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Celiac.com 11/05/2024 - A new lawsuit has been filed in the United States District Court for the Eastern District of Pennsylvania, where a former employee is accusing her previous employer of discrimination and wrongful termination. Lauren Boyd, the plaintiff, claims that her former employer, Cigna Healthcare, violated both the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). Boyd's complaint outlines a series of events she believes led to her unjust dismissal from the company, centering around her chronic health conditions and her request for reasonable accommodations. The Timeline of Employment and Health Struggles According to court documents, Lauren Boyd began her employment at Cigna Healthcare on August 16, 2021, working as a customer service advocate. During her time with the company, Boyd suffered from chronic health issues, including celiac disease, irritable bowel syndrome (IBS), and anemia. These conditions, she alleges, were well-documented and known by her employer. Complicating her medical situation, Boyd also sustained injuries from an incident at Walmart on July 29, 2022, further exacerbating her health challenges. These injuries, coupled with her chronic illnesses, led her to require more time off work for treatment and recovery. She regularly used approved unpaid leave and ADA accommodation days when she experienced health flare-ups, particularly after incidents of gluten contamination, which worsened her condition. August 2023: A Turning Point in Health and Employment The most significant period of contention in Boyd's lawsuit took place in August and September of 2023. In August, she experienced a gluten contamination episode that triggered severe symptoms, leaving her immune system compromised. As a result, she developed an upper respiratory infection and later contracted COVID-19. Despite her deteriorating health, Boyd continued to manage her condition with approved unpaid leave and ADA days between August 11 and September 6, 2023. In her complaint, Boyd states that her health issues were compounded by Cigna's refusal to approve a medical treatment she required due to low iron levels caused by her chronic conditions. Boyd was prescribed a single-infusion iron drug, but Cigna denied her request for this specific treatment, offering a five-infusion alternative instead. This suggestion, Boyd argues, was unreasonable, given her challenging work schedule of four-day, ten-hour shifts. She found it nearly impossible to arrange the frequent medical appointments required for the alternative treatment without taking even more time off from work. The Application for Short-Term Disability and Termination As Boyd’s health issues persisted, she applied for short-term disability (STD) in early September 2023. Her request for STD was made in addition to her ongoing use of FMLA leave, as she needed extended time off to recover. However, on September 13, 2023, Cigna terminated Boyd’s employment, citing attendance issues as the reason for her dismissal. Boyd contends that her termination came at an unjust time, as her FMLA/STD applications were still pending. She also highlights that Cigna’s workforce management had previously approved her unpaid time off. According to Boyd, the company failed to adequately accommodate her disability and did not engage in an interactive process to explore reasonable solutions for her health-related needs. Instead, she argues, the company retaliated against her by terminating her employment. Allegations of ADA and FMLA Violations The core of Boyd’s lawsuit is centered around two major federal laws: the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA). ADA Discrimination and Retaliation: Boyd claims that Cigna violated her rights under the ADA by failing to accommodate her medical conditions and by retaliating against her for requesting accommodations. She argues that Cigna was aware of her chronic health issues and should have made efforts to engage in an interactive process, which is required by law, to determine how best to support her continued employment. By terminating her, she believes the company punished her for seeking accommodations that were necessary for her health. FMLA Interference and Retaliation: Boyd also accuses Cigna of violating her FMLA rights. She states that her termination was a direct result of her taking FMLA leave to manage her chronic illnesses. Boyd argues that Cigna interfered with her lawful use of FMLA and retaliated against her for applying for short-term disability and using unpaid leave to attend to her health. The Plaintiff’s Requests for Relief In her lawsuit, Boyd is seeking several forms of compensation and restitution from Cigna Healthcare. She has asked the court for reinstatement to her former position with a salary and benefits package comparable to what she had before her termination. Additionally, she is requesting compensatory damages in excess of $150,000 for lost wages, back pay, and front pay. Boyd is also pursuing damages for emotional distress, alleging that the wrongful termination caused her significant personal hardship. Furthermore, she seeks punitive damages as a way to hold Cigna accountable for what she views as clear violations of her rights under federal law. Finally, she is asking the court to cover her legal fees and other associated court costs. The Case Moving Forward At this stage, the case is still in its early phases. Lauren Boyd is being represented by Mary LeMieux-Fillery from the Law Offices of Eric A. Shore P.C. No attorneys have been listed for Cigna Healthcare in the initial filings. This case could have far-reaching implications for employees with chronic health conditions and disabilities, as it may shed light on how large corporations manage requests for accommodations under the ADA and leave under the FMLA. As it progresses, the court will weigh the evidence from both sides to determine whether Cigna’s actions were in violation of federal law. Conclusion This lawsuit emphasizes the ongoing challenges faced by employees with chronic health conditions in maintaining their rights under the ADA and FMLA. Lauren Boyd’s claims against Cigna Healthcare, if proven true, could highlight the importance of employers engaging in meaningful discussions about accommodations and respecting an employee’s need for medical leave. This case serves as a reminder that employees should not be penalized for seeking accommodations for their disabilities or for taking legally protected leave to manage their health. The outcome of this lawsuit may provide further clarity on the responsibilities employers have in balancing attendance policies with the rights of employees facing health challenges. Read more at: pennrecord.com -
Celiac.com 07/23/2024 - A mother from Utah County is advocating for changes after her teenage daughter, who has type one diabetes and celiac disease, experienced what the family claims was discrimination at a Provo water park. The mother alleges that her daughter was denied entry with necessary dietary food, which led to her becoming ill. The water park, however, maintains that they made efforts to accommodate the teen's needs. Incident at Splash Summit Water Park Janae Cox prepared a small cooler filled with diet-specific food and snacks for her daughter Kolbie's visit to Splash Summit Water Park. Despite the careful preparation, most of the food was not permitted inside due to the park’s stringent policy. Janae believes that this policy is not only detrimental but also potentially violates the Americans with Disabilities Act (ADA). According to Janae, Kolbie did not have sufficient food to maintain her health throughout the day, resulting in her feeling unwell. Janae and her husband, Kevin, emphasize that ensuring Kolbie has appropriate food is a continual challenge due to her medical conditions. Although the park’s regulations allow some food, they impose significant limitations. Park Policy and Family's Concerns A representative from Splash Summit explained that visitors could leave and re-enter the park with additional food but could only bring a limited amount at any one time. The Cox family argues that this arrangement is neither practical nor safe for Kolbie. Given that Kolbie is 15 and does not drive, and her parents were dropping her off, leaving the park to get more food was not a feasible option. Kevin highlighted the potential danger, noting that if Kolbie's blood sugar levels dropped while she was alone, she could have a seizure before reaching her car for more food. ADA Compliance and Legal Perspective Nate Crippes, a supervising public affairs attorney with the Disability Law Center, states that businesses in Utah are obligated to modify policies to meet ADA requirements. Crippes argues that policies should be individualized to cater to different disabilities. Splash Summit claimed they offered to store Kolbie's cooler with her food and medical supplies in the front office, but the Cox family feels this solution is still discriminatory. Kevin pointed out that this arrangement forces individuals with dietary restrictions to eat separately from other park-goers, which he believes is unfair. Seeking Resolution The Cox family asserts that their primary goal is to prevent other families from facing similar issues. Kolbie expressed her desire for a policy change, supported by her mother, who is willing to take necessary actions to achieve this. Despite having her medical supplies when she eventually entered the park, the Cox family mentioned that they had not encountered problems with the cooler on previous visits. Water Park’s Response and Future Considerations Splash Summit stated that they offer gluten-free food options within the park. When questioned about the possibility of changing their policy, the park spokesman indicated that it could be considered. The Cox family is still awaiting further discussions with the park regarding their experience. Conclusion The article highlights the challenges faced by individuals with celiac disease and diabetes in public spaces and the importance of accommodating their needs. For those with celiac disease, ensuring access to safe food options is crucial to avoid health complications. The Cox family’s story underscores the necessity for businesses to implement flexible, inclusive policies that respect and address the unique requirements of all patrons. Their advocacy serves as a reminder of the ongoing need for awareness and adjustments to ensure equal access and treatment for people with disabilities. Read more at: kmyu.tv -
Celiac.com 06/15/2024 - In recent years, there has been a notable increase in the number of online job applications that include questions about disability status. At least 50% of these applications now inquire whether applicants have a disability, with celiac disease often listed as a potential disability. This trend raises important questions about the nature of celiac disease and whether it should be classified as a disability on a job application. While recognizing the challenges faced by individuals with celiac disease, it is crucial to critically examine whether it fits the standard definition of a disability, especially considering that adherence to a gluten-free diet typically leads to a symptom-free state. Understanding Celiac Disease Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine. Gluten is a protein found in wheat, barley, and rye. For individuals with celiac disease, even a small amount of gluten can trigger an immune response that damages the villi of the small intestine, leading to nutrient malabsorption and various symptoms, such as gastrointestinal issues, fatigue, and anemia. The Gluten-Free Diet as a Solution The primary treatment for celiac disease is a strict, lifelong gluten-free diet. Adherence to this diet usually results in the healing of the intestinal lining and the resolution of symptoms. Most individuals with celiac disease who follow a gluten-free diet for several months to a couple of years can achieve a symptom-free state and lead normal, healthy lives—without any issues that would interfere with work—especially if the job is remote work (yes, even remote jobs where you would work from home are now asking this question). Celiac Disease and Disability: Definitions and Implications The Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more major life activities. This definition includes conditions that are episodic or in remission if they would substantially limit a major life activity when active. Understanding how the ADA applies to work and jobs is crucial for both employers and employees, as it ensures that individuals with disabilities have equal access to employment opportunities and workplace accommodations. The ADA prohibits discrimination against qualified individuals with disabilities in all aspects of employment, including hiring, firing, promotions, job assignments, training, benefits, and any other terms, conditions, and privileges of employment. It applies to private employers with 15 or more employees, as well as to state and local government employers, employment agencies, and labor unions. Under the ADA, employers are required to provide reasonable accommodations to qualified employees with disabilities, unless doing so would cause undue hardship to the business. Reasonable accommodations are modifications or adjustments to a job or work environment that enable a person with a disability to perform essential job functions. Examples of reasonable accommodations include: Making existing facilities accessible Restructuring a job Modifying work schedules Acquiring or modifying equipment Providing qualified readers or interpreters For individuals with celiac disease, reasonable accommodations might include ensuring access to gluten-free food options in the workplace, providing flexibility in break times to allow for safe eating practices, or allowing remote work if gluten contamination in the workplace is a concern. The Case for Skepticism Symptom-Free State and Normal Functioning The primary argument against categorizing celiac disease as a standard disability is the fact that individuals with the condition can achieve a symptom-free state through dietary management. Once on a gluten-free diet, the majority of people with celiac disease do not experience limitations in their daily activities or work performance. They are not substantially limited in any major life activity, which is a key criterion for defining a disability under the ADA. If someone with celiac disease can bring their own food to work, of if they can work from home and fully control their food, it's very unlikely that a worker would ever be considered disabled to the point where it would affect their ability to perform their job. Comparisons with Other Disabilities Comparing celiac disease with other disabilities that inherently limit life activities can be illuminating. For example, conditions like multiple sclerosis, Parkinson's disease, or severe mental health disorders often have persistent symptoms and functional impairments despite treatment. In contrast, celiac disease, when managed with diet, does not typically present ongoing challenges or impairments that affect daily functioning. The Impact of Labeling Celiac Disease as a Disability Potential Benefits There are potential benefits to recognizing celiac disease as a disability. It can ensure that individuals with the condition receive necessary accommodations, such as access to gluten-free food options at work or understanding from employers regarding their dietary needs. It can also provide legal protections against discrimination. Potential Drawbacks However, labeling celiac disease as a disability can also have drawbacks. It may lead to unnecessary stigmatization or misconceptions about the capabilities of individuals with the condition. Employers might mistakenly believe that people with celiac disease require significant accommodations or are frequently ill, which is not the case for those adhering to a gluten-free diet. This could inadvertently affect hiring decisions and job opportunities. Navigating Job Applications Transparency and Honesty When faced with the question of disability status on job applications, individuals with celiac disease must navigate a complex landscape. Honesty is paramount, but so is understanding the implications of disclosing a condition that, when managed, does not cause substantial limitations. If someone with celiac disease has been symptom-free for a considerable period due to a strict gluten-free diet, they may not feel the need to disclose their condition as a disability. Caption: An actual job application—how would you answer? Legal Considerations Legally, it can be permissible for individuals with well-managed celiac disease to answer "no" to the disability question if their condition does not currently limit any major life activities. The ADA defines a disability based on the presence of substantial limitations, and if those limitations are effectively mitigated through diet, an individual may reasonably determine that they do not meet this criteria. However, it's important to note that the ADA also considers conditions that are episodic or in remission, meaning that if the person were to consume gluten, their major life activities would be substantially limited. Thus, while saying "no" can be legally justifiable, it is crucial for individuals to consider their specific circumstances and the potential need for future accommodations when making this decision. Consulting with a legal or HR expert can provide additional clarity and ensure compliance with ADA guidelines. Rethinking Disability Categories Criteria for Disability The inclusion of celiac disease in disability categories invites a broader discussion about what constitutes a disability. The criteria should focus on the extent to which a condition limits major life activities despite management or treatment. If a condition can be effectively managed to the point where it no longer imposes substantial limitations, its classification as a disability should be reconsidered. Individualized Assessments Rather than blanket classifications, individualized assessments might offer a more nuanced approach. Evaluating the specific circumstances and needs of each person with celiac disease can ensure that those who genuinely require accommodations receive them, while those who do not are not unnecessarily labeled. Conclusion The increasing inclusion of celiac disease in disability categories on job applications warrants critical examination. While it is crucial to protect the rights and accommodate the needs of individuals with celiac disease, it is equally important to recognize that effective dietary management typically leads to a symptom-free and fully functional state. Classifying celiac disease as a disability for all individuals may not reflect the reality of those who have successfully managed their condition through a gluten-free diet. A more nuanced, individualized approach to disability classification and disclosure may better serve the interests of both job applicants and employers, fostering a more accurate understanding of celiac disease in the workplace.- 13 comments
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Judge Reinstates Celiac Prisoner's Disease-Related Lawsuit
Jefferson Adams posted an article in Additional Concerns
Celiac.com 04/30/2024 - Inmate Daniel Phoenix filed a lawsuit against Virginia prison officials, including Dr. Paul Ohai and Dr. Mark Amonette, alleging deliberate indifference to his celiac disease. Initially, the district court denied summary judgment to Ohai and Amonette on Phoenix's Eighth Amendment claim. Around the same time that the case was set for mediation, it was transferred to a different district court judge. After mediation failed, the new judge set a date for a jury trial. Before trial, however, the district court excluded Phoenix’s experts because Phoenix did not timely submit expert reports. It then granted summary judgment to Ohai, concluding Phoenix could not prove his claim without an expert to testify about the “threshold standard of care or on the presence of an injury caused by” Ohai. The court granted summary judgment to Amonette because Phoenix’s inability to prove that Ohai violated his constitutional rights meant there was “no basis on which to award injunctive relief” against Amonette. The district court made an error in requiring an inmate to provide a medical expert for his Eighth Amendment claim against two doctors accused of neglecting his celiac disease. The ruling clarifies that there is no automatic requirement for expert testimony in such cases. Instead, it depends on whether the plaintiff presents enough evidence to dispute each essential element. Daniel Phoenix Sued Virginia State Officials for Neglecting his Celiac Disease Daniel Phoenix, an inmate in Virginia, sued state officials for neglecting his celiac disease. Two claims remained: an Eighth Amendment claim against Dr. Paul Ohai and a related claim for injunctive relief against Dr. Mark Amonette, the Chief Medical Director of the Virginia Department of Corrections. Initially, the district court denied summary judgment to Ohai and Amonette. Later, after mediation failed and the case was transferred to a different judge, the court excluded Phoenix's experts due to untimely reports. Subsequently, it granted summary judgment to Ohai, citing Phoenix's inability to prove his claim without expert testimony. Summary judgment was also granted to Amonette. Summary Judgment Phoenix argued procedural error in the district court's reconsideration. The appellate court found no abuse of discretion, as the exclusion of Phoenix's experts altered the evidentiary landscape. Expert Testimony The court disagreed with Ohai's defense suggesting a universal need for expert testimony. It clarified that expert testimony isn't mandatory, but rather depends on the evidence presented in each case. Merits A successful Eighth Amendment claim requires showing objective and subjective components. Phoenix demonstrated a genuine dispute on the objective component, providing ample evidence of his celiac disease and its treatment needs. Regarding the subjective component, evidence showed Ohai's knowledge of Phoenix's condition and his instructions to avoid gluten. The court rejected the district court's view that expert testimony was necessary to prove injury, as it conflated Phoenix's ability to succeed with his ability to prove damages. Consequently, the district court's judgment was vacated and remanded for further proceedings. Concurring/Dissenting Opinion While agreeing on certain aspects, Judge Wilkinson dissented from the majority's decision on the merits of the case, writing, in part: "I readily concur that the district court did not abuse its discretion in reconsidering the earlier summary judgment ruling. I also agree that the fact that experts may be helpful to a prison inmate’s claim of inadequate medical care does not mean that experts are required in every case. I disagree, however, with the majority’s decision to reject the defendants’ position on the merits in this appeal." This ruling underscores the importance of evaluating each case individually and considering the evidence presented, rather than imposing a blanket requirement for expert testimony. Read more in Virginia Lawyers Weekly//April 16, 2024-
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Going Gluten Free as a Human Rights Issue
Yvonne Vissing Ph.D. posted an article in Summer 2016 Issue
Celiac.com 07/11/2016 - People with celiac disease know that going gluten free isn't a choice—it is a health necessity. It is also a human rights issue. Food and nutrition should be seen as a citizen's human and social right. People who fail to be attentive to the health needs of people with celiac disease may be violating their rights. Like many rights issues, people may not realize they've violated someone's rights by doing, or not doing, something. But when you are the one whose rights have been violated, you know. The violation is serious for you, even when others may be oblivious to the larger context of the violation. Thinking about being gluten-free in this context may be different from the way most people view celiac disease. But it is a point of view that is well worth considering. When you've got celiac disease and people aren't attentive to making sure you can eat gluten-free foods that are safely prepared and not contaminated, you can end up very sick in the short-run. The short-term effects may include symptoms such as gastrointestinal upset, migraines, fuzzy brain, sweats, and general malaise. As a fundamental right, what one eats should ensure people's access to a healthy, dignified and full life. People who have been "glutened" do not feel dignified as they writhe in pain, wrestle with fears of embarrassment, or modify their lifestyle and social schedules to accommodate the illness. In the long-run, if someone is continually exposed to gluten in foods, a variety of serious preventable health conditions may result. Unlike a peanut allergy that can directly kill you, exposure to gluten may result in morbidity and early mortality for people in an indirect fashion. Adhering to a gluten-free diet is of paramount importance to avoid health problems such as compromising one's weight and pubertal development, fertility, bone mineral density, and deficiencies of micro and macronutrients, not to mention the increased risk of developing malignancies, especially in the gastrointestinal system. Because the health effects of ingesting gluten for someone with celiac disease are less visible to those who don't experience them, they have been easier to ignore. Thanks to vocal advocates who now know that going gluten-free can save their lives, it is obvious that the lack of attention to making sure people can eat safely is a violation of their rights. Let's put the issue of gluten into a larger rights context. The United Nations Declaration of Human Rights (UDHR) was adopted in 1948 after World War II and it is the first global document that codified rights to which all human beings are inherently entitled. It contains a wide range of rights and is regarded as the foundation upon which other rights documents have been built. Its Article 25 states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control" (www.un.org/en/universal-declaration-human-rights/). The right to health and well-being are directly linked to food. Conditions like celiac disease, which are genetic in nature, are thus beyond one's control and necessary to be addressed through appropriate care and management. In another rights treaty document that pertains directly to the rights of children and youth, the UN Convention on the Rights of the Child (UNCRC) addresses in Article 3 that "In all actions concerning children….the best interests of the child shall be a primary consideration", that individuals responsible for them are required to ensure that they receive the services and protections they need, particularly in the areas of safety (and) health…". Article 24 "recognizes the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services". It goes on to emphasize the importance of disease prevention and primary health care "through the provision of adequate nutritious foods" (http://www.ohchr.org/en/professionalinterest/pages/crc.aspx). This implies that nutritious foods are linked with disease prevention and well-being, and making sure children (and adults) get the proper foods is in their best interests. If a child has celiac disease and the responsible adults are inattentive to making sure they can eat safely, they are in fact violating the child's rights. There are, then, international treaties that link food and nutrition directly with human rights. Juliana Nadal at the Department of Nutrition, Food Quality and Nutrition at the Federal University of Parana in Brazil reviews in her journal article, "The principle of human right to adequate food and celiac disease" (Demetra; 2013; 8(3); 411-423), a variety of ways that people who have celiac disease have their rights violated. Because celiac disease can be considered the most common food intolerance in the world, it is one that both individuals and social structures need to address as a mainstream issue. From how laws and consumer protections are designed at the macro level, to how food is made available and prepared at the micro level, rights of people with celiac disease hang in limbo. Some places and people are very attentive to their rights protections while others are not. Nadal contextualizes food and nutrition insecurity that afflicts individuals with celiac disease with specific regard to the principle of the Human Right to Adequate Food (HRAF). Diet is the single most secure treatment form for people with celiac disease. Managing one's diet enables one to control the magnitude of the disease. Laws, standards, practices and policies are necessary to secure HRAF for people with celiac disease. It is therefore important that the public be educated regarding this. By protecting individual fundamental human right to food availability in both quantity and quality, it reflects the value of society to protect the welfare of this group of people. Ultimately, rights protections promote and improve the health of the entire population. Rights violations may also be seen through the limited availability of products intended for celiac individuals in the market. Whether looking at gluten-free food as a local, state, regional, national or global issue, there are certain countries and areas that do not have access to the same quantity and variety of gluten-free foods as in other areas. Online shopping may make it easier for some people to access foods they need, but this option is not necessarily available to everyone. If foods essential for good diets are not accessible, this forces people to make dietary compromises that may not be in their best interest. Another area of rights violations for people who have to go gluten-free is the high cost of products. Simply put, gluten-free foods tend to cost more than other foods. People who have celiac disease have to use more of their scarce dollars to pay for food. This means there is less money available to pay for other necessities. Because gluten-free foods tend to be more expensive, this creates a social class barrier, especially for poor people or financially-strapped people with celiac disease. Poorer people will have their right to safe nutrition compromised because they can't afford the same foods as more affluent people who have celiac disease. The issue of gluten contamination contributes to a constant situation of food and nutritional insecurity to holders of this special dietary need. The celiac diet must be completely gluten-free, which allows people to have a life relatively free of major pathological complications. Maintaining a totally gluten-free diet is not an easy task because the violation of the diet may occur voluntarily or involuntarily, and range from incorrect information on food labels to the gluten contamination of processed products. Difficulties in the availability and access to food without gluten violates the principle of the human right to adequate food. The condition of being a celiac individual exposes one to permanent food and nutrition insecurity, which could cause loss of quality of life, socialization, and health of the individual, both in the short and long term. The problematic situation of food and nutritional insecurity that afflicts individuals with celiac disease can productively be addressed with regard to the principle of the human right to adequate food (HRAF) from the perspective of Food and Nutrition Security (FNS). It is important to know and recognize the real need of the people who live in some way under threat of food insecurity, how it impacts their health and lifestyle. Constructing, implementing and improving health policies in order to meet their needs is imperative to provide access to adequate food of nutritional quality. and to ensure that food, biological, social and cultural needs are achieved. By understanding food as a basic human right, it is easy to understand that the absence of safe foods that address the needs of celiac individuals represents a concrete case of a group of people who often may have their rights to adequate nutrition violated. As a result, many live in a state of food and nutrition insecurity. Food must be viewed as a constitutional right of all citizens, including those with special needs which require a special diet.
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