Mental Illness: The ADA and Coverage Parity

Article excerpt

In recent weeks, the insurance industry press has given substantial attention to the issue of legal protection for those with mental illnesses. Three very recent events have been the subject of this attention:

* The release of an Equal Employment Opportunity Commission (EEOC) "guidance" on psychiatric disabilities

* A Sixth Circuit Appellate Court decision

* A report on the Mental Health Parity Act of 1996

This evolving area of law may affect pharmacists in several ways. First, R.Ph.s who are owners or managers of a pharmacy need to understand this law to properly supervise employees. Second, by understanding this area, pharmacists who may experience mental illnesses will know their rights. Finally, because pharmacists provide many services to patients with mental illnesses, they should understand these patients' rights.

EEOC guidance

The EEOC guidance describes how the Americans with Disabilities Act (ADA) applies to mental illnesses and psychiatric disabilities: An individual with a psychiatric disability is covered by the ADA, even if medication controls the effects of the disability. Under the ADA, the term disability means "(a) a physical or mental impairment that substantially limits one or more of the major life activities of an individual; (b) a record of such an impairment; or (c) being regarded as having such an impairment."

The ADA defines mental impairment to include "any mental or psychological disorder, such as ... emotional or mental illness." Examples of emotional or mental illnesses include major depression, bipolar disorder, anxiety disorders (e.g., panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder), schizophrenia, and personality disorders.

The EEOC said it receives a large number of charges under the ADA alleging employment discrimination based on psychiatric disability. Between July 26, 1992, and Sept. 30,1996, approximately 12.7% of all ADA charges filed with the EEOC were based on mental illnesses and psychiatric disabilities. According to the EEOC, the guidance is designed to answer the most commonly asked questions about application of the ADA to psychiatric disabilities.

The text of the guidance may be found on the EEOC Web site at www.eeoc.gov. Or the 38-page document can be obtained by calling EEOC's publications distribution center at 1-(800) 6693362.

Appeals Court

In 1990, the plaintiff filed a claim saying she was totally disabled due to "chronic severe depression of a physical origin. …