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.
VisionCorps’ mission is to empower individuals with vision loss to attain independence. They understood that accessibility to the programs and resources on their website was vital to the success of their mission. They partnered with our agency to design a website that would become the model for other businesses looking to create accessible web design for individuals who are blind or vision-impaired.
President George H.W. Bush signed the Americans with Disabilities Act into law July 26, 1990. The ADA prohibits discrimination of people with disabilities and guarantees the same opportunities as everyone else. These opportunities include employment possibilities, purchasing of goods and services and the ability to participate in State and local government programs.

When choosing an aid or service, title II entities are required to give primary consideration to the choice of aid or service requested by the person who has a communication disability. The state or local government must honor the person’s choice, unless it can demonstrate that another equally effective means of communication is available, or that the use of the means chosen would result in a fundamental alteration or in an undue burden (see limitations below). If the choice expressed by the person with a disability would result in an undue burden or a fundamental alteration, the public entity still has an obligation to provide an alternative aid or service that provides effective communication if one is available.
Through the Americans with Disabilities Act (ADA), our nation committed itself to eliminating discrimination against people with disabilities. The U.S. Department of Justice’s (DOJ) Civil Rights Division is proud to play a critical role in enforcing the ADA, working towards a future in which all the doors are open to equality of opportunity, full participation, independent living, integration and economic self-sufficiency for persons with disabilities.
Federal law isn't the only consideration for businesses. Additionally, each state interprets the law differently. Consider the case against Netflix in 2012. Lawsuits were brought in federal court in Massachusetts and California. Netflix was accused of violating the ADA by not offering "closed captioning" options for its Internet streamed movies. Illustrating the complexity of this issue, the courts reached completely opposite decisions. Massachusetts held that Netflix must comply with the ADA, while the California court found that Netflix did not fall under the ADA's definition of "public accommodation."
Web developers need to keep this in mind when creating websites. The best screen readers use naturalized voices and alter tone and inflection based on HTML tags, so choose layout elements carefully. It is also important to keep in mind that navigation is significantly slower when using a screen reader than it is for sighted people. Sighted people don't have to wait for the reader to get to the link we want- we spot links quickly and are able to navigate to our sought items, often without having to do any reading at all. Minimizing graphics also helps shorten reading times and speed navigation for disabled users.
Reha asked Vu if companies are obligated to comply? Vu said that unlike the physical access world, where any new building has to be compliant no matter what, there’s no such thing in the web world. The Justice Dept. hasn’t said that that’s the default, but they have said that the current regulatory regime requires it anyway. Equal access has been around since 1990.
In short, the ADA is meant to protect disabled individuals as they go about their daily lives. These regulations ensure that people with disabilities are not denied entry into the above places or denied services by a company due to their disability. It is important to note that these regulations are now applicable to services that are provided online or through other digital formats. For example, if a company accepts job applications online, then it must ensure that a person with a disability can also apply for the job online. In other words, it is illegal to have barriers on the website that would keep the disabled individual from successfully completing their application. Fortunately, the ADA guidelines help to remove barriers and ensure that the Internet remains a space that people of all backgrounds and disabilities can use.
Complying with ADA provisions will cost you time, money, and human effort. Based on the audit results, you will know accurately the amount of time, human effort, and money you need to invest in compliance. Armed with these facts, you can start budgeting for the above three forms of cost—time, money, and human effort. This will require a clear roadmap.
@Rick, I didn't specifically look at doctype, but Steve Faulkner did in his original article (see the link at the top of this post). He found that 101 of the 130 pages containing role="main" (78%) used the HTML5 doctype, which of course leaves 22% that didn't. I do recommend using ARIA even if using an earlier doctype. Validation is important, but if validation and accessibility conflict, I think most would agree accessibility should trump validation. Assistive technologies that support ARIA landmarks do so regardless of doctype, and otherwise the presence of these role attributes has no ill effects in any user agent.
The Americans with Disabilities Act (ADA) was first passed in 1990. Twenty years later, the US Department of Justice released an update called the 2010 ADA Standards for Accessible Design. These standards cover the design of physical spaces and have been interpreted to include web locations as well, so it can be difficult for the would-be accessible website designer to use them.