Disability Discrimination: Manager’s ‘ADD Brain’ Comments Keep Claim Alive

Some manager mistakes begin with an attempt to help — and then land companies in court.

In this case, a supervisor supported an underperforming employee with attention deficit disorder (ADD), but his alleged “ADD brain” remarks kept her disability discrimination claim alive, proving even well-intended efforts can turn into legal risk.

Employee’s Performance Issues Build

In 2018, Amber Motko was hired as a case manager registered nurse for Geisinger Health Plan. Throughout her employment, Motko had problems completing essential job tasks, including patient documentation – a compliance requirement for the company’s federal contract involving Medicare and Medicaid Services. She also had problems getting to work on time.  

Due to Motko’s ongoing performance issues, her supervisor frequently took a hands-on approach in managing her, often personally reminding Motko to get her documentation completed by an upcoming deadline. 

Motko continued to struggle at work, and by the end of 2021, the supervisor met with her to discuss the problems and outline strategies to get Motko’s performance on track. At that meeting, Motko confided that she was having some personal issues and had recently been diagnosed with attention deficit disorder (ADD). She clarified that she was fully capable of and committed to doing a good job. 

Supervisor Repeatedly Offers Job Help

In February 2022, Motko missed two more deadlines – despite receiving five reminders about them. That documentation failure caused the company to be written up by the Center for Medicare & Medicaid Services during one of its audits. The supervisor met with Motko to discuss this latest performance issue and specifically asked if she needed any assistance performing her job duties. Motko said no. 

But problems continued. The following month, the supervisor offered to have a nurse educator work with Motko during the workday to see if she needed extra help to meet her goals. On March 14, 2022, the nurse educator worked with Motko and offered strategies to help her improve her workplace performance. Among other things, the nurse educator helped Motko create an action plan to complete her overdue documentation.

Progressive Discipline Documents Failures 

On March 23, 2022, Motko received a verbal warning about her work performance — the first step in the company’s disciplinary process. Specifically, she failed to meet the quota on patient contact, and she also failed to transfer her documentation from her written notes into the company’s system. 

That same day, the supervisor held a Teams meeting to help Motko meet job expectations. During that call, he provided guidance on how to document patients in real time and showed her how to submit documentation into the system. 

On June 17, 2022, Motko received a written warning — the second step of the company’s disciplinary process — for her continued failure to submit documentation. The written warning provided dates of the failures, and the supervisor offered to have another nurse cover Motko’s shift so she could catch up on documentation. Motko refused the offer.

The supervisor also raised concerns about Motko arriving late to work. Nurses were supposed to start at 8 a.m. However, the supervisor allowed Motko to come in at 9 a.m. after she dropped her children off at school. On three occasions, Motko didn’t report to work until after 10 a.m. without notifying the supervisor. During that discussion, the supervisor told Motko that she had to let him know when she was going to be late in the future.

On September 23, 2022, Motko was suspended for continued failures to document patient charts as required. Her suspension included an action plan to complete all overdue charting by the end of that month. Motko failed to complete these tasks. 

Meanwhile, Motko’s tardiness escalated. She was late every workday in August 2022 and late 14 days in both November and December, prompting additional concern about reliability. 

Also in November, one of Motko’s assigned clients asked to be transferred to a new case manager because she could never reach Motko. 

Termination Follows Final No-Show 

On January 6, 2023, the supervisor and a nursing director went to the clinic to inform Motko that her employment was being terminated – but she had not shown up for work yet and had not informed the supervisor that she would be late. 

About 10 a.m., the supervisor called Motko and asked if she was coming to work that day. Motko said she’d be there as soon as possible and arrived about 15 minutes later. 

She was then informed that she was being let go due to ongoing performance issues. 

Motko sued, alleging disability discrimination and other claims. 

The employer asked the court to dismiss the case, arguing it fired Motko for a legitimate business reason – her ongoing performance issues. 

Court Dismisses Actual Disability, Advances ‘Regarded As’ Claim

The court first addressed whether Motko’s ADD qualified as a disability under the ADA. In the Third Circuit, an ADD diagnosis alone doesn’t automatically establish a disability. The employee must show the condition substantially limits a major life activity – and that must be determined on a case-by-case basis.

Here, the court found Motko had not done that. Evidence showed she repeatedly told her employer the diagnosis did not affect her productivity and that she did not need an accommodation. On that basis, the court determined her ADD didn’t meet the ADA’s definition of disability in this case.

But Motko didn’t stop there. She argued that even if her ADD did not qualify as an actual disability, her supervisor regarded her as disabled. 

The court refused to dismiss that theory. The record showed the supervisor knew about the diagnosis and repeatedly connected it to her performance struggles. He asked whether she needed assistance and arranged for a nurse educator to work with her.

Given those facts, a jury could conclude the supervisor regarded Motko as disabled.  

The employer argued the termination was based solely on documented performance problems. But Motko alleged the supervisor referred to her “ADD brain,” commenting that her brain worked differently and he didn’t know how to help her.

In the court’s view, those alleged remarks, if proven, could lead a jury to find that Motko’s termination was tied to her ADD. On that basis, the court allowed the disability discrimination claim to move forward. 

Now the company faces a trial — or an expensive settlement. The case highlights how “regarded as” disability discrimination claims can survive even when an employee does not meet the ADA’s definition of an actual disability.

4 HR Action Steps to Prevent ADA Lawsuits

It also reveals how manager language and processes can undermine even seemingly airtight performance docs. Adopt these four steps to help protect your organization against disability discrimination claims.

• Diagnosis Disclosure: Mandate immediate HR involvement to trigger ADA interactive process — avoids supervisors unwittingly creating “regarded as” evidence.
• Coaching Focus: Train managers to stick to observables like quotas and deadlines. Route accommodation talks exclusively to HR.
• Language Guardrails: Ban condition-linked phrases, like “ADD brain.” Provide training on neutral, behavior-based feedback.
• Pre-Term Review: Require HR review and sign-off for documented cases with disclosures, assessing bias risks.

Motko v. Geisinger Health Plan, No. 3:24-CV-00732 (M.D. Pa. 2/9/26).