Labor & Employment Law Daily Wrap Up, DISCRIMINATION—DISABILITY—C.D. Ill.: Physician’s assistant whose revenue declined following knee surgery advances bias claims, (Dec 4, 2025)

By Todd Harrison, J.D.

She was presented with a demotion proposal, despite her revenue being on track to meet or exceed projections from when the issue was brought to her attention earlier that year.

A physician’s assistant at an OB/GYN practice can move forward with her ADA and state-law claims for disability discrimination ruled a federal district court in Illinois, finding that an overheard conversation between the practice’s doctor and sole shareholder with an office administrator wherein they discussed the employee being a fall risk could lead a reasonable juror to infer a causal link between the adverse action and the employee’s disability. Further, there was evidence that the reason the employer terminated the employee—for failing to meet business expectations—was pretextual. The court did, however, grant summary judgment against the employee’s ADA and state-law claims for retaliation, finding she did not engage in protected activity (Voegel v. Obstetrics and Gynecology Care Assoc., S.C., No. 23-cv-1459 (C.D. Ill. Dec. 2, 2025)).

The employee worked at the OB/GYN practice as a physician’s assistant from January 3, 2005, until November 18, 2021.

Knee surgeries. In December 2016, the employee underwent a total left knee replacement. However, she still experienced issues in that knee, leading to a revision total knee replacement on October 21, 2020, resulting in her being out of work for several weeks. Prior to this second surgery, the employee had an incident at work where her knee buckled and she fell, although she did not sustain any acute injuries. The clinic’s doctor and the office administrator at the time were aware of the fall.

Nurse practitioner. The employer hired a second mid-level provider, a nurse practitioner, in 2019. The employee had generated more revenue for the office when she was the only mid-level provider as compared to when the nurse practitioner was brought on board.

Revenue discussion. On June 1, 2021, the employer had a meeting with the employee to discuss her declining revenue numbers. The employer projected that the employee’s projected revenue for 2021 would be $181,471.60 should her performance not improve. In making that projection, the employer annualized the employee’s revenue in the first five months of 2021.

Following this meeting, the employee increased her numbers, and by the end of June her projections for the end of the year had increased to $190,780.24. By the end of October, her end-of-year projections were at $196,655.37.

Demotion proposal. On November 11, 2021, the employer met with the employee and presented her with a proposal that would, among other things, decrease her total working hours per week, would make her an hourly employee, and would remove her from the employer’s cell plan. If she refused to accept the proposal, she would be given a severance package. That same day, the employer received a written statement from another worker stating that she had noticed the employee was having trouble with her hands.

The following day, the employee was presented with the choice of either accepting the demotion proposal or the severance package. At the meeting, the employee stated that she believed the employer was trying to get rid of her based on her perceived liability risk, an assertion the employer denied. The employee then left for a prescheduled vacation, returning on November 18 to collect her belongings. The revenue that she had generated for 2021 at that time stood at $180,020.88—or $1,450.72 less than what the employer predicted her total revenue for the year would have been at the June 1 meeting. Subsequently, the employee filed this lawsuit.

Overheard conversation. First, the court addressed the employee’s claims for disability discrimination. Here, the employer alleged that the employee had failed to adequately demonstrate a causal nexus between the adverse employment action and her disability. Specifically, it asserted that the employee was being treated for mobility issues as early as 2015, and it did not seek to change the terms of her employment until more than six years later based on issues related to her productivity.

In response, the employee attested that she overheard a conversation between the clinic’s doctor and a former office administrator shortly after she had fallen at work wherein the doctor stated something to the effect of needing to “get rid of” of the employee because she was a fall risk and was a risk for workers’ compensation.

According to the employer, even if this conversation occurred, it was not enough to support a claim for disability discrimination based on direct evidence because: (1) it was true the employee was a fall risk; and (2) the alleged statement had no temporal proximity to the adverse employment action.

Here, the court noted that the employer admitting the employee’s mobility issues put her at risk for a fall only supported the employee’s position. Further, while the court agreed the issue of temporal proximity weighed in favor of the employer, it could not consider this issue in isolation and must view the evidence in the light most favorable to the employee. As such, a reasonable juror could conclude there was a causal link between the adverse employment action and the employee’s disability.

Patient scheduling. In addition, the employee alleged that the doctor and nurse practitioner had instituted a practice to steer patients away from the employee and to the nurse practitioner, even though it had been the clinic’s policy that patients could choose their medical practitioner. The employer disputed this position, pointing to testimony from its current office administrator. However, the court found that the office administrator’s testimony failed to negate the employee’s position, nor did it touch on why the nurse practitioner was given all of the obstetrics patients and whether she was rebooking the employee’s patients with herself when the patient had not made such a request.

Ultimately, whether patients were being intentionally directed away from the employee was a disputed fact for a jury to decide, said the court.

Pretext. Finally, the employee proffered evidence that the reason she was terminated—for failing to meet business expectations—was pretextual. Prior to the June 1, 2021, meeting there was no evidence that the employer had ever discussed revenue expectations with the employee or that similar expectations were placed on other mid-level providers. Further, the employer used the employee’s revenue from 2017 and 2018 as its benchmark, revenue that was brought in before the nurse practitioner was hired. In addition, at the June 1 meeting, the only expectation placed on the employee was that she increase her revenue by 5-10 percent over the next 30-60 days or her salary would be reduced. After the 60 days had passed, she was given no indication that she was not meeting expectations or that her salary was going to be reduced.

The next time the employer met with the employee was on November 11, the same day it had received a note from a coworker alleging that the employee was having trouble with her hands. At the meeting, the record indicated that the employee was meeting the employer’s revenue expectations for the year.

In response, the employer contended that the amount of revenue the employee had generated at the time of the November meeting—$180,020.22—was close to the $181,471.60 amount it had deemed insufficient at the June meeting. However, observed the court, this figure did not account for the 1.5-2 months of revenue the employee would have generated in November and December had her employment continued.

Based on the above, the court determined that a reasonable jury could find both direct and indirect evidence that the employer wanted to get rid of the employee due to her disability. Accordingly, the employer’s motion for summary judgment as to the disability discrimination claims was denied.

Retaliation. Turning to the employee’s retaliation claims, the court observed that her position was that the same factors and analysis for her discrimination claims should apply to these claims. The court explained that this was not true and the employee had failed to proffer any evidence that she had engaged in protected activity. Accordingly, the employer’s motion for summary judgment against these claims was granted.

The case is No. 23-cv-1459.

Judge: Mihm, M.

Attorneys: Dawn L. Wall (Costigan & Wollrab) for Victoria C. Voegel. Robert B. McCoy (Miller, Hall & Triggs) for Obstetrics and Gynecology Care Associates, S.C.

Companies: Obstetrics and Gynecology Care Assoc., S.C.

Cases: Discrimination DisabilityDiscrimination Discharge Retaliation IllinoisNews