While legal considerations might be your biggest worry, making your site more accessible is simply good customer service. More than 39 million Americans are blind and another 246 million have "low vision," Another one million are deaf in the U.S. Add to that people with mobility issues that prevent them from using their hands and that's a huge portion of the country's buying power.
What services they offer. Make sure the web design agency you’re interested in offers all the web design services you’re looking for — like 508 compliance, ecommerce design, or CMS integration. You’ll also want to see if the agency provides other services like SEO and PPC. You’ll likely be interested in these services after your website is up and running, and it’s extremely beneficial to work with a web design agency that does it all. You’ll want to be sure that the agency you choose provides other services like SEO and PPC since a great website is essentially useless without the proper promotion.
Many government services and activities are also provided on websites because the public is able to participate in them at any time of day and without the assistance of government personnel. Many government websites offer a low cost, quick, and convenient way of filing tax returns, paying bills, renewing licenses, signing up for programs, applying for permits or funding, submitting job applications, and performing a wide variety of other activities.
The ADA statute identifies who is a person with a disability, who has obligations under the ADA, general non-discrimination requirements and other basic obligations. It delegates fleshing out those obligations to federal agencies. The agencies issue regulations and design standards. The regulations have the details on the rights of people with disabilities and responsibilities of employers, state and local governments, transportation providers, businesses and non-profit organizations. The design standards specify how many entrances need to be accessible, how many toilet rooms and the design for those elements.  To know what the ADA requires, you need to read the law, regulations and design standards.  
This portion of the law is regulated and enforced by the U.S. Equal Employment Opportunity Commission. Employers with 15 or more employees must comply with this law. The regulations for Title I define disability, establish guidelines for the reasonable accommodation process, address medical examinations and inquiries, and define “direct threat” when there is significant risk of substantial harm to the health or safety of the individual employee with a disability or others.  
This title outlines the administrative processes to be followed, including requirements for self-evaluation and planning; requirements for making reasonable modifications to policies, practices, and procedures where necessary to avoid discrimination; architectural barriers to be identified; and the need for effective communication with people with hearing, vision and speech disabilities. This title is regulated and enforced by the U.S. Department of Justice.
This is the reason why I think web design firms have to position themselves as solution providers and not just web guys/gals. A client doesn't need a website, they need sales. The website is just part of that solution but it's not the solution and unlike web design, service like email marketing automation, SEO, and PPC requires an experienced professional.
Ensure that in-house staff and contractors responsible for webpage and content development are properly trained. Distribute the Department of Justice technical assistance document “Accessibility of State and Local Government Websites to People with Disabilities” to these in-house staff and contractors on an annual basis as a reminder. This technical assistance document is available on the ADA Home Page at www.ada.gov.
The ADA states that a "covered entity" shall not discriminate against "a qualified individual with a disability".[12] This applies to job application procedures, hiring, advancement and discharge of employees, job training, and other terms, conditions, and privileges of employment. "Covered entities" include employers with 15 or more employees, as well as employment agencies, labor organizations, and joint labor-management committees.[13] There are strict limitations on when a covered entity can ask job applicants or employees disability-related questions or require them to undergo medical examination, and all medical information must be kept confidential.[14][15]
To be protected under the ADA, you must have, have a record of, or be regarded as having a substantial, as opposed to a minor, impairment. A substantial impairment is one that significantly limits or restricts a major life activity such as hearing, seeing, speaking, walking, breathing, performing manual tasks, caring for oneself, learning or working.
...the full and equal enjoyment of the goods, services, facilities, or accommodations of any place of "public accommodation" by any person who owns, leases, or operates a place of public accommodation. Public accommodations include most places of lodging (such as inns and hotels), recreation, transportation, education, and dining, along with stores, care providers, and places of public displays.
Title II applies to public transportation provided by public entities through regulations by the U.S. Department of Transportation. It includes the National Railroad Passenger Corporation (Amtrak), along with all other commuter authorities. This section requires the provision of paratransit services by public entities that provide fixed-route services. ADA also sets minimum requirements for space layout in order to facilitate wheelchair securement on public transport.[20]

Navigable: Content that’s repeated on multiple pages can be easily skipped. All pages have informative titles, headings, and labels that describe the page’s content and hierarchy. Navigating the page must take place sequentially, in a meaningful order that preserves relationships on the page. All link text is descriptive in order to make clear where the link will take users. If users are navigating via a keyboard, the current focus of the keyboard is always highlighted and visible.


An employer cannot require you to take a medical examination before you are offered a job. Following a job offer, an employer can condition the offer on your passing a required medical examination, but only if all entering employees for that job category have to take the examination. However, an employer cannot reject you because of information about your disability revealed by the medical examination, unless the reasons for rejection are job-related and necessary for the conduct of the employer's business. The employer cannot refuse to hire you because of your disability if you can perform the essential functions of the job with an accommodation.

Thanks for writing. While I’m not a lawyer I believe if your physical practice is ADA exempt your web presence, as an extension of that physical business would maintain the same exemption status. If you’d like to be absolutely certain I’d confer with an ADA lawyer (email us, questions at yokoco dot com if you need a referral) but I don’t believe you have reason to worry.
The Department has assembled an official online version of the 2010 Standards to bring together the information in one easy-to-access location.  It provides the scoping and technical requirements for new construction and alterations resulting from the adoption of revised 2010 Standards in the final rules for Title II (28 CFR part 35) and Title III (28 CFR part 36).
The ADA has four main components: (1) requirements for maintaining medical records and requiring medical testing, (2) an employer must reasonably accommodate disabilities, (3) an employer may not discriminate against an individual with a disability, and (4) an employer may not retaliate against someone who opposes discrimination of participates in protected activity.

The U.S. Department of Health and Human Services (HHS) also enforces Title II of the ADA relating to access to programs, services and activities receiving HHS federal financial assistance. This includes ensuring that people who are deaf or hard-of-hearing have access to sign language interpreters and other auxiliary aids in hospitals and clinics when needed for effective communication.

Enough Time: Users have sufficient time to read and use the website’s content. If part of the website has a time limit, users are able to turn off the time limit, or they can adjust or extend it to at least ten times the default limit (unless the time limit is essential to the website’s functionality, such as auction websites like eBay). Content that moves, blinks, or automatically updates can be paused or stopped unless it’s essential to the website’s functionality.
The way a lot of people think about getting a new website is, they have a certain amount of money and they think, If I pay less money for a website, I'll have extra money left over, therefore I win. And so they'll go and get a Square Space or a Wix or a Go Daddy website, and they'll think because they've saved money they're coming out ahead of the deal.

The ADA itself holds different organizations to more/less stringent standards based on a host of factors, government funding being a major one. Government agencies themselves are usually held to the most severe standards. That said, while ADA has adopted WCAG as the defacto standard, from what I’ve seen it appears they’re going with AA compliance as the most reliable one. That said, we’ve done work with some organizations who’ve chosen to comply with AAA in an effort to be as buttoned up as possible from an accessibility and experiential perspective. We’ve also worked with some who have tighter budgers and aim for level A compliance and have a more “react and repair” mindset when they discover anything in their site that is giving someone hardship from an accessibilirt standpoint.
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