Title VII “Reasonable Accommodation” Must Be Reasonable for the Employee, and “Undue Hardship” Is Generally Not Resolved on a Motion to Dismiss

Case: Theodore Federoff v. Geisinger Clinic
Court: United States Court of Appeals for the Third Circuit
Date: January 26, 2026
Disposition: Equal Protection dismissal affirmed; Title VII dismissal vacated and remanded; Rule 60(a) correction affirmed.

Introduction

This appeal arose from Geisinger’s COVID-19 employee vaccination mandate and its offered exemptions. Geisinger granted religious and medical exemptions from vaccination, but conditioned those exemptions on twice-weekly nasal swab testing. After exempted employees learned the swabs were allegedly sterilized with ethylene oxide (a carcinogen), they requested exemptions from testing as well. Geisinger denied those requests.

The plaintiffs—employees who had obtained religious exemptions from vaccination—sued multiple Geisinger affiliates. They asserted (i) Equal Protection claims under the Fourteenth Amendment (and related civil rights statutes) and (ii) Title VII religious-accommodation claims, alleging the testing “accommodation” was not reasonable. Procedurally, an earlier dismissal order did not expressly dispose of all plaintiffs’ claims; the District Court later corrected that omission under Rule 60(a), creating a final judgment and enabling this appeal.

The Third Circuit addressed three key issues: (1) whether Rule 60(a) permitted correction of the judgment to include omitted dismissals; (2) whether plaintiffs plausibly alleged “state action” for Equal Protection purposes; and (3) whether the Title VII claims were properly dismissed at the pleadings stage.

Summary of the Opinion

• Rule 60(a): The court held the District Court properly used Rule 60(a) to cure an omission and clarify that its earlier dismissal order was intended to dispose of all plaintiffs’ claims.
• Equal Protection: The court affirmed dismissal because plaintiffs did not plausibly allege Geisinger was a state actor; receipt of government funds is insufficient to transform a private hospital network into a state actor.
• Title VII: The court vacated dismissal of Title VII claims. Although plaintiffs did not plausibly allege the nasal swab testing itself conflicted with their religion, they plausibly alleged the offered “accommodation” could be unreasonable under the circumstances (alleged carcinogen exposure). The court further emphasized that “undue hardship” is a fact-intensive affirmative defense generally not resolved on a motion to dismiss.

Analysis

1) Precedents Cited

A. Rule 60(a) and post-judgment correction

• Pfizer Inc. v. Uprichard, 422 F.3d 124 (3d Cir. 2005): Cited for the proposition that Rule 60(a) is not a vehicle for altering substantive rights via “clerical” correction. The majority distinguished plaintiffs’ characterization of Rule 60(a) as purely clerical, explaining the rule also covers “oversight or omission,” and the District Court merely clarified its contemporaneous intent.
• Burton v. Johnson, 975 F.2d 690 (10th Cir. 1992) (quoted via treatise): Used to support the concept that Rule 60(a) can resolve ambiguity and align the written order with the court’s original intent.
• Monasky v. Taglieri, 589 U.S. 68 (2020): Invoked for the de novo standard of review for asserted mistakes of law.

B. Equal Protection and the state action requirement

• Nat'l Collegiate Athletic Ass'n v. Tarkanian, 488 U.S. 179 (1988): Anchors the core Fourteenth Amendment principle: the Equal Protection Clause constrains state actors, not private conduct, “no matter how unfair.”
• Manhattan Cmty. Access Corp. v. Halleck, 587 U.S. 802 (2019): Provides the specific rebuttal to plaintiffs’ funding theory: government funding or subsidization alone does not convert a private entity into a state actor.
• Brown v. Philip Morris, Inc., 250 F.3d 789 (3d Cir. 2001): Reinforces that receipt of federal funds has little or no bearing on the “state action” inquiry for Fourteenth Amendment purposes.
• Lutz v. Portfolio Recovery Assocs., LLC, 49 F.4th 323 (3d Cir. 2022): Cited for the Rule 12(b)(6) plausibility requirement; the complaint must plausibly allege each element—including state action for constitutional claims.

C. Title VII religious accommodation—what makes an accommodation “reasonable”

• Fallon v. Mercy Cath. Med. Ctr. of Se. Pa., 877 F.3d 487 (3d Cir. 2017): Supplies the elements of a Title VII religious discrimination/failure-to-accommodate claim, including that the asserted conflict stems from a sincerely held religious belief. Geisinger relied on Fallon to argue the swab objection was not “religious.”
• Wilkerson v. New Media Tech. Charter Sch., Inc., 522 F.3d 315 (3d Cir. 2008) and Shelton v. Univ. of Med. & Dentistry of N.J., 223 F.3d 220 (3d Cir. 2000): Cited for the general framework: employers must provide reasonable accommodation unless doing so causes undue hardship.
• Ansonia Bd. of Educ. v. Philbrook, 479 U.S. 60 (1986): Central to the majority’s reasoning on “reasonableness.” The opinion uses Ansonia in two ways:
  • To show reasonableness can be evaluated contextually (e.g., unpaid leave may be unreasonable when paid leave is offered for all purposes except religious ones).
  • To support that reasonableness is not only about whether the accommodation avoids direct religious offense, but also whether it is reasonable “under the circumstances.”
• Cosme v. Henderson, 287 F.3d 152 (2d Cir. 2002): Supports considering the practical burden of an accommodation on the employee as part of reasonableness.
• Passarella v. Aspirus, Inc., 108 F.4th 1005 (7th Cir. 2024): Cited for two propositions: (i) religious objections can be expressed in mixed religious/non-religious terms, and (ii) discovery often separates “reasonable accommodation” questions from “undue hardship” proof, with each side developing evidence.

D. Undue hardship—affirmative defense and pleading-stage limits

• Groff v. DeJoy, 600 U.S. 447 (2023): Supplies the modern Supreme Court articulation: “undue hardship” means “substantial increased costs in relation to the conduct of [the employer’s] particular business.”
• EEOC v. GEO Grp., Inc., 616 F.3d 265 (3d Cir. 2010): Characterizes undue hardship as fact-intensive and context-dependent—supporting the majority’s view that it is not normally decided on a motion to dismiss.
• Bazinet v. Beth Isr. Lahey Health, Inc., 113 F.4th 9 (1st Cir. 2024) and Bolden-Hardge v. Off. of Cal. State Controller, 63 F.4th 1215 (9th Cir. 2023): Reinforce undue hardship as an affirmative defense.
• Cole v. Grp. Health Plan, Inc., 105 F.4th 1110 (8th Cir. 2024): Cited for the procedural point that reasonable-accommodation and undue-hardship inquiries are “generally not appropriately considered at the motion to dismiss stage.”

E. The dissent’s competing approach (and its authorities)

Judge Krause would have affirmed dismissal of the Title VII claims. Her dissent relies on a narrower view: once the employer offers an accommodation that eliminates the religious conflict (here, testing instead of vaccination), “the inquiry is at an end,” and medical objections to the accommodation are not protected by Title VII.

• Trans World Airlines, Inc. v. Hardison, 432 U.S. 63 (1977): Cited for the proposition that Title VII requires reasonable accommodation of religious observances.
• Jackson v. Methodist Health Servs. Corp., 121 F.4th 1122 (7th Cir. 2024): Cited as analogous authority affirming dismissal where testing was deemed a reasonable accommodation to a vaccine objection.
• Detwiler v. Mid-Columbia Med. Ctr., 156 F.4th 886 (9th Cir. 2025): Cited for rejecting a Title VII claim where the objection to nasal-swab testing was medical (carcinogenic risk), not religious.

2) Legal Reasoning

A. Rule 60(a): “Oversight or omission” includes failure to expressly dispose of all claims

The court rejected the view that Rule 60(a) is limited to typographical or clerical errors. It emphasized the rule’s text permitting correction of “a mistake arising from oversight or omission.” Because Geisinger’s motion sought dismissal of all plaintiffs and the District Court intended its August 2022 order to resolve all claims, the later Rule 60(a) correction merely aligned the written judgment with that intent—creating finality rather than changing the merits.

B. Equal Protection: private hospital network + public funding ≠ state actor

The opinion treats “state action” as an essential element. Plaintiffs’ factual theory—receipt of state and federal funds—was insufficient under Manhattan Cmty. Access Corp. v. Halleck. Without plausible state action allegations, the equal protection claims could not proceed, regardless of alleged unfairness.

C. Title VII: “Reasonably” does real work, distinct from “undue hardship”

The court’s key move is interpretive and structural. Title VII defines “religion” to include observance and practice unless the employer cannot “reasonably accommodate” without “undue hardship.” The majority reads this as a two-part architecture:

• Reasonableness addresses whether the accommodation is reasonable from the employee’s side (including practical burden under the circumstances).
• Undue hardship addresses the employer’s side (costs/burdens on business operations), and operates as an affirmative defense.

Applying that framework, the court agreed the complaint did not plausibly allege that nasal swab testing itself offended any religious belief (and no such belief could be inferred without pleading the contours of the plaintiffs’ religious doctrine). Yet the court held the complaint did plausibly allege the accommodation was unreasonable under the circumstances because it required repeated use of swabs allegedly sterilized with a carcinogen.

The majority was careful to limit its holding to the pleading stage: discovery may show the alleged exposure is not meaningfully risky or is otherwise reasonable. But taking the allegations as true, dismissal was premature—especially because Geisinger’s “undue hardship” justification is a fact-intensive defense not usually resolved on Rule 12(b)(6).

3) Impact

A. Pleading-stage leverage in Title VII accommodation litigation

The most practically significant aspect is the court’s insistence that the “reasonable accommodation” analysis can include the accommodation’s practical burden on the employee, even when the employee’s objection to the accommodation sounds in safety/medical terms rather than expressly religious terms. That framing can make early dismissal harder in cases where an employer’s alternative to a religious exemption is alleged to impose non-trivial burdens (health risk, cost, time, or stigma).

B. Separating “reasonableness” from “undue hardship” may shift litigation sequencing

By emphasizing undue hardship as an affirmative defense generally unsuitable for resolution on a motion to dismiss, the decision encourages courts to permit at least targeted discovery before deciding whether an employer’s accommodation is lawful—especially in disputes involving contested facts about risk, feasibility, or workplace operations.

C. Equal Protection claims against private healthcare systems remain difficult

The state-action holding reinforces a consistent barrier: absent plausible allegations fitting recognized state-action tests, private hospital networks do not become state actors merely by participating in public funding streams. This continues to channel most workplace-religion disputes into statutory frameworks like Title VII rather than constitutional claims.

D. A clear split in approach (majority vs. dissent) signals future doctrinal development

The dissent’s view—once the accommodation eliminates the religious conflict, “the inquiry is at an end”—would narrow Title VII exposure and facilitate early dismissal where the remaining dispute is framed as “medical” rather than “religious.” The majority’s approach keeps “reasonably” as an independent constraint on employer-chosen accommodations. Future cases may refine how substantial an employee-side burden must be to render an accommodation “unreasonable,” and how closely tied that burden must be to the religious conflict.

Complex Concepts Simplified

• Rule 60(a): A rule allowing courts to correct the record when an order contains an accidental omission or oversight—so the written judgment matches what the court intended at the time.
• State action: Constitutional equal protection limits what governments do, not purely private actors. A private entity is not treated as the government simply because it receives government money.
• Rule 12(b)(6) / “plausibility”: At the motion-to-dismiss stage, the court assumes the complaint’s factual allegations are true and asks only whether they plausibly state a legal claim.
• Title VII “reasonable accommodation”: An employer must adjust workplace rules to allow religious practice, but only to a reasonable extent.
• Undue hardship (after Groff v. DeJoy): The employer can refuse a requested accommodation if it would impose substantial increased costs relative to its business. Typically, the employer must prove this with evidence.
• Affirmative defense: A defense the defendant must prove (not the plaintiff). Courts often do not resolve affirmative defenses at the pleading stage unless they are clear from the complaint itself.

Conclusion

The Third Circuit’s decision delivers three takeaways. First, Rule 60(a) can be used to correct an omission in a judgment to reflect the district court’s original intent and achieve finality for appeal. Second, equal protection claims fail against a private hospital network absent plausible “state action,” and government funding alone does not supply it. Third—and most importantly—Title VII’s requirement of a reasonable accommodation can turn not only on whether the accommodation avoids direct religious offense, but also on whether it is reasonable in context from the employee’s standpoint; meanwhile, the employer’s operational objections are generally addressed through the fact-intensive “undue hardship” defense, not at the motion-to-dismiss stage.