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Needle-Phobic Pharmacist Not Protected by Americans With Disabilities Act

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October 19, 2017

This month, we look at a case that made the headlines a few years ago, but was reversed on appeal very recently. The case involved a long-term Rite Aid pharmacist who was fired after Rite Aid changed its job descriptions for pharmacists to include the requirement of administering immunizations. The pharmacist, who had a fear of needles (trypanophobia) was fired after notifying the company that he was unable to give vaccinations.

Background & Original Decision

Prior to being fired in 2011, the pharmacist had worked for Rite Aid and its predecessor pharmacies for 34 years, in a dispensing and counseling capacity. In early 2011, the pharmacist was notified that Rite Aid was going to require all pharmacists to give immunization injections. The pharmacist submitted a note from his physician, saying that he was “needle phobic and cannot administer immunization by injection.” He told human resources that his condition causes him to feel faint and that he would not even consider trying to become an immunizing pharmacist. The pharmacist believed that this condition was a covered disability under the Americans With Disabilities Act (ADA), and he asked Rite Aid to provide him with a reasonable accommodation.

Rite Aid sent a list of questions to the pharmacist’s doctor regarding his phobia and whether there were any accommodations that could enable the pharmacist to perform injections. The physician replied that if the pharmacist were to administer an injection “he would become diaphoretic, hypotensive and probably faint.” The doctor further said that the likelihood of the pharmacist fainting made immunizing unsafe for both the patient and the pharmacist. Rite Aid ultimately told the pharmacist that the ADA didn’t apply, and that he would lose his job if he didn’t successfully complete immunization training. The pharmacist refused, and was fired for refusing to perform customer immunizations, which were (now) an essential function of his job.

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The pharmacist sued Rite Aid, claiming wrongful termination under the ADA. The case went to trial. At trial, the pharmacist’s physician testified that the pharmacist suffered from trypanophobia. Rite Aid management testified that the pharmacy chain had decided that “immunizing was going to be a requirement for all of our pharmacists across the country, so anyone who couldn’t perform that essential job function wouldn’t be able to be a pharmacist.” Following trial, a jury sided with the pharmacist, and awarded him a substantial sum of money in back-pay, front-pay, and damages.

It appeared that the law on this would be that a pharmacist who suffers from needle-phobia cannot be fired from his job on that basis. But then Rite Aid appealed.

Appeal & New Decision

On appeal, a three-judge panel reversed the jury’s decision and unanimously held that Rite Aid had not violated the ADA. The court’s reasoning was that the ADA prohibits employment discrimination against “a qualified individual on the basis of disability.” The term “qualified individual” is defined as one who “with or without reasonable accommodation, can perform the essential functions of the employment position.” The court agreed with Rite Aid that giving immunizations was an essential job function for Rite Aid pharmacists at the time the needle-fearing pharmacist was terminated. The evidence showed that the company had changed its policy and job descriptions to require immunization certification, and that another pharmacist with needle phobia was also terminated, further showing that the company believed administering immunizations to be an essential function of the job. The judges then looked at whether any reasonable accommodation could be made which would allow the pharmacist to fully perform his essential job functions and concluded that the pharmacist had presented no evidence of a reasonable accommodation which would have allowed him to perform immunizations. The court ultimately held that the pharmacist could not be viewed as qualified to perform the essential functions of his job (with or without a reasonable accommodation), and thus did not qualify for protection under the ADA.

The Takeaway

 Most, if not all, major pharmacy chains require pharmacists to immunize. Flu shots, shingles and pneumonia vaccines, and other immunizations are commonly available in the pharmacy these days. If you are a pharmacist with trypanophobia, a chain pharmacy setting may not be the best option for you. Be sure to familiarize yourself with the required functions of your job, and ensure that you can perform them. However, it can happen (as in this case) that an employer changes the essential functions of a job in mid-stream, creating an unfortunate situation where an employee suddenly may no longer be able to perform all the required functions of the job. While this certainly feels unfair, according to the law as interpreted by this case, it is not illegal.

Ann W. Latner, JD, is a freelance writer and attorney based in New York. She was formerly Director of Periodicals at the American Pharmacists Association.

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