This week’s blog entry is a case that has been previously blogged on by others in the blogosphere. Robin Shea in her blog blogged on our case of the week, here. However, as readers know, there are occasions where I will blog on a case that someone else has talked about first when I think I can offer my own perspective. This week’s blog entry is such a case. The case of the week is Carney v. Emory University, an unpublished decision from the 11^th Circuit decided on April 15, 2026, here. By way of full disclosure, I have participated as a judge in moot court and mock trial activities with Emory over the years, but have no other relationship with Emory (Emory is not far from where I am). As usual, the blog entry is divided into categories and they are: the situation (taken from the opinion, and I really struggled with whether I could make this section shorter); why coaching and medical examinations/disability -related inquiries are not the same; and thoughts/takeaways. Of course, the reader is free to focus on any or all of the categories.

I

The Situation

Dr. Carney worked for the Department of Urology in Emory’s School of Medicine. He was a urologist at Grady Hospital, where he also served as the site director for the residency program and director of undergraduate medical education. According to Dr. Carney, training residents and fellows was one of his most important job duties.

From 2013 through the remainder of his employment, Dr. Carney reported to Dr. Martin Sanda, the chair of Emory Urology. Dr. Carney testified that, during several disagreements with Dr. Sanda between May 2015 and July 2020, Dr. Sanda told Dr. Carney he needed to have his “head examined.”

In July 2022, the residency director for Emory Urology sent Dr. Sanda an email about certain concerns she had heard from Grady residents. These concerns were about Dr. Carney and they related to professionalism and respectfulness. Among other concerns cited in the email, female residents had complained about Dr. Carney touching them and making derogatory jokes about female surgeons. They also said they feared retaliation.

The School of Medicine conducted an internal investigation. It interviewed both urology residents and Dr. Carney. Dr. Carney called the residents’ complaints “lies.” He said he would “never” work with the complaining residents again, even if it meant losing his job.1 The review found that Dr. Carney’s denials and explanations “were generally convincing,” but that he failed to appreciate the impact his telling inappropriate jokes had on his reputation.

On January 4, 2021, Dr. Sanda emailed Dr. Carney. He said that, while the internal review “did not find cause for disciplinary action,” it did “confirm behaviors that warrant guidance,” including a need to “improve [his] awareness of how [his] behaviors and actions affect others and to enhance [his] approach in navigating conflict.” To that end, Dr. Carney was directed to do two things: (1) “engage with Gordon Tuttle of FSAP [(Emory’s Faculty Staff Assistance Program)] for coaching regarding navigating conflict, leadership, and responding to feedback”; and (2) complete a “professional development” program regarding sensitivity to boundaries.

Tuttle, a licensed psychologist, was the manager of physician services at FSAP. Dr. Sanda’s e-mail went on to explain that 1 The complaints were referred to Emory’s Title IX office, which reached out to the complaining residents. But no investigation was opened since none of the witnesses responded. Dr. Carney’s “engagement with Gordon Tuttle for professional development coaching is considered vital to advance the communication skills necessary” for him to resume his leadership position. Tuttle was copied on this email.

Dr. Carney completed a professional development program, but he refused to see Tuttle. In March 2021, Dr. Sanda emailed Dr. Carney about “next steps.” Those included contacting Tuttle “by the end of this week.” Dr. Sanda advised that Tuttle “has expertise in coaching clinical faculty on avoiding and resolving conflict and communicating effectively that will be invaluable to you and to the team alike,” and that he would “assess your goals and recommend strategies for moving forward.” When Dr. Carney failed to connect with Tuttle, Dr. Sanda sent another email stating that “connecting with [Tuttle] is a necessary step” to “repair the learning environment.”

Dr. Carney viewed the requirement to visit Tuttle as “childish,” demeaning, and unnecessary. He also felt it was an unlawful requirement to undergo a medical examination or inquiry into his mental health, based on Dr. Sanda’s prior comments that he needed his “head examined.” Dr. Carney made clear to Dr. Sanda in several emails that he had “no intention of seeing” Tuttle. Dr. Carney insisted that Dr. Sanda was “inventing a problem that does not exist,” that no coaching was necessary, and that he had been “cleared” of the residents’ “false accusations.”

The standoff continued through May 2021. At that point, Dr. Sanda told Dr. Carney that he could work with Rick Brandt, USCA11 Case: 24-13070 Document: 40-1 Date Filed: 04/15/2026 Page: 4 of 13 24-13070 Opinion of the Court 5 who was another leadership coach Dr. Sanda had worked with several years earlier, or a “suitable alternative coach,” instead of Tuttle. In an email on May 8, Dr. Sanda stressed that Dr. Carney’s “commitment to engage earnestly in leadership coaching will be a necessary first step” to remaining at Emory. According to Dr. Carney, Dr. Sanda told him on May 7, the day before the email, that “Brandt was a psychologist who would be able to help [him] work through [his] mental issues.” On May 26, 2021, Emory notified Dr. Carney that his appointment would not be renewed beyond August 31, 2021.

Following the non-renewal decision, Dr. Carney twice met with Tuttle, on June 1, 2021, and July 6, 2021. Before doing so, Dr. Carney signed a consent form to use FSAP’s services, which explained that FSAP provides services to faculty and stuff “through assessments, consultations, interventions, education, and prevention programs.” It explained, “Your first session with the FSAP clinician will involve an assessment to determine the type of services [that] may best meet your needs. We help employees discover and manage options and resources for dealing with any situation, behavior, or concern that may affect their ability to live or work in a healthy manner.” On June 1, Dr. Carney had a video call with Tuttle, who was in his FSAP office. Tuttle began by asking about Dr. Carney’s sleep patterns, exercise and energy levels, appetite, stress management, and worrying. Tuttle acknowledged that these questions could be relevant to assessing depression and anxiety. But he otherwise testified that “coaching isn’t a medical service,” and that he was simply checking in with Dr. Carney since he had “just lost his job.” Tuttle said that he offered both “mental health services” and “nonmedical physician coaching,” with the latter focused on the physicians’ “professional goals.” At the second appointment in July, Tuttle recommended that Dr. Carney read a book on emotional intelligence.

II

Why Coaching and Medical Exams/Disability -related Inquiries Are Not the Same

1. The ADA per 42 U.S.C. §12112(d)(4)(A), generally prohibits employers from requiring medical examinations or making disability related inquiries unless such an examination or inquiry is shown to be job-related and consistent with business necessity.
2. A plaintiff does not have to be disabled or regarded as having a disability in order to bring a claim under the medical examination/disability related inquiries provisions.
3. Neither the statute nor the regulation define “medical examination.”
4. Both parties referred to the EEOC Enforcement Guidance on the subject, which defines a “medical examination,” as a “procedure or test that seeks information about an individual’s physical or mental impairments or health.”
5. The Enforcement Guidance lists several factors for determining whether a test or procedure is medical, though it notes that one factor can be enough by itself, including: 1) whether the test is administered or interpreted by a healthcare professional; 2) whether the test is designed to reveal an impairment or physical and mental health; 3) how invasive the test is; and 4) whether the test is normally given in a medical setting or involves medical equipment. Further, the guidance goes on to state that medical examinations include psychological tests designed to identify a mental disorder or impairment, but not psychological tests measuring personality traits such as honesty, preferences, and habits.
6. The guidance also talks about how the ADA generally prohibits disability related inquiries, i.e. questions likely to elicit information about a disability. However, employers can ask other non-disability -related questions, including: asking generally about an employee’s well-being; asking an employee who looked tired or ill if they are feeling okay; asking an employee who is sneezing or coughing whether they have a cold or allergies; and asking how an employee is doing following the death of a loved one or the end of the marriage/relationship.
7. Unlike the case that we talked about here, plaintiff was not referred broadly for psychological counseling. Instead, the evidence reflects that he was ordered to obtain coaching, and that the coaching was specifically for navigating conflict, leadership, and responding to feedback. It was also for avoiding and resolving conflicts and communicating effectively, which was vital for advancing the communication skills necessary for the plaintiff to resume his leadership position. Plaintiff offered no evidence that he was required to undergo a procedure or test as part of his coaching or otherwise.
8. The mere fact that plaintiff could have obtained mental health services or psychological counseling from Tuttle, Brandt, or FSAP is not evidence plaintiff was required to receive those services.
9. It is a stretch to say that the content of the last session, which occurred after he had already been nonrenewed, would match the content of a hypothetical first session if the plaintiff had attended one. So, in context (he had been nonrenewed already and had previously refused to discuss the issues for which coaching had been ordered), the questions that were asked about sleep, appetite, exercise, and stress were not disability related inquiries or a medical exam.
10. The EEOC Guidance generally permits inquiries about an employee’s well-being and how an employee doing following a significant life event, which would include the loss of a long-term position of authority.
11. Tuttle testified that his coaching session started with a niceties or a check in, which often included asking gross indicators of how someone is doing. No one disputes that the plaintiff had just lost his job when he first met with Tuttle.
12. No evidence exists that Tuttle attempted to follow up on his broad inquiries, conducted any psychological testing, reviewed plaintiff’s medical records, or made any findings or diagnosis. Accordingly, no evidence exists that the coaching in question was likely to probe and explore whether the plaintiff suffered from a mental health disability, regardless of whether that was Emory’s intention.
13. The record reflects that Emory’s physician coaching was nonmedical and focused on professional goals. Tuttle testified that it wasn’t necessary to assess or evaluate an individual’s mental condition in order to engage in coaching, and that he did not perform exams or assessments to diagnose a mental condition as part of his coaching work. In addition, another witness for Emory testified that physician coaching involved a non-clinical assessment of the individual’s strengths and weaknesses, and that Emory never referred physicians for psychological counseling or treatment.
14. It is too speculative that the statement made by plaintiff’s supervisor that Brandt could help the plaintiff work through his mental issues necessarily leads to the conclusion that Brandt would have administered any test or procedure to the plaintiff let alone one designed to reveal a mental or physical impairment.
15. Since the plaintiff never saw Brandt (a psychologist who did not work for Emory but had coached Emory faculty), no evidence of the content of the coaching session with him exists. Plaintiff’s subjective beliefs and speculation about what might have occurred is not sufficient to defeat summary judgment.

III

Thoughts/Takeaways

1. Emory walked a very fine line here, but it worked out for them. Referrals for “coaching,” can go bad in a hurry.
2. The court cited to Kroll, which is one of my go to cases, when discussing medical exams. We discussed that case here.
3. A closely related blog entry is this one. That blog entry illustrates nicely why the fine line for referring to coaching can be extremely problematic. It also illustrates why it should not be surprising that plaintiff resisted going into the FSAP.
4. Another related article is this one, which discusses the obligations under the ADA of the people examining people in “fitness for duty,” situations.
5. Even after Loper Bright, this case illustrates that the EEOC enforcement guidance on medical exams/disability related inquiries is still influential with the courts.
6. When it comes to disability related inquiries, having that reviewed, as a preventive law approach, by a person with a disability can be incredibly helpful as people with disabilities are really sensitive to those types of issues.
7. I can see how it could be really easy for “coaching,” to turn into psychological counseling. Here, personnel walked right up to that line. However, in the court’s eyes they did not cross it. I could definitely see how a very disability sensitive judge might feel otherwise and deny/overrule summary judgment as the facts are a really close call.
8. Knowledgeable ADA legal counsel with sensitivity to persons with disabilities is extremely important when it comes to the issue of medical exam/disability related inquiries as this is an extremely sensitive area for people with disabilities.
9. A plaintiff does not have to have a disability to bring impermissible medical exam/disability related inquiries claims.
10. With respect to personality tests, they can be extremely problematic vis-à-vis medical exam/disability related inquiries. See this case (Karraker v. Rent-A-Center, Inc., 411 F.3d 831 (7^th 2005).
11. When it comes to licensing matters, it is really important to involve broad ADA expertise as soon as possible because numerous titles of the ADA are simultaneously involved. At a minimum, Title II (licensing boards), and Title III (the PHP or PRP, AP/assistance programs, etc.), are always involved. If the referral is the result of a person employed (many physicians nowadays, for example, are employees), then you make it a trio with Title I of the ADA being involved as well.