On August 8, 2025, the Eleventh Circuit (“the Court”) rendered its opinion in Mullin v. Secretary, U.S. Departmen of Veterans Affairs, No. 22-12354 (11th Cir. Aug. 8, 2025).[1] As relevant to this blog post, the Court made it clear that employers can be held liable for failing to protect confidential employee medical information.
By way of background, in Mullin, the plaintiff sued the Department of Veterans Affairs (“VA”) asserting claims for disability discrimination, failure to accommodate, retaliation, and, as pertinent here, unlawful disclosure of medical information under the Rehabilitation Act of 1973, which applies to federal agencies.[2] The district court granted summary judgment in favor of the VA.[3] The Court agreed with the district court as to the disability discrimination, failure to accommodate, and retaliation claims, but it reversed as to the unlawful disclosure claim.[4] Notably, the standards used for the Rehabilitation Act are the same used under Title I of the Americans with Disabilities Act (which applies to employment discrimination claims) (“ADA”); therefore, cases involving the Rehabilitation Act serve as precedent for ADA cases, and vice versa.[5]
The Court included a detailed chronology in its opinion due to the nature of the claims. For the sake of brevity, and given the limited scope of this blog post, only the most pertinent facts will be set forth here. Ms. Mullin began her employment with the VA in 2009, and she remains with the agency as a Ratings Veterans Service Representative in the St. Petersburg Regional Office.[6] In March 2012, Ms. Mullin was diagnosed with breast cancer, and her physician completed a Family and Medical Leave Act (“FMLA”) certification form stating she would require a six-month absence.[7] Ms. Mullin subsequently submitted the form to human resources.[8] A few months later, a steward with the union to which Ms. Mullin belonged sent her an email and “mentioned that he heard about Ms. Mullin’s ‘condition’ from Bonnie Wax, a human resources manager.”[9] He also asserted that Ms. Wax believed that breathing problems from which Ms. Mullin had suffered were due to the tumor.[10] Understandably, Ms. Mullin was surprised to learn that the steward knew of her diagnosis, as she had only told a friend at work and a Veterans Service Center manager.[11] Ultimately, Ms. Mullin filed a complaint that included a claim of unlawful disclosure and privacy violations related to the cancer diagnosis.[12]
As discussed above, the Court noted, “‘The standards used to determine whether [the Rehabilitation Act] has been violated . . . shall be the standards applied under [T]itle I of the Americans with Disabilities Act . . . and the provisions of [S]ections 501 through 504, and 510, of the Americans with Disabilities Act . . ., as such sections relate to employment.’”[13] Regarding the unlawful disclosure claim, the Rehabilitation Act “incorporates the confidentiality provisions of the ADA.”[14] In examining the relevant statutes and regulations, the Court stated, “Information obtained from an employee through a medical examination or inquiry [as permitted under 42 U.S.C. § 12112(d)(4)(A)] ‘shall be collected and maintained on separate forms and in separate medical files and be treated as a confidential medical record . . . . .’”[15] The Rehabilitation Act likewise provides that such information is generally “‘treated as a confidential medical record[.]’”[16] The Court noted that it had not previously addressed whether there is a private right of action under 42 U.S.C. § 12112(d)(4), but it held in Mullin that such a right of action does exist “irrespective of disability status.”[17] The Court clarified that to bring a claim under § 12112(d)(4), “an employee must show that (1) the employer either made an unlawful inquiry in violation of § 12112(d)(4)(A) or violated its confidentiality requirements after making a proper inquiry under § 12112(d)(4)(C), and (2) the employee suffered a tangible injury from the unlawful inquiry or disclosure.”[18]
Turning to Ms. Mullin’s claim, the Court first noted that the district court did not address the issue of whether the VA had made an inquiry because it determined that she had not suffered any harm, although the district court did state in a footnote that “it was ‘not at all convinced’ that an inquiry occurred when Ms. Mullin disclosed her medical information in a required FMLA form requesting leave for her cancer treatment.”[19] The Court disagreed, holding that “we believe that an inquiry was made and that there are issues of fact as to whether there was an unlawful disclosure stemming from that inquiry.”[20] The Court, relying upon a D.C. Circuit decision, held that “when an employer conditions an employee’s access to statutorily protected leave [such as FMLA leave] on the submission of medical information, that is an ‘inquiry’ under § 12112(d)(4).”[21] The Court noted that Ms. Mullin had previously sought FMLA leave related to asthma and had been informed that medical documentation would be required if she wished to extend her leave, and when she was diagnosed with cancer, she submitted medical documentation because she had previously been instructed to do so by the VA.[22] Thus, the Court held that Ms. Mullin “did not volunteer the information; she disclosed it because, under the Department’s previous letters, it was apparent that disclosing the information was the only way to maintain her leave and her pay.”[23] Ms. Mullin did not voluntarily disclose the condition.[24]
The Court next addressed whether the VA had made an unlawful disclosure. The Court held that, despite the VA’s assertion to the contrary, “[t]here is sufficient evidence in the record for a jury to find that Ms. Wax was the source of the allegedly unlawful disclosure and that she obtained the information from the FMLA form.”[25] The Court noted that first, an internal VA memorandum approving Ms. Mullin’s FMLA leave, which was dated before the e-mail from the steward and signed by Ms. Wax, stated that the medical condition was left off “‘to avoid accidental disclosure.’”[26] Next, the Court observed that the steward’s e-mail, which came after approval of the FMLA leave, explicitly stated that he and Ms. Wax has discussed Ms. Mullin’s diagnosis.[27] The Court found that although Ms. Mullin had discussed her condition with a few people, there was “insufficient evidence that [the union steward] learned of her diagnosis from anyone other than Ms. Wax,” and Ms. Mullin testified she never shared the diagnosis with Ms. Wax.[28] Notably, the Court stressed, “Of course, sharing a medical condition with a few relatives or close friends does not, as a matter of law, make the condition non-confidential.”[29] The Court held that “a reasonable jury could find that Ms. Wax disclosed Ms. Mullin’s cancer diagnosis to [the steward] after the FMLA form was submitted.”[30]
Finally, the Court addressed whether the evidence established that Ms. Mullin had suffered a tangible injury due to Ms. Wax’s conduct.[31] The Court held that Ms. Mullin had presented sufficient evidence to present an issue of fact as to whether she suffered a tangible injury.[32] Specifically, during her deposition, Ms. Mullin testified that the conversation between Ms. Wax and the steward still causes her emotional distress and impacted her recovery.[33] The Court determined that the testimony alone was enough to withstand summary judgment.[34] It further noted that “[a]lthough documentation of emotional distress is not required . . . we note that the record also contains two letters from the Department of Labor Office of Workers’ Compensation Programs updating Ms. Mullin’s medical conditions in her file.”[35] The letters updated her conditions to include PTSD and major depressive disorder.[36] Although Ms. Mullin did not rely on the two letters, the Court noted that “if those diagnoses are connected to the alleged unlawful disclosure, a jury could reasonably find that Ms. Mullin suffered a tangible injury from the disclosure—for example, anxiety that developed into PTSD and/or depression.”[37] The Court thus reversed as to the unlawful disclosure claim.[38]
Mullin makes it clear that employers must ensure they take steps to protect employees’ confidential medical information. Failure to do so could have dire consequences. If you have any questions or concerns regarding this topic, or any topic related to labor and employment law, please contact us.
[1] The opinion is available on the court’s website at https://media.ca11.uscourts.gov/opinions/pub/files/202212354.pdf (last visited Oct. 29, 2025). The citations in this blog post are to that version of the opinion.
[2] Mullin, at *2.
[3] Id.
[4] Id.
[5] Id., at *8.
[6] Id., at *2-3.
[7] Id., at *4.
[8] Id.
[9] Id., at *4-5.
[10] Id., at *5.
[11] Id.
[12] Id., at *7.
[13] Id., at *8 (citations omitted).
[14] Id., at *19.
[15] Id., at *20 (citation omitted).
[16] Id. (citation omitted).
[17] Id., at *20-21.
[18] Id., at *21 (citations omitted).
[19] Id., at *22.
[20] Id., at *22-23.
[21] Id., at *23.
[22] Id., at *25-27.
[23] Id., at *27 (citation omitted).
[24] Id. (citation omitted).
[25] Id., at *30.
[26] Id.
[27] Id., at *30-31.
[28] Id., at *31.
[29] Id.
[30] Id.
[31] Id., at *32.
[32] Id., at *35.
[33] Id., at *33-34.
[34] Id., at *34.
[35] Id. (citation omitted).
[36] Id.
[37] Id., at *34-35 (footnote omitted).
[38] Id., at *35, 38.