Last Updated on June 26, 2025

In a precedent-setting decision, the U.S. Court of Appeals for the 7th Circuit ruled in Nawara v. Cook County Municipality that an employer can be liable for back pay under the Americans with Disabilities Act (ADA) for requiring an unlawful medical examination even if the individual did not have or was not perceived as having a disability. This decision significantly broadens the interpretation of what constitutes “disability discrimination” under the ADA and reinforces the importance of compliance with medical inquiry rules.

Case Background: Nawara v. Cook County and ADA Back Pay

John Nawara worked as a correctional officer for Cook County, Illinois. In 2016, following a series of workplace confrontations and what the County deemed concerning behavior, Nawara was ordered to undergo a mandatory fitness-for-duty evaluation. The evaluation included mental health screenings and a release of his private medical records. Believing the request was unjustified and invasive, Nawara refused to comply. As a result, he was placed on unpaid leave and eventually removed from active duty.

Nawara filed a lawsuit against Cook County under the ADA, specifically citing Section 12112(d)(4), which prohibits medical examinations or inquiries that are not job-related and consistent with business necessity. The case proceeded to trial in federal district court, where the jury found that Cook County had indeed violated the ADA by mandating an unlawful medical exam. However, the jury awarded no damages, and the district court limited Nawara’s remedies to restoration of seniority and leave balances, denying his request for back pay.

Unsatisfied with the outcome, Nawara filed an appeal to the U.S. Court of Appeals for the Seventh Circuit. He argued that the violation of his rights under the ADA entitled him to more than symbolic relief. He argued that he was due compensation for the financial harm he suffered during his unpaid leave. The County maintained that because Nawara was neither disabled nor perceived as disabled, he could not claim back pay under the ADA.

On April 1, 2025, the Seventh Circuit reversed the lower court’s decision, ruling that an employer’s violation of ADA provisions regarding medical inquiries constitutes actionable discrimination, regardless of the employee’s disability status. The appellate court held that back pay is a permissible and appropriate remedy in such cases and remanded the matter for further proceedings to calculate damages.

Following the appellate decision, key developments continued into June 2025. On May 22, the Seventh Circuit issued its formal mandate returning the case to the district court. Then on June 10, Nawara’s legal team submitted a proposed judgment seeking approximately $30,774 in back pay, along with restoration of lost benefits, pension contributions, and 153 days of seniority for the period he was placed on unpaid leave.

7th Circuit Reverses: Key Findings

1. Unlawful Medical Exams Constitute Discrimination

The 7th Circuit unequivocally held that requiring an employee to undergo a non-job-related medical exam- without business necessity- is a form of disability discrimination, even if the employee is neither disabled nor regarded as disabled.

“Section 12112(d)(4) protects all employees, and its violation constitutes actionable discrimination under the ADA,” the court stated.

2. Back Pay Is an Available Remedy

The court further ruled that back pay is not contingent on the employee being disabled. Because the statute defines this type of unlawful inquiry as discrimination, all associated remedies- including back pay- are available.

3. National Trend Toward Broader Protections

This decision aligns with rulings in the 6th and 10th Circuits, establishing a clear judicial trend: the ADA’s medical exam protections apply to all employees. Employers must take notice that they are potentially liable for financial damages if they mandate exams that don’t meet the legal standard.

What Employers Should Do Now

In response to the Nawara v. Cook County ruling, employers everywhere, but especially within the 7^th circuit, should immediately review their policies and procedures surrounding fitness-for-duty examinations and medical inquiries. Employers must ensure that any such evaluations are clearly job-related and supported by documented business necessity, such as a legitimate safety concern or well-documented performance issue. HR teams should revise internal protocols to include pre-approval steps and legal review before initiating any medical evaluations for current employees. Supervisors and managers must be trained on ADA-compliant practices to avoid triggering unlawful inquiries. Finally, organizations should audit any recent or pending fitness-for-duty actions to confirm legal compliance and consider partnering with a qualified HR provider, like MyHRConcierge, to proactively mitigate risk.

Implications for Employers and HR Professionals Regarding the Case and ADA Back Pay

The 7th Circuit’s decision in Nawara v. Cook County significantly broadens the scope of employer liability under the ADA and raises the standard employers must meet before requiring medical or mental health examinations for current employees. Employers can no longer rely on general concerns or assumptions to justify fitness-for-duty evaluations. Instead, any such exam must be clearly job-related and supported by objective evidence—such as documented performance deficiencies or credible safety concerns.

Importantly, this ruling reaffirms that ADA protections extend to all employees, not just those with known or perceived disabilities. Any employee who is subjected to an improper or unjustified medical inquiry may now have grounds to pursue a discrimination claim and receive full remedies under the ADA, including financial compensation.

The potential consequences of noncompliance are substantial. Employers may be held liable for back pay, lost benefits, and attorneys’ fees—even if there was no intent to discriminate. This means that even well-intentioned actions, if not legally justified, can result in costly legal exposure. For HR professionals, this case is a clear call to reevaluate internal procedures, reinforce ADA training, and ensure all medical examination policies are rooted in lawful business necessity.

Final Thoughts on Nawara v. Cook County and ADA Back Pay

Nawara v. Cook County is a critical reminder that even well-intentioned employer actions can cross the legal line if they fail to meet compliance requirements, in this case specific to the ADA. This case reaffirms the ADA’s broad employee protections and underscores the need for vigilant, compliant HR practices.

MyHRConcierge’s SHRM-certified HR consultants can help you maintain compliance with complex regulations like the Americans with Disabilities Act (ADA). By implementing robust policies tailored to the specific needs of each business, MyHRConcierge ensures that employers remain compliant and up-to-date with legal requirements.

Contact MyHRConcierge today at 855-538-6947 ext 108, ccooley@myhrconierge.com. Or, schedule a convenient consultation below: