Title: Fallon Community Health Plan, Inc. v. Acting Director of the Department of Unemployment Assistance
Citation: N/A
Docket Number: SJC-13440
State: Massachusetts
Issuer: Massachusetts Supreme Court
Date: March 4, 2024

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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 
 
5 The notice specifically required employers to comply with 
"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.