Simonson v. Oswego County

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Status: Open
Court:
U.S. District Court for the Northern District of New York
Issues: Employment and Rights in the Workplace, Health Care Fairness, Transgender Rights

Lambda Legal has filed a lawsuit against Oswego County and the Oswego County Department of Social Services (DSS) on behalf of Sean Simonson, a retired transgender county employee.

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Lambda Legal has filed a lawsuit against Oswego County and the Oswego County Department of Social Services (DSS) on behalf of Sean Simonson, a retired transgender county employee. Sean was denied health insurance coverage for his transition-related care by his county-provided health insurance plan because of a discriminatory exclusion that prohibited coverage of all transition-related health care.

Following the filing of a charge of discrimination against Oswego County in October of 2015, the U. S. Equal Employment Opportunity Commission (EEOC) issued a determination finding reasonable cause to believe that Oswego County and DSS discriminated against Simonson “due to his sex (transgender status/gender identity) in violation of Title VII” on June 26, 2017. Following the EEOC’s filing and Lambda Legal’s notification of this matter to the New York Attorney General’s Civil Rights Bureau, Oswego County recently agreed to remove the exclusion of transgender-related health care from their employee health insurance plan as part of an agreement with the New York Attorney General’s office. The agreement, however, did not include compensation for current and former employees already denied coverage under the policy, including Sean Simonson.

An exemplary employee and public servant for nearly 30 years, Simonson worked as a Case Worker for Oswego County’s Department of Social Services before retiring in October of 2015. Upon being diagnosed in February of 2015 with gender dysphoria, Simonson began taking steps to transition in a manner consistent with his gender identity, including legally changing his name. As part of his transition and ongoing medical care, Simonson’s doctor determined that it was medically necessary for him to be placed on hormone replacement therapy and receive a double mastectomy. However, coverage for this care was denied because of the plan’s policy of excluding coverage of transition-related care, despite the same care being covered for non-transgender patients. After both Simonson and his doctor appealed the refusals through the insurance’s appeal process, Simonson filed a complaint with the EEOC.

Filed in in the U.S. District Court for the Northern District of New York, the lawsuit alleges that the county’s policy and the resulting refusal of insurance coverage of Sean Simonson’s care constitutes sex discrimination and violates federal and state laws, including the Fourteenth Amendment of the United States Constitution, Title VII of the Civil Rights Act of 1964, Section 1557 of the Patient Protection and Affordable Care Act and the New York State Human Rights Law.