Employers should be especially cautious when recommending psychological counseling or therapy to employees after the 6th Circuit ruled on Aug. 22 in Kroll v. White Lake Ambulance Authority that such counseling constitutes a “medical examination” under the Americans with Disabilities Act (ADA). Although other courts have ruled on whether employerrecommended medical examinations are “job-related and consistent with business necessity,” as required by the ADA, the 6th Circuit's ruling differed by focusing on the definition of the exam itself.

Emily Kroll began working as an emergency medical technician at the White Lake Ambulance Authority (WLAA) in Whitehall, Mich., in 2003. Although her supervisors initially considered her to be a good employee, her workplace behavior became problematic following an affair with a married co-worker. This behavior culminated in an April 2008 incident in which Kroll allegedly failed to administer oxygen to a patient because she was arguing with a colleague in a WLAA ambulance.

Kroll's supervisors, concerned about her well-being, asked her to attend counseling sessions, although they claim that they did not specify an exact therapy. Kroll refused and subsequently resigned.