Julia Hopple v. The Joint Commission on Accreditation of Healthcare

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[DO NOT PUBLISH]

In the

United States Court of Appeals

for the Eleventh Circuit

____________________

No. 22-11922

____________________

JULIA HOPPLE,

Plaintiff-Appellant,

versus

JOINT COMMISSION ON ACCREDITATION OF

HEALTHCARE ORGANIZATIONS, d.b.a. THE JOINT

COMMISION,

Defendant-Appellee.

____________________

Appeal from the United States District Court

for the Southern District of Florida

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2 Opinion of the Court 22-11922

D.C. Docket No. 21-61209-CIV-COHN/STRAUSS

____________________

Before JORDAN, ROSENBAUM, Circuit Judges, and MANASCO, District

Judge.∗

MANASCO, District Judge:

Plaintiff Julia Hopple appeals a summary judgment in favor

of her former employer, the Joint Commission on Accreditation of

Healthcare Organizations (“the Joint Commission”). Ms. Hopple

asserts that the Joint Commission violated the Americans with Dis-

abilities Act, 42 U.S.C. §§ 12101, et seq. (“ADA”), and the Florida Civil

Rights Act (“FCRA”) by refusing to provide reasonable accommo-

dations for her disability. The district court found that Ms. Hopple

failed to establish that she was a qualified individual under the ADA

and the FCRA. After careful review and with the benefit of oral

argument, we affirm.

BACKGROUND

The Joint Commission evaluates and accredits more than

21,000 healthcare organizations located throughout the United

States. In February 2012, Ms. Hopple began working for the Joint

Commission as a Field Representative, also known as a “Surveyor.”

Ms. Hopple worked in the home care area, with an emphasis on

hospices.

∗ The Honorable Anna M. Manasco, U.S. District Judge for the Northern Dis-

trict of Alabama, sitting by designation.

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22-11355 Opinion of the Court 3

The Joint Commission’s job description for a Field Repre-

sentative stated: “Field Representatives, with minimal immediate

direction or supervision, survey and/or review health care organi-

zations throughout the United States. Field Representatives apply

sophisticated analysis skills and inductive reasoning skills to deter-

mine a health care organization’s degree of compliance with appli-

cable standards and functionality of care delivery systems.” It fur-

ther stated that surveys of healthcare organizations required “on-

site activities, including without limitation inspections, required

conferences, tours and interviews with staff.”

According to the job description, one of fourteen “principal

duties and responsibilities” of a Field Representative was to

“[t]ravel extensively, including travel on weekends, at all times of

the day/night, and sometimes without prior notice, travel by auto-

mobile and on airplanes of all sizes, and travel in all weather con-

ditions.” A Field Representative was required to “travel to all types

of airports and in whatever type of ground transportation is nec-

essary to enable them to timely perform their duties.”

Diane Hill scheduled all surveys for the home care Survey-

ors, who numbered around ninety. Surveyors submitted to Ms. Hill

the weeks they wanted to work about two or three months in ad-

vance; Ms. Hill then compared their availabilities with the schedule

of surveys that were due in those months.

Ms. Hopple’s flight records from 2016 to 2018 establish fre-

quent travel to states in Pacific or Mountain time zones to conduct

on-site surveys and audits. In 2016, around thirty percent of Ms.

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4 Opinion of the Court 22-11355

Hopple’s surveys took place in Pacific or Mountain time zones. In

2017, around forty-five percent of her audits took place in Pacific

or Mountain time zones. In 2018, around forty-eight percent of her

audits took place in Pacific or Mountain time zones. Ms. Hopple

did not challenge the statistics presented at her deposition.

Flight records of other Surveyors also establish frequent

trips to states located in Pacific and Mountain time zones. Ms. Hop-

ple’s Field Director, Wayne Murphy, testified that California was

“by far, the busiest” area for home care surveys. A map of “Accred-

ited or Certified Programs by State” shows that California had the

highest number of facilities (1,724), which was more than three

times that of the second-highest state, Florida (459).

Ms. Hopple was diagnosed with Parkinson’s disease in 2012,

which is a “chronic, progressive disorder.” Around May 2018, Ms.

Hopple made her first request to limit her travel to Eastern and

Central time zones. She submitted a note from her doctor that

stated: “[B]ecause of your Parkinson’s disease, you will become stiff

and more slow if you are forced to sit for prolonged periods of

time. For this reason, I encourage you to take on work that will

allow air travel to be 2.5 hours or less. Which would include eastern

& central time zones.”

Ms. Hopple testified at her deposition that her body would

become stiff after prolonged sitting, at which point she would not

have as much control over her body and would feel as though she

was going to fall over without being able to catch herself. She de-

scribed two specific episodes in 2018 when she experienced

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difficulties with walking after long flights. After a flight to Phoenix,

Ms. Hopple needed a porter’s assistance to collect her suitcase and

get to the rental car bus.

On June 29, 2018, the Associate Director of Employee Rela-

tions, Ruth Metsch, notified Ms. Hopple that her request to limit

her travel to Eastern and Central time zones could not be granted.

Ms. Hopple thus continued to travel to states in Pacific and Moun-

tain time zones.

In December 2018, Ms. Hopple renewed her request to limit

her travel to Eastern and Central time zones. This time, Ms. Metsch

approved her request for a six-month period beginning January

2019. Ms. Metsch’s email to Ms. Hopple on December 20, 2018,

stated: “There is no guarantee that it will be extended. As we shared

with you, this kind of indefinite accommodation presents opera-

tional challenges.”

Other Surveyors received accommodations for limited

travel, and their accommodations were likewise temporary. Ms.

Hopple has presented no evidence of a Surveyor with a permanent

accommodation for limited travel. She testified only that she “knew

of some people that were regionalized at certain points in time, as

well as someone who did not go to the west coast for 15 months.”

In April 2019, Ms. Hill emailed Mr. Murphy and asked: “Is

[Ms. Hopple] still restricted as the Midwest region? I am running

out of options for her.” Ms. Hill testified at her deposition that, alt-

hough she referred to the “Midwest region” in this email, her in-

structions had been to limit Ms. Hopple’s travel to “Central and

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6 Opinion of the Court 22-11355

Eastern Time Zones” and that Ms. Hopple’s assignments in 2019

included surveys in states such as New Jersey, Virginia, North Car-

olina, and Texas.

Ms. Hill also testified that because there were not enough

surveys to assign Ms. Hopple, she had to pull forward some surveys

by several months to fill her schedule. According to Ms. Hill, some

of the Joint Commission’s clients took issues with surveys that

were pulled forward, because it meant that they would not benefit

from the full three years of accreditation accorded with each sur-

vey.

In July 2019, Ms. Hopple requested the continuation of her

accommodation. Ms. Metsch denied the request in an email sent

on July 22, 2019, explaining that during the accommodation period,

the Joint Commission struggled to identify surveys within Eastern

and Central time zones and that the accommodation “presented

operational challenges that cannot be continued on a longer term,

indefinite basis.” Ms. Metsch informed Ms. Hopple that she was

“expected to travel nationwide” from September, and that

“[n]ationwide travel is a requirement of the surveyor role.” Ms.

Metsch, Mr. Murphy, and Michael Kaba, the Joint Commission’s

Chief Human Resources Officer, each testified that nationwide

travel is an essential function of the Surveyor position.

Ms. Hopple told the Joint Commission that she could not

continue working without limiting her travel to Eastern and Cen-

tral time zones. As Ms. Hopple conceded at her deposition, she did

not identify any other accommodation that would allow her to

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continue working. Ms. Hopple confirmed her retirement in an

email on September 3, 2019.

Ms. Hopple filed suit against the Joint Commission in the

Southern District of Florida, alleging discrimination under the

ADA and FCRA. The Joint Commission moved for summary judg-

ment on both claims, which the district court granted.

STANDARD OF REVIEW

We review summary judgments de novo. Anthony v. Georgia,

69 F.4th 796, 804 (11th Cir. 2023). Summary judgment is proper “if

the movant shows that there is no genuine dispute as to any mate-

rial fact and the movant is entitled to judgment as a matter of law.”

Fed. R. Civ. P. 56(a). “In determining whether the movant has met

this burden, courts must view the evidence in the light most favor-

able to the non-movant.” Anthony, 69 F.4th at 804. Courts do not

“weigh conflicting evidence or make credibility determinations;

the non-movant’s evidence is to be accepted for purposes of sum-

mary judgment.” Wate v. Kubler, 839 F.3d 1012, 1018 (11th Cir. 2016).

“Summary judgment must be granted if the nonmoving

party has ‘failed to make a sufficient showing on an essential ele-

ment of her case with respect to which she has the burden of

proof.’” Rink v. Cheminova, Inc., 400 F.3d 1286, 1294 (11th Cir. 2005)

(quoting Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986)).

DISCUSSION

Because the FCRA is analyzed under the same framework

as the ADA, Ms. Hopple’s claims can be analyzed together. Holly v.

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Clairson Indus., L.L.C., 492 F.3d 1247, 1255 (11th Cir. 2007). “To es-

tablish a prima facie case of discrimination under the ADA, a plain-

tiff must show: (1) [she] is disabled; (2) [she] is a qualified individual;

and (3) [she] was subjected to unlawful discrimination because of

[her] disability.” Id. at 1255–56. An employer unlawfully discrimi-

nates against a qualified individual on the basis of a disability when

it fails to provide reasonable accommodations for the disability, un-

less the employer can demonstrate that the accommodation would

impose an undue hardship on the operation of its business. 42

U.S.C. § 12112(b)(5)(A).

I. Disability

The ADA defines a “disability” as (1) “a physical or mental

impairment that substantially limits one or more major life activi-

ties of [an] individual”; (2) “a record of such an impairment”; or (3)

“being regarded as having such an impairment.” 42 U.S.C. §

12102(1)(A)–(C). The ADA includes “walking” in its non-exclusive

list of “major life activities.” Id. at § 12101(2)(A).

The definition of a disability must “be construed in favor of

broad coverage of individuals . . . to the maximum extent permit-

ted by the terms of [the ADA].” Id. at § 12102(4)(A). “An impair-

ment need not prevent, or significantly or severely restrict, the in-

dividual from performing a major life activity in order to be con-

sidered substantially limiting.” 29 C.F.R. § 1630.2(j)(ii). And “[a]n

impairment that is episodic or in remission is a disability if it would

substantially limit a major life activity when active.” 42 U.S.C. §

12102(4)(D). “[E]xtensive analysis is not required to determine

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whether an individual’s impairment is a disability under the ADA.”

EEOC v. St. Joseph’s Hosp., Inc., 842 F.3d 1333, 1343 (11th Cir. 2016).

The district court found that Ms. Hopple “clearly presented

evidence of a physical impairment that impacts her ability to walk.”

Hopple v. Joint Comm’n on Accreditation, No. 21-61209-CIV-

COHN/STRAUSS, 2022 WL 1734473, at *4 (S.D. Fla. May 5, 2022).

The district court found that Ms. Hopple “detailed the nature of

her walking difficulties” and that her physician “specifically con-

nected these problems to her Parkinson’s disease.” Id.

The district court also distinguished two recent decisions of

this Court that the Joint Commission relied on “for the proposition

that Plaintiff must provide evidence regarding the severity, fre-

quency, and duration of her impairments in order to permit a find-

ing that her impairments substantially limit a major life activity.”

Id. The district court held that Lewis v. City of Union City, 934 F.3d

1169 (11th Cir. 2019), and Munoz v. Selig Enterprises, Inc., 981 F.3d

1265 (11th Cir. 2020), were distinguishable because “the frequency

of [Ms. Hopple’s] impairments clearly depends on how often she

sits for prolonged periods of time,” whereas in Lewis and Munoz,

there was no “evidence of an activity or situation that triggered or

exacerbated the plaintiffs’ conditions.” Id.

Ms. Hopple argues on appeal that she established her disa-

bility with her doctor’s note and her own testimony about the ef-

fects of Parkinson’s disease. Appellant’s Br. at 20. Specifically, Ms.

Hopple argues that she has presented evidence that Parkinson’s

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disease causes her body to stiffen after prolonged periods of sitting,

resulting in difficulties with walking. Id.

The Joint Commission responds that Ms. Hopple has failed

to establish a disability because she “failed to identify specific rec-

ord evidence of the timing, frequency and duration of the alleged

impairments resulting from her Parkinson’s disease.” Appellee’s Br.

at 46. The Joint Commission concedes that Ms. Hopple presented

evidence of losing her balance after sitting for prolonged periods

of time and having to seek the assistance of others at the airport to

walk. See id. at 48–49. But the Joint Commission argues that “[a]

condition that occurs only sporadically or when one engages in a

particular activity is evidence the impairment is transitory, condi-

tional, and infrequent, and not a substantial impairment[,]” id. at

48, and that Ms. Hopple’s testimony “reflects a transitory impair-

ment to her ability to walk independently, and not a severe or ex-

tended one,” id. at 49. The Joint Commission again relies on Lewis

and Munoz. See id. at 46.

In Lewis, the plaintiff alleged that a heart condition substan-

tially limited her ability to sleep and breathe. 934 F.3d at 1180. The

plaintiff testified to “periodic” shortness of breath, but without an

explanation as to when these episodes occurred or what triggered

them; and her doctor testified only that her shortness of breath

“could” affect her ability to sleep. Id. Because the record was “de-

void of evidence of the severity, frequency, and duration of these

episodes,” we held that the plaintiff did not produce evidence “that

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could lead a reasonable jury to conclude that [she] is substantially

limited in a major life activity.” Id.

In Munoz, the plaintiff alleged that her ovarian cysts, uterine

fibroids, and endometriosis substantially limited her ability to work

and sleep. 981 F.3d at 1273. The plaintiff testified that her physical

impairments caused “extreme pain, exhaustion, sleep interruption,

and lack of bodily function control,” but she did not “provide[] ev-

idence of how often and how long she experienced these symp-

toms.” Id. We held that we “therefore cannot assess whether her

impairments substantially limited her ability to work or sleep as

compared to most people in the general population.” Id.

We did not conclude in Lewis or Munoz that the plaintiff’s

limitations in major life activities were too infrequent or transient,

or insufficiently severe, to qualify as a disability. Instead, we held

the plaintiff could not establish a disability because the record

lacked evidence regarding the frequency, severity, and duration of

the plaintiff’s alleged limitation.

Here, the record contains evidence about the frequency, se-

verity, and duration of Ms. Hopple’s limitation in walking: the doc-

tor’s note and Ms. Hopple’s deposition testimony establish that she

experienced difficulties with walking whenever she sat for pro-

longed periods of time, and that the difficulties consisted of a tem-

porary loss of balance and an increased risk of falling during that

time. Again, “[a]n impairment need not prevent, or significantly or

severely restrict, the individual from performing a major life activ-

ity in order to be considered substantially limiting.” 29 C.F.R. §

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1630.2(j)(ii). Ms. Hopple has presented sufficient evidence for a rea-

sonable jury to find that she had a disability.

II. Qualified Individual

The ADA defines a “qualified individual” as an “an individual

who, with or without reasonable accommodation, can perform the

essential functions of the employment position that such individ-

ual holds or desires.” 42 U.S.C. § 12111(8). “[T]he ADA does not

require [the employer] to eliminate an essential function of [the

plaintiff’s] job.” Davis v. Fla. Power & Light Co., 205 F.3d 1301, 1305

(11th Cir. 2000).

Whether Ms. Hopple was a qualified individual turns on

whether nationwide travel was an essential function of her job. If

it was, she cannot establish that she was a qualified individual, be-

cause she did not identify an accommodation that would allow her

to travel nationwide. As the employee, Ms. Hopple had “the burden

of identifying an accommodation and demonstrating that it is rea-

sonable.” Frazier-White v. Gee, 818 F.3d 1249, 1255 (11th Cir. 2016).

“[A]n employer’s ‘duty to provide a reasonable accommoda-

tion is not triggered unless a specific demand for an accommoda-

tion has been made.’” Id. at 1255–56 (quoting Gaston v. Bellingrath

Gardens & Home, Inc., 167 F.3d 1361, 1363–64 (11th Cir. 1999)). It is

undisputed that the only accommodation that Ms. Hopple identi-

fied was to limit her travel to Eastern and Central time zones—a

request, in other words, to not travel nationwide.

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Essential functions are “the fundamental job duties of the

employment position the individual with a disability holds or de-

sires,” which do not “include the marginal functions of the posi-

tion.” 29 C.F.R. § 1630.2(n)(1); see also Earl v. Mervyns, Inc., 207 F.3d

1361, 1365 (11th Cir. 2000) (“‘Essential functions’ are the funda-

mental job duties of a position that an individual with a disability

is actually required to perform.”).

Whether a particular job function is essential depends upon

a case-by-case evaluation of multiple factors. Samson v. Fed. Express

Corp., 746 F.3d 1196, 1201 (11th Cir. 2014). Relevant factors include:

(1)“[t]he employer’s judgment as to which functions are essential”;

(2) “[w]ritten job descriptions”; (3) “[t]he amount of time spent on

the job performing the function”; (4) “[t]he consequences of not

requiring the [employee] to perform the function”; (5) “[t]he terms

of a collective bargaining agreement”; (6) “[t]he work experience

of past [employees] in the job”; and (7) “[t]he current work experi-

ence of [employees] in similar jobs.” 29 C.F.R. § 1630.2(n)(3); see

also Samson, 746 F.3d at 1201. The employer’s judgment is “entitled

to substantial weight in the calculus,” although it is not a conclusive

factor. Samson, 746 F.3d at 1201.

The district court held that every relevant factor supported

a finding that nationwide travel was an essential function of Ms.

Hopple’s position. In addition to finding that the Joint Commis-

sion’s judgment and the written job description provided evidence

that nationwide travel was an essential function, the district court

held that the amount of time Ms. Hopple spent on surveys that

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required nationwide travel, specifically travel to Western states,

“strongly weighs in favor of a finding that nationwide travel was an

essential function.” Hopple, at *6. The district court also found that

having to pull forward multiple surveys before they were due neg-

atively impacted the Joint Commission’s operations, so that the

consequence of not requiring Ms. Hopple to perform surveys in

Western states “weighs moderately in favor of a finding that na-

tionwide travel was an essential function.” Id. And because other

Surveyors traveled nationwide except for temporary periods of

travel accommodations, the district court found that the experience

of past and current employees also weighed in favor of finding that

nationwide travel was an essential function. Id.

No reasonable jury evaluating the applicable factors could

find that nationwide travel was not an essential function of Ms.

Hopple’s position. First, the Joint Commission considered nation-

wide travel an essential function of a Surveyor, as established by

the deposition testimony of its Chief Human Resources Officer, its

Associate Director of Employee Relations, and Ms. Hopple’s Field

Director. Second, Ms. Hopple traveled nationwide from 2016 to

2019, with somewhere between a third and half of her surveys or

audits taking place in Pacific and Mountain time zones. Third,

other Surveyors also traveled nationwide, making frequent trips to

Pacific and Mountain time zones. There is no evidence of a Sur-

veyor who did not travel nationwide on a permanent basis.

Ms. Hopple does not dispute that these factors weigh in fa-

vor of finding that nationwide travel was essential. See Appellant’s

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Br. at 26–28. Ms. Hopple argues instead that the job description

weighs against such a finding, because “[t]he description of a sur-

veyor’s travel duties does not include ‘nationwide’ travel.” Id. at 26.

That is, Ms. Hopple argues that that the job description requires

only “extensive travel,” and that “extensive travel does not equate

to needing to fly cross-country.” Id. at 27. But this argument ignores

the first sentence of the job description, which states that Surveyors

conduct surveys of “health care organizations throughout the

United States.” A reasonable jury reading the job description would

have to interpret “extensive travel” in the light of the earlier refer-

ence to “health care organizations throughout the United States,”

as well as evidence that all Surveyors did in fact travel nationwide.

Ms. Hopple also argues that “[t]he Joint Commission did not

have difficulty finding surveyors to perform surveys in Western

states” and that “[f ]inding surveys only in Eastern and Central time

zones [for her] was . . . not a significant burden.” Id. But it is undis-

puted that Ms. Hill had difficulty filling Ms. Hopple’s schedule

while her travel was limited to Eastern and Central time zones in

2019. Ms. Hopple’s assertion that the difficulties resulted from Ms.

Hill’s mistake in limiting her survey assignments to the Midwest,

id. at 29, is not supported by the record: Ms. Hopple’s assignments

in 2019 included surveys in states outside of the Midwest. And it is

undisputed that Ms. Hill had to pull forward several surveys be-

cause of the scheduling difficulties and that pulling forward surveys

meant that the Joint Commission clients could not benefit from

three full years of accreditation. These undisputed consequences

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16 Opinion of the Court 22-11355

of allowing Ms. Hopple to not travel nationwide weigh in favor of

finding that nationwide travel was an essential function of her job.

In the light of all relevant factors, no reasonable jury could

find that nationwide travel was not an essential function of Ms.

Hopple’s job. And Ms. Hopple did not identify an accommodation

that would allow her to perform the essential function of nation-

wide travel. Accordingly, Ms. Hopple failed to establish that she was

a qualified individual under the ADA and FCRA, and her claims un-

der those statutes fail.

CONCLUSION

We AFFIRM the district court’s grant of summary judgment

in favor of the Joint Commission.