The ADA Requires Reasonableness, Not Perfection

In this particular case at hand, Tartaro-McGowan v. Inova Home Health, LLC, a home health care aide with chronic arthritis in her knees refused to perform field assignments. She rejected a proposed accommodation from her employer that would have permitted her to preview and self-select which home-care assignments to accept.

She argued that the employer's proposal "would have been inadequate because of potential emergency or otherwise unexpected situations that might have arisen, which, given her physical limitations, she might not have been able to adequately address."

Her support came from a note in which her doctor stated that he did not "think" the screening and self-selection option was "reasonable" because a patient's needs "can never be truly determined until she is at the home doing a proper nursing assessment." Thus, by not accepting her doctor's opinion, her employer's accommodation was unreasonable.

Accommodations only need to be reasonable, not perfect

To put this into greater perspective, the employer had demand for its services and a depleted supply of field nurses due to the COVID-19 pandemic. So, while it was all hands on deck, it nonetheless allowed the plaintiff to screen field assignments to select those patients whose anticipated needs were compatible with her physical limitations, which is inherently reasonable.

But what if, hypothetically speaking, visiting patients is not an essential function of a home health care aide's job. Does an employer have to remove nonessential functions of the job from an employee with a disability as a reasonable accommodation?

"Tartaro-McGowan suggests that whenever the job function at issue is not an essential function, then a reasonable accommodation necessarily entails the outright elimination of that function from the employee's duties. Put simply," said the Fourth Circuit (Virginia), "that is not the law."

The ADA requires reasonableness, not perfection. Reasonableness does not demand that an accommodation have an airtight solution to every contingency conceivable. Its dictates are tethered to the practical realities of each case, not boundless hypotheticals. And the practical realities here were that (i) Inova Home Health had a severe shortage of field nurses created by an unprecedented pandemic; (ii) patients needed to be seen; (iii) all internal staff were required to assist with direct patient care field visits as a result; (iv) there were several field duties that Tartaro-McGowan, an experienced field nurse, could perform within her physical limitations; and (v) by screening field assignments, Tartaro-McGowan had the ability to select those patients whose anticipated needs were compatible with her physical limitations. Given these practical realities, no reasonable jury could conclude that Defendants' accommodation was unreasonable.

An employer may need to restructure a job by removing nonessential job functions to accommodate an individual with a disability. But the ADA has never required it. Instead, "what counts as a reasonable accommodation [...] is sensitive to the particular circumstances of the case."

If another reasonable accommodation exists — the list is not exhaustive — then the employer may implement it.

Frankly, the employee did herself a disservice by not at least trying the employer's proposed accommodation. If it worked, great! If not, she would have had a stronger basis to seek an alternative accommodation and a better failure-to-accommodate claim.