Case Title: Ohio Civ. Rights Comm. v. Case W. Res. Univ.

Citation: 1996-Ohio-53

Docket Number: 19950387

State: ohio

Court: Ohio Supreme Court

Date: 1996-07-31T00:00:00Z

Document:
Ohio Civil Rights Commission et al., Appellants, v. Case Western Reserve 
University, Appellee.  
[Cite as Ohio Civ. Rights Comm. v. Case W. Res. Univ. (1996), ___ Ohio St.3d 
___.] 
Civil Rights Commission -- Elements of prima facie case of 
discrimination in education under R.C. 4112.022(A) -- “Otherwise 
qualified” handicapped person, defined. 
 
(No. 95-387 -- Submitted March 6, 1996 -- Decided July 31, 1996.) 
1.  A prima facie case of discrimination in education under R.C. 4112.022(A) 
 
includes three elements: (1) the plaintiff is a handicapped person within 
 
the meaning of R.C. 4112.01(A)(13); (2) the plaintiff is otherwise 
 
qualified to participate in the program; and (3) the plaintiff is being 
 
excluded from the program on the basis of a handicap. 
 2.  An “otherwise qualified” handicapped person is one who is able to safely 
 
and 
substantially 
perform 
an 
educational 
program’s 
essential 
 
requirements with  reasonable accommodation. An accommodation is 
 
not reasonable where it requires fundamental alterations in the essential 
 
2 
 
nature of the program or imposes an undue financial or administrative 
 
burden. 
 
Appeal from the Court of Appeals for Cuyahoga County, No. 66721. 
 
Plaintiff-appellant, Ohio Civil Rights Commission (“OCRC”), appeals 
from a decision approving Case Western Reserve University’s (“CWRU”) 
denial of a blind candidate’s application for admission to its medical school.  
 
Plaintiff-appellant, Cheryl A. Fischer (“Fischer”), completely lost her 
vision during her junior year of undergraduate study at CWRU. To 
accommodate Fischer’s handicap while she pursued a chemistry degree, 
CWRU provided Fischer with lab assistants and readers, modified the written 
exams to oral ones, and extended the time periods in which to take exams. 
Fischer also used a closed circuit television to magnify images before she 
totally lost her sight, and books on tape to assist her.  Thus, in spite of her 
handicap, Fischer successfully completed all of CWRU’s academic 
requirements and received her baccalaureate degree, cum laude, in 1987. 
 
3 
 
Following graduation, Fischer sought admission to medical school.  All 
medical colleges in the United States belong to the Association of American 
Medical Colleges (“AAMC”).  In January 1979, the AAMC adopted the 
“Report of the Special Advisory Panel on Technical Standards for Medical 
School Admission.” The AAMC Technical Standards Report requires 
candidates for a medical school degree to have the ability to observe.  
Specifically, the report states, “[t]he candidate must be able to observe 
demonstrations and experiments in the basic sciences * * *.  A candidate must 
be able to observe a patient accurately at a distance and close at hand.  
Observation necessitates the functional use of the sense of vision and somatic 
sensation.”   The Technical Report further states, “a candidate should be able to 
perform in a reasonably independent manner. The use of a trained intermediary 
means that a candidate’s judgment must be mediated by someone else’s power 
of selection and observation.”   Although medical colleges are not required to 
follow the Technical Standards Report, the AAMC encouraged medical schools 
to use it as a guideline in developing their own standards.  
 
4 
 
In 1987, Cheryl applied to the medical school at CWRU.1   CWRU used 
the AAMC Technical Standards Report as a guideline in evaluating the four 
thousand to five thousand preliminary applications received annually for a 
class total of one hundred thirty-eight.2  Due to Fischer’s sufficient academic 
credentials and extraordinary letters of recommendation, Dr. Albert C. Kirby, 
Associate Dean for Admissions and Student Affairs at CWRU’s medical 
school, granted Fischer an interview.  Subsequently, Dr. Kirby placed Fischer 
on an alternate list but ultimately denied her application. The following year, 
Fischer reapplied to CWRU.3  
 
In this second application process, Fischer was one of seven hundred 
applicants granted an interview and the only applicant to be interviewed by 
three Admission Committee members: Dr. Kirby, Dr. Richard B. Fratianne and 
Dr. Mildred Lam.  Dr. Kirby believed that CWRU should accept Fischer into 
the class. Drs. Fratianne and Lam concluded that a blind student would be 
unable to complete the requirements of the medical school program.   
 
5 
 
CWRU’s four-year curriculum consists of three basic components: the 
core academic program, the flexible program, and the patient-based program. 
The core academic program occupies the medical student’s first two years, and 
is taught using traditional methods such as lectures, lab experiments and 
textbooks.   The core academic program consists of study in the basic sciences, 
such as anatomy, histology, pathology, and physiology. The flexible program 
consists of electives, allowing students to engage in independent research and 
study in a specific area.  The patient-based program includes clerkships in 
internal medicine, pediatrics, surgery, obstetrics and gynecology, psychiatry 
and primary care.   In these different clerkships, students provide direct patient 
care.   For example, students must perform a complete physical exam, review 
laboratory test results, review patient charts and perform basic medical 
procedures, such as starting an I.V., administering medications through veins, 
drawing blood, and responding in emergency situations.  The surgery clerkship 
includes rotations in the emergency room and intensive care unit.   
 
6 
 
After interviewing Fischer, Dr. Fratianne, Associate Professor of Surgery 
at CWRU, concluded that Fischer would be unable to complete the medical 
school program.  He believed that due to her lack of vision, Fischer would be 
unable to exercise independent judgment when reading an X-ray, unable to 
start an I.V., and unable to effectively participate in the surgery clerkship.    
 
Following an interview with Fischer, Dr. Lam, Associate Professor of 
Medicine at CWRU, concluded that a blind student would be unable to 
complete the first and second year courses in the basic sciences which required 
the student to observe and identify various tissues and organ structures.  For 
example, histology requires a student to identify tissue and organ structures 
through a microscope and pathology requires a student to observe how such 
structures are affected by disease.  She believed that no accommodation would 
enable a blind student to complete these course  requirements.   
 
Dr. Lam further opined that a blind medical student could not complete 
the third and fourth year clerkships. A blind student would be unable to start an 
I.V., draw blood, take night call, react in emergency situations, or pass the 
 
7 
objective clinical exam which required a student to perform a physical exam 
and to read an EKG and an X-ray. Dr. Lam prepared a list of forty-three 
medical conditions, such as jaundice or a patient’s state of consciousness, 
which require good vision to diagnose.  Dr. Lam also listed twenty-one medical 
procedures, such as arterial line placement, which require good vision.  Dr. 
Lam concluded that an intermediary could not assist a blind medical student 
because use of an intermediary would require extra time that is not available in 
an emergency situation, and the observations during and the accuracy of the 
physical exam would be “only as good as the intermediary.” Fischer recalled 
that during the interview, Dr. Lam commented that the “whole concept” of a 
blind medical student was “ridiculous.”  
 
After the three interviews and after consulting other CWRU medical 
school professors and students, CWRU’s Admissions Committee, by a 
unanimous vote, denied Fischer’s application.4  Although the committee was 
aware of Dr. David W. Hartman, a psychiatrist who graduated from Temple 
 
8 
University School of Medicine while totally blind in 1976, the committee did 
not contact Dr. Hartman or Temple University.   
 
Dr. Hartman’s experience affected the decision-making in this case.   
Temple University, in 1972, voluntarily increased the size of the incoming 
class by one to accept Dr. Hartman.  To facilitate his first two years of study in 
the basic sciences, Dr. Hartman used a raised line drawing board to diagram 
and illustrate various structures.  Postdoctoral or graduate students privately 
tutored Dr. Hartman by describing to him the slides of structures under 
microscope and using the raised line drawing board. Other medical students 
also assisted Dr. Hartman by describing experiments they conducted and 
otherwise sharing information. Dr. Hartman also listened to books on tapes, 
used readers, and relied on his sense of touch for classes such as anatomy.  
 
In virtually all of his first and second year courses, Dr. Hartman required 
one-on-one assistance from his professors. Dr. Hartman estimated that the 
professors in the anatomy department, which included courses in gross 
anatomy, neuroanatomy, embryology and histology, spent double or triple the 
 
9 
time tutoring him than they spent tutoring the average student.  John R. Troyer, 
Ph.D., a professor who was on the faculty at Temple when Dr. Hartman 
attended, believed that the extra time he spent with Dr. Hartman took away 
from time he had to tutor other students. For this reason, Dr. Troyer had 
reservations about accepting another blind student.    
 
Professors at Temple also modified their lectures to accommodate Dr. 
Hartman.  For example, professors diagrammed structures on the raised line 
drawing board that the other students viewed under a microscope and verbally 
described processes instead of visually demonstrating them.   One professor 
even sat next to Dr. Hartman during class and described procedures being 
conducted in a class demonstration.  
 
To facilitate his clerkships, Dr. Hartman would have a nurse, another 
student, the resident or intern perform parts of a physical examination which 
required visual observations and describe their observations to him.   Another 
student or a nurse would read patient charts and laboratory test results to him. 
 
10 
Dr. Hartman could not start an I.V. without the supervision and  assistance of a 
nurse and could not read an X-ray without relying on a radiologist.  
 
During the surgical clerkship, Dr. Hartman spent only one or two days a 
week for three to four hours a day in surgery, where other students spent six or 
seven hours a day every day in surgery.  Instead of being placed on night call 
alone, Dr. Hartman was paired with another student because the hospital relied 
on medical students to start I.V.s and draw blood.   
 
Dr. Hartman’s testimony revealed that his successful completion of the 
school’s requirements depended on the willingness of the faculty and other 
students to spend the extra time describing and sharing information with him.  
 
 Following the second denial of Fischer’s application to medical school, 
Fischer filed a complaint with the OCRC, alleging that CWRU had 
discriminated against her by denying her admission to the medical school on 
the basis of her handicap.  After an investigation, OCRC found it probable that 
CWRU engaged in discriminatory practices in violation of R.C. 4112.022 and 
filed a complaint and notice of hearing. 5    
 
11 
 
Following the hearing, the examiner concluded that CWRU had not 
discriminated against Fischer and recommended dismissal of her complaint. 
The hearing examiner found that (1) Fischer could not complete the first two 
years of CWRU’s requirements unless CWRU was willing to accommodate 
Fischer’s handicap beyond what is legally required and was willing to place an 
undue burden on its teaching faculty, and (2) Fischer could not successfully 
complete the core clerkships without substantial modification to the essential 
nature of the program.  
 
Upon its review of the hearing examiner’s report, OCRC came to a 
different conclusion.  Relying heavily upon Dr. Hartman’s experience, OCRC 
concluded that Fischer could complete the medical school program with 
reasonable accommodations that would not modify the essential nature of its 
program. OCRC further found that CWRU violated an affirmative duty to 
gather substantial information to ascertain whether Fischer could benefit from 
the medical school’s program. Finding CWRU had discriminated against 
 
12 
Fischer, OCRC issued a cease and desist order and ordered CWRU to admit 
Fischer into its next class.  
 
CWRU appealed to the Cuyahoga County Common Pleas Court, which 
found that reliable, probative and substantial evidence supported OCRC’s 
findings of fact and conclusions of law and affirmed the OCRC order.  The 
Court of Appeals for Cuyahoga County reversed, holding that the record did 
not support the trial court’s finding that admitting Fischer would not 
necessitate a modification of the essential nature of the program and would not 
place an undue burden on CWRU.  The court of appeals determined that the 
trial court had abused its discretion by relying upon Dr. Hartman’s experience 
at Temple University and in finding that Temple made only reasonable 
accommodations.  
 
This cause is now before the court upon the allowance of a discretionary 
appeal. 
 
13 
 
Betty D. Montgomery, Attorney General, Jeffrey S. Sutton, State 
Solicitor, Nancy Holland Myers and Denise M. Johnson, Assistant Attorneys 
General, for appellant Ohio Civil Rights Commission. 
 
Gary, Naegele & Theado, Thomas A. Downie and Robert D. Gary;  
Robert A. Dixon, Zygmunt G. Slominski and Russell D. Kornblut, for appellant 
Cheryl A. Fischer. 
 
Kelley, McCann & Livingstone, Joel A. Makee, Mark J. Valponi and 
Colleen Treml, for appellee. 
 
Ohio Legal Rights Service, Jane P. Perry and Robert S. Mills, urging 
reversal for amici curiae, Ohio Legal Rights Service and National Federation of 
the Blind of Ohio. 
 
Spater, Gittes, Schulte & Kolman, Kathaleen B. Schulte and Frederick 
M. Gittes, urging reversal for amicus curiae, Ohio Employment Lawyers 
Association. 
 
Chester, Willcox & Saxbe and Charles R. Saxbe; Brown, Goldstein & 
Levy, Daniel F. Goldstein and Dana Whitehead, urging reversal for amici 
 
14 
curiae, National Federation of the Blind and American Society of Handicapped 
Physicians. 
 
Betty D. Montgomery, Attorney General, Simon B. Karas, Deputy Chief 
Counsel, and John C. Dowling, Assistant Attorney General, urging affirmance 
for amici curiae, Ohio’s Public Medical Schools. 
 
Joseph A. Keyes, Jr., Kirk B. Johnson and Michael L. Ile, urging 
affirmance for amici curiae, Association of American Medical Colleges and 
American Medical Association. 
 
Cook, J.  In this case, we are presented with the question of whether 
CWRU violated R.C. 4112.022(A) by denying a totally blind applicant 
admission to its medical school.  We affirm the judgment of the court of 
appeals finding no violation. 
I.  PRIMA FACIE CASE OF HANDICAP DISCRIMINATION 
 
OCRC charges that CWRU violated R.C. 4112.022, which prohibits 
discrimination against handicapped persons by educational institutions.  
Specifically, the statute provides:   
 
15 
 
“It shall be an unlawful discriminatory practice for any educational 
institution to discriminate against any individual on account of any handicap: 
 
“(A)  In admission or assignment to any academic program, course of 
study, internship, or class offered by the institution[.]” 
 
Similarly, Ohio Adm.Code  4112-5-09(B)(1) provides: 
 
“Qualified handicapped persons shall not be denied admission or be 
subjected to discrimination in admission or recruitment on the basis of 
handicap at an educational institution covered by Chapter 4112. of the Revised 
Code.” 
 
The parties agree and we hold that a prima facie case of discrimination in 
education under R.C. 4112.022(A) includes three elements: (1) the plaintiff is a 
handicapped person within the meaning of R.C. 4112.01(A)(13); (2) the 
plaintiff was otherwise qualified to participate in the program6; and (3) the 
plaintiff was excluded from the program on the basis of a handicap.  See 
Hazlett v. Martin Chevrolet, Inc. (1986), 25 Ohio St.3d 279, 281, 25 OBR 331, 
333, 496 N.E.2d 478, 480 (discrimination against handicapped in employment 
 
16 
context).  See, also, Southeastern Community College v. Davis (1979), 442 
U.S. 397, 99 S.Ct. 2361, 60 L.Ed.2d 980 (construing federal law prohibiting 
discrimination against handicapped in education); Doherty v. S. College of 
Optometry (C.A.6, 1988), 862 F.2d 570, 573, certiorari denied (1989), 493 U.S. 
810, 110 S.Ct. 53, 107 L.Ed.2d 22.   The parties also agree that the only 
element at issue in this case is whether Cheryl Fischer is “otherwise qualified” 
to participate in CWRU’s medical school program.  
A.  OTHERWISE QUALIFIED HANDICAPPED PERSON 
 
The term “otherwise qualified handicapped person” in the educational 
discrimination context is not defined by statute or regulation.  In the 
employment discrimination context, however, a "qualified handicapped person" 
means  “a handicapped person who can safely and substantially perform the 
essential functions of the job in question, with or without reasonable 
accommodation.” Ohio Adm.Code 4112-5-02(K).  In the past, we have looked 
to federal law to support a finding of discrimination under R.C. Chapter 4112. 
Little Forest Med. Ctr. of Akron v. Ohio Civ. Rights Comm. (1991), 61 Ohio 
 
17 
St.3d 607, 575 N.E.2d 1164, certiorari denied (1992), 503 U.S. 906, 112 S.Ct. 
1263, 117 L.Ed.2d 491 (federal case law interpreting Title VII of the Civil 
Rights Act of 1964 applied to R.C. Chapter 4112 employment discrimination 
claim).  Accordingly, in the context of discrimination by educational 
institutions, we refer to Section 504 of the Rehabilitation Act of 1973, codified 
at Section 794, Title 29, U.S. Code, to assign meaning to the term “otherwise 
qualified” handicapped person. 
 
Our inquiry into the meaning of “otherwise qualified” as used in Section 
504 begins with the United States Supreme Court’s analysis in  Southeastern 
Community College v. Davis, supra, 442 U.S. at 397, 99 S.Ct. at 2361, 60 
L.Ed.2d at 980.  In that case, a deaf student alleged that a nursing school had 
discriminated against her after the school refused to admit her into its program.  
The Davis court defined an “otherwise qualified person” as “one who is able to 
meet all of a program’s requirements in spite of his handicap.” Id. at 406, 99 
S.Ct. at 2367, 60 L.Ed.2d at 988.  Applying this definition of “otherwise 
qualified,” the court held that the nursing school would not be forced to accept 
 
18 
this deaf student because her inability to understand speech without reliance on 
lip reading would jeopardize patient safety during the clinical phase of the 
program. Id. at 407 99 S.Ct. at 2367, 60 L.Ed.2d at 989.  The court did not 
require the school to modify its curriculum through a waiver of the clinical 
program because such an accommodation required a “fundamental alteration” 
in the nursing school’s program. Id. at 410, 99 S.Ct. at 2369, 60 L.Ed.2d at 990. 
 
Six years later, the Supreme Court revisited the issue in Alexander v. 
Choate (1985), 469 U.S. 287, 105 S.Ct. 712, 83 L.Ed.2d 661.  In clarifying its 
prior decision, the Alexander court stated, “Davis *** struck a balance between 
the statutory rights of the handicapped to be integrated into society and the 
legitimate interest of federal grantees in preserving the integrity of their 
programs: while a grantee need not be required to make ‘fundamental’ or 
‘substantial’ modifications to accommodate the handicapped, it may be 
required to make ‘reasonable’ ones.” Alexander at 300, 105 S.Ct. at 720, 83 
L.Ed.2d at 671. Thus, Alexander modified Davis to the extent that an 
 
19 
“otherwise qualified” person is one capable of participating in the program if a 
“reasonable accommodation” is available for implementation by the institution.  
 
Most recently, the Supreme Court discussed the “otherwise qualified” 
standard in School Bd. of Nassau Cty. v. Arline (1987), 480 U.S. 273, 107 
S.Ct. 1123, 94 L.Ed.2d 307.  The court elaborated on the definition of an 
“otherwise qualified” individual: 
 
“In the employment context, an otherwise qualified  person is one who 
can perform ‘the essential functions’ of the job in question.  When a 
handicapped person is not able to perform the essential functions of the job, the 
court must also consider whether any ‘reasonable accommodation’ by the 
employer would enable the handicapped person to perform those functions. 
Accommodation is not reasonable if it either imposes ‘undue financial and 
administrative burdens’ on a grantee or requires ‘a fundamental alteration in 
the nature of [the] program.’” (Citations omitted.) Id. at 288, 107 S.Ct. at 1131, 
94 L.Ed.2d at 321, fn. 17. 
 
20 
 
Similarly, Ohio Adm.Code 4112-5-09(D)(1) requires educational 
institutions to make necessary modifications to its academic requirements to 
prevent discrimination on the basis of handicap against a qualified handicapped 
applicant.  Such modifications include “changes in the length of time permitted 
for the completion of degree requirements, substitution of specific courses 
required for the completion of degree requirements, and adaptation of the 
manner in which specific courses are conducted.”  However, academic 
requirements that the educational institution can demonstrate are “essential to 
the program of instruction being pursued by such student or to any directly 
related licensing requirement will not be regarded as discriminatory ***,” and 
do not require modification.  
 
Applying these principles to R.C. 4112.022(A), we define an “otherwise 
qualified” handicapped person as one who is able to safely and substantially 
perform an educational program’s essential requirements with reasonable 
accommodation. An accommodation is not reasonable where it requires 
 
21 
fundamental alterations in the essential nature of the program or imposes an 
undue financial or administrative burden. 
   
Because inquiry into reasonable accommodation is not separate from but 
rather is an aspect of  “otherwise qualified,” we further hold that as part of its 
prima facie case, OCRC carries the initial burden of showing that Fischer could 
safely and substantially perform the essential requirements of the program with 
reasonable accommodation. See Ohio Adm.Code 4112-5-02(K); see, also, 
Wood v. Omaha School Dist. (C.A.8, 1993), 985 F.2d 437, 439; Carter v. 
Bennett (C.A.D.C.1988), 840 F.2d 63, 65.  Thereafter, the burden shifts to 
CWRU to demonstrate that Fischer is not “otherwise qualified,” i.e., the 
accommodations are not reasonable because they require fundamental 
alterations to the essential nature of the program or because they impose undue 
financial or administrative burdens. Id. CWRU may also rebut a prima facie 
case of discrimination by “establishing bona fide requirements or standards for 
admission or assignment to academic programs, courses, internships, or classes 
* * * which requirements or standards may include reasonable qualifications 
 
22 
for demonstrating necessary skill, aptitude, physical capability, intelligence, 
and previous education.” R.C. 4112.022.  Finally, the burden returns to OCRC 
and Fischer to rebut the evidence presented by CWRU. Doe v. New York Univ. 
(C.A.2, 1981), 666 F.2d 761, 776-777.  
II. STANDARD OF REVIEW 
 
Before we determine whether Fischer is otherwise qualified to 
participate in the medical school program at CWRU, we note the standards 
upon which we review this case.   Pursuant to R.C. 4112.06(E), a trial court 
must affirm a finding of discrimination under R.C. Chapter 4112, if the finding 
is supported by reliable, probative and substantial evidence on the entire 
record. Plumbers & Steamfitters Joint Apprenticeship Commt. v. Ohio Civ. 
Rights Comm. (1981), 66 Ohio St.2d 192, 20 O.O.3d 200, 421 N.E.2d 128. 
 
The role of the appellate court in reviewing commission orders is more 
limited -- to determine whether the trial court abused its discretion in finding 
that there was reliable, probative and substantial evidence to support the 
commission’s order. See Cleveland Civ. Serv. Comm. v. Ohio Civ. Rights 
 
23 
Comm. (1991), 57 Ohio St.3d 62, 65, 565 N.E.2d 579, 582.  A trial court 
abuses its discretion where its decision is clearly erroneous, that is, the trial 
court misapplies the law to undisputed facts. Alexander v. Mt. Carmel Med. 
Ctr. (1978), 56 Ohio St.2d 155, 10 O.O.3d 332, 383 N.E.2d 564.  
 
We agree with the court of appeals and find that the trial court abused its 
discretion in finding that (1) the OCRC order was supported by reliable, 
probative and substantial evidence, and (2) Fischer was “otherwise qualified” 
for admission with reasonable accommodations. 
A.  RELIABLE, PROBATIVE & SUBSTANTIAL EVIDENCE 
 
OCRC relied upon Dr. Hartman’s experience at  Temple University and 
Fischer’s experience at CWRU while she was an undergraduate to demonstrate 
that she could complete the essential requirements of CWRU’s medical 
program with reasonable accommodations.  The trial court agreed that Dr. 
Hartman’s testimony regarding Temple University’s accommodations fulfilled 
the requisite reliable, probative and substantial evidence to support OCRC’s 
order. See R.C. 4112.06(E).  We disagree. 
 
24 
  
“Reliable” evidence is dependable or trustworthy; “probative” evidence 
tends to prove the issue in question and is relevant to the issue presented; and 
“substantial” evidence carries some weight or value. Our Place, Inc. v. Ohio 
Liquor Control Comm. (1992), 63 Ohio St.3d 570, 571, 589 N.E.2d 1303, 
1305. We find that Dr. Hartman’s experience at Temple University is neither 
probative nor substantial evidence to demonstrate that Fischer is currently able 
to safely and substantially perform the essential requirements of CWRU’s 
program with reasonable accommodation. 
 
Dr. Hartman is not an expert in medical education.  He attended Temple 
University twenty years ago, under entirely different circumstances than 
proposed today.  Temple voluntarily accepted Dr. Hartman by increasing the 
class size by one.  The faculty at Temple acted upon a commitment to do 
whatever necessary to assist Dr. Hartman, and not upon a concept of reasonable 
accommodation.  Additionally, Dr. Hartman was accepted prior to the AAMC’s 
adoption of its technical standards for admission requiring each medical school 
student to have the ability to observe.  Fischer, who provided the only 
 
25 
testimony that she could complete the requirements of medical school with 
accommodations, admitted that she had no familiarity with what a medical 
student is required to do.  
 
With Hartman and Fischer as its witnesses, OCRC failed to present any 
probative or substantial testimony that Fischer would be able to complete 
CWRU’s course requirements with reasonable accommodation.  CWRU, 
however, presented testimony from several medical educators that a blind 
student could not perform the requirements of medical school. Consequently, 
the trial court abused its discretion in finding that OCRC’s cease and desist 
order was supported by probative or substantial evidence that Fischer could 
complete the medical program at CWRU with reasonable accommodation.  
B.  ACCOMMODATIONS WERE NOT REASONABLE 
 
The court of appeals also found that the trial court abused its discretion 
by finding that Fischer was otherwise qualified for admission with reasonable 
accommodations.  Whether an accommodation is reasonable is a mixed 
 
26 
question of law and fact.  Carter, 840 F.2d at 64-65, citing Pullman-Standard v. 
Swint (1982), 456 U.S. 273, 102 S.Ct. 1781, 72 L.Ed.2d 66.    
 
OCRC suggests that certain accommodations such as raised line drawing 
boards, tutors and faculty assistance, occasional use of sighted students, and 
laboratory assistance would permit Fischer to realize the benefits of the first 
two years of the medical school program.  OCRC also suggests modifications 
which would help her complete the required clerkships, such as the use of 
intermediaries to read X-rays and patient charts and to perform parts of a 
physical examination as well as the waiver of course requirements she could 
not perform such as starting an I.V. or drawing blood.  OCRC argues that these 
accommodations are reasonable because those skills are not necessary for 
Fischer to pursue a practice in psychiatry, are not necessary for CWRU to 
maintain its accreditation as a medical school, and would not require a 
fundamental alteration in the nature of the program, since they are not essential 
to it.  For the following reasons, we hold that the trial court’s finding that these 
 
27 
accommodations were reasonable is clearly erroneous and an abuse of 
discretion. 
 
First, a similar argument regarding intermediaries, supervision and 
course waiver was rejected by the United States Supreme Court in Davis,. 442 
U.S. 397, 99 S.Ct. 2361, 60 L.Ed.2d 980.  The court held that because the deaf 
nursing student would not receive “even a rough equivalent of the training a 
nursing program normally gives,” the school was not required to make such a 
“fundamental alteration” in its program. Id. at 410, 99 S.Ct. at 2369, 60 
L.Ed.2d at 990.  In the present case, all of the medical educators who testified 
at the hearing agreed that it would be impossible to modify the traditional 
methods of teaching in a manner that would impart the necessary skills and 
information for a blind student to complete the essential course requirements. 
 
Second, CWRU’s decision not to modify its program by waiving course 
requirements or permitting intermediaries to read X-rays or perform physical 
examinations is an academic decision. Courts are particularly ill-equipped to 
evaluate academic requirements of educational institutions. Bd. of Curators of 
 
28 
Univ. of Missouri v. Horowitz (1978), 435 U.S. 78, 92, 98 S.Ct. 948, 956, 55 
L.Ed.2d 124, 136; Regents of Univ. of Michigan v. Ewing (1985), 474 U.S. 
214, 226, 106 S.Ct. 507, 514, 88 L.Ed.2d 523, 533; Doe, supra, 666 F.2d at 
775-776.  As a result, considerable judicial deference must be paid to academic 
decisions made by the institution itself unless it is shown that the standards 
serve no purpose other than to deny an education to the handicapped. Id. at 
776; Wood v. President & Trustees of Spring Hill College (C.A.11, 1992), 978 
F.2d 1214, 1222; Strathie v. Dept. of Transp. (C.A.3, 1983), 716 F.2d 227, 231. 
Furthermore, an educational institution is not required to accommodate a 
handicapped person by eliminating a course requirement which is reasonably 
necessary to the proper use of the degree conferred at the end of study. 
Doherty, 862 F.2d at 575. 
 
 
The goal of medical schools is not to produce specialized degrees but 
rather general degrees in medicine which signify that the holder is a physician 
prepared for further training in any area of medicine. As such, graduates must 
have the knowledge and skills to function in a broad variety of clinical 
 
29 
situations and to render a wide spectrum of patient care. All students, 
regardless of whether they intend to practice in psychiatry or radiology, are 
required to complete a variety of course requirements including rotations in 
pediatrics, gynecology and surgery.  
 
Both the AAMC technical standards and the medical educators who 
testified at the hearing rejected the use of an intermediary by a medical student.  
In these medical educators’ opinions, the use of an intermediary would 
interfere with the student’s exercise of independent judgment -- a crucial part 
of developing diagnostic skills.  Accordingly, a waiver of the medical school’s 
requirements such as starting an I.V. or reading an X-ray, or the use of an 
intermediary to perform these functions would fundamentally alter the nature 
of the program.  
 
 Finally, an administrative agency should accord due deference to the 
findings and recommendations of its referee, especially where there exist 
evidentiary conflicts. Brown v. Ohio Bur. of Emp. Serv. (1994), 70 Ohio St.3d 
1, 2, 635 N.E.2d 1230, 1231. 
In this case, the referee concluded that Fischer 
 
30 
could not complete courses in the basic sciences without placing an undue 
burden on the faculty, and could not complete the clerkships without 
substantial modification to the essential nature of the program.  OCRC adopted 
the hearing officer’s findings of fact, but did not accept his recommendation.  
Rather, OCRC placed great weight upon Dr. Hartman’s testimony in arriving at 
a conclusion contrary to the hearing officer’s. As discussed supra, however, Dr. 
Hartman’s testimony was not probative of the issue and was insufficient to 
form the basis of a finding that the accommodations were reasonable. 
 
III.  DUTY TO INVESTIGATE 
 
Finally, OCRC contends that CWRU’s failure to inquire into 
technological advances to assist the blind, its failure to contact Dr. Hartman or 
Temple University, and its failure to consult experts in educating the blind 
during its decision-making process violated an affirmative duty to investigate 
whether accommodations would enable Fischer to complete the medical school 
program. 
 
31 
 
OCRC relies on Mantolete v. Bolger (C.A.9, 1985), 767 F.2d 1416, in 
support of an affirmative duty to investigate.  In Mantolete, the court 
considered the definition of a qualified handicapped person in the context of 
Section 501 of the Rehabilitation Act of 1973, codified at Section 791, Title 29, 
U.S. Code.  Section 501 prohibits handicap discrimination by federal 
employers, requiring such employers to take affirmative action against 
discrimination.   That section and its regulations imply that “a more active and 
extensive effort than ‘non-discrimination’ must be made to eliminate barriers to 
employment 
of 
the 
handicapped 
in 
federal 
agencies, 
departments, 
instrumentalities and contractors.” Id. at 1422.  The Mantolete court imposed a 
duty upon federal employers “to gather sufficient information from the 
applicant and from qualified experts as needed to determine what 
accommodations are necessary to enable the applicant to perform the job 
safely.” (Emphasis added.) Id. at 1423.  As noted in the concurring opinion in 
Mantolete, 
however, 
“impos[ing] 
demanding 
information-gathering 
requirements upon federal employers” is justified by the express “affirmative 
 
32 
action” language of Section 501 -- language that does not appear in Section 
504. Id. at 1425 (Rafeedie, J., concurring).  Thus, OCRC’s reliance on 
Mantolete is misplaced.7 
 
The United States Supreme Court recognized that in order to protect 
handicapped individuals from “deprivations based on prejudice, stereotypes, or 
unfounded fear,” a determination as to whether an individual is otherwise 
qualified should in “most cases” be made in the context of an “individualized 
inquiry into the relation between the requirements of the program and the 
abilities of the individual.” Arline, 480 U.S. at 287, 107 S.Ct. at 1130-1131, 94 
L.Ed.2d at 320; Buck v. United States Dept. of Transp. (C.A.D.C. 1995), 56 
F.3d 1406, 1408. 
 
Similarly, Ohio law does not support the imposition of a duty to 
investigate in all cases.  Rather, R.C. 4112.022 contemplates that there will be 
situations in which a school could justifiably exclude all persons with a 
particular handicap from admission to a program.  R.C. 4112.022 does not 
consider an act discriminatory where it is based upon a bona fide requirement 
 
33 
or standard for admission.  OCRC argues that vision is not a bona fide physical 
requirement for admission to medical school because CWRU failed to adopt 
the vision requirement prior to the rejection of Fischer’s application. 
 
Again, we must disagree. Regardless of when CWRU adopted its own 
set of admissions standards and whether the AAMC standards are mandatory, 
the AAMC technical standards represent a comprehensive study supporting 
denial of admission to blind medical school applicants. Once CWRU confirmed 
the complete absence of an ability to observe, CWRU could deny Fischer’s 
application based upon a bona fide standard for admission to the medical 
school.8 
 
IV.  CONCLUSION 
  
We agree with the court of appeals and find that the trial court abused its 
discretion in finding that the OCRC order was supported by reliable, probative 
and substantial evidence and that Fischer was otherwise qualified to participate 
in the medical school program.  First, the trial court abused its discretion in 
finding that OCRC’s cease and desist order was supported by probative or 
 
34 
substantial evidence because the testimony of Dr. Hartman was neither 
probative nor substantial on the issue of whether Fischer could complete 
CWRU’s requirements with reasonable accommodation.  Second, the trial 
court’s findings that  the modifications were reasonable and that Fischer was 
“otherwise qualified” to participate in CWRU’s medical school program were 
clearly erroneous and an abuse of discretion because the accommodations 
suggested by Fischer would (1) require fundamental alterations to the academic 
requirements essential to the program of instruction, and (2) impose an undue 
burden upon CWRU’s faculty.   Finally, once CWRU confirmed her complete 
absence of an ability to observe, CWRU could deny Fischer’s application based 
upon a bona fide standard for admission to the medical school. 
 
 
 
 
 
 
 
 
Judgment affirmed. 
 
MOYER, C.J., and POWELL, J., concur. 
 
F.E. SWEENEY, J., concurs in the syllabus and judgment only. 
 
DOUGLAS, RESNICK and PFEIFER, JJ., dissent. 
 
35 
 
STEPHEN W. POWELL, J., of the Twelfth Appellate District, sitting for 
WRIGHT, J. 
FOOTNOTES  
1  That same year, Fischer also applied to the medical schools at Ohio State 
University, University of Cincinnati, University of Toledo and Temple 
University.  Ohio State University also placed Fischer on an alternate list.  
However, all of the schools denied her admission. 
2 CWRU did not formally adopt its own technical admissions standards until 
June 1990.  These standards also require that an applicant have sufficient use of 
the sense of vision and the ability to observe both at a distance and close at 
hand.  
3 Fischer also reapplied to Ohio State University and, that same year, applied to 
the medical schools at Wright State University, George Washington University, 
and Georgetown University, among others. All of these schools denied Fischer 
admission. 
 
36 
4  CWRU had previously offered admission to students with handicaps such as 
paraplegia, visual and hearing impairments, and dyslexia. 
5 Fischer also filed charges against the medical schools at the Ohio State 
University and Wright State University, alleging discrimination on the basis of 
her handicap.  Following an investigation, however, OCRC did not find 
probable cause against these institutions and did not file complaints. 
6  The term “otherwise qualified” appears in Section 504 of the Rehabilitation 
Act of 1973 (“Section 504”), codified at Section 794, Title 29, U.S. Code.  
Section 504, as amended, provides that “[n]o otherwise qualified individual 
with disability * * * shall, solely by reason of his or her disability, be excluded 
from the participation in, be denied the benefits of, or be subjected to 
discrimination under any program or activity receiving Federal financial 
assistance.” Section 794(a), Title 29, U.S. Code.  
7  The dissent criticizes our discussion of Mantolete v. Bolger (C.A.9, 1985), 
767 F.2d 1416, as being “selectively extracted” from the cases cited by OCRC.  
However, the other cases were cited only in a footnote to OCRC’s Reply Brief, 
 
37 
and it was Fischer who characterized Mantolete as the “seminal case” on the 
issue of an affirmative duty to investigate. Furthermore, our discussion of 
Sections 501 and 504 is in response to the appellants’ view that such cases are 
persuasive authority for the proposition of an affirmative duty to investigate. 
This case, however, was brought only under R.C. Chapter 4112.  
8 The Office for Civil Rights, United States Department of Education, 
determined that CWRU’s 1991 denial of Fischer’s application to the medical 
school on the basis of the AAMC Technical Standards was consistent with 
Section 504 and dismissed Fischer’s complaint against CWRU.  
 
DOUGLAS, J., dissenting.     This case is not about whether appellant, 
Cheryl A. Fischer, a non-sighted person, should or should not be admitted to 
Case Western Reserve University’s medical school.  This case is about whether 
the university must, as all others, comply with R.C. 4112.022 and Section 504 
of the Rehabilitation Act of 1973, Section 794, Title 29, U.S. Code, or may the 
university rely, as it did and the majority does, on the blanket exclusion 
standard of the Association of American Medical Colleges. 
 
38 
 
The law mandates a clear and affirmative duty to investigate whether 
reasonable accommodations could be made by the medical school for Fischer’s 
needs.  It is conceivable that after such investigation, accommodations required 
to facilitate Fischer’s education would require more than a “reasonable” effort.  
If so, then admission could be lawfully denied.  Conversely, an investigation by 
the university might have produced information that would be helpful not only 
in Fischer’s case but, also, in other cases where physically challenged 
individuals might seek admission. 
 
Accordingly, because I believe that the university violated its lawfully 
mandated affirmative duty to gather information as to whether it could, or 
could not, reasonably accommodate the needs of Fischer, I must respectfully, 
on this ground, dissent. 
 
ALICE ROBIE RESNICK, J., dissenting.  “Prejudice” is defined as “an 
opinion or leaning adverse to anything without just grounds or before sufficient 
knowledge.”  Webster’s Third New International Dictionary (1986) 1788.  
Today, the majority opines that no reasonable accommodations can be made 
 
39 
which would enable a blind student to complete the medical school program.  
In so doing, the majority literally divests itself of knowledge to the contrary by 
completely disregarding as not probative or substantial the testimony of an 
individual who, while totally blind, was admitted to and graduated from 
medical school, and is a board-certified practicing psychiatrist who also 
happens to teach in his field.  This enables the majority to rely solely on the 
testimony of the very personnel who have prejudged the “whole concept” of a 
blind medical student as “ridiculous,” while simultaneously holding that those 
persons had no duty to investigate whether reasonable accommodations could 
be made to assist a blind student in completing the medical school program.  
This is a case of prejudice, pure and simple.  I dissent. 
I.  DUTY TO INVESTIGATE 
 
R.C. 4112.022, like Section 504 of the Rehabilitation Act of 1973, 
Section 794, Title 29, U.S.Code, is designed to protect “handicapped 
individuals from deprivations based on prejudice, stereotypes, or unfounded 
fear, while giving appropriate weight to such legitimate concerns of grantees as 
 
40 
avoiding exposing others to significant health and safety risks.”  School Bd. of 
Nassau Cty. v. Arline (1987), 480 U.S. 273, 287, 107 S.Ct. 1123, 1131, 94 
L.Ed.2d 307, 320.  It is a statute aimed at means, not ends.  At a fundamental 
level, it provides for a method of evaluation grounded in knowledge.  One 
would suppose, therefore, that the duty to investigate is axiomatic.  It should be 
obvious to any reasonable person that in order to give meaningful 
consideration to whether reasonable accommodations would enable a blind 
student to effectively complete the medical school program, the medical school 
must explore the nature and benefit of available methods of accommodating the 
blind. 
 
Nevertheless, the majority impugns the contention that Case Western 
Reserve University (“CWRU”) had an affirmative duty to investigate whether 
reasonable accommodations would enable plaintiff-appellant, Cheryl A. 
Fischer, to complete the medical school program, before denying her 
admittance on the basis of her visual handicap. 
A.  Mantolete v. Bolger 
 
41 
 
The majority begins its analysis of the duty to investigate by stating that 
the Ohio Civil Rights Commission (“OCRC”) “relies on Mantolete v. Bolger 
(C.A.9, 1985), 767 F.2d 1416, in support of an affirmative duty to investigate.”  
The majority then distinguishes Mantolete because, “[a]s noted in the 
concurring opinion in Mantolete, *** ‘impos[ing] demanding information-
gathering requirements upon federal employers’ is justified by the express 
‘affirmative action’ language of Section 501 [of the Rehabilitation Act of 1973, 
Section 791, Title 29, U.S.Code]--language that does not appear in Section 
504.”  The majority concludes, therefore, that “OCRC’s reliance on Mantolete 
is misplaced.” 
 
This portion of the majority’s analysis is disconcerting, not so much in 
the way it reviews Mantolete, but because it reviews Mantolete.9  Mantolete 
was only one of a litany of cases cited by OCRC in support of its proposition 
that there is a duty to investigate.  By selectively extracting Mantolete from the 
pile and simply distinguishing it from the instant case, the majority is able to 
make it appear as though the commission’s position on this issue is untenable.  
 
42 
In this way, the majority has managed to avoid confrontation with those courts 
which hold that, under Section 504, an educational institution must make 
reasonable efforts to explore alternative methods of accommodating the 
handicapped.  These cases reveal that the purpose and history of Section 504 
dictate such a requirement and that, in the absence of a duty to investigate, the 
requirement to make reasonable accommodations would be rendered 
meaningless.  Wynne v. Tufts Univ. School of Medicine (C.A.1, 1992), 976 F.2d 
791, 795; Wynne v. Tufts Univ. School of Medicine (C.A.1, 1991), 932 F.2d 19, 
25-28; Nathanson v. Med.  College of Pennsylvania (C.A.3, 1991), 926 F.2d 
1368, 1383-1387; Oberti v. Clementon School Dist. Bd. of Edn. 
(D.C.N.J.1992), 801 F.Supp. 1392, 1406-1407, fn. 25, affirmed (C.A.3, 1993), 
995 F.2d 1204; Wallace v. Veterans Administration (D.C.Kan.1988), 683 
F.Supp. 758, 766; David H. v. Spring Branch Indep. School Dist. 
(S.D.Tex.1983), 569 F.Supp. 1324, 1336.  In addition, as observed by Donald 
Jay Olenick, Accommodating the Handicapped:  Rehabilitating Section 504 
After Southeastern (1980), 80 Colum.L.Rev. 171, 188: 
 
43 
 
“[A]s a matter of fairness, the existence of such a duty should be 
recognized because the institution has greater knowledge of the components of 
its program than does the handicapped applicant.  The institution can look to its 
own experience, or, if that is not feasible, to that of other institutions in 
providing education to individuals with handicaps similar to those of the 
applicant in question.  In addition, it will be able to seek advice concerning 
possible accommodations from private and government sources.  The 
handicapped individual may also suggest accommodations and bring forward 
relevant employment experience demonstrating that accommodations are 
possible.”  Moreover, “institutions can consult handicapped individuals who 
have completed similar programs.”  Id. at 188, fn. 119. 
 
Investigation by CWRU would have revealed, at the very minimum, a 
number of possible sources for exploring the prospect of accommodating a 
blind medical student, including the experience of Dr. David W. Hartman and 
other blind physicians, not all of whom lost vision after completing training.  
See Wainapel, The Physically Disabled Physician (1987), 257 J.Am.Med.Assn. 
 
44 
2935; Wainapel & Bernbaum, The Physician With Visual Impairment or 
Blindness:  A Reappraisal (1986), 104 Arch.Opthalmol. 498; Hartman & 
Hartman, Disabled Students and Medical School Admissions (1981), 62 
Arch.Phys.Med.Rehabil. 90; Webster, Blind Internist Passes Board Exam, New 
England J. Med. (May 15, 1980) 1152.  In fact, these articles readily suggest 
that a blind medical student or physician can succeed.  “‘Aside from his 
surgical skill, the physician’s greatest commodity in trade is his intellectual 
ability to interpret and to correlate.  This is not impaired by the loss of one 
sensory modality.’”  Wainapel, The Physically Disabled Physician, supra, at 
2935, quoting Keeney & Keeney, Blindness Among Practicing Physicians 
(1950), 43 Arch. Opthalmol. 1036.  In fact, one article noted that “[a] broad 
spectrum of adapted instruments and devices [is] available for individuals with 
visual impairment, varying from the simple and mundane to the most 
sophisticated high technology,” and actually set forth a noncomprehensive 
resource table for the visually disabled physician.  Wainapel & Bernbaum, The 
Physician With Visual Impairment or Blindness, supra, at 499-500. 
 
45 
 
 CWRU either disregarded or never consulted any of these sources, 
including Dr. Hartman or Temple University, in deciding not to admit Fischer.  
CWRU’s “refusal to investigate and consider the modifications necessary to 
accommodate [Fischer] preclude it from rebutting plaintiffs’ evidence that such 
accommodation would neither change the essential nature of the program nor 
place an undue burden upon” CWRU.  Oberti, supra, 801 F.Supp. at 1406, fn. 
25.  See, also, Estate of Reynolds v. Dole (N.D.Cal.1990), 57 Fair Emp. Prac. 
Cas. (BNA) 1848, 1870. 
B.  Blanket and Bona Fide Requirements 
 
After distinguishing Mantolete, the  majority attempts to explain that any 
duty to investigate would not apply where the denial is based on a bona fide 
requirement or standard for admission.  The majority finds CWRU’s blanket 
exclusion of all blind medical school applicants to be bona fide because it is 
based on the technical standards of the Association of American Medical 
Colleges (“AAMC”). 
 
46 
 
In general, blanket exclusions are subject to the same level of scrutiny as 
are individual exclusions.  As explained in Bentivegna v. United States Dept. of 
Labor (C.A.9, 1982), 694 F.2d 619, 621: 
 
“[Southeastern Community College v. Davis (1979), 442 U.S. 397, 99 
S.Ct. 2361, 60 L.Ed.2d 980]  cannot mean that the [employer] can discriminate 
by establishing restrictive ‘program requirements’ where it could not so 
discriminate in making individual employment decisions.  The Rehabilitation 
Act, taken as a whole, mandates significant accommodation for the capabilities 
and conditions of the handicapped.  Blanket requirements must therefore be 
subject to the same rigorous scrutiny as any individual decision denying 
employment to a handicapped person.” 
 
As explained somewhat differently in Pandazides v. Virginia Bd. of Edn. 
(C.A.4, 1991), 946 F.2d 345, 349, the “defendants cannot merely mechanically 
invoke any set of requirements and pronounce the handicapped applicant or 
prospective employee not otherwise qualified.  The district court must look 
 
47 
behind the qualifications.  To do otherwise reduces the term ‘otherwise 
qualified’ and any arbitrary set of requirements to a tautology.” 
 
Thus, blanket requirements are not ipso facto bona fide. CWRU cannot 
exclude all blind medical school applicants without first investigating and 
considering reasonable accommodations for the blind, any more than it can 
exclude an individual applicant without conducting such an investigation.  
Otherwise, an educational institution could easily circumvent the statute by the 
simple expedient of turning an otherwise discriminatory act into a blanket 
prohibition against a particular type of handicap.  See,  e.g., Connecticut Inst. 
for the Blind v. Connecticut Comm. on Human Rights & Opportunities (1978), 
176 Conn. 88, 94, 405 A.2d 618, 621.   
 
The majority, however, has carved an exception in those cases where 
blanket exclusions are supported, even after the fact, by guidelines adopted by 
the AAMC.  The only authority cited by the majority that is arguably relevant 
to this issue is Buck v. United States  Dept. of Transp. (C.A.D.C.1995), 56 F.3d 
1406. 
 
48 
 
In Buck, three deaf truck drivers sought a waiver from the Federal 
Highway Administration (“FHWA”) regarding its regulation requiring that 
drivers of interstate commercial vehicles be able to hear.  The regulations at 
issue were promulgated pursuant to the Motor Carrier Safety Act, which 
requires the Secretary of Transportation to promulgate regulations ensuring that 
“the physical condition of operators of commercial motor vehicles is adequate 
to enable them to operate the vehicles safely.”  Section 31136(a)(3), Title 49, 
U.S.Code.  The FHWA denied the requests and the court denied the petitions 
for review. 
 
In denying petitioners relief, the court explained as follows: 
 
“The petitioners *** misstate the issue when they argue that the agency 
must decide whether a deaf individual is able to operate a truck safely in spite 
of his handicap.  They are really launching a collateral attack upon the validity 
of the hearing requirement itself, arguing in effect that the FHWA erred in 
determining that the ability to hear with the specified acuity is necessary in 
order to operate a vehicle safely. *** [T]he proper forum in which to get the 
 
49 
relief the petitioners seek is the FHWA, in a proceeding to modify or repeal the 
rule itself.  The agency is in fact in the process of conducting such a 
rulemaking, 58 Fed.Reg. 65634, and the petitioners have already filed 
comments therein.”  Id., 56 F.3d at 1409. 
 
Unwittingly, the majority has elevated the status of the AAMC 
guidelines to the level of a federal regulation.  This is particularly inappropriate 
for several reasons.  First, the AAMC is not a legislative body.  See Liaison 
Committee on Medical Education, Functions and Structure of a Medical 
School, Standards for Accreditation of Medical Education Programs Leading to 
the M.D. Degree (1985) 5.  There is no evidence that any legislative body, state 
or federal, has directly or indirectly considered, let alone adopted, the subject 
AAMC guidelines, much less interpreted them to preclude admission to all 
blind applicants to medical school. 
 
Additionally, Donald G. Kassebaum, M.D., who is secretary to the 
Liaison Committee on Medical Education (“LCME”), testified that the AAMC 
plays no role specifically in the accreditation of United States medical schools, 
 
50 
that the decision about accreditation is made wholly by the LCME, that the 
LCME has devised no accreditation standards which would prohibit the 
admission of blind applicants to medical school, that the failure of a medical 
school to adopt the AAMC guidelines would not affect accreditation, and that 
the “Report on Technical Standards” was not even published as AAMC policy, 
but as guidelines for use by schools in developing their own individual 
technical standards.   
 
There is no reason, therefore, to give the AAMC guidelines accrediting, 
let alone legislative, force.  In fact, in McGregor v. Louisiana State Univ. Bd. of 
Supervisors (C.A.5, 1993), 3 F.3d 850, 859, certiorari denied (1994), 510 U.S. 
___, 114 S.Ct. 1103, 127 L.Ed.2d 415, the court explained that “whether the 
[American Bar Association] accredits part-time programs is not determinative 
of reasonableness under the Rehabilitation Act, and we refrain from giving 
ABA accreditation such adjudicatory effect.”  Accordingly, CWRU’s after-the-
fact reliance on the AAMC guidelines does not transform its blanket preclusion 
 
51 
of blind medical students into a bona fide requirement or standard for 
admission, obviating its duty to investigate. 
II.  STANDARD OF REVIEW 
 
This portion of the majority’s opinion is, quite frankly, astonishing.   The 
majority sets forth some well-established standards of review.  One of these 
standards is that an appellate court cannot reverse a trial court’s judgment 
unless it finds that “the trial court abused its discretion in finding that there was 
reliable, probative and substantial evidence to support the commission’s order.  
See Cleveland Civ. Serv. Comm. v. Ohio Civ. Rights Comm. (1991), 57 Ohio 
St.3d 62, 65, 565 N.E.2d 579, 582.”   
 
Dr. Hartman is a psychiatrist.  Dr. Hartman has been totally blind since 
the age of eight.  He graduated from Gettysburg College in 1972, summa cum 
laude and as a Phi Beta Kappa.  He attended medical school at Temple 
University from 1972 to 1976.  He graduated from medical school and became 
a board-certified practicing psychiatrist.  He was assistant professor of 
psychiatry at the University of Pennsylvania from 1980 to 1982 and presently 
 
52 
serves as volunteer faculty at the University of Virginia.  Dr. Hartman’s 
curriculum vitae reads like a five-page laundry list of accomplishments, 
appointments, awards and publications. 
 
Dr. Hartman’s testimony in this case consisted of ninety-four transcribed 
pages of examination primarily concerning the issue of accommodations made 
for him at Temple’s medical school.  Dr. Hartman completed all required 
courses and clerkships at Temple.  No courses or clerkships were waived 
because of his blindness.  He completed studies in anatomy, histology, 
microscopic anatomy, biochemistry, neuroanatomy, physiology, pathology, and 
pharmacology.  He successfully completed his clerkships, including rotations 
in internal medicine, general surgery, psychiatry, obstetrics and gynecology, 
pediatrics, plastic surgery, neurology, and emergency room medicine.   
 
Dr. Hartman was able to complete these courses and clerkships by use of 
various accommodating aids, including raised line drawings, models, guidance 
and assistance from other students, laboratory technicians and professors, 
reliance on his other senses such as hearing and touch, and tape recorders.  He 
 
53 
also suggested that there may be some additional technological aids that would 
be of assistance, such as computerized voice reading or computer printing in 
Braille.   
 
With Dr. Hartman’s testimony staring it in the face, how can the majority 
conclude that the trial court abused its discretion in upholding the OCRC’s 
order that a blind medical student could perform the requirements of medical 
school with reasonable accommodation?  No problem--simply ignore it.  As 
incredible as it sounds, the majority  finds that “Dr. Hartman’s experience at 
Temple University is neither probative nor substantial evidence to demonstrate 
that Fischer is currently able to safely and substantially perform the essential 
requirements of CWRU’s program with reasonable accommodation.” 
 
In support, the majority explains that: 
 
“Dr. Hartman is not an expert in medical education.  He attended Temple 
University twenty years ago, under entirely different circumstances than 
proposed today.  Temple voluntarily accepted Dr. Hartman by increasing the 
class size by one.  The faculty at Temple acted upon a commitment to do 
 
54 
whatever necessary to assist Dr. Hartman, and not upon a concept of reasonable 
accommodation.  Additionally, Dr. Hartman was accepted prior to the AAMC’s 
adoption of its technical standards for admission requiring each medical school 
student to have the ability to observe.” 
 
This explanation serves only to enforce the majority’s commitment to rid 
itself of Dr. Hartman’s testimony.  No portion of this explanation has anything 
to do with whether Dr. Hartman’s testimony constitutes probative or substantial 
evidence in this case.  Whether or not Dr. Hartman is a so-called “expert in 
medical education,” there is no rule that a witness must qualify as an expert in 
medical education in order to testify in a handicap discrimination case such as 
this one.  In fact, Dr. Hartman’s testimony was not offered for any opinions he 
might hold relative to medical education.  Instead, the relevance and value of 
Dr. Hartman’s testimony lie in the nature of his experiences and the character 
of the accommodations made for him at Temple.  Moreover, such a rule would 
be absurd.  It would exclude virtually all testimony, both lay and expert, 
relevant to the issue of available accommodations vis-à-vis the capabilities and 
 
55 
limitations of particular handicaps.  Additionally, the majority does not reveal 
what qualifies someone as such an expert or the justification for imposing any 
particular set of qualifications.  For example, what justification could possibly 
support disregarding Dr. Hartman’s testimony, while considering the testimony 
of Albert C. Kirby and John R. Troyer, both of whom the majority accepts as 
“medical educators,” but neither of whom had ever attended medical school?   
 
Likewise, the circumstances under which Dr. Hartman was accepted at 
Temple have no bearing on the relevance or value of his testimony in this case.  
The level of Temple’s commitment to Dr. Hartman does not necessarily reflect 
the character of its actions.  Simply stated, just because Temple was prepared to 
do more for Dr. Hartman than what was required does not mean that what 
Temple actually did for Dr. Hartman was unreasonable.  What is relevant and 
valuable to the issue of reasonable accommodation in this case is the nature and 
extent of the actual accommodations made for Dr. Hartman at Temple, not the 
state of mind of Temple’s faculty. 
 
56 
 
On the contrary, Dr. Hartman’s experience at Temple is both probative 
and substantial evidence to demonstrate that Fischer is currently able to safely 
and substantially perform the essential requirements of CWRU’s program with 
reasonable accommodation.  Dr. Hartman’s experience at Temple presents a 
unique opportunity by which to gauge the nature and character of 
accommodations needed to enable a blind person to successfully and 
beneficially complete medical school.  The proof, so to speak, is in the 
pudding.  While his experience may not be conclusive of reasonableness, it is 
certainly relevant and carries some weight.  In fact, both the OCRC and the 
trial court found this evidence to be rather significant.  In its order below, 
OCRC found that Dr. Hartman’s experience and qualifications give him 
“unparallelled [sic] expertise as to whether a blind student can reap the 
benefits of a medical program.”  Additionally, Dr. Hartman has received seven 
major appointments in the area of  psychiatry.  He served as consultant to or 
member of five critical programs, including consultant to the National Institute 
for Advanced Studies on the admission of blind and otherwise handicapped 
 
57 
persons into the allied health fields in compliance with Section 504.  He has 
published in at least six publications and participated in fifteen relevant 
presentations on the subject of education and the blind.  The rejection of Dr. 
Hartman’s testimony as not probative or substantial is pure nonsense.   
 
After discounting Dr. Hartman’s testimony (and, incidentally, Fischer’s 
as well), the majority is able to blatantly conclude that “[w]ith Hartman and 
Fischer as its witnesses, OCRC failed to present any probative or substantial 
testimony that Fischer would be able to complete CWRU’s course requirements 
with reasonable accommodation.”  Simplistic reasoning is merely a mode for 
result-oriented decisions. 
 
Still unsatisfied, the majority goes on to invoke the rule that an 
administrative agency (OCRC) should accord due deference to the findings and 
recommendations of its referee (hearing officer).  The problem, however, is that 
this rule comes into play when an agency rejects its referee’s report without 
reviewing the record.  Even then, the rule loses its significance once the trial 
court reviews the record and upholds the agency’s decision.  See Brown v. 
 
58 
Ohio Bur. of Emp. Serv. (1994), 70 Ohio St.3d 1, 2-3, 635 N.E.2d 1230, 1231; 
Jones v. Franklin Cty. Sheriff (1990), 52 Ohio St.3d 40, 43, 555 N.E.2d 940, 
944; Aldridge v. Huntington Local School Dist. Bd. of Edn. (1988), 38 Ohio 
St.3d 154, 159, 527 N.E.2d 291, 295 (Douglas, J., concurring).  In its statement 
of the facts, the majority explains that “[u]pon its review of the hearing 
examiner’s report, OCRC came to a different conclusion.”  This is inaccurate.  
In its cease and desist order, OCRC specifically explained that it rejected the 
hearing examiner’s report “[a]fter careful consideration of the entire record.”  
Absent contrary evidence, there is no basis for the majority to conclude 
otherwise.  Moreover, a careful reading of those two opinions below reveals 
that a myriad of facts are set forth in the OCRC order that are not contained in 
the hearing examiner’s report.  In any event, the trial court reviewed the entire 
record and affirmed the OCRC. 
 
Thus, there is no legitimate basis for discounting Dr. Hartman’s 
testimony, or for according deference to the hearing examiner’s report. 
III.  CONCLUSION 
 
59 
 
If a particular professional door is to be closed to an entire class of 
people, it should not be done in such a cavalier manner.  The decision as to 
whether a medical school may deny admittance to the blind is of great social 
importance.  It cannot be made without a complete and careful consideration of 
all 
available 
information 
concerning 
possible 
modifications 
and 
accommodations, as well as the capabilities and limitations of the blind. 
 
It is our duty and responsibility under R.C. 4112.022 to ensure that 
educational decisions denying admittance to the handicapped are not 
discriminatory.  It is, therefore, a dereliction of this duty for the majority to 
allow CWRU to make such a determination without first investigating and 
considering reasonable accommodations, and for the majority itself to refuse to 
consider the experience of a successful blind medical student.  No educational 
institution, and no court, may justify a preordained conclusion by exorcising all 
knowledge to the contrary without running afoul of R.C. 4112.022’s mandate. 
 
The only issue properly before the court is whether the common pleas 
court abused its discretion in finding that OCRC’s order was supported by 
 
60 
reliable, probative and substantial evidence.  Dr. Hartman’s testimony 
constitutes reliable, probative and substantial evidence that Fischer could 
effectively and beneficially complete the essential requirements of CWRU’s 
medical program.10  It is  incredible that the majority has ignored this testimony 
and accorded substantial judicial deference to CWRU’s decisions, while 
refusing to impose upon CWRU the duty to investigate in the first instance. 
 
Justice requires that the court of appeals’ decision be reversed and that 
the decision of the trial court be reinstated.  I therefore vehemently dissent. 
 
DOUGLAS and PFEIFER, JJ., concur in the foregoing dissenting opinion. 
FOOTNOTES 
 
9  It should be noted, however, that even the concurring opinion in 
Mantolete expressly left the issue open as to whether Section 504 imposed a 
similar information-gathering requirement upon private employers.  Id., 767 
F.2d at 1425 (Rafeedie, D.J., concurring).  Thus, any implication in the 
majority’s use of language that the concurring opinion in Mantolete suggested 
a particular result under Section 504 is unfounded. 
 
61 
 
10  Ohio Adm.Code 4112-5-09(D)(1) provides that: 
 
“Educational institutions shall make such modifications to [their] 
academic requirements as are necessary to ensure that such requirements do not 
discriminate or have the effect of discriminating, on the basis of handicap, 
against a qualified handicapped applicant or student.  Academic requirements 
that the educational institution can demonstrate are essential to the program of 
instruction being pursued by such student or to any directly related licensing 
requirement will not be regarded as discriminatory within the meaning of this 
rule.  Modifications may include changes in the length of time permitted for the 
completion of degree requirements, substitution of specific courses required for 
the completion of degree requirements, and adaptation of the manner in which 
specific courses are conducted.”  (Emphasis added.) 
 
The majority finds that there are certain “essential” requirements that 
would have to be waived or performed through the use of intermediaries, such 
as reading X-rays, performing physical examinations or starting an I.V.  The 
majority rejects the use of supervisory personnel and waiver, pursuant to 
 
62 
Southeastern Community College v. Davis (1979), 442 U.S. 397, 410, 99 S.Ct. 
2361, 2369, 60 L.Ed.2d 980, 990, on the basis that Fischer would not receive 
even a rough equivalent of the training a medical education normally gives.  
Moreover, the majority gives considerable judicial deference to CWRU’s 
decisions, and feels that these requirements are essential because they are 
reasonably necessary to the proper use of the degree ultimately conferred. 
 
If we put Dr. Hartman’s testimony back into the equation, it is difficult to 
find as a matter of law that Fischer would be unable to receive the benefits that 
a medical education normally gives.  Any determinative effect that Davis, 
supra, may otherwise have had in this case dissipates upon consideration of Dr. 
Hartman’s testimony.  In fact, it was Dr. Hartman’s testimony that he could 
perform a physical examination alone, and that he would stand with other 
students and have an X-ray read to him.  The only two areas that give him 
trouble are starting an I.V. and drawing blood.  OCRC specifically found that 
“it has not been demonstrated that physically performing these tasks constitutes 
an essential component of [CWRU’s] program.”  Whether a requirement is 
 
63 
essential is a question of fact.  Hall v. United States Postal Serv. (C.A.6, 1988), 
857 F.2d 1073, 1079.  Moreover, in order to be considered essential, there must 
be some nexus between the requirement and the prospective profession.  
Pandazides, supra, 946 F.2d at 349.  Additionally, CWRU is not deserving of 
judicial deference in this case because it refused even to investigate the issue.  I 
do not believe, based on the record, that providing some visual assistance to 
Fischer in these limited tasks would, as a matter of law, sacrifice the integrity 
of CWRU’s entire medical program.  See Brennan v. Stewart (C.A.5, 1988), 
834 F.2d 1248, 1262.