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March 2006

Through the Cracks: The Americans With Disabilities Act’s Inappropriate Exclusion of Compulsive Gambling as a Protected Disability
By Jonathan P.

On July 26, 1990, President George H.W. Bush signed into law the Americans with Disabilities Act of 1990 (“ADA”, or “Act”), a wide-ranging civil rights law prohibiting a broad spectrum of discrimination against individuals with physical and mental disabilities.  The Act has been hailed as landmark legislation, drawing frequent comparisons to the revolutionary discrimination protection that characterized the Civil Rights Act of 1964, with some of the more effusive ADA sponsors going so far as to label it “the Emancipation Proclamation for those with disabilities." {FN1}  While the Act and its predecessor, the Rehabilitation Act of 1973, are indisputably Congress’ most proactive efforts to protect disabled persons from discrimination, its scope is not unlimited: the ADA explicitly narrows the class of individuals entitled to its protection.  One such restrictive provision enumerates compulsive gambling as a disorder excluded from coverage.  This article intends to explore how it came to be that the ADA, a piece of legislation that advertises itself as a “national mandate to end discrimination against individuals with disabilities and to bring them into the . . . social mainstream of American life” explicitly excludes a mental disorder that afflicts so many.  Although the bill’s language provides no explicit guidance on this question, the ADA’s legislative history and associated Congressional debate provide illuminating, and oftentimes frustrating glimpses into how the condition came to be earmarked for exclusion, even while biologically similar addictions to alcohol and narcotics are protected.  Finding the rationale for the provision to be based on a strikingly uninformed understanding of the disorder, this article concludes by proposing that the exclusionary language be removed from the Act.  The substantial research that has been conducted on the disease since the ADA’s inception requires it.

Although instances of compulsive gambling {FN2} behavior have been documented since medieval times, public perception of the illness has evolved substantially.  The relative absence of clinical research into the condition until the late 20th century results from the fact that gambling itself had long been considered both sinful from a religious perspective, and ethically reprehensible.  Those unable to control their wagering were viewed as morally deficient, and manifestly unworthy of medical diagnosis or treatment {FN3}, “deserving whatever misfortune (they) received.” {FN4}  A fundamental assumption of this early “moral model” of human behavior was that the underlying activity was consciously undertaken, and under the complete volitional control of the individual.  Modern studies, however, suggest that this assumption is fundamentally flawed, with much of the most recent research into the condition drawing parallels to the addictive psychological and biochemical dependencies of alcohol and narcotic abusers.

Stated bluntly, compulsive gambling is one of the most widespread mental health epidemics of the last decade.  The influential National Gambling Impact Study Commission (NGISC) conducted a survey of problem gambling behavior in the United States in 1999, the first such study in nearly 25 years, which estimated that approximately 1.2% of the population suffered from pathological gambling behavior, and a further 1.7% were “problem gamblers.”  An additional 7.7% of respondents were classified as being “at risk.”  The report found that access to gambling outlets was a significant factor in the development of addictive behavior, concluding that “the presence of a gambling facility within 50 miles roughly doubles the prevalence of problem and pathological gamblers.”  As of this writing, 48 of 50 States have some form of sanctioned wagering, up from only 13 in 1976. {FN5}  The internet explosion, and near-simultaneous introduction of online gaming exacerbated the problem, giving individuals immediate access to gambling from their own homes, in addition to allowing minors easier access to gambling outlets.  A watershed event in the recognition of compulsive gambling as a bona fide medical disease came in the late 1970s and early 1980s with its inclusion for the first time in the American Psychiatric Association’s (APA) influential Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) {FN6}, and the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems, 9th revision (ICD-9).  The diagnostic criteria for compulsive gambling in DSM-III closely modeled those used to evaluate addicts of alcohol and illicit drugs {FN7}, a similarity that drew modest criticism from some authors who argued that the criteria used to evaluate a substance abuse illness could not be neatly extrapolated to what was still considered to be a disorder of impulse control.  The argument attempting to distinguish addictions to drugs and alcohol from pathological gambling had a certain appeal: after all, the ingestion of a foreign substance results in quantifiable changes in body chemistry and neurotransmitter activity attributable directly to the composition of the ingested matter.  How, wondered critics, could individuals be considered “addicted” to a mere behavior or activity that apparently implicated no such chemical trigger?  Much of the earliest research into compulsive gambling behavior addressed this question, exploring the surprising physiological similarities between the addictions.  One prominent study compared the profiles of pathological gamblers to heroin addicts. {FN8}  The authors noted overwhelming similarities between their subject groups’ behavioral profiles and patterns of physiological arousal, suggesting that “the subjective ‘high’ may be the more important determinant underlying the addictive process.”  In other words, it may not be any external substance, per se, which is responsible for the development of an addiction, but rather the resulting pattern of physiological stimulation the subjects craved.  They concluded by postulating a possible medical basis for gambling addiction in “specific neurotransmitter substances mediat(ing) the reinforcing euphoria.”  Many studies followed soon after corroborating the similarities in behavioral patterns between alcohol, drug, and gambling addicts. {FN9}

            Several theories have been proposed in the scientific struggle to understand why individuals develop pathological gambling tendencies.  Earlier research largely eschewed the idea that compulsive gambling was anything more than a learned behavioral pattern that relieved stress or other psychological discomfort, and one that was at all times ultimately under the complete volitional control of the individual.  While these early authors satisfied themselves with exploring the shared social and behavioral tendencies of alcohol, drug, and gambling addicts, later research turned to developing a comprehensive medical model of addiction, exploring the underlying biological and chemical reactions that were responsible for these similarities.  The initial studies focused on alcoholism, as it was the best understood of the three addictions.  By the mid-1980s, researchers had documented a clear relationship between neuropsychological deficits and alcoholism, but it had long been assumed that the neural dysfunctions were themselves caused by the long-term abuse of alcohol. {FN10}  Addressing this issue, researchers Carlton and Goldstein carried out a seminal series of studies, which ultimately suggested that the neural deficits in fact preceded the alcoholics’ addiction, implying a previously unexplored genetic predisposition factor that led to the development of alcoholism. {FN11}   Following their studies on the possible biological predispositions to alcoholism, Carlton and Goldstein examined the brain activity of pathological gamblers, and found that their brainwaves, like those of alcoholics, closely resembled those of children with attention deficit disorder (ADD), suggesting that the biological characteristics correlated with childhood ADD may play a role in the later development of pathological gambling.  This was indeed a surprising set of findings for a scientific community that had until then generally shared the belief that compulsive gambling was no more than a behavioral disorder that individuals acquired or learned from adolescence onward.Later studies continued the exploration of biological factors in the development of the disease, finding that compulsive gamblers suffered from low serotonin and enzyme levels, and lending further support to the conceptualization of pathological gambling as a biologically rooted disease. {FN12}  Also supporting a medical model of gambling addiction were studies that explored a potential hereditary basis for pathological gambling, which noted a very high rate of correlation in compulsive gambling activity between parents and their children.  A large-scale behavioral study of fraternal and identical twins similarly concluded that roughly 40% to 50% of various pathological gambling traits were attributable to inherited or genetic underpinnings. {FN13} 
 
While a full discussion of the various biological and sociological theories of addiction and their application to compulsive gamblers is complex and beyond the scope of this paper {FN14}, the adverse consequences of the condition, for both the sufferer and her family, are well-documented.  Nearly all scientific research into compulsive gambling has found some degree of co-morbidity {FN15} with other psychological disorders.  One author found that 40 to 70 percent of pathological gamblers sought professional help for other psychological disorders before joining Gamblers Anonymous. {FN16}  More recent studies of substance abusers indicated that gamblers were three to five times more likely than non-gamblers to exhibit symptoms of depression, schizophrenia, and alcoholism. {FN17}  Other conditions that have shown a clear correlation to pathological gambling include bipolar disorder, obsessive-compulsive disorder, overeating, and antisocial personality disorder. {FN18}  Depression is the most frequently documented malady among compulsive gamblers, appearing in roughly three quarters of sufferers. {FN19}  Suicide attempts are also significantly elevated among the group’s constituents: various studies have placed the attempted suicide rate of affected individuals roughly between 15% and 30%, a rate dozens of times higher than that found in the general population. {FN20}  A study of Gamblers Anonymous members found that only 21 percent of those surveyed had never contemplated suicide. {FN21}  Even more disturbing was the finding that compulsive gamblers are more successful than other individuals when they attempt suicide. {FN22}  There is also substantial evidence of familial discord among compulsive gamblers, who report much higher rates of divorce and spousal abuse than the general population. {FN23}  While extensive comorbidity across dozens of psychological disorders, including pathological gambling, makes isolating the causes and effects of individual conditions too complicated to be thoroughly addressed here, the mental and physiological suffering of the compulsive gambler is unambiguous.  Lives are thrown into turmoil and families wrecked.  With the incidence of pathological gambling advancing at an alarming rate, research efforts have increased correspondingly, and will undoubtedly continue to disentangle the genetic and biochemical underpinnings of the disease.  For our present purposes, it is sufficient to acknowledge its deleterious sociological and physiological consequences for the sufferer, which have typically been found to strongly resemble the effects of alcohol and narcotic addiction.

Pathological gambling’s relatively recent recognition by the medical community as a diagnosable and treatable medical disorder, however, does not in and of itself demand a corresponding acknowledgement in the legal arena.  Apparently cognizant of the potential for confusion, the APA drafters of DSM-III stressed that their indexing of disorders was relevant only within the relatively narrow context of medical diagnosis and treatment, and expressly disavowed the idea that the DSM classifications should have any bearing on the determination of criminal responsibility. {FN24}  The ever-expanding body of research into the detrimental psychological and physiological effects of the illness, however, is casting an increasingly harsh light on the disconnect between the legislature’s profession of a deep commitment to protecting physically and mentally impaired persons from discrimination, and its concurrent denial of such protection to individuals overwhelmingly recognized by leading medical authorities to be just so impaired.  In considering the following discussion of the relative merits of the ADA’s absolute exclusion of compulsive gambling, it should not be forgotten just how little was known about the disease until as recently as 25 years ago.  Our scientific understanding of the illness is truly in its infancy.  Especially in the context of employment discrimination cases, which by their nature rely heavily on the testimony of medical experts describing the nature and extent of an employee’s disability, it seems irresponsible to disregard the voluminous research that has been carried out in recent years that illustrates unambiguously the deleterious effects of the disease.

Given the ADA’s objective of providing “a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities,” and the foregoing evidence that the medical community overwhelmingly recognizes pathological gambling as a diagnosable and treatable medical disease, we would be well served to examine just how it was that the Act came to explicitly exclude the illness from coverage.  The clause in question was nowhere to be found in the original text of the bill presented to Congress, but rather sprung from an 11th-hour amendment cosponsored by Republican Senators William Armstrong and Orrin Hatch.  During the final days of Senate debate, a small but vocal group of legislators – among them Armstrong, Hatch, and Jessie Helms – expressed concern that the roster of conditions subject to coverage under the ADA’s vague language was too broad, and would quickly ensnare small business owners in an avalanche of litigation based on disabilities of dubious merit.  Helms and Armstrong seemed especially concerned about homosexuality, HIV, and disabilities with what they perceived to be moral content such as kleptomania, compulsive gambling, and voyeurism.  Seeking to narrow the ADA’s scope, Armstrong favored limiting the Act’s coverage to physical disabilities {FN25}, but these overtures were met with stiff resistance from his colleagues.  Senator Domenici (R-NM) responded to the proposed exclusion of mental disabilities by reminding the objecting Senators that scientific evidence indicated that such even such celebrated minds as Abraham Lincoln and Winston Churchill suffered from bipolar disorder.  Senator Kennedy (D-MA) countered Helms’ virulent argument against protection for HIV-positive individuals by noting that voluntary testing for the virus was critical in controlling the burgeoning epidemic, and withholding statutory protection on the basis of HIV status would discourage high-risk individuals from getting tested. {FN26}

Rebuffed but undeterred, Armstrong streamlined his proposed amendment to a select group of disorders that he believed to be most egregious, a list that included compulsive gambling.  Despite general opposition to these attempts to narrow the Act’s definition of disability, most Senators recognized the importance of securing broad bipartisan support for the landmark legislation, and consequently approved the Armstrong/Hatch amendment.  Senator Harkin went so far as to underscore that he did not feel the amendment to be at all necessary, but was agreeing to it only as a compromise to appease the Senators who favored narrowing the definition of disability: “[W]e have here a compromise amendment to deal with various concerns that have been raised. I do not believe that this amendment is necessary or even particularly appropriate for this bill. Nevertheless, in order to deal with particular concerns raised, we are including this amendment.” {FN27, FN28}

A week after his amendment was approved, Armstrong defended in greater detail his belief in the necessity of the exclusion on compulsive gambling, and other so-called impulse control disorders enumerated in Amendment 722.  So questionable was the legitimacy of these mental disorders, he reasoned, that without specific exclusionary language, employers would be faced with a barrage of lawsuits premised on such dubious disabilities as compulsive gambling, fear of heights, paranoid schizophrenia, manic depression, and transexualism.  Since these types of egregious claims, he contended, had already been brought under the Rehabilitation Act, a specific amendment was needed to prevent them from being similarly litigated under the ADA.  In addressing compulsive gambling specifically, Armstrong referenced the case of an FBI employee who was discharged after taking money that he had received from his employer as part of an undercover operation, and gambling it away in Atlantic City. {FN29}  The employee brought suit against the FBI, claiming that he had been discriminated against based on his handicap of compulsive gambling.  The presiding Judge Ludwig framed the issue as one that required a determination of whether compulsive gambling was a handicap under the Rehabilitation Act. {FN30}  While the case was ultimately settled under confidential terms before a ruling could be made on the key issue, Judge Ludwig “gave every indication…of being ready to hold that compulsive gambling was a covered disability.”  Armstrong, incredulous that a plaintiff had been allowed to develop his case on a theory of compulsive gambling as a disability, argued that such frivolous claims would have become commonplace unless an amendment explicitly forbade them.

Thus was codified the exclusion of pathological gambling from ADA protection, the legislative curiosity with which this author now takes issue.  There is no recorded evidence that Armstrong or his Senatorial cohorts consulted any medical authority in determining what disabilities were to be ultimately marked for exclusion in Amendment 722.  What we are left with is the troubling inference that the exclusion of compulsive gambling was the result of a small number of Senators’ unfounded concerns about the breadth of ADA protection, which appeared to be fueled – at least in part – by their personal moral convictions.  Several prominent authors lament that a different result might have come about had there been a Senator present willing to rise to the defense of the excluded illnesses, as had Kennedy for HIV, and Domenici for manic depression.  Consider as illustrative the misgivings of Robert Burgdorf, Jr., one of the drafters of the original ADA bill presented to Congress in 1988:
“For while the ADA represents a huge advance for people with disabilities, those of us who have worked on the bill will continue to cringe when a focus on provisions of the Act that exclude from protection those individuals having real and difficult psychological and psychiatric disorders such as compulsive gambling, kleptomania and pyromania. It detracts from the principle underlying the Act that such people were denied protection because of stereotypes, ignorance and prejudice toward them and that their exclusion was permitted primarily because they had no organized representation present during the negotiations and no congressional champion arose to their defense.” {FN31}


It is this article’s proposition that the wealth of convincing scientific research that has been conducted since the ADA’s introduction, coupled with the epidemiological growth in the disease’s prevalence, should stimulate reconsideration of the explicit exclusion on pathological gambling.  Perhaps had members of Congress had access to the overwhelming evidence available today that validates the legitimacy of the disease and its deleterious psychological and physiological consequences, they would not have so readily compromised on Armstrong’s proposed exclusions.

Constrained by the ADA’s absolute language, courts have been unambiguous in their determination that compulsive gambling and its Section 511 brethren are specifically excluded from qualifying as disabilities, and accordingly have made short thrift of such arguments by simply invoking the Act’s explicit exclusionary language.  (See e.g. Johnson v. Fresh Mark, Inc., 337 F. Supp. 2d 996 (2003), “[T]he plain language of the statute indicates that transsexualism is excluded from the definition of disability no matter how it is characterized, whether as a physical impairment, a mental disorder, or some combination thereof.”)  Of course it is only natural – even commendable – that courts have faithfully interpreted the Act’s precise language in rejecting claims premised upon specifically excluded disabilities.  However, the distinction drawn by the ADA between individuals addicted to drugs or alcohol, and those addicted to gambling assumes a quite curious character when contrasted with the treatment of these conditions in other legal fora.  Consider, for instance, the fate of pathological gamblers in the context of criminal sentencing proceedings.  The Federal Sentencing Guidelines afford judges substantial discretion in determining appropriate sentences for convicted criminals, but forbid departures from established ranges based on certain factors including a defendant’s race, sex, national origin, economic hardship, and drug or alcohol dependence.  Courts are furthermore discouraged from granting departures based on “mental and emotional conditions”, but encouraged to make allowances for a defendant’s “diminished capacity”.  Justin W. Starr accurately synthesizes the resulting difficulty in determining whether courts have the authority to grant downward departures on the basis of an individual’s compulsive gambling affliction:

“Compulsive gambling presents a particularly complex situation because it can implicate all four categories of departure factors. Compulsive gambling is unmentioned in the Guidelines and departures based on unmentioned factors were expected to be ‘highly infrequent.’ Furthermore, compulsive gambling is considered an ‘emotional or mental condition’ and thus could be a discouraged factor.  Often times, those who commit crimes because they are compulsive gamblers do so because of personal financial difficulties, a forbidden factor.  But, if compulsive gambling does in fact cause diminished capacity, it becomes an encouraged factor for downward departure.  With all four departure factors implicated, courts are free to characterize compulsive gambling as they wish and either grant or deny the departure.”
Justin W. Starr, Diminished Capacity Departures for Compulsive Gambling: Punishing the Pathological or Pardoning the Common Criminal?, 2003 B.Y.U. L. REV. 385, 418 n.40 (2003).

While judges appear to have sufficient prerogative to either grant or deny a downward departure based on a defendant’s compulsive gambling, they have generally viewed such requests with considerable skepticism {FN32}.  Most tellingly, in explaining their reluctance to accept defendant arguments grounded in such a theory, judges and commentators alike have cited the difficulty in distinguishing an addiction to gambling from two explicitly prohibited conditions: alcoholism and drug dependence!  Consider as illustrative the narrative of Judge Wood in United States v. Katzenstein {FN33}:  “The Sentencing Guidelines' rationale for distinguishing between significantly reduced mental capacity (1) resulting from voluntary use of drugs or other intoxicants, and (2) resulting from other causes, is opaque…. [d]efendant's presentation to date has not convinced the court that compulsive gambling disorder can be distinguished in any principalled (sic.) way from abuse of drugs or alcohol.” {FN34}  (See also United States v. Harotunian, 920 F.2d 1040, C.A.1 (Mass.) (1990) (while declining to review the district court’s decision not to grant a downward departure, the appellate court commented that “even if appellant did suffer from a gambling addiction…the guidelines' general purpose of deterrence would be ill served by discounting appellant's sentence on this basis…such a dependence would be akin to drug or alcohol addiction-considerations to which the Sentencing Commission assigned little weight.”) {FN35}


This line of reasoning is both interesting and inescapably ironic with respect to this article’s thesis, because it is implicitly rejected by the provisions of the ADA, which apparently has no difficulty in distinguishing drug and alcohol addictions from pathological gambling, and endorsing divergent treatment for each.  It is naturally conceded that the criteria used to assess the propriety of a downward departure in criminal sentencing are substantially different from those used to evaluate the rationale of extending statutory protection from discrimination under the ADA, but the contradictory theoretical implications are unmistakable: criminal sentencing judges, unconstrained by an explicit statutory exclusion, express great difficulty in justifying disparate treatment for drug or alcohol addicts and pathological gamblers. {FN36}  Had the ADA included persuasive reasoning supported by compelling scientific evidence indicating why compulsive gambling should be exempt from coverage, its exclusion might prove more palatable.  An examination of the historical record, however, produces only the unsupported rhetoric of a lone unruly Senator, and a Congressional audience unprepared or otherwise unwilling to mount a timely response.

To this point, we have satisfied ourselves in laying bare the alarmingly weak foundation upon which the ADA’s wholesale exclusion of compulsive gambling is built.  There is, indeed, a good reason for first addressing that threshold matter, for it is at this preliminary stage that the Act’s current language defuses any potential litigation.  It would be irresponsible, however, to end the inquiry here, since our hypothetical plaintiff ultimately bears the burden of navigating a full gauntlet of ADA preconditions before her claim stands any chance of success.  After all, this article’s recommendation that the Act be stripped of its absolute exclusion on compulsive gambling would be altogether moot if a would-be plaintiff could not ultimately satisfy the entire spectrum of requirements for a successful ADA claim.  The following section discusses how the elements of a pathological gambler’s claim might conform to the Act’s various provisions.

Formal medical diagnosis notwithstanding, the ADA requires a more extensive showing before an impairment can be said to rise to the level of a “disability” for the purposes of the Act. {FN37}  A mere showing that an individual suffers from a physical or mental ailment is insufficient: the condition must be found to “substantially limit” one or more of the individual’s “major life activities.” {FN38}  The plaintiff may alternatively proceed if she can show either that she has a record of having a disability that substantially limits a major life activity, or that her employer regards her as being so limited. {FN39} A plaintiff must satisfy one of the three preceding prongs in order to successfully litigate an ADA claim.  The debate over what constitutes a “major life activity”, and when an individual can be said to be “substantially limited” in its performance has produced no shortage of litigation since the ADA’s promulgation.  The Equal Employment Opportunity Commission has published guidelines that list examples of major life activities that may be limited by an individual’s disability, a roster that includes functions such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.

Alcoholics and recovering narcotic addicts have had limited success in demonstrating that their disability has substantially limited them in a major life activity.  While courts have readily acknowledged that such individuals may qualify for protection under the Act, they have been equally quick to dismiss cases where the plaintiff fails to persuasively demonstrate how her disability has limited her in performing a major life activity. {FN40}  It is certain that compulsive gamblers would face similar rigorous scrutiny of their claims.  Of the major life activities, the most ‘promising’ candidates for being limited in an individual with an addictive gambling disorder are those of “caring for oneself” and “working”.  In Bilodeau v. Mega Industries {FN41}, Barbara Bilodeau sued her former employer under the ADA, claiming that she was unlawfully fired because of her alcoholism.  She argued that she was a qualified individual with a disability because her alcoholism substantially limited her ability to work and care for herself.  With regard to the major life activity of caring for herself, the court noted that testimony from both Bilodeau and her psychiatrist indicated that after suffering a relapse of her alcoholism, she “suffered from chronic diarrhea, did not eat properly, did not take good care of her appearance, did not sleep well, and cried all of the time.” {FN42}  She also was reported to have had frequent suicidal thoughts, including attempts to cut her wrists.  Based on this record, the court determined that Bilodeau had presented sufficient evidence to allow a jury to reasonably conclude that she was substantially limited in the major life activity of caring for herself.  Similarly, the court concluded that a jury might reasonably conclude that Bilodeau capacity to work was substantially limited.  Testimony was introduced indicating that she “was not able to think as quickly, react as quickly, and move as quickly, and ‘was doing the best [she] could to keep up with all of the demands, but maybe not as well as [she] could have or would have if [she] had never picked up a drink again.’” {FN43, FN44}  While the court in Bilodeau was merely considering the employer’s motion for summary judgment in finding that a jury could reasonably conclude that the plaintiff was substantially limited in the performance of these to major life activities, the important implication is that such an outcome is acknowledged as within the realm of possibility.  The issue for consideration, therefore, is whether compulsive gambling could be held to substantially limit the major life activities of caring for oneself or working.  The question cannot be answered in the absolute, since the ADA’s determination of “disability” is made on a case-by-case basis, and does not depend merely on the name of the affliction, per se, but rather on the effect that it has on that individual. {FN45}  However, given the noted similarities between compulsive gambling and addictions to alcohol and narcotics, and evidence that some courts have found the debilitating effects of alcoholism to substantially limit caring for oneself and working, it seems reasonable to imagine that a compulsive gambler might successfully make such a showing.

The pursuit of a potential ADA claim under the “regarded as” prong will likely prove to be the most easily satisfied of the three avenues, since it relies only upon the subjective beliefs of the employer as to an individual’s incapacity, whether justified or not.  Consider, for example, a brokerage firm that fires a financial advisor after discovering that he has been diagnosed as a pathological gambler, believing him unfit to manage sizeable client investments.  In order to satisfy the Act’s requirement, the discharged employee would need only show that his employer regarded him as being substantially limited in the major life activity of working, irrespective of whether the concern had any basis in fact.

An additional requirement of the ADA is that an employer provide qualified disabled employees with reasonable accommodations for their disability {FN46}, if the employee so requests {FN47}, unless doing so would cause an undue hardship on the employer {FN48}.  While what constitutes a reasonable accommodation is not explicitly defined by statute and must be individualized to each particular employee on a case-by-case basis, the accommodations that have been held to be appropriate for alcoholics and rehabilitated users of illegal drugs may provide guidance on what provisions might conceivably be extended to compulsive gamblers.  Most reasonable accommodation cases concerning alcoholics and recovering drug addicts have centered on rehabilitation and treatment programs.  Nearly all courts faced with the issue have acknowledged that an employer may be required to rearrange an employee’s work schedule or provide a leave of absence if doing so will allow an alcoholic to receive treatment for his condition and more competently perform the duties of his employment. {FN49}  While the employer is not necessarily required to finance the employee’s treatment, the requirement that they reasonably accommodate an employee’s participation in such a program has received broad support.  It is not difficult to imagine that similar allowances might be made for compulsive gamblers if this latter group were allowed to litigate ADA discrimination claims.  It is illuminating to consider Schenck v. U.S. Postal Service, a Rehabilitation Act {FN50} case from 1987 {FN51} that concerned a discharged postal worker who suffered from alcoholism and a chronic gambling habit {FN52}.  The court found that it was a reasonably accommodating measure for the employer to require the employee – who had been previously terminated for misconduct unrelated to his disability – to attend Gamblers Anonymous meetings as a condition of his re-hire.  While the case included several extraneous elements that make it somewhat unrepresentative of traditional “reasonable accommodation” cases, it is referenced here merely for the proposition that a compulsive gambling treatment program is well within the ambit of what might be considered reasonable accommodation in a hypothetical ADA disability claim.  A final interesting note on this case is that despite the fact that, due to Schenck’s concurrent alcoholism and other unique circumstances of the case, the court does not explicitly acknowledge his chronic gambling as a disability for the purposes of the Rehabilitation Act, it strongly implies that it is so viewed.  By endorsing the employer’s proposed requirement that Schenck sign a document agreeing to attend both Alcoholics Anonymous and Gamblers Anonymous meetings, the court appears to put two afflictions, from a legalistic standpoint, on equal footing.  An alternative reasonable accommodation that has been held appropriate by some courts has been a restructuring of a disabled employee’s employment duties to accommodate her disability.  In one Rehabilitation Act decision, for example, the court found that it would be a reasonable accommodation for an employer to restructure the duties of an attorney who was recovering from drug addiction so that he was not assigned cases involving narcotic abusers. {FN53}  Returning to our hypothetical example of a compulsive gambler employed as a financial advisor, a court might reasonably find that reassigning such an employee to a position of equal status that did not involve handling large client investments satisfied the ADA’s reasonable accommodation requirement.  It is not this article’s intent to exhaustively catalog every permutation of gambling-related suit that may come before a court – indeed, given the directive that each disability claim be subject to an individualized analysis based on its unique set of facts, such an exercise would be both impractical and misguided.  Rather this section is merely meant to discuss, in the broadest of terms, how the ADA’s various provisions might conceivably adapt to the elements of a compulsive gambler’s disability claim, and demonstrate that they are amenable to such a purpose.

Having now outlined the research supporting compulsive gambling as a diagnosable and treatable medical disorder and charted the hypothetical course of an ADA claim based thereupon, it might be appropriate to more thoroughly address Senator Armstrong’s concern that allowing such claims would encourage a barrage of lawsuits based on pathological gambling or any number of even more dubious disabilities.  In the face of overwhelming scientific evidence recognizing the disease, the reluctance to invite an avalanche of frivolous litigation appears to be the only remaining rational objection to discarding the ADA’s existing exclusionary language.  Senator Armstrong’s concerns, despite apparently being based on no more than personal intuition, might ultimately have been vindicated had his projected deluge of frivolous ADA litigation materialized following the bill’s ratification.  Unfortunately for the Senator, nothing of the sort occurred.  Christian Hardigee et al. astutely note that the ADA also introduced novel rights for alcohol and drug addicts, and yet those conditions represented only 638 EEOC complaints (less than 2% of all complaints) in the 12 years following the legislation’s enactment. {FN54}  Since alcohol remains far more accessible than does gambling, argues Hardigee, there is no reasonable basis to suggest that the judiciary might be inundated with suits from compulsive gamblers, should such claims be allowed.  Armstrong’s anxiety over excessive litigation, the sole explanation he advanced for his amendment excluding compulsive gambling, appears to be substantially lacking in merit.

An anticipated criticism of this article’s recommendation of discarding the prohibitory language barring claims based on compulsive gambling is that taken to its natural conclusion, it would imply the existence of ADA protection for any addiction – whether to gambling, sex, overeating, or even shopping {FN55}, if it could be shown that the condition featured the same biochemical and neurotransmitter patterns inherent in drug, alcohol, and gambling addiction.  Indeed, given the growing acceptance of a generalized medical model of addiction exhibiting a familiar set of physiological symptoms described earlier, it seems likely that a creative plaintiff could make such a showing.  Critics might thus argue that this article is no more than a poorly-cloaked argument for addiction itself as an ADA-covered disability.  This is perhaps a legitimate concern, since a general theory of addiction suggests that addictive behavior can be triggered by any number of stimuli, whether material or behavioral.  It is conceded that the present argument leaves open the possibility that a particularly resourceful and litigious plaintiff might mount a creative effort to bring an ADA claim based on a “niche” addiction, but consider that in this respect the removal of the exclusion on compulsive gambling would not render the ADA any more susceptible to the specter of such farfetched litigation than it is today.

Consider finally that there remains a persuasive deterrent, even for the most resourceful and determined plaintiff, against bringing an ADA suit based on an addiction of questionable validity.  Compulsive gambling enjoys a unique status among the studied addictions as one of only a handful that is currently validated by an established body of research into its etiology and the resulting sociopathic behavior exhibited by its victims.  The broad record of scientific research of alcohol, drug, and gambling addictions, and the higher prevalence of violent, criminal, and suicidal tendencies among their sufferers has been extensively documented, and can serve as a compelling basis for distinguishing between legitimate and more suspect claims of addiction. {FN56}  In examining a host of so-called “behavioral addictions,” an article in Science magazine noted that the scientific research on compulsive gambling is “uniquely convincing at this historical juncture,” and positions the disorder “in a class of its own as (the one) that most resembles drug addiction.” {FN57}  In conclusion, while this author recognizes the concern that plaintiffs may be encouraged to bring claims of discrimination based on addictions of more a dubious nature, this risk is substantially mitigated by the weight of scientific evidence supporting compulsive gambling as a bona fide and debilitating disability.

Irrespective of how harshly some critics have decried the ADA’s exclusion of compulsive gambling, the original injustice may yet be remedied by amending the Act’s language to remove the exclusion in question.  Though critical of the ADA’s formulation, this author does not deny its historic significance, nor do I intend to denigrate the importance of protecting disabled individuals from discrimination such that they may avail themselves of the same personal and professional opportunities enjoyed by other citizens of this country.  Rather, I argue merely that in seeking to limit the scope of the Act, its drafters performed a critical disservice to a great number of disabled individuals by capitulating to Senators Armstrong and Helms’ objections concerning the validity of several bona fide mental disorders.  While the scientific research required to competently object to a proposed exclusion on compulsive gambling may not have been readily available to the Senators who approved the Armstrong amendment, surely the nearly two decades of research that have been performed since the Act’s inception should convince the current Congress otherwise.

 

Foonotes

  1. Perlin, M.L., For the Misdemeanor Outlaw: The Impact of the ADA on the Institutionalization of Criminal Defendants with Mental Disabilities, 52 Ala. L. Rev. 193 (Fall 2000).
  2. There are divergent opinions in the field regarding what is the most appropriate terminology to describe excessive gambling behavior (and even debate over when the activity becomes ‘excessive’).  While many consider “compulsive gambling” and “pathological gambling” to connote different conditions, the terms are used interchangeably in this article.
  3. Nelson Rose, a leading authority on gambling and the law, points out that the term “gamble” itself was regarded as slang in the 18th century as “a term of reproach.”  Rose, N., Compulsive Gambling and the Law: From Sin to Vice to Disease, Journal of Gambling Studies Vol 4(4), Dec. 1988.
  4. Id., at 241.
  5. This growth was driven largely by a reduction in federal funding provided to the individual States, who in turn came to view legalized gambling (and the associated tax revenue) as an appealing alternative to raising taxes.
  6. The APA has periodically amended its diagnostic criteria for compulsive gambling, which now appear in their revised state in the Manual’s 4th edition (DSM-IV).
  7. Both, for example, included the following: (a) preoccupation with the activity and a need to engage in it, b) an increased tolerance, c) the loss of control, d) associated withdrawal symptoms, DSM-IV
  8. Blaszcynski, A.P., Burich, N., McConaghy, N., British Journal of Addiction 80 (1985), 315-319
  9. McCormick, R.A., Taber, J., Kruedelbach, N., Russo, A., Journal of Clinical Psychology 43 (1987), 521-527.
  10. Mikal Aasved, The Biology of Gambling, 106-107 (2003).
  11. Carlton, P.L., Goldstein, L., The Handbook of Pathological Gambling, 111-122 (1987).
  12. Carrasco, J.L., et al., Acta Psychiatrica Scandinavia 90(6), 427-431 (1994).
  13. The classic criticism of parent-offspring and twin studies, however, is that they are especially susceptible to the ‘shared environmental experience’ effect.  Briefly described, it recognizes the difficulty in ascertaining to what degree the results of such research may be affected by the common environmental variables that were shared by children and their parents, and by siblings.  There have not been any recent large-scale studies of siblings (or twins) raised from birth in separate environments, which might address some of these concerns with regard to compulsive gambling.
  14. For an excellent in-depth analysis of the various theories, and their proponents, see Aasvad (2003), supra note 9.
  15. Co-morbidity refers to the concurrent presence of several conditions.  This author does not go so far as to suggest that compulsive gambling is itself the cause of an increase in other psychological disorders in an individual, but merely observes that the concurrent incidence of other mental disorders is a well-documented characteristic of compulsive gambling.
  16. Aasvad, at 100.
  17. Id., at 101.
  18. Id., at 101.
  19. Id., at 101.
  20. One early study even found that 12.5% of compulsive gamblers’ spouses had attempted suicide.  Aasvad, at 102.
  21. Id.
  22. Id.
  23. Id.
  24. Rose, however, seriously questions whether this attempted distinction is at all persuasive, suggesting that it is foolhardy for a body as influential as the American Psychiatric Association to publish a national classification of mental disorders, and believe that they will not be considered by others as representing a quasi-official standard.  His skepticism appears to be on point, as Congress, in crafting the ADA, explicitly referenced the DSM-IV criteria as the touchstone for evaluating what mental disorders should be protected by the Act.  Rose, at 243.
  25. Senator Armstrong expressed his somewhat insular view of ‘disability’ as one most appropriately characterized by “people in wheelchairs, or who have some kind of a physical disability or handicap of some sort and who are trying to overcome it.” Cong. Rec. S 10753.
  26. Although Senators Armstrong and Helms framed their objections as stemming from concerns over excessive litigation, there are indications that they were more zealously fueled by ethical and moral considerations.  Consider statements Helms’ made on the Senate floor during his argument against allowing HIV-positive individuals to qualify as ‘disabled’ for the purposes of the Act:  “I do not understand why, for example, you went down the road of including in your definitions people who are HIV positive, because 85 percent or more of the HIV positive people in this country are known to be drug users or homosexual or both…(w)hat I get out of all of this is here comes the U.S. Government telling the employer that he cannot set up any moral standards for his business by asking someone if he is HIV positive, even though 85 percent of those people are engaged in activities that most Americans find abhorrent.” Cong. Rec. S 10772.
  27. Cong. Rec. S10786
  28. There is also somewhat disturbing evidence that the late hour and accumulating fatigue of the proceedings may have unnecessarily curtailed a full consideration of the amendments presented on the evening of September 7th, 1989.  When Senator Armstrong took the floor and asked for overnight consideration of certain disorders with which he took issue, Democratic Senator and ADA co-sponsor Tom Harkin rebuffed him with a forthright admission that it was his intention to conclude consideration of the bill that same night.  Cong. Rec. S 10754.  Later, in voicing his strong opposition to a different amendment, Senator Wendell Ford protested “I understand that we are pushed for time. It is quarter of 10 at night…apparently my colleagues are so anxious to get the bill passed tonight, they will swallow camels and choke on gnats.”  Cong. Rec. S 10781.  It is unknowable to what extent general fatigue or the efforts to meet a hurried legislative timeline affected deliberations on the evening of September 7th, but the implication that genuine debate over important provisions of the ADA might have been stymied by a weary Senate body is indeed unsettling.
  29. Rezza v. U.S. Dept. of Justice, Not reported in F.Supp., 1988 WL 48541, E.D.Pa. (1988). 
  30. Judge Ludwig flatly rejected two previous findings by the Merit Systems Protection Board that the condition did not so qualify.  Rezza, at 6.
  31. Robert L. Burgdorf, Jr., The Americans With Disabilities Act: Analysis and Implications of a Second-Generation Civil Rights Statute, 26 HARV. C.R.-C.L. L. REV. 413 (1991).
  32. An even more adverse response has greeted plaintiffs who have tried to introduce their compulsive gambling as a basis for an insanity plea.  Virtually all such attempts have been summarily rejected.  See Geis, G., Pathological Gambling and Insanity, Diminished Capacity, Dischargeability, and Downward Sentencing Departures, 8 Gaming L. Rev. 347, (2004).
  33. Not reported in F.Supp., 1991 WL 24386, S.D.N.Y. (1991)
  34. Id., at 416
  35. But some courts have granted downward departures, e.g. United States v. Sadolsky, 234 F.3d 938 (2000), U.S. v. Checoura, 176 F.Supp.2d 310, D.N.J. (2001), U.S. v. Liu, 267 F.Supp.2d 371 E.D.N.Y.,2003.
  36. A full consideration of whether pathological gambling should support downward departures in criminal sentencing guidelines is beyond the scope of this article.  For illuminating (and opposing) viewpoints, see Justin W. Starr, Diminished Capacity Departures for Compulsive Gambling: Punishing the Pathological or Pardoning the Common Criminal?, 2003 B.Y.U. L. REV. 385, 418 n.40 (2003) (arguing against permitting downward departures), and Lawrence S. Lustberg, Sentencing the Sick: Compulsive Gambling as the Basis for a Downward Departure Under the Federal Sentencing Guidelines, 2 Seaton Hall J. Sports L. 51 (1992) (arguing for allowing downward departures).
  37. As noted earlier, DSM-IV explicitly recognizes the important distinction between the medical and legal standards for disability, and dissociates itself from the latter:  “[I]nclusion here, for clinical and research purposes, of a diagnostic category such as Pathological Gambling or Pedophilia does not imply that the condition meets legal or other nonmedical criteria for what constitutes mental disorder, or mental disability. The clinical and scientific considerations involved in categorization of their condition as mental disorders may not be wholly relevant to legal judgments, for example, that take into account such issues as individual responsibility, disability determination, and competency.”  DSM-IV.
  38. 42 U.S.C.A. § 12102(2)
  39. Id.
  40. Roig v. Miami Federal Credit Union, 353 F. Supp. 2d 1213 (S.D. Fla. 2005), and Burch v. Coca-Cola Co.  119 F.3d 305, C.A.5 (Tex.),1997
  41. 50 F.Supp.2d 27, (D.Me. 1999)
  42. Id., at 36.
  43. Id, at 37.
  44. A frequent stumbling block for plaintiffs attempting to demonstrate a substantial limitation in the major life activity of working is the requirement that they be restricted in their ability to perform a class or broad range of jobs in various classes.  The inability to perform a single job does not satisfy the requirement.  29 CFR § 1630.2.  In Bilodeau, the court recognizes this requirement, but nevertheless concludes that the plaintiff’s disability prevents her from working in positions in the electrical field in which she was trained, and relegates her to assembly line work, and waiting tables.  Bilodeau, at 37.
  45. See Sutton v. United Air Lines, 527 U.S. 471, at 483 (1999); Toyota Motor Mfg. Kentucky, Inc. v. Williams, 534 U.S. 184, at 198 (2002).
  46. 42 U.S.C.A. § 12112(b)(5)(A)
  47. Brown v. Lucky Stores, Inc., 246 F.3d 1182, 11 A.D. Cas. (BNA) 1195 (9th Cir. 2001)
  48. 42 U.S.C. § 12111(10)
  49. Schmidt v Safeway Inc. (1994, DC Or) 864 F Supp 991, 6 ADD 1223, 3 AD Cas 1141.
  50. Note that the Rehabilitation Act, like its successor the ADA, included a reasonable accommodation requirement.
  51. Schenck v U.S. Postal Service (1987, MD Fla) 44 BNA FEP Cas 424, 43 CCH EPD 37216
  52. Neither “compulsive” nor “pathological” was used to describe his condition, although the court left little doubt that it considered the individual to suffer from an addictive gambling disorder.
  53. Nisperos v Buck, 720 F Supp 1424 (1989, ND Cal)
  54. Hardigee, C.E., Bernhard, B.J., Bybee, S., Sicknesses and Sanctions: The Exclusion of Pathological Gambling Under the Americans With Disabilities Act, Electronic Journal of Hospitality Legal, Safety and Security Research, Vol I (2003).
  55. All of these are recognized addictions, Aasvad, at 130.
  56. Lesieur, H.R., Society 29(4), 43-50 (1992).
  57. Hardigee et al., at 7.

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