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A hospital lab employee who was fired for refusing to be vaccinated against COVID-19 has lost her claim that she suffered discrimination because her employer failed to accommodate her disability under the Americans with Disabilities Act (ADA).

The Fourth Circuit Court of Appeals upheld her firing, finding that it was within her employer’s right because she blocked her employer from learning why her medical condition required a medical exemption and accommodation.

If an employee prevents the employer from understanding her disability, then the employer’s duty to accommodate never arises, and the employee’s claim fails, the appeals court found in affirming a lower court that ruled in favor of her employer, a Johns Hopkins University lab.

As a federal contractor, the hospital lab was required to have all of its employees vaccinated against COVID-19, except where medical or religious accommodations were warranted. Sally Tarquinio told her employer she had chronic Lyme disease and feared that if she got vaccinated, the COVID antigens would cause her “body to go crazy due to immune chaos.” She asked her employer for a medical exemption from the vaccine as a disability accommodation.

The hospital never questioned that her disease was a disability; however after the lab’s medical officer learned that Lyme disease is “not a medical contraindication” for COVID vaccination, he decided that he needed “further explanation” of her condition and why it foreclosed vaccination.

Tarquinio offered several personal accounts of her situation as “similar to an autoimmune disease” and submitted medical documentation that was more than nine years old. But she kept the medical officer from accessing her current medical records or speaking to her doctors so he could gain further explanation of her medical condition, why she needed an accommodation and what that accommodation might be.

Tarquinio also offered to take regular COVID tests and to work remotely but refused to release her medical records or grant access to her doctors. In her view, the lab must have wanted to contact her doctors to second-guess their medical judgment.

The medical director insisted he needed “medical justification for an accommodation.” Without access to Tarquinio’s records and doctors, he declined to grant a medical exemption. Because Tarquinio never got vaccinated and never got an exemption, the lab fired her.

The ADA makes it unlawful to “discriminate against a qualified individual on the basis of disability.” Congress defined that term to include “not making reasonable accommodations to the known physical or mental limitations of an otherwise qualified employee with a disability,” absent undue hardship to the employer.

The court noted that the ADA’s implementing regulations contemplate that an employer will often have to “initiate an informal, interactive process” with an employee to identify a reasonable accommodation.

The federal district court for Maryland entered judgment for the hospital lab because it held that Tarquinio was responsible for what it termed a “breakdown” in the interactive process.

The Fourth Circuit appeals court, noting that “the interactive process is not an end in itself,” described it as a means of giving employers and employees a chance to work together to figure out what accommodation, if any, would be reasonable and not unduly burdensome. “An employer’s obligation to engage in the interactive process is therefore closely tied to its duty to accommodate,” the court said.

An employer who sabotages or doesn’t engage in good faith with the interactive process violates the ADA. The interactive process also gives the employer a chance to confirm that it has a duty to accommodate to begin with. Employers “need not take the employee’s word for it that the employee has a disability that may require special accommodation.” Rather, employers have the right “to confirm whether a need for accommodation exists.”

The court explained that to be liable for a failure to accommodate, employers must know that an employee’s disability limits her in a way that needs accommodating and acquiring that knowledge is a central purpose of the interactive process. If the employer, for example, sabotages the interactive process to avoid discharging its duty, then the employee can use that sabotage to show that the employer refused an accommodation. But if the employee prevents the employer from understanding her disability, then the employer’s duty never arises, and the employee’s claim fails.

The appeals court noted that while Tarquinio told the lab about her disability, she never showed that she was limited in a way that required accommodation. She described many of her symptoms. But she never explained why her disability made COVID vaccination risky.

Perhaps Tarquinio’s medical providers could have explained that she was more likely to be harmed by the COVID vaccine than by COVID. But Tarquinio refused to let that conversation happen.

According to the appeals court, no reasonable jury could conclude that the lab knew enough to be on proper notice of Tarquinio’s needs. The lab had the right to ask for more objective evidence. Because Tarquinio prevented the lab from learning why her condition required the accommodations that she asked for, she was unable to show that the lab had a duty to accommodate.