In the face of tragic allegations, the Sixth Circuit has held that a patient’s disability discrimination claim against a hospital is not timed barred by the Rehabilitation Act, which borrows a state’s applicable statute of limitation (in this case, Tennessee’s one-year statute of limitation), because the patient’s disability discrimination claim under Section 1557 is governed by the default federal four-year statute of limitations. See Tomei v. Parkwest Med. Ctr., No. 21-5448, 2022 WL 153178, at *6 (6th Cir. Jan. 18, 2022).

Factual Background

As alleged in the complaint, the patient went to the hospital after he fell and hurt his foot and leg. The patient is deaf and communicates using American Sign Language (ASL). So when he arrived, he asked for an interpreter. But the hospital allegedly never provided one. The medical staff allegedly only x-rayed his knee, gave him an antibiotic and ibuprofen, and sent him home.

But the medication didn’t help, and the patient’s pain got worse. So two days later, he went to the emergency room, where doctors determined he had blood clots in his leg. The doctors sent him back to the hospital in an ambulance and requested that the hospital provide an interpreter for the patient. But when he arrived, the hospital allegedly refused. Instead, the hospital offered a Video Remote Interpreting device to connect the patient with an off-site interpreter. But as alleged by the patient, the connection was too glitchy, and the patient couldn’t effectively communicate with the medical team.

A doctor soon performed surgery for his blood clots. But afterward, the patient continued to suffer from intense pain. But without an interpreter, the patient alleged that he could not effectively communicate to the medical staff what he was experiencing. After a few nights at the hospital, the doctors sent the patient home, but the patient’s condition didn’t improve. Tragically, the doctors were forced to amputate nearly one-third of the patient’s leg. As alleged in the complaint, the hospital never told the patient that there was any chance that he’d lose his leg.

About fifteen months after he was first denied an interpreter at the hospital, the patient sued.

The Legal Question Presented

The defendants moved to dismiss the patient’s discrimination claim under Section 1557 of the ACA, arguing that the patient waited too long to sue and that his suit was time-barred. According to the defendants, Tennessee’s one-year statute of limitations for personal-injury suits applies through the Rehabilitation Act of 1973. The district court disagreed and denied defendants’ motion to dismiss. In doing so, the district court held that the standard federal statute of limitations—four years—applied instead. The district court nevertheless certified the question for an interlocutory appeal to the Sixth Circuit. On appeal, the Sixth Circuit Court of Appeals affirmed the district court’s ruling that the patient’s claim was not time-barred.

The Sixth Circuit’s Analysis

As explained by the Sixth Circuit, Congress has set a default statute of limitations for federal causes of action. Unless federal law provides otherwise, a civil action “arising under” a federal statute enacted after December 1, 1990, is subject to a four-year statute of limitations. 28 U.S.C. § 1658(a).

The patient plainly sued under the Affordable Care Act, alleging that the hospital violated the ACA’s nondiscrimination provision by failing to accommodate his disability. But the issue is that Section 1557 bars healthcare actors from discriminating on the grounds “prohibited under” the Rehabilitation Act. Section 1557 also incorporates “[t]he enforcement mechanisms provided for and available under” the Rehabilitation Act’s own nondiscrimination provision. Courts interpreting the Rehabilitation Act, which was enacted before 1990, have held the law borrows state statutes of limitations. See McCormick v. Miami Univ., 693 F.3d 654, 662–63 (6th Cir. 2012).

Therefore, the Sixth Circuit explained, the fate of the patient’s claim depended on which statute of limitations applied. If the Rehabilitation Act’s borrowed statute of limitations applies—here, Tennessee’s one-year personal-injury statute of limitations—the patient’s suit was untimely. But if the standard federal four-year statute of limitations applies, his suit could proceed.

In ruling that the federal four-year statute of limitations applied, the Court rejected the defendants’ argument that the Rehabilitation Act’s “enforcement mechanisms” include the statutes of limitations that courts borrow from state laws for Rehabilitation Act claims. But according to the Sixth Circuit, that argument conflicts with the ACA’s text. As the Court has previously held, an “enforcement mechanism” is a tool “for compelling compliance with the substantive requirements” of a statute. Doe v. BlueCross BlueShield of Tenn., Inc., 926 F.3d 235, 239 (6th Cir. 2019); see also id. (defining “enforcement” and “mechanism” (citing 5 Oxford English Dictionary 245 (2d ed. 1989); 9 id. at 536)). Therefore, because the Rehabilitation Act did not contain a statute of limitation within its text, the default federal four-year statute of limitation applied to the patient’s disability discrimination claim under Section 1557.

Conclusion

The effect of the Sixth Circuit’s ruling is to give patients more time to bring disability discrimination claims under Section 1557. This holding, therefore, creates additional risk for healthcare systems without effective compliance programs dedicated to providing effective communication to deaf or hard of hearing patients. The same can be said for healthcare systems that do not provide digital accessibility to individuals with sight disabilities or provide accommodations to individuals with mobility disabilities.

The Sixth Circuit’s opinion also makes clear that courts will need to carefully consider what is an “enforcement mechanism” under the pre-existing civil rights statutes referenced in Section 1557. For example, because the Age Discrimination Act explicitly requires an exhaustion of administrative remedies, the Sixth Circuit has previously held that an age-discrimination claimant under Section 1557 must satisfy that same standard. See Galuten on behalf of Est. of Galuten v. Williamson Cty. Hosp. Dist., No. 21-5007, 2021 WL 3043275, at *4 (6th Cir. July 20, 2021). (“Accordingly, because Galuten based his ACA claim on the type of age discrimination prohibited by the ADA, the ADA’s ‘enforcement mechanisms,’ including its exhaustion requirement, apply to this claim.”).