UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

MONICA WINKELMAN,

Plaintiff,

v.

CONTINENTAL NURSING AND 

REHABILITATION CENTER, LLC and

INFINITY HEALTHCARE MANAGEMENT 

OF ILLINOIS, LLC, 

Defendants.

No. 20 CV 2480

Judge Manish S. Shah

MEMORANDUM OPINION AND ORDER

Monica Winkelman, a healthcare administrator, was diagnosed with kidney 

failure and needed time off for surgery and dialysis training. She alleges her 

employers, Continental Nursing and Rehabilitation Center, LLC and Infinity 

Healthcare Management of Illinois, LLC violated her rights under the Americans 

with Disabilities Act and Illinois Human Rights Act. The defendants’ motion to 

dismiss is granted in part, denied in part. 

I. Legal Standard

A complaint must contain a short and plain statement that plausibly suggests 

the violation of a legal right. Fed. R. Civ. P. 8(a)(2); Bell Atl. Corp. v. Twombly, 550 

U.S. 544, 556–58 (2007); Ashcroft v. Iqbal, 556 U.S. 662, 677–80 (2009). At the motion 

to dismiss stage, I accept the plaintiff’s factual allegations as true and draw all 

reasonable inferences in her favor, but do not accept bare assertions, conclusory 

statements, or legal conclusions. Iqbal at 678–79.

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II. Facts 

Infinity Healthcare Management of Illinois manages and operates nursing and 

rehabilitation centers. [1] ¶¶ 6–7.1 Infinity hired Monica Winkelman as an 

administrator of one of its facilities. [1] ¶ 7. About two months later, the company 

transferred Winkelman to the Continental Nursing and Rehabilitation Center. [1] 

¶ 7. Continental and Infinity were owned by the same individuals and operated as an 

integrated enterprise. [1] ¶ 6. Continental issued Winkelman’s paychecks, while 

Infinity supervised and assessed her work, and oversaw her title, responsibilities, 

compensation, and employment status. [1] ¶ 8. Winkelman’s boss was a regional 

director at Infinity. [1] ¶ 8.

For a while, Winkelman enjoyed success as an administrator, the highest-level 

employee at Continental. [1] ¶¶ 8–9. She quickly increased the number of patients at 

the facility. [1] ¶ 9. She consistently met expectations. [1] ¶ 9. After a year, she 

received a positive performance review and a merit-based raise. [1] ¶ 9. About three 

months later, Winkelman was diagnosed with end-stage renal disease, which meant 

a loss of normal kidney function, including blood filtration. [1] ¶ 10. Winkelman told 

her boss and a HR representative about her diagnosis and explained that she needed 

one week off for surgery and recovery, and after that, at some point, two additional 

weeks for dialysis training. [1] ¶ 11. 

1 Bracketed numbers refer to entries on the district court docket. Referenced page numbers 

are from the CM/ECF header placed at the top of documents. 

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Winkelman formally requested these accommodations under the ADA. [1] 

¶ 12. The next day, Winkelman’s requests were approved and senior leadership 

arrived at the facility. [1] ¶¶ 12–14. Infinity’s CEO and COO rarely visited, and 

Winkelman’s boss, a regional director, visited on a weekly basis. [1] ¶ 14. But after 

Winkelman’s accommodation request was approved, the CEO, COO, and her boss 

were at Continental every day until early June. [1] ¶ 14. They micromanaged staff 

and imposed unreasonable demands, causing two managers quit and two other 

employees to seek jobs elsewhere. [1] ¶¶ 13, 15. During this time period, Winkelman 

took her first one-week leave of absence for surgery and recovery. [1] ¶ 16. 

In mid-June, Winkelman confirmed the dates of her dialysis training for her 

second approved absence with her boss and the HR representative. [1] ¶ 17. The next 

day, Winkelman’s boss and another regional director terminated Winkelman. [1] 

¶ 18. They told her the decision was not performance-related, describing Winkelman 

as someone with “great experience, knowledge, and skills,” and offered to write her 

“excellent letters of recommendation.” [1] ¶ 18. They did not explain why Winkelman 

was terminated. [1] ¶ 18. 

Later that year, Winkelman filed EEOC charges against Infinity and 

Continental, alleging disability discrimination, failure to accommodate, and 

retaliation. [1] ¶¶ 19–20. The EEOC issued right-to-sue notices, which Winkelman 

sent to the Illinois Department of Human Rights. [1] ¶¶ 21–22. The IDHR has yet to 

issue a final decision. [1] ¶ 22. Winkelman filed this lawsuit, alleging failure-toCase: 1:20-cv-02480 Document #: 25 Filed: 09/28/20 Page 3 of 11 PageID #:110
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accommodate, discrimination, and retaliation claims under the Americans with 

Disabilities Act and Illinois Human Rights Act. [1]. 

III. Analysis

The ADA prohibits disability discrimination in employment, and the failure to 

reasobably accommodate a disability is one type of discrimination under the act.

42 U.S.C. § 12112(a), (b). To state a failure-to-accommodate claim, a plaintiff must 

allege that 1) she was a qualified individual with a disability; 2) her employer was 

aware of her disability; and 3) the employer failed to reasonably accommodate her 

disability. See Youngman v. Peoria County, 947 F.3d 1037, 1042 (7th Cir. 2020); 42 

U.S.C. § 12112(b)(5)(A). Defendants argue that Winkelman was not disabled or a 

qualified individual. 

Under the ADA, a “disability” includes “a physical or mental impairment that 

substantially limits one or more major life activities of such individual.” 42 U.S.C. 

§ 12102(1)(A). “Disability” should be construed in favor of broad coverage, and the 

term “substantially limits” should not demand extensive analysis. 42 U.S.C. 

§ 12102(4)(A), (B); 29 C.F.R. 1630.2(j)(1)(i).2 A late-stage disease that allows waste to 

accumulate in blood and requires surgery and dialysis, [1] ¶¶ 10–11, plausibly 

suggests substantial limitations to Winkelman’s ability to care for herself and 

perform manual tasks, as well as substantial limitations to her immune system, 

digestive track, and circulatory system. See 42. U.S.C. § 12102(2)(A), (B) (listing 

2 EEOC regulations interpreting the ADA are entitled to deference. See Richardson v. 

Chicago Transit Authority, 926 F.3d 881, 887 (7th Cir. 2019).

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major life activities and bodily functions); see also Stedman’s Medical Dictionary 

842740 (end stage is “the late, fully developed phase of a disease; e.g., in end-stage 

renal disease, a shrunken and scarred kidney”) (West 2014). Winkelman’s diagnosis 

was serious enough that she doesn’t need to provide more facts about the condition, 

nature, or duration of her limitations at the pleading stage. See 29 C.F.R. 1630, App. 

§ 1630.2(j)(4) (“someone with end-stage renal disease is substantially limited in 

kidney function, and it thus is not necessary to consider the burdens that dialysis 

treatment imposes”).3 Winkelman plausibly alleges an actual impairment. See 42 

U.S.C. § 12102(1)(A). For the short time period between Winkelman’s post-surgery 

recovery and second leave of absence, she sufficiently alleges substantial limitations 

to major bodily functions because she still required dialysis training. See id. By then, 

Winkelman also had a “record” of impairment because her recent medical history 

established a substantial limitation in the past. See 42 U.S.C. § 12102(1)(B); 29 C.F.R. 

1630, App. § 1630.2(k) (individuals should not be discriminated against because of a 

history of disability, and a record of impairment is satisfied where evidence 

establishes that the individual has had a substantially limiting impairment). 

Winkelman adequately alleges a disability under the ADA. 

A “qualified individual” is one who has the requisite qualifications to perform 

the essential functions of her job, with or without reasonable accommodation, at the 

3 After the ADA was amended, the regulations retained the concept of “condition, manner, or 

duration,” but no longer included the additional list of “substantial limitation” factors from 

the old regulations, including the nature and severity of the impairment (which defendants 

argue Winkelman must show). 29 C.F.R. 1630, App. § 1630.2(j)(4). 

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time of the employment decision. 42 U.S.C. § 12111(8); 29 C.F.R. § 1630.2(m); 29 

C.F.R. 1630, App. § 1630.2(m). While Winkelman does not list the essential functions 

of a nursing and rehabilitation facility administrator, she alleges enough facts to 

permit a reasonable inference that she was qualified: she increased the facility’s 

patient population, consistently met expectations, received a positive annual review, 

a merit-based raise, and was not terminated because of her performance. [1] ¶¶ 9, 18. 

Even her boss acknowledged her skills and expertise. [1] ¶ 18. See Iqbal, 556 U.S. at 

678–79 (all reasonable inferences must be drawn in the plaintiff’s favor). Winkelman 

also plausibly alleges she was able to perform the essential functions of her job with 

reasonable accommodations—the two, short leaves-of-absence she requested under 

the ADA. [1] ¶ 12. Presumably, Winkelman could not work during this time, so 

someone else needed to cover for her, or she completed enough work in advance to 

meet her job responsibilities. Leave is a form of reasonable accommodation. See 

EEOC Enforcement Guidance: Reasonable Accommodation and Undue Hardship 

under the Americans with Disabilities Act, 2002 WL 31994335, at *14 (October 

2002);4 29 C.F.R. 1630, App. § 1630.2(o) (reasonable accommodations “could include 

permitting the use of accrued paid leave or providing additional unpaid leave for 

necessary treatment”); Severson v. Heartland Woodcraft, Inc., 872 F.3d 476, 481 (7th 

Cir. 2017) (“a brief period of leave to deal with a medical condition could be a 

4 EEOC interpretive guidance reflects “a body of experience and informed judgment to which 

courts and litigants may properly resort for guidance” and is entitled to a measure of respect, 

which is less deferential than the standard for implementing regulations. Richardson v. 

Chicago Transit Authority, 926 F.3d 881, 889 (7th Cir. 2019) (internal citations and 

quotations omitted).

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reasonable accommodation in some circumstances,” unlike a long-term leave of 

absence) (citing Byrne v. Avon Products, Inc., 328 F.3d 379, 381 (7th Cir. 2003)).5 The 

one- and two-weeks of leave Winkelman requested are more analogous to a part-time 

or modified work schedule than an extended leave of absence. See Severson, 872 F.3d 

at 481. Defendants also approved Winkelman’s requests, [1] ¶ 12, suggesting they too 

thought Winkelman was able to perform the essential functions of an administrator 

with these accommodations before and after surgery. Winkelman thus provides more 

factual context for being a qualified individual than the conclusory, formulaic 

allegations defendants cite to for comparison.6 Winkelman’s failure-to-accommodate 

claim survives defendants’ motion to dismiss. 

So does Winkelman’s discrimination claim. To state a claim for discrimination, 

Winkelman must allege that 1) she was disabled; 2) she was qualified to perform the 

essential functions of her job with or without reasonable accommodation; and 3) that 

her disability was the “but for” cause of the adverse employment action. See Castetter 

v. Dolgencorp, LLC, 953 F.3d 994, 996 (7th Cir. 2020). For the reasons discussed

above, Winkelman plausibly alleges the first two elements of her discrimination 

claim. As for causation, Winkelman alleges that she had been successfully working 

5 According to EEOC guidance, “[a]n employer does not have to provide paid leave beyond 

that which is provided to similarly-situated employees. Employers should allow an employee 

with a disability to exhaust accrued paid leave first and then provide unpaid leave.” See

EEOC Enforcement Guidance: Reasonable Accommodation and Undue Hardship under the 

Americans with Disabilities Act, 2002 WL 31994335, at *14 (October 2002). In other words, 

the ADA, like the FMLA, does not require employers to give paid leave. 

6 Winkelman is not required to provide documentary evidence at the pleading stage—only a 

“short and plain statement” that plausibly suggests the pleader is entitled to relief is 

required. See Fed. R. Civ. P. 8(a)(2); Twombly, 550 U.S. at 556–58; Iqbal, 556 U.S. at 677–80.

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as a healthcare administrator for over a year, but that everything changed after she 

disclosed her medical condition. [1] ¶¶ 7, 9, 12. Leadership swarmed into her facility, 

causing employees to leave. [1] ¶ 14–15. The day after confirming the dates of her 

second leave of absence, she was fired for reasons unrelated to performance. [1] 

¶¶ 17–18. This plausibly suggests that, by process of elimination, Winkelman’s 

disability was the sole factor in her removal. Prior to her ADA requests, her job did 

not appear to be at risk—she was performing well and her employer agreed to provide 

two leaves of absence. [1] ¶¶ 8–9, 12. Discovery may prove otherwise, but that 

moment of proof is for a later stage in the case. 

Winkelman’s final claim for retaliation under the ADA requires a plausible 

suggestion that she suffered an adverse action solely because she engaged in 

statutorily protected activity. See Kotaska v. Federal Express Corporation, 966 F.3d 

624, 632 (7th Cir. 2020). About one month after her accommodation requests were 

approved, Winkelman confirmed the dates of her second leave of absence with her 

boss. [1] ¶ 17. See Preddie v. Bartholomew Consolidated School Corp., 799 F.3d 806, 

814 (7th Cir. 2015) (requesting accommodations under the ADA is statutorily 

protected activity). The next day, her boss fired her. [1] ¶ 18. See Koty v. DuPage 

County, Illinois, 900 F.3d 515, 520 (7th Cir. 2018) (adverse retaliatory actions are 

ones that would dissuade a reasonable employee from engaging in protected activity, 

like termination of employment). While temporal proximity, standing alone, is 

usually insufficient to establish causation, “[o]ccasionally ... an adverse action comes 

so close on the heels of a protected act that an inference of causation is sensible.” 

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Milligan v. Board of Trustees of Southern Illinois University, 686 F.3d 378, 389 (7th 

Cir. 2012) (internal citations and quotations omitted). Here, Winkelman’s boss knew 

about Winkelman’s protected activity and fired Winkelman the next day. [1] ¶¶ 17–

18. Moreover, the complaint alleges more than suspicious timing, because it alleges 

that the decision was unrelated to Winkelman’s performance. [1] ¶ 18. The close 

timing (24 hours or less), incomplete explanation, and unusual behavior of leadership, 

which started the day Winkelman’s requests were approved, are suspicious enough 

to plausibly suggest but-for causation at the pleading stage. Winkelman’s retaliation 

claim survives defendants’ motion to dismiss.7 

Winkelman alleges the same three claims under the Illinois Human Rights 

Act. Under state law, “any party seeking to pursue a civil-rights claim in Illinois must 

first exhaust administrative remedies available under the Act (by filing a claim with 

the [Illinois Human Rights Commission] and proceeding with an IHRC investigation 

and adjudication).” Garcia v. Vill. of Mount Prospect, 360 F.3d 630, 640 (7th Cir. 

2004); 775 ILCS § 5/8-111(D). Defendants raise a failure-to-exhaust argument, an 

affirmative defense, for the first time in their reply brief. Because the “reply brief is 

not the appropriate vehicle for presenting new arguments or legal theories to the 

court,” defendants forfeit their argument. See Gyorgy v. C.I.R., 779 F.3d 466, 472 n.4 

(quoting U.S. v. Feinberg, 89 F.3d 333, 341 (7th Cir. 1996)). However, a district court 

7 Winkelman’s retaliation claim is not duplicative of her failure-to-accommodate claim. While 

some of the facts overlap, she alleges two separate legal theories and sufficiently alleges the 

elements of each claim. According to Winkelman, defendants failed to accommodate her 

second leave of absence, and terminated her in retaliation for seeking an accommodation. 

Plaintiffs are allowed to plead alternative theories. See Fed. R. Civ. P. (8)(d)(2). 

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may, sua sponte, dismiss a complaint for failure to exhaust if it is obvious from the 

complaint. See Walker v. Thompson, 288 F.3d 1005, 1009–10 (7th Cir. 2002) (internal 

citations omitted). Winkelman has yet to receive a right-to-sue letter from the Illinois 

Department of Human Rights. [1] ¶ 22; [21] at 2. Consequently, dismissal is 

warranted. 775 ILCS § 5/8-111(B)(1) (a complainant may only obtain judicial review 

of a final order); Garcia, 360 F.3d at 640. However, dismissal for failure to exhaust is 

without prejudice and does not bar reinstatement of the suit. See Walker, 288 F.3d at 

1010.8

8 Winkelman’s state-law claims are analyzed under the same framework as the ADA. See 

Teruggi v. CIT Group/Capital Finance, Inc., 709 F.3d 654, 659 (7th Cir. 2013); Zaderaka v. 

Ill. Human Rights Comm’n, 131 Ill.2d 172, 178–79 (1989) (adopting Title VII framework for 

IHRA cases); Luckett v. Human Rights Comm’n, 210 Ill.App.3d 169, 180–81 (1st Dist. 1989) 

(“When analyzing claims of discrimination under the [IHRA], Illinois courts have looked to 

the standards applicable to analogous federal claims.”). Consequently, defendants will not be 

prejudiced if Winkelman is able to obtain a final order from the IDHR and add her state-law 

claims before the merits of her federal claims are decided—the scope of discovery and proof 

will be the same. 

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IV. Conclusion

The defendants’ motion to dismiss, [13], is denied in part, granted in part. 

Winkelman’s claims under the ADA survive, while her state-law claims are dismissed 

without prejudice. Defendants shall file an answer to the complaint by October 19, 

2020, and the parties shall file an updated status report with a proposed discovery 

schedule by October 19, 2020.

ENTER:

___________________________

Manish S. Shah

United States District Judge

Date: September 28, 2020

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