Because they only read text, screen readers and refreshable Braille displays cannot interpret photographs, charts, color-coded information, or other graphic elements on a webpage. For this reason, a photograph of a mayor on a city’s website is inaccessible to people who use these assistive technologies, and a blind person visiting the website would be unable to tell if the image is a photo, a logo, a map, a chart, artwork, a link to another page, or even a blank page.
Leading web developers have been pioneering accessibility and publishing standards since 1994. In 1999, the Web Accessibility Initiative (WAI) and the World Wide Web Consortium (W3C) created the Web Content Accessibility Guidelines (WCAG). In essence, the people who determine how the internet is written came together to advise web developers on how to make websites accessible not only to people with disabilities, but to all web users, including those with highly limited devices.
State and local governments will often post documents on their websites using Portable Document Format (PDF). But PDF documents, or those in other image based formats, are often not accessible to blind people who use screen readers and people with low vision who use text enlargement programs or different color and font settings to read computer displays. 

As a client, you might think web design comprises things like a homepage and a few interior page layouts, but web design is so much more. What about call-to-actions, buttons, and images? What about design flow? What about your navigation, headers, footers, and any side elements for up-selling products? Basically, design includes all the elements of your site, and they all need to flow with your color scheme and business idea.
ADA disabilities include both mental and physical medical conditions. A condition does not need to be severe or permanent to be a disability.[6] Equal Employment Opportunity Commission regulations provide a list of conditions that should easily be concluded to be disabilities: deafness, blindness, an intellectual disability (formerly termed mental retardation), partially or completely missing limbs or mobility impairments requiring the use of a wheelchair, autism, cancer, cerebral palsy, diabetes, epilepsy, Human Immunodeficiency Virus (HIV) infection, multiple sclerosis, muscular dystrophy, major depressive disorder, bipolar disorder, post-traumatic stress disorder, obsessive compulsive disorder, and schizophrenia.[7] Other mental or physical health conditions also may be disabilities, depending on what the individual's symptoms would be in the absence of "mitigating measures" (medication, therapy, assistive devices, or other means of restoring function), during an "active episode" of the condition (if the condition is episodic).[7]
The web design company you choose must be able to interpret your company’s mission and identity and turn it into an appealing website that connects with potential customers. They must help you reach your target audience and meet your business goals. A web design agency should have on staff both talented web designers, with fresh ideas and extensive technical and creative skills, and a marketing team that knows how to drive traffic to your site, encourage visitor engagement, and convert visitors into customers. Web designers should be able to build in search optimization and integrate your site with a content management system and e-commerce tools. Look, too, for a website design company that understands responsive design and can optimize your website for mobile devices and desktop browsers. The right web design company understand current design and website trends, has experience building sites in a variety of industries (not just yours), and has an expansive portfolio of live websites. Finally, don’t simply hire the cheapest bidder — in web design, as in all things, you get what you pay for.
In 2001, for men of all working ages and women under 40, Current Population Survey data showed a sharp drop in the employment of disabled workers, leading at least two economists to attribute the cause to the Act.[52] By contrast, a study in 2003 found that while the Act may have led to short term reactions by employers, in the long term, there were either positive or neutral consequences for wages and employment.[53] In 2005 the rate of employment among disabled people increased to 45% of the population of disabled people.[54]
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.
ADA compliance isn’t a set-it-and-forget-it thing. Compliance standards must be followed and will evolve just as your website does. There are guidelines all website contributors must know to stay within ADA guidelines. It is generally not burdensome but it does require some web managers to change their workflows. For example, loading images up to your ecommerce site will always need some of that alternative text (alt tags) mentioned above.
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).

Because web designers tend to work as freelancers on a project basis, they must be excellent communicators, willing to manage their own work, and available on your schedule. Some critical skills, such as working collaboratively and responding enthusiastically to feedback, aren’t core to good web design, but make working with a web designer much easier. Finally, look for a web designer who has cross-functional knowledge, such as understanding marketing and conversion rate optimization in addition to web design.
The fastest, most certain way to be sure your website is in compliance is to contact a qualified web design agency and have them perform an audit of all your online properties. Make sure you interview the agency thoroughly first, as not all agencies are up to speed on ADA website compliance rules. A qualified web design firm will be able to identify any violations of ADA Website Compliance and outline a plan for updating your online content and properties. 

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.

Signed in 1990 at a time that most people hadn’t even used the Internet, the Americans with Disabilities Act does not explicitly regulate how websites need to follow nondiscrimination requirements. We now know that using the Internet is one of the most important ways for people with disabilities to fulfill their needs and desires. For many people with disabilities, especially impairments to sight and motion, visiting a store or other physical location can be a challenging experience. Online shopping, for example, allows people with disabilities to make the purchases they need easily and securely within the comfort of their own homes.
Aloha Tatiana! I wish your questions had straightforward easy answers – and if you are government funded it kind of is. (See here: https://www.ada.gov/websites2_prnt.pdf) if you are not government funded, this is something that is currently being debated in the legal system. That being said, the WCAG 2.0 guidelines are a good set of guidelines to help protect yourself if you feel you should. (You can see more on WCAG here: https://www.yokoco.com/find-out-how-to-make-your-website-compliant/)
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