addressed a second question of much greater difficulty -- whether "regarded as" plaintiffs must be accommodated by their employers within the meaning of the ADA. It may well be, as two members of the panel concluded, that after the employer is disabused of its improper perception of the individual's disability, there is no reason to afford the individual any special treatment, and hence the employee is not statutorily entitled to accommodation from the employer. However, as resolution of that issue is not necessary [p141]  to final disposition of this appeal, we will not decide it.

I.
In April 1990, PMC hired Deane as a registered nurse to work primarily on the medical/surgical floor. On June 22, 1991, while lifting a resistant patient, she sustained a cartilage tear in her right wrist causing her to miss approximately one year of work. In June 1992, Deane and Barbara Manges, a nurse assigned to Deane's workers' compensation case, telephoned PMC and advised Charlene McCool, PMC's Benefits Coordinator, that Deane intended to return to work with certain restrictions. According to Deane, she informed McCool that she was unable to lift more than 15-20 pounds or perform repetitive manual tasks such as typing, but that her physician, Dr. Osterman, had released her to return to "light duty" work. Deane further explained to McCool that, if she could not be accommodated in a light duty position on the medical/surgical floor, she was willing to move to another area of the hospital, as long as she could remain in nursing. Unfortunately, this telephone call was PMC's only meaningful interaction with Deane during which it could have assessed the severity of or possible accommodation for her injuries. PMC never requested additional information from Deane or her physicians, and, according to Deane, when she subsequently attempted to contact PMC on several occasions, she was treated rudely by McCool and told not to call again.

After speaking with Deane and Manges, McCool advised Barbara Hann, PMC's Vice President of Human Resources, of Deane's request to return to work, of her attendant work restrictions, and of her stated need for accommodation. Shortly after considering the information conveyed by McCool and after comparing it to the job description of a medical/surgical nurse at PMC, Hann determined that Deane was unable to return to her previous position. Hann then asked Carol Clarke, PMC's Vice President of Nursing, and Susan Stine, PMC's Director of Nursing Resources/Patient Care Services, to review Deane's request to return to PMC and to explore possible accommodations for her. Both Clarke and Stine concluded that Deane could not be accommodated in her previous job as a nurse on the medical/surgical floor or in any other available position at the hospital. Finally, Hann asked Marie Werkheiser, PMC's Nurse Recruiter, whether there were any current or prospective job openings for registered nurses at PMC. According to Werkheiser, there were no such openings at that time.

As a result of the collective determination that Deane could not be accommodated in her previous job or in any other available position in the hospital, PMC sent Deane an "exit interview" form on August 7, 1992. On August 10, 1992, Hann notified Deane by telephone that she could not return to work because of her "handicap", and this litigation ensued. In March 1993, Deane accepted a registered nurse position at a non-acute care facility, where she remained until May 1993. Deane has been employed by a different non-acute care facility since July 1993. Neither of these positions require heavy lifting, bathing patients, or the like.

Deane argued to the district court that she was both actually disabled as a result of her injury and that she was perceived to be so by PMC. On summary judgment, the court rejected both theories and held that Deane was neither disabled nor regarded by her employer as being disabled and that, even if she were, she failed to meet the statutory definition of a qualified individual with a disability. Deane has not appealed the district court's determination that she was not actually disabled. Indeed, she now concedes that "in light of the decisional trends in this Circuit and others," she is not now and never was [p142]  disabled and, consequently, that, but for PMC's erroneous perception of her actual impairment, she would have no claim under the ADA.

What is left, then, are Deane's contentions that she was disabled under the terms of the ADA by virtue of the fact that PMC regarded her limitations as being far worse than they actually were, that PMC failed to accommodate her lifting restriction, and that she was eventually terminated on account of PMC's perception that she was disabled. In support of her perception claim, Deane relies on a "laundry list" of PMC's allegedly erroneous perceptions. According to Deane, PMC believed that she was unable to lift more than ten pounds, push or pull anything, assist patients in emergency situations, move or assist patients in the activities of daily living, perform any patient care job at PMC or any other hospital, perform CPR, use the rest of her body to assist patients, work with psychiatric patients, or use medical equipment. Deane refutes each of these perceptions -- or, in her view, misperceptions-- and contends that her injury was, in fact, relatively minor in nature. Deane further contends that PMC should be held responsible for these misperceptions because they were the result of PMC's "snap judgment" arrived at without making a good faith analysis, investigation, or assessment of the nature of her injury.

Finally, Deane maintains that she requires and is entitled to accommodation for her lifting restriction. In this regard, Deane contends that she could be accommodated either in her previous position as a nurse on the medical/surgical floor or through reassignment to another position that would not require heavy lifting. As to the former, Deane has suggested the following accommodations: (1) use of an assistant to help her move or lift patients; (2) implementation of a functional nursing approach, in which nurses would perform only certain types of nursing tasks; and (3) use of a Hoyer lift to move patients. Deane also maintains that she could have been transferred to another unit within the medical center such as the pediatrics, oncology, or nursery units, which would not have required heavy lifting. In the alternative, Deane submits that she can perform the essential functions of her previous job in the medical/surgical floor without accommodation because lifting is not an essential function of nursing. We set forth our jurisdiction and standard of review in the margin.

II.
The core anti-discrimination section of the ADA provides that:

"No 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. In order to make out a prima facie case under the ADA, a plaintiff must be able to establish that he or she (1) has a "disability" (2) is a "qualified individual" and (3) has suffered an adverse employment action because of that disability. See Gaul v. Lucent Techs. Inc., 134 F.3d 576, 580 (3d Cir. 1998).

A.
Turning to the first prong of the prima facie case, we must determine whether Deane is disabled under the terms of the Act. The ADA defines a "disability" as:


 * [p143] (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); 29 C.F.R. § 1630.2(g). Because Deane concedes that she is not actually disabled, but that she was only "regarded as" being disabled, we direct our focus to the third tier of the statutory definition. Read in conjunction with the first tier, which defines an actual disability, the third tier requires us to determine whether PMC regarded Deane as having an impairment and whether the impairment, as perceived by PMC, would have substantially limited one or more of Deane's major life activities. 5 Deane's actual impairment, therefore, is of no consequence to our analysis.

Turning to the EEOC Regulations, they provide that an individual is "regarded as" being disabled if he or she:


 * (1) has a physical or mental impairment that does not substantially limit major life activities but is treated by a covered entity as constituting such limitation;


 * (2) has a physical or mental impairment that substantially limits major life activities only as a result of the attitude of others toward such impairment; or


 * (3) has none of the impairments defined in paragraph (h)(1) or (2) of this section but is treated by a covered entity as having a substantially limiting impairment.

29 C.F.R. § 1630.2(l). See also H.R. Rep. No. 101-485 (II), at 53 (1990) ("House Labor Report"), reprinted in 1990 U.S.C.C.A.N. 303, 335; House Judiciary Report at 29, reprinted in 1990 U.S.C.C.A.N. at 452. Common to each definition is the requirement that the individual not in fact have an impairment that, absent the misperceptions of others, would substantially limit a major life activity. [p144] Deane contends that she satisfies the first definition because PMC erroneously perceived that the nature and extent of her physical impairment "substantially limited" her ability to "work", which is included within the EEOC's definition of a "major life activity". See generally Olson, 101 F.3d at 953-55; MacDonald v. Delta Airlines, Inc., 94 F.3d 1437, 1445 (10th Cir. 1996); Bridges v. City of Bossier, 92 F.3d 329, 333-34 (5th Cir. 1996). The district court rejected Deane's perceived disability claim on three grounds. First, the court found, as a matter of undisputed fact, that PMC regarded Deane's impairment as limiting only her ability to work as a nurse on the surgical/medical floor, not her ability to work as a nurse in general. Next, the court determined that Deane could not have been generally precluded from working in her field because, following her termination from PMC, she held two positions as a registered nurse. Finally, the court concluded, as a matter of law, that PMC's perception of Deane's impairment was not motivated by "myth, fear or stereotype" and, therefore, was not actionable under the ADA. We disagree with all three of the court's rationales, discussing them in reverse order.

Although the legislative history indicates that Congress was concerned about eliminating society's myths, fears, stereotypes, and prejudices with respect to the disabled, the EEOC's Regulations and Interpretive Guidance make clear that HN10Go to the description of this Headnote.even an innocent misperception based on nothing more than a simple mistake of fact as to the severity, or even the very existence, of an individual's impairment can be sufficient to satisfy the statutory definition of a perceived disability. See 29 C.F.R. pt. 1630, app. § 1630.2(l) (describing, as one example of a "regarded as" disabled employee, an individual with controlled high blood pressure that is not substantially limiting, who nonetheless is reassigned to less strenuous work because of the employer's unsubstantiated fear that the employee will suffer a heart attack). Thus, whether or not PMC was motivated by myth, fear or prejudice is not determinative of Deane's "regarded as" claim.

The second ground -- that Deane's subsequent employment in the field of nursing demonstrated that she was not substantially limited in the major life activity of working -- confuses her actual impairment with PMC's misperception thereof. Deane's subsequent work history could, at most, reflect her lack of an actual disability, and it therefore sheds no light whatever on whether, at the time of her termination, PMC regarded her impairment as substantially limiting her ability to work.

Finally, contrary to the district court's conclusion, Deane has adduced sufficient evidence to create a genuine issue of material fact as to whether PMC regarded her as substantially limited in the major life activity [p145]  of working. First, there is deposition testimony from PMC officials documenting confusion as to the extent of Deane's physical capacity, with regard to pushing, pulling, and lifting. There is also evidence that PMC fundamentally misunderstood and exaggerated the limitations that the wrist injury imposed on Deane. Moreover, PMC's apparent misunderstanding is in line with other testimony that PMC did not evaluate Deane, contact her physicians, or independently review her medical records, but rather relied solely on one telephone conversation it had with Deane.

Deane also produced the affidavit and report of Daniel Rappucci, her vocational expert, who explained the import of PMC's perception of Deane's injury. Rappucci concluded that, had Deane been impaired to the extent allegedly perceived by PMC, she would have been precluded from consideration for employment, both within her chosen profession and within a wide range of jobs within her geographic region. Rappucci further opined that Deane would have been precluded from performing not only many of the available jobs in service-producing industries, (including transportation, wholesale/retail, finance, real estate, hospitality industries, medical services, and professional services), which made up 83% of the 41,000 non-agricultural jobs in Deane's county of residence, but also most of the jobs in the goods-producing industries (contract construction, mining, and manufacturing), which comprised the remaining 17% of available positions. PMC counters with the argument that it attempted to accommodate Deane by placing her in other light-duty positions when and if they became available, and that this suggests that PMC did not believe Deane to be disabled. PMC submits that its actions indicate only that PMC considered Deane to be incapable of performing certain functions that precluded her from returning to nursing.

As the preceding discussion makes clear, however, there are factual disputes over how impaired PMC regarded Deane as being compared with her actual level of impairment, and whether PMC's perception of Deane constituted a "significant[] restriction in [Deane's] ability to perform either a class of jobs or a broad range of jobs in various classes as compared to the average person having comparable training, skills and abilities." 29 C.F.R. § 1630.2(j)(3)(i). Deane has thus adduced sufficient evidence that PMC regarded her as substantially more physically impaired than she actually was, and that PMC's misperception, if correct, would satisfy the § 1630.2(j)(3)(i) threshold. Therefore, summary judgment on this issue was inappropriate.

B.
The second element of Deane's prima facie case under the ADA requires her to demonstrate that she is a "qualified individual". The ADA defines this term as an individual "who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires." 42 U.S.C. § 12111(8). The Interpretive Guidance to the EEOC Regulations divides this inquiry into two prongs. First, a court must determine whether the individual satisfies the requisite skill, experience, education and other job-related requirements of the employment position that such individual holds or desires. See 29 C.F.R. pt. 1630, app. § 1630.2(m). Second, it must determine whether the individual, with or without reasonable accommodation, can perform the essential functions of the position held or sought. See id.; see also Bombard v. Fort Wayne Newspapers, Inc., 92 F.3d 560, 563 (7th Cir. 1996); Benson v. Northwest Airlines, Inc., 62 F.3d 1108, 1112 (8th Cir. 1995). Because PMC does not dispute Deane's general qualifications as a registered nurse, we need not dwell on the first step of the "qualified individual" analysis.

[p146] Determining whether an individual can, with or without reasonable accommodation, perform the essential functions of the position held or sought, also a two step process, is relatively straightforward. First, a court must consider whether the individual can perform the essential functions of the job without accommodation. If so, the individual is qualified (and, a fortiori, is not entitled to accommodation). If not, then a court must look to whether the individual can perform the essential functions of the job with a reasonable accommodation. If so, the individual is qualified. If not, the individual has failed to set out a necessary element of the prima facie case.

The majority panel opinion, in deciding for PMC, reasoned that to satisfy the first step, a "regarded as" plaintiff must make a showing that he or she could perform all the functions of the job (with or without accommodation), not just its essential functions. PMC disassociated itself from the panel's position before the en banc court. As this issue is one of statutory construction, the "first step in interpreting a statute is to determine whether the language at issue has a plain and unambiguous meaning with regard to the particular dispute in the case." Robinson v. Shell Oil Co., 519 U.S. 337, 117 S.C.t. 843, 846, 136 L. Ed. 2d 808 (1997).

1.
The ADA prohibits a "covered entity" from discriminating against a "qualified individual with a disability." 42 U.S.C. § 12112(a). Section 12111(8), which defines the latter term, reads:

"The term 'qualified individual with a disability' means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires. For the purposes of this subchapter, consideration shall be given to the employer's judgment as to what functions of a job are essential, and if an employer has prepared a written description before advertising or interviewing applicants for the job, this description shall be considered evidence of the essential functions of the job."

Section 12111(8) is plain and unambiguous. The first sentence of that section, makes it clear that the phrase "with or without reasonable accommodation" refers directly to "essential functions". Indeed, there is nothing in the sentence, other than "essential functions", to which "with or without reasonable accommodation" could refer. Moreover, nowhere else in the Act does it state that, to be a "qualified individual", an individual must [p147]  prove his or her ability to perform all of the functions of the job, and nowhere in the Act does it distinguish between actual or perceived disabilities in terms of the threshold showing of qualifications. Therefore, if an individual can perform the essential functions of the job without accommodation as to those functions, regardless of whether the individual can perform the other functions of the job (with or without accommodation), that individual is qualified under the ADA.

The history of the ADA confirms this view. In the committee reports that accompanied the ADA, Congress spoke directly to the qualifications standard adopted in the statute. Repeatedly, Congress stated that the qualifications standard turned on the individual's ability to perform the "essential functions" of the job. See e.g., House Labor Report at 55, reprinted in 1990 U.S.C.C.A.N. at 337; House Judiciary Report at 32-33, reprinted in 1990 U.S.C.C.A.N. at 455. Congress explained that the Act focused on an individual's ability to perform "essential functions" to ensure that persons with disabilities "not be disqualified because of the inability to perform non-essential or marginal functions of the job." House Judiciary Report at 31-32, reprinted in 1990 U.S.C.C.A.N. at 454. As stated in one committee report, the purpose of the ADA's qualifications standard is to "ensure that employers can continue to require that all applicants and employees, including those with disabilities, are able to perform the essential functions, i.e., the non-marginal functions of the job in question." House Labor Report at 55, reprinted in 1990 U.S.C.C.A.N. at 337 (emphasis added).

2.
Having rejected the panel's position that Deane needed to make a showing that she can perform all of the functions of her former job, we must now determine whether Deane has, in fact, adduced sufficient evidence to survive summary judgment on the question whether she can perform the essential functions of the job without accommodation as to those functions. Deane claims that the heavy lifting she is restricted from doing is not an essential job function of a nurse. Deane describes nursing as a profession that focusses primarily on skill, intellect, and knowledge. While conceding that lifting constitutes part of a nurse's duties, she submits that it is only a small part.

In support of her contentions, Deane again offers Rappucci's affidavit and report. Rappucci opines that patient care, not heavy lifting of patients, is the essential function of registered nursing. As evidence, he references the Department of Labor's Dictionary of Occupational Titles Job Descriptions ("DOL Dictionary"), which details four critical tasks of a general duty nurse, none of which involves heavy lifting: (1) administering medications and treatments, (2) preparing equipment and aiding physicians during the treatment of patients, (3) observing patients and recording significant conditions and reactions to drugs, treatments, and significant incidents, and (4) taking temperature, pulse, blood pressure, and other vital signs to detect deviations from normal and assess the condition of the patient. Rappucci also notes that nursing is a professional occupation, and he compares it with orderly work to exemplify the differences between the two positions. For example, whereas nursing is classified by the Department of Labor as skilled, medium duty labor, orderly work is classified as semi-skilled, heavy-duty labor. Also, whereas none of a general nurse's critical tasks under the DOL Dictionary description include lifting, the description of orderly work enumerates "lifting patients onto and from bed" as critical task number five. This is because, according to Deane, the orderly position exists to assist the nurse professional in the performance of his or her job duties. Finally, Deane points out that, recognizing the difficulty of unassisted heavy lifting, PMC uses a team approach to the lifting of patients, both in routine matters and in responding to emergency situations.

PMC responds that lifting is an essential function of a nurse. In support, PMC cites [p148]  its job description, which details under the heading "MAJOR TASKS, DUTIES AND RESPONSIBILITIES" that one of the "WORKING CONDITIONS" for a staff registered nurse is the "frequent lifting of patients." PMC also notes that Deane conceded that the PMC job description was "an accurate reflection of the tasks, duties and responsibilities as well as the qualifications, physical requirements and working conditions of a registered nurse at [PMC]," and that among her "critical job demands" at PMC were: (1) the placement of patients in water closets, tub chairs or gurneys, (2) the changing of position of patients, and (3) the lifting of laundry bags. These pieces of evidence, contends PMC, constitute multiple admissions by Deane that lifting is an essential function of a staff registered nurse at PMC. Finally, PMC asserts that the consequences of a nurse's inability to lift patients could create a dangerous situation in the hospital for Deane and her patients.

We decline to apply conclusive effect to either the job description or PMC's judgment as to whether heavy lifting is essential to Deane's job. HN17Go to the description of this Headnote.The EEOC's Interpretive Guidance indicates that "the employer's judgment as to which functions are essential" and "written job descriptions prepared before advertising or interviewing applicants" are two possible types of evidence for determining the essential functions of a position, but that such evidence is not to be given greater weight simply because it is included in the non-exclusive list set out in 29 C.F.R. § 1630.2(n)(3). See 29 C.F.R. pt. 1630, app. § 1630.2(n). Thus, the job description is not, as PMC contends, incontestable evidence that unassisted patient lifting is an essential function of Deane's job. Moreover, the EEOC Regulations also provide that while "inquiry into the essential functions is not intended to second guess an employer's business judgment with regard to production standards," whether a particular function is essential "is a factual determination that must be made on a case by case basis [based upon] all relevant evidence." Id. (emphasis added). Finally, the import of the rest of PMC's evidence (e.g., her alleged admissions, etc.) is disputed by Deane. For all these reasons, we find that there is a genuine issue of material fact on the issue of whether Deane was a qualified individual under the ADA.

[p149] 

C.
Finally, we find that Deane can easily establish the third prong of her prima facie case. The August 10, 1992, call from Hann terminating Deane because of her "handicap" is uncontroverted direct evidence that Deane suffered an adverse employment action because of her employer's perception of her disability. See Martinson v. Kinney Shoe Corp., 104 F.3d 683, 686 (4th Cir. 1997) ("HN19Go to the description of this Headnote.When an employer concededly discharges an employee because of a disability, the employee need prove nothing more to meet the third prong of the prima facie test.").

III.
For the foregoing reasons, the judgment of the district court will be reversed and the case remanded to the district court for further proceedings consistent with this opinion. Although not a ground of our decision, we take this opportunity to observe that this protracted (and very much ongoing) litigation would likely have been unnecessary had the parties taken seriously the precepts announced in our opinion in Mengine v. Runyon, 114 F.3d 415 (3d Cir. 1997). In that decision, we highlighted the importance of communication and cooperation between employers and employees in seeking reasonable accommodations. See id. at 416. Specifically, we noted that, in the context of the Rehabilitation Act, "both parties have a duty to assist in the search for appropriate reasonable accommodation and to act in good faith." Id. at 420. In this case, the single telephone interaction between Deane and McCool at PMC hardly satisfies our standard that the employer make "reasonable efforts to assist [the employee], to communicate with him in good faith, and to not impede his investigation [for employment]." Id. (citations omitted). While it may turn out that reasonable accommodation for Deane is impossible (or is not required because she is a "regarded as" plaintiff), nevertheless, an employer who fails to engage in the interactive process runs a serious risk that it will erroneously overlook an opportunity to accommodate a statutorily disabled employee, and thereby violate the ADA. Id. at 420-21.