Title IV of the ADA amended the landmark Communications Act of 1934 primarily by adding section 47 U.S.C. § 225. This section requires that all telecommunications companies in the U.S. take steps to ensure functionally equivalent services for consumers with disabilities, notably those who are deaf or hard of hearing and those with speech impairments. When Title IV took effect in the early 1990s, it led to the installation of public teletypewriter (TTY) machines and other TDD (telecommunications devices for the deaf). Title IV also led to the creation, in all 50 states and the District of Columbia, of what was then called dual-party relay services and now are known as Telecommunications Relay Services (TRS), such as STS relay. Today, many TRS-mediated calls are made over the Internet by consumers who use broadband connections. Some are Video Relay Service (VRS) calls, while others are text calls. In either variation, communication assistants translate between the signed or typed words of a consumer and the spoken words of others. In 2006, according to the Federal Communications Commission (FCC), VRS calls averaged two million minutes a month.
The 2014 case involving Peapod, an online grocery retailer emphasizes that being ADA compliant goes beyond your website. The settlement required Peapod to make its mobile applications accessible by March 2015 and its website accessible by September 2015. Since mobile apps are fast becoming the preferred method of online shopping, e-commerce sites must focus on app accessibility too. 

The ADA has been criticized on the grounds that it decreases the employment rate for people with disabilities[48] and raises the cost of doing business for employers, in large part due to the additional legal risks, which employers avoid by quietly avoiding hiring people with disabilities. Some researchers believe that the law has been ineffectual.[49] Between 1991 (after the enactment of the ADA) and 1995, the employment rate of men with disabilities dropped by 7.8% regardless of age, educational level, or type of disability, with the most affected being young, less-educated and mentally disabled men.[50] Despite the many criticisms, a causal link between the ADA and declining disabled employment over much of the 1990s has not been definitively identified.[51]
Most recently, however, pizza chain Domino's has been brought under suit for their website not being accessible for specialty ordering. The U.S. Supreme Court refused to review the case, instead upholding the decision of the 9th U.S. Circuit Court of Appeals who said the “alleged inaccessibility of Domino’s website and app impedes access to the goods and services of its physical pizza franchises—which are places of public accommodation.”
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