The court denied both panel rehearing and rehearing en banc in Detwiler v. Mid-Columbia Medical Center, where the original panel had affirmed dismissal of Sherry Detwiler's Title VII religious discrimination claim. Detwiler, a data privacy executive at Mid-Columbia Medical Center, had sought religious exemptions from both vaccination and testing requirements.

The original panel held that Detwiler failed to adequately plead a bona fide religious belief that conflicted with her employer's COVID-19 policies. According to the rehearing order's summary, the panel required plaintiffs to show "a clear nexus between their religious convictions and their choice not to comply with those measures that does not involve secular knowledge" and held that "invocation of prayer, without more" was insufficient to establish religious significance.

Judge Kathryn Kimball Forrest, joined by six other judges, dissented from the denial of rehearing, writing that the standard "necessarily requires judging religious belief, and it is a significant misstep that risks reducing the freedom of belief to the freedom of accepted belief, which is not freedom at all."

Judge Tung, joined by seven other judges, wrote separately that the panel majority "legally erred by recharacterizing the plaintiff's clearly religious objection to a company policy as purely secular merely because the objection turned in part on a secular consideration."

The case originated when Detwiler challenged Mid-Columbia Medical Center's requirement that healthcare workers be vaccinated against COVID-19. She had initially received a religious exemption from vaccination but was terminated when the hospital required weekly COVID-19 testing using nasal swabs treated with ethylene oxide as a condition of the exemption.