Total disability benefits; The Employee Retirement Income Security Act (ERISA); Whether defendant-insurer was required to pay plaintiff-insured 24 months of additional disability benefits under the contract; Okuno v Reliance Standard Life Ins; Whether plaintiff’s physical disabilities no longer made her “totally disabled”

[This appeal was from the ED-MI.] The court held that the two-year mental health limitation in defendant-Reliance Standard Life Insurance Company’s total disability policy was improperly applied to discontinue plaintiff-McEachin’s benefits where “physical conditions alone” entitled her to disability coverage before 4/21—“the mere presence of additional mental-health issues” did not support applying the limitation. McEachin was injured in a car accident and Reliance began paying her total disability benefits under a policy governed by ERISA in 2017. The policy defined “Total Disability” as the inability to “‘perform the material duties’ of her job[.]” Reliance stopped paying her after concluding that she was no longer totally disabled. McEachin sent Reliance medical documentation asserting that her “depression, migraines, and chronic pain showed she was still totally disabled.” Reliance acknowledged that she still could not work full-time, but denied benefits based on the policy’s 24-month limitation for mental issues that had contributed to the total disability. She sued under ERISA. The district court agreed that she was no longer totally physically disabled as of 4/21 but ruled that her “mental-health disability entitled her to 24 months of additional benefits starting” at that point. Reliance claimed that the district court misinterpreted the relationship between the physical/mental components in the policy and erred by ruling that it owed McEachin 24 months of benefits. The court noted that it had previously interpreted much the same policy in Okuno, where it held that Reliance was required to determine whether the insured’s “physical condition rendered her totally disabled” without considering the presence of mental-health conditions. Thus, the court asked “whether McEachin’s total disability exists without regard to her mental-health conditions. . . . If it does, if in other words her physical disabilities alone justify disability benefits, the mental-health 24-month clock does not start.” Applying this test, the court concluded “the 24-month limitations period in McEachin’s policy began to run in [4/21]. Until then, McEachin’s physical disability alone justified benefits.” Turning to her cross-appeal, the court rejected McEachin’s argument that the district court erred by ruling that her physical disabilities no longer rendered her totally disabled in 4/21. But it ordered the district court on remand to consider whether she may use post-4/21 evidence “to show that the 24-month clock should have been tolled at certain points between [4/21] and [4/23], and that her eligibility for benefits thus may go beyond” 4/23. Vacated in part, affirmed in part, and remanded.