Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_16-cv-01193/USCOURTS-cand-3_16-cv-01193-6/pdf.json

Nature of Suit Code: 442
Nature of Suit: Civil Rights Employment
Cause of Action: 28:1332 Diversity-Employment Discrimination

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

TAMMI FUQUA,

Plaintiff,

v.

UNITED PARCEL SERVICE, INC.,

Defendant.

Case No.16-cv-01193-JSC 

VERDICT FORM

We, the jury, unanimously find as follows:

PART A: DISABILITY DISCRIMINATION—REASONABLE ACCOMMODATION

1. Did Tammi Fuqua have a disability that limited a major life activity?

_____ Yes _____ No

If your answer to Question 1 is “Yes,” continue to Question 2. If your answer to Question 1 is 

“No,” do not answer any further questions in any part of the verdict form. Sign and date the 

form, and notify the courtroom deputy that you are finished. 

2. Did UPS know of Tammi Fuqua’s disability that limited a major life activity? 

_____ Yes _____ No

If your answer to Question 2 is “Yes,” continue to Question 3. If your answer to Question 2 is 

“No,” do not answer any further questions in Part A, and continue to Part B.

3. Was Tammi Fuqua able to perform the essential job duties with reasonable 

accommodation for her disability?

_____ Yes _____ No

If your answer to Question 3 is “Yes,” continue to Question 4. If your answer to Question 3 is 

“No,” do not answer any further questions in Part A, and continue to Part B.

Case 3:16-cv-01193-JSC Document 149 Filed 09/24/18 Page 1 of 6
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4. Did UPS fail to provide reasonable accommodation for Tammi Fuqua’s 

disability?

_____ Yes _____ No

If your answer to Question 4 is “Yes,” continue to Question 5. If your answer to Question 4 is 

“No,” do not answer any further questions in Part A, and continue to Part B.

5. Was UPS’s failure to provide reasonable accommodation a substantial factor 

in causing harm to Tammi Fuqua?

_____ Yes _____ No

Regardless of your answer to Question 5, continue to Part B.

PART B: FAILURE TO ENGAGE IN INTERACTIVE PROCESS

Do not answer any questions in this Part B unless you answered “Yes” to Question 1 in Part A.

6. Did Tammi Fuqua request that UPS make reasonable accommodation for her 

disability so that she would be able to perform the essential job requirements, or was UPS 

otherwise aware of Tammi Fuqua’s need for a reasonable accommodation?

_____ Yes _____ No

If your answer to Question 6 is “Yes,” continue to Question 7. If your answer to Question 7 is 

“No,” do not answer any further questions in Part B, and continue to Part C.

7. Was Tammi Fuqua willing to participate in good faith in an interactive 

process to determine whether reasonable accommodation could be made so that Tammi 

Fuqua would be able to perform the essential job requirements?

_____ Yes _____ No

If your answer to Question 7 is “Yes,” continue to Question 8. If your answer to Question 7 is 

“No,” do not answer any further questions in Part B, and continue to Part C.

8. Did UPS fail to participate in a timely, good-faith interactive process with 

Tammi Fuqua to determine whether reasonable accommodation could be made?

_____ Yes _____ No

If your answer to Question 8 is “Yes,” continue to Question 9. If your answer to Question 8 is 

“No,” do not answer any further questions in Part B, and continue to Part C.

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9. Was UPS’s failure to participate in a good-faith interactive process a 

substantial factor in causing harm to Tammi Fuqua?

_____ Yes _____ No

If your answer to Question 9 is “Yes,” continue to Question 10. If your answer to Question 9 is 

“No,” do not answer any further questions in Part B, and continue to Part C.

10. At the time UPS failed to participate in a good-faith interactive process, was 

Tammi Fuqua able to perform the essential job duties with reasonable accommodation for 

her disability?

_____ Yes _____ No

Regardless of your answer to Question 10, continue to Part C.

PART C: HARASSMENT

Do not answer any questions in this Part C unless you answered “Yes” to Question 1 in Part A.

11. Was Tammi Fuqua subjected to unwanted harassing conduct by a supervisor 

because she was disabled? 

_____ Yes _____ No

If your answer to Question 11 is “Yes,” continue to Question 12. If your answer to Question 11 is 

“No,” do not answer any further questions in Part C or Part D, and continue to Part E.

12. Was the harassment severe or pervasive?

_____ Yes _____ No

If your answer to Question 12 is “Yes,” continue to Question 13. If your answer to Question 12 is 

“No,” do not answer any further questions in Part C or Part D, and continue to Part E.

13. Would a reasonable person in Tammi Fuqua’s circumstances have considered 

the work environment to be hostile or abusive?

_____ Yes _____ No

If your answer to Question 13 is “Yes,” continue to Question 14. If your answer to Question 13 is 

“No,” do not answer any further questions in Part C or Part D, and continue to Part E.

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14. Did Tammi Fuqua consider the work environment to be hostile or abusive?

_____ Yes _____ No

If your answer to Question 14 is “Yes,” continue to Question 15. If your answer to Question 14 is 

“No,” do not answer any further questions in Part C or Part D, and continue to Part E.

15. Did UPS fail to take immediate and appropriate corrective action?

_____ Yes _____ No

If your answer to Question 15 is “Yes,” continue to Question 16. If your answer to Question 15 is 

“No,” do not answer any further questions in Part C, and continue to Part D.

16. Was the harassing conduct a substantial factor in causing harm to Tammi 

Fuqua?

_____ Yes _____ No

Regardless of your answer to Question 16, continue to Part D.

PART D: FAILURE TO PREVENT HARASSMENT

Do not answer any questions in this part unless you answered “Yes” to Question 14.

17. Did UPS fail to take all reasonable steps to prevent the harassment?

_____ Yes _____ No

If your answer to Question 17 is “Yes,” continue to Question 18. If your answer to Question 17 is 

“No,” do not answer any further questions in Part D, and continue to Part E.

18. Was UPS’s failure to prevent the harassment a substantial factor in causing

harm to Tammi Fuqua?

_____ Yes _____ No 

Regardless of your answer to Question 18, continue to Part E.

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PART E: DISABILITY DISCRIMINATION—WRONGFUL DISCHARGE

Answer the questions in this Part E only if your answers to Questions 1, 2, and 3 in Part A were 

“Yes.” If any of the answers to Questions 1, 2, and 3 in Part A were “No,” continue to Part F

and do not answer any questions in Part E.

19. Did UPS discharge Tammi Fuqua?

_____ Yes _____ No

If your answer to Question 19 is “Yes,” continue to Question 20. If your answer to Question 19 is 

“No,” do not answer any further questions in Part E, and continue to Part F.

20. Was Tammi Fuqua’s disability a substantial motivating reason for UPS’s 

decision to discharge Tammi Fuqua?

_____ Yes _____ No

If your answer to Question 20 is “Yes,” continue to Question 21. If your answer to Question 20 is 

“No,” do not answer any further questions in Part E, and continue to Part F.

21. Was UPS’s decision to discharge Tammi Fuqua a substantial factor in causing 

harm to Tammi Fuqua?

_____ Yes _____ No

Regardless of your answer to Question 21, continue to Part F.

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Part F: Damages

Instructions: If you answered “Yes” to any of Questions 5, 10, 16, 18, and 21 (the final questions 

in each part), complete Part F by listing Tammi Fuqua’s damages. 

If you did not answer “Yes” to any of those questions, do not complete Part F. Sign and date the 

verdict form, and inform the courtroom deputy that you are finished.

a. Past economic loss $ _____________

 (lost earnings and benefits)

b. Future economic loss $ _____________

 (lost earnings and benefits)

c. Past noneconomic damages $ _____________

 (mental suffering and emotional distress)

d. Future noneconomic damages $ _____________

 (mental suffering and emotional distress)

TOTAL: $ _____________

Sign and Date

When you are finished, have the presiding juror sign and date this form. 

Signed: _____________________________

Presiding Juror

Dated: _________________

Date

After this verdict form has been completed and signed, notify the courtroom deputy that you are 

ready to present your verdict in the courtroom.

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