Corporate Counsel Daily, RN fired due to lifting restrictions gets trial on PWFA failure-to-accommodate claim, (Mar 25, 2026)

By Kathleen Kapusta, J.D.

The RN “brings her failure to accommodate claim pursuant to the PWFA—a relatively new federal law ‘[a]imed at addressing gaps in existing legislation regarding protections for pregnant workers[.]’”

A registered nurse for a hospice services provider who was fired after she was placed on medical restrictions related to her high-risk pregnancy, including lifting restrictions of no more than 25 pounds, can advance to trial on her Pregnant Workers Fairness Act (PWFA) claim, a federal court in Mississippi ruled. Finding fact issues as to whether the company’s ability to provide hospice care would be impacted by allowing the nurse to continue planning “buddy” visits with CNAs to assist her in providing nursing care, the court denied summary judgment against her failure-to-accommodate claim (King v. Legacy Hospice of the South dba Mercy Hospice, LLC, No. 1:24-cv-197-SA-DAS (N.D. Miss. 24, 2026)).

As a case manager for Legacy Hospice of the South, the RN traveled to her assigned patients in her designated geographical work area to provide nursing care. Shortly after learning in January 2024 that she was pregnant, the RN informed the branch administrator and her supervisor that, due to her history of miscarriages, she would have more doctor’s visits than typical.

Lifting restriction. In February, her doctor restricted her from lifting more than 35 pounds. Although the RN claimed she told the administrator and her supervisor about this restriction, Legacy claimed it did not receive the restriction letter. In March, the RN informed HR about her pregnancy and her plans to work until her delivery date if there were no complications. She also mentioned the lifting restriction at that time.

Second restriction. The RN received a second restriction letter in April recommending that she lift no more than 25 pounds, not work over 40 hours, and be allowed to take frequent bathroom breaks, and elevate her legs as necessary. In response to HR’s request for an update on her restrictions, the RN stated that she would attach her restriction letter and noted that as of 32 weeks, she would need to be on light-duty work.

Buddy visits. In a subsequent email exchange, the administrator told HR that, based on the RN’s restrictions, it was not possible for her to do her job. When asked at a meeting shortly thereafter about her ability to perform her job duties, the RN stated that she had been coordinating with the certified nursing assistant (CNA) assigned to her patients to be present at the same time she provided nursing care if she needed lifting or other assistance, an arrangement she referred to as “buddy visits.” According to the administrator, Legacy could not guarantee that a CNA would be available every time the RN saw a patient. Concluding that it could not accommodate the RN’s restrictions, Legacy fired her.

Failure to accommodate. Moving for summary judgment on the RN’s failure-to-accommodate claim, Legacy first argued that she did not adequately and timely communicate her restrictions to HR. The court, however, found it undisputed the RN emailed HR in March 2024 to inform it of her pregnancy and of her first restriction letter. Though she did not attach the February letter to the email, the email was sufficient to put Legacy on notice she had a pregnancy-related need or problem.

Legacy next argued that the RN failed to comply with its policy regarding pregnant workers because she did not provide HR with the required explanation of her pregnancy-related limitations. The company provided no authority, however, indicating that the RN was required to comply with its internal policy to obtain relief under the PWFA. Her March email to HR provided Legacy with sufficient notice of her limitations, said the court, noting that under the PWFA, “[t]he communication may be made orally, in writing, or by another effective means… [It] need not be in writing, be in a specific format, use specific words, or be on a specific form in order for it to be considered ‘communicated to the employer.’” Further, HR’s follow-up email asking the RN whether she had any updates to her restrictions demonstrated its knowledge of her limitation.

Qualified individual. Turning to Legacy’s argument the RN was not qualified to be a case manager because of her lifting restrictions, the court noted that Legacy appeared to argue it was an essential function of her job to lift and maneuver patients weighing over 25 pounds by herself. Here, the court noted that while the job description for that position includes the ability to “… lift, position and/or transfer patients,” it was silent on whether a case manager was required to be able to do such tasks alone, and it lists no specific amount of weight case managers are required to lift.

And while there was also evidence that lifting 50 pounds is standard in the healthcare industry, there was also testimony that providing wound care to a patient could require assistance from another person. Viewing the evidence as a whole, the court found this sufficient to create a fact question as to whether an essential function of the RN’s case manager position included the ability to lift and maneuver patients weighing over 25 pounds by herself.

Further, the court noted, Legacy appeared to have conceded that there were exceptions to any lifting requirement depending on the amount of weight involved and the RN testified that no nurse would lift a fallen patient alone “regardless of restrictions” as it would pose a safety issue for the nurse and the patient both. This, said the court, further demonstrated that a fact question remained as to whether the RN’s essential job functions included the ability to lift patients over her restriction limit without assistance.

Reasonable accommodation. In response to Legacy’s contention it could not reasonably accommodate the RN’s inability to lift patients over 25 pounds without assistance, she countered that allowing her to continue to arrange buddy visits with the CNAs was a reasonable accommodation it could have provided. But while Legacy contended that this would have required it to send a CNA with the RN on every patient visit and therefore it would have to make “… either material and frequent changes to the CNAs’ schedules or hir[e] another CNA” to ensure proper patient care, the court pointed out that the RN had been arranging the buddy visits on an as-needed basis, which only involved the scheduling of CNAs already employed by Legacy.

The court also noted evidence that case managers make their own schedules. They also tell CNAs how often they need to see a patient but do not give them specific dates or days that they have to see the patient. This evidence, said the court, “undercuts Legacy’s argument that allowing [the RN] to continue to arrange as-needed buddy visits would have been a material alteration to CNAs’ schedules.” Based on this, said the court, a reasonable jury could find that as-needed buddy visits were a reasonable accommodation given the case managers’ and CNAs’ flexibility in setting their own schedules.

Undue hardship. Finally, Legacy argued that allowing the RN to continue arranging the buddy visits would fundamentally change how it operates as a business and would require it to disrupt the schedules of its CNAs, who have their own patients and responsibilities, to ensure that a CNA was constantly available to accompany the RN. Here, the court found that while Legacy reiterated many of its arguments related to the reasonableness of the buddy visits in an attempt to prove its undue hardship defense, it failed to meet its “heavy burden” of proving the defense at this stage.

Further, Legacy’s Chief People Officer, one of the decisionmakers in the RN’s termination, testified that he did not fully consider the “ramifications” of continuing the buddy visits when the termination decision was made and relied on the assessments of HR and the administrator regarding the accommodation at issue. The HR generalist, however, testified that she was unaware of any occurrence where a patient was not seen or not timely seen as a result of the RN’s buddy visits.

And when asked whether rearranging the CNAs’ schedules harmed patient care in any way, the administrator testified that “nothing was brought to [her] knowledge about it.” Nor did she receive any complaints from the CNAs who participated in the buddy visits. Indeed, a CNA who participated in the visits testified that they did not interfere with her ability to perform her own duties. Based on all this, the court found a fact question as to whether Legacy’s ability to provide hospice care would be impacted by its allowance of the buddy visits. Accordingly, the court denied summary judgment on the RN’s PWFA failure-to-accommodate claim.

The case is No. 1:24-cv-197-SA-DAS.

Judge: Aycock, S.

Attorneys: Jim D. Waide, III (Waide & Associates) for Taylor Sharyn King. Mark Nolan Halbert (Phelps Dunbar) for Legacy Hospice of the South dba Mercy Hospice, LLC.

Companies: Legacy Hospice of the South; Mercy Hospice, LLC

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