972 F.3d 955
8th Cir.2020Background:
- Plaintiff Melissa McIntyre, who suffers from Charcot-Marie-Tooth disease, received short-term long‑disability benefits under a Reliance Standard Life Insurance Company (Reliance) ERISA plan and later sought long‑term benefits.
- The Reliance policy defined “Totally Disabled” differently for the first 24 months (Regular Occupation) and thereafter (Any Occupation), and expressly gave Reliance discretionary authority to interpret the plan and determine eligibility.
- Reliance concluded in December 2015 that McIntyre no longer met the long‑term (Any Occupation) disability standard and terminated benefits; McIntyre appealed and an independent exam in December 2016 also found she could perform sedentary work, after which Reliance upheld its denial.
- McIntyre sued under 29 U.S.C. § 1132(a)(1)(B); the district court reviewed Reliance’s denial de novo and granted judgment for McIntyre.
- The Eighth Circuit held the district court erred by applying de novo review (rather than abuse of discretion) because the plan conferred discretionary authority and Woo’s sliding‑scale approach never authorized conversion to de novo review.
- The Court vacated and remanded for the district court to review Reliance’s decision for abuse of discretion, taking into account Glenn and Woo as explained in the opinion.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Proper standard of review for plan administrator with discretionary authority | McIntyre: de novo review was warranted given procedural irregularities and a conflict | Reliance: abuse‑of‑discretion review applies because plan grants discretionary authority | Court: abuse‑of‑discretion is the correct standard; district court erred in applying de novo |
| Whether Woo’s two‑part test permits de novo review when triggered | McIntyre: Woo allows less deferential (de novo) review when procedural irregularities or conflict + breach are shown | Reliance: Woo only modifies abuse‑of‑discretion (sliding scale), not convert to de novo | Court: Woo adopted a sliding‑scale abuse‑of‑discretion approach and never authorized de novo review |
| Whether administrator delay on appeal triggers de novo review | McIntyre: decisional delay beyond regulatory/plan deadlines should trigger de novo (invoking other circuits) | Reliance: delay does not, under Eighth Circuit precedent; at most a factor in abuse‑of‑discretion review | Court: delay alone does not trigger de novo; only a complete failure to act in limited circumstances may do so (Seman/McGarrah) |
| Remedy | McIntyre: affirm district court award of benefits under de novo review | Reliance: reverse and remand for abuse‑of‑discretion review | Court: vacate and remand for district court to apply abuse‑of‑discretion review consistent with opinion |
Key Cases Cited
- Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989) (baseline rule: de novo review unless plan grants discretionary authority)
- Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105 (2008) (conflict of interest is a factor to weigh, not a standalone trigger to alter standard of review)
- Woo v. Deluxe Corp., 144 F.3d 1157 (8th Cir. 1998) (adopted a sliding‑scale modification of abuse‑of‑discretion review based on procedural irregularities or conflict)
- Armstrong v. Aetna Life Ins. Co., 128 F.3d 1263 (8th Cir. 1997) (earlier panel suggested de novo review for continuing conflicts; court explains this is not harmonizable with Woo)
- Seman v. FMC Corp. Retirement Plan for Hourly Emps., 334 F.3d 728 (8th Cir. 2003) (a total failure to act on appeal can, in narrow cases, permit de novo review)
- McGarrah v. Hartford Life Ins., 234 F.3d 1026 (8th Cir. 2000) (related to when failure to act justifies de novo review)
- Johnson v. United of Omaha Life Ins., 775 F.3d 983 (8th Cir. 2014) (delay in processing appeal does not by itself trigger de novo review in this circuit)