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Disability Discrimination in Health Care and Health Services

Disability discrimination happens in many contexts, including by health care providers. There are civil rights laws in place to prevent this type of discrimination.

Section 504 of the Rehabilitation Act of 1973 and Title II of the Americans with Disabilities Act (ADA) of 1990 do several things. They prohibit covered health care, human service providers, and institutions from discriminating against people with disabilities. They cannot discriminate when providing benefits or services or conducting programs or activities. The ADA aims to ensure full and equal access for people with disabilities.

Section 504 Specifics

Section 504 applies to programs or activities receiving federal financial assistance. Federal assistance includes public health benefits like Medicaid and Medicare.

Title II of the ADA covers all services, programs, and activities, including licensing, conducted by public entities.

Public entities include, but aren't limited to, the following:

  • State and local governments
  • Departments
  • Agencies

Title III of the ADA applies to places of public accommodation. This includes private hospitals and doctor's offices.

This article discusses who gets protection from disability discrimination and what qualifies as a disability. It also explains who can file a complaint or lawsuit and the process.

Who Is Protected Under Federal Law?

Section 504 and the Americans with Disabilities Act (ADA) protect qualified people with disabilities.

A person with a disability is someone who has one of the following:

  • A physical or mental impairment that substantially limits one or more major life activity
  • A record of such an impairment
  • Perception by others of having such an impairment

What Does Major Life Activities Mean?

Major life activities consist of things like:

  • Caring for one's self
  • Performing manual tasks
  • Walking
  • Seeing
  • Hearing
  • Speaking
  • Breathing
  • Learning
  • Working

Under Section 504 and the ADA, you're a qualified person with a disability if you meet the essential requirements for receipt of services or benefits.

You can also be qualified based on participation in the programs or activities of a covered entity. Whether a particular condition is a disability within the meaning of Section 504 and the ADA is determined on a case-by-case basis.

What Is a 'Physical or Mental Impairment?'

Physical or mental impairments include, but aren't limited to:

  • Visual, speech, and hearing impairments
  • Intellectual disabilities
  • Mental health disorders
  • Learning or developmental disabilities
  • Conditions such as cerebral palsy, epilepsy, muscular dystrophy, or multiple sclerosis
  • Health conditions such as cancer, heart disease, diabetes, and HIV (human immunodeficiency virus)

Specific Requirements

Section 504 and the Americans with Disabilities Act (ADA) impose various nondiscrimination requirements on covered entities.

Covered entities must not:

  • Establish eligibility criteria for receipt of services or participation in programs or activities that screen out or tend to screen out people with disabilities. There's an exception if criteria are necessary to meet the program's objectives.
  • Provide separate or different benefits, services, or programs to people with disabilities. There's an exception if implementation is necessary to ensure the benefits and services are equally effective.

Covered entities must:

  • Provide services and programs in the most integrated setting appropriate to the needs of qualified people with disabilities
  • Make reasonable modifications in their policies, practices, and procedures to avoid discrimination on the basis of disability (unless it would result in a fundamental alteration in their program or activity)
  • Ensure that buildings are accessible and allow physical access
  • Provide auxiliary aids to people with disabilities at no extra cost

Providing auxiliary aids at no extra cost is required to ensure equal opportunity for effective communication with people with hearing, vision, or speech impairments. Auxiliary aids include services or devices such as:

  • Qualified sign language interpreters
  • Assistive listening headsets
  • Television captioning and decoders
  • Telecommunications devices for the deaf (TDDs)
  • Videotext displays, readers, taped texts, braille materials, and large print materials

Who Can File a Complaint?

Contact the Office of Civil Rights (OCR) if you believe you, or a class of people, have been:

  1. Subjected to discrimination
  2. Discriminated against on the basis of disability
  3. Faced this discrimination in a health or human service program or activity conducted by a covered entity

The OCR is an agency within the U.S. Department of Health and Human Services (DHHS).

You can file a complaint online through the OCR Complaint Portal. You can also file a complaint by mail. To submit a mail complaint, contact the regional manager at the appropriate OCR regional office or mail your complaint to the following address:

Office for Civil Rights, U.S. Department of Health and Human Services

200 Independence Ave. SW, Room 509F, HH Building, Washington, D.C. 20201

What To Include in the Complaint

You must file a complaint within 180 days of the date of the alleged discrimination. The Office for Civil Rights (OCR) may extend the 180-day deadline if you can show "good cause."

Include the following information in your written complaint:

  • Your name, address, and telephone number
  • Name and address of the entity you believe discriminated against you
  • How, why, and when the discrimination happened
  • Any other relevant information

The complainant or an authorized representative must sign complaints.

Private Lawsuits

As a private person, you can also bring a lawsuit against a public entity to enforce your rights under Section 504 and the ADA.

If you bring a lawsuit, you might be eligible to get:

It isn't necessary to file a complaint with the U.S. Department of Justice (DOJ) before initiating a lawsuit.

The Affordable Care Act

The Affordable Care Act (ACA) is another federal law offering protection from disability discrimination. Section 1557 of the act bans disability discrimination under any health program or activity receiving federal funding or assistance.

The ACA is a healthcare reform law. A primary goal of the ACA is to reduce health insurance costs. It also expands health insurance coverage. Before the ACA, health insurance plans could refuse coverage to people with disabilities.

Get Legal Help With Your Discrimination Claim

Disability discrimination in healthcare is a serious matter that jeopardizes many patients seeking medical care. Disability discrimination is just as severe as discrimination based on national origin or sexual orientation.

Were you or a family member deprived of care at a health care facility because of being hard of hearing? Do you suspect your healthcare services were negatively affected by disability discrimination during a pandemic? Get legal help from an attorney. An attorney familiar with discrimination issues and human rights laws can help you understand how disability rights laws can protect you.

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Next Steps

Contact a qualified civil rights attorney to help you protect your rights.

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