The Post this week published an investigation into the 2015 NFL concussion deal, finding a disturbing reality hidden behind the $1.2 billion the league has awarded to more than 1,600 applicants. The NFL has touted this sum as proof that the arrangement is fair, but the only thing it shows for sure is the extent of the damage to athletes’ brains. According to The Post’s reporting, the NFL has saved hundreds of millions of dollars more by denying money and medical care to those who request relief, even when they are living with dementia and chronic traumatic encephalopathy (CTE).
The trouble starts with the settlement’s definition of dementia, which is more exacting than the standard medical definition in the United States. Typically, patients can be diagnosed by displaying substantial impairment in a single area, such as memory, language or executive function. NFL settlement-seekers must prove impairment in two domains to receive compensation. The NFL’s attorney has called this test more objective, characterizing it as a “necessity … in the context of a compensation-for-diagnosis” program — a fancy way, it seems, of saying the settlement was designed to spare the NFL significant expense.
The strategy works. Irv Cross, a defensive back who made history as a pioneering Black broadcast analyst of CBS’s “The NFL Today,” couldn’t speak coherently, forgot to change his clothes and experienced urinary incontinence. But he didn’t score low enough on cognitive tests for the settlement’s terms. The same goes for defensive lineman Ed Lothamer, who consistently became lost on simple drives around town. His learning and memory were deeply impaired, but that was only one domain — not enough, it turned out, for the settlement.
There are more obstacles in former players’ paths. Applicants for relief also have to qualify as sufficiently handicapped according to the Clinical Dementia Rating (CDR) scale. So to demonstrate even “mild dementia,” they must have abandoned hobbies and interests; struggle to independently function at social events; and forget to take care of their hygiene. That’s a high bar, which is probably why the CDR is typically a research tool rather than a diagnostic one. One neurologist, for a time part of the network of doctors the NFL set up to evaluate and treat patients, called the scale “junk science.”
Some of this doctor’s and others’ diagnoses were overturned by the administrative law firm overseeing the settlement because patients’ symptoms weren’t serious enough under the CDR scale: They could, the reviewers said, still drive or work. Glen Ray Hines Sr., a former offensive tackle, could maneuver a vehicle and walk on a treadmill — but he couldn’t manage his finances; and his wife had to explain TV programs and newspaper stories to him. His own doctor had been treating him for dementia for years. Review doctors, however, said the driving and exercise ruled him out. He died in an assisted-living facility; an autopsy found he had severe CTE. At least 12 more players have met the same fate, with the same postmortem diagnosis.
To add insult to traumatic brain injury, even when players’ symptoms do meet every definition of dementia, their struggle often still isn’t over. The NFL touted during settlement negotiations that it was protecting players with multiple health problems by waiving arguments about “causation.” Yet it turns out this only meant that players wouldn’t have to prove their football careers caused their dementia — it didn’t mean they wouldn’t have to prove their dementia, not something else, was causing their cognitive decline. Settlement review doctors denied claims by blaming sleep apnea, depression, alcohol abuse, bipolar disorder and even vitamin B12 deficiencies for former players’ impairment. It didn’t matter that sometimes those players’ own physicians had ruled out these other causes.
The stinginess, once summed up, is staggering. The NFL settlement has approved about 900 dementia claims in the seven years it has been open. It has denied nearly 1,100. Almost 300 of those involved players who were diagnosed by the same network of doctors the league set up to evaluate and treat its athletes. The NFL has blamed many of these denials on fraud; The Post found no such evidence in the more than 70 it reviewed. The collective value of the rebuffed claims could be more than $700 million.
The NFL, it appears, has set up for former players a process more difficult to navigate than a football field just after the snap. Meanwhile, it insisted the settlement arrangement is just the opposite — making a show of great responsibility while accepting far less. After The Post began discussing its reporting, the NFL and its top lawyer asked for a replacement of the company managing the league’s network of doctors. That’s a start. Though the league says the change was unrelated to The Post’s story, the facts suggest the NFL is more concerned with protecting its image than protecting its athletes. The public shouldn’t allow the league to succeed in the former until it truly begins caring about the latter.
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