Indergard v. Georgia-Pacific Corp.

O’SCANNLAIN, Circuit Judge,

dissenting:

The essential distinction between a medical examination and a physical fitness or *1059agility test, for the purposes of the Americans with Disabilities Act (“ADA”), is that the former is designed to reveal disability, while the latter is designed to determine whether an employee can perform her job. I cannot conclude that the evaluation Kris Indergard underwent on her return to work at Georgia-Pacific was a medical examination under 42 U.S.C. § 12112(d)(4)(A), for it was not designed to reveal disability. Furthermore, even assuming that there were any “medical” aspects of the physical capacity evaluation (“PCE”), they were merely incidental to the physical agility aspects and did not in any way cause the harms that Indergard alleges. Therefore, I must respectfully dissent.

I

Indergard characterizes the PCE as “two days of testing, poking, palpating, and examining.” However, over the course of those two days, no blood was drawn, no urine samples collected, no lab-work performed, and no x-rays or scans taken. No doctor or nurse ever examined, diagnosed, or treated her. Instead, she went to an occupational therapy facility and performed various physical tasks designed to determine whether she could safely perform the duties of her old job. Such testing was unquestionably advisable given her own physician’s permanent restrictions on climbing, kneeling, squatting, crawling, and lifting over thirty pounds. A common-sense reading of the term “medical examination” would not include this PCE.

Unfortunately, common sense plays no role in our ADA jurisprudence. Instead, the EEOC has muddied the jurisprudential waters by issuing “guidances” that appear to read the word “medical” right out of the statute. For example, the interpretive appendix to 29 C.F.R. § 1630.14(a) first states that “[pjhysical agility tests are not medical examinations” but then adds that “[i]f such tests screen out or tend to screen out individuals with disabilities, the employer would have to demonstrate that the test is job-related and consistent with business necessity....” Apparently, having a tendency to screen out disabled individuals automatically converts a physical agility test into a medical examination subject to the ADA. Given that physical agility tests by their very nature tend to screen out people with certain disabilities, I see no way for employers to conduct such tests without inviting ADA lawsuits from those who fail them.

In addition, an EEOC enforcement guidance defines a medical examination as “a procedure or test that seeks information about an individual’s physical or mental impairments or health.” EEOC Enforcement Guidance on Disability-Related Inquiries and Medical Evaluations, available at http://eeoc.gov/policy/docs/ guidance-inquiries.html [hereinafter Enforcement Guidance ]. Under this broad definition, any return-to-work test would necessarily qualify as a medical examination because it seeks to determine whether the employee is fit enough to resume her duties. Employers seeking to avoid ADA lawsuits would have to allow injured workers to return to the job without being able to verify their fitness for duty, creating the potential for re-injury.

The Enforcement Guidance also declares physical agility tests not to be medical examinations “as long as these tests do not include examinations that could be considered medical {e.g., measuring heart rate or blood pressure).” Hence, a single pulse measurement taken over the course of a two-day physical agility test would be sufficient to convert such test into a medical examination. If an employee taking a physical agility test shows obvious distress, the examiner would not be able to take her pulse or blood pressure as a precautionary *1060measure without implicating the ADA. Employers seeking to ensure returning workers’ safety must therefore navigate the precarious straits between the Scylla of ADA liability and the Charybdis of a negligence lawsuit. Fearing either form of liability, employers may very well decline to conduct any form of testing, thereby increasing the risk of returning worker injury.

The majority uncritically accepts these agency pronouncements as gospel, even though we owe them no deference when they subvert the plain text of the statute. See Gen. Dynamics Land Sys., Inc. v. Cline, 540 U.S. 581, 600, 124 S.Ct. 1236, 157 L.Ed.2d 1094 (2004). I decline to read the statute in such a way as to render a term entirely meaningless.

II

Turning to the PCE at issue in this case, I am not persuaded that it can be considered a medical examination merely by virtue of the “single factors” that the majority lists: range-of-motion and muscle strength tests, pulse measurement after a treadmill test, and observations about Indergard’s breathing after the treadmill test. It is important to remember that the PCE was a two-day examination comprising numerous tests. While one or two of these measurements may arguably have been medical in nature, these were at most de minimis components that were incidental to the physical tasks that formed the bulk of the PCE.

Furthermore, application of the seven-factor test also does not convince me that the PCE as a whole was a medical examination. In particular, I disagree with the majority’s conclusions regarding factors three, five, and seven. Factor three asks “whether the test is designed to reveal an impairment in physical or mental health.” Enforcement Guidance. According to the majority, “although the PCE was ostensibly intended to determine whether Indergard could return to work, the broad reach of the test was capable of revealing impairments of her physical and mental health.” Maj. op. at 1055. Here the majority appears to confuse intent with effect. Because the majority believes that the PCE could reveal an impairment, it assumes that Georgia-Pacific intended for it to do so. I do not read factor three so broadly. With respect to factors five and seven, any measurement of physiological response and use of medical equipment were de minimis in the overall context of the two-day PCE. On balance, the PCE looks overwhelmingly more like a physical agility test than a medical examination.

Ill

In my view, the PCE cannot be considered a single examination but rather a battery of individual tests. By its viewing of the PCE, the majority allows Indergard to proceed with her suit even though she has shown no injury resulting from the allegedly medical tests. However, it was unquestionably the lifting task that scuttled Indergard’s return to work, not her pulse rate after the treadmill test or her knee flexion. Because she has suffered no injury from the parts of the test that allegedly were medical examinations, she cannot maintain a claim for a violation of § 12112(d).

Our sister circuits have agreed that a plaintiff seeking relief under 42 U.S.C. § 12112(d) must be able to show “something more than a mere violation of that provision. There must be some cognizable injury in fact of which the violation is a legal and proximate cause for damages to arise from a single violation.” Armstrong v. Turner Indus., Inc., 141 F.3d 554, 562 (5th Cir.1998); see also Tice v. Centre Area Transp. Auth., 247 F.3d 506, 519 (3d Cir.2001); Cossette v. Minnesota Power & *1061Light, 188 F.3d 964, 970 (8th Cir.1999); Griffin v. Steeltek, Inc., 160 F.3d 591, 594-95 (10th Cir.1998). In other words, “a technical violation” is not enough. Tice, 247 F.3d at 520. Here, even assuming that Georgia-Pacific technically violated § 12112(d)(4)(A) by measuring Indergard’s pulse and range of motion, she has made no showing that such measurements have proximately caused her to lose her job. Therefore, any such measurements “presents no ‘injury’ capable of remedy, and thus affords no basis for suit.” Id. at 519.

Armstrong is instructive because it presents a scenario analogous to this case, albeit in the context of preemployment medical inquiries.1 Armstrong had applied for a position as a pipefitter and was asked questions in his application about prior injuries, his medical history, and worker’s compensation claims. The questionnaire also asked whether he had “any injury or condition not mentioned on this form,” and Armstrong answered “no.” A background check later revealed that Armstrong had previously reported “possible asbestos exposure,” and he was “rejected due to the provision of incorrect and/or incomplete information.” 141 F.3d at 556-57. Because the failure to hire had not resulted directly from the prohibited medical inquiries, the court held that Armstrong lacked standing to sue for damages and injunctive relief under § 12112(d)(2)(A). Id. at 562-63. The court noted that the ADA was not intended to protect employees from adverse employment actions “incident to a prohibited section 12112(d)(2)(A) inquiry.” Id. at 560 n. 15.

Similarly, Indergard’s termination was merely incident to an alleged technical violation of § 12112(d)(4)(A). Had Georgia-Pacific administered only the treadmill exercise and range-of-motion tests, she would not have a cause of action under the ADA even assuming that they are medical examinations because she suffered no adverse employment action from these tests. Conversely, had Georgia-Pacific administered the lifting task alone, she also would not have a cause of action because the lifting task is not a medical examination. Only by yoking these tests together and attributing an injury from a permissible physical agility task to an allegedly improper medical examination can Indergard manufacture an ADA violation.

IV

Because the majority renders the term “medical” meaningless and allows a plaintiff to continue her $250,000 suit on the basis of a pulse measurement that caused her no harm, I respectfully dissent.

. Preemployment medical inquiries and examinations fall under 42 U.S.C. § 12112(d)(2) of the ADA. Although the majority attempts to distinguish Armstrong on this basis, see Maj. op. at 1057-58 n. 3, the same analysis applies to all of the medical inquiry and examination provisions under 42 U.S.C. § 12112(d). See Tice, 247 F.3d at 519 ("Other courts of appeal have addressed the question whether a plaintiff has a cause of action for a violation of § 12112(d) without demonstrating the existence of an injury-in-fact.... All have concluded that a violation of § 12112(d), without a showing, presents no 'injury' capable of remedy, and thus affords no basis for suit.”).