Differences between federal and Missouri law make it difficult to compare   a wealth of federal case-law creating uncertainty for employers and attorneys who advise clients about the Americans for Disability Act (ADA). In an ADA case – Wells v. Lester E. Cox Medical Centers, – the Missouri Court of Appeals for the Southern District held that unlike the Federal Rehabilitation Act, the Missouri Human Rights Act (MHRA) makes the question of reasonable accommodations a part of the test of whether or not a disability exists.

Southern District

In the Lester E. Cox Medical case, Plaintiff had a hearing deficit since the age of three.  Her unaided hearing continued to deteriorate as she aged. Plaintiff was enrolled in the Lester E. Cox Medical Center’s College of Nursing (College) general education program during the Fall 2006 and Spring 2007 semesters. During these semesters, the College provided Plaintiff with accommodations to compensate for her hearing loss in the form of note takers, tape recordings of class sessions and American Sign Language (ASL) interpreters. Prior to admission to the College’s Associate of Science in Nursing (ASN) the College used one of its own employees to conduct the initial research to determine that a deaf/hard of hearing individual can be trained to do the job. Plaintiff was eventually admitted into the ASN program for the Fall 2007 semester.

Before Plaintiff’s classes began, she met with college administrators to discuss the accommodations she would need in order to participate in the ASN program. Plaintiff had received new hearing aids in 2007 that she thought would improve her hearing, and both college administrators and Plaintiff expected that she would be able to function in the clinical portions of the program without the assistance of an ASL interpreter based upon the anticipated improvement in her hearing. During the 2007 semester, Plaintiff received volunteer note takers and tape recordings of class sessions, and she was provided an ASL interpreter during the classroom portions of the ASN program.The Missouri Department of Vocational Rehabilitation reimbursed the College for 75 percent of the cost of the ASL interpreters, and it provided adapted equipment to allow Plaintiff to fully participate in her clinical exercises. Plaintiff also received an ASL interpreter during the first week of clinical rotations. 

After beginning her clinical rotations, Plaintiff requested that she be provided with ASL interpreters to assist her in the pre-clinical and post-clinical conferences. For the 2008 Spring semester, Plaintiff again requested note takers and ASL interpreters to assist her in completing her course and clinical work. Before the second semester, the College dismissed Plaintiff from its ASN program stating in its dismissal letter that Plaintiff’s “hearing loss would substantially limit and in some cases completely limit Plaintiff’s ability to safely perform clinical rotations.”

Plaintiff filed a claim under the MHRA, alleging that the College failed to provide her with reasonable accommodations so that she could participate in its nursing program despite her disability. The trial court granted the College’s motion for summary judgment, and the Plaintiff appealed to the Southern District, which reversed.

The Court held that: “Unlike the Federal Rehabilitation Act, the MHRA imposes an affirmative obligation to provide reasonable accommodations if the impairment, that is accommodated, does not interfere with the individual’s ability to utilize the program.” As noted above Missouri makes the question of reasonable accommodations part of the test of whether or not a disability exists, unlike the federal law.

I find this to be a very difficult and troubling case. It seems like the School did everything it could to accommodate the Plaintiff and finally  realized it was not going to work.  One concern  is that Cox used one of its own employees to conduct the initial research to determine that a deaf/hard of hearing individual could be trained to do the job. Monday morning quarterbacking is always easy, but perhaps an independent world-class expert might have figured this out before the College got deep into the training of a nurse.

Howard Wright @ 2013