Disability

Question 1

AMA impairment

Answer 1

loss/deviation of part of the body

Question 2

AMA disability

Answer 2

how the impairment effects functioning

Question 3

impairment rating

Answer 3

percentage estimate of loss of activity and limitations of ADLs

Question 4

maximum medical improvement (MMI) (AMA)

Answer 4

point at which there will be no further improvement in fx

Question 5

what is the limit for psychiatric impairment, per the AMA Guides 6th Edition?

Answer 5

50%

Question 6

social security disability insurance (SSDI)

Answer 6

pays workers who have become disabled

Question 7

supplemental security income (SSI)

Answer 7

• supports disabled regardless of work hx
• means tested
• provides minimum income

Question 8

social security disability

Answer 8

• inability to engage in any substantial gainful activity by reason of medically determinable impairment
• expected to result in death or last 12+ months

Question 9

how does SS handle drugs and alcohol?

Answer 9

• drug and alcohol related disabilities are NOT covered
• independent disorders caused by substance use ARE covered

Question 10

SS Paragraph A

Answer 10

• objective medical evidence of disorder
• info must be from “Acceptable” medical source

Question 11

SS Paragraph B

Answer 11

“limitations”
- understand, remember, or apply information
- interact with others
- concentrate, persist, or maintain pace
- adapt or manage oneself

Question 12

SS Paragraph C

Answer 12

• used to evaluate “serious & persistent” mental disorders (“Chronic”)
• must have disorder 2+ yrs and meet C1 & C2 criteria

Question 13

private disability insurance

Answer 13

• provides insurance in addition to that provided by Worker’s Comp or SS
• know relevant language for definition of disability (“any occupation”, “own occupation”, etc)

Question 14

Rehabilitation Act of 1973

Answer 14

• 1st legislation in the world to prevent workplace discrimination against disabled
• applied to fed govt, postal service, and fed contractors & subcontractors

Question 15

“handicapped individual,” per the Rehab Act of 1973

Answer 15

• has a physical/mental impairment which substantially limits 1+ major life activities
• has record of such impairment
• is regarded as having such an impairment

Question 16

School Board v Arline

Answer 16

USSC 1987
Facts: Gene Arline had TB in remission 20 yrs, became a teacher, relapsed 3x, fired as a result.
Issue: is a contagious dz a qualifying physical impairment?
Holding: Contagious dz are covered. Arline was “regarded” as having impairment. Remanded to lower court to determine if she was an actual threat.

Question 17

Americans with Disabilities Act, 1990

Answer 17

Rehab Act of 1973 was precursor.
Prohibits discrim v persons w/disabilities.
Must provide reasonable accommodations to enable a qualified individual w/disability to perform job, except for:
- undue hardship
- direct threat

Question 18

ADA “disability”

Answer 18

• physical/mental impairment which substantially limits 1+ major life activities
• record of such impairment
• being regarded as having such an impairment
  (from Rehab Act of 1973’s def of handicapped individual)

Question 19

substance use, per ADA

Answer 19

• “current” drug use/dependence NOT protected
• alcohol dependence IS protected
• past drug use or being in current tx IS protected
• NEITHER is protected if direct threat

Question 20

personality disorders, per ADA

Answer 20

• personality disorders DO qualify
• personality traits DO NOT

Question 21

Americans with Disabilities Act Amendments Act, 2009 (ADAAA)

Answer 21

• passed to prevent discrimination against individuals who should qualify under the ADA (Congress had become concerned that the USSC ruling in Sutton v United Airlines was eliminating persons w/disabilities who should be eligible under the ADA.)
• impairments must be considered in their UNMITIGATED state
• only exceptions are ordinary glasses and contact lenses

Question 22

Bragdon v Abbott

Answer 22

USSC 1998
Facts: Dentist Dr. Bragdon insisted on filling Abbott’s cavity in a hospital at her expense.
Issue: is HIV a disability covered by the ADA?
Holding: yes, because it limits the major life activity of reproduction. The case was remanded to evaluate if Ms. Abbott was a direct threat.

Question 23

If a mental and behavioral disorder accompanies a physical impairment, per the AMA…

Answer 23

The psychological issues are encompassed w/in the rating for the physical impairment, and the MENTAL AND BEHAVIORAL CHAPTER SHOULD NOT BE USED.

Question 24

Olmstead v L.C.

Answer 24

USSC 1999
LC was hospitalized with ID. Her team assessed her as appropriate for the community, but she remained hospitalized 2 more years. She sued, claiming that to keep her confined when she could be in a community program violated Title II of the ADA.
Title II forbids exclusion of qualified individuals w/disabilities from participation in a public entity’s services.
The ADA bans unjustified segregation of the disabled.

Question 25

Pennsylvania Dept of Corrections v Yeskey

Answer 25

USSC 1999
Sentencing court recommended Yeskey for Boot Camp w/possible release on parole after 6m, instead of his 18-36m sentence. He was then refused admission due to h/o HTN. Yeskey sued, claiming his exclusion was a violation of ADA. District Court dismissed claiming ADA was inapplicable to state prison inmates. 3rd Circuit Court of Appeals reversed.
Holding: Prisons are included in Title II’s definition of “public entity.” The ADA applies to inmates in state prisons, and they can sue if they are excluded from programs due to a disability (except if they pose a direct threat).

Question 26

Toyota Motor Mfg v Williams

Answer 26

USSC ruling overturned by ADAAA.
Held that for persons to claim they are disabled in the area of manual tasks, the tasks in question must be those central to daily life (rather than specific work tasks). The ADAAA notes that an impairment that “substantially limits one major life activity need NOT limit other major life activities in order to be considered a disability.”

Question 27

U.S. v Georgia

Answer 27

A paraplegic inmate in a GA prison challenged conditions of confinement in a 12’x3’ cell and his lack of PT, medical tx, and access to programs as violations of Title II of the ADA, seeking injunctive relief and money damages (1983 claims).
Inmates in state prisons can sue for violations of Title II of the ADA for money damages in state court. This decision prevents states from claiming sovereign immunity against such claims when constitutional violations of inmates’ 14A rights have been demonstrated (He had likely been subjected to cruel & unusual punishment in violation of 8A, which is applied to the states through 14A.)

Question 28

Fitness for Duty Exam (FFDE) criteria per ADA

Answer 28

Enforced by EEOC. FFDE exam is “job-related and consistent with business necessity” when there is:
1. A REASONABLE BELIEF based on objective evidence that
2. Employee’s ability to perform ESSENTIAL JOB FXS will be IMPAIRED due to a medical condition, or
3. Employee will pose a DIRECT THREAT due to a medical condition

Question 29

Conditions under which an employee disabled under ADA may be discharged

Answer 29

Direct threat =
A significant risk of substantial harm to the health or safety of the individual or others that cannot be limited or reduced by reasonable accommodations.

Question 30

Types of threats

Answer 30

Direct: IDs specific target, delivered in clear and explicit manner
Indirect: vague threat
Veiled: strongly implies, but does not explicitly threaten
Instrumental (conditional): made to control/influence target’s behavior
Expressive: made to control/influence target’s emotions

Question 31

Board of Education v Rowley

Answer 31

USSC 1982
The Education for All Handicapped Children Act’s requirement of a “free appropriate public education” is satisfied when the state provides personalized instruction with sufficient support services that the child with disability can benefit educationally from the instruction, “to achieve passing marks and advance from grade to grade.”
Amy Rowley was not entitled to a sign language interpreter.