ADA § 12112(d)(4): Mandatory Leadership Coaching Is Not a “Medical Examination” Absent Evidence of a Procedure/Test Seeking Impairment Information

Introduction

Case: K. Jeff Carney, M.D., PHARMD v. Emory University (11th Cir., Apr. 15, 2026) (unpublished)
Parties: Dr. K. Jeff Carney (plaintiff-appellant), Emory University (defendant-appellee)
Core issue: Whether Emory violated ADA § 12112(d)(4)(A) by requiring Dr. Carney to attend “leadership coaching” following resident complaints—allegedly a prohibited “medical examination” or disability-related inquiry not shown to be job-related and consistent with business necessity.

Dr. Carney, an Emory urologist and key residency-program leader at Grady Hospital, became the subject of complaints from residents concerning professionalism, respectfulness, and alleged inappropriate touching and jokes. Emory investigated, concluded there was no cause for discipline, but directed Dr. Carney to complete sensitivity-related professional development and to engage in coaching focused on conflict navigation, leadership, and responding to feedback. The coaching was to be with Gordon Tuttle of Emory’s Faculty Staff Assistance Program (FSAP) (a licensed psychologist) or an alternate coach (Rick Brandt).

Dr. Carney refused coaching for months, viewed the requirement as demeaning, and believed it was effectively an unlawful mental-health examination—particularly given alleged prior comments by his chair that he needed his “head examined.” After his nonrenewal, Dr. Carney met twice with Tuttle; during the first meeting, Tuttle asked general well-being questions (sleep, appetite, stress, etc.). Dr. Carney sued under ADA § 12112(d)(4)(A). The district court granted summary judgment to Emory, and the Eleventh Circuit affirmed.

Summary of the Opinion

The Eleventh Circuit held that the record did not permit a reasonable inference that Emory’s coaching requirement included a “medical examination” or a prohibited disability-related inquiry under ADA § 12112(d)(4)(A). The court emphasized that:

  • Emory directed “coaching” for leadership/conflict/feedback skills—not psychological counseling or testing.
  • There was no evidence Dr. Carney was required to undergo any “procedure or test” seeking information about mental impairments or health.
  • The mere fact that a coach was a psychologist, or that FSAP offered clinical services, did not establish that Emory required a medical exam.
  • General well-being “check-in” questions—especially in the context of a major life event (here, job loss)—did not convert coaching into a medical exam.
  • Speculation about what an alternate coach “would have done” could not defeat summary judgment.

Because no medical examination (or prohibited inquiry) was shown, the court did not need to resolve whether the requirement was job-related and consistent with business necessity.

Analysis

Precedents Cited

Owens v. Governor's Office of Student Achievement

The court cited Owens for the summary-judgment framework: de novo review, viewing evidence favorably to the nonmovant, but only drawing “justifiable” inferences. This mattered because Dr. Carney’s theory depended on inferring medical-exam content from job-coaching directives and the psychologist’s credentials—an inferential leap the panel treated as unjustified.

Cordoba v. Dillard's, Inc. and Boyle v. City of Pell City

These cases supplied the court’s repeated theme: speculation is not evidence. Cordoba is quoted for the proposition that speculation creates “false” issues that summary judgment is designed to eliminate, and Boyle supports that merely “colorable” or weakly probative evidence cannot survive summary judgment. The panel used these principles to reject Dr. Carney’s attempt to bootstrap a medical-exam claim from (i) FSAP’s broad menu of services, (ii) a generic consent form, and (iii) the coaches’ psychology backgrounds.

Owusu-Ansah v. Coca-Cola Co.

Owusu-Ansah was invoked for a key doctrinal point under ADA § 12112(d)(4)(A): a plaintiff need not be disabled (or regarded as disabled) to challenge an unlawful medical exam/inquiry. This clarified that Dr. Carney’s claim did not turn on proving disability; it turned on whether Emory “requested a medical examination or inquired into medical status” in the first place.

Mullin v. Sec'y. v. U.S. Dep't of Veterans Affs.

The court relied on Mullin to frame the trigger for § 12112(d)(4): it applies when an employer requests a medical examination or inquires into an employee’s medical status. This focus narrowed the case to a threshold question—was “leadership coaching” in this record a medical exam/inquiry at all?

Harrison v. Benchmark Electronics Huntsville, Inc.

Harrison supported the court’s use of EEOC enforcement guidance as persuasive authority: while not controlling, it is a “body of experience and informed judgment” that can guide interpretation where statutory/regulatory text does not define “medical examination.”

Kroll v. White Lake Ambulance Auth.

Kroll served as the panel’s principal comparator for when employer-mandated mental-health-related interventions can become ADA-regulated medical examinations. From Kroll (which quotes the EEOC guidance), the Eleventh Circuit adopted the definition of a medical examination as a “procedure or test” that seeks information about physical or mental impairments or health. The panel distinguished Kroll on the facts: unlike an open-ended referral for “psychological counseling,” Emory’s direction was for leadership/conflict coaching tied to workplace dynamics and communication.

The court also referenced Kroll’s caution that an employer’s stated intent is not dispositive if the employer requires a process “likely to probe and explore” whether the employee has a mental-health disability. The panel concluded that the record here did not show coaching “likely” to do that—especially absent testing, diagnoses, or follow-up probing.

Karraker v. Rent-A-Center, Inc.

Karraker was cited as an example of a clear medical examination: administering the Minnesota Multiphasic Personality Inventory (MMPI), which is designed to identify mental disorders. This contrasted sharply with Emory’s coaching requirement and the “check-in” questions asked in a single session.

Fernandez v. Seaboard Marine LTD.

Fernandez reinforced the boundary between permissible inference and impermissible conjecture. The court used it to reject Dr. Carney’s argument that a statement about Brandt helping with “mental issues” reasonably implied Brandt would conduct psychological testing or a diagnostic assessment. Without evidence of what Brandt’s sessions entailed, the inference was deemed a “guess.”

Timson v. Sampson

While not central to the ADA issue, Timson was used to hold that Dr. Carney abandoned an unrelated de facto tenure claim by not briefing it on appeal. The citation signals the panel’s adherence to strict appellate preservation rules.

Legal Reasoning

The opinion proceeds in a structured ADA § 12112(d)(4)(A) sequence:

  1. Threshold inquiry: Did Emory require a “medical examination” or prohibited disability-related inquiry?
    • Because neither the ADA nor its regulations define “medical examination,” the court used the EEOC guidance definition: a “procedure or test” seeking information about mental/physical impairments or health, informed by the EEOC’s multi-factor approach (including whether a healthcare professional administers it, whether it is designed to reveal impairment, and whether it is medical in setting/equipment).
    • Applying that definition, the court concluded “leadership coaching” as described in Emory’s directives was job-skill oriented: conflict navigation, leadership, communication, and response to feedback.
    • Critically, the court emphasized the absence of evidence of any mandated test, diagnostic tool, clinical exam, or impairment-focused procedure.
  2. Rejecting categorical proxies: The court declined to treat the following as sufficient, standing alone, to establish a medical exam:
    • FSAP’s ability to provide clinical mental-health services.
    • A broad consent form referencing “assessments” and “interventions.”
    • The fact that Tuttle and Brandt were psychologists.

    The underlying principle is evidentiary specificity: § 12112(d)(4) analysis turns on what the employer required this employee to do, not what a program could offer.

  3. “Check-in” questions and context:
    • Dr. Carney relied heavily on Tuttle’s initial well-being questions (sleep, appetite, stress). The court treated these as consistent with the EEOC guidance permitting general “How are you?” inquiries, including after major life events.
    • The court also found it unreasonable to extrapolate backward: the first session occurred after nonrenewal, and Dr. Carney refused to discuss the coaching’s intended leadership/conflict topics. Those circumstances undercut any inference that earlier coaching—had he complied—would have involved the same content or a medical inquiry.
    • The court noted the absence of follow-up probing, psychological testing, medical-record review, or diagnosis—facts that supported treating the interaction as nonmedical coaching rather than impairment investigation.
  4. Disposition without reaching business necessity: Having found no medical exam/inquiry, the court affirmed summary judgment without deciding whether the requirement was job-related and consistent with business necessity.

Impact

Although unpublished and thus nonprecedential in the strict sense, the decision provides a practical roadmap for how courts in the Eleventh Circuit may evaluate ADA § 12112(d)(4) claims involving employee assistance programs (EAPs), faculty/staff assistance programs, and “executive” or “leadership” coaching:

  • Substance over labels—but evidence still matters: Plaintiffs cannot rely on “psychologist” titles or generalized program descriptions; they must show the employer required a procedure or test aimed at impairment/health information or questions likely to elicit disability information.
  • Well-being inquiries are not automatically “disability-related”: Basic questions about stress, sleep, or coping—particularly after a significant event—may be treated as permissible, absent probing designed to uncover disability.
  • Reduced chilling effect on coaching interventions: Employers may view the opinion as lowering litigation risk for requiring professional coaching following substantiated interpersonal or professionalism concerns—so long as the intervention is framed and implemented as skills-based, not diagnostic.
  • Litigation strategy signal: Future plaintiffs will likely need discovery focused on the actual content of mandated sessions (protocols, questionnaires, testing instruments, documentation practices, diagnoses, referrals) rather than relying on program capability or provider credentials.

Complex Concepts Simplified

1) What does ADA § 12112(d)(4)(A) prohibit?

It generally bars employers from requiring current employees to undergo medical examinations or making disability-related inquiries unless the employer can justify them as job-related and consistent with business necessity.

2) “Medical examination” vs. ordinary workplace coaching

Using the EEOC guidance, a “medical examination” is a procedure or test that seeks information about physical/mental impairments or health—like diagnostic psychological testing (e.g., the MMPI referenced via Karraker v. Rent-A-Center, Inc.).

By contrast, coaching focused on communication, leadership, and conflict resolution is typically framed as skills development. It becomes legally risky under § 12112(d)(4) only when it functionally operates as an impairment investigation—through testing, diagnosis-oriented questioning, medical-record review, or similarly clinical processes.

3) “Disability-related inquiry”

The EEOC guidance describes this as questions likely to elicit information about a disability. The opinion underscores that general “how are you doing” questions, even touching on stress or sleep, can be permissible—especially after a major life event—unless they are used to probe for a disability.

4) Why “speculation” fails at summary judgment

Summary judgment can be defeated only by evidence creating a genuine dispute of material fact. The court held that guessing what a psychologist-coach “would have done,” without evidence of a required test/procedure, is conjecture (as emphasized through Cordoba v. Dillard's, Inc. and Fernandez v. Seaboard Marine LTD.).

Conclusion

The Eleventh Circuit affirmed summary judgment for Emory because Dr. Carney did not produce evidence that the mandated leadership coaching required any medical “procedure or test” or disability-probing inquiry under ADA § 12112(d)(4)(A). The opinion’s practical takeaway is that an employer’s requirement to participate in leadership/conflict coaching—without psychological testing, diagnosis-oriented assessment, or probing disability inquiries—will generally not be treated as a prohibited medical examination, even if delivered by a licensed psychologist within an assistance-program setting.