I should mention one caveat to all of this. Businesses that are required to comply but don't have the ability to bring their websites into compliance can provide an accessible alternative to provide the same information, goods, and services that they provide online, like a staffed phone line. The trick, however, is that this option has to provide at least equal access, including in terms of hours of operation. And, as we know, the internet is around 24/7, so good luck with that. 
The words in the tag should be more than a description. They should provide a text equivalent of the image. In other words, the tag should include the same meaningful information that other users obtain by looking at the image. In the example of the mayor’s picture, adding an “alt” tag with the words “Photograph of Mayor Jane Smith” provides a meaningful description.
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]

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 is an article that most other website developers probably don’t want you to read. The reason is that most other web designers basically like to think of themselves as all-powerful wizards with magical powers. And they use complex technical jargon and terminology to intimidate and mystify their clients into thinking that what they do is more complex than it is.
The Supreme Court decided under Title II of the ADA that mental illness is a form of disability and therefore covered under the ADA, and that unjustified institutional isolation of a person with a disability is a form of discrimination because it "...perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life." The court added, "Confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment."
Two agencies within the U.S. Department of Labor enforce parts of the ADA. The Office of Federal Contract Compliance Programs (OFCCP) has coordinating authority under the employment-related provisions of the ADA. The Civil Rights Center (CRC) is responsible for enforcing Title II of the ADA as it applies to the labor- and workforce-related practices of state and local governments and other public entities. Visit the Laws & Regulations subtopic for specific information on these provisions.
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.
Once you have been hired and started work, your employer cannot require that you take a medical examination or ask questions about your disability unless they are related to your job and necessary for the conduct of your employer's business. Your employer may conduct voluntary medical examinations that are part of an employee health program, and may provide medical information required by State workers' compensation laws to the agencies that administer such laws.
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