Fay became an activist after being injured in a trapeze accident at 16 that damaged his spinal cord. Fay learned that he would never walk again and began using a wheelchair and then driving a car.
When he was 17, Fay co-founded a counseling and information center with his mother Janet called “Opening Doors” and the Washington Architectural Barriers Project that fought for accessibility of the D.C. transit system.
Fay developed assistive technology systems that use computers to empower people with physical disabilities. He was pivotal to the movement that achieved the passage of the Architectural Barriers Act of 1968, Sections 503 and 504 of the Rehabilitation Act of 1973, the Individuals with Disabilities Education Act of 1975 and the Americans with Disabilities Act of 1990.