ADA Section 309 Requires Accessible Examination Procedures, Not Score‐Adjustment Mandates

Introduction

Jason Zangara v. National Board of Medical Examiners is a consolidated appeal decided by the United States Court of Appeals for the Third Circuit on April 28, 2025. The appellant, Jason Zangara, is a medical student diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and learning disorders who challenged the scoring methodology employed by the National Board of Medical Examiners (NBME) on several standardized exams required for medical licensure. Zangara argued that NBME’s practice of equating and scaling scores based on historical test‐taker performance discriminates against examinees with disabilities, in violation of Title III of the Americans with Disabilities Act of 1990 (ADA), the Rehabilitation Act of 1973, and analogous state‐law provisions. The District Court dismissed all claims under Federal Rule of Civil Procedure 12(b)(6), and Zangara appealed the dismissal of his ADA claim. The Third Circuit affirmed, holding that under ADA Title III § 309 a plaintiff must allege a failure to provide an accommodation or an inaccessible testing procedure, not merely that the scoring method produces disparate outcomes.

Summary of the Judgment

The Third Circuit held, by a per curiam opinion, that Zangara failed to state a plausible claim under Title III of the ADA. Section 309 of Title III governs examinations and requires entities like NBME to offer tests “in a place and manner accessible to persons with disabilities or offer alternative accessible arrangements.” The court reaffirmed the binding precedent of Doe v. National Board of Medical Examiners, 199 F.3d 146 (3d Cir. 1999), which clarified that ADA § 309 imposes an obligation to provide exam‐center or procedural accommodations—not to alter the psychometric scoring methodology or require that disabled and nondisabled test‐takers’ scores be “psychometrically comparable.” Because Zangara’s amended complaint did not plead that he had requested or been denied any specific accommodation or that NBME administered an exam in an inaccessible location or manner, his suit rested entirely on challenging NBME’s equating and scaling procedures—claims foreclosed by Doe. The Third Circuit affirmed the dismissal with prejudice.

Analysis

Precedents Cited

• Doe v. National Board of Medical Examiners, 199 F.3d 146 (3d Cir. 1999) – Held that ADA Title III § 309 requires examiners to provide accessible testing conditions or alternate arrangements, but does not mandate equalized scoring across disabled and nondisabled cohorts.
• Phillips v. County of Allegheny, 515 F.3d 224 (3d Cir. 2008) – Articulated that in reviewing a Rule 12(b)(6) motion, a court must accept a plaintiff’s well‐pleaded factual allegations as true.
• Bell Atlantic Corp. v. Twombly, 550 U.S. 544 (2007) and Ashcroft v. Iqbal, 556 U.S. 662 (2009) – Established the “plausibility” standard for surviving a Rule 12(b)(6) dismissal.
• E.E.O.C. v. Kronos Inc., 620 F.3d 287 (3d Cir. 2010) – Concerned the scope of EEOC investigative subpoenas in disparate treatment and disparate impact contexts; discussed but did not alter the principles of accommodations under ADA § 309.

Legal Reasoning

1. Statutory Framework: Title III of the ADA prohibits discrimination by public accommodations, including “eligibility criteria that tend to preclude … persons with disabilities” (42 U.S.C. § 12182(b)(2)(A)(i)). Section 309 provides a more specific mandate for entities “that offer examinations … for secondary or postsecondary education, professional, or trade purposes” to administer tests “in a place and manner accessible to persons with disabilities or offer alternative accessible arrangements” (42 U.S.C. § 12189).

2. Binding Precedent—Doe: The Court emphasized that Doe remains the controlling decision on ADA § 309. In Doe, the Third Circuit rejected the argument that ADA § 309 imposes a broad requirement to equalize outcomes or scores between disabled and nondisabled candidates. Instead, it requires only that examiners remove “features” that disadvantage disabled examinees by providing alternate accessible arrangements, such as extended time or assistive technology, not wholesale score‐adjustment formulas.

3. Failure to Allege Accommodations Claims: Zangara’s amended complaint did not allege that he ever requested a reasonable accommodation, was denied one, or was forced to take an exam in an inaccessible site or format. His suit attacked only the equating and scaling methodology—which compares each candidate’s raw performance to that of a historical “anchor group.” Under Doe, such a challenge does not state a Title III § 309 claim.

4. No Expansion of the § 309 Remedy: The appellant urged the court to read ADA Title III more broadly by combining provisions of general public‐accommodations law (§ 302), examination‐specific law (§ 309), and Title I employment‐testing rules. The Third Circuit declined to rewrite the statute or depart from Doe. It stressed that only Congress or the Supreme Court can overrule binding precedent, and it found no reason to carve out an exception for disparate‐impact or scoring‐methodology challenges under § 309.

Impact on Future Cases

• Reaffirmation of the Doe Rule: Courts will continue to require plaintiffs challenging professional or licensure exams to allege a discrete failure in the “place and manner” of administration or a denial of a requested accommodation.
• Limitation on Broad Disparate‐Impact Suits: The decision discourages theories that equate statistical or normative scoring methods with ADA discrimination absent an accompanying procedural accommodation claim.
• Guidance for Exam Administrators: Private testing bodies should maintain clear, reasonable processes for handling accommodation requests, but need not abandon or re‐engineer established equating and scaling techniques.

Complex Concepts Simplified

Equating and Scaling Methodology

A statistical process that adjusts raw test scores based on question difficulty and historical performance data to ensure fairness across different exam forms.

Accessible Place and Manner (ADA § 309)

The requirement that an examination be given in an environment and format that disabled examinees can use, such as a quiet room, extra time, or assistive devices—rather than a mandate to change how scores are calculated.

Reasonable Accommodation

Modifications or adjustments to a testing procedure (e.g., extended time, private room) that enable a person with a disability to participate on an equal basis without fundamentally altering the nature of the exam.

Conclusion

The Third Circuit’s decision in Zangara v. NBME clarifies that under ADA Title III § 309, plaintiffs challenging standardized professional or licensure exams must allege failures to provide accommodations or inaccessible testing conditions—not simply that an exam’s scoring process produces lower scaled scores for disabled candidates. By reaffirming Doe and applying the Rule 12(b)(6) plausibility standard, the court put to rest expansive theories of “score‐equalization” remedies under § 309. The ruling thus preserves a clear, administrable line between procedural accommodations and substantive alterations of scoring methodologies in ADA examination suits.