Maryanne Grande v. Saint Clare’s Health System (076606) (Morris County and Statewide)

JUSTICE SOLOMON

delivered the opinion of the Court.

We are called upon to determine whether in this action brought under New Jersey’s Law Against Discrimination (LAD), N.J.S.A. 10:5-1 to -49, the Appellate Division correctly reversed the trial court’s grant of summary judgment in favor of defendant Saint Clare’s Health System and against plaintiff Maryanne Grande, R.N. Because we conclude that, on the record before the trial court, issues of material fact exist, we affirm and modify the judgment of the Appellate Division and remand the matter to the trial court for further proceedings.

I.

A.

We glean the following facts from the record considered by the trial court, including Grande’s deposition, certifications by Saint Clare’s and its agents, various exhibits contained within each party’s summary judgment motion, and associated statements of material facts.

Grande has been a practicing registered nurse (R.N.) since 1985. She was employed by Saint Clare’s from approximately 2000 through July 2010. Beginning in about 2006, Grande worked in a hospital unit in which approximately half of the patients were stroke victims who required additional assistance with their daily living needs. Grande’s regular duties involved maintaining charts, administering medication, and general patient care, including assisting patients with daily living activities such as washing, bathing, dressing, walking, repositioning patients in bed, and guarding *8ambulant patients against falls. Thirty to forty percent of the patients in Grande’s unit wore armbands and had signage placed outside their hospital rooms to alert staff that they were at an increased risk of falling.

In August 2008, the hospital performed job system analyses for various nursing positions. The job analysis for R.N.s (Job Analysis) indicated the frequency with which job duties were to be performed and identified certain tasks as essential to the R.N. position regardless of how frequent their performance. The Job Analysis categorized occasional tasks as those performed “1-33% of the day” and frequent tasks as those performed “34-66% of the day.” Essential tasks were described as the “[ejssential function[s] of [the] job.” One essential duty of an R.N. is to lift fifty pounds from waist to chest “frequently.” According to the certification of Heather Jordan, Saint Clare’s human resources supervisor, the weightlifting requirements within the Job Analysis are identical for all R.N.-staffed units in the hospital.1

Beginning in 2007, prior to the Job Analysis, Grande suffered a series of work-related injuries. The first occurred in March 2007, when she injured her left shoulder while repositioning a patient in bed. Grande was unable to continue working that day, immediately saw a doctor, and reported the incident to Saint Clare’s. She had surgery on her shoulder in April, followed by physical therapy. Grande spent about three months recovering at home before returning to work on a full-time but “light duty” basis, which included chart administration, compliance review, and similar administrative tasks. Less than a month later, Grande returned to full duty, including patient care.

*9The second injury occurred in May 2008, when Grande felt pain in her right shoulder while repositioning a patient in bed. Grande reported the incident immediately to Saint Clare’s and saw a doctor, who performed a magnetic resonance imaging (MRI). The test found no injury, and Grande returned to full duty within two weeks. The record is unclear as to whether Grande’s work was restricted following the May 2008 injury.

In November 2008, Grande re-injured her left shoulder while lifting the legs of a 800-pound patient. As before, Grande immediately saw a doctor and reported the incident to her employer. Grande was unable to return immediately to work, underwent a second surgery on her left shoulder, and returned to full duty about six months after the incident.

Grande sustained her final injury in February 2010 when she was alone in a room caring for an overweight patient who was moving from a stretcher to a bed. While Grande stood on the far side of the bed, the patient began to fall. Grande leapt onto the bed, grabbed the patient’s shoulders from behind, and pulled the patient onto the bed and on top of herself. After doing so, Grande felt a sharp pain and believed she had re-injured her left shoulder, but an MRI revealed that she had injured her cervical spine. Grande underwent surgery and spent four months recovering and rehabilitating before returning to work. On her first day back, however, she left the hospital after just four hours because of residual pain. Two weeks later, Grande returned to full-time, light-duty work.

In early July 2010, Grande’s doctor cleared her to resume full-duty work. The hospital informed Grande that, before returning to full duty, she would have to undergo physical testing. Lori Briglio, the nurse case manager overseeing Grande’s workers’ compensation claim, instructed Grande to report to Kinematic Consultants, Inc. (KCI) for a functional capacity evaluation (FCE).

Grande complied and underwent the examination, which tested her ability to perform a variety of physical tasks, including turning her head, demonstrating mobility in her limbs, lifting objects from *10different heights, turning in different directions, pushing and pulling, and carrying weights. The report documenting the evaluation (KCI Report) provided results in several categories and compared Grande’s ability with her employer’s requirements and with the standards set forth in the Dictionary of Occupational Titles (D.O.T.).2 The Report specified that Grande’s job demanded that she perform tasks involving pushing, pulling, and lifting from waist to chest frequently (34-66% of the time), but that she was able to perform these functions only occasionally (1-33% of the time). Accordingly, the Report recommended maximum loads for Grande to bear, including that Grande frequently lift no more than sixteen pounds from waist to chest.

The KCI Report also provided several conclusions about Grande’s performance throughout the evaluation and her work abilities. The Report acknowledged that Grande had “demonstrated maximum effort” throughout the evaluation and confirmed that the documented results “are considered to be valid.” The Report noted that Grande’s results “may be compatible with mild residual functional issues, as per complaints and/or diagnosis,” but concluded that “[i]t is improbable that this will significantly affect job performance ability.”

The Report also explained that Grande qualified to return to work on “altered duty” based on the Report’s recommendations. Due to Grande’s previous cervical surgery, the Report recommended that Grande be “allowed changes in activities during periods of prolonged or repetitive” neck movements. The Report also recommended that Grande “seek appropriate assistance with *11heavier physical activities such as patient transfers, guarding ambulatory patients or handling loads” greater than fifty pounds.

Overall, the KCI Report concluded that Grande

demonstrate[d] ability for Medium category work (occasional lift and work up to 50 lbs.) with the above noted job movement demand changes. She demonstrate!)!] ability for administrative/supervisory duties, verbal instruction to patients/care givers, assisting physicians with examinations, assisting with wound care/dressing changes, dispensation of medications, pushing wheelchairs, assisting with moderate patient care, handling loads up to 50 lbs., etc.

Shortly after the KCI Report was issued, Briglio contacted KCI via e-mail to clarify several aspects of the Report, including the portions of the job description that Grande could not fulfill and the accommodations she would require.3 In an addendum, KCI responded that Grande “demonstrates ability for Medium category work (occasional lift and work up to 50 lbs.) with noted job movement demand changes” and reiterated that Grande could return to work with certain accommodations. Nonetheless, the addendum concluded with the following disclaimer: “Please note that determination for final return to work abilities for [Grande] is deferred to her treating physician, in this case, Joel H. Spielman, M.D.”

On July 21, 2010, following the functional capacity evaluation, Dr. Spielman re-examined Grande. He provided her with a form that indicated she could return to work the next day with restrictions, “per [the] FCE.” Briglio, in turn, advised the hospital that Dr. Spielman “agreed with the FCE report and advised that [Grande] should have permanent restrictions of lifting up to 50 lbs occasionally and that she should transfer patient with assistance only.”

The following day, Grande was summoned to a meeting with her supervisors, at which she was fired. Grande testified in her *12deposition that she was told she had limitations that would prevent her from doing her job.4

After her termination, Grande again visited Dr. Spielman, who issued another return-to-work form on August 25, 2010, clearing Grande to return immediately to full-time, full-duty work with no limitations. Grande submitted the new work authorization to Saint Clare’s, but Saint Clare’s refused to rehire her.

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Nearly a year after her discharge, Grande filed a two-count complaint against Saint Clare’s, alleging violations of N.J.S.A. 10:5-4.1, a subsection of the LAD. The first count alleged that Saint Clare’s unlawfully discriminated against Grande based on her disability, and the second count alleged unlawful discrimination based on a perceived disability,5

Saint Clare’s denied liability and, following discovery, filed a motion for summary judgment. In a certification supporting that motion, Saint Clare’s human resources supervisor, Jordan, asserted that “Grande was physically unable to perform an essential function of her job” and expressed “concern[ ] that Ms. Grande would be re-injured or that a patient would be injured if [Grande] returned to full duty.” Jordan also certified that the decision to terminate Grande’s employment was based on the findings in the KCI Report and the July 2010 recommendation of Grande’s own physician.

*13Grande filed a cross-motion for summary judgment. She conceded that she had periods of disability due to work-related accidents but asserted that she surpassed the D.O.T. weight-lifting requirements for nurses in her field, as reflected on the KCI Report. Grande also alleged that the weight-lifting requirements specified in the KCI Report were “fictitious” because the standards were “far higher” than those required by the D.O.T. and “ha[d] not been shown to have ever been adopted by Saint Clare’s.” She also contended that the hospital improperly interpreted the KCI Report’s recommended lifting restrictions as actual limitations on her abilities, highlighting that she had, in fact, lifted ninety-two pounds from waist to shoulders during the evaluation, far above her employer’s fifty-pound requirement.

The tidal court granted summary judgment in favor of Saint Clare’s, finding that Grande did not establish a prima facie ease of discriminatory discharge because she “failed to articulate whether she was performing (or was able to perform) her job at a level that met the employer’s legitimate expectations.”

A divided Appellate Division panel reversed, vacating summary judgment and remanding because the record contained several material facts in dispute that could only be resolved by a jury. According to the majority, “the motion court incorrectly resolved these materially disputed facts in favor of [Saint Clare’s] and rejected or minimized the importance of evidence a rational jury could find to support [Grande’s] case of unlawful discrimination due to her perceived physical disability.” The majority explained:

Here, plaintiff produced competent evidence, in the form of her treating physician’s certification, stating she had been medically cleared to return to work without restrictions. Defendant has not rebutted that medical opinion with the opinion of another physician. Instead, defendant relies on the results of a “functional capacity evaluation [FOE] test” conducted by an alleged independent company retained by defendant’s Department of Human Resources. KCI’s report contains facially equivocal findings with respect to plaintiffs abilities to perform the core requirements of a nurse,

The dissenting member of the panel emphasized that “[t]he law should not place a hospital in a position of sacrificing employee and patient safety in order to avoid potential liability for discrimi*14nation” and that the hospital “could sensibly rely on [Grande’s] actual work history [and history of injuries] when it placed safety interests above [her] continued employment.” The dissent also found no genuine factual disputes because “at the time the hospital made its decision to terminate [Grande], her treating physician had stated she could return to work, but only with lifting restrictions” — a recommendation which was modified “only after the hospital had already terminated [Grande’s] employment.”

Saint Clare’s filed this appeal as of right pursuant to Rule 2:2-1(a)(2), limited to whether summary judgment was appropriately awarded to the hospital by the trial court on the facts in the record before it. We granted amicus curiae status to the New Jersey Association for Justice (NJAJ) and the National Employment Lawyers Association of New Jersey (NELA-NJ).

II.

A.

Saint Clare’s argues that the LAD, its implementing regulations, and New Jersey employment discrimination jurisprudence authorize Grande’s termination. Saint Clare’s concedes that Grande is disabled under the LAD but agrees with the trial court that she failed to establish a prima facie case because she could not prove she was performing her job to the hospital’s legitimate expectations. Saint Clare’s highlights that Grande was working light duty at the time of her discharge, and both the KCI Report and Grande’s physician confirmed that she could return to her regular duties only with lifting restrictions.

Even if Grande established a prima facie case, Saint Clare’s maintains, the termination of her employment was legal. The hospital cites various provisions of the LAD, including N.J.S.A. 10:5 — 5(q), -2.1, -4.1, and -29.1, which provide that an employer may terminate a disabled employee who, in the reasonable opinion of the employer, is unable to perform adequately her job duties. The hospital also relies on N.J.AC. 13:13-2.8, which allows an *15employer to terminate a disabled employee if her continued employment “would be hazardous to the safety or health of such individual, other employees, clients or customers.” Saint Clare’s maintains that its decision to discharge Grande was appropriate because, unlike the employer’s improper reliance on a deficient medical report in Jansen v. Food Circus Supermkts., Inc., 110 N.J. 363, 541 A.2d 682 (1988), Saint Clare’s decision was based on objective evidence — the functional capacity evaluation — as well as Grande’s own undisputed history of injuries on the job.

B.

Grande contends that Saint Clare’s admission — that it fired her because of her perceived disability — is direct evidence of discrimination and, thus, Jansen does not require her to prove a prima facie case. Instead, Grande maintains that the burden rests on Saint Clare’s to assert an affirmative defense, which the hospital failed to do by competent medical or scientific evidence. Grande argues that because Saint Clare’s failed to follow up with her treating doctor, there is no competent evidence that she was a risk to herself or patients or that she could not perform her job duties.

Finally, Grande claims that certain factual issues remain in dispute, including (1) the applicability of Saint Clare’s purported lifting requirements to R.N.s in Grande’s position; (2) the number of injuries she sustained; (3) whether she would need assistance handling loads over fifty pounds; and (4) that she is likely to suffer future injury.

C.

Amici NJAJ and NELA-NJ agree with both parties that Jansen provides the controlling test on disability discrimination under the LAD. NJAJ asserts that Saint Clare’s made the same error here as the employer in Jansen — it improperly assumed that there was a probability of future injury without relying on an expert report linking Grande’s perceived disability to a probability of substantial harm.

*16NELA-NJ adds that because Grande presented direct evidence of discrimination, the only issue is “whether Saint Clare’s met its burden of proving ‘it would have made the same decision even in the absence of the impermissible consideration’ ” (quoting Bergen Commercial Bank v. Sisler, 157 N.J. 188, 209, 723 A.2d 944 (1999)). NELA-NJ also cautions that Saint Clare’s should not be given “carte blanche” to decide what the essential functions of a particular job are, as this would allow an employer to “invent unrealistic job requirements for the sole purpose of eliminating disabled people from consideration.” It urges that the proper approach is to allow a fact-finder to weigh the employer’s statements, the written job description, the work experience of current and former employees, and other factors, such as the D.O.T. standards, to determine whether the employer’s criteria are realistic or designed to discriminate against a disabled person.

III.

Turning to the law relevant to the parties’ arguments, the LAD prohibits an employer from terminating a disabled employee because of her disability unless the disability “reasonably precludes the performance of the particular employment.” N.J.S.A. 10:5-4.1. The law governing an action “seeking redress for an alleged violation of the LAD” depends upon whether the employee “ ‘attempts] to prove employment discrimination by ... direct or circumstantial evidence.’ ” Smith v. Millville Rescue Squad, 225 N.J. 373, 394, 139 A.3d 1 (2016) (quoting Sisler, supra, 157 N.J. at 208, 723 A.2d 944). Plaintiffs are permitted to prove their claim using either or both methods. Sisler, supra, 157 N.J. at 208, 723 A.2d 944.

A.

To prove a discriminatory discharge case by direct evidence, a plaintiff “must produce evidence ‘that an employer placed substantial reliance on a proscribed discriminatory factor in making its decision’ ” to terminate the employee. Smith, supra, 225 *17N.J. at 394, 139 A.3d 1 (quoting A.D.P. v. ExxonMobil Research & Eng’g Co., 428 N.J.Super. 518, 533, 54 A.3d 813 (App. Div. 2012)). “The evidence produced must, if true, demonstrate not only a hostility toward members of the employee’s class, but also a direct causal connection between that hostility and the challenged employment decision.” Sisler, supra, 157 N.J. at 208, 723 A.2d 944 (citing Price Waterhouse v. Hopkins, 490 U.S. 228, 277, 109 S.Ct. 1775, 1804, 104 L.Ed.2d 268, 305 (1989) (O’Connor, J., concurring)).

“After the plaintiff sets forth ‘direct evidence of discriminatory animus, the employer must then produce evidence sufficient to show that it would have made the same decision if illegal bias had played no role in the employment decision.’ ” Smith, supra, 225 N.J. at 395, 139 A.3d 1 (quoting Fleming v. Corr. Healthcare Sols., 164 N.J. 90, 100, 751 A.2d 1035 (2000)).

B.

If direct evidence of discrimination is unavailable, a plaintiff may prove her claim by circumstantial evidence. To evaluate circumstantial evidence cases, this Court has adopted the three-step burden-shifting test articulated by the United States Supreme Court in McDonnell Douglas Corp. v. Green, 411 U.S. 792, 93 S.Ct. 1817, 36 L.Ed.2d 668 (1973). Andersen v. Exxon Co., U.S.A., 89 N.J. 483, 492-93, 446 A.2d 486 (1982). Nevertheless, this Court has modified the McDonnell Douglas framework in evaluating disability discrimination claims. See id. at 498, 446 A.2d 486 (noting that, in “physical handicap” cases, “it will not be necessary to go through all of the strict steps of the McDonnell Douglas formula”).

1.

The first step of our modified framework requires that a plaintiff establish a prima facie ease. Jansen, supra, 110 N.J. at 382, 541 A.2d 682. When a plaintiff alleges she was fired discrimi-natorily based on a disability, she must prove by a preponderance *18of the evidence that: (1) she is disabled within the meaning of the LAD; (2) she “was performing [her] job at a level that met [her] employer’s legitimate expectations”; (3) she was discharged; and (4) the employer sought someone else to perform the same work after she left. Ibid. (quoting Clowes v. Terminix Int'l, Inc., 109 N.J. 575, 597, 538 A.2d 794 (1988)).

As to the first prong of the prima facie case, an employee who is perceived to have a disability is protected just as someone who actually has a disability. Victor v. State, 203 N.J. 383, 410, 4 A.3d 126 (2010); Rogers v. Campbell Foundry, Co., 185 N.J.Super. 109, 112-13, 447 A.2d 589 (App. Div.), certif. denied, 91 N.J. 529, 453 A.2d 852 (1982).

The second prong — whether the employee is able to perform at a level that meets “legitimate or reasonable expectations” — is to be evaluated by an objective standard. Viscik v. Fowler Equip. Co., 173 N.J. 1, 21, 800 A.2d 826 (2002). Thus, deficiencies in an employee’s performance are reserved for consideration at later stages in the analysis. Ibid. For the second prong, “[a]ll that is necessary is that the plaintiff produce evidence showing that she was actually performing the job prior to termination.” Zive v. Stanley Roberts, Inc., 182 N.J. 436, 454, 867 A.2d 1133 (2005).

The fourth prong requires proof that the “employer sought a replacement with qualifications similar to [the employee’s] own, thus demonstrating a continued need for the same services and skills.” Sisler, supra, 157 N.J. at 218-19, 723 A.2d 944 (emphasis omitted) (quoting Erickson v. Marsh & McLennan Co., 117 N.J. 539, 553, 569 A.2d 793 (1990)).

2.

If a plaintiff successfully establishes a prima facie case, “a presumption arises that the employer unlawfully discriminated against the plaintiff.” Clowes, supra, 109 N.J. at 596, 538 A.2d 794. The analysis then proceeds to the second step of the test, where *19“the employer’s burden varies depending on whether the employer seeks to establish the reasonableness of the otherwise discriminatory act or advances a non-discriminatory reason for the employee’s discharge.” Jansen, supra, 110 N.J. at 382, 541 A.2d 682.

If the employer claims that it has a non-discriminatory reason for the discharge, “the burden of production — not the burden of proof or persuasion — shifts to the employer.” Ibid. The employee may respond by proving by a preponderance of the evidence that the reason proffered by the employer “was not the true reason for the employment decision but was merely a pretext for discrimination.” Id. at 382-83, 541 A.2d 682 (quoting Andersen, supra, 89 N.J. at 493, 446 A.2d 486). As with the traditional McDonnell Douglas framework, the burden of proving that the employer intentionally discriminated remains at all times with the employee. Id. at 383, 541 A.2d 682.

If, in the second step, “the employer defends by asserting that it reasonably concluded that the handicap prevented the employee from working,” the employer bears the burden of proof as to its defense, and not a mere burden of production. Id. at 383, 541 A.2d 682; see N.J.A.C. 13:13-2.8(a)(3); see also N.J.S.A. 10:5-29.1 (stating that “[u]nless it can be clearly shown that a person’s disability would prevent [her] from performing a particular job, it is an unlawful employment practice to deny an otherwise qualified person with a disability the opportunity to ... maintain employment”). To carry its burden, the employer must prove “it ... reasonably arrived at its opinion that the [employee] is unqualified for the job.” Andersen, supra, 89 N.J. at 496, 446 A.2d 486. The employer must produce evidence that its decision was based on “an objective standard supported by factual evidence” and not on general assumptions about the employee’s disability. N.J.A.C. 13:13-2.8(a)(3).

One possible basis for the employer’s affirmative defense is safety. Recognizing the importance of safety in the workplace, the LAD regulations and this Court have made clear *20that an employer may terminate a disabled employee where continued employment “would be hazardous to the safety or health of [the employee], other employees, clients or customers.” N.J.A.C. 13:13—2.8(a)(2); Jansen, supra, 110 N.J. at 374, 541 A.2d 682. “When asserting [that] safety defense, the employer must establish with a reasonable degree of certainty that it reasonably arrived at the opinion that the employee’s handicap presented a materially enhanced risk of substantial harm in the workplace.” Jansen, supra, 110 N.J. at 383, 541 A.2d 682. Importantly, “[a]n employer may not base a decision to discharge an employee for safety reasons on subjective evaluations or conclusory medical reports.” Greenwood v. State Police Training Ctr., 127 N.J. 500, 511, 606 A.2d 336 (1992).

C.

In addition to the above analysis, the LAD regulations require an evaluation of whether a reasonable accommodation would have allowed the disabled employee to perform her job. The Administrative Code mandates that an employer “consider the possibility of reasonable accommodation before firing, demoting or refusing to hire or promote a person with a disability on the grounds that his or her disability precludes job performance.” N.J.A.C. 13:13—2.5(b)(2); see also Viscik, supra, 173 N.J. at 19-20, 800 A.2d 826 (noting that reasonable accommodation arises as issue in disability discrimination cases in two instances: where plaintiff affirmatively pleads failure to accommodate and where employer defends on grounds that employee was terminated due to inability to perform job).

We have yet to determine, outside of a failure-to-accommodate claim, at what point in the McDonnell Douglas analysis a court is to consider the availability of a reasonable accommodation. In discriminatory discharge cases, the Appellate Division has addressed reasonable accommodations in its analysis of the second prong of a plaintiffs prima facie case, where the employee must produce evidence that she was performing her job to her employ*21er’s expectations. See, e.g., Svarnas v. AT&T Commc’ns, 326 N.J.Super. 69, 74-81, 740 A.2d 662 (App. Div. 1999) (discussing whether reasonable accommodation would have allowed chronically absent employee to perform essential job requirements). That approach is consistent with the evaluation of discriminatory discharge claims under the Americans with Disabilities Act (ADA), 42 U.S.C.A. §§ 12101 to 12213. See, e.g., Taylor v. Phoenixville Sch. Dist., 184 F.3d 296, 306 (3d Cir. 1999) (plaintiff alleging discriminatory discharge under ADA must establish, as second prong of prima facie case, that she “is otherwise qualified to perform the essential functions of the job, with or without reasonable accommodations by the employer” (quoting Gaul v. Lucent Techs., 134 F.3d 576, 580 (3d Cir. 1998))).

In assessing “allegations of unlawful discrimination, this Court has looked to federal law as a key source of interpretive authority.” Grigoletti v. Ortho Pharm. Corp., 118 N.J. 89, 97, 570 A.2d 903 (1990). Moreover, our courts have evaluated an employer’s obligation to reasonably accommodate an employee’s disability under the LAD in accordance with the ADA. Royster v. N.J. State Police, 227 N.J. 482, 499, 152 A.3d 900 (2017).

Accordingly, we hold that the reasonable-accommodation consideration belongs in the second-prong analysis. A plaintiff may satisfy the second prong of the prima facie case for an allegation of discriminatory discharge based on a disability by putting forth evidence either that she was actually performing her job or was able, with or without reasonable accommodation, to perform her job to her employer’s legitimate expectations.

An employer may rebut a plaintiffs reasonable-accommodation showing by providing evidence that the proposed accommodation is unreasonable. See N.J.A.C. 18:13—2.5(b); -2.5(b)(3)(i) to (iv).6 As we recognized in Andersen, supra, where “the job *22qualifications [are] virtually a mirror reflection of the physical boundaries of the [employee’s] handicap,” proof by the employee that she could perform the job with or without a reasonable accommodation is “tantamount to proving” that the disability does not hinder the employee’s job performance. 89 N.J. at 499 n.5, 446 A.2d 486.

IV.

Before turning to the proofs necessary to establish Grande’s LAD claim, we must first determine whether this is a case of direct or circumstantial evidence. We note that the Appellate Division did not directly address this question, but the majority opinion references Jansen, indicating that, like the trial court, it was applying the McDonnell Douglas circumstantial evidence framework to Grande’s claim.

The parties contend that this is a direct evidence case because Saint Clare’s admits that Grande’s disability motivated its decision to terminate her. We disagree. Saint Clare’s concedes that Grande is disabled under the LAD and admits that it fired her because her perceived disability precluded her from performing as a R.N. Nonetheless, Grande has produced no evidence of discriminatory *23animus toward disabled employees. She alleges that the lifting standards identified in the KOI Report and the 2008 Job Analysis do not reflect the actual requirements of her job. Grande has not shown, however, that those requirements apply only to R.N.s with disabilities or are otherwise entirely unrelated to the performance of a R.N.’s duties. See A.D.P., supra, 428 N.J.Super. at 534-35, 54 A.3d 813 (finding direct evidence of discrimination when employer’s policy applied only to employees identified as alcoholics and employee’s discharge, based on noneompliance with policy, was unrelated to job performance).

We acknowledge that, in LAD claims alleging discrimination based on other protected classes, such as race, sex, national origin, or marital status, an employer’s admission that a protected characteristic motivated its employment decision would be direct evidence of discrimination. See, e.g., Smith, supra, 225 N.J. at 397-99, 139 A.3d 1 (finding direct evidence of marital status discrimination when employer stated that employee would not have been fired if he had reconciled with his wife). However, the LAD provides that an employer may lawfully terminate a disabled employee if the disability precludes job performance. N.J.S.A. 10:5-4.1. Therefore, more than Saint Clare’s admission is needed to establish direct evidence of discrimination here; evidence of animus or hostility toward the disabled must also be produced. Because Grande fails to show a “hostility toward members of [her] class,” Sisler, supra, 157 N.J. at 208, 723 A.2d 944, we agree with the Appellate Division that this case must be resolved by applying the McDonnell Douglas circumstantial evidence framework.

V.

Having concluded that this is a circumstantial evidence ease, we apply the McDonnell Douglas framework to determine the proofs necessary to establish Grande’s LAD claim and whether summary judgment was appropriately granted in Saint Clare’s favor. We review Saint Clare’s motion for summary judgment using the same standard applied by the trial court — whether, after *24reviewing “the competent evidential materials submitted by the parties” in the light most favorable to Grande, “there are genuine issues of material fact and, if not, whether the moving party is entitled to summary judgment as a matter of law.” Bhagat v. Bhagat, 217 N.J. 22, 38, 84 A.3d 583 (2014) (citing Brill v. Guardian Life Ins. Co. of Am., 142 N.J. 520, 540, 666 A.2d 146 (1995)). An issue of material fact is “genuine only if, considering the burden of persuasion at trial, the evidence submitted by the parties on the motion, together with all legitimate inferences therefrom favoring the non-moving party, would require submission of the issue to the trier of fact.” Ibid. (quoting R. 4:46-2(c)).

A.

We first consider Saint Clare’s argument that it was entitled to summary judgment because Grande failed to state a prima facie case. Once again, under our modified McDonnell Douglas analysis, Grande must establish a prima facie case by putting forth evidence that: (1) she is disabled within the meaning of the LAD; (2) she was actually perfonning her job or was able, with or without reasonable accommodation, to perform her job at a level that met Saint Clare’s legitimate expectations; (3) she was discharged; and (4) Saint Clare’s sought someone else to perform the same work after she left. See Jansen, supra, 110 N.J. at 382, 641 A.2d 682.

It is undisputed that Saint Clare’s perceived Grande as disabled and terminated her from her R.N. position. Further, neither party claims that whether Saint Clare’s filled or eliminated Grande’s nursing position is pertinent to the summary judgment motion under consideration. Therefore, only the second prong remains at issue.

Saint Clare’s argues that Grande failed to satisfy that second prong because her lengthy absences are proof that she was not performing her job. Cf. Svarnas, supra, 326 N.J.Super. at 77, 740 A.2d 662 (stating that employer is not required to accommodate “chronic and excessive absenteeism”). Although Grande worked *25for Saint Clare’s for ten years and was never warned that her job was at risk, she was absent for over twelve months due to her injuries, worked about two months on light-duty assignments, and was on light duty, concededly at the hospital’s request, at the time she was fired.

Grande argues that she made a showing sufficient to withstand summary judgment under the second prong by putting forth evidence that she was employed for ten years and her performance was “exemplary.” She relies on Zive, supra, where this Court stated that the “slight burden of the second prong is satisfied” when a plaintiff “adduces evidence that [s]he has, in fact, performed in the position up to the time of termination.” 182 N.J. at 455, 867 A.2d 1133. Grande further claims that, at the time of her termination, she was able to resume full-time, full-duty work, and her periods of absence, in light of her ten-year history with the hospital, did not keep her from satisfying her prima facie case.

In Zive, the employee suffered a stroke, after which he did not take time off from work but instead worked from home for three months while recovering. Id. at 442-43, 867 A.2d 1133. When the employee wished to return to work at the company, he was told that his services would no longer be required. Id. at 443, 867 A.2d 1133. The employer defended its decision to terminate the employee by claiming that he failed to meet an unusually high sales goal. Id. at 450-51, 867 A.2d 1133. This Court was not persuaded, reasoning that the employee had extensive experience in his field, had worked for his employer for eight years, had been actively engaged in management and administration, and had never been told that his job was at stake. Id. at 456, 867 A.2d 1133. Importantly, Zive did not address the employer’s obligation to consider reasonable accommodations prior to terminating a disabled employee, as required by the LAD regulations. See N.J.A.C. 13:13—2.5(b)(2). Zive, thus, did not involve an employee’s extended periods of absence from work and did not address the required reasonable-accommodation consideration.

*26We nevertheless agree with Grande that the modest burden to withstand summary judgment as to the second prong of the prima facie case has been met. An issue of fact exists as to whether Grande’s periods of absence from work were sufficiently “chronic and excessive,” Svarnas, supra, 326 N.J.Super. at 77, 740 A.2d 662, to preclude her from demonstrating that she was actually performing her job at the time she was terminated. While this factual dispute is material to Grande’s prima facie case, we express no opinion on the issue.

We additionally note that, as the parties acknowledged in oral argument, the record is rather undeveloped as to any reasonable accommodation that would allow Grande to perform the essential functions of her job despite her disability. While the record is silent as to specifics, it does indicate that Saint Clare’s considered accommodations that could potentially allow Grande to continue her employment, but that no reasonable accommodation existed. Grande maintains that she needed no accommodation. Therefore, we see no reason to allow additional discovery to develop the record in this regard, and we remand for trial on the record as it stands.

B.

Having concluded that factual disputes exist as to Grande’s prima facie ease, we now turn to Saint Clare’s alternate claim that, even if Grande has established a prima facie case, Saint Clare’s is entitled to summary judgment on the basis of the defenses it asserted under the second McDonnell Douglas step.

Saint Clare’s admits that it fired Grande because of her disability but claims that the firing was justified because Grande was both unable to perform the essential functions of her job and unable to do so without posing a risk of harm to herself or others. The hospital bears the burden of proof as to its defenses. Jansen, supra, 110 N.J. at 383, 641 A.2d 682.

*271.

To prove its claim that Grande’s perceived disability precluded her from performing as a R.N., Saint Clare’s must show that “it reasonably arrived at [its] opinion.” Andersen, supra, 89 N.J. at 499-500, 446 A.2d 486. That is, Saint Clare’s must demonstrate that its opinion is “based upon an objective standard supported by factual evidence”; general assumptions about Grande’s disability are insufficient. N.J.A.C. 13:13—2.8(a)(1).

Saint Clare’s maintains that it met this burden by relying on the KCI Report, which is more comprehensive than the cursory medical examination we found insufficient in Andersen, supra, 89 N.J. at 500, 446 A.2d 486. In Andersen, an applicant sought a position as a truck driver and underwent a “preplacement physical examination.” Id. at 489, 446 A.2d 486. The applicant disclosed to the examining doctor that he had had back surgery thirteen years prior. Ibid. The doctor performed a cursory physical evaluation and asked the applicant only to “raise his hands and bend over and touch his toes.” Ibid. The doctor then concluded that the applicant was unfit for the job because “people with back problems would not be hired.” Ibid. This Court held that such a deficient medical report was an insufficient basis on which the employer could reasonably arrive at its opinion that the applicant’s disability precluded job performance. Id. at 500, 446 A.2d 486.

While we acknowledge that the KCI Report here is more than a cursory evaluation, we find it presents material issues of fact that could not be resolved on the record before the trial court. First, there is a dispute as to whether the lifting standards identified by the KCI Report as Saint Clare’s requirements are actually the standards applicable to Grande’s position. Saint Clare’s 2008 Job Analysis indicates that R.N.s are required, as essential functions of their job, to lift fifty pounds from waist to chest frequently (34% to 66% of the day) and several other loads occasionally (1% to 33% of the day), including twenty-five pounds from floor to waist, ten pounds from chest to overhead, twenty pounds in a two-hand carry, and ten pounds in a one-hand carry. The Job Analysis does *28not identify any activity that is performed at a frequency greater than 66% of the day.

The KCI Report, on the other hand, lists the following as the hospital’s requirements: constantly (67% to 100% of the day) lift twenty pounds, frequently lift fifty pounds, and occasionally lift 100 pounds. The addendum to the KCI Report indicates that the Report’s standards were based on a job description provided by the hospital but does not confirm whether that job description is the 2008 Job Analysis. The record is also silent as to why the KCI standards differ from those listed on the Job Analysis. Grande contends that the standards on neither the KCI Report nor the Job Analysis reflect what she actually does in her position. Thus, from the record before us, we cannot discern which tasks were essential to Grande’s job.

Second, there is a dispute as to whether the KCI Report conclusively establishes that Grande is unable to perform her job. The Report indicates that, in some categories, Grande’s ability was below the hospital’s standards, The Report also states, however, that while the results “may be compatible with mild residual functional issues,” “[i]t is improbable that this will significantly affect job performance ability.” The addendum to the report makes clear that “determination for final return to work abilities ... is deferred to [Grande’s] treating physician.” Dr. Spielman had cleared Grande to return to full-time, full-duty work on July 8, 2010, four days before the FCE was performed. Although Dr. Spielman subsequently restricted Grande’s work pursuant to the FCE, Grande disputes that such restrictions were permanent.7 The hospital claims that Dr. Spielman recommended permanent lifting restrictions; Grande alleges Dr. Spielman told her she could resume her regular duties; and the KCI Report does not *29indicate whether its recommendations were permanent or temporary.

These factual disputes are material to the issue of whether Grande’s disability precluded her from performing the essential functions of her job.

2.

Saint Clare’s also maintains that Grande’s history of injuring herself on the job sufficiently proved her inability to perform her job without posing a risk of harm to herself or others.

To assert this defense, Saint Clare’s “must establish with a reasonable degree of certainty that it reasonably arrived at the opinion that [Grande’s] handicap presented a materially enhanced risk of substantial harm in the workplace.” Jansen, supra, 110 N.J. at 383, 541 A.2d 682. The New Jersey Administrative Code explains the employer’s burden as follows:

Refusal to select a person with a disability may be lawful where it can be demonstrated that the employment of that individual in a particular position would be hazardous to the safety or health of such individual, other employees, clients or customers where hazard cannot be eliminated or reduced by reasonable accommodation. Such a decision must be based upon an objective standard supported by factual or scientifically validated evidence, rather than on the basis of general assumptions that a particular disability would create a hazard to the safety or health of such individual, other employees, clients or customers. A “hazard” to the person with a disability is a materially enhanced risk of serious harm.
[N.J.A.C. 13:13—2.8(a)(2) (emphases added).]

Thus, the Administrative Code requires that an employer base its conclusion to terminate an employee on “factual or scientifically validated evidence.” Ibid.

Here, viewing the facts in the light most favorable to Grande, she sustained at least three disabling injuries for which she was required to be absent from work. After each of the first two injuries, however, she was cleared to return to work and did so. After the final injury, Grande’s physician also cleared her to return to regular duty prior to her termination.

*30There is no indication in the record that plaintiff caused injury to the patients in the course of incurring her own injuries. Moreover, the KOI Report only recommends that Grande be assisted in attempting to lift more than fifty pounds, even though she was able to lift much heavier loads during testing. The Report says nothing about Grande’s ability to otherwise perform her job without causing injury to patients or to herself.

Furthermore, there is no expert testimony that Grande’s perceived susceptibility to injury posed a “materially enhanced risk of serious harm” to herself or her patients. N.J.A.C. 13:13-2.8(a)(2); accord Jansen, supra, 110 N.J. at 374-75, 541 A.2d 682. We conclude, therefore, that the evidence that Grande presented a risk of injury to herself or patients is inadequate to resolve conclusively this material issue.

In affirming the requirements set forth in Jansen, we remain cognizant of the need for safe work environments. Our holding today is not intended to limit an employer’s ability to promulgate safety standards or to require of its employees the physical ability to safely perform their duties. Nonetheless, when terminating a disabled employee because of an inability to abide by such standards, an employer must prove that its standards relate to the employee’s duties and that no reasonable accommodation exists that will allow the employee to continue in her position.

VI.

For the reasons set forth above, the judgment of the Appellate Division is affirmed as modified, and the matter is remanded to the trial court for further proceedings.

CHIEF JUSTICE RABNER and JUSTICES LaVECCHIA, ALBIN, PATTERSON, FERNANDEZ-VINA, and TIMPONE join in JUSTICE SOLOMON’S opinion. JUSTICE LaVECCHIA filed a separate, CONCURRING opinion.

The only job description provided by the hospital is the Job Analysis, prepared in 2008, eight years after Grande began working at Saint Clare's. The description indicates that it applies to "Job Title: Nursing, RN, LPN, NA; Acute Care, Medical-Surgical, Emergency Services.” It makes no distinction between R.N.s working in the stroke ward and those in acute care, medical-surgical, or emergency services. There is nothing in the record that indicates a similar job description existed prior to 2008.

The D.O.T. was "a catalogue of the occupational titles used in the U.S. economy" and was intended to provide "reliable descriptions of the type of work performed in each occupation.” John C. Dubin, The Labor Market Side of Disability-Benefits Policy and Law, 20 S. Cal. Rev. L. & Soc. Lust. 1, 3 n.7 (2011) (citation omitted). The U.S. Department of Labor published its last updated edition of the D.O.T. standards in 1991. Ibid. The D.O.T. was subsequently replaced with the Occupational Information Network, also known as the O*NET database, last revised in 2010. See About O*NET, O*NET Resource Center, https:// www.onetcenter.org/overview.html.

Briglio’s e-mail is not in the record before this Court, but KCI’s response quotes from her e-mail.

In Grande's complaint, she alleged that the hospital provided her with a letter confirming her termination and stating that the results of the functional capacity evaluation "indicated specific restrictions" and the hospital was "unable to make accommodations or find a comparable position that w[ould] accommodate [Grande's] medical requirements,” A copy of that letter is not in the record before us,

Earlier versions of the LAD used the word "handicap" rather than "disability.” See Victor v. State, 203 N.J. 383, 398 n.3, 4 A.3d 126 (2010). We use the term "disability,” except where language is quoted from an opinion or statute.

In Raspa v. Office of Sheriff of Cty. of Gloucester, the plaintiff conceded that his medical limitation — degenerating eyesight — rendered him "unable to per*22form any of the essential functions" of his position as a corrections officer, and the evidence showed "no objectively viable and reasonable accommodation would ever make" the plaintiff qualified to perform those essential functions. 191 N.J. 323, 328, 338, 924 A.2d 435 (2007). This Court held that "an employee must possess the bona fide occupational qualifications for the job position that employee seeks to occupy in order to trigger an employer’s obligation to reasonably accommodate the employee." Id. at 327, 924 A.2d 435. The Court also held that "the LAD does not require that an employer create an indefinite light duty position for a permanently disabled employee if the employee's disability, absent a reasonable accommodation, renders him otherwise unqualified for a full-time, full-duty position.” Id. at 340, 924 A.2d 435. We conclude that Raspa stands for the proposition that an employer is not required to accommodate a disabled employee by creating a permanent, light-duty position. In a wrongful discharge case, an employee may nonetheless show in her prima facie case that an accommodation other than the creation of a new, light-duty position would allow her to perform her job to her employer's legitimate expectations.

Because the August 2010 return-to-worlc certificate issued by Grande’s doctor clearing her to return to full-time, full-duty work with no limitations postdated her discharge by Saint Clare’s, it is not relevant to our determination.