K. - Epilepsy Foundation THE UNITED STATES COIJRT OF APPEALS FOR THE NINTH CIRCUIT NO. 83-2197 Bonnie Mantolete, Plaintiff - Appellant V. William G. Bolger, et al., Defendants - Appellees

IN THE

UNITED STATES COIJRT OF APPEALS

FOR THE NINTH CIRCUIT

NO. 83-2197

Bonnie Mantolete,

Plaintiff - Appellant V.

William G. Bolger, et al.,

Defendants - Appellees

ON APPEAL FROiUI THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ARIAONA

EPILEPSY FOUNDATION OF AMEHICA AND

CENTRAL ARIZONA REGIONAL EPILEPSY SOCIETY

IN SUPPORT OF APPELLANT

Alexandra K. Finucane Attorney at Law Epilepsy Foundation of America 4351 Garden City Drive Suite 406 Lanaover, Naryland 20785

Attorney for Amici Curiae (301) 459-3700

November 7, 1983

TAdLE O F CONTENTS

TAE$LE OF AUTHORITIES .................................... TABLE OF CITATIONS TO THE coum R E C O ~ .................. INTEREST O F A M I C I CURIAE ................................

..................................... SUlYMARY O F ARGUMENT

ARGUMENT ................................................ I e POSSIBILI'I'Y OF HARP4 I S AN INADEQUAI'd JUSTIFICATION

FOR REFUSING EivlPLOYtYENT TO PERSONS WITH EPILEPSY AND I S NOT SUPPORTED EITHER k3Y AN UNDEKSTANDILJG O F THE ZPILEPSIES OK BY EXPdKIENCE. .............

A , C u r r e n t ivIedica1 K n o w l e d g e and T r e a t m e n t of t n e E p i l e p s i e s maKes i t P o s s i o i e f o r t n e ivlajority of I n d i v i d u a l s w i t n t h e Uisorder t o be S a f e l y a n d Productively E m p l o y e d . ...............................

B., E x p e r i e n c e Demonstrates t n a t P e r s o n s w i t h E p i l e p s y c a n be S a f e l y a n d I_

P r o d u c t i v e l y E m p l o y e d . .................... 11, POSSIBILITY OF rlAfiq A S A JUSTIFICATION

FOR REFUSING EivlPLOYMENT T O PERSONS ~J1'fi-i EPILEPSY CONTRAVENES PUk3LIC PULICY SEHIND THd REHAdILITATION ACT O F 1 9 7 3 . .............. A. T n e Law and P u b l i c P o l i c y Requires

F u l l Access t o E m p l o y m e n t f o r Handicapped P e r s o n s , .................................

ae N e g a t i v e E m p l o y e r A t t i t u c l e s a r e a Major R e a s o n P e r s o n s w i t h E p i l e p s y a r e dxc luded from f i m p l o y m e n t . ............

I I I . P U B L I C POLICY AND 'THE NA'I'UKE OF THE EPILEPSIES REQUIRE THAT EiYPLOYERS UB~0NSTM'T.E A SU~STANTIAL AND CURRENT PROBABILITY OF HAKtvl BJLFORE EXCLUDING AN INDIVIDUAL WITH EPILEPSY PROM THE NOHKPLACE.

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4 L

TABLd OF AUTHORITIES

Page

CASES

In re Samuel Bingham Co., 67 LaD. Arb, 7 0 6 (1976)

Bucyrus-Erie Company v. DILHR, 90 Nis- Ld 4 0 8 , 280 N.W Ld 142 (1979)

Chicago and Nortnwestern R.R. v. Labor and Industry Review Commission, 91 N i s a Ld 4b2 , 2 8 3 N.w. Ld 603 ( d i s . App. 1979)

Griffin v. Illinois Dept. of Law Enforcelnent ivlerit 130ardt Charge No. 1980 CLV 0 0 3 5 , Recommended Order and Decision (Ill, Hum. Rts. Comm. lY82)

Montqomery Ward V. Bureau of LaDorl ,280 Ore. 570 P.2d 7 6 (1977)

In re Trans Worla Airways, Inc., 74 LaD. Aro. 1154 (April 1 6 , 1980)

Rose v, Hanna Mining Company, 616 P.2d 1229 (Wash. Sup. Ct. 1980)

Ross v. Gama Shoes, 20 F.E.P. 150 (U.C. Sup. Ct, % ’’

1980)

STATUTES

The Rehabilitation Act of 1 5 7 3 , 29 U.S.C. SS791 - et seq., as amended by P.L. 95-002

Act to Establish the Commission for tne Control of Epilepsy and Its Consequences, d 9 Stat. 348 (1975), P,L. 94-63

The Civil Rights Act of 1964, 42 U.S.C. S 2 0 0 0 et seq. -

Title IX of the Education Amendments of l Y 7 2 , 42 U.S,C. S 1683

CONGRESSIONAL MATERIALS

S. Rep. No. 93-318, 93d Cong., 1st S e s s , 4, reprinted in (1973) U.S, Code Cong. & Ad, News 20/8

3 5 , 3 9

3b

3 6

37, 3 8

36 , 37

37, 3 8

3 4

3 8

5

19

19

20

S. Reps No. 93-48, 93d Cong., 1st Sess. (1974)

S, Rep. No. 93-1139, 93d Conyaf 2d Sess. (1974

S. Rep. No. 93-1297, 93d Cong., 2d Sess. 56, reprinted in (1974) U . S . Code Cong. & Ad, News 6373, 6 4 0 6

118 Cong. Rec. 32310 (1973)

Over ,sight Hearings on Rehab1 Handicapped Programs and of Same by Agencies unde

A c t of 1973. &fore the

sight Hearings on Rehabilitation of tne Handicapped Programs and the Implemencatlon of Same by Agencies under tne Renaollltation Act of 1973, defore the SuPcommittee on the Handicapped of tne Senate Committee on Labor and Public Welfare, 94th Congel Ld Sessef pt. 3, 1 5 0 2 (1976)

litation of tne the Implemencatlon

aoilitation ~. ttee on the

Handicapped df tne Senate Committee on Labor and Public Welfare, 94th Congel Ld Sessef pt. 3, 1 5 0 2 (1976)

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20

19, 2 0

20

OTHER AUTHORITIES

r tne Ren SuPcommi

Annegers, Hauserr et ale, Remission of Seizures and Relapse in Patients with Epilepsy, LO Epilepsia 723 (1Y7Y)

Arangio, Behind tne Stigma of Epilepsy, Epilepsy Foundation of America ( l Y 7 5 )

Benson, Epilepsy and Employment: Placement Problems and Techniaues, 3 American HenaDilitation 3 (Mar cn/Apr a'l 13 7 d )

Brief of amicus curiae American urtnopsycniatric Assn. in Glassman v. New YorK Medical College, 11753/ 1969 (Sup. Ct. N . Y . 1969)

Brody, Epilepsy': Dispelling the Mytns, New YorK Times, April 19, 1978

Burgdorf and durgdorf, A History of Unequal Treatment: The Qualifications of Handicapped Persons as a "Suspect Class" under the Equal Protection Clause, 15 Santa Clara Law. 885 (1975)

Caveness and Gallup, A Survey of Public Attitudes Toward Epilepsy in 1979 Witn An Indication of Trends Over the Past Thirty Years, 21 Epilepsia 503 (1980)

Commission f o ~ the Contro-8 of Epilepsy I t s Consequences, U.S. Department of Health, Education and Nelfare, Plan for Nationwide Action on Epilepsy, Volumes 1, II (DHEVJ PuDlication Nos.: (NIH) 78-27b and 78-312 (1978

2 2

37

2 4

30

33

2 5

28

25

5, b # 12, 25, 27f 2 8 ? 30, 31

13 E. I. duPont de Nemours ancl Cor Equal to tne 'Task (1982)

Eilers and Malone, Impact on Employer Insurance Coats of Hiring Persons With Epilepsy, Epilepsy Foundation of America: Wasnington, D.C. ( 1 9 6 b )

the Epilepsies, F.A. Uavis Company: Philadelphia,

12

Epilepsy Foundation of America, Basic Statistics on

Pa. (19/5) 12

(Nov. 1382 ) 15

Tne Evolutlon or tne 'l'raining and Placement Service: An Historical Perspective

. How to Recounize and d

Classify Seizures, A Supplement to tne 211 minute color & sound rilm

I Interviewing Guiae for the Epilepsies, developed with U . S . Oepartment of LaDor funds

I Tne Leqal Kignts of Persons with Epilepsy, Epilepsy Founaation of America: Washington, D.C. (1976) 27

, New Directions in dpilepsy Rehabilitation: H Resource ivlanual, Epilepsy Foundation

of America: NaShingtOn, D. C. (1379) 29

Equal Employment Opportunity Commission, Employment of Handicapped Individuals incluaing DisaDled Veterans in the Federal Government, Washington, D.C. (1980) 2 3

Fdblng and Barrow, Medical Discovery As A Legal Catalyst: Modernization of Epilepsy Laws to Heflect the ivledical

Progress, 50 Nw.U.L.Rev. 42 (1955) Lo

Finesilver, The Leqal Aspects of Epilepsy, in dpilepsy Rehabilitation 51, (G. N. Wrignt, ed.)(1975) 26

Hardin, Employment Discrimination and L'pilepsy, Epilepsy Foundation of America, Wasnington, U.C. (1980) 21

Hayesl Factors Influencing EmployaDility: An Analysis of the Successful Training and Placement Service, paper presented at the 1983 International Symposium on Epilepsy, Sept, 26-30, Wasnington, D o c s l to be published in 1984 in proceedings of XVth Epilepsy International Symposium 16

Kovarsky and Hauck, Arbitration and the Epileptic, a977 Lab, L,J, 597 3 3

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I

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111

Linn, Uncle Sam Doesn't Want You: Entering the Federal Stronghold of Employment Discrimination Against Handicappea Individuals, 27 De Paul L. Rev. 1047 (1978)

Masland, Epileptics: Their Medico-Legal Problems and Confrontations, 7 Law. Med. J. 339 (1979).

Risch, Attitudes and Practices in Industry, Tor;al Rehabilitation of the Epileptic ( G , N . Wrignt, ed. 1962)

Risch, The Industrialization of tne Person with Epiiepsy, paper presented at the 1983 International Symposium on Epilepsy, Sept. 26- 30, Wasnington, 0.C. to De pualished in 1984 in proceeaings of tne XVtn k3pilepsy

International Symposium

Sands and Zalkind, Effects of an Educational Campaign to Change Employer Attituaes Toward Hirinq Epileptics, 1 3 Epilepsia 87 (1972)

Smolin, The Epilepsies: Their Effect on tne BiolFqical Family, The State-Decreed Family, and Civil Liability - in California, 13 San Diego L. Rev. 978 (1976)

U . S . Commission on Civil Rights, Accommodating tne Spectrum of Individual Abilities, Clearingnouse PUD. d 1 (Sept. 1983)

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28

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TABLE OF CITATIONS TO THE COURT RECORD

Page CR N u m b e r 1 8 2 ( R e p o r t e r ' s T r a n s c r i p t of T r i a l

Proceedings, V o l s . A-E)

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INTERES'P OF AMICI CURIAE:

The Epilepsy Foundation of America is a non-profit corporation

founded in 1968 to advance tne interests of the two million

Americans with epilepsy througn research, vocational programss

public information and education, psofesslonal awareness, and

advocacy. The Epilepsy Foundation of America nas a long standlny

interest and commitment to secure the legal rignts of persons witn

epilepsy ana encourage the development of legal principles Dased

on current medical and psychosocial concepts, sdther than on

stereotyped pre~udices and outmoded perceptlons, wnicn have no

basis in fact, about people witn seizures.

Since its founding, the Epilepsy F o u m a t r o n os America has

compiled, maintained, published, and periodicalLy upaatea a

comprehensive survey of state laws and administrative p c j l i c ~ e s

relating to persons with epilepsy. Tnrougn tnis survey and otner

legal advocacy efforts, the epilepsy Foundation of Mnerica n a s

sought and attained tne reform of state ana federal law, including

the repeal of arbitrary laws which prohiuited persons with

epilepsy from marriage or subjected them to involuntary

sterilization.

The Central Arizona Regional Epilepsy Society (CARES) is a

non-profit corporation founded .in 1972. CARES is affiliated with

t h e Epilepsy Foundation of America; its territory includes all of

Maricopa County.

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The primary purpose of CARES is to educate the pu~lic and to

help eradlcate myths and misconceptions about epilepsy,

is accomplished through the distribution of puDlic information

materials, the School Alert program, monthly puDlic meetings witn

speakers! counselling, and through dlrect asslstance to persons

with epilepsy in overcoming the many psychosocial problems they

may face as a result of the disorder.

This goal

The term "epilepsy" evokes stereotyped images and fears,

affecting persons with this meaical condition in all aspects of

life, including employment, Since its inception, tne Epilepsy

Foundation of America has stood against the stigma and

estrangement associated with epilepsy.

America and its affiliates have encouragea soc ie t y to view the

person with epilepsy in a more realistic fashion -- as a n

individual who has many capabilities and whose dysfunction is

often quite limited in scope and in time,

Tne Epilepsy Foundation of

* Amici have entered this lawsuit because of their belief

that it involves issues and principles of law important t o a l l

persons witn epilepsy, Affirmance of the District Court's

decision would strike a serious blow t o efforts aimed at

integrating persons witn epilepsy into tne mainstream of societyI

and amici support appellant?s petition to reverse the lower court

order

* In accordance with R u l e 29 of the Federal Rules of Appellate Procedure, written permission for amici to file this brief has been obtained from all parties and is appended hereto.

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SUMMARY OF AKGUivlEl~T

Amici will address one or the primary questions presented

to this Court: whether the District Court used the proper legal

standard in finding Bonnie Mantolete was not a qualified

handicapped person within the protection of the Rehabilitation Act

of 1973, because she presented some elevated risK of injury on the

job.

should not and cannot be excluded from the workplace based upon a

It is the contention of amici that persons with epilepsy

possibility of injury.

Rehabilitation Act of: 1973 is to afford tne handicapped full

participation in American societyB with particular emphasis on

equal access to employment in accordance with individual

capabilities and skills. Current medical knowledge and treatment

makes it possible for the majority of persons with epilepsy to be

employed in almost any job, with the caveat that an individualized

determination of capability and safety in the workplace be made.

To allow employers to exclude persons with epilepsy from

employment because of the possibility of a seizure would

effectively bar all persons with epilepsy from tne workplace, and

would contravene the puDlic policy mnind tne Rehabilitation Act.

Instead, before excluding a person with epilepsy from employment

because of safety concerns, employers should be required to show a

reasonable and current probability that the individual will have a

seizure on the j o b and be harmed.

The public policy behind the

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ARtiUAENT

I , POSSIBILITY OF HARM IS AN INAOEQUA'L'E J U S T I F i C A T I O N FOR REFUSING EiWLOYiYENT TO PERSONS NI 'YH EPILEPSY AND I S NOT SUPPORTED EITkWH k3Y AN UNDfiKSTANDING O F THE EPILEPSIES OK BY EXPFAIENCE.

To al low employe r s g e n e r a l l y t o u s e t h e p o s s i D i l i t y of a

f u t u r e s e i z u r e c a u s i n g i n j u r y on t h e j o b as a s u f f i c i e n t

j u s t i f i c a t i o n f o r deny ing employment t o p e r s o n s w i t h e p i l e p s y

would have t h e d i s a s t r o u s e f f e c t o f e s s e n t i a l l y b a r r i n g a n e n t i r e

g r o u p of hand icapped p e r s o n s from t h e work f o r c e . By t h e v e r y

n a t u r e o f t h e d i s o r d e r a l l p e r s o n s w i t h e p i l e p s y r u n some r i s k of

h a v i n g a n o t h e r s e i z u r e a t some f u t u r e t i m e , a l t n o u g h t h l s E i S K

v a r i e s d r a m a t i c a l l y among i n d i v i a u a l s . Tne chance t h a t a n

i n d i v i d u a l w i l l be a t w o r k when a s e i z u r e o c c u r s r though a lesser

r i s k , is p r e s e n t . There a l s o e x i s t s a n even smaller c h a n c e t n a t

a n i n d i v i d u a l may be i n j u r e d w n i l e on t h e J O D because of

s e i z u r e - r e l a t e d a c t i v i t y . F o r t u n a t e l y , fo r t h e overwhelming

m a j o r i t y of g e r s o n s w i t h e p i l e p s y , i n t h e m a j o r i t y oL jobs , t h e

p o s s i b i l i t y i s j u s t t h a t - a remote p o s s i b i l i t y . Most p e r s o n s

w i t h e p i l e p s y have s e i z u r e s t n a t a re e i t he r c o m p l e t e l y c o n t r o l l e d

O K w e l l - c o n t r o l l e d by mediCatiOn. P e r s o n s who have n o t had

s e i z u r e s fo r a spec i f ic l e n g t h of t i m e may be COnsideKed t o be i n

r e m i s s i o n . Among those i n d i v i d u a l s wnose s e i z u r e s a r e n o t

c o m p l e t e l y c o n t r o l l e d , t h e l i k e l i h o o d of employment i n j u r y i s

s u b s t a n t i a l l y reduced, e i t he r b e c a u s e s e i z u r e s a r e i n f r e q u e n t ,

occur only a t a t i m e or i n s i t u a t i o n s n o t e n c o u n t e r e d i n t h e

workplace, have f a l l e n i n t o a predic table p a t t e r n , or because

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realistic dangers are not present due to the nature of tne

workplace, Other individuals with epilepsy may continue to have

frequent seizures, but of a type tnat creates no foreseeaDle

hazard in the workplace. All of tnese individuals snould be

safely employable in almost any j o D because tne proDaDllity of a

seizure on the J o b - much less a seizure resulting in injury to the employee or fellow employees - is not high.

A. Current Medical Knowledge and Treatment of the Epilepsies maKes It PossiDle for the Majority of Individuals with the Disorder to be Safely and Productively Employed.

Few medical conditions are as misunderstood or as

surrounded by myths as epilepsy, despite vast medical advances in

knoMledye and treatment of the epilepsies in recent years, The

Congressionally-created Commission €or the Control of Epilepsy and

Its Consequences in its 1 9 7 7 report stressed the acute need of all

people for a greater awareness and understanding of this

condition*'

comprehend the problems or the potenr;ial; many professionals,

"Individuals and tneir families often do not

l P , L . 9 4- 6 3 , 8 9 Stat, 348 (1975) establishing the Commission, was enacted to make a comprenensive study of tile stace of the art of medical and social management of the epilepsies, and to investigate and make recommendations for the proper role of Federal, state, public, and private agencies in research, prevention, identification, treatment, and rehabilitation of persons witn epilepsy, P.L. 94-63, s' 604(b),

including physicians, have not been adequately trained; and the

public still rejects and scorns those afflicted with this

condition. 0 2

3 1. Brief Description of the Epilepsies

People with epilepsy are not homogeneous. Some have only one or two seizures through a lifetime; others have frequent ana recurring seizures. For nearly half of the estimated 2,P35,OUO Americans with epilepsy, medication controls seizures and permits them to lead nearly normal lives.4

Epilepsy occurs among all races and ethnic groups and in

all strata of society. It is an episodic disoraer. It can first

appear at any age, altnough onset begins in childhood tor 75% of

all persons with epilepsy. It impairs the physical abilities of

the person who has it only during the seizure itself and the

usually short period of recovery afterwards. Most people with

epilepsy, therefore, are persons with only a part-time physical

limitation. Epilepsy has no single ''cause''f but can De caused by

any number of conditions that injure or affect the function of the

2Commission for the Control of Epilepsy and I ts Consequencesp U.S. Department of Healtn, Education, and Welfare, Plan for Nationwide Action on Epilepsy, Volume I at 131 (1Y77)(hereinafter cited as Commission's Report.)

+or the assistance of the Court, a more detailed description of the epilepsies is contained in Appendix A,

*commissionBs Report, supra, Volume I at 15,

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b r a i n . Some causes c a n be cured,

w i t h e p i l e p s y , n o u n d e r l y i n g cause f o r t h e s e i z u r e s c a n D e found .

I n aoout half of a l l p e r s o n s

The term " e p i l e p s y " r e f e r s t o repeated s e i z u r e s of any

E p i l e p s y i s n o t a disease o u t i s r a t h e r a c o l l e c t i o n of t y p e .

symptoms whicn are t h e ou tward s i g n s of a t emgora ry m a l f u n c t i o n i n

t h e b r a i n . The t empora ry e l e c t r i c a l m a l f u n c t i o n i n t h e form of a

sudden e x c e s s i v e d i s c h a r g e of e l e c t r i c a l impulses between c e l l s

i n a p e r s o n ' s b r a i n w i l l cause v a r i o u s d i s t i n c t i v e r e a c t i o n s t n a t

are c a l l e d ep i l ep t i c s e i z u r e s . fiecause t h e s e i z u r e s t h e m s e l v e s

a re v a r i e d and complex among d i f f e r e n t i n d i v i d u a l s , and because

t h e y stem from a v a r i e t y of u n d e r l y i n g causes, t h e y have more

c o r r e c t l y m e n termed t h e "epi leps ies ."

The t y p e of s e i z u r e t h a t occurs depends upon the n a t u r e

and l o c a t i o n of t h e e l e c t r i c a l d i s t u r b a n c e i n t h e b r a i n . S e i z u r e s

may be br ief and m i l d , s o t h a t t h e y a r e n o t even n o t i c e a D 1 e t o

a n o t h e r p e r s o n p or t h e y may produce c o n v u l s i o n s and a lapse of

c o n s c i o u s n e s s , T h e r a n g e of s e v e r i t y of s e i z u r e s among

i n d i v i d u a l s i s anywhere Detween t n e s e e x t r e m e s .

An i n d i v i d u a l ' s s e i z u r e s may l i K e w i s e B e few o r many; t h e y

may occur d a i l y , or t h e y may occur y e a r s a p a r t . I n many casesB

s e i z u r e s s t o p f o l l o w i n g e f f e c t i v e t r e a t m e n t and do n o t r ecu r , I n

o the r p e r s o n s , t h e symptoms of s e i z u r e s may n o t be c o n t r o l l a b l e by

any means, Each p e r s o n w i t h epi lepsy t e n d s t o e s t a b l i s h a p a t t e r n

of se izure f r e q u e n c y which , a f t e r t r e a t m e n t and a per iod of

a d j u s t m e n t t o t r e a t m e n t , c a n r e a s o n a b l y be e x p e c t e d t o c o n t i n u e ,

KTR a t ~ 3 0 1

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P e r s o n s w i t h e p i l e p s y c a n D e c a t e g o r i z e d a c c o r d i n g t o t h e

t y p e of s e i z u r e t h e y e x p e r i e n c e . A t one time, s e i z u r e s were

c l a s s i f i e d a c c o r d i n g t o t h e names g r a n d mal, p e t i t mal, and

psychomotor e p i l e p s y , T h e t r a d i t i o n a l t h o u g h t was t h a t a t y p i c a l

e p i l e p t i c s e i z u r e was a g e n e r a l i z e d c o n v u l s i o n . We now know t h a t

t h i s d e s c r i p t i o n i s much t o o l i m i t e d t o f i t t h e modern c o n c e p t of

t h e d i s o r d e r , and t h a t so-called g rand mal e p i l e p s y is n o t e v e n

t h e most f r e q u e n t l y e n c o u n t e r e d t y p e of s e i z u r e i n a d u l t s .

Today, t h e d e s c r i p t i o n of s e i z u r e s a s g r a n d mal, p e t i t

m a l , or psychomotor h a s been g e n e r a l l y discarded i n f a v o r of t h e

I n t e r n a t i o n a l C l a s s i f i c a t i o n or' Epileptic S e i z u r e s sys t em. I n

t h i s s y s t e m , e p i l e p t i c s e i z u r e s a re d i v i d e d i n t o two main

c a t e g o r i e s , depend ing upon t h e d e g r e e t o wnicn t h e wnole b r a i n 1s

affected by t h e s e i z u r e a c t i v i t y . [TR a t A361 S e i z u r e s w h i c h

i n v o l v e most of t h e b r a i n a re ca l l ed q e n e r a l i z e d s e i z u r e s , [ T K a t

A 3 6 , A371 Tne most common forms of g e n e r a l i z e d s e i z u r e s a r e t h e

t o n i c - c l o n i c s e i z u r e and t h e a b s e n c e s e i z u r e . Tne t o n i c - c l o n i c

s e i z u r e is w h a t most p e o p l e t h i n k of a s e p i l e p s y ; i t is t h e

g e n e r a l i z e d c o n v u l s i v e s e i z u r e t r a a i t i o n a l l y associa ted w i t h

e p i l e p s y . Some i n d i v i d u a l s , a f t e r t h e i n i t i a l l o s s of

c o n s c i o u s n e s s , e x p e r i e n c e o n l y t n e t o n i c or c l o n i c pnase, [TR a t

2469-721 The a b s e n c e s e i z u r e , most common i n c h i l d r e n , is a

'Appendix A c o n t a i n s a c o m p l e t e d e s c r i p t i o n of t h e I n t e r n a t i o n a l C l a s s i f i c a t i o n OS E p i l e p t i c S e i z u r e s s y s t e m ,

n o n- c o n v u l s i v e s e i z u r e c h a r a c t e r i z e d by e x t r e m e l y b r i e f s t a r i n g

spe l l s . [TR a t A37, A 3 9 1 I t i s commonly m i s d i a g n o s e d .

S e i z u r e s which i n v o l v e o n l y a p o r t i o n of t n e D r a i n a re

c l a s s i f i ed a s p a r t i a l s e i z u r e s . ['LR a t A 3 6 , A 3 7 , A381 I n p a r t i a l

s e i z u r e s , o n l y a s p e c i f i c area or t h e body or a p a r t i c u l a r l e v e l

of c o n s c i o u s n e s s is a f f e c t e d . A common t y p e of p a r t i a l s e i z u r e

i s t n e complex p a r t i a l s e i z u r e , which is character ized by v a r i o u s

s t e r e o t y p e d , a u t o m a t i c b e h a v i o r s . [TR a t A37, A381 A p a r t i a l

s e i z u r e may p r o g r e s s t o a g e n e r a l i z e d s e i z u r e .

S e i z u r e s have v a r y i n g e f f e c t s on c o n s c i o u s n e s s . For

example , i n some t y p e s of s e i z u r e s , i n d i v i d u a l s know t h a t t h e y a re

e x p e r i e n c i n g a s e i z u r e b u t a re p o w e r l e s s t o s t o p i t ; o r t h e p e r s o n

may be a b l e t o hear and respond t o o t h e r p e o p l e t h r o u g h yestures

b u t b e u n a b l e t o speak w h i l e t h e s e i z u r e c o n t i n u e s . Other t y p e s

o f s e i z u r e s may i n v o l v e lapses of c o n s c i o u s n e s s so g r i e f t he

i n d i v i d u a l s a re unaware t n a t a s e i z u r e ha s t a k e n place; t he re may

b e a l t e red c o n s c i o u s n e s s i n which i n d i v i a u a l s a r e unaware o f t h e i r

s u r r o u n d i n g s w h i l e t h e s e i z u r e l a s t s . F i n a l l y s t h e r e may be

c o m p l e t e u n c o n s c i o u s n e s s f o r a b r i e f p e r i o a of t i m e .

I n order t o p r o p e r l y d i a g n o s e e p i l e p s y t h e p h y s i c i a n m u s t

f i r s t d i s t i n g u i s h be tween t h e o c c u r r e n c e o f e p i l e p t i c s e i z u r e s and

o t h e r k i n d s of b r i e f , r e v e r s i b l e a l t e r a t i o n s i n c o n s c i o u s n e s s ,

b e h a v i o r , or b o t h , Next t h e p h y s i c i a n m u s t d e t e r m i n e t h e t y p e o f

s e i z u r e t h e i n d i v i d u a l hasl s i n c e p r o p e r c l a s s i f i c a t i o n is a major

g u i d e to t h e i n i t i a l c h o i c e of drugs f o r t r e a t m e n t , The

p h y s i c i a n 8 s main t o o l i n d i a g n o s i n g e p i l e p s y i s a c a r e f u l meaical

h i s t o r y of t h e p e r s o n i n v o l v e d a n a as much i n f o r m a t i o n as p o s s i o l e

began.

B r a i n waves d u r i n g or oetween s e i z u r e s may show spec ia l p a t t e r n s

w h i c h h e l p t h e doctor decide whether or n o t t h e p e r s o n has

A second major t o o l i s a n e l e c t r o e n c e p h a l o g r a p h ( E E G ) .

e p i l e p s y . The EEG may D e normal f o r some p e r s o n s w i t h e p i l e p s y .

The major way i n whicn s e i z u r e s a re c o n t r o l l e d is t h r o u g h

proper d i a g n o s i s and t h e u s e of a n t i - c o n v u l s a n t m e d i c a t i o n .

S i x t e e n a n t i - e p i l e p t i c ( o r a n t i - c o n v u l s a n t ) d r u g s a re c u r r e n t l y

l i c e n s e d i n t he U n i t e d S ta tes , and t h e y have produced a h i g h

d e g r e e of r e l i a D l e s e i z u r e c o n t r o l i n most p e r s o n s who have

e p i l e p s y .

comple t e c o n t r o l of s e i z u r e s , p e r m i t t i n g t i i e m t o o b t a i n d r i v e r ' s

l i c e n s e s and enaDl ing them t o l i v e normal or nea r- norma l l i v e s .

Another 30 p e r c e n t e x p e r i e n c e a c o n s i d e r a b l e r e d u c t i o n i n t h e

number of s e i z u r e s and about 20 p e r c e n t f i n d t h a t e x i s t i n g

I t is estimated t h a t about n a l f of a l l people g a i n

m e d i c a t i o n s do n o t work f o r them.

I m p o r t a n t n o n - s p e c i f i c measures i n t n e t r e a t m e n t and

c o n t r o l of s e i z u r e s i n c l u d e t h e s c n e d u l e a n a r o u t i n e of t h e

i n d i v i d u a l ' s l i f e . Great v a r i a t i o n s i n terms of Sleep o r W O r k f

f a t i g u e , and e m o t i o n a l a i s t u r b a n c e may d i s r u p t s e i z u r e c o n t r o l .

[ T R a t A 3 1 1

Apart from t h e s e i z u r e s , t h e p e r s o n w i t h e p i l e p s y shou ld

be r e g a r d e d as a n i n d i v i d u a l l i K e any o t n e r , w i t n d i s t i n c t i v e

s t r e n g t h s and weaknesse s , a b i l i t i e s , s k i l l s and p e r s o n a l

p r e f e r e n c e s ,

i n t e l l e c t u a l a b i l i t y found in t h e g e n e r a l p o p u l a t i o n , Some are

people w i t h e p i l e p s y d i s p l a y the same r a n g e o f

- 11 -

highly intelligent, some are of low intelligence, and most fail

somewhere in the middle range. Side effects from tne medication

also vary with individuals, as do the amount and combination Of

anti-epileptic drugs that have to be taken to achieve control.

Some people experience a slignt slowiny effect from the

medication, but this again is a matter of individual reaction.

B. Experience Demonstrates That Persons with Epilepsy can be Safely and Productively Employed.

For tne majority or persons witn epilepsy wno lead

completely seizure-free lives, seizure activity should not pose an

impediment to employment. The additional 3 0 percent of tne

individuals with substantially reduced seizure activity tnrougn

medication, are employable in most jobs if tnere 1s an adequate

evaluation of the seizure type, frequency, custoinary time of

occurrencer and the exact nature of the 700. Tne best judge of

individual capability is usually the seizure-prone person him or

herself, his OK her family, and the treatlng neurologist,

Numerous studies have been publisned on tne employability

of persons witn seizure disorders. These show that the employee

with epilepsy is as good an employee as any otner. In fact, the

studies indicate consistently that work performance was nign,

often better than the work performance of so-called "normalsg

workersB accident rates for worKers witn epilepsy were comparable

to accident nates for non-nandicapped workers, insurance rates

- 12 -

t h a t hand icapped workers d i d n o t e x p e r i e n c e g r e a t e r a b s e n t e e i s m

t h a n o t h e r workers.

f o l l o w s *

A v e r y br ief r e v i e w o f these s t u d i e s 7

A s t u d y of 58 o i l f i e l d w o r k e r s w i t n e p i l e p s y i n a w o r k

f o r c e of 9 ,600 men, conduc ted i n 1 9 6 1 , showed t n a t 8 1 p e r c e n t of

t h e workers w i t h e p i l e p s y had Det ter s a f e t y r e c o r d s and be t t e r

r a t e s of a b s e n t e e i s m t h a n t h e g e n e r a l p o p u l a t i o n . Seventy- two

p e r c e n t of t h e workers w i t h e p i l e p s y had be t t e r j o b pe r fo rmance

r e c o r d s .

A 1 9 b O s t u d y of 7 7 cases in four N e w York C i t y companies

showed a v e r a g e a b s e n t e e i s m for worKers w i t n e p i l e p s y ; t h ree ot t h e

four companies had n o t l o s t t i m e due t o accidents i n v o l v i n g

workers w i t h e p i l e p s y , and t h e f o u r t h company had n o t l o s t t i m e

beyond t h e day of t h e a c c i d e n t .

showed t h e same job per formance for w o r k e r s w i t h e p i l e p s y a s foK

T n r e e of t n e f o u r companies

6 E i l e r s , R,D, & Halone , J. J.# Impact on Employer I n s u r a n c e C o s t s of H i r i n g P e r s o n s w i t n E p i l e p s y , E p i l e p s y F o u n d a t i o n O f America: Washington, D.C. ( 1 9 6 7 )

7Commiss.=i.on's Report, s u p r a , V o l u m e 11, pp. 497- 501; E p i l e p s y Founda t ion of America, Basic S t a t i s t i c on t n e E p i l e p s i e s , FeA. Davi s Company: P h i l a d e l p h i a , Pa. (1975) pp. 8b-100. Each of these s t u d i e s is rev i ewed i n g r e a t e r d e t a i l i n these m a t e r i a l s , and d i rec t c i t a t i o n s t o each s t u d y is c o n t a i n e d t h e r e i n .

II I I I I I I 0

I I I I

- 13 -

non-disabled workers, and the fourch company had a better

performance rate by workers with epilepsy.

A 1973 report on a DuPont Company study of 1,452

handicapped employees stated that in comparison with tne

able-bodied work force, the handicapped had a 96 percent average

or better safety record, both on and o f f tne JOD. A total of 27

employees were known to nave epilepsy, among them five managers

and supervisors, two computer operators, one technician, one

chemist, 14 craftsmen, one guard, one lab assistant, and one

service worker, Tne most recent report from DuPont concluded that

"DuPont studies over a period of twenty-five years have ShOWn that

the performance of handicapped employees is equivalent to that of

their non-impaired co-workers. In safety, ] O b duties and

attendance, the handicapped hold their own. 'I8

have a broad spectrum of disabilities and in 1981 included 6 2

persons with epilepsy.

DuPont employees

The first "Epi-Hab" industrial plant for workers with

epilepsy was developed in the mid-1950's. Tne plant had many

kinds of moving machinery, incluaing drill presses, band saws,

pneumatic riveters, and other medium power tools. This closed

workshop for persons with epilepsy, including those who had not

obtained seizure control, achieved a safety record good enough to

earn a 20 percent discount in its worker's Compensation

8E. I, duPont de Nemours and C o , , Equal to the Task at 4 (1982) e

- 14 -

i n s u r a n c e ,

macn ine ry I equ ipment , wal l s , f l o o r s , and t h e l i k e . Over a t n r e e

y e a r period, a l m o s t no work t i m e was l o s t because o f a c c i d e n t s on

t h e job.

Epi-Hab d i d n o t u s e any e x c e p t i o n a l s a f e g u a r d s on

The success of t h i s e x p e r i m e n t r e su l t ed i n t n e o p e n i n g

of o t h e r c l o s e d i n d u s t r i a l s h o p s f o r w o r k e r s w i t h u n c o n t r o l l e d

s e i z u r e s . E p i- H a b , L , A . , I n c . c o n t i n u e s t o o p e r a t e t o d a y , and

c o n t i n u e s t o r e c e i v e s u b s t a n t i a l d i s c o u n t s i n i t s w o r K e r ' s

compensa t ion i n s u r a n c e r a t e s d e s p i t e einploying p e r s o n s s e v e r e l y

hand icapped by s e i z u r e s . 9

Lockheed C a l i f o r n i a i n 1 9 7 4 r e p o r t e d between 7 5 and 1 0 0

known p e r s o n s w i t h e p i l e p s y on i t s p a y r o l l .

d i smissed f o r h e a l t h r e a s o n s over t h e p r e v i o u s t w e n t y - f i v e y e a r

and t h e company 's medical director found t h a t e p i l e p s y , i f

Few had t o be

uncompl ica ted by o t h e r c o n d i t i o n s , had l i t t l e a d v e r s e e f f e c t upon

a b i l i t y t o p e r f o r m , w i t h s e i z u r e a c t i v i t y even d l m l n l s h l n g i n

f r e q u e n c y and s e v e r i t y o v e r time on t h e Job.

P e r h a p s t h e most u s e f u l da t a on t h e successru l inelusaonof

p e r s o n s w i t h e p i l e p s y i n c o m p e t i t i v e employment comes from t n e

T r a i n i n g a n d P l a c e m e n t S e r v l c e (TAPS) of t h e E p i l e p s y F o u n d a t i o n

of America. TAPS w a s begun i n 1 9 7 6 t n r o u g h a c o n t r a c t w i t h t h e

U.S. Depar tment of Labor" t o d e s i g n and i n i t i a t e a

9 R i S C h , P r a n k , The I n d u s t r i a l i z a t i o n of t h e P e r s o n w i t n Epilepsy, p r e s e n t a t i o n a t E p i l e p s y I n t e r n a t i o n a l Symposium, September 26-30, 1983 , Washington, D.C. , t o D e p u b l i s h e d i n 1 9 8 4 as p a i t of p r o c e e d i n g s o f X V t h E p i l e p s y I n t e r n a t i o n a l Symposium,

1oD05t C o n t r a c t No. 99-3-0766-!M-O03-02 e

- 15 -

demonstration project to assist people with epilepsy to find ana keep

competitive employment. 11

TAPS has been effective in identifying tne many barriers to.

full-time employment that face people with epilepsy (including employer

attitudes, inadequate education of the individual about seizures, a

lack of job seeking and social sKills, family pressures and inadequate

medical care), and has successfully developed a program to overcome

these barriers by bot0 educating employers and working with clients to

teach them job seeking Skills tnat help them acnieve independence.

The TAPS program now operates in 13 cities throughout tne

countryp and has provided services to over 10,000 persons with

epilepsy, Even more importantly TAPS nas placed over 5,600 persons in

competitive employment since 1976. Tnis is a placement rate of 558,

consistent over the past six years. Tnese placements include persons

with all types of seizures, including tnose whose seizures are not

completely controlled.

In July 1982, TAPS Degan a new data collection system,

Preliminary findings snow that of 1,087 persons with epilepsy placed by

TAPS since the expanded data collection system nas been in place, Sd%

had tonic-clonic seizures, 12% had complex partial seizures, 178 had

tonic-clonic and other seizures, ana 11% haa aBsence seizures. 815

clients who indicated tonic-clonic seizures alone or in combination

llFor a history of TAP$, E, Epilepsy Founaation of America, The Evolution of tne Training and Placement Service: An Historical Perspective, November 1982,

- 1 6 -

with other seizures were positively placed.

44% experienced seizures less than once a yearl 40% experienced one to

s i x seizures per year, 12% experienced 7 to 1 2 seizures per year, and

5,4% experienced 13 to 52 seizures per year.

only 17% of these clients indicated tne existence of an aura

Among these inaividuals,

c Perhaps surprlsinglyr

(warning I 12

In the past there nas been a tendency to restrict drastically I period).

I I I I I I I I

the job opportunities availaole to employees with epilepsy.

restrictions were based on the fear of possiDle harm that might result

Such

if a seizure took place in certain environments, Placninery, handling

of hot OK caustic materials, worK at heights, and similar activlties

were automatically barred to a person with epilepsy,

recognized that, while it is still true that some people with epilepsy

should avoid such workl these restrictaons are uy no means appropriate

Today it 1s

for everyone. Job requirements and the specific history of epiLepsy in

the individual job seeker should oe zeviewed? and a determination of

relative risks should be made on tne basis of the evaluation rather

than on tne basis of blanket pronibitions against persons with epilepsy

in specific jobs.

The TAPS program has demonstrated tnat these old limitations

12Hayes, Catherine, Factors Influencing Employability: An Analysis of the Successful Traininq and Placement Service, paper presented at the International Symposium on Epilepsy, September 26-30, 1983 Washington, D.C, Proceedings of XVth International Symposium will be published in late 1984-

- 17 -

a r e n o t a p p r o p r i a t e f o r a l l p e r s o n s w i t h e p i l e p s y . Tne t y p e s o f JODS

i n which p e r s o n s w i t h e p i l e p s y h a v e Deen s u c c c e s s f u l l y placed t h r o u g h

TAPS cover t h e spectrum, and i n c l u d e : a p p r e n t i c e c a r p e n t e r , n u r s e , -

plumDerl d r i l l press o p e r a t o r , s a n d b las te r , a i r c r a f t mechan ic , r>oiler

o p e r a t o r s , meatcutter, s a f e t y i n s p e c t o r , p r o d u c t i o n s u p e r i n t e n d e n t r and

s t r u c t u r a l s t e e l w o r k e r s . l3

i n d e t e r m i n i n g p l a c e m e n t s , TAPS c o n s i d e r s a l is t of f a c t o r s s u c h a s

t y p e of s e i z u r e , f r e q u e n c y , t h e t i m e o f s e i z u r e o c c u r r e n c e and

I n s t e a d of r e l y i n g upon r i g i d g u i d e l i n e s

I p r e d i c t a b i l i t y ( e . g . l i f someone e x p e r i e n c e s n o c t u r n a l s e i z u r e s o n l y ,

j o b pe r fo rmance would n o t be a f f e c t e d ) , and t h e worK h i s t o r y of t n e I

i n d i v i d u a l , l4 T h i s a p p r o a c n has been h i g h l y s u c c e s s f u l .

11. P O S S I B I L I T Y O F HARM AS A J U S ' F I F I C A T I O N FOR REFUSING EMPLOYMENT TO PERSONS WI'I'H EPILEPSY CONTRAVENES P U B L I C P O L I C Y l33EdIND THE R E H A B I L I T A T I Q N ACT O F 1 9 7 3 .

To a l l o w e m p l o y e r s t o a s se r t t h a t t n e p o s s i D i l i t y of a

f u t u r e s e i z u r e c a u s i n g i n j u r y i s a n adequate j u s t i f i c a t i o n f o r

deny ing employment t o p e r s o n s w i t h e p i l e p s y c o n t r a v e n e s t h e p u b l i c

p o l i c y u n d e r l y i n g a n t i - d i s c r i m i n a t i o n l e g i s l a t i o n .

I3Appendix C c o n t a i n s a n a d a i t i o n a l sample l i s t i n g of p l a c e m e n t s ,

1 4 T h i s p r o c e d u r e is describea more r ' u l l y i n t n e " I n t e r v i e w i n g G u i d e for t h e E p i l e p s i e s " ( c o n t a i n e d i n Appendix D) I d e v e l o p e d by t h e E p i l e p s y F o u n d a t i o n of America w i t h U , S . Depar tment of Labor f u n d s , and i t has been e f f e c t i v e i n p l a c i n g p e r s o n s i n J O O S t h e y c a n p e r f o r m s a f e l y and w e l l ,

I - 1 8 -

Congress, after years of receiving testimony on the

treatment of the disabled in American society, responded by

enacting comprehensive legislation designed to commt the

prejudices and discrimination tne disabled face in all aspects of

tneir lives. Many states also extendea tneir antidiscrimination

legislation to ensure opportunity for full participation in

society to the handicapped. Lawmakers recognized tnat safety and

ability could De a legitimate issue in employment of the

handicapped, and various schemes were written into tne legislation

to address these concerns. When fears about safety are used to

effectively exclude from employment one of tne very groups the

Congress and otner lawmakers were trying to protect, however,

these concerns cannot be supported unless based upon a realistic

probability of harm in the individual case. In fact, employersg

safety concerns too commonly reflect the very attitudes Congress

intended to erase when it passed tne Rehabilitation A c t , rather

than demonstrable evidence that a nandicapped person would be

dangerous in a given job.

A . The Law and Public Policy Require Full Access to Employment for Handicapped Persons.

A public policy of ensuring equal opportunity for all

citizens has been reflected in Congressional legislation mandating

- 1 9 -

non-discrimination against minorities and disadvantaged

groups. This policy was extended to include tne handicapped

national policy tne protection of the civil rignts of handicapped

people, and was based on tne doctrine that handicapped people have

a "basic human right to full participation in life and

society. It 17

Briefly, the legislation is designed to promote equal

employment opportunities in both tne puDlic and private

sector e l8 Section 5 U 1 of Title V requires all Federal

departments, agencies and instrumentalities to have arfirmative

action plans (updated annually) providing adequate hiring, 19 placement and advancement opportunltles for the handicapped.

Section 503 mandates affirmative action for federal contractors

and subcontractors and provides an administrative enforcement

mechanisme2' Sectlon 504 ensures that programs and

I5See, _I e,g,, The Civil Kignts Act of 1964, 4 2 U . S . C . Bd 2000 .; Title IX of the Education Amendments of 1972, 4 2 U , S . C .

17S, Rep. No, 1297, 93d Cong,, Zd Sess. 5 b , reprinted in (1974) U.S. Code Cong. and Ad. News 6 3 7 3 , 64d6. For a tnorough review of the civil rights issues of handicapped persons in America, see the U.S. Commission on C i v l l Rights report, Accommodating the Spectrum of Individual Aoillties, Clearingnouse Publication 81, SeptemDer 1983.

activities receiving federal financial assistance will not discriminate

against otherwise qualified handicapped persons; it is explicitly

applicable to all executive and federal agencies, including the U.S.

Postal Service. 21

In enacting these ineasures, Congress recognized tne barriers

that exist to the integration of the handicapped into the mainstream of

American society,

recognized that employer attitudes and fears were largely responsible

f o r the exclusion of the handicapped from employment. 22

Senate Report accompanying the 1974 amenaments to the Rehabilitation

Act the Senate Committee on LaDor and Puolic Welfare noted that:

Congress took substantial evidence and expressly

In the

Individuals with handicaps are all too often excluaed from school and educational programs, barred from employment or are under-employed because of archaic attitudes and

23 laws, e * . Senator Humphrey stressea that the b i l l protecting employment

rights in the Rehabilitation Act was intended to "make every effort to

enable a handicapped person to lead a productive and financially

independent life, I 8 24

The Congressional policy of extending equal employment

opportunity to the handicapped has been reflected at tne state level.

2129 U.S.C. S 794, as amended by P.L. 95-bOL

22S. Rep. No. 93-318, 93d Cong., 1st Sess. 4, reprinted in

23S, Rep. 93-1297, 93d Cong,f 2d Sess. 32, reprinted in

241J.8 Cong, Rec. 32310 (1973)

(1973) U.S.Code Cong. and Ad. News 2078,

(1974) U.S. Code Cong, and Ad. News 6400.

- L 1 -

The majority of states now have anti-discrimination statutes tnat cover

the handicapped, including persons witn epilepsy. 25

In addressing federal employers and contractors, Congress cnose

to utilize the term "affirmative actlon" in its requirements under the

Rehabilitation Act clearly implying tnat a more active and extensive

effort than "non-discrimination" must be taken to eliminate barriers to

employment of tne handicapped in federal agencies, departments,

instrumentalities and by federal contractors. 26 As the Senate

Committee on Labor and PuDlic Welfare pointed outl

[flor those millions of handicapped individuals who pay taxes and have the right to expect that their tax money will go toward making their ... employment easier, the creation of.,.an affirmative action program to insure that tney have the right to employment which compliments their abilities represents an overdue avenue of restitution for previous societal neg~ect,27

25Hardin, ivlark, Employment Discrimination and Epilepsy, Epilepsy Foundation of America: Nashington, D.C. (1980) at 4 b ,

2629 U.S.C. s 791 and s 7Y3. Section 501 requires federal agencies and departments not only to have an affirmative action plan for the hiring, placement, and advancement of handicappea individuals, but to fully describe the extent to which such efforts are being met, subaect to Civil Service Commission (now EEOC) review.

27S. Rep. No. 48, 63d Conge# 1st Sess. 16 (1974)-

- 22 -

The Senate Committee emphaslzed tnat "tine Federal

government must be an equal opportunity employer, and tnat tnis

equal opportunity must apply to handicapped individuals.

After conducting oversight hearings on tne

It26

implementation of the Rehabilitation Act in 1976, Senator Williams

reiterated that tne Rehabilitatlon Act was a ma-jor step taken to

remedy discrimination against handicapped persons i n American

society. 29 At the Same time, he empnasized tne role of tne

28Se Rep. No. 93-318, Y3d Cong., 1st Sess, 49 (1973)+

290versiqht Hearings On Rehabilltation of tne Handicappea Programs and tne Implementation of Same by Aqencies under the Kehabilitation Act of 1973, before the Subcommittee on the Handicapped of the Senate Committee on Lmor and Public Welfare, 94tn Coni,, 2d Sess., pt, 3 at 1502 (1976).

- 23 -

Federal government as a model employer under t n e A c t r ana

e x p r e s s e d deep c o n c e r n t h a t s o l i t t l e p r o g r e s s i n remedying

d i s c r i m i n a t i o n , p a r t i c u l a r l y ~y Feaeral employe r s , had been made i n t h e th ree y e a r s s i n c e p a s s a g e of t n e A c t . 30

301d, - a t 1502- 3 , The Federal government h a s come under a t t a c k even more r e c e n t l y f o r i t s abysmal r e c o r d i n einploying and advanc ing t h e hand icappea . See, e . g . , L inn , B. J . , Uncle Sam D o e s n ' t d a n t You: E n t e r i n g t h e F e d e r a l S t r o n g h o l d of Employment Discrimination A g a i n s t Handicapped I n d i v i d u a l s , 1 0 4 7 ( 1 3 7 8 ) ; U.S. C i v i l R i g n t s Commission r e p o r t , s u p r a , n o t e 17 a t 31. The U . S . P o s t a l S e r v i c e h a s a p a r t i c u l a r l y poor r e p u t a t i o n i n t n i s a r e a ; w i t n e s s i t s f a i l u r e t o f i l e a f r i r m a t i v e a c t i o n p l a n s f o r 1979 and 1980, - see, U . S . E q u a l Employment O p p o r t u n i t y Commission, Employment of Handicapped I n d i v i d u a l s i n c l u d i n g Disab led V e t e r a n s i n t h e Federal Government a t 3 0 , Washing ton , D.C. (1960); t o p r o v i a e d a t a t o t h e E.E.O.C. on tae numDers of d i sao led p e r s o n s employed, - I d . a t 51; and t n e numDer of l e g a l a c t i o n s f i l e d a g a i n s t i t . - See, e.g., Gibson v. U . S . Postal S e r v i c e , C i v i l A c t i o n No. 77-2453 (W.D. Tenn. Consen t Order A p r i l 27, 1978); Coun t s v . U.Se P o s t a l S e r v i c e , N o . 77-0028, (N.D. F la . Consen t Decree J u n e L 9 , 1 9 8 3 ) ; AtKinson v. U . S . P o s t a l S e r v i c e , 12 Empl- Prac. Dec. 5L08 (S.DeN.Ye 1 9 7 9 ) ; P r e w i t t v . U.S. P o s t a l S e r v i c e , 27 F.E.P. Cases 1 0 4 3 ( 5 t h C i r . 1981); Stewart v. U . S . P o s t a l S e r v i c e , N o . C-79-2676-WHO (N.D. C a l . Urder fo r Compromlse S e t t l e m e n t , J u n e 2 ,

2 7 D e P a u l L. H.

.ab+, =. I ---____ - U . U . * " " C Y - I-- ---- , -- ~-~ - &.c1

77-2453 (W.D. Tenn. Consen t Order A p r i l 27, 1978); Coun t s v . U.Se

1 9 8 3 ) ; AtKinson v. U.S. P

1981) conce rned a p p l i c a n t s w i t n e p i l e p s y .

Perhaps n o t s u r p r i s i n g l y , a number of t n e s e a c t i o n s

- 2 4 -

As Congress knew, outmoded stereotypes and prejudices can

be manifested in a variety of ways. Too often, safety concerns

have reflected stereotypes rather tnan factual evidence that an

individual was dangerous on the ] O D .

stereotypes Deen more evident tnan in tne attitudes of employers

towards persons with epilepsy.

Nownere have tnese outmoded

B , Negative Employer Attitudes are a iYrajor Heason Persons witn Epilepsy are Excluded froin Employment.

The person witn epilepsy is usuaily far less handicapped

by the seizures tnan by society's fear and misunderstanding of tne

disorder (I 31

complexities of the brain and medical advances in treatment of

epilepsy nave outstripped the social reactions to tne disorder.

Based on the most recent survey of representative adults by the

American Institute of Puolic Opinion (Gallup P o l l ) , in 1979 six

Percent (6%) of tne American population still oDjected to their

children associating witn people with epilepsy, nine percent (9%)

still believed persons with epilepsy should not be employed,

percent (3%) believed tnat epilepsy was a form of insanity, and

nearly one out of five ( L 8 a percent) adults would oDject to a son

Unfortunately, scientiiic understanding of the

three

31Gallup, Introduction to Arangio, Behind the Sr;igma O K Epilepsy. Epilepsy Foundation of America, 1975,

- 2 5 -

Al though 3 2 or d a u g h t e r m a r r y i n g a p e r s o n w i t h e p i l e p s y .

a c c e p t a n c e of e p i l e p s y h a s improved c o n s i d e r a b l y s i n c e tile f i r s t

puol ic o p i n i o n s u r v e y was t a k e n i n 1943, t h e s t i g m a of e p i l e p s y

r e m a i n s a s o c i a l rorce a f r e c t l n y the l i v e s o f p e r s o n s w i t n t h e

c o n d i t i o n , 3 3

1. H i s t o r i c a l Overview of A t t i t u d e s Toward Ep i l ep sy

Many of t h e p r e s e n t d a y s t i g m a s , b o t h p s y c n o l o g i c a l and s o c i a l

aspects, o r i g i n a t e i n a h i s t o r y l i n k i n g e p i l e p s y w i t h p o s s e s s i o n s

magic , and m y s t i c a l p h i l o s o p h i e s .

E p i l e p s y was known t o t h e a n c i e n t s w e l l De fo re Hippocrates

r i g h t l y d i a g n o s e d i t as stemming f rom a n i n j u r y t o t n e b r a i n , The

E g y p t i a n s were aware of e p i l e p s y ; t h e y had a l r e a d y r e f i n e d

t e c h n i q u e s of b r a i n s u r g e r y whicn were d i s c l o s e d i n t n e t r ea t i se s

d u r i n g t h e Middle Kingdom.

t r e a t i s e s and H i p p o c r a t e s ' n o t e s were n o t w i d e l y r e a d or

a c c e p t e d . I n s t e a d , e p i l e p s y became a s s o c i a t e d w i t h mood madness ,

demonic p o s s e s s i o n y t h e f a l l i n g s i c k n e s s of t h e Caesars, or t h e

v i s i o n a r y o f t h e O l d Tes t amen t wno was capaDle of d i v i n e i n s i g n t .

V e s t i g e s of t h e s e b e l i e f s remain t o d a y .

U n f o r t u n a t e l y , t n e E g y p t i a n 34

3 5

32Caveness , W . F e r and G a l l u p , G . H.! J r . , A Su rvey of P u b l i c A t t i t u d e s Toward E p i l e p s y i n 1 9 7 9 w i t n a n I n d i c a t i o n of T rends Over t h e P a s t T h i r t y Years, 21 Epi leps ia SO9 ( O c t . 198~))

3 3 ~ 0 m m i s s i o n ~ s Report , supra, V o l u m e 11, P a r t I a t 4 9 ~ .

3 % ~ - - 35Brody, E p i i e p s y : D i s p e l l i n g t h e myths , N e w Y o r ~ T i m e s ,

A p r i l 1 9 , 1978,

- 2 6 -

Epilepsy was seen as a sacred illness when Julius Caesar

had it, but fear characterized tne prevailing attitude toward this

mysterious disorder during most of nistory.

Scotland during the Middle Ages, men with epilepsy were frequently

castrated, while women were buried alive with their children.

Althougn today violent societal reactions do not tnreaten tne

lives of people witn epilepsy, swtle aspects of discrimination

have led victims of epilepsy to adopt roles as socially isolated

and u s e l e s s individuals.

For example, in

36

As the Commission for the Control or Epilepsy and I t s

Consequences pointed out "[elpilepsy can carry with it a nost of

psychological and social problems - misunderstanding and rejection by family and friends, inaDility t o get a j o D , insecurity, anger,

frustration - that for most victiins are more difficult to handle than the actual seizure proDlem itself. For manyf it is n o t the

disorder, but society's reaction to it, that creates the

-~

36Finesilver I The Legal Aspects of Epilepsy, in Epilepsy Rehabilitation, ed., G. P a . Wright, (Little, Brown and Company: BostonB Mass.) (1976) sp . 51-65 at 5 b . See also, FaDing and Barrow, Medical Discovery as a Legal Catalyst: iqodernization of Epilepsy Laws to Heflect the Medical Pro:ress, 50 Nortnwestern l J , L Rev. 42, 46 (1955); and lulasland, Epileptlcs: Tneir Meaicolegal Problems and Confrontations, 7 Lawyer's ivledlcal Journal 339 (2d Series) (1979) e

- 2 7 -

3 7 d i s a b i l i t y .

N e g a t i v e s o c i e t a l a t t i t u d e s have been r e f l e c t e d i n

American laws and p o l i c i e s . S i n c e t h e t u r n of t n e c e n t u r y r

n i n e t e e n ( 1 9 ) s t a t e s have nad s t a t u t e s t n a t e i t n e r p r o h i b i t e d , or

s e v e r e l y r e s t r i c t ed t h e r i g h t s of people w i t n e p i l e p s y t o marry

and c o n d u c t a normal f a m i l y l i f e . 38 These m a r r i a g e s t a t u t e s

were o r i g i n a l l y e n a c t e d on t h e p r e s u m p t i o n t h a t e p i l e p s y was

h e r e d i t a r y , p r o g r e s s i v e l y d e g e n e r a t i n g , and D a s i c a l l y i n c u r a t s l e .

I t was also b e l i e v e d t h a t p e r s o n s w i t n e p i l e p s y were l e s s

i n t e l l i g e n t t h a n t n e g e n e r a l p o p u l a t i o n , and hence , p r o h i b i t i n g

m a r r i a g e and p r o c r e a t i o n was a metnoa of s o c i a l c o n t r o l o v e r t n i s

f e a r e d c o n d i t i o n .

Even t o d a y r one s t a t e (ArKansas) s t i l l permi t s t n e

annulment of a d o p t i o n s i f t h e c n i l d d e v e l o p s e p i l e p s y w i t n i n f i v e

y e a r s a f t e r t n e a d o p t i o n t akes place.

Eugen ic s t e r i l i z a t i o n laws nave Deen i n e f f e c t i n t h e

U n i t e d S t a t e s s i n c e t h e t u r n of t n e c e n t u r y , ana a few s t a t e s

s t i l l have s t a t u t e s p e r m i t t i n g t n e i n v o l u n t a r y s t e r i l i z a t i o n ot

p e r s o n s w i t h e p i l e p s y . 3y

t h e r e s u l t o f a g e n e r a l movement a d v o c a t i n g s t e r i l i z a t i o n of t h e

Tne e n a c t m e n t 02 tnese s t a t u t e s was

h a b i t u a l c r i m i n a l , t n e m e n t a l l y ill, anu f e e o l e m i n a e d a s a means

37Commiss ionss Report , supra , Vol. I a t 1 3 3 .

3 8 F i n e s i l v e r , sup rap n o t e 3 6 a t 57 ; e d e I O K l a . S t a t s , Ann,

39See , - The L e g a l R i q n t s of P e r s o n s w i t h E p i l e p s y : A Su rvey of S t a t e Laws and A d m i n i s t r a t i v e P o l i c i e s R e l a t i n g t o P e r s o n s w i t n Epilepsy, E p i l e p s y F o u n d a t i o n of A m e r i c a : Washington, D.C, ( 1 3 7 6 e d i t i o n ) a t 1 0 ,

4 a 3 ~ s . 3 4 1 ( 1 9 5 4 ) .

4 0 of e l i m i n a t i n g " d e t r i m e n t a l e l emen t s '@ from s o c i e t y .

For many y e a r s it was accepted t n a t t n e s e " d e t r l m e n t d l

1 e l e m e n t s" c o u l d best be managed w i t h i n a specia l community'

s p e c i f i c a l l y s t r u c t u r e d to meet t n e n e e d s of t n e s e selected

p o p u l a t i o n s ,

C o l o n i e s " w h e r e r e s i d e n t s w i t h presumed l i m i t e d a b l l l t l e s cou ld be

41 p r o d u c t i v e l y y e t s a f e l y engaged .

Indeed , t h e f i r s t i n s t i t u t i o n s were " e p i l e p t i c

d h i l e i n t h e l a s t f i f t e e n y e a r s , a i l s t a t e s have I I

I e l i m i n a t e d s t a t u t e s b a r r i n g m a r r i a g e t o p e r s o n s w i t h e p i l e p s y r

most s t a t e s nave g o t t e n r i d of e p i l e p s y as a D a s i s f o r a n v o l u n t a r y

commitment or i n v o l u n t a r y sterilization, and a l l s t a t e s a l l o w

p e r s o n s w i t n e p i l e p s y t o o b t a l n d r i v e r ' s l i c e n s e s once e s t a b l i s h e d

c o n d i t i o n s a r e m e t , t n e s e changes nave g i v e n r i s e to l o g i c a l a n a

r e a s o n a b l e c o r o l l a r i e s t h a t remain u n r e a l l z e d l For exampie,

worker 's compensa t ion laws now g e n e r a l l y provide f o r ' s econd

i n j u r y f u n d s ' w h i c h o s t e n s i b l y f o s t e r t h e n i r i n y of p e r s o n s w i t n

e p i l e p s y , b u t these c h a n g e s have n o t a v o i d e a d i s c r i m i n a t i o n i n

h i r i n g I 4 2

4oCommission 's R e p o r t , Suprar Volume I , p y . 1 1 7 .

411d, L_ See also,. Smol in , T h e Epilepsies: I 'neir E f f e c t 0r"l t h e Biological Fam;ly, the S t a t e - D e c r e e d Family, and C l v l l L i a D l l i t y C a l i f o r n i a 13 San Diego L, Rev. 978 , 986 (1976).

42Burgdor f and B u r g d o r f , A H i s t o r y of Unequal T rea tmen t : T n e Q u a l i f i c a t i o n s of Handicapped P e r s o n s as "Suspect Class" Under tl E q u a l P r o t e c t i o n C l a u s e , 1 5 S a n t a Clara Lawyer 6 5 5 , n o t e 7 a t 85; ( 1 3 7 5 ) e

- 29 - 1

2 . Effect of Neqative Attitudes on Employment

Perhaps the most. dramatic social consequence of seizures

to the individual has been the effect on oDtainin9 and maintaining

employment. Unfortunately, all too often persons witn epilepsy

are denied employment or not trained for worK tney could do well

and safely because of an unreasoned fear of tneir seizures. Tne

working community has not welcomed persons with epilepsy witn open

arms,

In 1948, the U.S. Department of Labor reportea tnat

epilepsy was the most difficult nandicap to overcome in oDtaining

employment, as exclusionary policies were common. 43

study conducted by the same department reported that epilepsy

ranked lowest among conditions wnich employers were willing to

accept. This was despite

effectiveness studies that continued to demonstrate tnat tne

efficiency of the handicapped WOrker was as great as or exceeded

that of the "normal" worker

In 1960, a

4 4

The number of unemployeu persons with epilepsy (among

those fully able to work) remains disproportionately high today.

The Commission for the Control of Epilepsy and Its Consequences

43Epilepsy Foundation of America, New Directions in Epilepsy Rehabilitation: A Resource Manual. Epilepsy Foundation of America: Washington, D.C, 1979 at i.

*4Detailed i n Part I.,kjef above,

- 5 0 -

reported that the unemployment rate has been consiscently two to

three times the national average. 45 The underemployment rate I

that is, persons employecr in positions below tneir level of skill,

remains even higher.

that might contribute to these nigh rates, and identified tne two

major barriers: employer attitudes towards hiring persons with

epilepsy, and the self-image of tnr person with seizures, ,Tnese

factors have been identifled repeatedly. "Undoubtedly, the

biggest omtacle to the renaDilitation of persons with epilepsy is

employer resistance to hiring them. Furthermore, the emotional

'The Commission revievred tne many factors

roots of this resistance aren't easily altered oy logic or

intelligent reasoning. ,846

A study by Sands and LalKind wnicn sought to explore the

effects of an educational campaign on changing employer attitudes

found that:

(e)ven though employers view favorably the epileptics who work for them, they do not yet generalize these positive feelings into niring behavior and practices. Their feelings toward hiring--that is, not to employ more epileptic worKers--remain steadfast. Furtnermore, their denial that unemployment among epileptics is due to employer attitudes makes them almost imGervious to conventional education tecnniques. 4 7

45~ommission~s Report, suprar Volume I at 8 5 -

46Benson, Epilepsy and Employment: Placement Problems and Techniaues, 3 American RenaDilitation 3 (Marcn/April 1978).

47Sands, and Zalkind, Effects of An Educational Campaign to Cnange Employee Attitudes Toward Hiring Epileptics, 1 3 Epilepsla 8 7 (1972) at 94-95,

- 3 1 -

i n d u s t r i e s . F o l l o w i n g is a br ief ove rv l ew of some of these s t u d i e s &

I n 1 9 7 4 , a s u r v e y of s e v e n ( 7 ) i n d u s t r l e s , a l l employing more

t h a n 200 workers, was conduc ted by the F e d e r a t i o n of Jewish

P h i l a n t h r o p i e s .

e p i l e p s y upon d i s c o v e r y of t h e c o n d i t i o n despi te a t tempts by co- worke r s

t o h i d e t h e e p i l e p s y . Six of t n e s e v e n companies e x c l u d e d p e r s o n s w i t n

e p i l e p s y t o a g r e a t e r e x t e n t t n a n t n e y d i d t n e o r t h o p e d i c a l l y disaDlea,

t h e v i s u a l l y impaired, tnose w i t h c e rema l p a l s y , and card iac p a t i e n t s .

P e r s o n n e l d i r e c t o r s admitted t n e y f i r e d p e r s o n s w i t n

A 1 9 6 0 s t u d y ~y Wolfson of 3 1 4 Phoen ix coinpanies showed o n l y

f i f t y - n i n e ( 5 9 ) p e r s o n s w i t n e p i l e p s y i n a Work f o r c e of 6 4 , 8 1 1 , or a I I mere 0 . 1 p e r c e n t , and o n l y t w e l v e (12) companies were h i r i n g p e r s o n s

w i t n e p i l e p s y a t t n e t i m e of t h i s 1 9 6 0 s u r v e y , 4 9 Among r e a s o n s c i t e d

I f o r t h i s h i r i n g p o l i c y / b e h a v l o r , t h e f o l l o w i n g e x p l a n a t i o n s were I

I o f f e r e d : t h e worker w o u l d h u r t h i m s e l f , t h e worker w o u l d n u r t others,

and t h e s e i z u r e s would cause a c c i d e n t s , Y e t these i e a r s Were n o t l

49Risch, F r a n k . A t t i t u d e s and Prac t i ces i n I n d u s t r y , i n T o t a l R e h a b i l i t a t i o n o f t h e Epi lept ic . (ed.) G . N. N r i g h t . U , S , Depar tment of H e a l t n , E d u c a t i o n and Wel fa r e : Wasnington, D.C.

I I (1962) e

s u b s t a n t i a t e d

48These s t u d i e s a r e r ev i ewed i n g r e a t e r d e t a i l i n t h e Commission 's Report, s u r a , Volume 11 a t 493 -737 ; and i n 6as ic

t h e r e i n are d i r e c t c i t a t i o n s t o e a c n s t u d y ment ioned above . S t a t i s t i c s on t h e E p i rp- epsies , supra, at 86-100. A l s o c o n t a i n e d

- 3 L -

by company accident records.

with epilepsy, only one company rated a person witn a seizure

disorder as inferior -- because ne drank heavily, rated their workers with epilepsy as better tnan the average

When askecl to rate their employees

Other companies

handicapped employee.

Commencing in 1956, a ten-year study or employer attitudes regarding epilepsy was conducted in the San Francisco Bay area

among 100 of tne largest employers.

manufacturers, retailers, banks, insurance companles, hotels, and

Tnose studiea include

utilities. Overall, 54 percent of the employers would knowingly

hire a person with epilepsy in 1966, as compared with only 20

percent in 1956. The various reasons used to avoid initial niring

remained the same over tne ten year period.

Five nundred manufacturers ~n Arlzona were asKecl in I Y b U

whether they would knowingly hire a person with epilepsy f o r any

job.

percent replied they would not.

Of the 6 3 percent responding to the questlonnarre, n e c i r ~ y 7 s

Anotner longitudinal stuay was conducted in the Midwest

between 1962 and 1973. Nearly 1,400 employers were questioned

regarding their views on three aisaoility categories, one of wnicn

was epilepsy. Questions centered on work tolerance, reliability,

need for extra supervision, absenteeism, coworker relationships,

ability to adjust to a new Work environment, and tolerance of JOD

pressure, After ten years, 124 esployers were recontacted,

Although persons witn epilepsy gained considerably in favor

compared to tnose with the other handicaps, employers who

knowingly nired people with seizure disorders rose from a mere 5

percent in 1962 to only 12 percent in 1973,

These negative employer attitudes towards hlrlng the

person with epilepsy are still manifested today in a variety of

ways. A common practice, particularly among government employers,

is the use of seemingly ob~ective medical stanaards. 50

recent survey of 23 Caliiornia local government jurisaictions, the

~n a

501t has Deen pointed out thar: the company medical aoctor is not always in the position to be the most ODjective deCiSiOnmakeK in determining tne employaDility o f a particular applicant, Too commonly, there is pressure on the aecisionmaker to err on the side of the conservative: "If the psycniatrist recommends admission or an applicant who subsequently has difficulties, ne will be visably(sic) and dramatically conironted with his mistaken judgment and perhaps by the criticism of nis colleagues in the admission office and in t h e faculty. Ii, on tne other nanu, ne erroneously recommends rejection of tne applicant he will never De confronted with error.'' Glassman v. New YorK iYedical C o l l e y e , 11753/1969 (Sup. Ct. N.Y, l363), brief for amicus curiae American Orthopsychiatric Association, at 4, This reasoning has been applied to employment cases involving epilepsy. In descriDing the probative value of the testimony of a company doctor concerning tne employaDility of a person with epilepsy, Kovarsky and Hauck state: "Nhile the acceptance of this medical testimony is proper and entitled to careful evaluation, arDitrators are aware, or snould be aware, that company doctors testifying are expected to display allegiance to the firm. Many company doctors are unnecessarily conservative when evaluating employees, cnoosing to err on tne side of their employers," Kovarsky and Hauckr Arbitration and the dpileptic, Lab. L. J. 597, 602 (Septemoer, 1 9 7 7 ) .

- 34 -

following exclusionary medical standards were revealed:

A l l cities and counties impose restrictlons of various Kinds regarding the hiring of persons with past or present epileptic conditlons. will not hire an applicant for any ]OD if he or she has had any kind of seizure witnin tne last three years, even if the condition causing tne seizures is under control. Anotner county flatly states that epilepsy is unacceptaDle for any

One county

j0b.51

These medical standards often Dear no relationsnip to the

actual requirements of the job, and operate to perpetrate myths

about epilepsy as well as to arbitrarily exclude qualified

individuals from employment. It was exactly these types of 52

attitudes and practices that antidiscrimination legislation was

intended to overcome.

111. PUBLIC POLICY AND THE NATURE OF THE EPILEPSIES REQUIRE THAT ElvlPLOYERS UEMONSTRATE A SUdSTAN'rIAL AND CUHRSNT PKOdABILITY OF HA&q BE,FORE EXCLUOING AN INDIVIDUAL NITH EPILJ3PSY FliOiY 'THE WORKPLACE

The function of federal ana state antidiscrimination laws

is to ensure the handicapped, like persons with epilepsy, are not

51Employment Law Center's Disability Rights Education and Defense Fund, Inc., Medical Standards Project: Pundinq Proposal-Final Year at 8-9 (1982))

52Another common practice is tne use of pnysical or safety requirements that are unreasonably inflated, which in fact Dear relation to the successful performance of tne JOD, 9, e.g., Duran v, City of Tampap 430 F.Supp. 75 (M.D. F l a , 1977); Rose v Hanna ivlining Company, 616 P.Lu 1223 (Wash. Sup. Ct. 1980); Panettieri v. C.V. Hill Refrigeration, 159 N.J, Super, 472, 388 A,2d 630 (1978); Sterling Transit Co. v. FEPC, 1 L 1 Cal. App, 3d 7911, 175 Cal. Rptr. 548 (1981)

no

- 3 5 -

e x c l u d e d because of myths when i n t a c t t h e y c a n D e s a f e l y and

p r o d u c t i v e l y employed. T n e s e s t a t u t e s and t n e i r r e g u l a t i o n s

address t h e f a c t t h a t w h i l e there is a s t r o n g p u D l l c p o l i c y t o

c o m p l e t e l y i n t e g r a t e t h e handicapped i n t o s o c i e t y , i t is a l s o i n

t h e p u b l i c i n t e r e s t t o have employees who c a n work s a f e l y .

EmplOyeKS a r e n o t r e q u i r e d by f e d e r a l o r s t a t e laws and

r e g u l a t i o n s t o t a k e u n r e a s o n a b l e r i s k s i n h i r i n g p e r s o n s w i t n

h a n d i c a p p i n g c o n d i t i o n s . A d m i t t i n g t h a t s a f e t y c a n be a

l e g i t i m a t e i s s u e i n h i r i n g the handicapped does n o t mean t n a t

employer f ea rs a re w e l l - f o u n a e a . I n a d d i t i o n , i n o r d e r t o e n s u r e

t h a t t h e R e h a b i l i t a t i o n H C ~ anu comparab le l e g i s l a t i o n a re n o t

v i t i a t e d , e m p l o y e r s c a n n o t D e permitted t o a s s e r t t h e e x i s t e n c e

of a p o s s i b i l i t y of narm, o r some i n c r e a s e d r i s k o f narm, no

matter how u n l i k e l y , a s a 7 u s t i f i c a t i o n f o r r e f u s i n g t o h i r e t n e

h a n d i c a p p e d ,

"Safe p e r f o r m a n c e of t h e j o g " n e e d s t o D e k e p t i n

p e r s p e c t i v e . I t n a s Deen n o t e d t h a t t h e c o n c e p t of " s a f e t y " h a s

a t times been e l e v a t e d " t o t h e s t a t u s o f a sacred cow, ' ' 5 3

l e v e l of risK of i n j u r y i n any i n d u s t r y c a n n e v e r b e Drought t o

z e r o , and no s t a n d a r d u n r e a s o n a b l y c l o s e t o t h a t c a n o r s h o u l d D e

used. W h i l e t h e e x c l u s i o n of p e r s o n s w i t h e p i l e p s y from

employment may be a n " e a s y " s c r e e n i n g d e v i c e , i t is n o t a n

a p p r o p r i a t e or e v e n e f f e c t i v e way t o lower t n e a c c i d e n t l e v e l s in

a p a r t i c u l a r company.

T h e

531n r e Samuel dingnam Co. , 6 7 L a g A K Q . 7 0 6 , 7 0 7 (1976)-

- 3 6 -

r e c o g n i z e d t h a t e m p l o y e r s ' f e a r s of p o s s i b l e i n j u r i e s a re n o t

s u f f i c i e n t j u s t i f i c a t i o n for deny ing p e r s o n s w i t n e p i l e p s y access

t o employment.

280 N.W. 2d 1 4 2 , 1 5 0 ( 1 9 7 9 ) , t n e c o u r t a e s c r i b e d t n e bu rden upon

I n d u c y r u s- E r i e Company v . D I H L A , 9 0 W i s . 2d 4 0 8 ,

t h e employer a s f o l l o w s :

I f t h e e v i d e n c e shows t n a t t h e a p p l i c a n t n a s a p r e s e n t a b i l i t y t o p n y s i c a l l y accompl i sh the tasKs which m a k e u p t n e j ob d u t i e s , t h e employer m u s t e s t a b l i s h t o a r e a s o n a b l e p r o b a D i l i t y t h a t because of t h e c o m p l a i n a n t ' s p h y s i c a l c o n d i t i o n , employment i n t h e pos i r ; l on Sough t would oe n a z a r d o u s t o t n e h e a l t h or s a f e t y of t n e c o m p l a i n a n t OK t o o t h e r employees or f r e q u e n t e r s of t h e place of employment. [Emphasis addedJ

S i m i l a r l y , t h e C o u r t i n Chicago and N o r t n w e s t e r n K.R. v.

LaDor and I n d u s t r y Review Coirunission, 9 1 W i s . 2d 4bL, 2 8 3 N.N. 2a

603 ( W i s . App. 1979) h e l d t n a t t n e employer nad n o t met its Duarden

of p r o v i n g t h a t tnere was a r e a s o n a b l e p r o o a b i l i t y t h a t t h e

a p p l i c a n t would h a v e a f u t u r e s e i z u r e t n a t would s u b j e c t him or

t h o s e a r o u n d him t o d a n g e r , Tne C o u r t a l s o n o t e d t h a t the

employer was n o t r e l i e v e d of t h e c h a r g e of d i s c r i m i n a t i o n o y i t s

r e l i a n c e on the o p i n i o n of t n e company d o c t o r c o n c e r n i n g t h e

r e a s o n a b l e p r o b a b i l i t y of a f u t u r e s e i z u r e . = . a t 608 54

L i k e w i s e , i n Montgomery Ward v. b u r e a u of L a D o r I 2 d 0 O r e .

1 6 3 , 165 , 570 P ,2d 7 6 ( 1 9 7 7 ) , t h e s t a t e supreme cour t found t n a t

a n app l i can t cou ld n o t be refused employment based o n l y upon a

54See -- also, n o t e 50 , supra ,

- 37 -

“reasonable medical possiDility that tne applicant

might,..experience injury as a result of attempting to perform the

job.” [Emphasis in original]

As a metnod for demonstrating the 1iKelinood of a Seizure

causing injury wnile on the Job, a type of statistical analysis is

being increasingly used. Sucn an analysis relies upon recent data

on the likelihood of future seizures in given individual^,^^ tne type of seizure conuition, and the nature of tne employment, in

order to more precisely determine liKelihood of inlury on the job,

So, in In re Trans Nor ld Airways, Inc., 74 Lao. Arb. 1154

(April 16, 1980) the arDitration panel hela that the airline had

imprOpeKly refused to reinstate a flight attendant witn epilepsy

who had not had a seizure in two and one nalf years. By looKing

at seizure possibility in a year, tne numDer of hours spent in

flight in a year (less than 10% in tnis case), and the possibility

of an emergency requiring tne availability of all flight

attendants, the arbitrators found the r i s k of possiDle harm too

small to justify the airline’s refusal to reinstate the flight

attendant. - Id. at 1156

In Griffin v. Illinois Department of Law Enforcement Merit

Board the administrative law Judge used a similar type of

statistical reasoning to find tnat a man seizure free f o r 1 0 years

(and off medication for five years) could D e safely employed as a

55ELq. I Annegers, Hauser# and Eiveback, Remission of Seizures and Relapse in Patients with Epilepsy, 21) Epilepsia 729 (1979)

- 3 6 -

s t a t e po l i ce o f f i c e r . 5 6

of s t a t e police o f f i c e r i n v o l v e s a g r e a t dea l of s t r e s s and some

d a n g e r ,

10 y e a r s was less t h a n 10 p e r c e n t , and t h e l i k e l i h o o d of s u c n d

s e i z u r e o c c u r r i n g a t a c r i t i c a l t i m e was even smal le r , t n e j u d g e

found t h e p o s s i b i l i t y of a s e i z u r e c a u s i n g i n j u r y on t h e job t o o

smal l t o deny p l a i n t i f f employment as a pol ice o f f i c e r ,

T h e j u d g e r e c o g n i z e d t n a t t n e p o s i t i o n

Because t n e p r o D a D i l i t y of a f u t u r e s e l z u r e o v e r t h e n e x t

57

A s t h e a r b i t r a t i o n p a n e l i n T r a n s Worlu A i r l i n e s , supra

p o i n t e d o u t r t h e r e a l i s s u e i n these cases i s n o t a meaical

q u e s t i o n b u t a s o c i o - l e g a l q u e s t i o n WnetheK t n e g o l i c y of

n o n- d i s c r i m i n a t i o n a g a i n s t p e r s o n s w i t h h a n d i c a p s o u t w e i g h s

whatever r l s k s l no matter how s l i g n t ,

e p i l e p s y i n t o t h e workp lace .

i n a l l o w i n g a pe rson w i t n 58

C o u r t s have a l s o r e c o g n i z e d t h a t t h e i s s u e is a p o l i t i c a l

more t h a n a m e d i c a l q u e s t i o n ,

C o u r t awarded Dackpay damages t o a s h o e s a l e sman who was f i r e d

a f t e r e x p e r i e n c i n g a complex p a r t i a l s e i z u r e w h i l e a t work.

I n R o s s v . Gama S h o e s I Into, t h e

I n

56Charge No. 1 9 8 0 CN 0035 ( u n r e p o r t e d ) Recommended Orde r and D e c i s i o n , ( I l l i n o i s Human K i g h t s Commission, PeDruary 1 9 , 1982.)

571d, - a t 12

581n r e T r a n s World Ai rways , supra a t 1155,

-. 3 5 -

f i n d i n g i n f a v o r of t h e p l a i n t i f f under the D.C. Human R i g h t s A c t s

t h e C o u r t r e a s o n e d :

[ a l a m i t t e d l y i n t h i s case i f t h e p l a i n t i f f i n j u r e s a cus tomer or employee a u r i n g a s e i z u r e , s u c n i n j u r y c o u l d l p e r h a p s , have Deen a v o i d e d had t h e p l a i n t i f f n o t been employed. I n t h i s case t n e n , a s i n t n e case of any o t h e r employment s o as n o t t o e x c l u d e a l l b u t p e r f e c t p e r s o n s , t h e r e m u s t be a r e a s o n a b l e b a l a n c e between q u a l i f i c a t i o n s f o r employment and s a f e t y of t h e community. S i n c e no one would s u g g e s t t n a t e p i l e p t i c s m u s t o e s e g r e g a t e d o r i s o l a t e d froin s o c i e t y as a w n o l e p t h e r i s k of i n j u r y t o s h o e s t o r e c u s t o m e r s o r

~~

employees ~y a n e p i l e p t i c s a l e s m a n i s n o t s u D s t a n t i a l l y g r e a t e r t h a n r i s k of i n j u r y o t h e r g e n e r a l m e m D e r o f t h e p u D l i c ~y e p i l e p t i c s . 59

I n Bingham, s u p r a , a n a r D i t r a t o r o r d e r e d

t o any

h e r e i n s t a t

of a worker w i t h " m o d e r a t e i y w e l l c o n t r o l l e d " e p i l e p s y , a f t e r

examining the g r i e v a n t ' s work r e c o r d o v e r the p r e v i o u s s e v e n

y e a r s , A s t h e a r b i t r a t o r so a p t l y s t a t e U : On a l l sides we a r e f a c e d w i t h campaigns t o h i r e

t h e ' h a n d i c a p p e d e 8 Here i s t h e pe r tec t o p p o r t u n i t y f o r h i r i n g t h e h a n d i c a p p e a - i f r i n d e e d d g r i e v a n t can r e a l l y D e termed s u c h .

What gooa d o e s i t d o t h e puo l i c t o spend h u n d r e d s o f d o l l a r s t o c o n t r o l a i l m e n t s s u c h a s e p i l e p s y i f t h e end r e s u l t is t o have t n e e p i l e p t i c condemned t o a r o c k i n g cha i r i n f r o n t or T . V . ? . . .

N o douDt t h e r e is a c e r t a i n r i s k i n employing G r i e v a n t . B u t s i n c e h e h a s been employed f o r a l m o s t s e v e n y e a r s w i t h no ep i l ep t i c- re la ted i n j u r i e s , t h a t r i s k seems v e r y small . . . . Even a t t h e r a t e o f two o r t h r e e s e i z u r e s a m o n t n . . . w i t n e s s e s c o u l d o n l y t e s t i f y t o two o f tnese h a v i n g o c c u r r e d a t t h e p l a n t . ...

S a f e t y is des i rable , of c o u r s e , b u t t o a t t e m p t t o create a n a b s o l u t e l y r i s k l e s s s o c i e t y i s t o place on i m p o s s i b l e b u r d e n on t h e p u o l i c , Some r i s k m u s t D e a s s u m e d . , , . [ I ] f w e r e f u s e t o t a k e t h e s m a l l r i s k i n v o l v e d h e r e , t h e n ' s a f e t y @ becomes " c a l l o u s n e s s " and " i n d i f f e r e n c e . I) 60

5928 F , E , P . Cases 1 5 0 , 1 5 2 (U,C. Sup. C t , 1 9 8 0 ,

Gogingham, s u p r a , n o t e 53 a t 7 U 8 .

ment

- 4u -

A s f r l e n d s of t n e C o u r t , t ne LplLepsy F o u n d a t l o n of

America and C e n t r a l Ar izona R e g l o n a l Eailepsy S o c i e t y support

a p p e l l a n t ' s p e t l t i o n t o o v e r t u r n the Order or t n e Court t3elow.

T n e legal s t a n d a r d t h e C o u r t r e l i ea upon i s a t oads w i t n t n e

R e h a b i l i t a t i o n A c t and i t s i n t e n t Decause i t e x c l u d e s q u a l l f l e d

handicapped p e r s o n s from employment.

s t a n a a r d would r e p r e s e n t a malor s t e p DacKwara in t n e strldes tnat

h a v e Deen macle I n integrating p e r s o n s w i t n epilepsy i n t o t h e work

f o r c e

To a l l o w t n e u s e of s u c n a

Hespectfuily s u o m i ~ ~ t e s l ~

k 1 c ~ \ J ( ) L < 0 C'CC'-LGLM-L!J- [{ ----.-.--

A l e x a n a r a & e r ' l nucane At to rney- a t- Law E p i l e p s y E o u n d a t l o n o t America 4351 Garden C i t y D r i v e Landover Maryland 2 0 7 d 3

A t t o r n e y f o r A m i c l C u r i a e ( 3 U l ) 459-3711(1

- 41 -

CERTIFICATE O F SERVICE

I h e r e b y c e r t i f y t h a t a t r u e and correct copy o f t h e

above amicus cu r iae b r i e f w a s m a i l e d f i r s t c lass ,

p r e p a i d t o :

p o s t a g e

Amy G i t t l e r Neal J. Beets Ar izona C e n t e r f o r Law

1 1 2 N o r t h F i f t h Avenue Phoen ix , A2 85003 ( 6 0 2 ) 252-4904

A t t o r n e y s f o r P l a i n t i f f - A p p e l l a n t

Barbara S . F r e d e r i c k s Mary S. E l c a n o O f f i c e of Labor Law U n i t e d S t a t e s Pos ta l S e r v i c e 475 L ' E n f a n t P l a z a , S.W. Washington, D.C. 20260 A t t o r n e y s f o r Defendant- Respondent

E l i z a b e t h J u l i u s Dunn A s s i s t a n t U n i t e d S t a t e s A t t o r n e y 4000 U . S . Cou r thouse Phoen ix , A2 9 5 0 2 5 A t t o r n e y f o r Defendant- Respondent

i n t h e P u b l i c Interest

on t h i s ?,tic day of November, 1983

A t t o r n e y a t Law