ADA §12112(d)(4) Medical Inquiries as Disability Discrimination: Back Pay Entitlement Clarified

Introduction

John Nawara, a Cook County correctional officer, initiated heated workplace altercations in 2016. The Cook County Sheriff’s Office placed him on paid—and later unpaid—leave pending a mandatory fitness-for-duty examination and execution of medical‐information release forms. Nawara sued under § 12112(d)(4) of the Americans with Disabilities Act (ADA), claiming that requiring the examination and medical releases violated the ADA’s prohibition on unconsented medical inquiries. A jury found in his favor but awarded zero damages. On post-trial motions, the district court restored his seniority but denied back pay, reasoning that under Title VII’s remedial scheme back pay is barred unless discrimination occurred “on account of” a disability. Nawara appealed the back pay denial; the Sheriff cross-appealed the seniority restoration. The Seventh Circuit’s April 1, 2025 decision resolves both issues, clarifying that any violation of § 12112(d)(4) is discrimination “on the basis of disability,” thus permitting back pay, and affirming the restoration of seniority.

Summary of the Judgment

The Seventh Circuit held that:

• Under the ADA, § 12112(d)(1) incorporates medical examinations and inquiries into the ADA’s broad prohibition of “discrimination … on the basis of disability” (42 U.S.C. § 12112(a)), so a § 12112(d)(4) violation equals disability‐based discrimination.
• The ADA’s remedial provision, 42 U.S.C. § 12117(a), adopts Title VII remedies—including back pay—subject to the limitation in 42 U.S.C. § 2000e-5(g)(2). Because requiring medical inquiries is discrimination “on account of disability,” the Title VII bar on back pay for non-discriminatory suspensions does not apply.
• The district court’s denial of back pay was reversed and remanded for calculation of back pay and lost pension benefits.
• The court affirmed the restoration of Nawara’s seniority. The Sheriff’s mootness argument failed because Nawara’s restored seniority retains utility in his subsequent position as a Sheriff’s police officer.

Analysis

Precedents Cited

• Kurtzhals v. County of Dunn (7th Cir. 2020): Held § 12112(d)(4)(A) applies to all employees, not only those with actual or perceived disabilities.
• Franks v. Bowman Transportation Co. (1976): Supreme Court recognized that seniority restoration can be equitable relief in Title VII cases.
• Food Marketing Institute v. Argus Leader Media (2019): Plain-meaning statutory interpretation governs when text is clear.
• United States v. Ron Pair Enterprises (1989): Courts must enforce statutes according to their terms if the language is plain.

Legal Reasoning

1. Statutory Text and Structure
The ADA’s core prohibition (§ 12112(a)) forbids “discrimination … on the basis of disability” in employment terms and conditions. Subsection (d)(1) provides that this general ban “shall include medical examinations and inquiries.” Subsection (d)(4)(A) then limits employer-required medical examinations and inquiries to those “job-related and consistent with business necessity.”

2. Incorporation of Title VII Remedies
Section 12117(a) incorporates Title VII’s remedial scheme (42 U.S.C. § 2000e-5). Under § 2000e-5(g)(1), courts may award back pay. Section 2000e-5(g)(2)(A) bars back pay if the adverse action was for any reason “other than discrimination on account of” a protected characteristic. In a Title VII context, that characteristic is race, sex, religion, etc. Under the ADA, that characteristic becomes disability.

3. Linking § 12112(d)(4) to Disability Discrimination
The Seventh Circuit rejected the district court’s view that medical inquiries are merely one more way of discriminating under § 12112(a). Instead, it held that the statute’s plain language defines any § 12112(d)(4) violation as discrimination “on the basis of disability,” even if the employee is not actually or perceived to be disabled. This interpretation avoids rendering § 12112(d)(1) surplusage and aligns with the ADA’s broad remedial purpose.

4. Back Pay Availability
Because a § 12112(d)(4) violation is necessarily discrimination on account of disability, the Title VII bar on back pay for non-discriminatory suspensions does not apply. The Sheriff’s violation supports an award of back pay and pension benefits.

5. Seniority Restoration and Mootness
The Seventh Circuit affirmed seniority restoration under Franks v. Bowman. The Sheriff’s mootness argument failed; Nawara’s seniority still benefits him in tie-breaking under collective-bargaining agreements in the Sheriff’s police department.

Potential Impact

This decision has significant implications for ADA litigation:

• It clarifies that any unlawful medical inquiry or fitness-for-duty requirement under § 12112(d)(4) is discrimination on the basis of disability, entitling successful ADA plaintiffs to back pay and other equitable relief.
• Employers must carefully ensure that fitness-for-duty exams and disability-related record requests are unequivocally “job‐related and consistent with business necessity.”
• The ruling may encourage more ADA claims challenging pre-employment and return-to-work medical screenings where employees have no actual or perceived disability.

Complex Concepts Simplified

• “Discrimination on the basis of disability”: Under the ADA, this phrase covers not only firing or demoting disabled employees but also any improper medical questions or exams.
• “Job‐related and consistent with business necessity”: Fitness‐for‐duty exams are allowed only if the employer can prove they are essential to the safe performance of the job.
• “Back pay”: Financial compensation covering the period an employee lost wages due to an ADA violation.
• Title VII remedial incorporation: The ADA borrows the remedies and procedures from Title VII, modified so that “race” and “sex” become “disability.”
• Mootness and seniority: A case is moot if there’s no longer any live dispute. Here, restored seniority remains relevant in the employee’s new role, so the dispute persists.

Conclusion

The Seventh Circuit’s decision in Nawara v. Cook County Municipality establishes that mandatory fitness-for-duty exams and medical‐information releases violate the ADA’s ban on disability-based discrimination, even for non-disabled employees. By construing § 12112(d)(4) violations as discrimination “on the basis of disability,” the court ensures that successful plaintiffs may recover back pay under the ADA’s adoption of Title VII remedies. The ruling reinforces the ADA’s broad remedial goals and compels employers to limit medical inquiries to those essential for safe and effective job performance.