I believe this is about whether the teacher is exempt from the ADA re: her dismissal. ADA requires that employers make reasonable accomodations to those who are disabled as defined in the act when they are requested to do so by the employee. They are to do this provided the essential nature of the job function is not compromised by the accomodation. Rasonable accomodation may be special equipment, it may be being reassigned to another post, it might be different hours. I suppose for a teacher with narcolepsy it might be to have an aide in the classroom to protect her from self injury and to wake her up.
The Church probably required a fitness for duty report and the Doctor gave them a report which said she was o.k to return to work if on medication. The employer is not obligated to agree with the report but is free to make its own decision. The ADA claim is a separate issue since having a disability that can be controlled or relieved by medication does not mean you are no longer disabled.
This teacher believes and the EEOC agrees she was discriminated against under ADA. The CHurch and those filing the Amicus Curae dispute that claiming a determination in her favor is a major government intrustion into the self determination of religious organizations.
The Holy Spirit is sitting this one out.
IMHO, This case is going to be a big deal in the church state separation discussions. Especially the ministerial exception. Ministers today have no protection in man made worldly pharisaic religious institutions.