This month we look at an intractable issue: dealing with mental illness/cognitive impairment in the workplace. Laws change, yet attitudes and mindsets remain the same. Here are three cases and three lessons.

Lesson No. 1: HR is not an MD. An employee suffers a closed head injury. (By the way, according to Medscape there are 570,000 injuries a year in the United States.) He is a water service employee for a city and has been on the job for 14 years. The employee takes time off to heal and the city requires that he submit to a fitness for duty exam by a physician. The doctor looks at the job’s essential functions and gives him a medical examination. He gets a green light to go back to work. His supervisor observes the worker in the field performing his tasks. Passing grade here as well. One day the worker is driving in his city truck and a clipboard falls to the floor. He takes his eyes off the road (he is passing through an intersection when the light is green) for a second to pick it up. Turns out, a co-worker sees him disappear for the 15 seconds or so it takes to pick up the clipboard. HR is informed. The employee is placed on administrative leave and the same doctor is asked for his opinion. This time, the MD is only provided with documents regarding performance, including the intersection incident. No physical examination. The MD reports: can’t do the job. HR decides: he is fired. The jury in the ADA lawsuit says: violation and pay up to the tune of $225,000 in mental anguish damages and back pay to the tune of $354,070.72. The Seventh Circuit affirms, saying that the jury was entitled to infer discrimination from the failure to ask for a second medical exam. And, by the way, the court says that the city could not prove that the employee was a “direct threat” because there were no facts to support that assertion. And “No,” says the court to the city, “Your good faith that he did pose a threat only means you had a pure heart, but an empty head.”