by David M. Reutter

The U.S. Court of Appeals for the Ninth Circuit reversed the grant of summary judgment for the California Department of Corrections and Rehabilitation (CDCR) in a prisoner’s action alleging CDCR violated Title II of the Americans with Disabilities Act (ADA) by failing to reasonably accommodate his disabilities.

Bilal Adom alleged that while imprisoned at the Salinas Valley State Prison (SVSP) he was denied adult diapers and other incontinence supplies. Adom suffers from a spinal condition that caused severe pain and confined him to a wheelchair. He had surgery in 2008 and had a standing order for another surgery.

Adom began suffering incontinence in 2020. He was unable to control his urinary evacuations, particularly at night, and sometimes involuntarily evacuates stool. In December 2020, Adom filed a medical request complaining of incontinence. Beginning shortly thereafter, Adom was issued a weekly supply of diapers and incontinence supplies. In May 2021, the order for those supplies from CDCR’s Durable Medical Equipment and Medical Supply program was made permanent.

In August 2021, Adom was transferred from SVSP’s Alpha Unit to the Delta Unit. Adom received his last supply of incontinence supplies on September 1. The CDCR officially terminated the order for incontinence supplies on September 17. He was not provided incontinence supplies again until January 20, 2022. During the intervening five months, Adom repeatedly requested custodial and medical personnel for incontinence supplies and was denied. On October 14, 2021, CDCR’s Reasonable Accommodation Panel denied Adom’s request for diapers.

In November 2022, Adom filed a complaint in the U.S. District Court for the Northern District of California. During screening, the court dismissed certain claims but allowed Adom to proceed upon the ADA claim against the CDCR and the Eighth Amendment claim against Warden M. Atchley, Dr. Montegrande, Dr. Scott Ladd, Dr. Lotersztain, ADA Coordinator R. Mojica, Certified Nursing Assistant Bianca Rubio, and S. Sawyer. The defendants moved for summary judgment, which the court granted. Adom appealed.

The Ninth Circuit began its analysis by detailing the three elements of an ADA claim. Adom had to allege and prove he was: (1) a qualified individual with a disability; (2) he was either excluded from participation in or denied benefits of a public entity’s services, programs, or activities, or was otherwise discriminated against by the public entity; and (3) such exclusion, denial of benefits, or discrimination was by reason of his disability. To recover monetary damages, the plaintiff must also prove the public entity defendant acted with deliberate indifference. See: Duvall v. County of Kitsap, 260 F.3d 1124 (9th Cir. 2001).

The district court failed to determine whether Adom was a qualified individual. The Ninth Circuit concluded Adom suffered a disability under Title II. The ADA defines disability as “a physical or mental impairment” that “substantially impairs one or more life activities.” See: 42 U.S.C. Section 12102(1)(A).

CDCR argued there was no medical indication that Adom’s incontinence required diapers or other service. The Court stated that incontinence could qualify as a disability despite the fact it was not understood by doctors, writing “The comparison of an individual’s major life activity to the same major life activity by people in the general population will not require medical, scientific, or statistical evidence.”

“Adom’s spinal and incontinence condition are physical impairments,” the Court further found. “A jury could conclude that each of these impairments substantially limits Adom’s life activities.” A jury, the Court continued, could find that it is “more difficult to manage involuntary urination and defecation when such evacuations necessitate twisting and moving around in a wheelchair to clean up, and such movements exacerbate spinal pain.”

The Court concluded a jury could find CDCR denied the benefit of its toiletry and hygiene services. The CDCR has an “affirmative duty” to provide Adom “meaningful access” to those “self-explanatory” services: “Although Adom was technically able to relieve himself (by soiling his bed or wheelchair) and clean after himself (though with spinal pain) during the period he was not provided with incontinence supplies, a reasonable jury could conclude that was not comparable to the toileting and hygiene services provided to inmates who did not suffer from Adom’s impairments.”

 The alternative services of a commode in his cell, priority access to showers and laundry, and a few extra towels and pairs of boxers could be found by a jury to not provide meaningful access to services.

 The Court rejected the argument that CDCR must be free to treat all prisoners alike. The purpose of the ADA is to treat persons with disabilities differently. Compliance with the ADA may require architectural changes or “reasonable modification to rules, policies, or practices” or “the provision of auxiliary aids or services.”

Next, the Court found a jury could conclude that CDCR denied Adom service by reason of his disability. Adom’s spinal condition and incontinence made it harder for him to enjoy CDCR’s toiletry and hygienic services without diapers, not any other characteristics.

The Court, therefore, found Adom was entitled to a trial to determine if he was entitled to declaratory relief. Adom’s request for injunctive relief would require the district court to make findings as to CDCR’s policy relating to renewing the temporary incontinence services approval to determine if injunctive relief is necessary to make those services permanent.

Finally, the Court turned to the issue of monetary damages, which required proof of deliberate indifference. To establish deliberate indifference under the ADA, a plaintiff must show a public entity: (1) was on notice as to the need for the accommodation; and (2) failed to adequately act on that notice. “[P]roviding one accommodation,” the Court stated, “does not necessarily defeat the argument that the public entity was deliberately indifferent to the need for a different accommodation.”

Deliberate indifference could be inferred from the abrupt discontinuation of Adom’s incontinence supplies. Additionally, CDCR “ignored and summarily denied” Adom’s repeated requests for reinstatement of services. Third, CDCR denied services without a further investigation of whether Adom’s request was reasonable and feasible. Dr. Ladd told Adom that services were denied because other prisoners were malingering incontinence conditions, and such abuse was costly. Even after Adom’s condition was medically diagnosed, it was two weeks before he received incontinence supplies.

The Court stated, “The denial of a disability accommodation is reviewable even when grounded in medical judgment. And decisions by doctors can evince deliberate indifference.”

Adom was entitled to a trial to determine if monetary damages are warranted.

The district court’s grant of summary judgment was reversed and remanded. See: Adom v. Cal. Dep’t of Corr. & Rehab., 2026 U.S. App. LEXIS 27530 (9th Cir. Sep. 8, 2026).  

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