A group of former National Football League players is suing the organization, alleging that it has a pattern of denying disability benefits for those with both physical injuries and mental impairments, despite evidence from medical and team records.
The plaintiffs include Jason Alford, Daniel Loper, Willis McGahee, Michael McKenzie, Jamize Olawale, Alex Parsons, Eric Smith, Charles Sims, Joey Thomas and Lance Zeno.
They are "seeking redress for the wrongful denial of benefits, the denial of statutorily mandated full and fair review of benefits denials, violations of plan terms or governing regulations, and breaches of fiduciary duty," according to the complaint, which was filed Thursday in the U.S. District Court for the District of Maryland.
Several of them had their applications for benefits denied on multiple occasions, marred by conflicting reports from doctors with denial rates often exceeding more than 90%, the lawsuit says.
The complaint suggests the doctors who analyzed the plaintiffs were highly paid by the league, and therefore purposefully minimized the former players' complaints in reports so the league was justified in denying their applications to avoid payouts. Conversely, doctors who made less were more likely to accurately detect disabilities, the lawsuit says.
For example, the complaint says a doctor who evaluated Smith was never paid more than $72,765 in a year from the board in 11 years. From April 2015 through March 2016, he was paid $34,268. The next year, after the doctor found 20 impairment points during his examination of Smith – and the player was approved for disability benefits – the doctor's pay fell to $16,711.
The plaintiffs point out that physicians are supposed to be neutral, but the league does not have a system in place to audit physicians' reports or collect data on how many claims are approved or denied, and does not penalize those who make inaccurate or incomplete reports.
The NFL was not immediately available for comment, but on Wednesday, NFL Commissioner Roger Goodell was asked at a press conference how he justifies so many players being denied disability benefits.
"We have to obviously have a system to be able to identify who qualifies for those benefits and who doesn't qualify for those benefits, and that's done with union and management," he said. "And the facts are that's done independently with doctors who make a determination of whether ... an individual qualifies under that program."
"So you don't want people to benefit from it that don't qualify for it, because it takes away from people who do qualify for it. So you're always going to have people who may think they qualify for it – doctors disagree, the joint board disagrees. That's a way the system works, but I would tell you the benefits in the NFL are off the charts."
Goodell is listed as a defendant in the suit, and is also on the board of the NFL Player Disability and Neurocognitive Benefit Plan. He said about $2.5 billion of the league's $10 billion player compensation package this year is for benefits.
Yearly disability compensation can range from $65,000 a year to $265,000 a year, depending on if the injury was sustained while performing activities for the league or not, and how long ago the injury happened.
A doctor for McGahee, who played 11 years as a running back, incorrectly stated McGahee was unimpaired, despite several tests showing impaired cognitive function, and used McGahee's demographic information, including his race, to estimate his IQ prior to the injury, the lawsuit says.
Education level and prior training is not allowed to be evaluated when determining players' benefits.
According to the lawsuit, Sims was approved for Inactive A benefits, which do not require an injury be sustained during a player's time in the league, even though he qualified for Total and Permanent benefits, which are given to those who have "become totally disabled to the extent that he is substantially prevented from or substantially unable to engage in any occupation or employment and such condition is permanent."
In Sims' decision letter, the seven-person board wrote that one member did not believe Sims sustained his injuries – including "'post-concussive syndrome' and multiple orthopedic 'NFL related impairments'" – during his four years in the league as a running back, despite the doctor's report saying so. Therefore, the board could not agree on a classification for Sims' benefits, the lawsuit says.
In an appeal, Sims submitted additional team and medical records, but was once again denied, as the board determined there still was no evidence proving Sims was injured as a player, according to the complaint.
The plaintiffs are seeking to make their complaint a class action lawsuit, have the current members of the board removed and be given monetary relief.
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