Santos v. McDonough

District Court, District of Columbia·Decided July 10, 2025·No. Civil Action No. 2024-1759·Published

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

LAURETTE SANTOS,

Plaintiff,

v. Civil Action No. 24-1759 DOUGLAS A. COLLINS, Secretary, Department of Veterans Affairs,

Defendant.

MEMORANDUM OPINION

For years, Laurette Santos, a blind Department of Veterans Affairs (“VA”) employee, relied on a screen-reader software called Job Access With Speech (“JAWS”) to operate VA’s electronic health record system (“EHR”). But in June 2022, Santos’s VA facility switched to a new EHR—one incompatible with JAWS. After raising the inaccessibility issues to VA to no avail, Santos brought this lawsuit, alleging that VA’s deployment of the new EHR and failure to provide her with a reasonable accommodation violate Sections 508 and 501 of the Rehabilitation Act of 1973. See 29 U.S.C. §§ 794, 794d(a)(1)(A). Now VA moves to dismiss Santos’s complaint for lack of subject matter jurisdiction and failure to state a claim.

BACKGROUND1

Santos is a licensed social worker who has worked at VA’s White City, Oregon, location for over a decade. Am. Compl. [ECF No. 23] ¶¶ 13–14. Since 2019, she has served as the

1 The following facts are from Santos’s amended complaint because, on a motion to dismiss, a court generally accepts a plaintiff’s well-pleaded allegations as true. See Cunningham v. Cornell Univ., 145 S. Ct. 1020, 1025 n.2 (2025). Throughout this Opinion, the Court also cites to the Equal Employment Opportunity Commission (“EEOC”) record where relevant. See Ndondji v. InterPark Inc., 768 F. Supp. 2d 263, 272 (D.D.C. 2011) (courts can consider public records, such as administrative records, when ruling on a motion to dismiss for failure to state a claim).

location’s Visual Impairment Services Team (“VIST”) coordinator, meaning she “is responsible for coordinating all services for visually impaired veterans and service members and their families.” Id. ¶ 15. That breaks down into an array of duties, including “referring visually impaired veterans to the appropriate service component in the continuum of care; developing focused treatment plans containing goals to meet the veterans’ needs; . . . providing follow-up for rehabilitation services;” and “assisting veterans and their family members with issues surrounding the emotional adjustment to blindness.” Id.

Those duties require the use of an EHR.2 When Santos became VIST coordinator in 2019, VA’s White City location used an EHR called the Computerized Patient Record System (“CPRS”). Id. ¶ 17. Critically for Santos, CPRS was and is compatible with JAWS, a screen-reader software. Id. ¶ 18. Screen-reader software “monitor[s] computer screen[s] and convert[s] . . . textual information displayed into synthesized speech or into Braille on a device known as a ‘refreshable Braille display.’” Id. ¶ 11. Put simply, the software allows blind people like Santos to review printed materials on computers and other technological devices. See id. ¶ 12.

With JAWS’s help, Santos was able to use CPRS to “perform the essential functions of her job” like making referrals, placing and approving orders for assistance devices, and updating veterans’ health records and other information. Id. ¶ 18. She could perform all these tasks “independently . . . with only limited assistance of [her] sighted assistant.” Id.

However, the whole time Santos was successfully using CPRS, VA was working to replace it. In 2008, Congress required by statute that VA and the Department of Defense (“DoD”) make

2 “An EHR is software that’s used to securely document, store, retrieve, share, and analyze information about patient care” and “enables a digital version of a patient record.” What Is the FEHRM?, Fed. Elec. Health Rec. Modernization, https://www.fehrm.gov/about-fehrm/ (last visited Apr. 29, 2025). Throughout this Opinion, the Court takes judicial notice of government websites. See, e.g., Dastagir v. Blinken, 557 F. Supp. 3d 160, 163 n.3 (D.D.C. 2021).

their EHRs interoperable—a directive Congress reaffirmed and clarified in 2014 and 2020 (together, “the NDAA”).3 See National Defense Authorization Act (“NDAA”) for FY 2008, Pub. L. No. 110-181, § 1635, amended by Duncan Hunter NDAA for FY 2009, Pub. L. No. 110-417, § 252; NDAA for FY 2014 (“2014 NDAA”), Pub. L. No. 113-66, §§ 713(a)–(b), 127 Stat. 672, 794–95; NDAA for FY 2020, Pub. L. No. 116-92, § 715(c), 133 Stat. 1198, 1447–48. To fulfill this mandate, VA decided to acquire the EHR DoD uses: Oracle Cerner EHR (“the Cerner System”). See Joint Audit; Am. Compl. ¶¶ 20–21.

Throughout the acquisition process, the blind community expressed concerns about the risk of VA adopting an EHR system that was incompatible with screen-reader software. Before VA had chosen the Cerner System, the National Federation of the Blind (“NFB”) wrote a letter to VA urging it “and the DOD to select a vendor that would design an accessible system ‘for compatibility with screen-access software.’” Am. Compl. ¶ 19. And when Cerner won the design contract in 2015, NFB urged the corporation to “ensure that its technology be fully accessible” to blind individuals, and to “shar[e] complaints that the NFB had received from blind employees in other workplaces who reported problems accessing Cerner’s EHR system.” Id. ¶ 20.

So, “[w]hen the VA” contracted with Cerner to implement its newly designed Cerner System in 2018, VA “was well aware of the need to meet accessibility requirements.” Id. ¶¶ 19, 21. Yet it did not ensure the Cerner System was compatible with screen-reader software before it entered that contract. See id. ¶ 23. Instead, it included in the contract an ex post requirement that the Cerner System be compatible in the future. See id. ¶ 22.

3 See Inspector Gen. U.S. Dep’t of Def. & Inspector Gen. U.S. Dep’t of Veterans Affs., Joint Audit of the Department of Defense and the Department of Veterans Affairs Efforts to Achieve Electronic Health Record System Interoperability (May 3, 2022), https://media.defense.gov/2022/May/17/2002999634/-1/-1/1/DODIG-2022- 089_508.PDF (“Joint Audit”).

But VA did not require Cerner—or its corporate successor Oracle—to immediately comply with that part of the contract. See id. ¶¶ 24–28. VA knew the Cerner System was not compatible with screen-reader software “[b]y, at latest, October 21, 2019.” Id. ¶ 24. In fact, because VA was aware of the system’s deficiencies, VA asked Santos to work with it and Cerner “to prepare for the rollout of” the Cerner System at the White City facility. See id. ¶ 25. While so involved, Santos began in early 2020 to raise concerns about the Cerner System’s screen-reader compatibility. Id. ¶ 26. Throughout that year and the next, VA conducted numerous audits of the Cerner System—audits that confirmed the system’s incompatibility with screen-reader software. Id. ¶ 27. Despite these audits, the concerns Santos voiced, and VA’s ability to postpone the rollout, VA deployed the Cerner System at the White City facility and one other VA location in June 2022. Id. ¶ 29; EHR Deployment Schedule, U.S. Dep’t of Veterans Affs., https://digital.va.gov/ehr- modernization/ehr-deployment-schedule/ (last visited Apr. 29, 2025). Those two locations joined three others at which VA had already rolled out the Cerner System. See EHR Deployment Schedule.

The deployment of the Cerner System confirmed Santos’s fears. It “has had disastrous consequences for [her] ability to work independently.” Am. Compl. ¶ 31. No longer can she independently fulfill the duties she could with CPRS—e.g., “receiving and making referrals; placing and approving orders for devices, software, and other items for veterans; . . . reading, reviewing, and updating veterans’ records” and “schedul[ing] appointments for veterans or access[ing] Cerner to track upcoming appointments.” Id. ¶¶ 31, 62. She must instead “delegate these tasks to sighted employees” like her sighted assistant and her supervisor. Id. ¶ 32. These difficulties have caused Santos to “suffer discrimination” and “emotional distress.” Id. ¶¶ 63–64.

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