California’s protection & advocacy system
For legal assistance call 800-776-5746. For all other purposes call 916-504-5800 in Northern CA
or 213-213-8000 in Southern CA. TTY 800-719-5798.
March 2005, Pub #5447.01
As a person who is deaf or hard of hearing, you have the right to understand and be understood in medical settings. You have the right to get aids and services that let you and your provider communicate so you can say what you need and understand your treatment options and medication.
Use this publication to learn about laws that protect you, accommodations your provider has to make, and aids and services that can help you in medical settings.
This publication also explains where to get more help if you need it.
If you are deaf or hard of hearing, you have the right to aids and services that help you communicate effectively with your medical provider.
Aids and services can help you explain your condition to your medical providers so you can get the medical treatment you need. Aids and services also let you understand your treatment options and medication instructions.
Medical settings include:
The medical provider must pay for the aid or service. They cannot charge you or your insurance company.
Not usually. But if your provider asks you for proof, send them a copy of your audiogram. You can get one from your Vocational Rehabilitation Counselor, audiologist, or school nurse.
If you are deaf or hard of hearing, your medical provider must communicate with you as effectively as they communicate with other patients. This means you are entitled to face-to-face communication and written correspondence, just like any other patient.
You are also entitled to use telephones, fax, e-mail, electronic systems and the Internet if necessary because of your disability.
If you need aids and services to communicate effectively, the medical provider must give them to you, including:
Depending on the length and complexity of the communication, a hospital would have to provide a sign language interpreter or real time transcription to communicate with patients that have hearing disabilities. (Real time transcription is when speech is displayed on a screen.)
Your medical provider must make “reasonable modifications” to their policies, practices, and procedures if needed to provide equal treatment to people with hearing or other disabilities.
For example, a hospital waiting room would need to provide telephones that work with hearing aids.
Every person is different. For example, not everyone who is deaf or hard of hearing uses TTY/TDD machines. You probably know which aids or services will work best for you.
No. They do not have to provide an aid or service that is not necessary for effective communication or would:
Yes. If you need an interpreter to communicate effectively and to get the same care as other patients, ask for one.
Ask in writing 2 weeks before (if possible) your medical appointment. That way, the office will have time to make the arrangements. Keep a copy of your letter.
No. Do not hire your own interpreter and ask to be reimbursed. Ask the provider to hire an interpreter for you.
In California, there are state laws that protect your rights in a medical setting. There is also a federal law, called the American with Disabilities Act (ADA) that protects you.
The California Civil Code says businesses or organizations that are open to the general public must not discriminate against you because you are deaf or hard of hearing. The law also says you have the right to full use of the medical facilities.
Hospitals, clinics and medical offices are open to the public. This means you have the right to ask for support, like an interpreter or other aid that would give you access to the same services and privileges as other patients.
If they do not give you the services or aids you need, you can sue them. You can also file a complaint with the Department of Fair Employment and Housing (DFEH).
For more information on the state laws, read California Civil Code, Section 51 (called the Unruh Civil Rights Act) and Sections 54–55.2.
The Americans with Disabilities Act is a federal law. It also says that public places cannot discriminate against you because you are deaf or hard of hearing.
Any medical facility that is open to the general public MUST follow the ADA. It does not matter how small the medical office is. Even if the office is in a private home, the part of the home used by the public must follow the ADA.
For more information, read Title III, 28 CFR sections 36.207 and 36.204. Or contact Disability Rights California and ask for:
ADA – A Comprehensive Overview, Publication # 5097.01
The ADA says the medical provider MUST:
They are probably wrong. The only exceptions to following the law would be if the service or aid:
But, your provider still has to give you some other aid or service that lets you fully use their services. If your provider refuses, California law says you can sue them for violating the ADA.
Sometimes. If the services are open to other families, the provider must offer aids or services to your family members, too.
For example, prenatal classes are for mothers AND fathers. So, fathers who need aids or services could also get them. Or if a parent is deaf or hard of hearing, they can get aids or services to help them understand their child’s care.
If your visit is for something simple, like making an appointment or getting billing or insurance information, a notepad and pen may be appropriate.
But, when a visit is more complicated, like an exam or talking about test results, treatment options, confidential or personal situations, the provider MUST give you the aids and services you need to communicate effectively.
If you do not read English well, written methods like a note pad are not considered effective communication.
What if the provider asks me to use a relative or friend to interpret?
It is usually better to use a professional who understands medical terminology. You may have problems of accuracy, objectivity or confidentiality if you use a friend or relative to interpret for you.
What if my provider says they only have to give me aids or services in the examining room?
They are mistaken. Providers have to give you other aids and services too. For example:
Yes. If other patients watch TV, the facility must also make closed- captioned programs available. If the TVs don’t have built-in decoder ability, the facility can connect a separate decoder.
Yes. Federal and state law say that new buildings (built or remodeled after 1992) with pay phones, must also have at least one public TTY/TDD pay phone next to a hospital waiting room, recovery room, or emergency room. If the facility has 4 or more pay phones and one of them is inside the building, then the TTY/TDD phone must be inside the building, too.
Newer buildings (built or remodeled after 1992) must also have flashing visual alarm systems, visual doorbells and other notification devices, volume control telephones, and assistive listening systems in meeting rooms and waiting rooms.
Sometimes. If the medical facility can make the changes fairly easily and without too much expense, it must also do things like install flashing alarm systems and permanent signage.
Yes. Medical facilities may be able to get tax credits or deductions from the IRS. The “Disabled Access Tax Credit” and the “Tax Deduction to Remove Architectural and Transportation Barriers to People with Disabilities and Elderly Individuals” allow tax deductions for the costs of complying with the ADA.
If your health care provider offers education, classes or videotapes, the ADA says the provider must make that information available to you, too.
In general, any class, support group or other activity that is open to the public, must be open to participants who are deaf or hard of hearing. The provider can use interpreters, real-time transcribers, captioning or other assistive listening systems. Ask for the aid or service that works best for you.
If you were denied an aid or service you asked for, send your provider a letter. See the sample letter on page 12.
In your letter,
You can file a complaint with:
Deadline to file your complaint:
Send a letter to:
U.S. Department of Justice
Civil Rights Division, Disability Rights - NYAVE
950 Pennsylvania Avenue, NW
Washington, D.C. 20530
Your letter should include:
The Disability Rights Section at DOJ will investigate your complaint and let you know if they think there should be a lawsuit.
If DOJ believes there is discrimination, or your complaint seems important to the general public, they may try to negotiate a settlement.
Or DOJ may take the case to U.S. District Court. If they do this, they will represent the people of the United States. They will not be your attorney or represent you personally.
Call or fax your questions to DOJ:
TDD & Voice: (202) 307-0663
Fax: (202) 307-1198
TDD: (800) 514-0383
Voice: (800) 514-0301
Monday-Friday: 9:30 – 5:30 (EST)
Tuesday: 12:30-5:30 (EST)
Or call Disability Rights California Voice:
(800) 776-5746 Voice,
TTY: (800) 576-9269
Follow these steps:
To learn about filing a case in Small Claims Court, contact Disability Rights California and ask for:
Disability Rights California Publication # 5206.01 - How to Sue a Private Business for Discrimination in Small Claims Court
Filing a case in Superior or Federal Court can be expensive and complicated. Think about asking a lawyer to help you. Disability Rights California can give you a list of lawyers.
If you already tried to get your provider to give you the aid or service you need, you can use this letter to ask again. If you do not get an answer, read pages 10-12 of this booklet for more help.
RE: Request for Accommodation Dear [Provider’s Name]:
On [date], I sent you a letter explaining that I am deaf and asked you for an ASL interpreter to help me at my appointment on [date].
On [date], [name] of your office told me you would not provide an interpreter. S/he said I should [… go to another medical provider … bring my own interpreter… or whatever happened].
The law requires your office, as a place of public accommodation, to provide aids and interpreters to patients who are deaf or hard of hearing. The law also gives me the right to file a complaint or sue you for denying these services. But, I would like to try to solve this problem with you first. Please answer this letter within 14 days.
If you have questions about your legal responsibilities to provide interpreters to patients like me, please read the federal and state laws (ADA, Unruh Civil Rights Act, and California Civil Code, sections 54-55) that protect the rights of people with disabilities, including my right to effective communication.
If I do not receive your answer, I will assume you do not want to resolve this issue.
Disability Rights California is funded by a variety of sources, for a complete list of funders, go to http://www.disabilityrightsca.org/