AUG 28, 1992

The Honorable Howard L. Berman
Member, U.S. House of Representatives
14600 Roscoe Blvd., Suite 506
Panorama City, California 91402

Attn: Margaret Mott

Dear Congressman Berman:

        This letter is in response to your inquiry on behalf of your
constituent, (b)(6) concerning provision of sign
language interpreters under the Americans with Disabilities Act
(ADA) for medical patients who are deaf.

        The ADA authorizes the Department of Justice to provide
technical assistance to individuals and entities with rights or
obligations under the Act. This letter provides informal
guidance to assist Ms. (b)(6) in understanding the ADA.
However, this technical assistance does not constitute a legal
interpretation of the statute and it is not binding on the
Department.
        The ADA requires physicians to furnish appropriate auxiliary
aids and services where necessary to ensure effective
communication with individuals with disabilities. A physician
may not impose a surcharge on any particular individual with a
disability to cover the costs of measures, such as providing
auxiliary aids, that are required by the ADA. These provisions
appear in sections 36.301(c) and 36.303 of the enclosed ADA title
III regulation, at pages 35596 and 35597, respectively. Under
section 36.301(c) of the regulation, the cost of an interpreter
must be absorbed by the doctor in the limited circumstances when
an interpreter is necessary. However, as provided in section
36.303(f), a doctor is not required to provide any auxiliary aid
that would result in an undue burden.

cc: Records, Chrono, Wodatch, Bowen, Russo, McDowney, Library,
    FOIA
    Udd:Russo:Cong.Berman. (b)(6)

01-01458
                                - 2 -
        What constitutes an effective auxiliary aid or service will
depend upon the unique facts of each situation, including the
length and complexity of the communication involved. Generally,
a doctor may satisfy the auxiliary aid or service requirement by
using a note pad and written materials where a deaf patient is
making a routine office visit. By contrast, a discussion of
whether to undergo major surgery may require the provision of a
sign language interpreter. Further discussion of this point may
be found on page 35567 of the enclosed regulation. Also enclosed
is the Department's Technical Assistance Manual, which includes
discussion of these provisions at page 26.

        If Ms. (b)(6) believes, after reviewing the enclosed
materials, that she has been discriminated against on the basis
of her disability she has two enforcement options under the ADA:
(1) She may secure private legal representation and bring an
action in Federal court, or (2) she may file a complaint with the
Department of Justice.

        If Ms. chooses to file a complaint with the
Department of Justice, she should send it to one of two offices
of the Civil Rights Division assigned to investigate such
complaints. If the medical office is operated by a State or
local government, she should send any relevant information to the
Coordination and Review Section, Civil Rights Division, U.S.
Department of Justice, P.O. Box 66118, Washington, D.C. 20035-
6118. If, on the other hand, the medical office is operated by a
private entity, she should send any relevant information to the
Office on the Americans with Disabilities Act, Civil Rights
Division, U.S. Department of Justice, Post Office Box 66738,
Washington, D.C. 20035-9998. All complaints should be in writing
and should set forth, in as complete a manner as possible, the
factual circumstances surrounding the complaint.

        I hope this information is of assistance to you in
responding to your constituent.

                                        Sincerely,
                                        James P. Turner
                                Acting Assistant Attorney General
                                        Civil Rights Division
Enclosure (2)
01-01459