# Julia Hopple v. The Joint Commission on Accreditation of Healthcare

> Court of Appeals for the Eleventh Circuit · July 23, 2024

URL: https://www.frixlaw.com/law-library/cases/10478235

## Case

- **Court:** Court of Appeals for the Eleventh Circuit
- **Decided:** July 23, 2024
- **Precedential status:** Unpublished
- **Opinion:** Opinion
- **Nature of suit:** NEW
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

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[DO NOT PUBLISH]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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22-11355 Opinion of the Court 5

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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22-11355 Opinion of the Court 7

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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8 Opinion of the Court 22-11355

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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22-11355 Opinion of the Court 9

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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10 Opinion of the Court 22-11355

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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22-11355 Opinion of the Court 11

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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12 Opinion of the Court 22-11355

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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22-11355 Opinion of the Court 13

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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14 Opinion of the Court 22-11355

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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22-11355 Opinion of the Court 15

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.

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10478235. Public record. Not legal advice.
