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Face Masks and Disabilities – Fact Sheet

Table of Contents

What you need to know Wondering what to do when face masks are required but you can’t wear one? We’ve got you covered.

Does North Carolina require me to wear a face covering if it is not safe for me to wear?

No. The state requirements have exemptions for people who have a medical or behavioral condition or disability that makes it unsafe for them to wear a face covering. The Americans with Disabilities Act also requires accommodations for people with disabilities from businesses and state and local governments. 

Review North Carolina’s current COVID-19 restrictions and recommendations as well as NC’s current executive orders to learn more.  

Can local laws require me to wear a mask if it is not safe for me to wear?

No. Cities and counties may impose stricter laws than the State requires. However, under Title II of the Americans with Disabilities Act, they must make reasonable modifications to their laws to accommodate people with disabilities who cannot safely wear masks.

Can medical providers or hospitals require me to wear a mask if it is not safe for me to wear?

They likely cannot but it may depend on your individual circumstances. Under the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, Section 1557 of the Affordable Care Act, and the North Carolina Persons with Disabilities Protection Act, medical providers and hospitals must make reasonable modifications to their policies to accommodate people with disabilities who cannot safely wear masks.

The Center for Disease and Control (CDC) has recommended that face coverings should not be required for anyone who has trouble breathing or is unable to remove the cover without assistance. Medical providers and hospitals may only refuse a reasonable modification if there are objective reasons that the policy change you request would fundamentally alter business operations or pose a direct threat to others.

The reason we wear masks is to filter air we breathe in and out. Any mask that is at least three layers of tightly-woven cotton will do a good job of filtering air you breathe out. This will help protect other people from you if you have COVID and don’t know it. Better quality masks will do a better job of filtering the air you breathe in, protecting you from people around you.
Face shields don’t filter air. They don’t do the same job as a mask. The purpose of a face shield is to keep germs from getting in your eyes. Wearing a face shield over your mask can help you stay safer if you have to be in a very high-risk environment. You should be aware that a face shield without a mask will not offer good protection to you or the people around you.

Can a local business require me to wear a mask if it is not safe for me to wear?

They likely cannot. Under the Americans with Disabilities Act and the North Carolina Persons with Disabilities Protection Act, places of public accommodation must make reasonable modifications to their policies and procedures to accommodate people with disabilities who cannot safely wear masks. The Center for Disease and Control (CDC) has recommended that face coverings should not be required for anyone who has trouble breathing or is unable to remove the cover without assistance.

Businesses may only refuse a reasonable modification if there are objective reasons that the policy change you request would fundamentally alter business operations or pose a direct threat to others. A business may accommodate a customer with a disability by offering curbside service outside, delivery service, or attendance to the store at hours that are not normally busy. Again, a business may provide an alternative accommodation to you so long as it is effective to provide service to you. 

May a business require me to provide documentation of my medical condition?

Medical documentation may only be required when it is reasonable under the circumstances. The Department of Justice has said that requiring “persons with disabilities to obtain medical documentation and carry it with them any time they seek to engage in ordinary activities of daily life . . . would be unnecessary, burdensome, and contrary to the spirit, intent, and mandates of the ADA.” However, there is little guidance on this issue. At this time, the law is unclear whether the ADA requires providing medical documentation to get an exception to a business’ policy.

Are there cards that I can use to show that I am exempt from face mask requirements?

No. There is no government program that permits people to obtain a card to show that they are exempt from face mask requirements. These cards are misleading and unauthorized by federal and state governments.

What if I am deaf or hard of hearing and cannot communicate with an employee of a business or government office?

People who are deaf or hard of hearing may also request accommodations under the ADA. Some accommodation examples may include asking the employee to repeat himself or herself, writing notes, using clear masks, using voice-to-text programs on a smart phone or tablet, asking for a qualified ASL interpreter, or other means of communication that is effective for the individual depending on the complexity of the conversation. 

What can I do if I have been denied a modification to a face mask policy?

If you have requested and been denied a reasonable modification to a hospital’s or medical facility’s face mask policy because your disability prevents you from wearing one, and no alternative accommodation is offered that meets your needs, then you may consider filing a complaint. You can file a complaint with the U.S. Department of Health & Human Services Office for Civil Rights (OCR). This agency can investigate your complaint to determine if there was disability discrimination. 

It is important to note that a claim for discrimination may be stronger if you have documentation of your accommodation request in writing AND if you provided the hospital/medical center with a verification letter from a physician. The letter from your physician should state why your disability prevents you from wearing a face mask. 

  • If you have been denied a reasonable accommodation to a business’s face mask policy, you may consider filing a Title III ADA complaint with the U.S. Department of Justice. 
  • If you have been denied a reasonable accommodation to a public entity’s face mask policy, such as any state or local government building, you may consider filing a Title II ADA complaint with the U.S. Department of Justice. 

How do I file an administrative complaint for disability discrimination?

Title II ADA Complaint 

Title II of the ADA protects individuals with disabilities from disability-based discrimination in the services, programs, or activities of public entities, such as state and local government entities. Public entities must operate in a manner that is accessible to individuals with disabilities. If you believe that you have been discriminated against because of your disability, you may file a complaint online or by mail or by fax

Title III ADA Complaint 

Title III of the ADA prohibits places of public accommodation (private businesses or organizations that provide goods and services to the public) from discriminating against persons based on their disability. If you believe that you have been discriminated against because of your disability, you may file a complaint online. You may also file by mail or by fax.

Section 1557 or Section 504 Grievance

Section 1557 and Section 504 prohibit discrimination on the basis of disability in healthcare programs, settings, or activities receiving federal financial assistance. These laws require such facilities to offer an internal grievance to address complaints of disability discrimination. Often times, the steps to file these grievances are explained in documents provided to patients, on their websites, and/or upon request. It is best for a grievance to be in writing and you should keep a copy for your personal records. It may help to supplement your grievance with a letter from your healthcare provider who knows of your disability to explain your disability-related need for an accommodation. A grievance may be a faster way to resolve the issue at a healthcare facility without filing an ADA complaint. 

You can also file a Section 1557 and Section 504 disability discrimination complaint with the U.S. Department of Health & Human Services Office for Civil Rights if you believe you that you have been discriminated against because of your disability by a hospital or health care provider. You may file online. do so online: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html. You may also mail, fax, or email your complaint

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