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GUICE-MILLS v. DERWINSKI

September 6, 1991

CONSTANCE GUICE-MILLS, PLAINTIFF,
v.
EDWARD J. DERWINSKI, SECRETARY OF THE DEPARTMENT OF VETERANS AFFAIRS, DEFENDANT.



The opinion of the court was delivered by: Newman, Senior Judge, United States Court of International Trade, sitting as a United States District Court Judge by Designation:

  OPINION, FINDINGS OF FACT AND CONCLUSIONS OF LAW

Introduction

Plaintiff, formerly a federal employee and Head Nurse at the Veterans Administration's Franklin Delano Roosevelt Hospital, Montrose, New York ("Hospital"), seeks an award of compensatory and punitive damages, injunctive and other relief against defendant, Secretary of the Department of Veterans Affairs, for alleged handicap discrimination pursuant to the Rehabilitation Act of 1973, as amended, 29 U.S.C. § 701 et seq. The court has federal question jurisdiction pursuant to 28 U.S.C. § 1331. A bench trial was held on May 1 and 2, 1991, decision was reserved and the parties have filed post-trial submissions.

The primary issue to be resolved is whether plaintiff, who at the time of her employment by the Hospital received medical treatment for stress and depression, was an "otherwise qualified handicapped individual" but was denied reasonable accommodation by defendant. For the reasons that follow, the complaint is dismissed.

The following constitute the court's findings of fact and conclusions of law as required by Fed.R.Civ.P. 52(a).

Findings of Fact

1. Constance Guice-Mills holds a Bachelor of Science degree in Nursing from Meharry Medical College and a Master of Science degree in Psychiatric Nursing from Hunter College. At the time of trial plaintiff was 55 years of age.

2. Plaintiff's professional experience is extensive and quite impressive: staff nurse, supervisory positions, psychiatric nursing instructor at the City University of New York and Pace University in New York City, Chairman of Psychiatric Nursing at the Beth Israel Medical Center School of Nursing, Supervisor of the Methadone Maintenance Training Program at Beth Israel Medical Center, Assistant Director of Psychiatric Nursing at Harlem Hospital, and Field Director of Community Mental Health in Westchester County, New York. There is no dispute regarding plaintiff's professional qualifications — which are obviously outstanding — to hold the position of Head Nurse.

3. In February 1980 plaintiff commenced her employment at the Hospital and in March 1980 assumed the position of Head Nurse. She worked in that capacity until April 1986, when she retired on a disability pension.

4. Shortly after assuming her duties as Head Nurse, plaintiff's interpersonal relations with her supervisors rapidly deteriorated, became extremely strained and contentious, with various charges and countercharges that need not be detailed. According to plaintiff's psychiatrist, Dr. Cynthia D. Barnes of New York City, in December 1980 "[plaintiff's] supervisors * * * were seeking to destroy her efforts for reasons that were never objectively identified" (pltf's exh. 8, p. 2, emphasis added). There can be no doubt whatever from the record that plaintiff suffered from stress and depression early on, dating back to at least 1980 when she sought treatment from the Hospital's personnel physician (pltf's exh. 6, pp. 1-2). Plaintiff's mental difficulties were significantly exacerbated by a strained relationship with her supervisors and, from plaintiff's perspective, a stressful environment at the Hospital dating back to 1980.

5. Commencing in January 1981, plaintiff began reporting to Dr. Berg, an internist and long-time family physician, complaints of severe anxiety, depression, insomnia and headaches, which plaintiff attributed to stress on her job (deft's exh. K).

6. In September 1981 plaintiff was reassigned to be Head Nurse of the Drug Dependency Treatment Center.

7. By 1984, following an allegedly unrelenting episodic history of brouhahas involving a number of personnel who set out to undermine plaintiff's professionalism, more charges and countercharges of misconduct and wrongdoing, plaintiff developed migraine headaches, severe anxiety and a major depressive episode, as described below (see pltf's exh. 8; deft's exh. K)). Plaintiff's anxiety and depression became progressively severe during 1984 and she sought further treatment from the personnel physician at the Hospital. Upon the advice of the personnel physician, plaintiff pursued continued treatment by Dr. Berg.

8. In June 1984, Dr. Berg diagnosed plaintiff as severely depressed. As part of her anxiety-depression syndrome, plaintiff experienced: feelings of hopelessness, malaise, insomnia, inability to get up in the morning, abnormally increased appetite with resultant binging and significant weight gain, chest pain, palpitations, extreme fatigue, listlessness, inability to concentrate, memory deficit (forgetfulness), irritability and a dread of going to work. Dr. Berg recommended that plaintiff take two months leave of absence from her job, initiated antidepressant drug therapy, and referred plaintiff to Dr. Arnold Gallo, a psychiatrist, who added sedatives to plaintiff's drug regimen (deft's exh. K).

9. During July and August 1984 plaintiff took the two months sick leave recommended by Dr. Berg. She returned to the Hospital in September 1984 and attempted to resume her normal duties. However, plaintiff's depressive symptomatology quickly recurred and in October 1984 she returned to Dr. Berg for further treatment. Dr. Berg found plaintiff to be still suffering from severe depression, particularly insomnia, extreme fatigue, lack of ability to concentrate and make decisions, listlessness — in short, great difficulty in carrying on her normal activities. Plaintiff complained to Dr. Berg of lack of support and understanding from her co-workers and supervisors, hostility, and her belief she was under constant attack from which she needed to protect herself. Other symptoms reported by plaintiff included a complete loss of interest in activities — especially in good job performance — in which she had previously taken a great interest and derived satisfaction, feelings of extreme rage and anger directed at her supervisors and others, general malaise, occasional nightmares, appetite disturbance and weight gain, hopelessness, and especially almost a total inability to get out of bed and prepare herself to go to her job, which she felt had become intolerable.

10. Dr. Berg advised plaintiff to resume an extended indefinite leave of absence from her job, and again referred plaintiff to Dr. Gallo for reevaluation and drug therapy (deft's exh. K)

11. Plaintiff was granted an extended leave of absence — without pay — from February 8, 1985 to September 9, 1985 (approximately seven months) — after which plaintiff returned to the Hospital and resumed all her duties. At the time, plaintiff was active in patient treatment and was supervising five employees in her ward (pltf's exh. 5). While plaintiff was on her seven month leave of absence, the Head Nurse of an adjoining ward concurrently covered plaintiff's ward and the adjoining ward. Additionally, during plaintiff's long absence, a staff nurse in the drug unit, Violet Sheedy, assumed many of plaintiff's duties and was able to perform them well.

12. Unfortunately, plaintiff's depressive symptoms continued during her extended leave of absence, and in September 1985 plaintiff began treatment under the care of Dr. Barnes. Thereupon, Dr. Barnes wrote a detailed report concerning plaintiff dated November 20, 1985 (deft's exh. K) and more recently testified on behalf of plaintiff at trial in May 1991. The symptomatology reported by Dr. Barnes includes feeling of being unable to "go on," insomnia, extreme fatigue, lassitude, physical deterioration, substantial weight gain, loss of interest in everyday activities, malaise, difficulty in concentrating, feelings of isolation and betrayal by her supervisors and co-workers, crying spells, feelings of extreme anger and rage, hopelessness, occasional nightmares, enormous difficulty in getting out of bed in the morning and arriving at work with enormous dread. A major depressive episode, as listed in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders III-R, includes many of plaintiff's symptoms.

13. Viewing plaintiff's mental distress as multifaceted, Dr. Barnes prescribed several psychopharmacologic modalities — Desyrel (for depression), Valium (for anxiety and agitation), and Fiorinal (for migraine headaches). These medications typically, as a side effect, leave many patients significantly sedated over an extended period of time. In point of fact, "Desyrel is one of the most sedating antidepressant medications" (deft's exh. Q, p. 3). However, given plaintiff's symptomatology prior to treatment with drugs, particularly her sleeping disturbances and inability to get up in the morning (she was never a "morning person," pltf's exh. C), plaintiff's assumption that her medications were solely responsible for her morning drowsiness and inability to arrive at work prior to 10:00 A.M. was erroneous. Dr. Barnes believed that a combination of depression and the medication accounted for plaintiff's morning problem (deft's exh. Q, p. 2).

14. "As all antidepressant medications are equally efficacious in combating depression, the prescription of an antidepressant is based primarily upon its side-effect profile" (deft's exh. Q, p. 3). Because sleep disturbance (particularly insomnia) and extreme anxiety were among plaintiff's chief complaints, Dr. Barnes selected a sedating antidepressant — Desyrel — as the medication of choice in plaintiff's case because of its tendency to relieve stress and induce sleep. After experimenting with different medication schedules, Dr. Barnes instructed plaintiff to take her complete daily dose of Desyrel at dinnertime to promote sleep through the night.

16. After resuming work on September 9, 1985 following her extended leave, plaintiff seldom arrived at the Hospital before 10:00 A.M. and frequently much later. Plaintiff's punctuality and attendance were erratic, and plaintiff made unapproved changes in working hours to accommodate her morning problem. Plaintiff was repeatedly directed by her supervisors to arrive at work by 8:00 A.M., but plaintiff persistently failed to do so. Plaintiff's continued tardy arrivals were a source of constant friction with her supervisors.

17. On or about September 19, 1985, approximately two weeks after her return to work following the extended leave, plaintiff, herself recognizing that she could not indefinitely continue her erratic attendance and arrival times, requested that her tour of duty as Head Nurse be officially changed to allow her to work from 10:00 A.M. to 6:30 P.M. In support of that request, plaintiff submitted a letter from Dr. Barnes, dated September 19, 1985, stating that plaintiff was under her care for "extreme stress" and "needs to work a later shift daily. This could best be accomplished by her starting work after 10 A.M. daily" (pltf's exh. 2). This terse request for a change in plaintiff's regular work schedule, ostensibly for an indefinite period of time, made no mention whatever of plaintiff's depressive illness, treatment, medication regimen or prognosis and offered no explanation whatever regarding the significance of a 10:00 A.M. starting time.

18. A memorandum dated September 20, 1985 from Lily I. Lee, R.N., Assistant Chief of Nursing Service/Psychiatry, discloses that Lee met with plaintiff on September 19, 1985 and inquired, inter alia, concerning why plaintiff "was working such odd tours, as she was a Head Nurse and must work an administrative work week of 7:30 a.m. to 4:00 p.m. or 8:00 a.m. to 4:30 p.m., as posted." Lee made it clear to plaintiff that to effectively operate a unit, any other hours than an administrative tour of duty would be unacceptable for a Head Nurse (deft's exh. F).

19. Dr. Richard Donn, Chief of Staff of the Hospital and Clinical Associate Professor of Psychiatry, wrote to Dr. Barnes on September 23, 1985 seeking information concerning plaintiff's clinical history, onset and nature of symptoms, diagnosis, treatment plan, prognosis, etc. Plaintiff refused Dr. Barnes' request for consent to release of the medical information sought by Dr. Donn (deft's exh. H); accordingly, Dr. Barnes did not respond and furnish the requested medical information.

20. On September 24, 1985 Lee denied plaintiff's request for a change in tour of duty and directed plaintiff, in writing, to work an administrative tour of duty, 8:00 A.M. to 4:30 P.M., which could be changed only after discussion with her supervisor (joint exh. 1A). Further, plaintiff was informed by Lee: "Any deviation from this direct documented order shall result in a disciplinary action" (Id.).

21. Dissatisfied with the denial of her request, plaintiff immediately contacted an Equal Employment Opportunity (EEO) Counselor for informal resolution of her problem. ...


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