The broken promises of the NFL concussion settlement
Good, sad and long article
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When Irv Cross applied for money from the NFL concussion settlement in 2018, his dementia was obvious to anyone who spent more than a few minutes with him.
At 78, the former NFL player and trailblazing sports broadcaster struggled to speak coherently, forgot to change his clothes and suffered from urinary incontinence, his wife told doctors. Cross had been diagnosed with dementia by another doctor months before he was evaluated by two NFL settlement doctors, his medical records show.
But the settlement doctors concluded they couldn’t diagnose Cross with anything, their reports state. While Cross’s symptoms met the standard definition for dementia in American medicine, they agreed, his test scores didn’t meet the NFL settlement’s definition.
“He does not appear to qualify for any diagnosable conditions through the NFL program,” a settlement neurologist wrote. Cross died three years later, of what his doctors thought was just Alzheimer’s disease. An autopsy found he also had suffered from severe chronic traumatic encephalopathy (CTE), a brain disease linked to football.
When Al Bemiller filed his settlement claim in 2019, his children hoped for a quick approval and money to help with his care. He had been diagnosed with dementia four years earlier and needed around-the-clock assistance preparing meals, showering and getting dressed.
But a doctor on the NFL settlement’s review panel responded to Bemiller’s records with skepticism. Perhaps depression was actually causing his dementia symptoms, the review doctor suggested. Claim denied. Bemiller died two years later of dementia.
And when Don Maynard applied in 2019, his doctor was so alarmed he said he would file the diagnostic paperwork right away, Maynard’s son recalled. But that paperwork went into a bureaucratic black hole for more than two years. The letter informing Maynard that settlement doctors diagnosed him with dementia arrived in January 2022 — three days after he died of dementia.
Finalized in 2015, the NFL concussion settlement resolved the most serious threat America’s most popular and lucrative sports league has faced. While the NFL admitted no wrongdoing, it promised to pay every former player who developed dementia or several brain diseases linked to concussions. Players suffering from CTE, the league pledged, also would get paid once they developed symptoms of dementia. The league even agreed to fund a nationwide network of doctors to evaluate players and provide those showing early signs of dementia with medical care.
In seven years since the settlement opened, the NFL has paid out nearly $1.2 billion to more than 1,600 former players and their families — far more than experts predicted during settlement negotiations. The league points to these figures as evidence of the settlement’s fairness.
But behind the scenes, the settlement routinely fails to deliver money and medical care to former players suffering from dementia and CTE, a Washington Post investigation found, saving the NFL hundreds of millions of dollars, if not more.
The Post reviewed more than 15,000 pages of documents relating to efforts by more than 100 former players to qualify for settlement benefits, including thousands of pages of confidential medical and legal records. The Post also interviewed more than 100 people involved with the settlement — including players, widows, lawyers and doctors — as well as 10 board-certified neurologists and neuropsychologists for their expertise on how dementia is typically diagnosed.
Among The Post’s findings:
- The settlement’s definition for dementia requires more impairment than the standard definition used in the United States. Several doctors who have evaluated players told The Post that if they used the settlement’s definition in regular care, they would routinely fail to diagnose dementia in ailing patients. “I assumed this was written this way, on purpose, just to save the NFL money,” said Carmela Tartaglia, an associate professor of neurology at the University of Toronto.
- At least 14 players have, like Cross, failed to qualify for settlement money or medical care and then died, only to have CTE confirmed via autopsy. Eight of these players were diagnosed in life with dementia or a related memory disorder but still failed to qualify for settlement benefits.
- In more than 70 cases reviewed by The Post, players were diagnosed with dementia by board-certified doctors, only to see their claims denied by the administrative law firm that oversees the settlement. While the NFL has often blamed denied claims on fraud, none of the denials reviewed by The Post contained allegations of fraud. Instead, records show, settlement review doctors simply overruled physicians who actually evaluated players, often blaming dementia symptoms on other health problems also linked to concussions, including depression and sleep apnea.
- The NFL’s network of settlement doctors has been beset by systemic administrative breakdowns since its inception. Former players suffering from dementia wait, on average, more than 15 months just to see doctors and get the records they need to file a claim. Maynard was one of two players The Post found who waited more than two years to get paperwork and died before they could get paid.
In total, court records show, the settlement has approved about 900 dementia claims since it opened in 2017. It has denied nearly 1,100, including almost 300 involving players who were diagnosed by the settlement’s own doctors...........
https://www.washingtonpost.com/sports/interactive/2024/nfl-concussion-settlement/