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SJC-13440
FALLON COMMUNITY HEALTH PLAN, INC. vs. ACTING DIRECTOR OF THE
DEPARTMENT OF UNEMPLOYMENT ASSISTANCE & another.1
Worcester. October 4, 2023. – March 4, 2024.
Present: Budd, C.J., Gaziano, Lowy, Kafker, Wendlandt,
& Georges, JJ.2
Employment Security, Appeal, Judicial review, Eligibility for
benefits, Burden of proof, Misconduct by employee.
Evidence, Religious beliefs. Administrative Law, Agency's
interpretation of statute.
Civil action commenced in the Worcester Division of the
District Court Department on July 14, 2022.
The case was heard by Paul F. LoConto, J.
The Supreme Judicial Court on its own initiative
transferred the case from the Appeals Court.
Francesco A. DeLuca (Alicia Maziarz also present) for the
plaintiff.
1 Shanika Jefferson.
2 Justice Lowy participated in the deliberation on this case
prior to his retirement.
2
Konstantin Tretyakov, Assistant Attorney General, for
Acting Director of the Department of Unemployment Assistance.
Margaret E. Monsell, Jamie A. Sabino, & Ruth A. Bourquin,
for Massachusetts Law Reform Institute & another, amici curiae,
submitted a brief.
BUDD, C.J. In October 2021, Fallon Community Health Plan,
Inc. (Fallon), adopted a policy requiring its employees to be
vaccinated against COVID-19. Shanika Jefferson, a home health
aide employed by Fallon, sought a religious exemption from the
vaccination requirement, but her request was denied, and her
employment was terminated. Jefferson applied for and eventually
was approved to receive unemployment benefits from the
Department of Unemployment Assistance (department); however,
Fallon contended that Jefferson was ineligible for the benefits,
and sought review of the decision. The board of review of the
department affirmed the decision, as did a District Court judge.
For the reasons explained infra, we affirm.3
1. Overview of the unemployment compensation system.
General Laws c. 151A, the unemployment insurance law, was
enacted "to provide temporary relief for those who are
realistically compelled to leave work through no fault of their
own, whatever the source of the compulsion, personal or
3 We acknowledge the amicus brief submitted by the
Massachusetts Law Reform Institute and the American Civil
Liberties Union Foundation of Massachusetts, Inc.
3
employer-initiated" (quotation omitted). Raytheon Co. v.
Director of the Div. of Employment Sec., 364 Mass. 593, 596
(1974). The law sets out conditions under which individuals
whose employment has been terminated may be eligible for and
receive unemployment benefits.4 See G. L. c. 151A, §§ 22, 24.
In enacting c. 151A, "the Legislature recognized that job
layoffs can occur for countless reasons unrelated to the
individual worker's willingness and desire to stay at his job."
Garfield v. Director of the Div. of Employment Sec., 377 Mass.
94, 96 (1979). When that occurs, the aim of the law is "to
lighten the burden . . . on the unemployed worker and his
family." G. L. c. 151A, § 74.
However, an employee may be ineligible for unemployment
benefits under certain conditions. As pertinent here:
"[N]o benefits shall be paid to an individual under this
chapter . . . after the individual has left work . . . by
discharge shown to the satisfaction of the commissioner by
substantial and credible evidence to be attributable [(1)]
to deliberate misconduct in wilful disregard of the
employing unit's interest, or [(2)] to a knowing violation
of a reasonable and uniformly enforced rule or policy of
4 The law's protections only apply to those who meet the
statutory definition of "employee." See G. L. c. 151A, § 1 (h),
(i), (k) (defining "employee" as someone engaged in
"employment," i.e., "service . . . performed for wages or under
any contract, oral or written, express or implied"). See also
G. L. c. 151A, §§ 2, 3, 4A, 5, 6, 8A, 8B, 8C (setting forth
additional parameters of "employment"). The parties do not
dispute that Jefferson was an "employee" of Fallon for purposes
of c. 151A.
4
the employer, provided that such violation is not shown to
be as a result of the employee's incompetence."
G. L. c. 151A, § 25 (e) (2). Under the first clause of
§ 25 (e) (2), an employee is disqualified from unemployment
benefits if he or she was discharged because of "intentional
conduct or inaction which the employee knew was contrary to the
employer's interest." Still v. Commissioner of Employment &
Training, 423 Mass. 805, 810 (1996), quoting Goodridge v.
Director of the Div. of Employment Sec., 375 Mass. 434, 436
(1978). In turn, "[t]o determine whether the employee's state
of mind demonstrated 'wilful disregard' of the employer's
interest, the factfinder must 'take into account the worker's
knowledge of the employer's expectation, the reasonableness of
that expectation and the presence of any mitigating factors.'"
Still, supra at 810-811, quoting Garfield, 377 Mass. at 97.
The second clause of § 25 (e) (2) disqualifies an employee
who is discharged due to a "knowing violation of a reasonable
and uniformly enforced rule or policy of the employer." Again,
state of mind is key: "a discharged employee is not
disqualified unless it can be shown that the employee, at the
time of the act, was consciously aware that the consequence of
the act being committed was a violation of an employer's
reasonable rule or policy." Still, 423 Mass. at 813. Here,
too, mitigating circumstances may "serve as some indication of
5
an employee's state of mind, and may aid the factfinder in
determining whether a 'knowing violation' has occurred." Id. at
815.
2. Factual and procedural history. The material facts are
uncontested. Fallon employed Jefferson from September 2017
until November 2021. While employed at Fallon, Jefferson worked
as a home health aide in Fallon's Summit ElderCare program,
which provides long-term, personal care to elderly patients. In
October 2021, the Executive Office of Health and Human Services
(EOHHS) sent out a notice to organizations that provide
integrated care plans in the Commonwealth, including Fallon,
mandating that such organizations require their employees to be
vaccinated against COVID-19.5 In response, Fallon adopted a
policy requiring all employees who work "at Summit ElderCare
sites [and] provide direct care or have any physical contact or
are in proximity with" patients to provide proof of vaccination
by November 8, 2021. The policy provided for medical and
religious exemptions but conditioned the exemptions on "the
individual's job [being] such that the employer can offer a
The notice specifically required employers to comply with
5
"all applicable [COVID-19] guidance documents posted on [the
Massachusetts Department of Public Health] website . . .[and]
additional . . . guidance . . . bulletins . . . and any
subsequent updates." The parties both understood the notice to
require that all employees providing health care in the
Commonwealth to be vaccinated.
6
reasonable accommodation to avoid risk of contracting or
transmitting COVID-19 on the job," as well as the employee's
compliance with the exemption application process. An
employee's failure to comply with the vaccine requirement or to
obtain an exemption would constitute a resignation.
Jefferson applied for a religious exemption from the
vaccination requirement, submitting with her application a
letter from the president of her congregation confirming the
sincerity of her religious objection. Per Fallon's policy,
Jefferson met with Fallon's human resources department and a
vice-president to discuss her application to be exempt from the
vaccine mandate and whether accommodations could be made to
allow her to continue working for Fallon despite her
unvaccinated status. Jefferson expressed her willingness to
wear full personal protective equipment, to frequently test for
COVID-19, and to comply with alternative accommodations proposed
by Fallon. However, Fallon determined that, absent Jefferson's
vaccination, no reasonable accommodations could be made to
adequately protect Jefferson's patients from contracting COVID-
19. Jefferson's request for a religious exemption was denied,
and she was discharged.
Thereafter, Jefferson applied for unemployment benefits
from the department and initially was determined to be
7
ineligible. However, after a hearing, the decision was reversed
by a departmental review examiner who concluded that Fallon
"failed to establish by substantial and credible evidence" that
Jefferson was disqualified from benefits pursuant to either
clause of § 25 (e) (2).6
Fallon appealed to the department's board of review, see
G. L. c. 151A, § 40, which affirmed the review examiner's
decision. Fallon subsequently sought judicial review of that
decision in the District Court pursuant to G. L. c. 151A, § 42,
and G. L. c. 30A, § 14 (7). After a nonevidentiary hearing, the
judge affirmed the board of review's decision on different
grounds.7 Fallon appealed, and we transferred the matter to this
court on our own motion.
3. Analysis. Fallon contends that the department erred in
concluding that § 25 (e) (2) does not disqualify Jefferson where
she refused the COVID-19 vaccine in knowing violation of
6 Because the "grounds for disqualification in § 25 (e) (2)
are considered to be exceptions or defenses to an eligible
employee's right to benefits, . . . the burdens of production
and persuasion rest with the employer." Still, 423 Mass. at
809.
7 The judge determined that Jefferson did not comply with
Fallon's policy, but that she was still eligible for benefits
because the policy was "not reasonable on [its] face [nor] in
the manner in which it was implemented," because Fallon refused
to grant a religious exemption to any applicant. As discussed
infra, we disagree with the judge on this point.
8
Fallon's reasonable policy and in willful disregard of Fallon's
interest in keeping its vulnerable patient population healthy.
We review the department's decision pursuant to G. L. c. 30A,
§ 14 (7). See G. L. c. 151A, § 42. Under that framework, we
may set aside or modify a decision by the department if it is,
among other things, in "violation of constitutional provisions,"
"[b]ased upon an error of law," "[a]rbitrary or capricious," an
"abuse of discretion," or "otherwise not in accordance with
law." G. L. c. 30A, § 14 (7). Although we review questions of
law on a de novo basis, we give "substantial deference to a
reasonable interpretation of a statute by the administrative
agency charged with its . . . enforcement." Craft Beer Guild,
LLC v. Alcoholic Beverages Control Comm'n, 481 Mass. 506, 511-
512 (2019), quoting Commerce Ins. Co. v. Commissioner of Ins.,
447 Mass. 478, 481 (2006).
As the party appealing from the final agency decision,
Fallon bears a "heavy burden" to demonstrate that the decision
is invalid. Massachusetts Ass'n of Minority Law Enforcement
Officers v. Abban, 434 Mass. 256, 263-264 (2001). Moreover,
with regard to the unemployment compensation law in particular,
we are mindful that the statute specifically states it is to be
"construed liberally in aid of its purpose, which purpose is to
9
lighten the burden which now falls on the unemployed worker and
his [or her] family." G. L. c. 151A, § 74.
a. Deliberate misconduct in willful disregard of Fallon's
interest. Fallon asserts that Jefferson engaged in deliberate
misconduct in willful disregard of Fallon's interests because
she was aware of the vaccination policy and that the consequence
of her failure to comply with the policy put Fallon's vulnerable
patients at risk. This argument misses the mark.
First, it presupposes that Jefferson engaged in "deliberate
misconduct" by failing to get the COVID-19 vaccine. In fact,
Jefferson engaged in a good faith effort to comply with Fallon's
policy by applying for a religious exemption, which was offered
under the policy, based on her sincerely held religious beliefs.
That her request for an exemption was denied does not mean that
she engaged in deliberate misconduct. See, e.g., Garfield, 377
Mass. at 98 (insufficient proof of deliberate misconduct where
employee "was neither insubordinate nor recalcitrant").
Second, even if Jefferson's actions could be considered
deliberate misconduct, Fallon improperly conflates the
"deliberate misconduct" prong with the "willful attempt to
undermine an employer's interest" prong, presuming that if one
is met, both are met. We have held, however, that deliberate
10
misconduct and disregarding an employer's interest are distinct
elements:
"The provision requires a two-part analysis: both
'deliberate misconduct' and 'wilful disregard' of the
employer's interest must be shown in order to disqualify
the employee, and the employee's state of mind at the time
of the misconduct is an issue for both parts."
Still, 423 Mass. at 810, quoting Jean v. Director of the Div. of
Employment Sec., 391 Mass. 206, 208-209 (1984). See Goodridge,
375 Mass. at 436 ("Deliberate misconduct alone is not enough.
Such misconduct must also be in 'wilful disregard' of the
employer's interest").
Here, the record demonstrates that rather than disregarding
Fallon's interest, Jefferson was willing to take several
measures, including wearing personal protective equipment and
undergoing frequent testing, in order to keep Fallon's
vulnerable patient population safe.
b. Knowing violation of a reasonable and uniformly
enforced policy. Fallon fares no better in carrying its burden
to demonstrate that the second clause of § 25 (e) (2) applies to
Jefferson. That is, although Fallon's policy was reasonable and
uniformly enforced,8 Fallon has failed to demonstrate that
8 In concluding that Fallon's policy was "not reasonable on
[its] face and in the manner in which it was implemented," the
judge erred. Fallon issued its vaccination policy in response
to compulsory directives from the EOHHS and thereafter enforced
that policy in a manner consistent with the severity of the
11
Jefferson should be disqualified on the basis of a "knowing
violation" of that policy. Although Jefferson may have violated
the terms of Fallon's vaccination policy, the critical question
is whether it was a "knowing" violation. This determination
depends, in part, on our consideration of any mitigating
circumstances relating to the employee's state of mind at the
time of the violation. See Still, 423 Mass. at 815 (mitigating
factors "may aid the factfinder in determining whether a
'knowing violation' has occurred"). Here, the key mitigating
factor is the reason for Jefferson's noncompliance with the
vaccination policy -- namely, her sincere religious beliefs.
Although Jefferson was aware of the policy prior to and
during her noncompliance, the unique circumstances here did not
present Jefferson with a meaningful choice regarding vaccination
given her religious beliefs. In other cases in which this court
determined that an employee was rightfully disqualified under
§ 25 (e) (2), the court found the employee had some capacity to
risks presented by its work, providing in-person health care to
vulnerable patients. Although Fallon's policy included a
procedure by which employees could request medical or religious
exemptions, Fallon's inability to provide a reasonable
accommodation in these circumstances is not dispositive of the
vaccination mandate's reasonableness, as reasonable
accommodations may not be available in every line of work. See
G. L. c. 151B, § 4 (1A) (employers are not required to provide
accommodations that would impose "undue hardship," such as
"unduly" compromising "the health or safety of the public" or
"the orderly transaction of business").
12
refrain from violating the employer's policy but chose not to do
so. Compare Jean, 391 Mass. at 209 (noting disqualification may
not be warranted due to mitigating circumstances where employee
may have misunderstood instructions due to language barrier),
and Still, 423 Mass. at 807, 815-816 (holding one-time violation
of employee subject to provocation and "extreme stress" was not
disqualifying due to mitigating circumstances), with Shriver
Nursing Servs., Inc. v. Commissioner of the Div. of Unemployment
Assistance, 82 Mass. App. Ct. 367, 375 (2012) (disqualification
warranted where employee fell asleep on job without mitigating
circumstances).
4. Conclusion. In the final analysis, we agree with the
department that Jefferson's violation of Fallon's policy did not
result from a choice for which the Legislature intended to
withhold unemployment benefits. See Still, 423 Mass. at 809
("the issue is not whether the employee had been discharged for
good cause, but whether the Legislature intended to deny
benefits in the circumstances presented by the case"). See also
Smith v. Director of the Div. of Employment Sec., 376 Mass. 563,
567 (1978) ("While the violation of a work rule may well justify
the discharge of an employee, such a violation does not
necessarily amount to misconduct for unemployment compensation
purposes" [citation omitted]). Accordingly, we affirm the
13
decision of the District Court judge albeit on different
grounds.
So ordered.