On September 28th 2016, Rosa Martinez (formerly a school nurse in the New Brunswick New Jersey school district) was awarded $2 million as settlement in an employment disability discrimination lawsuit involving the New Brunswick Board of Education.
During trial testimony before Middlesex County Superior Court Judge Douglas K. Wolfson, the school board agreed to settle the case, which alleged discrimination, harassment and failure to reasonably accommodate her situation, in which she said a visual disability made it difficult to work on a computer. The visual demands were exacerbated when the school district went to electronic medical records in 2009.
I am quite familiar with this case as I served as an expert witness for the plaintiff, Rosa Martinez. What is remarkable and perhaps precedent setting was the visual disability in question was a severe case of convergence insufficiency (as well as dry eye syndrome). Rosa attempted to have the condition treated with vision therapy, but was unable to complete treatment when her health insurance would not pay for vision therapy. She attempted spectacles with prism to treat her convergence problem but these were ineffective in allowing her to do her computer work.
Also of great interest is that several optometrists and ophthalmologists were initially consulted by Rosa and they all recommended basic workplace accommodations in addition to other treatment. These accommodations ranged from allowing more time to complete the increased load of data entry, to having a lower level person do some of the data entry, to talk to text software to reduce the quantity of computer data entry. None of these accommodations were implemented (indeed there were allegations of frank harassment instead). Rosa felt compelled to leave this job she loved, and later sued the school district.
There are several important lessons for us to learn here:
- Convergence insufficiency can be legally considered to be a serious visual disability.
- Workplace accommodations are just as important (and legally protected) as school accommodations are for a student.
It is unfortunate and ironic that a school district which is presumably quite familiar with student accommodations was found to not provide the same for one of their employees.
The VisionHelp Blog 
“It is unfortunate and ironic that a school district which is presumably quite familiar with student accommodations was found to not provide the same for one of their employees.” – I would suggest school boards only rarely accommodate for visual disabilities/dysfunction.
While I agree historically with your observation, I am encouraged (at least where I practice), that accommodations which I recommend for my patients are often incorporated into their 504 plan
Barry, good to hear. Not so much the case in Canada. Some persistent voices may well change that soon.
Amen to that!
It is good to hear of this precedent for two reasons. 1: The issue of care for CI as an accepted diagnosis. 2: The acceptance of Optometric expert testimony on this issue.
I agree. While CI has the best track record of being an accepted diagnosis, this case certainly elevates the significance of it’s impact on patients (and adults in particular).
Reblogged this on Mindsight: Exploring Vision, Health, and Learning and commented:
COVD President Dr. Barry Tannen shares a recent court case in which he served as an expert witness for a former school nurse whose workplace had failed to implement the reasonable accommodations she so clearly needed as a person with convergence insufficiency. The legal precedents this case has established are so important for the future of behavioral vision problems being recognized by a larger community of professionals!
Is this a case of mostly dry eyes? I don’t know the patient’s age or family history or what dry eye tests were performed for osmolarity or whether this is evaporative dry eye or aqueous dry eye or even if she had thyroid problems or an autoimmune dx.
It seems for all the suffering this is more dry eye than CI especially if the VT or Prism did not help.
On the other hand her contract for the job must have clearly stated responsibilities and that she signed on that she could do the job.
Yes, go ahead and shout at me. August
Hi August,
Having evaluated her I can tell you that while the dry eye syndrome was significant, I believe the convergence insufficiency was of even greater significance. A piece of the story that I didn’t share is an automobile accident years earlier. She showed characteristics of “post-traumatic vision syndrome” which complicated the condition and made it recalcitrant in my opinion. Regardless, the jobs visual demands changed greatly years after she was hired, and she was asking for accommodations, rather than not performing her new increased job responsibilities.
Barry, Thank so much. I agree. My initial response was because of the increase in dry eye related to work changes that many patients are in real pain, so much that they can hardly keep their eyes open. Again, I recommend the HydroEye supplement with GLA and DHA in addition to the Bruder Mask and the new XIIDRA (listitegrast). The XIIDRA works and the company gives the patient the first 60 vials free (30 day supply) while the company works with the patient in getting insurance to pay for the next dosage. No more calling the pharmacy and begging for restasis.
Personal thanks to Dr. Press for this blog. August
August, Thanks for your excellent comments and insight!