Motko v. Geisinger Health Plan

UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF PENNSYLVANIA
AMBER MOTKO,
Plaintiff,
v.
GEISINGER HEALTH PLAN,
Defendant.
CIVIL ACTION NO. 3:24-CV-00732
(SAPORITO, J.)
MEMORANUM
On April 29, 2024, the plaintiff, Amber Motko, initiated this action
against Geisinger Health Plan (“Geisinger”) by filing a complaint raising
claims of discrimination, retaliation, and failure to accommodate under
the 	Americans 	with 	Disabilities 	Act 	(“ADA”) 	and 	the 	Pennsylvania
Human Relations Act (“PHRA”), 42 P.S. § 951
et seq. (Doc. 1). On August
23, 2024, the plaintiff filed an amended complaint asserting those same
claims. 	(Doc. 	18). 	Now 	before 	the 	Court 	is 	Geisinger’s 	motion 	for
summary judgment. (Doc. 25). The motion has been briefed (Doc. 26; Doc.
27; Doc. 28; Doc. 29; Doc. 30) and the matter is ripe for review.
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I. 	Background1
The plaintiff began working for Geisinger as a Case Manager
Registered Nurse in March of 2018. The plaintiff ’s position was a full-
time dayshift position, and she was expected to work forty (40) hours a
week. While the plaintiff ’s position consisted of many job duties2, one of
the 	most 	essential 	duties 	was 	the 	maintenance 	of 	all 	required
documentation for all case management activities. Registered nurses
must document all information in Geisinger’s computer systems after
speaking to a member. This action is critical to Geisinger’s compliance
with the requirements of its Centers for Medicare and Medicaid Services
contracts3 so that all providers will have the most-up-to-date information
about the patient. These contracts include the Special Needs Program
1 	The facts are taken from Geisinger’s “Statement of Material
Facts” (Doc. 26) and admitted by the plaintiff. (Doc. 29).
2 Other duties included: (1) designing individualized plans of care
by working collaboratively with the patient, primary care provider, and
other members of the health care team to ensure coordination of services;
(2) continuously evaluate lab results and tests while serving as a resource
to the patient or member and healthcare team; and (3) collecting and
utilizing data to adjust a patient’s treatment plan when necessary.
3 These contracts are those between Geisinger and the federal
government, which sets forth specific requirements that Geisinger must
follow in providing services to its Medicare and Medicaid healthcare plan
members.
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healthcare plan. Geisinger requires case manager registered nurses to
document all relevant information for their patients within forty-eight
(48) hours after contact with that patient. This standard is communicated
to 	all 	case 	manager 	registered 	nurses 	during 	their 	orientation,
subsequent 	training, 	and 	all 	performance 	reviews 	or 	performance
discussions.
As a general rule, registered nurses were expected to ask other
nurses to cover their shifts and perform their daily tasks if they required
time off from work. All nurses were expected to help and cover for their
coworkers. Before taking planned time off, case manager registered
nurses were expected to ensure that they were up-to-date on long-term
tasks so that the covering registered nurses only had to perform broader
daily tasks, such as speaking to patients over the phone and properly
documenting information from those phone conversations. If a registered
nurse required time off and no one volunteered to cover his or her shift,
another nurse would be assigned 	to cover that shift on a rotating
schedule.
The plaintiff was supervised by regional manager David Augustine,
who supervised approximately ten to twelve case manager registered
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nurses in different clinics throughout Pennsylvania. While Mr. Augustine
did not physically work in the same clinic as the plaintiff, he would often
speak with her to monitor and resolve any issues that arose during her
employment. Mr. Augustine would communicate with the plaintiff via
cell phone, text message, or email throughout the workday. He interacted
in the same capacity with all other registered nurses working throughout
Pennsylvania.
Throughout her employment, the plaintiff faced various workplace
performance issues that required monitoring by Geisinger. In 2021, the
plaintiff failed to conduct a necessary Special Needs Program assessment
for her job even though she was given notice of that assessment a month
in advance. She had also previously failed to complete numerous Special
Needs Program assessments by their deadlines in the past. Due to the
plaintiff ’s history of missing deadlines, Mr. Augustine often personally
reminded 	the 	plaintiff 	to 	complete 	her 	Special 	Needs 	Program
assessments by the required date so much so that the plaintiff became
accustomed to Mr. Augustine reaching out to her about deadlines for
upcoming assignments.
By the end of 2021, because of the plaintiff ’s continuing struggles,
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Mr. Augustine emailed the plaintiff to meet and address issues with her
work performance, including her failure to complete her Special Needs
Program assessments by the deadline, failure to complete her required
number of daily calls and tasks, and her failure to follow up with patients
for up to eight months about their medical history. At their meeting, Mr.
Augustine informed the plaintiff that her work performance issues were
concerning and that he was reaching out so they could come up with a
better plan on how to handle those issues moving forward. In response,
the plaintiff admitted to missing deadlines and acknowledged that she
was behind on her required assessments, but she informed Mr. Augustine
that she wanted to improve her work performance.
At the time of this meeting, the plaintiff alleged that she and Mr.
Augustine had a good working and personal relationship, characterizing
him 	as 	“understanding.” 	Because 	of 	this 	relationship, 	the 	plaintiff
confided in Mr. Augustine that she faced many difficulties in her personal
life. The plaintiff told Mr. Augustine that she and her husband were
having marital problems, and she was attending marriage counseling
during 	her 	lunch 	breaks 	to 	help 	improve 	her 	marriage. 	She 	also
expressed that her life was “falling apart at home,” as she had late bills,
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a disorganized and cluttered home, and she felt that she was unprepared
for her children to start school. She told Mr. Augustine that she was
failing as an employee, as a person, as a mother, and as a wife. During
this conversation, the plaintiff also informed Mr. Augustine that she had
been diagnosed with attention deficit disorder (“ADD”) six months prior.
She stated that she had begun taking a medication called Vyvanse to help
with her diagnosis in addition to starting therapy. But the plaintiff also
informed Mr. Augustine that she was quite capable of performing her job
duties and that she was not going to leave her work to others when she
could do it herself.
In February of 2022, Mr. Augustine received a report that the
plaintiff 	submitted 	at 	least 	two 	of 	her 	Special 	Needs 	Program
assignments after the deadlines. Geisinger contends that the plaintiff
missed these deadlines despite her receiving at least three general
reminding alerts from Geisinger and two separate direct reminders from
Mr. Augustine. Moreover, Geisinger argues that the plaintiff had also
failed to document patients’ information in its systems on at least eight
occasions, leading to Geisinger being written up by the Center for
Medicare & Medicaid Services during one of its audits. After receiving
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this report, Mr. Augustine subsequently met with the plaintiff for several
hours to discuss the plaintiff ’s performance. During that review, when
going through the plaintiff ’s employment history, Mr. Augustine details
that neither he nor the plaintiff could identify a single instance where
the plaintiff had met Geisinger’s expectation that she call at least eight
patients daily and document their information. Mr. Augustine contends
that 	he 	again 	asked 	the 	plaintiff 	if 	she 	required 	any 	assistance
performing her job duties. The plaintiff denied that she needed any
assistance. Thereafter, Mr. Augustine sent the plaintiff an email four
days later detailing instances of her insufficient, untimely, and missing
documentation and asked that the plaintiff update the patients’ records
with any necessary information.
Despite her interactions with Mr. Augustine, the plaintiff continued
to struggle in her position as she consistently failed to submit required
documents and meet Geisinger’s standards for patient touches and new
enrollments throughout 2022. As a response to the plaintiff ’s workplace
performance, Mr. Augustine contacted the plaintiff on March 3, 2022, and
offered to have nurse educator Tammy Pittsman meet with her during
the workday to determine whether the plaintiff needed assistance to
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complete 	her 	daily 	goals. 	Ms. 	Pittsman 	performed 	the 	orientation
training for the new case manager registered nurses and if needed,
offered additional training and education to those registered nurses. The
plaintiff accepted Mr. Augustine’s offer, and on March 14, 2022, she met
with Ms. Pittsman. The plaintiff was given tips, training, and assistance
to help her improve her workplace performance.
At 	that 	time, 	the 	plaintiff 	had 	a 	personal 	notebook 	full 	of
outstanding patient notes for approximately forty-five patients. Due to
those unfinished notes, Ms. Pittsman, Mr. Augustine, and the plaintiff
agreed on an action plan to help the plaintiff complete her overdue
documentation. The plaintiff agreed to spend the last hour of each
workday charting the overdue documents in her personal notebook and
promised to arrive early to work to complete that documentation. Despite
that action plan, the plaintiff failed to make any significant progress with
her documentation. She repeatedly submitted required documentation
late and, at times, failed to submit it altogether. The plaintiff explained
that she failed to do so because she was busy with her children and her
cleaning business.
On March 23, 2022, as the first step in Geisinger’s discipline
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process, the plaintiff received a verbal warning for her work performance.
The plaintiff ’s warning provided her with the specific dates and instances
in which she failed to submit her required documentation and failed to
meet Geisinger’s overall expectations. The warning also detailed the
plaintiff ’s failure to meet Geisinger’s standard for daily patient touches
in addition to the plaintiff ’s persistent problem in writing patient notes
in 	her 	own 	personal 	notebook 	rather 	than 	in 	Geisinger’s 	systems.
Although she had the ability to do so, the plaintiff chose not to submit
any comments or questions in response to her verbal warning.
On May 23, 2022, Mr. Augustine held a Teams meeting with the
plaintiff to help her improve her work performance. Mr. Augustine
provided 	the 	plaintiff 	with 	recommendations 	on 	how 	to 	document
patients in real time while teaching her different ways to submit her
documents 	so 	that 	the 	plaintiff 	could 	better 	meet 	Geisinger’s
expectations. Nonetheless, on June 17, 2022, the plaintiff received a
written warning as part of the second step in Geisinger’s discipline
process for her continued failure to meet Geisinger’s expectations of
submitting documentation. The plaintiff ’s warning again provided her
with the specific dates and instances that she failed to submit her
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required documentation and meet Geisinger’s overall expectations. Mr.
Augustine again offered to have another case manager registered nurse
cover the plaintiff ’s shift so that the plaintiff could focus on completing
her overdue documentation. The plaintiff declined Mr. Augustine’s offer.
In response, Mr. Augustine met with the plaintiff not only to discuss
her repeated failure to submit her requirement documentation, but also
to address her failure to arrive to work on time. Geisinger’s policies
require case manager registered nurses to report to work on time and
notify their supervisor if they are going to be late for any reason,
including reasons related to work. Generally, Geisinger case manager
registered nurses began work at 8:00 a.m. to input required documents
and call their assigned patients before many of those patients begin their
days. Mr. Augustine, however, allowed the plaintiff to begin working a
few minutes after 9:00 a.m. during the school year so that she could drop
her children off at school or at their bus stop. Despite Mr. Augustine’s
accommodations, the plaintiff consistently arrived to work after 9:00 a.m.
On June 17, 2022, the plaintiff reported to work at 10:15 a.m., failing to
notify Mr. Augustine that she was going to be late for work that day. On
at 	least 	two 	other 	occasions, 	the 	plaintiff 	arrived 	at 	work 	at
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approximately 10:45 a.m. without notifying Mr. Augustine. In response,
Mr. Augustine met with the plaintiff and reiterated to her that it was
exceptionally important for her to let him know when she was going to
be late for work in the future, even for work-related reasons.
Later that year, in response to the plaintiff ’s continuing struggles,
Mr. Augustine cancelled one of the plaintiff ’s training sessions and
rescheduled 	it 	for 	September 	of 	2022. 	The 	cancellation 	eliminated
approximately sixteen hours of training to give the plaintiff additional
time to clean up her calendar and complete her overdue documentation.
On 	September 	23, 	2022, 	after 	consistently 	failing 	to 	meet
Geisinger’s expectations to timely submit requirement documentation,
Mr. Augustine issued the plaintiff a suspension as the next step in the
discipline process. The suspension provided the plaintiff specific dates
and instances that she failed to submit requirement documentation and
included an action plan to improve the plaintiff ’s performance. The
plaintiff ’s action plan included completing all overdue charting by the
end of September of 2022. The plaintiff, however, failed to complete these
assignments.
By May 2022, the clinic consistently advised Mr. Augustine that the
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plaintiff was frequently absent from her job when she was needed to
discuss her assigned patients, particularly in the morning hours. On May
31, 2022, after investigating the plaintiff ’s arrival times, Mr. Augustine
confirmed 	the 	clinic’s 	concerns 	as 	he 	checked 	the 	plaintiff ’s 	work
computer and saw no record of her logging into that computer at all the
previous Wednesday or Friday. That same day, the plaintiff was observed
arriving at work at 11:30 a.m. and leaving at 2:00 p.m. for lunch.
Moreover, the plaintiff was observed arriving at work around 10:30 a.m.
the following day. The clinic again notified Mr. Augustine that the
plaintiff ’s tardiness was becoming a daily issue. Indeed, in November of
2022, one of the plaintiff ’s assigned members asked her pharmacist if she
could get a new case manager registered nurse because she could never
contact the plaintiff.
In total, the plaintiff swiped her badge and arrived at her clinic for
the first time after 9:10 a.m. on the following occasions:
a. Three (3) times in March 2021;
b. Ten (10 times in April 2021;
c. 	Five (5) times in May 2021;
d. Thirteen (13) times in June 2021;
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e. Ten (10) times in July 2021;
f. 	Fifteen (15) times in August 2021;
g. Fourteen (14) times in September 2021;
h. Eleven (11) times in October 2021;
i. 	Seventeen (17) times in November 2021;
j. 	Fifteen (15) times in December 2021;
k. Four (4) times in January 2022;
l. 	Fifteen (15) times in February 2022;
m. Eleven (11) times in March 2022;
n. Twelve (12) times in April 2022;
o. Fourteen (14) times in May 2022;
p. Sixteen (16) times in June 2022;
q. Four (4) times in July 2022;
r. 	Eighteen (18) times in August 2022;4
s. 	Eight (8) times in September 2022;
t. 	Six (6) times in October 2022;
u. Fourteen (14) times in November 2022; and
4 Geisinger states, and the plaintiff confirms, that the work log
shows that the plaintiff failed to arrive for work on time a single day in
the month of August of 2022.
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v. Fourteen (14) times in December 2022.
The plaintiff cannot confirm where she was before her first badge swipe
any day between March of 2021 and January 5, 2023.5
On 	January 	6, 	2023, 	Mr. 	Augustine 	and 	Jennifer 	Remetta,
Geisinger’s Director of Care Coordination and Integration, arrived at the
plaintiff ’s clinic to inform her that she was being terminated due to her
consistent failure to adequately perform her job duties. The plaintiff,
however, was still at home and had failed to inform Mr. Augustine that
she would be late to work on that date. At approximately 10:00 a.m., Mr.
Augustine called the plaintiff and asked if she was coming to work that
day. The plaintiff responded that she would come to work as soon as
possible and subsequently arrived at the clinic fifteen minutes after her
conversation with Mr. Augustine. The plaintiff was then informed that
she 	was 	terminated 	from 	her 	employment 	with 	Geisinger 	for 	her
5 	Geisinger 	notes 	two 	further 	reasonings 	for 	the 	plaintiff ’s
termination. The plaintiff created social media content at work that was
unrelated to her job duties and on at least three occasions, the plaintiff
made TikTok videos at work just for fun. Moreover, the plaintiff would
discuss her cleaning business with a fellow employee while at work,
which resulted in the clinic receiving many complaints that she was
working on her cleaning company schedules during working hours.
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continued performance issues.
Beyond the plaintiff ’s failure to complete her job duties, Geisinger
also cites the plaintiff ’s poor attendance as reasons for her termination.
As early as February 2022, Geisinger received complaints that the
plaintiff was never at work when she was supposed to be speaking to her
patients. The first documented complaint was received on February 10,
2022, when the plaintiff arrived to work shortly before 11:00 a.m. and left
the clinic between 12:45 p.m. and 2:45 p.m. without explanation. The
clinic reported this incident to Mr. Augustine and advised him that it had
voiced prior concerns about the plaintiff ’s poor attendance and tardiness.
II. 	Legal Standard
Rule 56 of the Federal Rules of Civil Procedure dictates summary
judgment should only be granted if “there is no genuine dispute as to any
material fact and the movant is entitled to judgment as a matter of law.”
Fed. R. Civ. P. 56(a). A fact is “material” only if it might affect the outcome
of the case.
Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A
dispute of material fact is “genuine” only if the evidence “is such that a
reasonable jury could return a verdict for the non-moving party.”
Id. at
248. In deciding a summary judgment motion, all inferences “should be
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drawn in the light most favorable to the non-moving party, and where the
non-moving party’s evidence contradicts the movant’s, then the non-
movant’s must be taken as true.”
Pastore v. Bell Tel. Co. of Pa., 24 F.3d
508, 512 (3d Cir. 1994).
Parties seeking summary judgment bear “the initial responsibility
of 	informing 	the 	district 	court 	of 	the 	basis 	for 	its 	motion,” 	and
demonstrating the absence of a genuine dispute of material fact.
Celotext
Corp. v. Catrett, 477 U.S. 317, 323 (1986). If the movant makes such a
showing, the non-movant must set forth specific facts, supported by the
record, 	demonstrating 	that 	“the 	evidence 	presents 	a 	sufficient
disagreement to require submission to the jury.”
Anderson, 477 U.S. at
251–52. A court must first determine if the moving party has made
prima
facie showing that it is entitled to summary judgment when evaluating
such a motion.
See Fed. R. Civ. P. 56(a);
Celotex, 477 U.S. at 331. Only
once that
prima facie showing has been made does the burden shift to the
nonmoving party to demonstrate the existence of a genuine dispute of
material fact.
See Fed. R. Civ. P. 56(a);
Celotex, 477 U.S. at 331.
Parties may cite to “particular parts of materials in the record,
including 	depositions, 	documents, 	electronically 	stored 	information,
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affidavits or declarations, stipulations (including those made for the
purposes of the motion only), admissions, interrogatory answers or other
materials.” Fed. R. Civ. P. 56(c)(1)(A). “An affidavit or declaration used to
support or oppose a motion must be made on personal knowledge, set out
facts that would be admissible in evidence, and show that the affiant or
declarant is competent to testify on the matters stated.” Fed. R. Civ. P.
56(c)(4). “Although evidence may be considered in a form which is
inadmissible at trial, the content of the evidence must be capable of
admission at trial.”
Bender v. Norfolk S. Corp., 994 F. Supp. 2d 593, 599
(M.D. Pa. 2014);
see also Pamintuan v. Nanticoke Mem’l Hosp., 192 F.3d
378, 387 n.13 (3d Cir. 1999) (noting that it is not proper, on summary
judgment, to consider evidence that is not admissible at trial).
III. 	Discussion
The plaintiff has alleged claims of discrimination, retaliation, and
failure to accommodate under the ADA and the PHRA. Claims under the
ADA and 	the 	PHRA are 	analyzed 	under 	the 	same 	burden-shifting
framework set forth in
McDonell Douglas Corp v. Green, 411 U.S. (1973).
See generally Salley v. Circuit City Stores, Inc., 160 F.3d 977, 979 n.1 (3d
Cir. 1998) (“[A] claim under the PHRA is coextensive with a claim under
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the ADA.”);
Kelly v. Drexel Univ., 94 F.3d 102, 105 (3d Cir. 1996) (noting
that “Pennsylvania courts … generally interpret the PHRA in accord with
its federal counterparts”). This framework applies to both claims of
discrimination and retaliation.
See Fowler v. AT&T, Inc., 19 F.4th 292,
298 (3d Cir. 2021) (discrimination);
Shaner v. Synthes, 204 F.3d 494, 500
(3d Cir. 2000) (retaliation). As summarized by the Supreme Court, under
McDonnell Douglas:
[A] plaintiff must first establish a prima facie case of
discrimination. The burden then shifts to the employer
to articulate a legitimate, nondiscriminatory reason for
its 	employment 	action. 	If 	the 	employer 	meets 	this
burden, the presumption of intentional discrimination
disappears, but the plaintiff can still prove disparate
treatment 	by, 	for 	instance, 	offering 	evidence
demonstrating 	that 	the 	employer’s 	explanation 	is
pretextual.
Raytheon Co. v. Hernandez, 540 U.S. 44, 49 n.3 (2003) (citations omitted).
A. Plaintiff ’s Discrimination Claims
Under the first step of
McDonnell Douglas, to establish a prima
facie case of discrimination under the ADA and the PHRA, a plaintiff
must establish that: (1) he was disabled; (2) he was otherwise qualified
for the position at issue, with or without reasonable accommodation; (3)
he was subject to an adverse employment action; and (4) the adverse
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employment action was because of his disability.
See Fowler, 19 F.4th at
299;
Sulima v. Tobyhanna Army Depot, 602 F.3d 177, 185 (3d Cir. 2010).
Here, 	Geisinger 	moves 	for 	summary 	judgment 	contesting 	the 	first,
second, and fourth elements by arguing that the plaintiff has failed to
establish that she was disabled, that she was qualified for her position,
and that her termination was connected to her disability.6
Under the first element, the ADA defines a “disability” as “(1) a
physical or mental impairment that substantially limits one or more
major life activities of such individual; (2) a record of such impairment;
or (3) being regarded as having such an impairment.” 42 U.S.C. §
12102(1). A plaintiff is disabled within the meaning of the ADA only if
she had a disability at the time of the adverse employment decision.
Rahsman 	v. 	Dewberry-Goodkind, 	Inc., 	No. 	1:05-CV-1931, 	2007 	WL
188571, at *6 (M.D. Pa. Jan. 22, 2007). Here, the plaintiff contends that
her attention-deficit disorder (“ADD”) diagnosis meets the definition of a
6 There is no dispute that the plaintiff ’s termination constitutes an
adverse employment action, as adverse employment actions include “all
tangible employment actions ‘such as hiring,
firing, failing to promote,
reassignment 	or a 	decision causing 	significant 	change 	in benefits.’”
Sherrod v. Philadelphia Gas Works, 57 F. App’x. 68, 73 (3d Cir. 2003)
(quoting
Burlington Indus., Inc. v. Ellerth, 524 U.S. 742, 761 (1998))
(emphasis added).
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“disability” because it constitutes a physical or mental impairment that
substantially limits a major life activity. In response, Geisinger argues
that the plaintiff has failed to show that her ADD diagnosis affected any
major life activities.
While an ADD (or ADHD) diagnosis can serve as a “disability”
under the ADA,
see Gibbs v. City of Pittsburgh, 989 F.3d 226, 229 (3d Cir.
2021), the Third Circuit has held that a diagnosis alone is insufficient to
establish an ADA disability.
Tice v. Centre Area Transp. Auth., 247 F.3d
506, 513 n. 5 (3d Cir. 2001). “Rather, the inquiry as to disability is to be
made on a case-by-case basis.”
Id. Here, the plaintiff argues that her ADD
diagnosis substantially limited her ability to “focus[] on one thing” and
made it difficult to “switch[] to another task.” (Doc. 28, at 12) (“Plaintiff
informed Mr. Augustine that she struggled with prioritizing and that she
becomes hyper focused.”). The plaintiff ’s limitations, however, are not
enough to serve as a substantial limit to a major life activity.
There is no doubt that concentrating and thinking are major life
activities.
See, e.g., Gagliardo v. Connaught Labs., Inc., 311 F.3d 565, 569
(3d Cir. 2002) (concentrating);
Taylor v. Phoenixville Sch. Dist., 184 F.3d
296, 307 (3d Cir. 1999) (thinking). But there is nothing in the record that
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indicates that the plaintiff is substantially impaired, rather than slightly
or moderately impaired, in her ability to think or concentrate as a
symptom of his ADD diagnosis.
Collins v. Prudential Inv. & Ret. Servs.,
119 F. App’x 371, 376 (3d Cir. 2005) (“We do not intend to be uncharitable
in noting that [the plaintiff] describes difficulties that many people who
are not suffering from ADHD/ADD must regularly cope with … [but] [a]t
most, the impact on thinking, learning, concentrating and remembering
can be accurately characterized as moderate.”);
Warshaw v. Concentra
Health 	Servs., 	719 	F. 	Supp. 	2d 	484, 	495 	(E.D. 	Pa. 	2010) 	(“As 	for
[plaintiff ’s] 	remaining 	difficulties–in 	multitasking, 	maintaining
attention and focus, and pacing his work–although plaintiff is limited to
some degree in these areas, there is no indication that these limitations
are substantial or severe.”);
see Dlugos v. Eastman Kodak Co., No. 95-
1525, 1996 WL 679411, at *5 (W.D. Pa. Sept. 5, 1996) (rejecting the notion
that a plaintiff ’s concentration was seriously impaired because, as a
result of his condition, “[a]n extra effort was required to concentrate,
particularly on detailed paperwork”). Indeed, the plaintiff conveyed to
Geisinger numerous times that her diagnosis did not impact her work
productivity. (Doc. 26, ¶ 101) (“Plaintiff specifically told Mr. Augustine
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that she was recently diagnosed with ADD and she was still doing
everything she was doing before…”); (
Id., ¶¶ 106, 107) (confirming in
writing that she was capable of doing her job duties); (
Id., ¶ 175) (“Even
after advising Mr. Augustine that she had been diagnosed with ADD,
Plaintiff confirmed to Mr. Augustine that she did not require any type of
accommodation to perform her job duties.”). Her admissions run counter
to her allegations that her major life activities were substantially limited.
See 	Warshaw, 	719 	F. 	Supp. 	2d 	at 	495 	(finding 	that 	the 	plaintiff ’s
admission 	that 	his 	ADHD 	diagnosis 	did 	not 	affect 	any 	“day-to-day
activities” provided “no evidence from which a reasonable fact-finder
could determine that plaintiff is substantially limited…”). Therefore, the
plaintiff ’s ADD diagnosis in this action does not fall under the definition
of “disability” for her discrimination claim under the ADA.
The plaintiff also argues, however, that her ADD diagnosis qualifies
as a “disability” under the ADA because Geisinger regarded her as having
such 	an 	impairment. 	A person 	is 	regarded 	as 	disabled 	when 	“the
employer either ‘mistakenly believed that the employee has a physical
[or mental] impairment that substantially limits one or more major life
activities’ or ‘mistakenly believed that an actual non-limiting impairment
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substantially limits one or more major life activities.’”
Sulima, 602 F. 3d
at 188;
see also 42 U.S.C. § 12102(3)(A). Here, a genuine dispute of
material fact remains as to whether Mr. Augustine perceived the plaintiff
as having an impairment due to her ADD diagnosis. There is no dispute
that on August 20, 2021, the plaintiff shared with Mr. Augustine through
email that she had been diagnosed with ADD in the last six months, and
therefore, Mr. Augustine would have had knowledge about that diagnosis
at the time of the underlying events. (Doc. 26, ¶¶ 98, 99). In response,
Geisinger notes that “the mere fact that an employer is aware of an
employee’s impairment is insufficient to demonstrate that the employer
regarded the employee as disabled or that the perception caused the
adverse employment action.”
Kelly, 94. F.3d at 109. But the record shows
that not only was Mr. Augustine aware of the diagnosis, but he also
consistently accommodated, or tried to accommodate, the plaintiff due to
her work performance struggles potentially due to her ADD. (Doc. 26, ¶
111) (“[Mr. Augustine] regularly asked [plaintiff] whether she required
any assistance in the workplace.”); (
Id., ¶ 123) (“Mr. Augustine contacted
Plaintiff and offered to have Nurse Educator Tammy Pittsman sit with
her during a workday to see if there was anything Ms. Pittsman could do
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to help Plaintiff complete her daily goals.”); (
Id., ¶ 160) (“Mr. Augustine
also cancelled a training that Plaintiff was scheduled to attend and
rescheduled the training for September 2022.”). Therefore, a reasonable
factfinder could conclude that Mr. Augustine perceived the plaintiff as
having a disability due in part to his awareness of her diagnosis and his
attempts to accommodate her throughout her employment.
Having established that the plaintiff survives the first element of
her prima facie discrimination case, we turn to Geisinger’s argument that
the plaintiff has failed to show under the second element that she was
otherwise qualified for her position. We also find, however, that there is
a genuine dispute of material fact as to this prong that prevents the
granting of summary judgment. It is undisputed that one of the essential
duties 	of 	the 	case 	manager 	registered 	nurse 	position 	concerns 	the
required documentation for all case management activities, (Doc. 26, ¶
37), and a review of the record supports the assertion that the plaintiff
struggled with this area of her workplace performance. (
Id., ¶¶ 64–184).
Indeed, the plaintiff admits as much.
See (
Id., ¶ 88) (“Plaintiff admitted
to missing these deadlines and acknowledged that she was behind on her
required 	SNP 	assessments”); 	(
Id., 	¶ 	134) 	(“Plaintiff 	informed 	Mr.
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Augustine that she was not able to complete as much back charting as
she hoped….”). But the job duties of a case manager registered nurse at
Geisinger include more than just the maintenance of all requirement
documents for case management activities.
See (
Id., ¶ 36) (listing other
duties such as “integrating clinical guidelines; developing systems of
care; assisting with the design, implementation, and evaluation of the
advanced patient center care model…”). Indeed, the record before us is
limited to only one aspect of the plaintiff ’s job duties, the maintenance of
requirement documents, rather than speaking on the qualifications of all
functions of the plaintiff ’s job. Thus, viewing the evidence in favor of the
non-moving plaintiff, the incomplete record creates a dispute of material
fact as to the plaintiff ’s qualifications for the entirety of the duties of her
job. Moreover, the plaintiff has identified past favorable performance
reviews in which Mr. Augustine referred to her as a “valued contributor”
in the workplace. (Doc. 28-1, ¶¶ 5,7,10). Therefore, the determination of
whether the plaintiff was qualified for her position is better left to a jury
as 	there 	remains 	a 	genuine 	dispute 	of 	material 	fact 	as 	to 	those
qualifications.
Nonetheless, Geisinger contends that even if the plaintiff has
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satisfied the first three elements of
McDonnell Douglas, the plaintiff has
still 	failed 	to 	show 	that 	the 	plaintiff ’s 	termination 	related 	to 	her
disability 	as 	required 	under 	the 	fourth 	element.
	See 	Emmell 	v.
Phoenixville Hosp. Co. LLC, 303 F. Supp. 3d 314, 332 (E.D. Pa. 2018)
(“Causation is required for both discrimination and retaliation claims
under the ADA.”). “There are two ways to establish a causal connection
under the ADA: (1) where the temporal proximity of the alleged disability
and the adverse employment action are ‘unduly suggestive,’ no other
evidence is required; or (2) where the timing is not ‘unusually suggestive,’
but there is other evidence of discrimination or a ‘pattern of antagonism.’”
Quick v. GEO Grp., Inc., No. 3:18-CV-93, 2020 WL 532343, at *17 (W.D.
Pa. Feb. 3, 2020) (citing
Krouse v. Am. Sterilizer Co., 126 F.3d 494, 503–
04 (3d Cir. 1997)). Here, the plaintiff does not argue that the temporal
proximity 	of 	her 	ADD 	diagnosis 	and 	her 	termination 	are 	“unduly
suggestive,” but rather contends that the evidence in the record directly
shows a causal connection.
The 	plaintiff 	testified 	that 	Mr. 	Augustine 	would 	make
discriminatory comments about her ADD, such as:
He didn’t know how my brain worked, didn’t know how
to 	address 	things 	knowing 	that 	my 	brain 	works
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differently. “ADHD brain.” Or if he would send me a
message that we have to, like, Hey, can you jump on a
call later, it would be, No, don’t get anxious, don’t want
your ADHD to get out of control…. No he would say, I
don’t know how to help you with the way your brain
works or your ADHD brain.
(Doc. 28-1, ¶ 33). The plaintiff ’s testimony indicates that at a minimum,
Mr. Augustine perceived the plaintiff ’s ADD diagnosis as a negative and
contributing factor in her overall workplace performance. We find that
based on this premise, a reasonable factfinder could conclude that the
plaintiff ’s 	termination 	stemmed 	from 	Geisinger’s 	perception 	of 	the
negative 	implications 	of 	the 	plaintiff ’s 	disability. 	Geisinger 	argues
otherwise, contending that the record unequivocally shows that the
plaintiff ’s termination was based on her workplace performance rather
than her disability. But Geisinger’s assertion merely creates a genuine
dispute of material fact as to the cause of the plaintiff ’s termination, and
as we have indicated above, these types of disputes are better left to the
jury. Therefore, the plaintiff has provided enough evidence under step
one of
McDonell Douglas to survive Geisinger’s motion for summary
judgment.
But 	the 	plaintiff 	must 	also 	show 	evidence 	of 	pretext 	for 	her
termination as required under the third step in
McDonell Douglas to
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survive summary judgment. The third step of the
McDonell Douglas
framework requires a plaintiff to:
identify[] 	evidence 	from 	which 	a 	factfinder 	could
reasonably 	either 	(1) 	disbelieve 	the 	employer’s
articulated legitimate reasons; or (2) believe that an
invidious discriminatory reason was more likely than
not 	a 	motivating 	or 	determinative 	cause 	of 	the
employer’s action. A plaintiff must do more than simply
claim a decision was wrong or mistaken to discredit a
proffered justification. The plaintiff must demonstrate
such 	weaknesses, 	implausibilities, 	inconsistencies,
incoherencies, 	or 	contradictions 	in 	[the 	employer’s]
proffered 	legitimate 	reasons 	for 	its 	action 	that 	a
reasonable 	factfinder 	could 	rationally 	find 	them
unworthy of credence, and hence infer that the employer
did not act for the asserted non-discriminatory reasons.
Duran v. Cnty. of Clinton, 380 F. Supp. 3d 440, 452 (M.D. Pa. 2019)
(citations, 	internal 	quotation 	marks, 	and 	brackets 	omitted). 	Here,
Geisinger proffers that it terminated the plaintiff due to her workplace
performance, citing the plaintiff ’s failure to complete her necessary tasks
and her tardiness from work, among other issues, as justification for that
action. The plaintiff therefore bears the burden to demonstrate “such
weaknesses, 	implausibilities, 	inconsistencies, 	incoherencies, 	or
contradictions in [the employer’s] proffered legitimate reasons for its
action that a reasonable factfinder could rationally find them unworthy
of credence.”
Lichtenstein v. Univ. of Pittsburgh Med. Ctr., 691 F.3d 294,
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310 (3d Cir. 2012) (quoting
Fuentes v. Perskie, 32 F.3d 759, 764 (3d Cir.
1994)). We find that she has done so here.
We 	note 	again 	the 	plaintiff ’s 	testimony 	that 	Mr. 	Augustine
consistently made discriminatory comments about her ADD.
See (Doc.
18-1, ¶ 33). As we did above, we find that a reasonable factfinder could
conclude, based on Mr. Augustine’s comments, that the plaintiff ’s ADD
diagnosis served as the underlying justification for her termination. In
doing so, we acknowledge that Geisinger identifies multiple instances in
the record that it argues demonstrates that the plaintiff was terminated
for failure to perform her essential job duties. But this determination is
one for the factfinder and therefore must be decided by a jury. For these
reasons, 	Geisinger’s 	motion 	for 	summary 	judgment 	concerning 	the
plaintiff ’s discrimination claim will be denied.
B. Plaintiff ’s Retaliation Claims
The plaintiff ’s retaliation claims are analyzed under the same
McDonnell Douglas framework as her discrimination claims.
Shaner, 204
F.3d at 500. To establish a prima facie case of retaliation under the first
step of the
McDonnell Douglas framework, a plaintiff must show: “(1)
protected employee activity; (2) adverse action by the employer after or
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contemporaneous with the employee’s protected activity; and (3) a causal
connection between the employee’s protected activity and the employer’s
adverse action.”
Jones v. Se. Pa. Transp. Auth., 796 F.3d 323, 329 (3d Cir.
2015). Unlike with the plaintiff ’s discrimination claim, however, the
plaintiff has failed to establish a prima facie case of retaliation to
preclude the granting of summary judgment.
The plaintiff argues that Geisinger retaliated against her when she
requested accommodations for her disability. Under the first element, a
request for an accommodation for a disability is a protected activity for
purposes 	of 	a 	claim 	under 	the 	ADA.
	See 	Shellenberger 	v. 	Summit
Bancorp, Inc., 318 F.3d 183, 190–191 (3d Cir. 2003);
Abramson v. William
Paterson Coll. of N.J., 260 F.3d 265, 288 (3d Cir. 2001). But we note that
whether the plaintiff requested an accommodation for her disability is
convoluted. The plaintiff has alleged in passing two accommodations in
her own “Statement of Facts” that are neither substantiated by the record
nor advanced in any of her briefs.
See (Doc. 28-1, ¶ 31) (alleging that she
asked for an additional case manager at her clinic and asked not to be
moved 	to 	a 	different 	office). 	But 	“unsupported 	allegations 	in 	…
memorand[a] 	and 	pleadings 	are 	insufficient 	to 	repel 	summary
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judgment.”
Schoch v. First Fidelity Bancorporation, 912 F.2d 654, 657 (3d
Cir. 1990);
see also Longstreet v. Holy Spirit Hosp., 67 F. App’x 123, 126
(3d 	Cir. 	2003) 	(finding 	that 	a 	non-moving 	party 	cannot 	rely 	on
“unsupported assertions, speculation, or conclusory allegations” to defeat
a 	summary 	judgment 	motion). 	The 	plaintiff 	has 	therefore 	failed 	to
substantiate these allegations of a protected activity at the summary
judgment stage. Moreover, the plaintiff alleges that she requested that
her Special Needs Program assessments, ones that required the most
amount of time, be moved over to the dedicated Special Needs Program
team.
See (Doc. 28-1, ¶¶ 26, 27, 28) (“[Geisinger] has an SNP team that
is dedicated to just doing SNP comprehensive annual assessments” and
“Plaintiff asked Mr. Augustine ‘[f]or the assessments that were due to be
put on the SNP team so that there wouldn’t be a chance of them being
late.’”). But contrary to this assertion, the plaintiff also conversely admits
that she never reached out to Mr. Augustine or anyone on the Geisinger
team to ask for help regarding her missed Special Needs Program
assessments. (Doc. 29, ¶ 89). It is unclear whether the plaintiff asked for
accommodations concerning her Special Needs Program assessments. We
find that this uncertainty alone regarding the plaintiff ’s alleged actions
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casts grave doubt on the plaintiff ’s retaliation claim and provides a
sufficient basis for granting Geisinger’s motion for summary judgment.
Nonetheless, even if we view the record in light most favorable to
the plaintiff and find that there remains a genuine dispute of material
fact as to this prong preventing summary judgment, the plaintiff has also
failed to prove a causal connection between her ask of accommodations
concerning the Special Needs Program assessments and her subsequent
termination. Again, “[t]here are two ways to establish a causal connection
under the ADA: (1) where the temporal proximity of the alleged disability
and the adverse employment action are ‘unduly suggestive,’ no other
evidence is required; or (2) where the timing is not ‘unusually suggestive,’
but there is other evidence of discrimination or a ‘pattern of antagonism.’”
Quick, 2020 WL 532343, at *17. The plaintiff fails to identify any
evidence 	of 	a 	pattern 	of 	antagonism 	stemming 	from 	her 	ask 	of
accommodations concerning her Special Needs Program assessments.
Therefore, the plaintiff ’s retaliation claim 	relies upon the temporal
proximity of her protected activity and her termination as “unduly
suggestive.”
The Third Circuit has held that “[a]lthough there is no bright line
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rule as to what constitutes unduly suggestive temporal proximity, a gap
of three months between the protected activity and the adverse action,
without 	more, 	cannot 	create 	an 	inference 	of 	causation 	and 	defeat
summary judgment.”
LeBoon v. Lancaster Jewish Cmty. Ctr. Ass’n, 503
F.3d 217, 233 (3d Cir. 2007) (citing
Clark Cnty. Sch. Dist. v. Breeden, 532
U.S. 268, 273 (2001)). Here, in light of that foundation, no reasonable
factfinder could find that the temporal proximity between the plaintiff ’s
protected activity and her termination are “unduly suggestive.” The
plaintiff states that she made her request for accommodations “within
the spring to summer of 2021.” (Doc. 28-1, ¶ 29). But the plaintiff was not
terminated until January 6, 2023. (Doc. 26, ¶ 184). Therefore, at a
minimum, a gap of eighteen months existed between the protected
activity and the adverse action. This temporal proximity, without more,
cannot create an inference of causation, and as we noted above, the
plaintiff has failed to identify any potentially discriminatory actions
suggesting a causal connection between her accommodations request and
her firing. 	Therefore, the plaintiff ’s failure to demonstrate a casual
connection between her ask for accommodations and her termination
additionally prove a sufficient basis to grant Geisinger’s motion for
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summary judgment on this claim. We need not analyze the third step of
McDonell Douglas to determine pretext.
C. Plaintiff ’s Failure to Accommodate Claims
A plaintiff bringing a failure-to-accommodate claim must establish:
“(1) he was disabled and his employer knew it; (2) he requested an
accommodation or assistance; (3) his employer did not make a good faith
effort to assist; and (4) he could have been reasonably accommodated.”
Capps v. Mondelez Glob., LLC, 847 F.3d 144, 157 (3d Cir. 2017) (quoting
Armstrong v. Burdette Tomlin Mem’l Hosp., 438 F.3d 240, 246 (3d Cir.
2006)). Geisinger has moved for summary judgement, arguing that the
plaintiff has failed to establish all four elements of her claim.
Upon review of the record, the plaintiff has demonstrated enough
evidence to survive the first element of her failure-to-accommodate claim.
As we held for the plaintiff ’s discrimination claim, a genuine dispute of
material fact still exists as to whether the plaintiff ’s ADD diagnosis
qualified as a disability and whether the Geisinger regarded her as
having such an impairment. But regarding the second element, the
plaintiff ’s request for accommodations is based on the same Special
Needs Program assessments as her retaliation claim, and as we noted
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before, the plaintiff ’s convoluted answer as to whether she even asked for
assistance for those assessments casts grave doubt on her failure-to-
accommodate claim. This uncertainly alone supports the granting of
Geisinger’s motion for summary judgment.
Nonetheless, even if we view the record in light most favorable to
the plaintiff and find that there remains a genuine dispute of material
fact as to this prong that prevents summary judgment, we find that no
reasonable factfinder could conclude that Geisinger failed to make a good
faith effort to assist the plaintiff with her ADD diagnosis. The plaintiff
alleges that Geisinger failed to make a good faith effort to accommodate
her Special Needs Program assessments and decrease her workload.
(Doc. 28, at 18–20). But even if the plaintiff ’s allegations are true, for
which 	we 	note 	that 	the 	plaintiff 	has 	provided 	little 	evidence, 	the
plaintiff ’s allegations ignore the multitude of accommodations provided
by Geisinger in the record before the Court. The plaintiff admits that
throughout her employment Geisinger offered her additional time to
complete tasks while decreasing her workload and offering her added
assistance. (Doc. 26, ¶¶ 82–83, 86, 116–119, 124–126, 160–162, 169–170).
The record demonstrates that Mr. Augustine regularly checked in with
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the plaintiff about her performance (
id., ¶ 111), directed other registered
nurses to cover the plaintiff ’s shifts and daily duties when necessary (
id.,
¶¶ 169–170), allowed the plaintiff to arrive at work after 9:00 a.m. (
id., ¶
150), permitted the plaintiff to work from home to minimize distractions
(
id., ¶171), created action plans for the plaintiff when she was struggling
(
id., 	¶ 	123), 	and 	cancelled 	training 	sessions 	to 	allow 	the 	plaintiff
additional time to finish her uncompleted work. (
Id., ¶ 160). All of these
actions, among other accommodations, constitute “reasonable efforts to
assist the employee and communicate with the employee in good faith.”
Mengine v. Runyon, 114 F.3d 415, 416 (3d Cir. 1997). No reasonable
factfinder could conclude otherwise. Therefore, because the plaintiff has
failed 	to 	identify 	sufficient 	evidence 	to 	support 	her 	failure-to-
accommodate claim, Geisinger’s motion for summary judgment will be
granted as to this claim.
IV. 	Conclusion
For 	the 	foregoing 	reasons, 	Geisinger’s 	motion 	for 	summary
judgment will be granted in part and denied in part. Geisinger’s motion
for 	summary 	judgment 	will 	be 	granted 	concerning 	the 	plaintiff ’s
retaliation and failure-to-accommodate claims. Geisinger’s motion for
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summary judgment will be denied as to the plaintiff ’s discrimination
claim.
An appropriate order follows.
Dated: February 9, 2026
	s/Joseph F. Saporito, Jr.
JOSEPH F. SAPORITO, JR.
United States District Judge
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