School Board of Nassau County v. Arline

The Respondent, Arline, an elementary school teacher, brought suit against a local public school board alleging the school had violated § 504 of the federal Rehabilitation Act of 1973  (the Act) when they dismissed Arline after she suffered a third relapse of tuberculosis in two years.

The following statutory provisions were relevant to Arline’s complaint:

• Section 504 of the Act, which prohibited federally funded state programs from discriminating against an “otherwise qualified handicapped individual” solely by reason of their handicap;
• Section 706(7)(B) of the Act, which defined “handicapped individual” to mean any person who “(i) ha[d] a physical . . . impairment which substantially limit[ed] one or more of [their] major life activities, (ii) ha[d] a record of such an impairment, or (iii) [was] regarded as having such an impairment”; and
• Regulations issued by the Department of Health and Human Services (HHS), which among other things, defined “physical impairment” to include any physiological disorder affecting the respiratory system, and defined “major life activities” to include working.

The District Court held that Arline was not a “handicapped person” under § 504. The Court of Appeals reversed the decision and remanded the complaint for further findings as to whether Arline was “otherwise qualified.

The Court held that Arline could be a "handicapped individual," as defined in § 706 (7)(B) of the Act and by HHS regulations, based on a “record of a physical impairment.” The Court held that this was evidenced by Arline’s previous hospitalization for tuberculosis, a disease that affected her respiratory system, and which substantially limited her ability to work―one of her “major life activities.”

The Court further held that a person with a record of physical impairment was not removed from § 504's coverage simply because the disease was contagious. It explained that allowing an employer to justify discrimination by distinguishing between a disease's perceived contagious effects on others and its physical effects on the employee would be unfair; would be contrary to § 706(7)(B)(iii) of the Act; and would be inconsistent with the Act’s legislative history, which demonstrated Congressional concern about an impairment's effect on others.

The Court held that not extending coverage to contagious diseases would be inconsistent with § 504's basic purpose, which was to ensure that handicapped individuals were not denied jobs as a result of the prejudice or ignorance of others. The Court added that the Act was carefully structured to replace irrational fears and reflexive reactions with actions based on “reasoned and medically sound judgments” as to whether contagious handicapped persons were "otherwise qualified."

The Court next considered how a judicial determination must be made as to whether a person handicapped by contagious disease was “otherwise qualified” under § 504. The Court held that a district court must conduct an individualized inquiry and make appropriate “findings of fact, based on reasonable medical judgments given the state of medical knowledge.” It listed the following factors to be considered:

a)      The nature of the risk (how the disease is transmitted),

b)     The duration of the risk (how long is the carrier infectious),

c)      The severity of the risk (what is the potential harm to third parties) and

d)     The probabilities the disease will be transmitted and will cause varying degrees of harm.

The Court added that, when making these findings, “courts normally should defer to the reasonable medical judgments of public health officials,” and must then “evaluate, in light of these medical findings, whether the employer could reasonable accommodate the employee under the established standards for that inquiry.”

Finally, the Court held that the District Court did not make appropriate findings as to whether Arline was “otherwise qualified” for her job. It remanded the case for additional findings of fact.

“The amended definition reflected Congress' concern with protecting the handicapped against discrimination stemming not only from simple prejudice, but also from ‘archaic attitudes and laws’ and from ‘the fact that the American people are simply unfamiliar with and insensitive to the difficulties confront[ing] individuals with handicaps.’ []. To combat the effects of erroneous but nevertheless prevalent perceptions about the handicapped, Congress expanded the definition of ‘handicapped individual’ so as to preclude discrimination against ‘[a] person who has a record of, or is regarded as having, an impairment. [but who] may at present have no actual incapacity at all.’” 480 U.S., p. 279.

“Arline's contagiousness and her physical impairment each resulted from the same underlying condition, tuberculosis. It would be unfair to allow an employer to seize upon the distinction between the effects of a disease on others and the effects of a disease on a patient and use that distinction to justify discriminatory treatment.” 480 U.S., p. 282.

“Allowing discrimination based on the contagious effects of a physical impairment would be inconsistent with the basic purpose of § 504, which is to ensure that handicapped individuals are not denied jobs or other benefits because of the prejudiced attitudes or the ignorance of others. By amending the definition of "handicapped individual" to include not only those who are actually physically impaired, but also those who are regarded as impaired and who, as a result, are substantially limited in a major life activity, Congress acknowledged that society's accumulated myths and fears about disability and disease are as handicapping as are the physical limitations that flow from actual impairment. Few aspects of a handicap give rise to the same level of public fear and misapprehension as contagiousness.” 480 U.S., p. 284.

“The fact that some persons who have contagious diseases may pose a serious health threat to others under certain circumstances does not justify excluding from the coverage of the Act all persons with actual or perceived contagious diseases. Such exclusion would mean that those accused of being contagious would never have the opportunity to have their condition evaluated in light of medical evidence and a determination made as to whether they were ‘otherwise qualified.’ Rather, they would be vulnerable to discrimination on the basis of mythology — precisely the type of injury Congress sought to prevent. We conclude that the fact that a person with a record of a physical impairment is also contagious does not suffice to remove that person from coverage under § 504.” 480 U.S., p. 285-86.