’WPCr% ߣĶ“×H& Óń»’äVm—EŽL…C–ĪĻšå–ØÆŽČEüķĄ¹N!bņ¾ü>”Ö¬§›ōnQž†ļ?:%Æ@ž\Ž2^.JīGŗ› 3 ėš—l½Œ„aCģ =”łć|ī¶ Ķ39¹ÕLS!ŌqcĪØĖŽ;5čSqžœ嬅⧠rõŅ¾šOŚ„„*ŸĖ¤›”Ļīŗ,äg"Š„­[?5(ŠI_&Ō¦‹&^‘»³l*ż¤ĖD3d8øfźįs÷„yo¶”eŁ„&±é†ż+Ā Ēћ—ģϧűĄT,ćßc‘ī%HŽ.ЇÄEØY9H(©½qķuLęyķ!yńŻ”®ź.• ƒÓ3ĶÜYłļč3{1ņŽ;žPŲģßC’ZuYśz|“cą–¾7łD0IŒģl=/ćö³KĘ[·ßåŪ„ń÷>µL•Ė(”qäIøI~ŁDBHņ,a¶OcÄļ­ÓĢźĄ}Ļi“»„ ±tKxüēM™ˆsFū¬Ń…„\’’ģØs˜ŚŅ…ógŪ)!+™\iE|Ś«åC»U‡ĒU{溺Č:‰Ī­B¶+Ÿµ%[ąs5œ‚‡ü^܁H½0ļAā9lU(#Į0 %ń 0D÷ 0(;U:c 0ʝUNcnT±N U> ^ E wQ 4U i x mz E‘ f“ a• N© UB« bķ ķ õ u£{›„¹ ======M%M%M%M% BU%˜HP LaserJet 4,ü,,,,,ü0X(#Ć$ņņŚ  Ś0Ś  Śóó($””<ž6X9`("Courier NewTT(d:2µX$¤¤Ż ƒ!ŻŻ  ŻÓ  ÓÓ=€0įX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś0Ś  ŚóóvÖr Z‹6Times New Roman Regular«<ž6X9`("Courier NewTTXXxž6X@ÉDQX@<ž6X9`(CourierTTXXwž6X@ÉüQX@<č\( 9Z+&Courier Regular/¬,s -H|,?,}£backup3|x’U‹’ĄĄĄųĄTABLE A<ž6X9`(*Courier 12pt10cpi- ł- Ż ƒµX$ŻÓ  ÓÓ=€%qX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś1Ś  ŚóóŻ  ŻŌ_ŌIf€the€insured€does€not€return€to€work,€the€insured's€monthlyŠ ° Šbenefit€is€70%€of€his/her€basic€monthly€earnings,€i.e.€his/herŠ xČ Šaverage€monthly€earnings€in€the€year€preceding€the€disability,€asŠ @ Šlong€as€this€amount€does€not€exceed€a€maximum€monthly€benefitŠ X Šestablished€in€the€policy€specifications€(minus€any€other€benefitsŠ Š  Šthe€insured€may€be€receiving€for€his€disability€such€as€workmen'sŠ ˜č Šcompensation).€€Policy€at€L„BEN„1.€In€a€situation€where€the€insuredŠ ` ° Šreturns€to€work€part„time,€the€benefit€is€calculated€by€taking€theŠ ( x Šmonthly€benefit€the€insured€would€have€received€as€above€as€theŠ š @ Šbaseline,€but€by€multiplying€this€amount€by€a€percentageŠ ø   Šrepresenting€the€actual€lost€income€due€to€the€disability.€€ThisŠ € Š  Špercentage€is€calculated€by€subtracting€the€insured's€currentŠ H ˜  Šmonthly€earnings€from€his€indexed€pre„disability€earnings€andŠ `  Šdividing€that€figure€by€his€indexed€pre„disability€earnings.€Š Ų(  ŠPolicy€at€L„BEN„2.€€In€either€case,€the€higher€the€basic€monthlyŠ  š  Šearnings€immediately€preceding€the€disability,€the€higher€theŠ hø  Šmonthly€benefits€that€follow. kŻ ƒµX$ŻÓ  ÓÓ=€%qX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś2Ś  ŚóóŻ  ŻŌ_ŌUnum€also€initially€determined€that€Dandurand€was€no€longerŠ ° Šdisabled€under€the€Policy,€but€this€determination€was€reversed€onŠ xČ Šadministrative€review.€ ™Ż ƒµX$ŻÓ  ÓÓ=€%qX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś3Ś  ŚóóŻ  ŻŌ_ŌAlthough€one€may€normally€assume€that€a€one„timeŠ ° Šdiscretionary€bonus€would€not€be€included€in€monthly€earnings,€theŠ xČ ŠPolicy€provides€for€the€calculation€of€basic€monthly€earnings€basedŠ @ Šon€"the€W„2€form€(from€the€box€which€reflects€wages,€tips€and€otherŠ X Šcompensation)."€€Policy€at€L„PS„2.€€Dingley€Press€awarded€the€bonusŠ Š  Što€Dandurand€in€recognition€of€his€efforts€to€return€to€workŠ ˜č Šdespite€his€disability.€€The€district€court€found€that,€upon€aŠ ` ° Šspecific€inquiry€by€Dingley€Press's€owner€as€to€any€effect€theŠ ( x Šbonus€would€have€on€Dandurand's€disability€benefits,€an€UnumŠ š @ Šemployee€erroneously€told€him€that€the€bonus€income€would€not€beŠ ø   Šincluded€in€the€calculation€of€Dandurand's€income€for€1995.€Š € Š  ŠņņDandurandóó€v.€ņņUnum€Life€Ins.€Co.€of€Am.óó,€No.€00„220„P„C,€R.€Doc.€29Š H ˜  Šat€6€(D.€Me.€July€23,€2001).€€Despite€this€apparentŠ `  Šmisrepresentation,€Dandurand€does€not€argue€here€that€the€bonusŠ Ų(  Šshould€not€have€been€included€in€the€calculation€of€his€1995Š  š  Šearnings. ‘Ż ƒµX$ŻÓ  ÓÓ=€%qX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś4Ś  ŚóóŻ  ŻŌ_ŌWhen€Unum€initially€contacted€Dandurand,€it€claimed€that€itŠ ° Šhad€overpaid€Dandurand€by€$70,859.28,€but€the€parties€have€sinceŠ xČ Šstipulated€that€the€overpayment€claimed€by€Unum€is€$67,957.18. zŻ ƒµX$ŻÓ  ÓÓ=€%qX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś5Ś  ŚóóŻ  ŻŌ_ŌThe€district€court€also€addressed€the€question€of€whetherŠ ° ŠUnum€properly€included€Dandurand's€contributions€to€a€401(k)€planŠ xČ Šas€income€in€its€calculations€of€his€1997,€1998,€and€1999€incomeŠ @ Šand€granted€partial€summary€judgment€in€favor€of€Unum€on€itsŠ X Šdetermination€of€the€1997€income,€but€not€on€the€1998€and€1999Š Š  Šincome.€€This€issue€is€not€before€us€on€appeal.  Ż ƒµX$ŻÓ  ÓÓ=€%qX‚ŠXdŠd=Óą  ąÓÓņņŚ  Ś6Ś  ŚóóŻ  ŻŌ_ŌAdditionally,€we€hasten€to€point€out€that,€even€if€we€were€toŠ ° Šassume€that€Unum€indeed€worked€within€the€recurrent€disabilityŠ xČ Šprovisions€to€come€up€with€its€interpretation€of€Dandurand'sŠ @ Šdisability€„„€a€possibility€hinted€at€but€not€developed€in€Unum'sŠ X Šbrief€„„€we€cannot€find€reasonable€its€conclusion€that€1996€was€aŠ Š   Šnew€period€of€disability.€€It€may€be€that€Unum€is€suggesting€thatŠ ° ŠDandurand's€particular€circumstances€are€analogous€to€the€insuredŠ xČ Šwho€goes€back€to€work,€full„time,€for€more€than€six€months,€beforeŠ @ Šbecoming€disabled€again,€and€thereby€begins€a€new€period€ofŠ X Šdisability€under€the€Policy.€€We€find€that€this€analogy€does€notŠ Š  Šhold€up€because€the€consequences€under€the€provisions€for€anŠ ˜č Šinsured€returning€to€work€part„time€for€more€than€six€months€and€anŠ ` ° Šinsured€returning€to€work€full„time€for€more€than€six€months€areŠ ( x Šmaterially€different.€€If€the€insured€returns€to€work€full€time€forŠ š @ Šsix€months€or€more€before€becoming€disabled€again,€his€benchmarkŠ ø   Šbasic€monthly€earnings€are€still€based€on€his€full„time€incomeŠ € Š  Šduring€that€period€and€therefore€more€accurately€serve€to€measureŠ H ˜  Šhis€lost€income€in€the€period€of€disability€that€follows€(although,Š `  Šadmittedly,€he€is€subjected€to€a€new€elimination€period).€€On€theŠ Ų(  Šother€hand,€when€an€insured€returns€to€work€part„time€for€more€thanŠ  š  Šsix€months€before€becoming€disabled€again,€his€already€reducedŠ hø  Šincome€immediately€preceding€the€new€period€of€disability,€if€takenŠ 0€  Šas€the€benchmark€in€subsequent€calculations,€does€not€accuratelyŠ ųH  Šreflect€his€loss€of€income€in€the€next€period€of€disability.€€InŠ Ą Šthis€sense,€basing€the€calculation€of€Dandurand's€monthly€benefitŠ ˆŲ Šon€basic€monthly€earnings€already€lowered€by€disability€in€1995€isŠ P  Šnot€only€inconsistent€with€the€purpose€and€structure€of€the€PolicyŠ h Šbut€also€not€contemplated€by€the€recurrent€disability€provisions.€Š ą0 Š  dŻ ƒ!ŻŻ  ŻŌ_ŌŃTRY,3Ų'Xą3Ų' Letter 3Ų' Letter’3Ų'TŃŃ ? ŃŁ*ƒ !ŁŌ€Xi©XXXŌŌ€°©i°XXi©Ōņ ņÓ  ÓÓ  ÓUnited€States€Court€of€AppealsŌ€„<„°°©iŌŠ ° ŠFor€the€First€Circuitó óŌ€ „d„„„<ŌŌ€ X%qX„ „dŌŠ „Ō ŠÓ÷ÓĢĢßA€') °°` dE<s ` Aߊ t Ä ŠĢĢNo.€01„2204Š  c ŠĢą@<< ģąLUCIEN€J.€DANDURAND,ˆŠ £ ó  ŠĢą@ ģąPlaintiff,€Appellant,ˆŠ 3ƒ  ŠĢą@tt)ģąv.ˆŠ Ć  ŠĢą@Č Č ģąUNUM€LIFE€INSURANCE€COMPANY€OF€AMERICA,ˆŠ S£  ŠĢą@<< ģąDefendant,€Appellee.ˆŠ ć3 ŠĢßA€') °°` dE<r` Aߊ sĆ ŠĢą@œ œ ģąAPPEAL€FROM€THE€UNITED€STATES€DISTRICT€COURTˆŠ Jš ŠĢÓ  ÓFOR€THE€DISTRICT€OF€MAINEŠ Ś* ŠÓ  ÓĢĢą@Č Č ģą[Hon.€Gene€Carter,€ņņU.S.€District€Judgeóó]ˆŠ 2‚ ŠĢßA€') °°` dE<Į` Aߊ Ā ŠĢą@„„'ģąBeforeˆŠ ™é ŠĢÓ  Óą@@((ģą€Torruella,€ņņCircuit€Judgeóó,Š )y  ŠStahl,€ņņSenior€Circuit€Judgeóó,Š ńA! Šand€Lipez,€ņņCircuit€Judgeóó.ņņóóŠ ¹ " ŠĢĢßA€') °°` dE<!` Aߊ !a% ŠĢÓ  ÓÓ  Óą  ąņņGraydon€G.€Stevensóó,€with€whom€ņņKelly,€Remmel€&€Zimmermanóó,€wasŠ č!8' Šon€brief,€for€appellant.Š °"( Šą  ąņņRonald€W.€Schneideróó,€with€whom€ņņPatricia€A.€Peardóó€andŠ x#Č) ŠņņBernstein,€Shur,€Sawyer€&€Nelsonóó,€were€on€brief,€for€appellee.Š @$* ŠĢĢŌ*‹ƒ'ddd Xdd Xdd X°(#°(#‹ŌŌ,( dd ŌŌ,( dd ŌŌ,( dd ŌŌ+  ŌŠ ˜&č!-˜&č! ‹‹ŠÓwÓŠ SIü&L". `<ā@37347„„‰`<ā@‰‹‹SŠĢApril€2,€2002Š Ä'#0 ŠŠ RHCŒ(Ü#1" `<ā@37347 `<ā@ ‹‹RŠŠ(ü&L"2  (ŠÓ  ÓŁ* !ŁĢĢÓ  ÓŠ  +d&4? ŠŃ  ŃÓÓŃ8€%qXXdČdČ8ŃŃ€ŃÓ*°,X°` Ø ƒX°œX*Óą ` ąņ ņSTAHL,€ņņSenior€Circuit€Judgeó óóó.€€Plaintiff„appellant€LucienŠ ° ŠJ.€Dandurand€("Dandurand")€receives€a€monthly€benefit€under€a€groupŠ ą Šlong€term€disability€policy€issued€by€defendant„appellee€Unum€LifeŠ  p ŠInsurance€Company€of€America€("Unum").€€Dandurand€appeals€the€AprilŠ °  Š3,€2001,€grant€of€partial€summary€judgment€in€favor€of€Unum,€inŠ @  Šwhich€the€district€court€found€reasonable€Unum's€interpretation€ofŠ Š   Šthe€policy€that€has€had€the€effect€of€significantly€reducingŠ `°  ŠDandurand's€monthly€benefit.€€We€reverse.Š š@  ŠÓ  ÓI.Š €Š  ŠÓ[Óą ` ąDandurand€has€worked€as€an€employee€of€Dingley€PressŠ ` Šsince€August€1988€and€is€an€eligible€beneficiary€of€Unum's€GroupŠ  š ŠLong€Term€Disability€Insurance€Policy,€No.€379228,€(Defendant'sŠ 0€ ŠStatement€of€Material€Facts,€No.€00„220„P„C,€R.€Doc.€8,€App.€Exh.Š Ą Š1€(D.€Me.€Jan.€22,€2001))€(hereinafter€"Policy"),€obtained€byŠ P  ŠDingley€Press€for€the€benefit€of€its€employees.€€The€policy€isŠ ą0 Šgoverned€by€the€Employee€Retirement€Income€Security€Act€of€1974Š pĄ Š(ERISA).€€ņņSeeóó€29€U.S.C.€šš€1001„1461.€€Š P  Šą ` ąIn€January€1994,€Dandurand€developed€viralŠ ą" Šcardiomyopathy,€an€inflammation€of€the€heart€muscle.€€ForŠ  !p$ Šapproximately€four€months€thereafter,€he€was€not€able€to€work,€butŠ °"& Šhe€returned€to€work€at€Dingley€Press€on€a€reduced€schedule€withŠ @$( Šreduced€responsibilities€in€May€1994€and€has€continued€to€workŠ Š% !* Šthere€ever€since.€Š  `'°", ŠņņA.€The€PolicyóóŠ ° Šą ` ąThe€Policy€defines€the€term€"disability"€in€two€ways.€€AŠ @ Šperson€is€disabled€if,€"because€of€injury€or€sickness":Š Š  ŠÓÓą8 ` ą1.€the€insured€cannot€perform€each€of€theŠ ` ° Šmaterial€duties€of€his€regular€occupation;€orŠ( x` x` x ŠĢą8 ` ą2.€the€insured,€while€unable€to€perform€all€ofŠ ø   Šthe€material€duties€of€his€regular€occupationŠ € Š  Šon€a€full„time€basis,€is:ŠH ˜ ` x` x Šą8 ` ąą0Ø ` x` xąa.€performing€at€least€one€of€theŠ `  Šmaterial€duties€of€his€regularŠ Ų(  Šoccupation€or€another€occupation€on€aŠ  š  Špart„time€or€full„time€basis;€Šhø Ø xØ x Šą8 ` ąą0Ø ` x` xąb.€earning€currently€at€least€20%€lessŠ 0€  Šper€month€than€his€indexed€pre„Š ųH  Šdisability€earnings€due€to€that€sameŠ Ą Šinjury€or€sickness.ŠˆŲØ xØ x Šą0 ` ąą Ø ąŠ ` (#` (# ŠÓÓPolicy€at€L„DEF„4.€€The€Policy€defines€"indexed€pre„disabilityŠ h Šearnings"€as€the€"insured's€basic€monthly€earnings€in€effect€justŠ Øų Šprior€to€the€date€his€disability€began,"€adjusted€for€inflation.Š 8ˆ ŠņņId.óó€at€L„DEF„2.€€"Basic€monthly€earnings"€are€in€turn€defined€asŠ Č Š"the€insured's€average€monthly€earnings,"€calculated€"from€the€W„2Š XØ Šform€.€.€.€received€from€the€employer€for€the€calendar€year€justŠ č8 Šprior€to€the€date€disability€begins."€ņņId.óó€at€L„PS„2.€€Hence,€inŠ xČ! Šorder€to€be€disabled€within€the€meaning€of€the€Policy,€an€insuredŠ  X# Šreturning€to€work€"part„time"€must€earn€on€average,€per€month,€noŠ ˜!č% Šmore€than€80%€of€what€he€earned€on€average,€per€month,€in€theŠ (#x' Šcalendar€year€immediately€prior€to€the€date€the€disability€began,Š ø$ ) Šadjusted€for€inflation.€€When€an€insured€returns€to€work,€theŠ H&˜!+ ŠPolicy€thus€defines€disability€not€only€in€relation€to€an€injury€orŠ Ų'(#- Šillness,€but€also€in€relation€to€income.Š h)ø$/ Š€ą ` ąņņóóThe€Policy€imposes€a€180„day€elimination€period,Š ų*H&1 Šbeginning€with€the€date€on€which€the€insured€becomes€disabled,Š ˆ,Ų'3 Šduring€which€no€benefits€are€payable€to€the€insured.€€ņņId.óó€at€L„PS„Š ° Š1.€€The€monthly€benefit€an€insured€receives€after€the€eliminationŠ @ Šperiod€is€based€on€a€formula€that€sets€the€benefit€in€proportion€toŠ Š  Šthe€insured's€basic€monthly€earnings€in€the€calendar€year€prior€toŠ ` ° Šthe€disability.׃ׯ ƒ#ĆŻņņŚ  Ś1Ś  ŚóóŻ  Ż×  ׀€ņņSeeóó€ņņid.óó€at€L„PS„1,€L„BEN„1„2.€€The€amount€of€theŠ š @ Šinsured's€pre„disability€monthly€earnings€thus€has€consequences€forŠ € Š  Šthe€monthly€benefit€one€receives€upon€disability,€in€addition€toŠ `  Šthe€determination€of€whether€the€insured€continues€to€meet€theŠ  š  Šincome€definition€of€disability€in€a€given€year.Š 0€  Šą ` ąThe€Policy€also€defines€a€"recurrent€disability."€€AŠ Ą Šrecurrent€disability€is€"a€disability€which€is€related€to€or€due€toŠ P  Šthe€same€cause(s)€of€a€prior€disability€for€which€a€monthly€benefitŠ ą0 Šwas€payable."€€ņņId.óó€at€L„BEN„4.€€A€recurrent€disability€may€beŠ pĄ Štreated€in€one€of€two€ways:€If€the€insured€returns€to€work€full„Š P Štime€for€six€months€or€more,€the€recurrent€disability€is€consideredŠ ą Ša€new€disability,€with€the€insured€subject€to€the€same€terms€as€aŠ  p Šnewly„disabled€insured,€including€the€completion€of€anotherŠ °  Šelimination€period.€€ņņSeeóó€ņņid.óó€€On€the€other€hand,€if€the€insuredŠ ° Š"returns€to€his€regular€occupation€on€a€full„time€basis€for€lessŠ @ Šthan€six€months;€and€.€.€.€performs€all€the€material€duties€of€hisŠ Š  Šoccupation,"€the€insured's€benefits€for€the€recurrent€disabilityŠ ` ° Šare€subject€to€the€same€terms€as€his€prior€disability.€€ņņSeeóó€ņņid.óóŠ š @ ŠņņB.€The€Policy€as€Applied€to€Dandurand's€CaseóóŠ € Š  Šą ` ąAlthough€Unum€initially€determined€that€Dandurand€wasŠ `  Šeligible€for€benefits€and€paid€such€benefits€between€July€20,€1994Š  š  Šand€August€19,€1999,€in€1999€Unum€informed€Dandurand€that,€due€toŠ 0€  Šan€error€in€its€calculation€of€his€1995€earnings,€it€had€overpaidŠ Ą Šhim€by€almost€seventy€thousand€dollars.׃ׯ ƒ#ĆŻņņŚ  Ś2Ś  ŚóóŻ  Ż×  ׀€The€claimed€error,€whichŠ P  Šwas€made€by€an€Unum€employee€and€went€undetected€by€at€least€threeŠ ą0 Šother€Unum€employees,€derived€from€the€fact€that€Unum€had€notŠ pĄ Šincluded€bonus€income€received€by€Dandurand€in€1995€whenŠ P Šcalculating€his€average€monthly€earnings€for€that€year.׃čׯ ƒ#ĆŻņņŚ  Ś3Ś  ŚóóŻ  Ż×  ׀€With€theŠ ą Šbonus€income€included,€Dandurand's€average€monthly€earnings€forŠ ° Š1995€exceeded€80%€of€his€indexed€pre„disability€earnings,€asŠ @ Šcalculated€from€his€1993€earnings.€€Dandurand€was€therefore€notŠ Š  Š"disabled"€in€1995,€according€to€the€income€definition€of€theŠ ` ° ŠPolicy.€€Š š @ Šą ` ąHaving€determined€that€Dandurand€was€not€disabled€inŠ € Š  Š1995,€Unum€proceeded€to€analyze€whether€he€was€entitled€to€benefitsŠ `  Šin€1996.€€Unum€did€so€by€treating€1996€as€a€potential€newŠ  š  Šdisability€period.€€Unum€thus€compared€Dandurand's€1996€averageŠ 0€  Šmonthly€earnings€to€his€basic€monthly€earnings€in€1995,€theŠ Ą Šcalendar€year€immediately€preceding€the€date€of€the€potential€newŠ P  Šdisability,€and€not€to€his€earnings€in€1993.€€€Unum€determined€thatŠ ą0 ŠDandurand€was€in€fact€disabled€during€that€year,€because€hisŠ pĄ Šaverage€monthly€earnings€for€1996€were€less€than€80%€of€his€averageŠ P Šmonthly€earnings€for€1995.€€However,€the€fact€that€Unum€treatedŠ ą Š1996€as€a€new€period€of€disability€had€several€adverseŠ  p Šconsequences.€€First,€Unum€imposed€a€new€180„day€elimination€periodŠ °  Šon€Dandurand€at€the€beginning€of€1996,€during€which€he€was€notŠ @" Šentitled€to€receive€any€benefits.€€Second,€because€Unum€hadŠ Š $ Šestablished€1995,€instead€of€1993,€as€the€benchmark€year€„„€andŠ `"°& Šbecause€Dandurand's€average€monthly€earnings€had€been€lower€in€1995Š š#@( Šthan€in€1993€„„€Unum€calculated€that€Dandurand's€monthly€benefitŠ €%Š * Šfor€1996€would€be€lower€than€it€had€been€in€1994.€€Third,€and€justŠ '`", Šas€importantly,€Unum's€recalculation€of€Dandurand's€indexed€pre„Š  (š#. Šdisability€earnings€based€on€the€1995€earnings€resulted€in€a€lowerŠ 0*€%0 Šbenchmark€for€comparing€average€monthly€earnings€in€subsequentŠ Ą+'2 Šyears.€€Unum€consequently€determined€that€Dandurand's€1997€earningsŠ ° Šhad€exceeded€80%€of€his€indexed€pre„disability€earnings€and€that€heŠ @ Štherefore€was€not€disabled€in€1997€under€the€Policy€and€notŠ Š  Šentitled€to€any€benefits.€€Comparing€his€1998€average€monthlyŠ ` ° Šearnings€to€his€1997€average€monthly€earnings,€Unum€then€alsoŠ š @ Šconcluded€that€Dandurand€was€not€disabled€in€1998€and€not€entitledŠ € Š  Što€any€benefits€that€year.€€Finally,€Unum€determined€that,€althoughŠ `  ŠDandurand€was€once€again€disabled€under€the€Policy€in€1999,€whenŠ  š  Šhis€1999€earnings€were€compared€to€his€1998€earnings,€Unum€couldŠ 0€  Šimpose€another€180„day€elimination€period€at€the€beginning€of€theŠ Ą Šyear€and€calculate€Dandurand's€benefits€based€on€his€earnings€inŠ P  Š1998,€which€were€lower€than€both€1995€and€1993.€Š ą0 Šą ` ąHaving€thus€concluded€that€it€had€overpaid€Dandurand€fromŠ pĄ Š1995€to€1999,׃ׯ ƒ#ĆŻņņŚ  Ś4Ś  ŚóóŻ  Ż×  ׀Unum€informed€him€that€it€would€offset€his€futureŠ P Šmonthly€benefits€in€their€entirety€until€the€overpayment€had€beenŠ ą Šrecovered.€€Dandurand€consequently€brought€the€present€action€underŠ  p ŠERISA,€29€U.S.C.€šššš€1132(a)(1)(B)€and€(a)(3),€seeking€reinstatementŠ °  Šof€his€monthly€benefit,€repayment€of€the€benefits€withheld,€aŠ @" Šruling€on€the€parties'€conflicting€interpretations€of€how€theŠ Š $ Šmonthly€benefit€should€be€calculated,€and€a€ruling€that€Unum€shouldŠ `"°& Šnot€be€allowed€to€recover€the€overpayment.€€Dandurand€did€notŠ š#@( Šcontest€that€he€was€not€disabled€in€1995.€€Instead,€he€objected€toŠ €%Š * ŠUnum's€determination€that€1996€and€1999€constituted€new€disabilityŠ '`", Šperiods,€with€the€consequences€we€have€discussed.€€He€argued€thatŠ  (š#. Ša€reasonable€interpretation€of€the€Policy€would€treat€hisŠ ° Šdisability€in€1996,€and€thereafter,€as€a€recurring€disability€thatŠ @ Šwas€part€of€a€prior€disability€and€therefore€not€subject€to€a€newŠ Š  Šelimination€period€or€a€recalculation€of€the€indexed€pre„disabilityŠ ` ° Šearnings.€€Unum€answered€with€a€counter„claim€seeking€recovery€ofŠ š @ Šthe€overpayment,€to€which€Dandurand€raised€the€affirmative€defenseŠ € Š  Šthat€it€would€be€inequitable€to€allow€recovery€of€any€overpayment.Š `  Šą ` ąUpon€a€motion€by€Unum,€the€district€court€granted€partialŠ  š  Šsummary€judgment€on€the€question€of€the€reasonableness€of€Unum'sŠ 0€  Šinterpretation€of€the€Policy's€terms.€€ņņDandurandóó€v.€ņņUnum€Life€Ins.Š Ą ŠCo.€of€Am.óó,€No.€00„220„P„C,€R.€Doc.€17€(D.€Me.€April€3,€2001)Š P  Š(hereinafter€"Order").€€The€court€found€that€"Unum€did€not€engageŠ ą0 Šin€an€unreasonable€application€of€the€Policy€by€regardingŠ pĄ ŠDandurand's€1995,€1997,€and€1998€basic€monthly€earnings€as€hisŠ P Šindexed€pre„disability€earnings"€and€that€its€decision€to€do€so€wasŠ ą Š"a€straightforward€application€of€the€Policy's€express€language."Š  p ŠOrder€at€10.׃ׯ ƒ#ĆŻņņŚ  Ś5Ś  ŚóóŻ  Ż×  ׀€This€is€the€holding€which€is€before€us€on€appeal.Š °  Šą ` ąThe€district€court€subsequently€held€a€bench€trial€onŠ @" ŠUnum's€counter„claim€for€recovery€of€the€overpayment.€€The€districtŠ Š $ Šcourt€denied€the€counter„claim€on€the€basis€that€it€wasŠ `"°& Šinequitable,€ordered€Unum€to€cease€deducting€money€from€Dandurand'sŠ š#@( Šmonthly€payments,€and€directed€Unum€to€refund€the€money€it€hadŠ €%Š * Šdeducted€to€date€in€an€effort€to€recoup€the€claimed€overpayment.€Š ° ŠņņDandurandóó€v.€ņņUnum€Life€Ins.€Co.€of€Am.óó,€No.€00„220„P„C,€R.€Doc.€29Š @ Š(D.€Me.€July€23,€2001).€€Unum€did€not€appeal€this€ruling.Š Š  Šą ` ąFollowing€the€entry€of€final€judgment,€Dandurand€timelyŠ ` ° Šappealed€the€partial€summary€judgment€ruling€that€accepted€as€Š š @ Šreasonable€Unum's€interpretation€of€the€Policy€under€which€1996€andŠ € Š  Š1999€were€considered€new€disability€periods€with€monthly€benefitsŠ `  Šthereafter€calculated€based€on€Dandurand's€earnings€in€1995€andŠ  š  Š1998,€respectively.€Š 0€  ŠÓ  ÓII.Š Ą ŠÓ  Óą ` ąAlthough€the€district€court€held€that€Unum€may€notŠ P  Šrecover€any€amount€it€may€have€overpaid€to€Dandurand€from€1995€toŠ ą0 Š1999,€the€reasonableness€issue€appealed€by€Dandurand€is€not€moot.€Š pĄ ŠSpecifically,€under€Unum's€interpretation€of€the€Policy,Š P ŠDandurand's€basic€monthly€earnings,€which€set€the€benchmark€for€theŠ ą Šcalculation€of€his€monthly€benefit,€are€based€on€his€lower€1998Š  p Šincome€instead€of€his€1993€income,€resulting€in€a€lower€monthlyŠ °  Šbenefit€paid€to€him€from€1999€on.€€Dandurand€argues€that€1993,€notŠ @" Š1998,€should€be€the€benchmark€year€for€the€calculation€of€his€basicŠ Š $ Šmonthly€earnings.€€€Under€the€position€advocated€by€Dandurand€andŠ `"°& Šaccording€to€his€calculations,€the€difference€between€what€heŠ š#@( Šshould€be€receiving€and€what€Unum€has€calculated€to€be€his€currentŠ €%Š * Šbenefit€is€close€to€one€thousand€dollars€per€month.€Š '`", Šņņóóą ` ąWe€review€the€district€court's€grant€of€summary€judgmentŠ  (š#. Šde€novo.€€ņņDoyleóó€v.€ņņPaul€Revere€Life€Ins.€Co.óó,€144€F.3d€181,€183€(1ņņstóóŠ 0*€%0 ŠCir.€1998).€€Summary€judgment€is€appropriate€when€the€recordŠ Ą+'2 Šreveals€no€genuine€issue€as€to€any€material€fact€and€when€theŠ ° Šmoving€party€is€entitled€to€summary€judgment€as€a€matter€of€law.Š @ ŠņņSeeóó€Fed.€R.€Civ.€P.€56(c).€€In€deciding€whether€summary€judgment€isŠ Š  Šappropriate,€we€are€required€here€to€give€deference€to€Unum'sŠ ` ° Šinterpretation€of€its€own€policy,€because€the€Policy€grants€UnumŠ š @ Š"discretionary€authority€both€to€determine€an€employee'sŠ € Š  Šeligibility€for€benefits€and€to€construe€the€terms€of€th[e]Š `  Š[P]olicy."€€Policy€at€L„PS„2;€ņņseeóó€€ņņFirestone€Tire€&€Rubber€Co.óó€v.Š  š  ŠņņBruchóó,€489€U.S.€101,€115€(1989)€(holding€that€a€denial€of€benefitsŠ 0€  Šwill€not€be€reviewed€de€novo€where€the€language€of€an€ERISA€planŠ Ą Š"gives€the€administrator€or€fiduciary€discretionary€authority€toŠ P  Šdetermine€eligibility€for€benefits€or€to€construe€the€terms€of€theŠ ą0 Šplan");€ņņPari„Fasanoóó€v.€ņņITT€Hartford€Life€and€Accident€Ins.€Co.óó,€230Š pĄ ŠF.3d€415,€418€(1ņņstóó€Cir.€2000).€€We€have€previously€clarified€thatŠ P Šthe€proper€standard€for€reviewing€the€decision€of€an€insurer€thatŠ ą Šhas€such€discretionary€authority€is€the€arbitrary€and€capriciousŠ  p Šstandard,€but€that€"the€reasonableness€of€the€insurer's€decisionŠ °  Šdetermines€whether€or€not€it€constituted€an€abuse€of€the€discretionŠ @" Švested€in€the€insurer€by€the€plan€.€.€.€."€€ņņId.óó€at€419;€ņņseeóó€ņņalsoóóŠ Š $ ŠņņDoeóó€v.€ņņTravelers€Ins.€Co.óó,€167€F.3d€53,€57„58€(1ņņstóó€Cir.€1999).€Š `"°& ŠDespite€the€deferential€nature€of€this€standard,€Dandurand€asks€usŠ š#@( Šhere€to€find€that€Unum's€decision€to€base€the€calculation€of€hisŠ €%Š * Šbasic€monthly€earnings€on€his€income€in€any€year€other€than€1993Š '`", Šwas€unreasonable.€€Because€this€determination€was€unreasonable,€heŠ  (š#. Šargues,€the€district€court€improperly€granted€summary€judgment€inŠ 0*€%0 ŠUnum's€favor.€€We€agree.Š Ą+'2 Šą ` ąWe€begin€by€trying€to€identify€the€essence€of€the€disputeŠ ° Šbetween€the€parties.€€The€parties€agree€that€in€1994,€Dandurand€wasŠ @ Šdisabled€under€prong€two€of€the€definition€of€disability€in€theŠ Š  ŠPolicy.€€Policy€at€L„DEF„4€("the€insured€.€.€.€is€.€.€.€performingŠ ` ° Šat€least€one€of€the€material€duties€of€his€regular€occupation€.€.Š š @ Š.€and€.€.€.€earning€currently€at€least€20%€less€per€month€than€hisŠ € Š  Šindexed€pre„disability€earnings€.€.€.€.").€The€parties€furtherŠ `  Šagree€that€in€1995,€Dandurand€was€no€longer€disabled€under€thisŠ  š  Šdefinition€of€disability€because,€with€the€bonus€included,€heŠ 0€  Šearned€more€than€80%€per€month€of€what€he€had€earned€per€month€inŠ Ą Š1993.€€In€1996,€Dandurand's€average€monthly€earnings€dipped€againŠ P  Što€a€level€that€was€20%€less€per€month€than€his€indexed€pre„Š ą0 Šdisability€earnings,€whether€these€earnings€were€calculated€basedŠ pĄ Šon€his€1993€income€or€1995€income.€€The€parties€thus€once€againŠ P Šagree€that€Dandurand€was€disabled€during€1996€„„€albeit€based€onŠ ą Šslightly€different€calculations.€€Š  p Šą ` ąThe€points€of€agreement€end€there.€The€first€issueŠ °  Šsharply€contested€by€the€parties€„„€and,€as€we€shall€see,€the€onlyŠ @" Šone€we€must€resolve€here€„„€is€whether€1996€was€a€new€period€ofŠ Š $ Šdisability€under€the€Policy,€so€that€Dandurand's€indexed€pre„Š `"°& Šdisability€earnings€and€his€monthly€benefit€were€properlyŠ š#@( Šcalculated€based€on€his€1995€basic€monthly€earnings.€€Unum€arguesŠ €%Š * Šthat,€because€Dandurand€was€not€disabled€in€1995€according€to€theŠ '`", Šexpress€language€of€the€Policy,€his€disability€in€1996€constitutedŠ  (š#. Ša€new€period€of€disability.€€Therefore,€Unum€claims,€it€wasŠ 0*€%0 Šentitled€in€1996€to€set€a€new€benchmark€of€basic€monthly€earningsŠ Ą+'2 Šbased€on€Dandurand's€1995€income.€€Dandurand€counters€that€his€1996Š ° Šdisability€was€a€continuation€of€an€existing€disability,€asŠ @ Špermitted€under€certain€circumstances€by€the€Policy's€recurrentŠ Š  Šdisability€provisions,€and€Unum€therefore€should€have€continued€toŠ ` ° Šuse€1993€as€the€benchmark€for€Dandurand's€basic€monthly€earnings.Š š @ Šą ` ąAs€we€stated€ņņsupraóó,€a€recurrent€disability€is€definedŠ € Š  Šunder€the€Policy€as€"a€disability€which€is€related€to€or€due€to€theŠ `  Šsame€cause(s)€of€a€prior€disability€for€which€a€monthly€benefit€wasŠ  š  Špayable."€€Policy€at€L„BEN„4.€€€Although€Dandurand's€particularŠ 0€  Šcircumstances€may€not€constitute€the€typical€case€contemplated€byŠ Ą Šthe€Policy,€we€agree€with€Dandurand€that€he€has€a€recurrentŠ P  Šdisability.€€Dandurand€was€entitled€to€monthly€benefits€in€1994Š ą0 Šbecause€cardiomyopathy€caused€him€to€drop€some€of€hisŠ pĄ Šresponsibilities€at€work€with€a€corresponding€reduction€in€pay€ofŠ P Šmore€than€20%.€€In€1996,€he€continued€to€suffer€from€cardiomyopathyŠ ą Šand€continued€to€work€at€a€reduced€level,€with€the€same€result€thatŠ  p Šhe€had€a€pay€reduction€of€more€than€20%.€€Thus,€his€disability€inŠ °  Š1996,€i.e.,€his€illness€combined€with€20%€lower€income,€was€"due€toŠ @" Šthe€same€cause(s),"ņņóó€i.e.,€cardiomyopathy€and€the€resultantŠ Š $ Šinability€to€work€on€a€full€schedule,€as€his€disability€in€1994.€Š `"°& ŠAlthough€it€is€true€that€Dandurand€ceased€to€be€disabled€in€1995,Š š#@( Šnot€because€he€had€recovered€from€his€illness,€but€because€he€hadŠ €%Š * Ša€spike€in€income€due€to€the€one„time€bonus,€we€see€nothing€in€theŠ '`", Šdefinition€of€recurrent€disability€that€precludes€its€applicationŠ  (š#. Što€such€a€situation€„„€in€fact,€as€Unum€has€repeatedly€stated,Š 0*€%0 Šdisability,€under€the€Policy,€is€defined€not€just€in€terms€ofŠ Ą+'2 Šillness€or€injury€but€also€in€terms€of€income€loss.€€We€thereforeŠ ° Šhold€that€Dandurand€had€a€recurrent€disability€in€1996,€under€theŠ @ Šplain€language€of€the€Policy.Š Š  Šą ` ąAs€Unum€correctly€argues€and€Dandurand€concedes,€however,Š ` ° Šour€analysis€cannot€end€there.€€The€language€of€the€Policy€goes€onŠ š @ Što€divide€those€disabilities€that€fit€under€the€recurrentŠ € Š  Šdisability€umbrella€into€two€categories:€€those€that€will€beŠ `  Š"treated€as€part€of€the€prior€disability"€and€those€that€will€beŠ  š  Štreated€"as€a€new€period€of€disability."€€ņņId.óó€€Specifically,€theŠ 0€  ŠPolicy€states€that€a€recurrent€disability€will€be€treated€as€partŠ Ą Šof€a€prior€disability€if€the€insured€"returns€to€his€regularŠ P  Šoccupation€on€a€full„time€basis€for€less€than€six€months,"€but€willŠ ą0 Šbe€treated€as€a€new€period€of€disability€if€the€insured€"returns€toŠ pĄ Šhis€regular€occupation€on€a€full„time€basis€for€six€months€orŠ P Šmore."€€ņņId.ó󀀀Dandurand€did€neither€„„€when€he€returned€to€workŠ ą Šafter€his€initial€four„month€absence,€he€never€resumed€his€full„Š  p Štime€duties€and€worked€continuously€thereafter€on€a€reducedŠ °  Šschedule.€€Thus,€the€crux€of€the€controversy€is€this:€Was€itŠ @" Šunreasonable€for€Unum€to€choose€to€classify€Dandurand's€recurrentŠ Š $ Šdisability€as€a€new€disability,€instead€of€a€continuation€of€aŠ `"°& Šprior€disability,€when€Dandurand's€particular€situation€is€coveredŠ š#@( Šby€neither€category€under€the€Policy€language€addressing€recurrentŠ €%Š * Šdisabilities?Š '`", Šą ` ąUnum€attempts€to€side„step€this€question€by€taking€anŠ  (š#. Šextremely€narrow€view€of€the€recurrent€disability€provisions.€Š 0*€%0 ŠUnum's€position€is€that€the€contract€provides€only€one€path€toŠ Ą+'2 Šhaving€a€disability€be€treated€as€a€continuation€of€a€previousŠ ° Šdisability€and€that€that€path€requires€the€insured€to€meet€twoŠ @ Šconditions:€(1)€the€disability€must€be€"related€to€or€due€to€theŠ Š  Šsame€cause(s)"€as€the€previous€disability€and€(2)€the€insured€mustŠ ` ° Šgo€back€to€work€full„time€for€less€than€six€months.€€SinceŠ š @ ŠDandurand€does€not€meet€these€criteria,€Unum€argues,€he€has€a€newŠ € Š  Šdisability€that€must€be€analyzed€under€the€general€disabilityŠ `  Šdefinition€and€guidelines€of€the€Policy,€and€Unum€was€not€requiredŠ  š  Što€extend€the€recurrent€disability€provisions€to€cover€Dandurand'sŠ 0€  Šsituation.€€Š Ą Šą ` ąWe€disagree.€€The€recurrent€disability€provisions€do€notŠ P  Šembody€the€clarity€and€purposefulness€that€Unum€wants€to€ascribe€toŠ ą0 Šthem.€€Rather€than€the€clear€path€Unum€claims€the€provisionsŠ pĄ Šprovide,€they€operate€(1)€to€group€a€category€of€disability€claimsŠ P Šunder€the€title€of€"recurrent€disability"€and€(2)€to€sort€theseŠ ą Šclaims€„„€crudely€„„€into€those€that€will€be€treated€as€newŠ  p Šdisabilities€and€those€that€will€be€treated€as€prior€disabilities.€Š °  ŠDandurand's€case€is€clearly€grouped€under€the€recurrent€disabilityŠ @" Šumbrella,€but€the€provisions€do€not€clarify€how€Unum€should€ņņtreatóóŠ Š $ Šthe€type€of€recurrent€disability€created€by€Dandurand'sŠ `"°& Šcircumstances€„„€in€fact,€they€are€totally€silent€on€the€question.Š š#@( Šą ` ąThe€fact€that€the€recurrent€disability€provisions€areŠ €%Š * Šsilent€as€to€whether€Dandurand's€disability€should€be€treated€as€aŠ '`", Šnew€disability€or€a€continuation€of€a€prior€disability,€does€not,Š  (š#. Šhowever,€change€the€fact€that€he€fits€the€definition€of€an€insuredŠ 0*€%0 Šwith€a€recurrent€disability.€€Unum€cannot€"bump"€Dandurand€out€ofŠ Ą+'2 Šthe€recurrent€disability€category€into€the€general€disabilityŠ ° Šcategory€by€default,€simply€because€the€language€of€the€former€doesŠ @ Šnot€provide€Unum€sufficient€guidance€as€to€how€to€deal€with€thisŠ Š  Šparticular€fact€scenario.€€Instead,€as€Dandurand€correctlyŠ ` ° Šcontends,€Unum€must€work€within€the€language€and€purpose€of€theŠ š @ Šrecurrent€disability€provision€to€come€up€with€a€reasonableŠ € Š  Šinterpretation€of€how€the€provisions€should€treat€Dandurand'sŠ `  Šparticular€case.€€Unum€has€not€done€so;€rather,€Unum€claims€thatŠ  š  Šthe€recurrent€disability€definition€does€not€cover€Dandurand'sŠ 0€  Šsituation€at€all.€€We€cannot€find€this€interpretation€of€the€policyŠ Ą Šreasonable.Š P  Šą ` ąWe€note€that,€in€addition€to€not€being€supported€by€theŠ ą0 Šlanguage€and€structure€of€the€Policy,€Unum's€treatment€ofŠ pĄ ŠDandurand's€situation€under€the€general€disability€provisions€leadsŠ P Što€a€result€that€defies€common€sense.€€As€Dandurand€argues,€theŠ ą Špurpose€of€the€basic€monthly€earnings€calculation€is€to€establishŠ  p Ša€benchmark€by€which€to€measure€how€much€income€an€insured€has€lostŠ °  Šdue€to€the€injury€or€illness€underlying€his€disability.€AŠ @" Šcomparison€of€Dandurand's€1996€and€1995€income€does€not€provide€anŠ Š $ Šaccurate€measurement€of€the€income€loss€Dandurand€experienced€as€aŠ `"°& Šresult€of€working€on€a€reduced€schedule€while€suffering€from€viralŠ š#@( Šcardiomyopathy;€the€only€benchmark€year€that€can€provide€thatŠ €%Š * Šcomparison€is€1993.׃ׯ ƒ#ĆŻņņŚ  Ś6Ś  ŚóóŻ  Ż×  ׊ '`", Їą ` ąHaving€found€Unum's€determination€that€it€would€re„setŠ ° Š1995€as€the€benchmark€for€calculation€of€Dandurand's€benefits€inŠ @ Š1996€unreasonable,€we€need€go€no€further.€€€It€follows€that€Unum'sŠ Š  Šcalculations€regarding€Dandurand's€disability€status€and€benefitsŠ ` ° Šthereafter€were€unreasonable€for€the€same€reasons.€Š š @ ŠÓ  ÓIII.Š € Š  ŠÓ  Óą ` ąWe€accordingly€reverse€the€district€court's€grant€ofŠ `  Šsummary€judgment€in€favor€of€Unum€and€remand€to€the€district€courtŠ  š  Šfor€further€proceedings,€consistent€with€this€ruling.Š 0€  Šą ` ąņņņ ņReversedóó.€€ņņCosts€shall€be€taxed€in€favor€of€theŠ Ą Šappellantó óóó.