A  Virginia district court has held, once again, that a hospital does not have to accommodate a nurse whose disability causes lifting restrictions so extensive that, in effect, she cannot perform the essential functions of her position. The plaintiff in Wulff v. Sentara Healthcare, Inc. was a nurse clinician in the hospital’s emergency department. In September 2009, she presented the hospital with a doctor’s note stating that she could not lift more than ten pounds.  The hospital accommodated that restriction until March of 2010. Then the nurse presented a new form with the following restrictions: “no lifting 0-20 pounds,” no pushing or pulling, no stretching above shoulder level. At that time, her supervisor stated that they could not accommodate those restrictions. They also told her that if the restrictions were lifted or modified, she could return to work. The nurse’s doctor later lifted the restrictions and she was offered her job back, but she never came back to the job. Instead, she sued under the Americans with Disabilities Act (ADA), claiming the hospital failed to accommodate her disability, and discriminatorily discharged and retaliated against her for seeking accommodation.

The court found that, even if plaintiff was “disabled” under the Act, she could not establish that she could perform the essential functions of the job with a reasonable accommodation. In so doing, the court found that the hospital had proven that an emergency room nurse had to be able to lift heavy equipment; push and pull stretchers and wheelchairs;  physically assist patients to chairs, wheelchairs, stretchers, exam tables, or bathrooms; lift patients to chairs and exam tables; roll patients on stretchers; and grab and use equipment located above shoulder-level. The hospital had also stated that, given the nature of an emergency room, the need to perform such tasks often cannot be predicted. Noting that it was the plaintiff’s burden to prove that a reasonable accommodation existed, the court found there was no reasonable accommodation that would have allowed the plaintiff to perform the functions of an emergency room nurse. For that reason, it granted summary judgment to the hospital, dismissing the plaintiff’s accommodation claim. The court also dismissed the discriminatory discharge and retaliatory termination claims, finding that the plaintiff was terminated for a legitimate non-discriminatory reason – her inability to perform essential job functions.

While this case resulted in a favorable decision for the hospital, healthcare employers should be aware that ADA accommodation decisions are highly fact-intensive. The outcome in each case will depend on such factors as the specific requirements of the particular position in question, the specific restrictions and limitations of the employee, and, in some cases, the availability of other positions the plaintiff can perform given the nature of those restrictions and limitations. In making an accommodation decision it is therefore important to document the facts on which the decision is based, including efforts to engage in the interactive process and the physical requirements of the employee’s position as well as other available positions. In addition, as discussed in a previous blog entry, a number of states have recently enacted legislation protecting healthcare employees from disciplinary action in response to a good faith refusal to engage in unsafe patient transport or lifting. Accordingly, in dealing with employees with lifting restrictions, healthcare employers must tread cautiously to avoid the minefields in this area of the law.