Appendix—Litigation Forms
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V. APPENDIX—LITIGATION FORMS
Attached are forms which may assist in litigation. Appendix begins on next page.
A. Redacted Rehabilitation Act Disability Discrimination Complaint
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA
PLAINTIFF [address], Plaintiff,
v.
ERIC HOLDER, as and his capacity as Attorney General Department of Justice 810 7th Street, N.W., Room 3424 Washington, D.C. 20531, Defendant.
Case No.
JURY TRIAL DEMANDED
1. The Court has jurisdiction of this case under Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. §§ 2000e-5(f) and 2000e-16(c); the Rehabilitation Act, 29 U.S.C. § 791; and 28 U.S.C. §§ 1331, 1343.
2. Venue properly lies within this District under Title VII, 42 U.S.C. § 2000e-5(f), because plaintiff's claims arose within this judicial district.
3. Plaintiff [Plaintiff] (hereinafter "plaintiff") is a resident of Washington, DC, and is currently an employee of the [DOJ UNIT], Department of Justice (hereinafter "the Agency").
4. Plaintiff sues Defendant Eric Holder in his official capacity as Attorney General.
5. The Department of Justice (DOJ) is a government agency, which employs over 50,000 employees across the United States, including the District of Columbia. At all times relevant to this action, the DOJ has been an Executive Agency as defined by 5 U.S.C. § 102 and covered by Title VII, 42 U.S.C. § 2000e-16(a).
6. Plaintiff is an African-American female.
7. Plaintiff has worked for the DOJ for 15 years, of which 12 have been in [DOJ UNIT] ("[DOJ UNIT]") as a Staff Accountant.
8. In 1995, plaintiff began her employment with the Agency as a GS5 Staff Accountant with the Office of Community Oriented Policing Services.
9. In March 1998, plaintiff began working as a GS-9 with [DOJ UNIT] under the Monitoring Division as a Staff Accountant.
10. Beginning with her employment with [DOJ UNIT], plaintiff has had a history of asthma.
11. In March 2005, plaintiff filed an EEO complaint due to her reassignment from the Monitoring Branch to the Audit Resolution Branch while she was on extended medical leave for knee surgery in March 2005. Since the Agency returned her to her original position, performing her original duties, the Agency dismissed her EEO complaint.
12. In or about May 2005, the Monitoring Division/External Oversight Division, where plaintiff worked, moved back into the main DOJ building at 810 7th Street, N.W.
13. In late December 2005, plaintiff begun to experience asthma attacks more frequently and severely because the overhead air vents/slotted diffusers forcefully blew cold air directly on her in her workspace.
14. Before the move, plaintiff had not experienced asthma attacks at her prior work location as frequently or as severely.
15. During this time, as plaintiff's asthma condition worsened, she contacted various management officials to complain about the cold blowing air and to ask for an accommodation to a workspace free from cold blowing air.
16. From December 2005 to the present, the Agency has made poor attempts to accommodate plaintiff's asthma. For example, it moved vents two or three tiles over and it partially or completely closed the vents in her workspace. On occasion, the Agency completely closed the vents in plaintiff's workspace, or it moved her workplace to different areas.
17. However, the Agency never effectively accommodated plaintiff's requirements to work in a space free from cold, blowing air. No matter where the Agency placed her, plaintiff always felt some cold air blowing on her.
18. On January 4, 2006, Dr. __________, plaintiff's primary care physician, recommended that the Agency arrange for an occupational physician to evaluate her workspace to confirm whether the excessive airflow aggravated her asthma.
19. Beginning on or about January 5, 2006, plaintiff made several inquiries to [DOJ UNIT] officials, requesting the name of the Agency's occupational physician.
20. However, the Agency did not respond to plaintiff's requests until February 13, 2006, when it replied that it did not have an occupational physician.
21. In July 2006, the Agency detailed plaintiff to the [Branch] ([BRANCH]), Financial Accounting Division, Office of the Chief Financial Officer, [DOJ UNIT] ("OCFO") as a Staff Accountant and moved her to the fifth floor of the building.
22. At most relevant times Darlene [First-line supervisor] (white) was the Branch Manager of [BRANCH] and plaintiff's first-line supervisor. Joanne Suttington (white), the Assistant Chief Financial Officer, has been plaintiff's second and acting first line supervisor.
23. Although the Agency relocated plaintiff to a different office, she still experienced cold air blowing on her, even more than what she encountered in her previous workspace.
24. Plaintiff complained to Ms. [First-line supervisor] and Ms. Marshall about the Agency's failure to accommodate her.
25. As with plaintiff's prior complaints, the Agency handled them by turning vents down and/or moving vents. However, the Agency never completely shut of the vents, and the cold air continued to blow on her, aggravating her asthma.
26. Angela Hill, the Special Assistant to the CFO, mentioned to plaintiff that she had several discussions with Ms. [First-line supervisor] about moving plaintiff to a different office.
27. However, the Agency never did so.
28. Beginning about July 2006 and continuing until about December 2009, Ms. [First-line supervisor] continuously subjected plaintiff to a hostile work environment because of her disability and race and retaliated against her for requesting accommodations and for engaging in other protected activities.
29. Prior to plaintiff's detail to [BRANCH], she had shoulder and multiple knee surgeries, which required a significant amount of leave for recovery. Plaintiff also used leave in connection to asthma attacks.
30. In or about August 2006, Ms. [First-line supervisor] issued plaintiff a Memorandum of Counseling for Possible Leave Restrictions, without discussing her prior leave use (which her former supervisors approved without any concerns).
31. Thus, Ms. [First-line supervisor] unfairly disciplined plaintiff based on her documented disability. This was the first incident, which contributed to a hostile work environment for plaintiff.
32. By contrast, at about this same time, Ms. [First-line supervisor] sat down with [another employee] to obtain an explanation for his low and/or negative leave balances. Upon information and belief, [another employee] does not have a documented disability and has never asked for an accommodation.
33. In December 2006, Dr. Leslie Kingslow, a pulmonary specialist, concluded that plaintiff should attempt to have her office space moved to avoid cold air.
34. Dr. Kingslow based his conclusions on peak flow readings, which showed that plaintiff's breathing deteriorated significantly when exposed to cold air blowing directly on her.
35. Nevertheless, to date, the Agency has continued to mishandle plaintiff's requests for an accommodation for her asthma disability.
36. In January 2007, the Agency reassigned plaintiff to her current position as Staff Accountant in the OCFO's [Branch].
37. As a Staff Accountant, plaintiff works on closeout grants, which involve a lot of typing. She also prepared letters to grantees and performed numerous accounting duties requiring keyboarding duties.
38. In early March 2007, plaintiff began experiencing problems with her right hand and wrist. Her right hand became swollen and discolored, causing her pain and discomfort. In addition, her fingertips were numb and tingled.
39. Ms. [First-line supervisor] could see that the condition of plaintiff's right hand was swollen.
40. At the time, plaintiff's daily work activities involved working on paper files approximately sixty to seventy percent of the time. This involved flipping through files with her hands, lifting files from one place to another, and entering data into a word processor and various DOJ software programs approximately thirty percent of the time.
41. On March 1, 2007, Ms. [First-line supervisor] asked plaintiff if she had a medical note from the pulmonary specialist so that she could put in plaintiff's request to move to an office that had very little ventilation.
42. This was an office that was actually built for Ms. [First-line supervisor], but she stated that she preferred to sit in a cubicle since the ventilation was poor, the office was small, and she was claustrophobic.
43. Two contractors were currently occupying the office, but Ms. [First-line supervisor] stated that they could be moved to plaintiff's cubicle and she could be moved to the office if she had medical documentation to support her request for accommodation.
44. Plaintiff informed Ms. [First-line supervisor] that Erica Smith, her union representative, had given the medical documentation to Jamie Payne in Human Resources.
45. Ms. [First-line supervisor] questioned why plaintiff did not give it to her. Plaintiff responded that in a meeting with Ms. Payne and Stuart Smith, union president, Ms. Payne had advised plaintiff to forward such medical documentation to HR through the union.
46. On or about March 12, 2007, Dr. Bledsoe examined plaintiff's swollen right hand and wrist, sent her for X-tays, and referred her to Dr. David Dorin, an orthopedist.
47. On or about March 23, 2007, Dr. Dorin diagnosed plaintiff with severe tendonitis. Because of its severity, Dr. Dorin determined that Plaintiff's engaging in certain major life activities, such as keyboarding, writing, and lifting would worsen the conditions of her right hand and wrist.
48. As part of her treatment, Dr. Dorin placed plaintiff's hand and wrist in a splint. In addition, he ordered her to stay off work from March 23, 2007, to March 30, 2007.
49. Dr. Dorin also instructed [PLAINTIFF] to do as little as...
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