The Social Security Act (SSA) provides disability insurance
(SSDI) for individuals with a disability that, considered in the light of their
age, training, and experience, makes it impossible for them to work in the U.S.
economy. The Americans with Disabilities Act (ADA) prevents employers from discriminating
against employees with a disability that are otherwise qualified to do a job
and can do it with a reasonable accomodation. This case arises from a seeming
conflict between these laws: Can a plaintiff who claims she is totally disabled
in an application for SSDI also claim that she is otherwise qualified and employable
if she is given a reasonable accomodation? The Fifth Circuit ruled that such
a plaintiff was estopped from claiming under the ADA, but other circuits had
reached differing results, so the United States Supreme Court reviewed the Fifth
Circuit case to resolve the split among the circuits.
Plaintiff had worked for some time for her employer. She had
a stroke, which impaired her concentration and ability to remember. At first,
she was unable to return to work and filed a claim for SSDI. Later, she improved
and returned to work. She notified the Social Security Administration (SSA)
of her return to work and they denied her benefits because she was able to work.
A few days later, she was fired for not being able to perform the job. She amended
her applications for SSDI and was eventually granted benefits. At the same time,
she sued her employer under the ADA for not providing reasonable accomodation
to allow her to return to work. The trial judge dismissed her compliant on the
pleadings, finding that her representation to the SSA that she was totally disabled
prevented her from prosecuting a claim for compensation under the ADA because
she was not otherwise qualified to perform the job. She was not given a chance
to address the factual issues and demonstrate whether her two claims were identical,
or whether they could be distinguished. The Fifth Circuit affirmed the trial
court's decision.
The United States Supreme Court looked carefully at the underlying
statutes and focused on one key difference: The SSDI provisions deal with the
person's condition without accomodation, and the ADA is based on providing reasonable
accomodation for the disability. SSDI determinations are classic "grid" regulations,
in that there are a set of standards for qualifications and the claimant qualifies
if she meets the right combination of them. They do not require a detailed analysis
of the claimant's specific work skills or history, as would be required for
a reasonable accomodation analysis. In some circumstances, the claimant may
even be able to work and still satisfy the requirements as long as she does
not take a job. (The qualifying conditions have been partially shaped by direct
Congressional action and reflect political, rather than medical, determinations.)
The ADA, by contrast, depends on individualized factual inquiry. The disabled
individual may propose a way to do her job that will accommodate her disability.
Without such an accomodation, she cannot work and is totally disabled under
the SSDI criteria. The employer must provide the accomodation if it is reasonable,
which is based on the cost of the accomodation and whether it requires that
the job be so modified that employee is no longer doing an essential function
of the job. If the employer provides the accomodation and the claimant takes
the job, that will eventually end the SSDI. (There are provisions to continue
benefits for a trial of work.) Until an employer provides such a job, the claimant
is disabled under the terms of the SSDI regulations.
The Court recognized that in many circumstances the claim for
SSDI will conflict with the claim for ADA compensation. In these cases the plaintiff
must explain, to the jury's satisfaction, how to reconcile the two claims or
she will lose her ADA claim. If she is unable to make such a showing in her
pleadings, it may be appropriate for the court to dismiss the case. The court
may not assume, however, that the mere existence of a claim for SSDI will preclude
a successful ADA claim.
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