The panel affirmed the district court’s summary judgment in favor of Legacy Health in a Title VII action brought by Legacy employees who were denied religious exemptions from a COVID-19 vaccination policy.

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The panel held that Title VII requires employers to make reasonable accommodations for their employees’ religious beliefs unless doing so would cause “undue hardship” to the employer’s business.  Under Groff v. DeJoy, 600 U.S. 447 (2023), showing more than a de minimis cost is insufficient to establish undue hardship under Title VII.  Rather, undue hardship is shown when a burden is substantial in the overall context of an employer’s business.  Under Petersen v. Snohomish Reg’l Fire & Rescue, 150 F.4th 1211 (9th Cir. 2025), the substantial additional costs need not be exclusively monetary.  They can extend to health and safety costs and operational burdens as well as traditional financial burdens.  In addition, costs need not be realized prior to raising an undue-hardship defense.  A risk of undue hardship will suffice, provided it is realistic and not merely conceivable or hypothetical.

The panel concluded that Legacy, a regional healthcare system, showed undue hardship in the context of the COVID-19 Delta variant and a predicted surge of hospitalizations across Legacy’s locations.  Granting the employees’ exemption requests posed three risks.  First, there was a risk that the employees would become ill and cause staffing issues from their absence.  Second, the employees’ risk of infection posed concerns for other staff needed to treat patients.  Finally, the transmission risk would also affect Legacy’s patient population.  Taken together, Legacy’s “realistic” concerns threatened a “substantial” burden on its business of providing quality healthcare.

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https://cdn.ca9.uscourts.gov/datastore/opinions/2026/05/06/24-5977.pdf