Public Health Law Map - Beta 5 - Medical and Public Health Law Site

Section 504 was a remedial statute that provided standards to judge whether a given
individual was the victim of discrimination. It allowed employers to use medical
examinations and inquiries to determine the status of a potential or current
employee’s medical condition, including disabilities. The ADA presumes that
employers will discriminate against disabled individuals. It seeks to prevent
discrimination by limiting the employer’s access to information, as well as providing
legal remedies for victims of discrimination. It is this shift from nondiscrimination to
noninquiry into disability that changes traditional occupational medicine practice.
H. ADA-Defined Disability
Disability, as used in the ADA, is much more expansive than the accepted medical
usage. In the congressional findings supporting the ADA, it was estimated that
approximately 43 million persons were disabled by the standards of the ADA.
Although traditional definitions of disability would hardly include one fifth of the
population, the ADA defines disability, with respect to an individual, as the following:
1. a physical or mental impairment that substantially limits one or more of the major
life activities of such individual;
2. a record of such an impairment;
3. or being regarded as having such an impairment.
1. Exemptions
The ADA covers only long-term disabilities, not those from acute illnesses or injuries
that affect the worker for less than six months. The ADA specifically exempts illegal
drug use, drunkenness, sexual preference (homosexuality, bisexuality, and
transvestism), and pregnancy from the definition of disability. Beyond these specific
exemptions, it provides that the employee’s physical or mental condition cannot be
considered except as directly relevant to job performance. This follows the existing
law that limits educational testing to qualifications that are directly related to job
performance. Employers may not use a calculus test to screen applicants for janitorial
jobs, Griggs v. Duke Power Co., 401 U.S. 424 (1971). and they may not use blood
sugar testing to screen potential secretaries.
2. What Is a Major Life Activity?
Many of the federal courts do not like the broad reach of the ADA and have
attempted to limit it by a restricted reading of what constitutes a major life activity.
The regulations to the Rehabilitation Act, which also govern this aspect of the ADA,
are ambiguous: “Major life activities” means functions such as caring for one’s self,
performing manual tasks, walking, seeing, hearing, speaking, breathing, learning,
and working. [45 C.F.R. § 84.3(j) (ii).] Some courts take this literally, finding that
activities that are not on the list, such as reproduction, are not major life activities.
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