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For Your Patients – Concussion: Why Some Neurologists Are Calling “Foul” over Criteria for NFL

Written by Berkowitz

doctor talking to patient about brain scans

Concussion experts, tasked with reviewing Traumatic Brain Injuries (TBIs), now argue against eligibility determinations for NFL player concussion settlements, stating that the eligibility requirements for retirees are not appropriate or complete.

Currently, the NFL’s concussion settlement criteria dictate whether a player suffered a brain injury that warrants compensation. The requirements, however, ignore clinical standards for diagnosing dementia. Furthermore, the requirements were found to have vague wording that made it easy to misinterpret, and it included other apparent symptoms of head trauma (e.g., chronic headaches, behavioral changes, and mood changes). Neurologists reported these findings in Neurology Today, and their concerns are something no one should dismiss.

Whether you are the victim of an NFL concussion, were injured in college or high school sports, or you are concerned about a loved one who may need to explore legal options, it is best to contact an attorney that has experience handling concussion cases. They can help you decipher these new requirements, and help you to better understand the conflicting evidence.

What Concussion Experts Have to Say about NFL Concussion Requirements

The medical professionals who reviewed the NFL requirements have publicly stated that the result of these vague requirements is that they under-diagnose, but also over-diagnose, brain disorders associated with game-related concussions.

The Director at the Florida Center for Headache and Sports Neurology, Dr. Frank Condi, DO, stated that the settlement process has nothing to do with medicine due to the requirements used to determine candidates injuries.

Settlements started January 7, 2017, and already more than 20,000 retirees have signed up for compensation eligibility checks if they develop disorders associated with repeated concussions during their career in the NFL.

Initially, the cost of these concussions from the sport was estimated to be about $400 million during the first decade. Already, the settlements have totaled more than $534 million in under two years. Attorneys representing injured players estimate that the NFL will see payouts entering the $1.4 billion mark – more than double their original estimate.

Claims of Widespread Fraud Were Disputed

The NFL is doing what they can to reduce payouts. Like most defendants in an injury lawsuit, they will blame players, physicians, and even attorneys representing the injured. One claim made by the NFL earlier in 2018 was that the settlement process was dealing with “widespread fraud,” – mainly false accusations made by over-eager players and their attorneys.

The physicians reviewing the lawsuit and the regulations from the Florida Center for Headache and Sports Neurology found there was no evidence of fraudulent claims or anyone taking advantage of the system. Instead, they found that the players seeking compensation, or their loved ones, did have brain disorders clearly linked to their injuries from their career within the NFL and denying their settlement requests would be unfair.

Background on the NFL Concussion Settlement

Plaintiffs in the NFL lawsuit had initially filed their lawsuit against the National Football League and NFL Properties, LLC, with claims that retirees of the game had suffered repeated head trauma during their career, and those concussions might have caused them long-term deficits.

They requested compensation from the NFL, citing that the NFL was aware of the brain injuries, but did not warn or protect players from the long-term complications that would ensue. The NFL had been made aware of the risks of repetitive TBIs and did not protect their players. In fact, some allege that the NFL concealed this information.

While the NFL has denied knowledge of repeated TBIs and their long-term results, they did agree to settle with players suffering neurological deficits.

The Baseline Assessment Program

The Baseline Assessment Program is what is currently under heavy scrutiny. This is a program that creates a baseline of neuropsychological and neurological examinations for retired players, and it provides additional testing, counseling, and treatment once a player is diagnosed with a concussion-related degenerative disorder. Qualified retired players should receive their one-time baseline assessment for free as part of the settlement.

Settlements for Deaths from CTE

Some NFL players did not live long enough to seek compensation against the NFL. However, part of the agreement allowed for monetary compensation to those player’s families if they died and were diagnosed with Chronic Traumatic Encephalopathy (CTE) before April 2015.

Who Qualifies for Compensation under the Lawsuit?

Three groups can qualify for compensation under the NFL lawsuit:

  1. Retirees: Retired NFL players, including those who played in the World League of American Football, American Football League, and Europa leagues, as well as players on preseason rosters can file for compensation as long as they meet the date requirements.
  2. Representatives: CTE is a degenerative brain disease that will eventually make a person mentally incapacitated and unable to represent themselves in a lawsuit case such as this. Therefore, the lawsuit allows for an authorized representative to seek compensation on their behalf if the NFL player has been diagnosed as incapacitated or incompetent to do so themselves.
  3. Derivative Claims: A deceased player’s family can seek compensation from the NFL, including spouses, parents, children, or those with financial dependence on the player.

What Medical Conditions Qualify for Compensation?

Unfortunately, CTE can only be diagnosed after a brain autopsy. Therefore, most people suffering from CTE will be diagnosed with other degenerative conditions. As part of the settlement, the requirements allow for claims with medical records that reflect a qualifying diagnosis. These “qualifying” diagnoses include:

  • Alzheimer’s Disease: A retired football player with a diagnosis of Alzheimer’s Disease or Alzheimer’s related dementia.
  • Parkinson’s Disease: Must have major neurocognitive disorders due to Parkinson’s Disease.
  • Death: Upon death, if the brain autopsy confirms that the death was due to Chronic Traumatic Encephalopathy (CTE).
  • ALS: A diagnosis of Amyotrophic Lateral Sclerosis, also known as Lou Gehrig’s Disease.

The requirement for “neurological impairment,” with a condition mentioned above, can be confusing. It is one of the areas where physicians feel the provisions are too ambiguous, which can lead to an underdiagnosis or overdiagnosis.

When the claims administrator reviews the medical records of a player seeking compensation, they will look for critical findings in their chart indicating a neurological impairment or decline, including:

  • Concerns about the severe decline in cognitive function
  • A moderate to a severe decline in their patient’s cognitive function that involves two or more cognitive needs, such as memory, learning, perceptual-spatial, language, and so forth
  • A category 1.0 functional impairment, which affects the patient’s ability to care for themselves
  • A diagnosis of early onset dementia
  • No record of dementia caused exclusively by delirium, substance abuse, or side effects from prescription medications
  • The severe decline in cognitive function or early severe onset dementia

Do You Qualify for an NFL Settlement?

While the requirements for qualification are under scrutiny, do not let them deter you from seeking compensation. If you are concerned about your medical condition or you were recently diagnosed with cognitive impairment after years of playing professional football, you could qualify for compensation under the NFL settlement.

The process for these cases does take time. The National Football League settlement processes will take several months to complete. And if you miss a deadline or forget a step, it will only prolong your wait time.

Therefore, it is in your best interest to speak with an attorney that has experience handling NFL concussion settlements.

What Steps Do You Take to Get an NFL Concussion Settlement?

The steps for these cases take time, and they involve multiple procedures:

  • Notify the Monetary Award Fund (MAF) of your request for compensation.
  • Wait for an appeal and Claims Administrator file review (including medical records).
  • The  Claims Administrator only reviews and issues their findings on specific days of the month. Then you have lead times along with an appeal process you may have to wait through.
  • Once the NFL is ready to disperse the funds, you must wait for the Claims Administrator to send their disbursement report to the Special Masters.
  • Special Masters then can approve or deny the disbursement report.
  • Finally, the bank would issue the payment.

In between this timeline, you have a multitude of steps. You need an advocate who understands the unique rules and relationships between the Special Master, settlement requirements, and the Claims Administrator.

Furthermore, you need someone who can advocate for your right to compensation.

As you can see from the recent findings, the requirements for these lawsuit payments can result in an underdiagnosis. Therefore, the doctor reading the conditions could easily say that you do not meet the baseline requirements, even though a regular physician would state otherwise. Due to the new evidence presented by these medical experts, it may be easier for an attorney to argue against these unfair denials and secure compensation.

Having an advocate ready to appeal and fight the medical decisions on your behalf and cite the ambiguous nature of these requirements could prevent you from having an unfair denial of your compensation.

Speak with an NFL Concussion Attorney Today

The attorneys at Berkowitz Hanna understand what you and your loved ones are going through.

It was your dream to play for the NFL. After putting in several years of hard work, you find that you have a degenerative brain disorder that will significantly shorten your lifespan and even destroy your quality of life. You should not have to suffer these long-term consequences because the league refused to notify you of the risks and let you make an informed decision about your health.

To explore your options, we request that you contact our firm immediately.

We have proudly represented NFL players, including those in the American League, in their concussion cases against the NFL.

We understand the questions you have, your concerns, and we want to advocate for your right to compensation. We aggressively fight for every client we have, and we combat the unfair denials of NFL settlement claims.

Contact Berkowitz Hanna today to schedule a no-obligation consultation. Contact us online with your questions about NFL settlements.