## Facts

- Dr. Stephanie Bekker, an internist employed by Humana Health Plan, worked demanding clinical shifts, sometimes as the only physician on site.
- In 1990, a nurse relayed a rumor that Bekker smelled of alcohol at work; the clinical director discussed it with Bekker and attributed the odor to mouthwash.
- In 1995, after a patient reported smelling alcohol on Bekker, Humana arranged an independent evaluation by a physician specializing in substance abuse among physicians.
- The specialist did not formally diagnose alcohol abuse or dependence in 1995 but noted indicators suggesting problematic alcohol use, including a colleague’s reports of alcohol odor on Bekker’s breath on several occasions.
- In 1996, another patient complained that Bekker smelled of alcohol during an appointment; Humana suspended Bekker and investigated.
- During the investigation, multiple patients and employees reported smelling alcohol on Bekker and observing signs such as glassy eyes and a flushed face, though there was no direct proof she consumed alcohol while working.
- The investigator recontacted the specialist, who concluded Bekker met criteria for alcohol abuse, believed heavy drinking the night before work could affect her the next day, and recommended she refrain from practicing medicine and enter rehabilitation.
- Humana terminated Bekker, stating it believed she was an alcoholic and posed a risk to patient safety.
- Bekker sued under the ADA, alleging Humana discharged her based on a perceived disability (alcoholism). The district court granted summary judgment to Humana.

## Issues

1. Whether Bekker produced sufficient evidence that Humana discharged her because it regarded her as disabled (alcoholic) under the ADA.
2. Whether Bekker raised a genuine dispute that Humana’s stated reason—patient-safety concerns based on reports and expert input—was pretext for unlawful disability discrimination.

## Decision

- The Seventh Circuit affirmed summary judgment for Humana.
- The court assumed, without definitively deciding, that Humana may have regarded Bekker as an alcoholic.
- Humana articulated a legitimate, nondiscriminatory reason for discharge: a good-faith belief that Bekker’s alcohol-related condition created an unacceptable risk to patients.
- Bekker failed to present evidence from which a reasonable jury could find Humana’s safety rationale was pretextual.

## Legal Principles

- Under the ADA, a plaintiff must show that an adverse action occurred because of disability (including a “regarded as” disability); once the employer provides a legitimate reason, the plaintiff must show pretext.
- Pretext may be shown by evidence that the employer’s stated reason is factually baseless, not the real motivation, or insufficient to motivate the action.
- An employer does not violate the ADA merely by believing an employee has a condition such as alcoholism; liability turns on whether the employer acted for discriminatory reasons rather than an honestly held, job-related justification.
- In evaluating pretext, the question is whether the employer honestly believed its proffered reason; an employee cannot avoid summary judgment by showing the decision may have been mistaken or poorly reasoned.
- Patient-safety concerns may constitute a legitimate basis to remove a clinician from practice when the employer reasonably concludes the clinician’s condition poses a significant risk to others.

## Conclusion

The court upheld Humana’s termination decision because the record supported an honest, safety-based rationale grounded in repeated reports and specialist assessment, and Bekker did not produce evidence that the stated patient-safety concern was a pretext for ADA “regarded as” disability discrimination.


Bekker v. Humana Health Plan, Inc., 229 F.3d 662 (7th Cir. 2000)