The Fourth Circuit recently decided in Carolyn Hall v. Sheppard Pratt Health System, Inc. that a hospital employee was not entitled to a religious accommodation for a COVID-19 vaccination. [Read the Court’s Opinion Here] While the COVID pandemic is several years in our rearview mirror, many of the lawsuits that resulted out of the Biden Administration’s vaccine mandate are just now coming up for a review by the appeals court and/or for trial. The Fourth Circuit Court of Appeals, which decided this case, covers federal cases out of South Carolina, so it’s relevant to any SC employees.
Healthcare Employee Made a Request for a Religious Accommodation and Was Fired
In this case, the employee served as an admissions coordinator in the Center for Eating Disorders at a Maryland hospital. Her job required in-person interactions with patients and their families, although she had worked remotely for prior brief periods of time. In September 2021, the hospital implemented a vaccine mandate for all employees at the healthcare facilities, with a procedure provided for employees to make requests for religious or medical accommodations. Religious exemption requests required an application, which included a requirement to describe the nature of the religious objection, and then an interview to discuss job duties and possible accommodations of those job duties. Medical exemption requests, on the other hand, were reviewed by a third-party doctor, and if approved, then employees could work remotely if job duties allowed, and if not, then the employee could be masked and tested weekly. The masking and testing option was not permitted for religious exemptions. [Read more: Religious Accommodations Under Title VII for South Carolina Employees]
The employee made a request for a religious exemption. After review, the hospital said it could not accommodate her request to work remotely since so much of her job duties required in-person contact with patients, families, and co-workers. The employee had the option to apply for other jobs that she could do remotely, but she did not apply elsewhere and was therefore fired.
What is an “Undue Burden” Caused by a Religious Accommodation Request?
The ultimate question that the Fourth Circuit had to determine was whether the hospital had unreasonably failed to accommodate the employee’s religious exemption request. This question turns on the concept of “undue hardship.” A company does not have to accommodate a religious accommodation request if doing so would cause an undue hardship to the company. [Read more: Must SC Employers Provide Religious Accommodations?] In 2023, the U.S. Supreme Court held that a company “must show that the burden of granting an accommodation would result in substantial increased costs in relation to the conduct of its particular business.” Groff v. DeJoy, 600 U.S. 447, 470 (2023). The Fourth Circuit, in deciding the hospital employee’s case, said that those costs can be both economic and non-economic, including the health and safety of employees and the patients.
Ultimately, the Fourth Circuit determined under this standard that the employee’s position required her to interact with medically compromised patients, and that allowing the employee to remain unvaccinated would have posed too high a risk to patient safety. The Court also noted the dangers to co-workers and the dangers of causing another COVID outbreak. Therefore, the hospital was legally permitted to deny the employee’s request and could terminate her as a result without violating Title VII. [Read More: Vaccine Mandate: Can SC Employees Be Terminated For Refusing the COVID 19 Vaccine?] And because the standard for undue hardship under Title VII (religion) was different than the standard under the Americans with Disabilities Act (ADA), the Fourth Circuit allowed the hospital to only provide masking and testing alternatives for medical exemptions, not religious exemptions.
I don’t really buy that last argument. The hospital approved over fifty employees for the medical exemption (masking and testing allowed instead of remote work). If one unvaccinated worker would pose an undue burden to the hospital, as the Court claims, then it makes no sense why the fifty medical exemptions would be allowed but not the religious objections. I understand the argument about health and safety, but the hospital still allowed 50 unvaccinated people work in the hospital, apparently without issue. Granting more religious accommodations for the same reasons shouldn’t be any different. But hey, I’m not a judge, so no one’s asking me.
Takeaways for South Carolina Employees regarding Religious Accommodations
While COVID vaccines are no longer mandated by the federal government, businesses can still require vaccines for employees to work there. Employees with medical issues can still request a medical exemption under the ADA, and employees with religious objections can still request a religious accommodation under Title VII of the Civil Rights Act. But as this new case illustrates, you may have a harder time claiming a religious exemption than a medical exemption.
However, many of the health and safety concerns regarding patients raised by the hospital would not be as relevant at a non-hospital employer. I do think the court might have ruled differently if the case did not involve a healthcare facility.
Ultimately, religious and medical accommodation cases are highly fact specific, based on job duties, schedules, and interactions with co-workers and customers. If you are in need of an accommodation and have been denied, feel free to reach out to our office for a consultation.
