I hope everyone had a Fourth of July weekend that was fantastic and safe.
Our blog entry for the week is a case that we have blogged on before. It asks the question of whether a claim of morbid obesity requires an underlying physical impairment or mental impairment or is just the claim of morbid obesity as a scientific standard is sufficient by itself. As we discussed previously, here, a Court of Appeals in Texas had held that morbid obesity by itself was sufficient to be able to claim protection under the Texas Commission on Human Rights Act (TCHRA). We also blogged here where the Washington Supreme Court reached the same conclusion. The Texas case was appealed to the Supreme Court of Texas (Texas actually has two Supreme Courts-one for civil cases and one for criminal cases). The Supreme Court of Texas winds up deciding that the trend of cases at the federal level where morbid obesity claims require an underlying physical or mental impairment is the correct way to go. The decision was 7-2 with two Justices concurring and two Justices dissenting. As a preliminary matter, Texas does waive sovereign immunity in cases like this, but the waiver depends upon essentially getting by, for lack of a better word, a summary judgment motion first, i.e. having to show that a genuine issue of material fact exists. As usual, the case is divided into categories and they are: Facts; Justice Hecht majority opinion; Justice Blacklock concurring opinion; Justice Boyd dissenting opinion; and thoughts/takeaways. Of course, the reader is free to focus on any or all of the categories.
Facts:
The facts of this case are quite egregious and can be found in great detail in the opinion, here. Basically, you have a medical resident that weighed over 400 pounds. The program where she was doing a residency at did not appreciate that. She had a particular problem with the person who ran the residency program, an interim director. At one point, the interim director actually went into the University legal counsel’s office to figure out whether she could terminate the resident because of the plaintiff’s weight. The lawyer for the school said that she could not terminate based upon that reason because it would be discrimination. After hearing that, she repeated to the attorney that she believed that the resident was not performing well because of her weight and that she needed to find another reason to terminate her from the program. The University did not take steps to protect the information from when the program director consulted legal counsel when it was revealed what the nature of that conversation was at the program director’s deposition. She filed a claim with the Texas Workforce Commission and the EEOC and then upon receiving a right to sue letter brought suit. Her claim was that she was dismissed as a result of her morbid obesity. However, she never claimed either in her complaint or in her deposition any underlying physical or mental impairment associated with the morbid obesity. She also originally brought both an actual disability claim and a regarded as claim. However, on appeal, she abandoned the actual disability claim and proceeded only under the regarded as claim.
I
Justice Hecht Majority Opinion
- In 1993, the Texas legislature amended the TCHRA to bring it into compliance with the ADA. That enactment modified the definition of disability contained in the TCHRA to conform with the ADA definition.
- The definition of disability under the ADA at the time the TCHRA was amended is essentially the same as it is today. Both definitions call for a physical or mental impairment.
- At the time the TCHRA was amended, the final implementing federal regulations defined an impairment as, “any physiological disorder, or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genito-urinary, hemic and lymphatic, skin, and endocrine.” It can be presumed that the Texas legislature was aware of its regulatory interpretation and was accepting of that meaning of impairment when it adopted the ADA definition of disability.
- Since the TCHRA express purpose is to provide for the execution of the policies embodied in title I of the ADA and its subsequent amendments, the interpretation of the definition of disability is guided by both federal court decisions interpreting the ADA and the federal administrative regulations regarding the ADA.
- The federal regulatory definition of impairment today is not that much different from the definition in 1993. Today, per 29 C.F.R. §1630.2(h),an impairment is, “any physiological disorder or condition, cosmetic disparagement, or anatomical loss affecting one or more body systems, such as neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genitourinary, immune, circulatory, hemic, lymphatic, skin, and endocrine.”
- The plain language of both the 1993 and the current definition of impairment in the final implementing regulations require a physiological disorder or condition in order to find an impairment.
- Weight, even when it is outside the normal range, is not a physiological disorder or condition, rather it is a physical characteristic. The mere physical characteristic does not, without more, equal a physiological disorder. So, a plaintiff has to be able to point to a physiological disorder or condition causing one’s weight in order to show an impairment.
- The parties appear to agree that obesity is not an impairment absent evidence of an underlying physiological disorder or condition. So, it would make no sense to require an underlying physiological disorder or condition for morbid obesity but not for obesity.
- The United States Court of Appeals for the Sixth, Seventh, and Eighth Circuits have all concluded that the plain language of the EEOC regulation compels the conclusion that morbid obesity must stem from a physiological disorder or condition in order to qualify as an impairment for regarded as claims.
- The Second Circuit has held that a physiological disorder is required to show impairment based upon the regulatory definition in a case involving obesity and not morbid obesity.
- The federal decisions are of great help in understanding what constitutes a disability qualifying impairment since there have been so few cases in Texas involving morbid obesity. In a footnote, the Texas Supreme Court noted that there’ve only been three reported morbid obesity cases in the last 30 years in Texas.
- Whether obesity is a disorder in the medical community doesn’t say much with respect to whether morbid obesity qualifies as an impairment under the Texas Labor Code.
- In a footnote, the Texas Supreme Court says that the ADA is an antidiscrimination statute and not a public health statute. Therefore, Congress’s desires as it relates to the ADA do not necessarily align with those of the medical community.
- Reading the regulation as a whole and looking at dictionaries, reveals that a physiological disorder or condition means an abnormal bodily function or state. However, the accumulation of fat cells is a normal bodily process, so asserting that one is overweight is insufficient by itself to show a physiological disorder or condition.
- A person’s morbid obesity may be the result of that person’s normal natural response to the person’s lifestyle choices or eating habits. Therefore, a plaintiff would have to show that her body’s process of accumulating fat cells is somehow abnormal, i.e. the result of an underlying physiological disease or condition.
- The EEOC interpretive guidance on title I of the ADA, 29 C.F.R. Pt. 1630, App. at 1630.2(h), here, also support that morbid obesity is not an impairment without an underlying physiological disorder or condition. That guidance states: “the definition of the term “impairment” does not include physical characteristics such as eye color, hair color, left-handedness, or height, weight, or muscle tone that are within “normal” range and (emphasis added by me), are not the result of a physiological disorder. The definition, likewise, does not include characteristic predisposition to illness or disease. Other conditions, such as pregnancy, that are not the result of a physiological disorder are also not impairments.”
- A natural reading of the interpretive guidance is that weight is an impairment only if it falls outside the normal range and (emphasis in opinion), it occurs as a result of a physiological disorder. Both requirements have to be satisfied. This reading is further supported by the interpretive guidance reference to other conditions not being the result of a physiological disorder, such as pregnancy, not being considered an impairment by the EEOC.
- It goes too far to say that any physical characteristic slightly outside the normal range would be a physical impairment in the absence of an underlying physiological cause. Such a reading would be inconsistent with the TCHRA text and purpose and would transform the regarded as claim into a catchall cause of action for discrimination based upon appearance, size, and any number of other things far removed from the reasons why the TCHRA was passed.
- The plaintiff does not contend that there is evidence that her morbid obesity resulted from a physiological disorder or that such was the defendant’s perception. In fact, she said as much in her deposition.
- The missing pieces are any evidence or inference that plaintiff’s coworkers regarded her obesity as being caused by health issues rather than causing health issues. The distinction matters.
II
Justice Blacklock Concurring Opinion
- Excessive weight is a physical characteristic and not a disability.
- Excessive weight may be a symptom of an underlying physiological impairment, in which case it is the underlying physiological impairment and not the weight itself that qualifies as a disability triggering the employment protections of the Texas Labor Code.
- Whether obesity is considered an impairment, disability, disorder, condition, or anything else by the medical community in 2023, says nothing about whether obesity qualifies as a disability or impairment under the Texas Labor Code enacted in 1993.
- The Labor Code is a legal text and therefore, the meaning of the words in that statute must be the same today as it was in 1993 when the provisions were enacted. Mentioning Justice Scalia, statutory terms mean what they are conveyed to reasonable people at the time they were written.
- There is no shortage of evidence from the time of the statute’s enactment and shortly thereafter, including from federal cases interpreting the same language, that obesity was regarded as a physical characteristic and not a disability in the absence of an underlying physiological disorder.
- The Court needs to be wary about adopting federal case law when it comes to interpreting Texas statutes because it is entirely possible that Texans prefer to go in a different way based upon the wording of their own legislation. That is, federal sources of law should not become controlling authority and should only be used as guidance when appropriate.
- Extending the Texas Labor Code to the obese would have substantial social and economic consequences. After all, that might render 50% of the population disabled by 2030. On a matter of such vast economic and political significance, the Court should expect the legislature to speak clearly, which is not the case here.
III
Justice Boyd Dissenting Opinion
- Nothing in the Texas Labor Code imposes an underlying physiological disorder or condition requirement or otherwise limits the term disability to physical or mental impairment resulting from any particular cause.
- With the amendments to the ADA, Congress amended the ADA to expressly reject the Supreme Court of the United States inappropriately high level of limitation necessary to obtain coverage under the ADA and to reinstate a broad view of the ADA’s applicability.
- With the amendments to the ADA, Congress amended the ADA to expressly require courts to construe the term disability in favor of broad coverage to individuals to the maximum extent permitted by the ADA’s terms.
- Congress expressly conveyed its intent that the question of whether an individual’s impairment as a disability under the ADA should not demand extensive analysis. Instead, the focus should be on whether covered entities complied with their ADA obligations.
- The Texas Labor Code likewise requires that the term disability be construed in favor of broad coverage of individuals and to the maximum extent allowed.
- In a regarded as claim, the plaintiff must show that the defendant regarded her as having more than a minor impairment that is expected to last less than six months, but she does not have to show that the defendant regarded her as having an impairment that limited the major life activity.
- The Texas Labor Code does not define the term impairment. When looking at dictionaries, dictionary to find an impairment as simply a diminishment, deterioration, or loss of function or ability.
- Under the plain meaning, and impairment is simply a loss, reduction, or limitation of function or ability. To qualify as a disability, the impairment must be mental or physical and must substantially limit a major life activity. However, nothing about the definition requires that the limitation be caused by an underlying physiological disorder or any other particular cause or source.
- Neither the parties nor the majority points to any other statute using the term impairment in a way suggesting anything other than its common, ordinary meaning, much less say that loss or limitation in function qualifies as an impairment only if it results from a particular cause.
- When the legislature intended to limit a statutory reference to impairments to those resulting from a particular cause, it consistently and expressly includes that limitation within the statute, such as for workers compensation purposes and for purposes of deciding whether a judge is fit to serve.
- In a footnote, Justice Blacklock says that the common ordinary meaning of impairment has not changed since 1993.
- No prior decision of the Texas Supreme Court has ever required that this particular statute requires the claimant’s physical loss or limitation to result from any particular cause.
- Other sections of the Texas Labor Code indicate that an impairment is simply a condition limiting claimant’s function. Further, two other provisions appear to use the term limitation interchangeably with the term impairment.
- The Texas Labor Code expressly compels court to construe the term broadly without imposing any unexpressed requirements.
- In a footnote, Justice Blacklock says that the majority concerns about social and economic consequences of a contrary decision are misplaced. In particular, the majority forgets about how a major life activity must be substantially limited. Further, if the legislature makes a policy choice to define the term disability more broadly than wise, a court is not at liberty to veto that choice.
- Most people suing for discrimination based upon disability will go with the actual disability prong. Thus, they will have to show a substantial limitation in at least one major life activity. Further, for those opting for the regarded as claim, the plaintiff would have to show that the disability was more than minor. Therefore, plaintiffs cannot rely on the fact that they are obese or morbidly obese. Instead, they have to demonstrate that the obesity is about physical limitations that are substantial or are perceived to be more than just minor.
- 21.105 of the Texas Labor Code says that the provision referring to disability discrimination applies only to discrimination because of her on the basis of a physical or mental condition that does not impair an individual’s ability to reasonably perform a job. So, an employer does have the ability to terminate an employee because of impairment if the person cannot reasonably perform her job. Therefore, this particular section actually reduces the number of people who can sue when that disability impairs their performance.
- Federal law provides no clear guidance and is conflicting at best with respect to whether a morbid obesity claim requires an underlying physiological impairment.
- 29 C.F.R. §1630.2(h)(1) defines an impairment as a physiological disorder or condition affecting one or more body systems. The Texas Workforce Commission has adopted a rule defining impairment in the same way, though that rule only applies to provisions addressing housing discrimination and fair housing requirements as opposed to employment discrimination. Morbid obesity is undoubtedly such a physiological condition.
- The regulations define disability in terms of limiting mental and physical conditions and not in terms of underlying mental or physical processes.
- The statute requires an impairment and not just the condition.
- The EEOC regulation talking about physical characteristics could easily be read as if the “and,” is actually an, or.”
- All the federal courts within the Fifth Circuit (which is Texas), have declined to impose an underlying physiological disorder requirement for weight related disability claims.
- The evidence clearly establishes that the University perceived the plaintiff not only being morbidly obese but also being physically impaired as a result of her obesity. In fact, the University doesn’t dispute that, rather they just say that they didn’t perceive an underlying physiological disorder. Whether they perceive an underlying physiological disorder is irrelevant.
- While there were certainly numerous concerns with the plaintiff’s performance, the plaintiff only has to show that the impermissible concerns were a motivating factor for the adverse actions even if other factors also motivated those actions. Plenty of direct evidence exists to show that disability was a motivating factor in the termination.
IV
Thoughts/Takeaways
- Texas and Oklahoma are the only two States with a highest court for civil matters and another one for criminal matters.
- It will be interesting to see how this opinion affects the courts in the Fifth Circuit when they deal with obesity centered claims.
- The federal courts are indeed all over the place with respect to whether morbid obesity requires an underlying physiological or mental condition. For example, we discussed here how the state of Washington has decided that it does not. So, be sure to check your particular federal or state jurisdiction when dealing with obesity claims.
- The amendments to the ADA made it such that it shouldn’t be too much of a stretch to find a physical or mental impairment that substantially limits a major life activity when a person is morbidly obese. That is, you may not even have to allege morbid obesity to find coverage under the ADA actual disability prong where a person is morbidly obese. So, I would not give up easily, if I am on the plaintiff side, in pursuing an actual disability claim when representing a client with morbid obesity.
- The reason morbid obesity gets so confusing is that unlike other disabilities the physical or mental impairment isn’t obvious. For example, a deaf ,Deaf, or hard of hearing person clearly has a physical impairment, i.e. hearing loss. They also are substantially limited in the major life activity of communicating with others. Most other disabilities are such that the physical or mental impairment is fairly obvious. Morbid obesity and obesity in general is an exception to that.
- Jurisdictions, though it is not necessarily a trend, around the country are enacting laws or ordinances protecting people who are obese from discrimination.
- In another life, I litigated over a missing comma. Here, I could foresee litigation over whether the EEOC interpretive guidance “and,” really means “and,” and not, “or.” Of course, it is in an EEOC interpretive guidance and is not necessarily entitled to much deference per Kisor, which we discussed here.
- The policy concern that the concurrence has about obesity in Texas is not without justification. For example, the What’s Cooking America website says that Texans are estimated to eat 800,000 orders of chicken fried steak every day. That said, you don’t have to read much to see how obesity is becoming an issue throughout America.
- The dissenting opinion does a nice job of laying out the arguments of why morbid obesity should not require an underlying physiological or mental condition.
- Interesting perspective from the dissenting opinion talking about the distinction between impairment and conditions. The dissent also talks about the distinction between limiting mental and physical conditions v. underlying mental or physical processes, which is interesting as well.
- The advantage to the regarded as prong is that you don’t have to show a substantial limitation on a major life activity. All you have to do is show a physical or mental impairment. On the other hand, the regarded as prong has its disadvantages. First, at least with respect to the ADA, it doesn’t apply to an impairment that is both transitory and minor (the transitory part did not appear in this case). Second, it does not allow for reasonable accommodations.
- I am licensed in Texas. That said, the vast majority of my practice is federal based rather than state based. Since I am licensed in Texas, I could do some legal research into what does §21.105 of the Texas labor Code actually mean. That section states: “Sec. 21.105. DISCRIMINATION BASED ON DISABILITY. A provision in this subchapter or Subchapter B referring to discrimination because of disability or on the basis of disability applies only to discrimination because of or on the basis of a physical or mental condition that does not impair an individual’s ability to reasonably perform a job.” The question I have about the statutory section is what does “reasonably perform a job,” mean? That is, it would seem to suggest that it must mean whether a person could perform the job with or without reasonable accommodations. If it does not mean that, then this Texas statute goes way below the ADA in terms of its coverage because the ADA also contains the qualified requirement, i.e. whether the person can do the essential functions of the job with or without reasonable accommodations. If I get a chance, I will do that research. I will be surprised if there is not a reasonable accommodation requirement baked into the statutory provision. It wouldn’t make sense otherwise for there not to be, but you never know.
- If question of morbid obesity as a disability goes to the Supreme Court, my guess is that this configuration of the United States Supreme Court would hold that morbid obesity requires an underlying physiological or mental impairment. Again, the workaround to that is it shouldn’t be terribly difficult to find mental or physical impairments that substantially limit a major life activity when a person is morbidly obese besides the morbid obesity.
- The concurrence requiring the legislature to speak clearly when huge policy implications are involved reminds me of the United States Supreme Court decision invoking the major question doctrine, which we discussed here.