Updated

A New Jersey appeals court ruled on Thursday that First Amendment protections allowing people to refuse medical procedures on religious grounds also extends to those opting out of treatment for secular reasons.

The Superior Court of New Jersey's appellate division said the state's Department of Labor erred in refusing to pay unemployment insurance to a nurse fired for declining to receive a flu vaccine out of personal conviction, rather than on religious or medical grounds.

"The Board's ruling unconstitutionally violated appellant's freedom of expression," said the three-judge panel.

June Valent was a nurse at the Hackettstown Community Hospital in September 2010 when the company issued a policy requiring employees to get a flu vaccination. The rule allowed workers to claim an exemption on religious or medical grounds provided they submitted a note from a religious leader or a doctor.

Valent refused the vaccine, opting to wear a protective face mask during flu season. But she did not have a note and was later fired. The New Jersey Department of Labor, at the behest of the hospital, then tried to deny her unemployment benefits on the grounds she had been fired for insubordination, the opinion said.

Valent, who argued on behalf of herself, rejected that claim, saying she agreed to wear a face mask, which was part of the new policy for those who chose to forgo the vaccination on religious grounds.

"The religion-based exemption irrefutably illustrates that the flu vaccination policy is not based exclusively on public health concerns," the opinion said.

Lee Moore, a spokesman for the state's attorney general, declined to comment on the case, other than to say: “The decision is under review.”

Valent could not be immediately reached for comment.