In the Seventh Circuit, Another Wellness Litigation Setback for the EEOC | Practical Law

In the Seventh Circuit, Another Wellness Litigation Setback for the EEOC | Practical Law

The Seventh Circuit has affirmed a district court decision dismissing a challenge brought by the Equal Employment Opportunity Commission (EEOC) regarding requirements under an employer's wellness program. The court concluded that relief sought by the EEOC is either unavailable or moot.

In the Seventh Circuit, Another Wellness Litigation Setback for the EEOC

Practical Law Legal Update w-005-6319 (Approx. 6 pages)

In the Seventh Circuit, Another Wellness Litigation Setback for the EEOC

by Practical Law Employee Benefits & Executive Compensation
Published on 30 Jan 2017USA (National/Federal)
The Seventh Circuit has affirmed a district court decision dismissing a challenge brought by the Equal Employment Opportunity Commission (EEOC) regarding requirements under an employer's wellness program. The court concluded that relief sought by the EEOC is either unavailable or moot.
The US Court of Appeals for the Seventh Circuit has turned back a challenge by the Equal Employment Opportunity Commission (EEOC) to requirements under an employer's wellness program. The court ruled that the relief sought by the EEOC is either unavailable or moot (EEOC v. Flambeau, , at *1 (7th Cir. Jan. 25, 2017); see Practice Notes, Wellness Programs and Wellness Programs: EEOC Rules Under the ADA). The EEOC asserted that the disputed wellness program, which required employees to complete a medical questionnaire and undergo biometric testing as conditions to receiving employer-subsidized health insurance, violated a prohibition on involuntary medical examinations under the Americans with Disabilities Act (ADA). Without ruling on the case's merits, the Seventh Circuit affirmed a district court decision to dismiss the case (see Legal Update, ADA Allows Wellness Exams as Condition of Health Plan Enrollment: Western District of Wisconsin).

Background

The employer's wellness program included:
In 2012 and 2013, the employer required employees to participate in the wellness program in order to receive employer contributions to their health insurance premiums. One of the employer's employees failed to complete the wellness program's health risk assessment and biometric test for the 2012 plan year. As a result, the employer:
  • Terminated the employee's health plan coverage.
  • Offered him COBRA continuation coverage, which the employee declined (see Practice Note, COBRA Overview).
The employee filed complaints with the EEOC and Department of Labor (DOL), and the employer later reinstated the employee's coverage, subject to his completion of the wellness program's testing and payment of plan premiums. The employee agreed and his coverage was reinstated retroactive to January 2012. Nonetheless, the EEOC sued the employer on the employee's behalf, asserting that the plan's wellness program requirement violated the ADA's ban on employer-mandated medical examinations (42 U.S.C. § 12112(d)(4)).
In court, the employer argued that:
  • Its wellness plan was covered by the ADA's insurance safe harbor, which limits the ban on involuntary medical examinations in the case of a "bona fide benefit plan."
  • In the alternative, the health testing and assessments under its wellness program were voluntary because they were not conditions of employment.
Ruling for the employer, the district court concluded that the safe harbor could apply to some wellness programs, and that it covered the program at issue in this litigation. Following oral argument on the EEOC's appeal of this outcome, the Seventh Circuit requested additional briefing on whether the case was moot.

Outcome

On appeal, the Seventh Circuit concluded that the EEOC's claim for:
  • Compensatory and punitive damages on the employee's behalf were unavailable based on the undisputed facts.
  • Injunctive relief was moot.

No Recovery Under the EEOC's Theories for Awarding Damages

The court rejected the EEOC's argument that the employee was entitled to:
  • Out-of-pocket damages for medical expenses incurred while he lacked health coverage, because those bills were either written off or paid by third parties.
  • Emotional distress damages, because the employee's testimony did not adequately demonstrate why he should receive these damages.
Regarding a third theory for recovery, for punitive damages, the Seventh Circuit held that the employer's actions did not evidence discrimination with "malice or reckless indifference" to the employee's rights (that is, the governing standard for punitive damages under the ADA). The court reasoned that the scope of the ADA's insurance safe harbor, which formed the basis of the EEOC's theory of discrimination, was the subject of open questions in 2012 and 2013 (and remained so even today). The court noted that at the time the employer terminated the employee's health coverage:
In the Seventh Circuit's view, the "unsettled legal landscape" surrounding the safe harbor distinguished this litigation from cases awarding punitive damages for better understood ADA violations.

Claim for Injunctive Relief is Moot

The Seventh Circuit also rejected the EEOC's argument for injunctive relief, concluding that this claim was moot because the employer had discontinued its mandatory wellness program so there was nothing to enjoin. The EEOC argued that the employer's voluntary cessation of purportedly illegal conduct did not render the case moot. However, the court rejected this voluntary cessation theory because, among other reasons, there was no reasonable expectation that the alleged violations would recur (see Legal Update, Supreme Court Applies Voluntary Cessation Doctrine in Finding Nike Trademark Case Moot). Here, the court observed that the employer stopped requiring biometric testing and health risk assessments because it determined that their costs outweighed their benefits, making it unlikely that the alleged discrimination would recur.

Practical Impact

As indicated in the Seventh Circuit's punitive damages analysis, the relationship between the ADA's prohibition on involuntary medical examinations and its insurance safe-harbor provision remains an area of unsettled law. Although the Seventh Circuit's decision does not address the merits of this conflict, the court does express some skepticism of the EEOC's position on this question, noting that while the agency's guidelines are important and entitled to some deference, they are not controlling law. Moreover, many circuit courts of appeals have yet to weigh in on this conflict, meaning that employers should continue to proceed with caution in implementing health risk assessments and biometric screenings as part of their wellness programs.