The lawsuit alleges that, in many cases, physicians are penalized when they find that former NFL players are entitled to disability benefits.
A group of former professional athletes have filed a lawsuit against the National Football League (NFL), alleging that its management has a pattern of denying disability benefits to players who have suffered physical injuries and mental impairments.
According to National Public Radio, the plaintiffs named in the lawsuit include Jason Alford, Daniel Loper, Willis McGahee, Michael McKenzie, Jamize Olawale, Alex Parsons, Eric Smith, Charles Sims, Joey Thomas, and Lance Zeno.
The complaint, which was filed Thursday in U.S. District Court for the District of Maryland, seeks compensation 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.”
The lawsuit notes that several of the former players had their applications for disability benefits denied several times, even though their physicians had—in many cases—supported their claims.
However, in other cases, attorneys for the players suggest that benefit denial rates exceeded 90%.
The high rate of denials led the athletes’ lawyers to conclude that the physicians who analyzed the plaintiffs were, in all likelihood, either paid or incentivized by the National Football League to unilaterally deny benefits.
The lawsuit notes that the physician who evaluated Smith, for example, was never paid more than $72,765 per year from the disability board in 11 years. Between April 2015 and March 2016, he was paid $34,268.
The next year, when he examined Smith and identified 20 impairment points that enabled Smith to qualify for disability benefits, the doctor’s board-related pay fell to $16,711.
While physicians who evaluate disability claimants are supposed to be impartial, the National Football League allegedly has no system in place to audit doctors’ reports, collect data on approved or denied claims, or penalize practitioners who make inaccurate judgments.
National Public Radio reports that League Commissioner Roger Goodell, when asked how the organization justifies its high rates of disability benefits denial, provided a somewhat opaque explanation.
“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,” Goodell 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,” Goodell said. “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.”
The plaintiffs, notes N.P.R., are hoping to have their lawsuit certified as a class action, meaning that other athletes who have been denied disability benefits can seek compensation, too.