Wednesday, June 15, 2005

Former NFL Player Loses Disability Claim

NFL players can reap large monetary rewards during their playing years but face potentially disabling degenerative conditions afterwards. The NFL's retirement plan for players includes disability benefits but the players face the same hurdles to obtain those disability benefits as employees in less glamorous occupations. ERISA governs claims under the NFL's disability plan, so benefits denials are subject to an arbitrary and capricious standard of review, as demonstrated in a recent case, Boyd v. Bell. Boyd, a former NFL lineman, played from 1980 to 1987. After retiring from the NFL, Boyd held various jobs until 1999 when he was no longer able to work. Boyd's claimed he was suffering from organic brain problems that he traced back to a 19980 preseason game where he was knocked unconscious, suffered temporary blindness in one eye but continued to play. During his football career, Boyd noticed various symptoms that are traditionally associated with concussions such as lack of focus and forgetfulness.

The NFL Plan provides a range of disability benefits depending on the timing of the disabling condition's onset, its severity and origin. In this case, the NFL Plan initially determined that Boyd was totally and permanently disabled arising from non-football related activities. Boyd, however, claimed he was entitled to Football Degenerative disability, which would entitle him to a much higher benefit payment. Two doctors performed a special brain scan and concluded that Boyd was disabled due to a brain injury or head trauma. Another doctors, a neurologist, described as a "plan neutral" physician (i.e. not Boyd's treating physician) concluded that Boyd had "several problems that may arise out of head injuries suffered in the course of his NFL career" and checked the "yes" box when asked whether the injury was football-related. A psychologist also concluded that Boyd's disabling psychological problems were due to football-related injuries.

The Plan, however, referred Boyd to a fifth doctor (not described as plan neutral), also a neurologist, who concluded that the August 1980 head injury could not be the cause of Boyd's problems. The Plan subsequently denied Boyd's claim for Football Degenerative benefits based on the fourth doctor's opinion. The court held that the Plan's denial was not an abuse of discretion. The Plan was not required merely to tally the opinions and decide based on numbers. The court also noted that some of the favorable evidence was equivocal, especially the neurologist's opinion that Boyd's problems "may" arise out football-related head injuries. On the other hand, the fourth doctor seemed to downplay the severity of the 1980 head injury (describing it as "alleged") and the results of a special scan performed by the two doctors who concluded that Boyd's disability was due to brain injury.

Former NFL players seem to be in a third and long situation when it comes to seeking disability benefits. As an article from a Pittsburgh newspaper shows, many players are unaware of the benefits and those who do apply must overcome the Plan's strict rules and the arbitrary and capricious standard to prevail. Although a daunting task, it is not impossible. Recently, the estate of Mike Webster convinced a federal judge that the NFL Plan abused its discretion by denying Webster's brain-injury based disability claims. It is likely that more such claims will be litigated in the future, given the nature of the sport.