Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caDC-07-05101/USCOURTS-caDC-07-05101-0/pdf.json

Parties Involved:
Kathy E. Adams
Appellant
American Association of Retired Persons
Amicus Curiae for Appellant
Condoleezza Rice
Appellee

Document Text:

United States Court of Appeals 

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued April 11, 2008 Decided July 18, 2008 

No. 07-5101 

KATHY E. ADAMS, 

APPELLANT

v. 

CONDOLEEZZA RICE, SECRETARY OF STATE, 

APPELLEE

Appeal from the United States District Court 

for the District of Columbia 

(No. 05cv00941) 

Ellen K. Renaud argued the cause for appellant. With her 

on the briefs was David H. Shapiro. Richard L. Swick entered 

an appearance. 

Daniel B. Kohrman and Melvin Radowitz were on the 

brief for amici curiae American Association of Retired 

Persons and American Cancer Society in support of appellant. 

John C. Truong, Assistant U.S. Attorney, argued the 

cause for appellee. With him on the brief were Jeffrey A. 

Taylor, U.S. Attorney, and R. Craig Lawrence, Assistant U.S. 

Attorney. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 1 of 44
2 

Before: HENDERSON, TATEL, and KAVANAUGH, Circuit 

Judges. 

Opinion for the Court filed by Circuit Judge TATEL. 

Dissenting opinion filed by Circuit Judge HENDERSON. 

TATEL, Circuit Judge: Appellant Kathy Adams, a 

candidate for the United States Foreign Service, passed the 

required entrance examinations and received a medical 

clearance, only to learn thereafter that she had been diagnosed 

with stage-one breast cancer. Upon hearing the news, the 

State Department, expressing concern that many of its 

overseas posts lack the follow-up care it believed Adams 

required, revoked her medical clearance, disqualifying her 

from the Foreign Service. Adams sued under the 

Rehabilitation Act of 1973, which prohibits federal agencies 

from discriminating in employment against disabled 

individuals—including those with a “record of” a disability, 

29 U.S.C. § 705(20)(B)(ii). In her complaint, she alleged that 

her surgical treatment rendered her cancer-free and able to 

work anywhere in the world without requiring specialized 

follow-up care. Without allowing discovery, the district court 

granted summary judgment to the State Department, 

concluding among other things that Adams had no record of a 

disability as defined in the statute. For the reasons set forth in 

this opinion, we reverse. 

I. 

Viewed in the light most favorable to Adams, the 

evidence tells the following story. See Czekalski v. Peters, 

475 F.3d 360, 363 (D.C. Cir. 2007) (explaining standard of 

review on summary judgment). 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 2 of 44
3 

The Foreign Service, an arm of the State Department, 

requires its officers to be “available to serve in assignments 

throughout the world,” 22 U.S.C. § 3901(a)(4), and frequently 

assigns junior Foreign Service officers to overseas locations 

that—due to factors such as “unreliable air service, poor or 

non-existent medical facilities, and unreliable postal or other 

delivery systems”—are considered “hardship posts.” John M. 

O’Keefe Decl. ¶ 3; see generally Taylor v. Rice, 451 F.3d 

898, 900-01 (D.C. Cir. 2006) (explaining Foreign Service 

hiring requirements and assignment procedures). Candidates 

who pass the Foreign Service’s rigorous written and oral 

examinations receive conditional offers of employment, 

requiring, among other things, that they “receive a medical 

examination and be issued a medical clearance.” 3 U.S. DEP’T 

OF STATE, FOREIGN AFFAIRS MANUAL (“FAM”) § 1931.1(b) 

(2002); see also 22 C.F.R § 11.1 (establishing Foreign 

Service testing and application procedures). The State 

Department’s Office of Medical Services (“MED”) performs 

the required medical examinations and issues “Class 1” 

clearances to examinees “who have no identifiable medical 

conditions that would limit assignment abroad.” 3 FAM § 

1931.3-1(1). The State Department refers to Class 1-

approved candidates as “worldwide available.” Taylor, 451 

F.3d at 901. Those failing to obtain such clearances 

automatically receive “Class 5” clearances, 3 FAM § 

1931.1(b), meaning they “have a medical condition which is 

incapacitating or for which necessary specialized medical 

care is best obtained in the United States,” id. § 1931.3-1(3). 

Because individuals with Class 5 clearances are deemed 

unable to serve safely outside the United States, they are 

declined appointments to the Foreign Service unless they 

request and receive an administrative waiver of the medical 

standards for employment. Such waivers result in a “Class 2” 

clearance, meaning the applicant “can be treated adequately at 

some but not all posts outside the United States.” Bruce L. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 3 of 44
4 

Cole Decl. ¶ 7; see also 3 FAM § 1931.3-1(2). Rarely 

granted, waivers are issued on the basis of factors such as the 

extent of worldwide availability and extraordinary skills 

possessed by the applicant. 

Appellant Kathy Adams applied to the Foreign Service 

and by April 2003 had passed both the written and oral 

examinations. In July, after undergoing the required medical 

screening, Adams learned that she had received a Class 1 

unlimited medical clearance for worldwide assignment. In 

mid-August, however, Adams was diagnosed with stage-one 

breast cancer. 

After discussing treatment options with her physicians, 

Adams elected to undergo a mastectomy and simultaneous 

reconstructive surgery, reasoning that it “would provide the 

best option for me to be able to resume my normal life 

activities.” Adams Decl. ¶ 10. The surgery took place in 

mid-September. According to Adams, after the procedure she 

“could not work at all” for three weeks, “was unable to 

perform household chores for several weeks,” and “was 

unable to care for [her]self properly and . . . drive for about 

two weeks.” Id. ¶ 12. Two months later, as part of her breast 

cancer treatment, Adams had her ovaries and fallopian tubes 

removed, a procedure necessitating an additional week of 

recovery. 

As Adams grappled with her medical diagnosis and 

treatment, the State Department continued processing her 

application. In late September it sent Adams her final 

security clearance indicating that she was “eligible for 

appointment to the Foreign Service” and had “been added to 

the Consular register of those awaiting appointment.” Letter 

from Patricia Evans, Human Resources Specialist, Bd. of 

Exam’rs for the Foreign Serv. to Kathy Adams (Sept. 25, 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 4 of 44
5 

2003). After receiving this letter on October 2, Adams 

learned from State Department human resources official 

Patricia Evans that she was ranked seventh out of 200 

consular candidates due to her high score on the Foreign 

Service Examination. Evans told Adams that “barring some 

unforeseeable catastrophe,” she would receive an 

appointment to the Foreign Service beginning in January 

2004. Adams Decl. ¶ 15; Patricia Evans Decl. at 2. 

The next day, Adams told the State Department about her 

breast cancer diagnosis. Upon learning this information, 

MED nurse Rebecca Forsman asked Adams for a “typed 

summary report from your primary treating physician” that 

included pathology reports, blood-work results, a summary of 

care, and a “[t]reatment plan detailing the type and frequency 

of follow-up care/monitoring needed.” Email from Rebecca 

Forsman to Kathy Adams (Oct. 10, 2003). Forsman warned 

Adams “that there is a significant possibility that we will not 

be able to re-issue a Class One (worldwide available) medical 

clearance in the near future,” but assured her that “once all of 

the MD documentation has been received, the providers here 

will review this carefully.” Id. In a telephone conversation, 

Adams recalls, “Ms. Forsman remarked that it would be in 

my best interest to remain in the United States . . . after an 

occurrence of breast cancer, rather than to join the Foreign 

Service and live outside the U.S.” Adams Decl. ¶ 24. 

Responding to the State Department’s request for 

information, Adams had her primary physician, Doctor Mark 

A. O’Rourke, send a letter to the State Department explaining 

that she had been successfully treated for early stage breast 

cancer and was “in completed remission with an excellent 

prognosis.” Letter from Dr. Mark A. O’Rourke 1 (Nov. 19, 

2003). According to Dr. O’Rourke, Adams was “cancerfree,” had “no job limitations whatsoever,” could “undertake 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 5 of 44
6 

a full schedule of work, travel, and vigorous sports,” and was 

“entirely able to work overseas for long periods of time.” Id.

at 1-2. As for follow-up care, Adams needed one pill per day 

of Tamoxifen (an anti-estrogen drug), an annual mammogram 

(recommended for all women Adams’s age), and—crucially 

for this case—a “clinical breast exam at 6-month intervals for 

the next 5 years.” Id. at 1. Adams, he concluded, “is a 

remarkable individual with excellent health, high energy, 

determination, and enthusiasm. I can say with complete 

confidence that this history of breast cancer will not slow her 

down one bit at all.” Id. at 2. 

After reviewing the submitted materials, MED informed 

Adams in mid-December that she was no longer “worldwide 

available” and issued her a Class 5 clearance. Explaining this 

decision, MED Director Laurence Brown later stated that 

Adams “disclosed to MED . . . that she had been diagnosed 

with Stage 1 breast cancer and had undergone an operation in 

August 2003,” and that “[o]n that basis, MED determined that 

she was not eligible for service worldwide.” Brown Decl. ¶ 

14. Specifically, MED based its decision on its conclusion 

that “the Department could not guarantee . . . [Adams] access 

to the required medical follow-up and surveillance for her 

condition . . . at all overseas assignments” since only 53% of 

all Foreign Service posts had “surgeons and/or oncologists” 

available to perform a semi-annual breast exam. Id. ¶ 18. 

Echoing this rationale, MED nurse Forsman explained that 

“[t]he problem was that [Adams] needed to be seen every six 

months for follow-up care (preferably by a specialist).” 

Forsman Decl. at 3. 

Attempting to salvage her candidacy, Adams sought an 

administrative waiver from MED. In support, Dr. O’Rourke 

sent another letter emphatically endorsing Adams’s ability to 

work “anywhere in the world for prolonged periods of time.” 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 6 of 44
7 

Letter from Dr. Mark A. O’Rourke to Dep’t of State Bd. of 

Exam’rs for the Foreign Serv. ¶ 7 (Jan. 12, 2004). The letter 

also clarified that “any competent physician [could] perform 

[Adams]’s examinations; an oncologist or other specialist is 

not required,” and that a nurse practitioner “would be 

competent to perform” the bi-annual breast exams “if a 

physician were not conveniently available.” Id. ¶¶ 9, 14; see 

also O’Rourke Supp. Decl. ¶ 5. Another oncologist, Doctor 

Kimberly Blackwell of Duke University Breast Cancer 

Center, concurred with Dr. O’Rourke’s assessment of 

Adams’s follow-up care needs. 

MED denied the waiver request. Despite Dr. O’Rourke’s 

assurance that Adams required no medical specialists to 

provide any of her follow-up care, the MED doctor who 

denied the waiver confirmed that in MED’s view only “53% 

of all Foreign Service posts have the professional and 

technological support required in this case.” Memorandum 

from Emil Von Arx III, Medical Advisor to Employee 

Review Comm. (Mar. 23, 2004). Left holding a Class 5 

medical clearance, Adams was denied entry into the Foreign 

Service. 

Adams filed an Equal Employment Opportunity (EEO) 

complaint in July 2004 claiming discrimination on the basis 

of a physical disability, namely her history of “Stage 1 breast 

cancer.” Formal Compl. of Discrimination (July 22, 2004). 

According to her complaint, Adams had “resumed all 

physical activities,” and “require[d] only one extra check-up 

per year for four more years and tamoxifen,” a drug that 

thanks to its long shelf life could be “readily store[d] at post.” 

Id. The EEOC initiated an investigation, but after Adams 

filed suit in the U.S. District Court for the District of 

Columbia in May 2005, the Commission dismissed Adams’s 

administrative complaint and terminated the EEO process. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 7 of 44
8 

See 29 C.F.R. § 1614.107(a)(3) (instructing EEOC to dismiss 

complaint when complainant has filed a civil action in federal 

district court more than 180 days after filing administrative 

complaint). 

In her amended complaint, Adams alleges that the 

Department discriminated against her because of a disability, 

i.e., breast cancer. The State Department responded with a 

motion to dismiss, or in the alternative, for summary 

judgment. Noting that “[n]o discovery has taken place, but 

both parties have submitted declarations and other forms of 

documentary evidence to support their positions,” the district 

court treated the Department’s motion as one for summary 

judgment and granted it. Adams v. Rice, 484 F. Supp. 2d 15, 

19 (D.D.C. 2007). Although the district court found the State 

Department’s “refusal to accept the recommendations of 

[Adams]’s physicians or otherwise accommodate her minor 

medical needs . . . both callous and unreasonable,” it 

nonetheless concluded that Adams had failed to show she had 

a disability as defined in the Act. Id. at 23-24. 

Adams now appeals, and the American Cancer Society 

and AARP filed an amicus brief on her behalf. We review 

the district court’s ruling de novo, drawing all reasonable 

inferences from the evidence in Adams’s favor and without 

making credibility determinations or weighing the evidence. 

See Czekalski, 475 F.3d at 362-63. 

II. 

Rehabilitation Act section 501 prohibits federal agencies 

from engaging in employment discrimination against disabled 

individuals. 29 U.S.C. § 791(b); see also Taylor, 451 F.3d at 

905 & n.11 (explaining that section 501(b) provides a private 

cause of action for claims alleging employment 

discrimination); 22 U.S.C. § 3905(e)(4) (expressly applying 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 8 of 44
9 

section 501’s prohibition on “discrimination on the basis of 

handicapping condition” to the Foreign Service). This 

deceptively simple injunction against disability discrimination 

implicates an interlocking web of statutory definitions. First, 

although the Act includes no definition of “discrimination,” it 

instructs courts to use the same standards employed in cases 

arising under the Americans with Disabilities Act (ADA). 29 

U.S.C. § 791(g); see also Breen v. Dep’t of Transp., 282 F.3d 

839, 841 (D.C. Cir. 2002) (applying ADA employment 

discrimination standards to Rehabilitation Act claim). 

Adams’s claim therefore incorporates ADA section 102, 

which provides that “[n]o covered entity shall discriminate 

against a qualified individual with a disability because of the 

disability of such individual in regard to job application 

procedures, the hiring, advancement, or discharge of 

employees, employee compensation, job training, and other 

terms, conditions, and privileges of employment.” 42 U.S.C. 

§ 12112(a). The ADA also includes within the definition of 

“discriminate” the failure to “mak[e] reasonable 

accommodations to the known physical or mental limitations 

of an otherwise qualified individual with a disability who is 

an applicant or employee, unless [the employer] can 

demonstrate that the accommodation would impose an undue 

hardship.” Id. § 12112(b)(5)(A); see also 29 C.F.R. § 

1630.9(a). 

Here, Adams alleges that the State Department denied 

her employment because of her status as a cancer survivor. 

She seeks no accommodation of any sort—indeed, her entire 

case rests on the proposition that she is “fit as a fiddle,” 

Adams Decl. ¶ 47, and perfectly able to serve anywhere in the 

world no matter the conditions without requiring the services 

of medical specialists for follow-up care. See Pl.’s Mem. in 

Opp’n to Def.’s 2d Mot. to Dismiss or for Summ. J. 33 (“Ms. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 9 of 44
10 

Adams needs no accommodation to perform the duties of a 

foreign service officer.”). 

“Disability” is another term of art under the statute that 

carries a specific meaning. An individual is disabled under 

the Rehabilitation Act only if she can show that she (1) “has a 

physical or mental impairment which substantially limits one 

or more . . . major life activities,” (2) “has a record of such an 

impairment,” or (3) “is regarded as having such an 

impairment.” 29 U.S.C. § 705(20)(B). In other words, as the 

Supreme Court explained when interpreting nearly identical 

language in the ADA, “to fall within this definition one must 

have an actual disability . . . , have a record of a disability 

 . . . , or be regarded as having one.” Sutton v. United Air 

Lines, Inc., 527 U.S. 471, 478 (1999). Adams argues that she 

meets all three definitions, and we will examine each in turn. 

Before doing so, we observe that all three disability 

definitions include a reference—central to this case—to a 

substantial limitation on a major life activity. To qualify as 

disabled, Adams must therefore do more than show that she 

has, had, or was regarded as having an impairment of some 

sort. Rather, she must show that her alleged impairment is, 

was, or was believed to be one that “substantially limits one 

or more . . . major life activities.” 29 U.S.C. § 705(20)(B). In 

other words, the impairment must be one whose “severity is 

such” that it qualifies under the statutory definition. H.R.

REP. NO. 101-485, pt. 2, at 52 (1990) (internal quotation 

marks omitted) (explaining definition of the term “disability” 

for purposes of the ADA); see also Toyota Motor Mfg. v. 

Williams, 534 U.S. 184, 195 (2002) (“Merely having an 

impairment does not make one disabled for purposes of the 

[Act]. Claimants also need to demonstrate that the 

impairment limits a major life activity.”). The Act nowhere 

defines the phrase “major life activity,” but the Supreme 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 10 of 44
11 

Court has explained that “the word ‘major’ denotes 

comparative importance and suggests that the touchstone for 

determining an activity’s inclusion under the statutory rubric 

is its significance.” Bragdon v. Abbott, 524 U.S. 624, 638 

(1998) (alteration and internal quotation marks omitted); see 

also Toyota, 534 U.S. at 197 (“‘Major’ in the phrase ‘major 

life activities’ means important.”). Accordingly, while “such 

basic abilities as walking, seeing, and hearing” easily qualify, 

Toyota, 534 U.S. at 197; see also Desmond v. Mukasey, No. 

07-5139, Slip op. at 15-19 (D.C. Cir. 2008) (recognizing 

sleeping as a major life activity), activities that lack “central 

importance to most people’s daily lives” will not satisfy the 

statute, Toyota, 534 U.S. at 198; see also Singh v. George 

Washington Univ. Sch. of Med., 508 F.3d 1097, 1104 (D.C. 

Cir. 2007) (holding that test-taking is not a major life activity 

under the ADA). For reasons explained in greater detail 

below, see infra Part III, when the employee alleges pure 

discrimination on the basis of a disability the claimed 

limitation need have nothing to do with the employee’s ability 

to work. By contrast, when an employee seeks a workplace 

accommodation, the “accommodation must be related to the 

limitation that rendered the person disabled.” Nuzum v. 

Ozark Auto. Distribs., Inc., 432 F.3d 839, 848 (8th Cir. 2005). 

The reason is this: as the ADA’s legislative history makes 

clear, the substantial limitation and major life activity 

requirements act as statutory filters distinguishing those 

suffering from relatively serious impairments from those with 

“minor, trivial impairment[s].” H.R. REP. NO. 101-485, pt. 2, 

at 52 (explaining that under the ADA a person with “a simple 

infected finger is not impaired in a major life activity”). 

Accordingly, if Adams can show that her impairment 

substantially limited an activity qualifying as a “major life 

activity” under the Act—work-related or not—then she 

qualifies as disabled under the statute. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 11 of 44
12 

With this framework in mind, we turn to the sole issue 

before us: whether Adams qualifies as disabled under one or 

more of the Act’s three disability definitions. Because we can 

easily dispose of Adams’s arguments under two of those 

definitions, we address them first. 

Actual Disability 

Adams’s first claim—that the State Department 

discriminated against her on the basis of “a physical or mental 

impairment which substantially limits one or more . . . major 

life activities,” 29 U.S.C. § 705(20)(B)(i)—fails for an 

obvious reason: Adams’s breast cancer—her only claimed 

impairment—was gone by the time the State Department 

made its allegedly discriminatory employment decisions. As 

the government points out, Adams’s illness had been fully 

treated by November 2003, at which point her doctors 

pronounced her “cancer-free” and “in completed remission.” 

Letter from Dr. Mark A. O’Rourke 1 (Nov. 19, 2003). She 

thus had no physical impairment either in December 2003 

(when the State Department revoked her Class 1 medical 

clearance) or in March 2004 (when MED denied her waiver 

request). Dr. O’Rourke made the same point, explaining that 

Adams “does not have an active illness or condition” but must 

remain vigilant given her “history of breast cancer” in order 

to “detect a return of her cancer.” O’Rourke Decl. ¶¶ 12-13 

(emphases added). Accordingly, the State Department could 

not have discriminated against Adams “solely by reason of 

her . . . disability,” 29 U.S.C. § 794(a), given that her 

“impairment” had already been eradicated. At oral argument, 

Adams’s counsel suggested that the risk of cancer recurrence 

could itself constitute a physical impairment, but because 

Adams never made that allegation in the district court, see

Adams, 484 F. Supp. 2d at 20 n.2, we will not consider it 

here. See Flynn v. Comm’r, 269 F.3d 1064, 1068-69 (D.C. 

Cir. 2001) (noting that, absent exceptional circumstances, 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 12 of 44
13 

arguments not made to the district court are forfeited). And 

given that Adams had no impairment at the time the allegedly 

discriminatory actions took place, we need not decide 

whether she was substantially limited in a major life activity 

for purposes of the actual disability definition. 

“Regarded as” Having a Disability 

An individual is “regarded as” disabled if her employer 

“mistakenly believes that [the] person has a physical 

impairment that substantially limits one or more major life 

activities” or “mistakenly believes that an actual, nonlimiting 

impairment substantially limits one or more major life 

activities.” Sutton, 527 U.S. at 489. Although many circuits 

have recognized working as a major life activity, see, e.g., 

Bartlett v. N.Y. State Bd. of Law Exam’rs, 226 F.3d 69, 80 (2d 

Cir. 2000); EEOC v. R. J. Gallagher Co., 181 F.3d 645, 654 

(5th Cir. 1999), both the Supreme Court and this court have 

scrupulously avoided deciding whether working constitutes a 

major life activity for purposes of the Act. See Sutton, 527 

U.S. at 492; Gasser v. District of Columbia, 442 F.3d 758, 

763 n.7 (D.C. Cir. 2006) (noting “the difficulties the issue 

presents” (internal quotation marks omitted)). Instead, for 

purposes of analysis, we have assumed without deciding that 

working qualifies. See Duncan v. WMATA, 240 F.3d 1110, 

1114 n.1 (D.C. Cir. 2001) (en banc). 

Doing the same here, we reject Adams’s claim. “[T]o be 

regarded as substantially limited in the major life activity of 

working, one must be regarded as precluded from more than a 

particular job.” Murphy v. United Parcel Serv., Inc., 527 U.S. 

516, 523 (1999). Adams must therefore present enough 

evidence to persuade a reasonable jury that the State 

Department viewed her as “precluded from more than one 

type of job, a specialized job, or a particular job of choice.” 

Sutton, 527 U.S. at 492. She failed to carry this burden. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 13 of 44
14 

Nothing in the record reveals that the State Department 

believed Adams was unable to hold any position other than 

that of Foreign Service officer—and even then, the 

Department thought her unable to serve only at certain 

“hardship posts” overseas. Adams argues that by denying her 

a Class 1 medical clearance the State Department revealed 

that it regarded her as unable to hold a host of other 

government jobs requiring similar clearances, but such an 

interpretation would mean that every Foreign Service 

candidate denied a Class 1 medical clearance would be 

disabled under the Rehabilitation Act. See Thompson v. Rice, 

422 F. Supp. 2d 158, 175-76 (D.D.C. 2006). We decline to 

adopt such a broad reading of the statute. 

“Record of” a Disability 

Seeking to “make clearer that the [Act’s] coverage . . . 

extends to persons who have recovered—in whole or in 

part—from a handicapping condition, such as a mental or 

neurological illness, a heart attack, or cancer,” S. REP. NO. 93-

1297, at 38-39 (1974), Congress amended the Rehabilitation 

Act in 1974 to cover not only those individuals with 

impairments that substantially limit a major life activity, but 

also those having “a record of such an impairment,” Pub. L. 

No. 93-516, § 111, 88 Stat. 1617, 1619 (now codified at 29 

U.S.C. § 705(20)(B)(ii)) (emphasis added). The “record of” 

definition was tailor-made for plaintiffs who, like Adams, 

claim they once suffered from a physical or mental 

impairment that substantially limited a major life activity, 

recovered from the impairment, but nonetheless faced 

employment discrimination because of it. See 29 C.F.R. pt. 

1630, app. § 1630.2(k) (explaining that the “record of” 

definition “protects former cancer patients from 

discrimination based on their prior medical history”). 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 14 of 44
15 

Our dissenting colleague seems to adopt a narrow 

reading of the term “record,” suggesting that it refers only to 

tangible documentation of the plaintiff’s impairment. See

Dissenting Op. 6-7. But Department of Health and Human 

Services (HHS) regulations interpreting the Rehabilitation 

Act—which the Supreme Court has called a “particular[ly] 

significan[t]” source of guidance, Toyota, 534 U.S. at 195; 

Bragdon, 524 U.S. at 632—define the phrase “has a record of 

such an impairment” more broadly, namely “has a history of, 

or has been misclassified as having, a mental or physical 

impairment that substantially limits one or more major life 

activities,” 45 C.F.R. § 84.3(j)(2)(iii) (emphasis added). 

Thus, although “record of” disability claims will often 

involve tangible documents of some kind, such as medical 

reports or employment forms detailing a previous medical 

condition, plaintiffs may satisfy the “record of” definition 

simply by showing that they “ha[ve] a history of” a qualifying 

impairment. Id. And just as a plaintiff may not qualify as 

disabled or regarded as disabled based on an illness alone—

even a serious illness like cancer—evidence of a prior illness, 

without more, is insufficient to show a record of disability. 

Because the Act protects individuals having a “record of such 

an impairment,” Adams must show that her alleged 

impairment “substantially limit[ed] one or more . . . major life 

activities.” 29 U.S.C. § 705(20)(B) (emphasis added); see 

Gallagher, 181 F.3d at 655 (“[I]t is not enough for [a] . . . 

plaintiff to simply show that he has a record of a cancer 

diagnosis; in order to establish the existence of a “disability” . 

. . there must be a record of an impairment that substantially 

limits one or more of the . . . plaintiff’s major life activities.”). 

Our inquiry under the “record of” definition therefore 

follows a three-step process. First, we ask if Adams has a 

history of a mental or physical impairment. If so, we ask 

whether the impairment limited an activity qualifying as a 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 15 of 44
16 

major life activity under the Act. Finally, if both the 

impairment and activity pass muster under the statute, we ask 

whether the alleged limitation was substantial. We consider 

each of these issues in turn. 

Here it is undisputed both that Adams has a history of 

breast cancer and that breast cancer qualifies as a “physical 

impairment” under the Act. Indeed, commentary 

accompanying the HHS regulations expressly names “cancer” 

as part of a “representative list of disorders and conditions 

constituting physical impairments.” Bragdon, 524 U.S. at 

633 (quoting 42 Fed. Reg. 22,676, 22,685 (1977)); see also

45 C.F.R § 84.3(j)(2)(i) (defining “impairment” as “any 

physiological disorder or condition, cosmetic disfigurement, 

or anatomical loss affecting one or more of the following 

body systems: neurological; musculoskeletal; special sense 

organs; respiratory, including speech organs; cardiovascular; 

reproductive, digestive, genito-urinary; hemic and lymphatic; 

skin; and endocrine”). And because the government nowhere 

argues that breast cancer fails to qualify as an “impairment” 

under the Act, we will not belabor the point. 

Having found that Adams has a history of an impairment, 

we next determine whether that impairment has limited any of 

her major life activities. Adams argues that it has in two 

ways. First, she contends that after her various surgeries—

which required brief hospital stays—she “was unable to care 

for herself and unable to work.” Appellant’s Opening Br. 39. 

Under Toyota, however, “the impairment’s impact must . . . 

be permanent or long term.” 534 U.S. at 198; see also

Haynes v. Williams, 392 F.3d 478, 483 & n.4 (D.C. Cir. 

2004). Here, the evidence shows that Adams’s difficulty 

caring for herself, working, performing household chores, and 

driving lasted for only several weeks following her surgeries. 

Assuming any or all of these activities qualify as major life 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 16 of 44
17 

activities under the Act, we agree with the district court that 

because Adams’s “recovery times . . . consisted only of 

several weeks,” they were “hardly enough to qualify as . . . 

permanent or long-term.” Adams, 484 F. Supp. 2d at 22; see 

also Sutton v. Lader, 185 F.3d 1203, 1209 (11th Cir. 1999) 

(“A temporary inability to work while recuperating from 

surgery is not . . . a permanent or long-term impairment and 

does not constitute evidence of a disability covered by the 

Act.”). 

Adams’s second argument is that her cancer substantially 

limited her in the major life activity of engaging in sexual 

relations. Adams alleges that although she remains cancerfree, has an “excellent prognosis,” no longer requires ongoing 

cancer treatment, and “has no particular limits on her work 

activities,” she remains “limited in the major life activity of 

sexual contact and romantic intimacy.” Am. Compl. ¶ 12. 

According to Adams, her cancer treatment left a “residual 

effect . . . that may never resolve”—one that is “psychological 

in nature.” Adams Decl. ¶ 48. She explains: 

Like many breast cancer survivors, whether by 

virtue of my discomfort with the way my body 

looks, loss of sensation after my surgeries, my 

deep-seated fear that prospective suitors will 

reject me because of my history of cancer, loss 

of a breast, and current physical appearance, or 

the side effects of medication that causes loss 

of libido, I now find that the prospect of dating 

and developing an intimate relationship is just 

too painful and frightening. While I have 

overcome the physical disease, my ability to 

enter into romantic relationships has been 

crippled indefinitely and perhaps permanently. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 17 of 44
18 

Id. ¶ 49. 

This circuit has yet to decide whether sexual relations 

constitutes a major life activity for purposes of the Act. 

Arguing that it does, Adams relies on the Supreme Court’s 

holding in Bragdon v. Abbott that human reproduction 

qualifies as a major life activity, see 524 U.S. at 638, and the 

government’s brief presents no argument to the contrary. 

Based on the statute’s text, the Supreme Court’s reasoning in 

Bragdon, and a hefty dose of common sense, we hold that 

engaging in sexual relations qualifies as a major life activity 

under the Act. 

Beginning with the statute, we can easily conclude 

without resorting to the dictionary that engaging in sexual 

relations clearly amounts to an “activity” in any sense of that 

word. As for the word “major,” the Supreme Court has 

explained that “the touchstone for determining an activity’s 

inclusion under the statutory rubric is its significance.” Id. 

(internal quotation marks omitted). At the risk of stating the 

obvious, sex is unquestionably a significant human activity, 

one our species has been engaging in at least since the biblical 

injunction to “be fruitful and multiply.” Genesis 1:28. As a 

basic physiological act practiced regularly by a vast portion of 

the population, a cornerstone of family and marital life, a 

conduit to emotional and spiritual fulfillment, and a crucial 

element in intimate relationships, sex easily qualifies as a 

“major” life activity. 

Bragdon supports this self-evident conclusion. There the 

Supreme Court held that asymptomatic HIV constitutes a 

disability under the ADA because it is a physical impairment 

that substantially limits the major life activity of reproduction. 

524 U.S. at 637-41. Our holding follows directly from 

Bragdon. In concluding that reproduction meets the statutory 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 18 of 44
19 

definition, the Bragdon Court explained that “[r]eproduction 

and the sexual dynamics surrounding it are central to the life 

process itself.” Id. at 638 (emphasis added). Furthermore, 

Bragdon explains that one of the ways in which HIV limits 

reproduction is by creating a risk that an infected individual 

will transmit the disease to another while engaging in sexual 

contact. See id. at 639. Finally, the Court placed special 

emphasis on an opinion issued by the Justice Department’s 

Office of Legal Counsel (OLC) stating that “‘[t]he life 

activity of engaging in sexual relations is threatened and 

probably substantially limited by the contagiousness of the 

virus.’” Id. at 643 (quoting Application of Section 504 of the 

Rehabilitation Act to HIV-Infected Individuals, 12 Op. Off. 

Legal Counsel 264, 274 (1988)). It bears mentioning that 

when Congress passed the ADA—a statute directly patterned 

on the Rehabilitation Act—it considered this same OLC 

opinion, explaining that HIV-infected individuals qualify as 

disabled “because of a substantial limitation to procreation 

and intimate sexual relationships.” H.R. REP. NO. 101-485, 

pt. 2, at 52 (emphasis added); see also S. REP. NO. 101-116, at 

22 (1989) (citing OLC opinion). 

Based on this reasoning, many courts, including district 

courts in this circuit, have read Bragdon to imply that 

engaging in sexual relations qualifies as a major life activity. 

See, e.g., McAlindin v. County of San Diego, 192 F.3d 1226, 

1234 (9th Cir. 1999); Norden v. Samper, 503 F. Supp. 2d 130, 

151 (D.D.C. 2007); Sussle v. Sirina Prot. Sys. Corp., 269 F. 

Supp. 2d 285, 298-99 (S.D.N.Y. 2003); Powell v. City of 

Pittsfield, 221 F. Supp. 2d 119, 146 (D. Mass. 2002). And in 

his separate Bragdon opinion, Chief Justice Rehnquist took a 

similarly pragmatic view of the Court’s holding: 

Calling reproduction a major life activity is 

somewhat inartful. Reproduction is not an 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 19 of 44
20 

activity at all, but a process. One could be 

described as breathing, walking, or performing 

manual tasks, but a human being (as opposed 

to a copier machine or a gremlin) would never 

be described as reproducing. I assume that in 

using the term reproduction . . . the Court [is] 

referring to the numerous discrete activities 

that comprise the reproductive process . . . . 

524 U.S. at 659 n.2 (Rehnquist, C.J., concurring in the 

judgment in part and dissenting in part). Thus, whether 

Bragdon explicitly recognizes sexual relations as a major life 

activity or merely strongly suggests as much, we have little 

difficultly concluding that sexual relations is a major life 

activity under the Act. 

Having decided that engaging in sexual relations 

qualifies as a major life activity, we next determine whether 

Adams has sufficiently alleged a substantial limitation on that 

activity. This is an individualized inquiry that focuses on 

Adams’s own experience. See Toyota, 534 U.S. at 198 

(requiring plaintiffs “to prove a disability by offering 

evidence that the extent of the limitation . . . in terms of their 

own experience . . . is substantial” (internal quotation marks 

omitted) (second omission in original)). Moreover, “if a 

person is taking measures to correct for, or mitigate, a 

physical or mental impairment, the effects of those 

measures—both positive and negative—must be taken into 

account when judging whether that person is ‘substantially 

limited’ in a major life activity and thus ‘disabled’ under the 

Act.” Sutton, 527 U.S. at 482 (emphasis added). 

Accordingly, in determining whether Adams’s breast cancer 

substantially limited her in a major life activity, “[w]e must 

consider the actual effects of [her] impairment and the side 

effects of [her] treatment.” Gallagher, 181 F.3d at 654. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 20 of 44
21 

Finally, in determining the substantiality of a claimed 

limitation, we may consider: (1) “[t]he nature and severity of 

the impairment;” (2) “[t]he duration or expected duration of 

the impairment;” and (3) “[t]he permanent or long term 

impact, or the expected permanent or long term impact of or 

resulting from the impairment.” 29 C.F.R. § 1630.2(j)(2) 

(EEOC regulations interpreting the ADA); cf. Toyota, 534 

U.S. at 194 (assuming without deciding that EEOC 

regulations are reasonable and declining to decide what 

deference, if any, they are due). 

According to Adams, her breast cancer treatment 

rendered her completely unable to engage in sexual relations. 

Due to the scarring from her mastectomy and breast 

reconstruction, her overall post-surgery physical appearance, 

lack of physical sensation, loss of libido accompanying her 

medication, or some combination of those factors, she claims 

that her “ability to enter into romantic relationships has been 

crippled indefinitely and perhaps permanently.” Adams Decl. 

¶ 49. The government nowhere challenges Adams’s assertion 

that she was substantially limited in her ability to engage in 

sexual relations or that this limitation was anything but a 

direct result of her cancer treatment. By failing to do so, the 

government has effectively conceded—at least for summary 

judgment purposes—that Adams’s claimed impairment did, 

in fact, substantially limit her in a major life activity. See 

Bragdon, 524 U.S. at 641 (noting that “[t]estimony from 

[plaintiff] that her HIV infection controlled her decision not 

to have a child [was] unchallenged” and therefore taken as 

true “[i]n the context of reviewing summary judgment”). Of 

course, a jury hearing Adams’s testimony on this point could 

well decide otherwise. But at this stage of the litigation, 

Adams’s breast cancer qualifies as a disability because it 

amounted to a physical impairment that substantially limited 

her in the major life activity of sexual relations. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 21 of 44
22 

The dissent disagrees, finding Adams’s characterization 

of her substantial limitation insufficient for lack of “evidence 

that her impairment substantially limited her in a major life 

activity at any time before the alleged discriminatory acts in 

December 2003 and March 2004.” Dissenting Op. 2. This 

argument fails for two reasons. First, the government never 

raised it, and we therefore “have no occasion to reach [it] in 

this case.” Bell v. Wolfish, 441 U.S. 520, 532 n.13 (1979); 

see also United States ex rel. Totten v. Bombardier Corp., 380 

F.3d 488, 497 (D.C. Cir. 2004) (“Ordinarily, arguments that 

parties do not make on appeal are deemed to have been 

waived.”). Second, even were we to consider the argument, 

our standard of review on summary judgment requires us to 

view the evidence in Adams’s favor, drawing all reasonable 

inferences from her statements. See Woodruff v. Peters, 482 

F.3d 521, 526 (D.C. Cir. 2007). Although Adams could have 

stated with greater precision when her sexual limitation first 

arose, we think it reasonable to conclude that her alleged 

inability to engage in sexual relations began in September 

2003 when Adams had her right breast removed and began 

taking tamoxifen—the two treatment methods driving her 

alleged sexual limitation. Given that Adams’s limitation 

flowed directly from her post-surgery cosmetic disfigurement 

and drug regimen, it makes no sense to infer, as the dissent 

does, that the limitation first arose well into—or long after—

her course of treatment. See Dissenting Op. at 2, 13 n.11. 

Accordingly, although we agree with the dissent that Adams 

must have “a record of an impairment that substantially limits 

one or more of the . . . plaintiff’s major life activities,” id. at 5 

(quoting Gallagher, 181 F.3d at 655), we, unlike the dissent, 

believe that Adams has made the requisite showing. 

In a footnote, our dissenting colleague offers a second 

argument not made by the government, namely that the Act 

offers Adams no protection because “the impairment—

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 22 of 44
23 

cancer—and the claimed limitation—fear of sexual activity—

never coincided.” Id. at 12 n.11. In the dissent’s view, 

Adams could thus find no refuge in the Act even if she had 

expressly stated that her sexual limitation commenced 

immediately following her mastectomy and before the State 

Department’s alleged discriminatory acts. This interpretation 

renders the Rehabilitation Act a Catch-22 for cancer survivors 

like Adams: when impaired, she had no limitation, and when 

substantially limited, she’d been cured of her impairment. 

Not only does this approach render the Rehabilitation Act a 

mirage for claimants like Adams, but it ignores Sutton’s 

instruction that when identifying substantial limitations under 

the Act, courts must take into account “both positive and 

negative” effects of treatment measures. 527 U.S. at 482. 

The dissent’s approach would exclude from the Act’s 

coverage cancer patients who experienced few limitations on 

their life activities until they began the often grueling process 

of surgery, radiation, and/or chemotherapy. This seems an 

odd result for a remedial statute designed in no small part to 

protect cancer survivors from employment discrimination. 

See S. REP. NO. 93-1297, at 38-39. 

Having left the sufficiency of Adams’s claims 

unchallenged, the government’s only argument boils down to 

this: an employer cannot be held liable for discrimination 

based on a record of a disability unless it knows not only 

about the employee’s alleged history of a physical or mental 

impairment, but also how that impairment substantially 

limited a major life activity. As the government sees it, 

because Adams had not told the State Department—at the 

time it revoked her medical clearance—that her cancer 

limited her ability to engage in sexual relations, it cannot be 

held responsible for any alleged discrimination. Far from 

constituting a “spectacular red herring,” Dissenting Op. 8, this 

is the sum total of the government’s argument before this 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 23 of 44
24 

court. For her part, Adams, again relying on Bragdon, rejects 

the view “that an employer is permitted to discriminate 

against a person with a disability so long as it is unaware of 

how the employee meets the definition of disability.” 

Appellant’s Opening Br. 34. Finding no support for the 

government’s interpretation in the statute or the case law 

interpreting it, we agree with Adams. 

Once again, Bragdon provides helpful guidance. There 

an individual infected with HIV visited a dentist. Aware of 

the patient’s HIV status, the dentist performed an examination 

but upon discovering a cavity, refused to fill it in his office. 

Bragdon, 524 U.S. at 628-29. The patient sued under the 

ADA, alleging that the dentist had denied her equal access to 

a public accommodation on the basis of a disability. See 42 

U.S.C. § 12182(a) (prohibiting discrimination on the basis of 

disability by any person operating a place of public 

accommodation). After holding that the plaintiff’s HIV 

qualified as a disability under the ADA, the Supreme Court 

concluded that “no triable issue of fact impedes a ruling on 

the question of statutory coverage.” Bragdon, 524 U.S. at 

641. Notably the Court said nothing about whether the 

dentist knew or cared that the plaintiff was limited in the 

major life activity of reproduction—and that limitation had 

nothing to do with the dentist’s refusal to treat the plaintiff—

yet the Court concluded that the dentist could be found liable 

just the same. For the Court, it was enough that (1) the 

dentist knew the plaintiff had a physical impairment (HIV), 

(2) the impairment did, in fact, substantially limit a major life 

activity, and (3) the dentist denied treatment because of the 

plaintiff’s impairment. The same analysis applies here. 

Viewed in the light most favorable to Adams, the record 

shows (1) the State Department knew Adams had a record of 

an impairment (breast cancer), (2) the impairment did, in fact, 

substantially limit a major life activity, and (3) the State 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 24 of 44
25 

Department denied Adams employment because of her cancer 

history. True, Bragdon involved the ADA’s “actual 

disability” definition, as the plaintiff had the impairment at 

the time she was refused treatment, but we see no principled 

reason why the same logic should not apply when the alleged 

discrimination is based on a history of a qualifying disease 

rather than on its present manifestation. 

Even though Adams relies heavily on Bragdon, the 

government’s brief never mentions the case. Instead, it relies 

on two cases from this circuit, Crandall v. Paralyzed 

Veterans of America, 146 F.3d 894 (D.C. Cir. 1998), and 

Department of State v. Coombs, 482 F.3d 577 (D.C. Cir. 

2007). But neither of those cases stands for the proposition 

that an employer must know in what way the employee’s 

impairment limits a major life activity in order to be held 

liable for disability discrimination. For example, in Crandall

we held that a plaintiff’s Rehabilitation Act claim failed 

because “he never told anyone” about his alleged impairment, 

i.e., “that he had been diagnosed with or treated for bipolar 

disorder or any other psychiatric disorder,” 146 F.3d at 895, 

and we explained that to be held liable for disability 

discrimination an employer needs “awareness of the disability 

itself, and not merely an awareness of some deficiency in the 

employee’s performance that might be a product of an 

unknown disability,” id. at 897. In Coombs, a Foreign 

Service officer challenged a negative performance evaluation 

and subsequent termination decision by the Foreign Service’s 

Performance Standards Board. 482 F.3d at 578. After that 

decision was made, the employee submitted an affidavit from 

a psychiatrist alleging that he had various mental disorders. 

We held that no Rehabilitation Act discrimination claim could 

lie because, as was true in Crandall, the defendant employer 

had no knowledge of any alleged impairment when it made 

the challenged decision. Indeed, we explained—in language 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 25 of 44
26 

relied on by the government—that the plaintiff must show 

“that the employer knew or had reason to know about the 

employee’s alleged impairment when it made an adverse 

employment decision.” Id. at 579 (emphasis added). Note 

the use of the word “impairment” rather than “limitation.” 

Neither Crandall nor Coombs holds that an employer must 

know anything more than the employee’s impairment to be 

held liable for discrimination. Indeed, the question we face 

here—whether the employer must know about the employee’s 

particular limitation—was not before the court in either of 

those cases. 

The district court cited two additional cases when 

rejecting Adams’s “record of” claim—cases also cited in the 

government’s brief: Colwell v. Suffolk County Police 

Department, 158 F.3d 635 (2d Cir. 1998), and Hilburn v. 

Murata Electronics North America, Inc., 181 F.3d 1220 (11th 

Cir. 1999). Neither case supports the government’s position. 

In Colwell, the plaintiff claimed that a previous cerebral 

hemorrhage, which caused him to be hospitalized for thirty 

days, constituted a record of an impairment that substantially 

limited a major life activity. 158 F.3d at 645. The Second 

Circuit disagreed, explaining that although the plaintiff’s 

“hospitalization is certainly a record of an impairment, and 

the hemorrhage was certainly an impairment,” the plaintiff 

failed “to show that the impairment for which he was 

hospitalized was imposing a substantial limitation on one or 

more of his major life activities.” Id. at 646. The court then 

recounted the plaintiff’s evidence, concluding that none of it 

demonstrated a substantial limitation on any major life 

activity. Id. (noting that the “only evidence of the extent of 

the impairment caused by [plaintiff]’s hemorrhage” was a 

brief hospital stay, six months recovery at home, and several 

months of light duty upon his return to work). We agree with 

the government—and the Colwell court—that a record of 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 26 of 44
27 

temporary hospitalization, without more, is insufficient to 

prove a disability. But more to the point, nothing in Colwell

suggests that the record presented to the employer had to 

include information detailing the plaintiff’s substantial 

limitation; the question was whether the record before the 

court established that the statutory standard had been met. 

Similarly, in Hilburn the Eleventh Circuit explained that “the 

record-of-impairment standard is satisfied only if [plaintiff] 

actually suffered a physical impairment that substantially 

limited one or more . . . major life activities.” 181 F.3d at 

1229. There, the plaintiff presented no evidence to the court 

that her claimed impairment, heart disease, had in fact limited 

any of her major life activities. See id. Here, by contrast, 

Adams not only has shown that the State Department was 

aware of her breast cancer history, but also has furnished 

uncontroverted evidence that the impairment did, in fact, 

substantially limit her ability to engage in sexual relations. 

We find this sufficient under the Act’s “record of” definition. 

Just as in Bragdon, whether the State Department knew the 

precise details of her limitation is neither here nor there. 

EEOC guidance interpreting the ADA’s “record of” 

regulations supports this conclusion—indeed, it seems to go 

further. According to the guidance, “[t]he impairment 

indicated in the record must be an impairment that would

substantially limit one or more of the individual’s major life 

activities.” 29 C.F.R. pt. 1630, app. § 1630.2(k) (emphasis 

added). And cancer, the guidance suggests, is a paradigmatic 

example of just such an impairment. See id. (“[T]his 

provision protects former cancer patients from discrimination 

based on their prior medical history.”). 

Moreover, the government’s proposed knowledge 

requirement conflicts with other aspects of federal hiring 

procedures. According to HHS regulations interpreting the 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 27 of 44
28 

Rehabilitation Act, federal employers “may not make 

preemployment inquir[ies] of an applicant as to . . . the nature 

or severity of a handicap.” 45 C.F.R. § 84.14(a). Although 

this prohibition does not extend to “an applicant’s ability to 

perform job-related functions,” id., no one suggests that 

engaging in sexual relations has anything to do with serving 

as a Foreign Service officer. Thus, under the government’s 

view, Adams’s claim fails because the State Department 

lacked knowledge of a fact that it was legally barred from 

asking about. That makes no sense at all. 

For a similar reason, we reject the government’s 

jurisdictional argument that Adams failed to exhaust her 

administrative remedies by omitting a reference to her sexual 

limitation on her formal EEO complaint. No such disclosure 

was necessary. A complainant need only file a signed 

statement with the agency that is “sufficiently precise to 

identify the aggrieved individual and the agency and to 

describe generally the action(s) or practice(s) that form the 

basis of the complaint.” 29 C.F.R. § 1614.106(c) (emphasis 

added). Under this standard, Adams’s complaint sufficed. 

Indeed, the EEO “Formal Complaint of Discrimination” form 

simply asked Adams, “Why do you believe you were 

discriminated against?” and to “[e]xplain specifically how 

you were discriminated against (treated differently from other 

employees or applicants) because of your physical 

disabilities.” Nothing on the form asked how her impairment 

substantially limited a major life activity, and for good 

reason: given that employees often file administrative 

complaints without the aid of counsel, it would frustrate the 

statute’s aim to expect employees not only to explain in their 

complaints the allegedly discriminatory action they suffered, 

but also to list the precise way in which they satisfy the 

Rehabilitation Act’s definitional section in 29 U.S.C. § 

705(20)(B). Here, Adams alleged that the State Department 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 28 of 44
29 

denied her employment because she once had stage-one 

breast cancer. That suffices for administrative exhaustion 

purposes. Cf. Shehadeh v. Chesapeake & Potomac Tel. Co. 

of Md., 595 F.2d 711, 727 (D.C. Cir. 1978) (noting in a Title 

VII case that “complaints to the Commission are to be 

construed liberally since very commonly they are framed by 

persons unschooled in technical pleading”). 

III. 

It seems to us that what’s driving the government’s 

argument is basic confusion over the various ways in which a 

person can suffer discrimination under the Act. An 

employer’s knowledge of an employee’s limitation—as 

opposed to her impairment—is certainly relevant when the 

disabled employee requests a workplace accommodation. As 

discussed above, in such cases the accommodation sought 

must relate to the limitation at issue. See McAlindin, 192 F.3d 

at 1237 (“[T]he major life activities affected by the 

impairment are relevant only to the extent that they affect the 

type of accommodation that may be necessary and whether 

the employer has provided a reasonable accommodation.”);

Taylor v. Principal Fin. Group, Inc., 93 F.3d 155, 164 (5th 

Cir. 1996) (“This distinction is important because the ADA 

requires employers to reasonably accommodate limitations, 

not disabilities.”). But in pure discrimination cases like 

Adams’s, an employer’s knowledge of the precise limitation 

at issue is irrelevant; so long as the employee can show that 

her impairment ultimately clears the statutory hurdle for a 

disability—i.e., it substantially limited a major life activity—

the employer will be liable if it takes adverse action against 

her based on that impairment. 

Consider the following hypothetical. Suppose a 

telephone receptionist takes a leave of absence from work 

because he’s experiencing headaches only to discover that he 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 29 of 44
30 

has a malignant brain tumor. The tumor is surgically 

removed, rendering the employee cancer-free. As a result of 

the treatment, however, the employee experiences significant 

hearing loss. Now suppose the employer learns about the 

tumor—but has no idea about the hearing loss—and informs 

the employee he’s not welcome back at work because he had 

cancer. Is that illegal discrimination under the Act? Of 

course it is. In such situations it makes no difference whether 

an employer has precise knowledge of an employee’s 

substantial limitation; as in Bragdon, it is enough for the 

employer to know about the impairment. Cf. Blackwell v. 

Dep’t of Treasury, 830 F.2d 1183, 1183-84 (D.C. Cir. 1987) 

(stating that the Rehabilitation Act does not require 

complainants to provide employers with “precise notice of a 

handicap”). If, however, the hypothetical telephone 

receptionist sought an accommodation from his employer so 

that he could return to work, the employer would obviously 

need to know about the employee’s claimed hearing 

limitation. The upshot is this: if an employer discriminates 

against an employee on the basis of a physical or mental 

impairment, or the record thereof, and if the impairment in 

fact qualifies as a “disability” under the Act, i.e., it 

substantially limits or once limited a major life activity, then 

the employer may be vulnerable to a charge of employment 

discrimination. 

This conclusion makes sense because creating a 

knowledge requirement in situations involving pure 

discrimination would shield the most ignorant, irrational, and 

prejudiced employers—precisely the kinds of employers 

Congress intended the Act to reach. Under the government’s 

theory, an employer could lawfully fire an employee solely 

for revealing that she had recovered from ovarian cancer after 

undergoing a hysterectomy, so long as the employer didn’t 

know the effect such treatment has on reproduction. A better 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 30 of 44
31 

informed employer, however, would suffer the full 

consequences of his decision. Congress could not have 

intended ignorance to act as a safe harbor. Moreover, in the 

government’s view, to preserve a claim under either the 

Rehabilitation Act or the ADA, cancer survivors would have 

to announce to employers, “Yes, I once had cancer, and it 

substantially limited me in the following major life 

activities.” Absent such disclosure, the employer could 

discriminate at will simply because he didn’t like having 

cancer survivors around the office, or because he harbored 

“the irrational fear that they might be contagious.” Sch. Bd. 

of Nassau County v. Arline, 480 U.S. 273, 284 (1987). As 

amici point out in their brief, Congress enacted the 

Rehabilitation Act and the ADA to forbid such blatantly 

discriminatory actions, intending to protect cancer survivors 

who qualify as disabled under the statute from employment 

discrimination based on myths, fears, and stereotypes about 

the disease. 

IV. 

In sum, because Adams has provided sufficient evidence 

showing that she has a record of an impairment that 

substantially limited her in a major life activity, and because 

the government nowhere contested any of the evidence 

Adams offered in support of her disabled status, we reverse 

the district court’s grant of summary judgment to the State 

Department and remand for proceedings consistent with this 

opinion. 

So ordered. 

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 31 of 44
1

The Rehabilitation Act of 1973 (Rehabilitation Act or Act)

defines “individual with a disability” as

“any person who—

(i) has a physical or mental impairment which

substantially limits one or more of such person’s

major life activities;

(ii) has a record of such an impairment; or

(iii) is regarded as having such an impairment.

Id. § 705(20)(B). Adams has no claim under section 705(20)(B)(i)

(“first prong”) because her physical impairment—Stage one breast

cancer—was “cured” by her mastectomy and she does not meet

section 705(20)(B)(iii) (“third prong”) under Gasser v. District of

Columbia, 442 F.3d 758 (D.C. Cir. 2006); see also Duncan v.

Washington Metro. Area Transit Auth., 240 F.3d 1110 (D.C. Cir.

2001) (en banc). Her remaining claim is her “record of impairment”

(“second prong”) claim.

2

In light of my dissent from the “record of impairment” holding,

I would not reach the question, as yet unanswered in this Circuit,

whether sexual activity constitutes a major life activity under the

statutory definition. In asserting that such a limitation exists, the

majority relies on Bragdon v. Abbott, 524 U.S. 624 (1998), in which

the United States Supreme Court held only that “reproduction” is a

KAREN LECRAFT HENDERSON, Circuit Judge, dissenting:

My colleagues and I agree that the only way Kathy Adams

(Adams) survives summary judgment in favor of the U.S.

Department of State (Department) on her Rehabilitation Act

claim is under 29 U.S.C. § 705(20)(B)(ii), the “record of

impairment” definition of “disability.”1 Applying the wellsettled standard set forth in Celotex Corp. v. Catrett, 477 U.S.

317, 323 (1986), I am convinced that Adams “has failed to make

a sufficient showing on an essential element of her case.”

Accordingly, I believe the district court correctly granted

summary judgment to the Department and I respectfully

dissent.2

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 32 of 44
2

major life activity. See 424 U.S. at 638-39. The Bragdon Court did

not address whether sexual activity outside of the reproduction context

qualifies as Adams claims.

3

Because the inquiry focuses on “such person’s major life

activities,” 29 U.S.C. § 705(20)(B)(i) (emphasis added), it does not

suffice that a record of breast cancer can substantially limit a major

life activity. Instead, Adams must demonstrate that at the time of the

alleged discrimination she had such a record.

To be an “individual with a disability” under the second

prong of section 705(20)(B), Adams must “ha[ve] a record of

such an impairment.” “Such an impairment” refers to the first

prong, that is, an “impairment which substantially limits one or

more . . . major life activities,” 29 U.S.C. § 705(20)(B)(i). See

Webster’s Third New Int’l Dictionary 2283 (1993) (defining

“such” as “having a quality already or just specified”). Thus,

there must be a record, or a history, showing that at some time

before the alleged discrimination Adams had a disability under

the first prong. See Heisler v. Metro. Council, 339 F.3d 622,

630 (8th Cir. 2003) (“To have a record of an impairment, an

employee must ‘ha[ve] a history of . . . a mental or physical

impairment that substantially limits one or more major life

activities.’ ” (quoting 29 C.F.R. § 1630.2(k) (alteration in

Heisler))). While it is undisputed that she had an

impairment—breast cancer—during the fall of 2003, she offered

no evidence that her impairment substantially limited her in a

major life activity at any time before the alleged discriminatory

acts in December 2003 and March 2004.3

 Instead, Adams relied

on allegations made long after the fact. In her amended

complaint, filed some 15 months after the Department reduced

her medical clearance, Adams asserted for the first time that she

“is . . . limited in the major life activity of sexual contact and

romantic intimacy” and “[t]his limitation may be due to a

variety of physical and psychological effects of cancer

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 33 of 44
3

4

Adams, herself a lawyer, made no mention of the alleged sexual

limitation in her EEOC complaint or her original district court

complaint. In fact, in her EEOC complaint dated July 22,

2004—several months after the alleged discrimination occurred—she

affirmatively declared that she had “resumed all physical activities,”

making no exception for sexual activities. Formal Compl. of

Discrimination 1 (emphasis added).

treatment.” Adams v. Rice, No. 05-941, Am. Compl. ¶ 12

(D.D.C. filed March 9, 2005) (emphasis added).4 She elaborated

somewhat in a subsequent declaration:

Like many breast cancer survivors, whether by virtue of

my discomfort with the way my body looks, loss of

sensation after my surgeries, my deepseated fear that

prospective suitors will reject me because of my history

of cancer, loss of a breast, and current physical

appearance, or the side effects of medication that causes

loss of libido, I now find the prospect of dating and

developing an intimate relationship just too painful and

frightening.

Nov. 26, 2005 Decl. of Kathy E. Adams ¶ 49 (emphasis added).

In both statements, Adams described only a current (2005)

limitation, using a present tense verb and the adverb “now.” She

has never asserted that the limitation (and thus her disability)

existed before the alleged discrimination. In the absence of any

record—documentary, or otherwise—of a qualifying

impairment when she was allegedly discriminated against, the

second prong was not satisfied and therefore Adams was not as

a matter of law an “individual with a disability” protected under

the Act. That the second prong requires a record that manifests

both a physical or mental impairment and its substantial

limitation on a major life activity is reinforced by decisions from

other circuits.

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 34 of 44
4

5

The ADA definition of “disability” provides:

The term “disability” means, with respect to an

individual—

(A) a physical or mental impairment that

substantially limits one or more of the major life

activities of such individual;

(B) a record of such an impairment; or

(C) being regarded as having such an impairment.

42 U.S.C. § 12102(2).

In EEOC v. R.J. Gallagher Co., 181 F.3d 645 (5th Cir.

1999), the Fifth Circuit recognized that under the definition of

“disability” in the Americans with Disabilities Act (ADA), 42

U.S.C. § 12102(2)(A), which tracks almost verbatim the

Rehabilitation Act’s definition of “individual with a disability,”5

the historical record must indicate both an impairment and a

major life activity limitation. The Gallagher court relied on the

Supreme Court’s decision in Sutton v. United States, 527 U.S.

471 (1999) (Sutton), in which the Court held that neither of two

severely myopic sisters, who had been rejected for positions as

commercial airline pilots, had a disability under the ADA. The

Court explained that, although each sister had an impairment

(severe myopia), the impairment did not limit a major life

activity at the time they claimed they were discriminated against

because each sister’s vision was by then normal (or better) with

corrective lenses. Citing Sutton, the Gallagher court rejected a

portion of the EEOC interpretive guidance promulgated in 1991

stating that the record of impairment prong “ ‘protects former

cancer patients from discrimination based on their prior medical

history’ ” 181 F.3d at 655 (quoting 29 C.F.R. pt. 1630, App.

§ 1630.2(k)) (interpreting statutory phrase “record of such

impairment”). The court explained:

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 35 of 44
5

6

The EEOC interpretive guidance on the record of impairment

prong states in pertinent part:

The second part of the definition provides that an

individual with a record of an impairment that substantially

limits a major life activity is an individual with a disability.

The intent of this provision, in part, is to ensure that people

are not discriminated against because of a history of

disability. For example, this provision protects former

This broad position obviously cannot be the rule in the

wake of Sutton, which emphasizes both the ADA’s

requirement of individualized inquiry and a focus on the

actual effects of the impairment. In other words, it is not

enough for an ADA plaintiff to simply show that he has

a record of a cancer diagnosis; in order to establish the

existence of a “disability” under § 12102(2)(B), there

must be a record of an impairment that substantially

limits one or more of the ADA plaintiff’s major life

activities.

Id. (emphasis added). Here, as in Gallagher, there was a record

of cancer but no record of any substantial limitation it produced.

Even more on point is the Second Circuit’s decision in

Colwell v. Suffolk County Police Department, 158 F.3d 635 (2d

Cir. 1998). In Colwell, three police officers asserted they had

been passed over for promotion on account of the lingering

effects of past injuries, claiming they were disabled under all

three prongs of the ADA definition. The Second Circuit first

rejected the plaintiffs’ impairment claims under the first prong

because they failed to produce “evidence sufficient to show that

the limitation [each] suffered with respect to a major life activity

was substantial.” 158 F.3d at 645. The court then addressed the

plaintiffs’ record of impairment claims and rejected them as

well, quoting language from the same EEOC interpretive

guidance discussed in Gallagher.

6

 The interpretive language the

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 36 of 44
6

cancer patients from discrimination based on their prior

medical history. * * * This part of the definition is satisfied

if a record relied on by an employer indicates that the

individual has or has had a substantially limiting

impairment. The impairment indicated in the record must

be an impairment that would substantially limit one or more

of the individual’s major life activities. There are many

types of records that could potentially contain this

information, including but not limited to, education,

medical, or employment records.

29 C.F.R. pt. 1630, App. § 1630.2(k).

Colwell court discussed states: “This part of the definition is

satisfied if a record relied on by an employer indicates that the

individual has or has had a substantially limiting impairment.”

29 C.F.R. pt. 1630, App. § 1630.2(k) (emphases added).

Relying on this language, the court rejected the plaintiffs’

contention that their personnel records “show[ed] a history of a

substantially limiting impairment” because “the records of

impairment that each plaintiff showed involved no greater

degree of limitation of major life activities than the continuing

impairments they showed.” 158 F.3d at 645. In the Second

Circuit’s view, the personnel records were inadequate to

establish a “record” of a qualifying impairment under the second

prong because they manifested only an impairment and not a

resulting major life activity limitation.

Like the plaintiffs in Colwell, Adams has pointed to a record

existing at the time of the alleged discrimination that identified

an impairment but none that even suggested a resulting

substantial limitation. To the contrary, the record in late 2003

to early 2004 painted a rosy picture of Adams’s condition,

indicating she had made a full recovery. See, e.g., 12/9/03

Letter from Adams to State Dep’t Office of Med. Servs.

(reporting after doctor visit: “Everything is fine.”); 11/19/03

Letter from Dr. Mark A. O’Rourke to State Dep’t (“At this time,

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 37 of 44
7

Kathy has no job limitations whatsoever. She is cancer-free and

is able to undertake a full schedule of work, travel, and vigorous

sports, as she had already enjoyed. . . . I can say with complete

confidence that this history of breast cancer will not slow her

down one bit at all.”); 1/12/04 Letter from Dr. Mark A.

O’Rourke to State Dep’t Bd. of Exam’rs for Foreign Serv. (“She

has fully recovered from her surgeries . . . She remains cancerfree. . . . Kathy’s post-cancer status is in no way incapacitating.

She has no performance limitations whatsoever on her ability to

work, travel, or engage in the vigorous sports she enjoys . . . .”).

Given that she had no record of a qualifying impairment when

the Department reduced her medical clearance and denied her a

waiver, she could not then be an individual with a disability

under 29 U.S.C. § 705(20)(B) so as to be protected by the Act.

In asserting otherwise, the majority does precisely what the Fifth

Circuit in Gallagher proscribed as contrary to Sutton, namely,

finding that a person has a disability based on a record of a

cancer diagnosis but without a record of a resulting substantial

limitation. See Gallagher, 181 F.3d at 655. The majority’s

holding similarly conflicts with the Second Circuit’s conclusion

in Colwell, 158 F.3d at 645.

Most recently, the Eleventh Circuit decided a first prong

Rehabilitation Act claim that is nonetheless strikingly similar to

Adams’s. In Garrett v. University of Alabama, Birmingham,

507 F.3d 1306, 1315 (11th Cir. 2007), the plaintiff, who was

also diagnosed with breast cancer, underwent two surgeries, a

course of radiation and chemotherapy treatments between

August 1994 and June 1995. She returned to work in July 1995

and on July 21, 1995, her supervisor allegedly demoted her on

account of her cancer. Garrett’s limitations included “caring for

herself, performing manual tasks, lifting, and working.” Id. at

1310. The Eleventh Circuit affirmed the grant of summary

judgment to the defendant, rejecting the plaintiff’s reliance “not

only upon the status of her impairments and limitations prior to

[demotion] but also [her] misplace[d] . . . reliance upon her

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 38 of 44
8

7

Adams’s 2005 allegations suffer from yet another defect the

Garrett court highlighted. Her amended complaint and her declaration

describe the causal link between her cancer treatment and the alleged

sexual limitation only “in general and vague terms,” 507 F.3d at 1315

(noting “the lack of any objective evidence of the extent of Garrett's

limitations”) (emphasis added). See Am. Compl. ¶ 12 (“may be due

to”); Adams Decl. ¶ 49 (“whether by virtue of”).

8

In Crandall, we applied the version of section 794(a) in effect at

the time of the alleged discrimination, which version prohibited

condition years after . . . .” Id. at 1312. Adams’s reliance on her

belated claim of a sexual limitation in 2005 is equally

misplaced—and fatal to her case. In accepting her claim as a

sort of nunc pro tunc allegation, the majority directly clashes

with the Eleventh Circuit’s holding in Garrett.

7

 As the Eleventh

Circuit correctly stated: “The Rehabilitation Act does not

protect employees who become disabled after the discriminatory

act, but protects those employees who were disabled at the time

of the discriminatory act.” 507 F.3d at 1315.

Additionally, the majority’s focus on notice in this case is a

spectacular red herring. See maj. op. 23-28, 29-31. Notice is

not an issue because Adams did not have the requisite record of

which the Department could have had notice when it reduced

Adams’s medical clearance. Nonetheless, given the support for

such a requirement in the case law, I cannot let pass

unchallenged the majority’s dicta rejecting a notice requirement.

The Rehabilitation Act imposes liability only if the employer

discriminates against the applicant “solely by reason of her or

his disability,” 29 U.S.C. 794(a). In Crandall v. Paralyzed

Veterans of America, 146 F.3d 894 (D.C. Cir. 1998), we made

clear that the quoted language requires that the employer be on

notice of the claimed “disability,” that is, on notice of both the

impairment and the resulting limitation that together constitute

the disability.8

 See § 705(20)(B)(i). In Crandall, the plaintiff

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 39 of 44
9

discrimination against an “otherwise qualified handicapped individual

in the United States . . . solely by reason of his handicap,” 29 U.S.C.

§ 794(a) (1992). Although the language was amended in 1992 to

replace “handicap” with “disability,” see Pub. L. No. 102-569,

§ 102(p)(36), 106 Stat. 4344, 4360 (1992), the earlier version defined

“individual with handicaps” in the same way that the current version

defines “individual with a disability.” Compare 29 U.S.C.

§ 706(8)(B) (1992) with 29 U.S.C. § 705(2)(B)(2008).

Notwithstanding we applied the “handicap” version in Crandall, we

used the then-current statutory term “disability” throughout the text of

the opinion in place of the dated “handicap.” Compare 146 F.3d at

896 (quoting statutory prohibitions against discriminating against a

“handicapped individual . . . solely by reason of his handicap”) with

id. at 897 (rejecting argument that “if the poor performance causes

dismissal, then the dismissal was ‘by reason of'’ the disability” so as

to satisfy the statutory prohibition).

was fired for “acts of rudeness” and afterward disclosed to the

employer that he had been diagnosed as suffering from bi-polar

disorder. The district court granted summary judgment to the

employer, holding that “no reasonable factfinder could have

found that [the employer] discriminated on the basis of [the

employee’s] disability, since it had neither actual nor

constructive notice of his disability when it fired him.” 146 F.3d

at 895. We affirmed, declaring quite broadly:

The courts of appeals have overwhelmingly agreed

that for this causal link to be shown the employer must

have acted with an awareness of the disability itself, and

not merely an awareness of some deficiency in the

employee’s performance that might be a product of an

unknown disability. They have so found under both the

Rehabilitation Act itself and the analogous provision of

the [ADA], 42 U.S.C. § 12112(a) (providing that no

employer “shall discriminate against a qualified

individual with a disability because of the disability of

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 40 of 44
10

such qualified individual . . . .”). See, e.g., Taylor v.

Principal Financial Group, Inc., 93 F.3d 155, 163 (5th

Cir. 1996) (“To prove discrimination [under the ADA],

an employee must show that the employer knew of such

employee’s substantial physical or mental limitation.”);

Morisky v. Broward County, 80 F.3d 445, 447-49 (11th

Cir. 1996) (liability under the ADA requires actual or

constructive notice of the disability); Collings v.

Longview Fibre Co., 63 F.3d 828, 834 (9th Cir. 1995)

(assuming plaintiffs had a medically recognizable drug

disability, they could not make out a case under the

ADA where they could not show that employer was

aware of it); Miller v. National Casualty Co., 61 F.3d

627, 629 (8th Cir. 1995) (under ADA, “[b]efore an

employer must make accommodation for the physical or

mental limitation of an employee, the employer must

have knowledge that such a limitation exists.”); Hedberg

v. Indiana Bell Tel. Co., 47 F.3d 928, 932 (7th Cir.1995).

146 F.3d at 896-97 (emphases added). That Crandall and the

decisions it quotes use “disability” and “limitation” rather than

“impairment”—each of which terms has a precise statutory

meaning—manifests that the employer must have notice of both

the impairment and the limitation that make up the disability.

And it is of no consequence that Crandall is a first prong case

because a second prong case must incorporate a first prong

disability. See infra note 11.

To support its contention that an employer need have notice

only of an impairment and not of a limitation (at least if the

limitation does not require accommodation, see maj. op. 29-30),

the majority looks to the Supreme Court’s decision in Bragdon

v. Abbott, 524 U.S. 624 (1998), in which the Court concluded

that a woman infected with the human immunodeficiency virus

(HIV) was disabled under the first prong because her

impairment, HIV, limited her major life activity of reproduction.

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 41 of 44
11

9

While I have assumed arguendo that sexual activity constitutes

a major life activity, see supra note 2, I note that the Department’s

position is that sexual activity “can” qualify “to the [extent] that

procreation may be implicated.” Oral Arg. at 20:15. But the

Department has nowhere accepted that Adams had that limitation at

the time of the medical clearance denial nor could it inasmuch as at

that point she had not even mentioned the limitation. In fact, Adams’s

counsel, in response to a question about Adams’s failure to so note in

her EEO complaint, said that an immediate limitation resulted from

the treatment. Oral Arg. at 17:15. Adams’s physical impairment,

however, was the breast cancer, not the mastectomy. While I agree

that the Department did not define what precisely the “record” of

impairment must comprise under prong two, we of course are free to

affirm on that ground. See In re Swine Flu Immunization Prods. Liab.

Litig., 880 F.2d 1439, 1444 (D.C. Cir. 1989). Moreover, because the

issue is one of statutory construction, I believe we are obligated to

construe it accurately. See Eldred v. Ashcroft, 255 F.3d 849, 853

(D.C. Cir. 2001) (en banc) (“ ‘When an issue or claim is properly

before the court, the court is not limited to the particular legal theories

advanced by the parties, but rather retains the independent power to

524 U.S. at 631-48. The majority emphasizes that “the Court

said nothing about whether the dentist knew or cared that the

plaintiff was limited in the major act of reproduction.” Maj. op.

24. The Court’s silence, however, is unremarkable given that

the dentist’s knowledge vel non of the limitation was not one of

the issues the respondent dentist raised in his petition and on

which the court granted certiorari. See Bragdon, 524 U.S.628

(“We granted certiorari to review, first, whether HIV infection

is a disability under the ADA when the infection has not yet

progressed to the so-called symptomatic phase; and, second,

whether the Court of Appeals, in affirming a grant of summary

judgment, cited sufficient material in the record to determine, as

a matter of law, that respondent’s infection with HIV posed no

direct threat to the health and safety of her treating dentist.”)

(emphasis added).9

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 42 of 44
12

identify and apply the proper construction of governing law.’ ”

(quoting Kamen v. Kemper Fin. Servs., Inc., 500 U.S. 90, 99 (1991));

U.S. Nat’l Bank of Or. v. Indep. Ins. Agents of Am., Inc., 508 U.S. 439,

447 (1993) (“[The] court may consider an issue antecedent to and

ultimately dispositive of the dispute before it, even if the parties fail

to identify and brief.” (ellipsis and quotations omitted)).

10The majority acknowledges that Adams could have described

“with greater precision” when her sexual limitation began but finds it

“reasonable to conclude that [it] began in September 2003,” maj. op.

22, as a result of her “course of treatment.” Id. The reasonableness of

the majority’s conclusion escapes me both in light of the showing

Adams did make of her “full recovery” by December 2003, supra pp.

6-7, and in light of case law rejecting recuperation from surgery as a

qualifying limitation. See, e.g., Garrett, 507 F.3d at 1315 (“ ‘A

temporary inability to work while recuperating from surgery is not . . .

a permanent or long-term impairment and does not constitute evidence

of a disability covered by the Act.’ ” (quoting Sutton v. Lader, 185

F.3d 1203, 1209 (11th Cir. 1999))).

11Unlike the majority, I believe that Adams’s first prong

deficiency also dooms her second prong claim. Adams failed to

establish a first prong disability because she offered no evidence that

at the time she was allegedly discriminated against, she was

simultaneously both impaired and limited in a major life activity so as

to qualify under the first prong, which applies only to a person who

“has a physical or mental impairment which substantially limits one

or more of [her] major life activities.” (Emphasis added.)

Significantly, each of the first prong’s requirements is expressed in the

present tense, indicating that each must occur simultaneously, that is,

In sum, because Adams had no record—documentary, or

otherwise—of a qualifying impairment when the Department

allegedly discriminated against her,10 I would affirm the district

court’s grant of summary judgment on the ground that she was

“unable to demonstrate that she is disabled within the definition

of the Rehabilitation Act.” 484 F. Supp. 2d at 17.11 I therefore

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 43 of 44
13

the person must have an impairment and the impairment must limit a

major life activity at the same time. That the tense of the verbs is

significant is clear from the Supreme Court’s Sutton opinion, in which

the Court relied heavily on the statute’s use of “the present indicative

verb form” of “limits,” which the Court interpreted as “requiring that

a person be presently—not potentially or hypothetically—substantially

limited in order to demonstrate a disability.” 527 U.S. at 482. The

verb “has” in the same provision is the same tense as “limits”—the

present indicative. In other words, the plain language of the first

prong requires that a disabled person have an impairment and a

resulting limitation occurring together. In Adams’s case, the

impairment—cancer—and the claimed limitation—fear of sexual

activity—never coincided. Once Adams’s treatment was complete,

she no longer had an impairment because her cancer was gone. See

11/19/03 Letter from Dr. Mark A. O’Rourke to State Dep’t (declaring

Adams “cancer-free”). Nor was Adams disabled under the first prong

before her treatment (when she still had the impairment of cancer)

because she did not then experience the limitation she now claims.

Her sexual limitation arose only after and as a result of her cancer

treatment. See Nov. 26, 2005 Decl. of Kathy E. Adams ¶ 49 and

Adams v. Rice, No. 05-941, Am. Compl. ¶ 12 (both quoted supra pp.

2-3). How long after, we can only guess on this record. See supra pp.

2-3 & note 4. Because Adams never had an impairment that, at the

time she had it, substantially limited a major life activity under the

first prong, she could likewise not have a “record of such an

impairment” under the second prong.

12It is the timing of this case, I think, that makes it such a bad fit

under the Rehabilitation Act and, consequently, a bad candidate for a

precedent-setting opinion on the requirements of a second prong

claim. There are record indications that, had Adams delayed pursuing

her Foreign Service career somewhat longer than three months postop, the Department would have considered her fit for duty. See, e.g.,

Brown Decl. ¶¶ 3, 4; FAQ (JA 104).

respectfully dissent.12

USCA Case #07-5101 Document #1128299 Filed: 07/18/2008 Page 44 of 44