Former football players who are not totally and permanently disabled may be entitled to a short term disability benefit known as NFL Line of Duty disability (or LOD) where a player incurs a “substantial disablement arising out of NFL football activities.”
Pro football players face all manner of disabilities. Because of the complex nature of these injuries and a rigid compensation policy, claims submitted under the NFL Line of Duty plan are often wrongly denied or improperly classified.
Football is remarkable in many ways. It is the only major sport where a typical career is just a few years long. It’s part of the game. Because of the high-impact injuries sustained, in a single play a talented athlete can be crossed off the roster.
Disabled NFL players are counting on vital disability benefits they are owed to help carry them through the coming years, and often the remainder of their lives. But too often the NFL plays it the other way.
Your Lawyer for NFL Line of Duty Disability Benefits
The team at Marc Whitehead & Associates disability law firm avidly represents former players suffering disabling injuries who have been let down by their league. If you need assistance getting your rightful LOD payments, or have questions about disability coverage under the NFL Player Disability Plan, contact Marc Whitehead & Associates today.
What Disability Benefits Are Available to NFL Players?
Under the current (2011) NFL Collective Bargaining Agreement (CBA), the NFL Players Association offers insurance and health benefits to its players. The disability insurance portion of the Agreement is under the Bert Bell/Pete Rozelle NFL Player Retirement Plan.
NFL players have three types of disability benefits:
- Line-of-Duty Disability Benefits (LOD) – shorter-term disability benefits that can last up to 90 months (7.5 years). Monthly payments are determined by the number of credited NFL seasons you have.
- Total and Permanent Disability Benefits (T&P) – Long term disability benefits;
- Neurocognitive Disability Benefits – coverage for neuro-cognitive impairments for eligible players not receiving LOD or T&P disability benefits.
Each benefit has different qualification rules and amounts available.
If the NFL awards a player Line of Duty benefits, once the payments conclude the player may still apply for Total and Permanent disability benefits. These benefits can mean dramatically increased monthly payments. However—as many disabled players have found—an award of LOD benefits in no way guaranties a subsequent award of T&P benefits.
NFL Line of Duty Disability and Your Legal Rights
The NFL disability plan is controlled by ERISA law. This is important to your case because if your application for LOD benefits is denied, these rules govern everything about what you must do to appeal, or dispute, the denial. These laws are not in your favor.
Because of ERISA’s constraints and deferential standard of review, the law favors the employers and benefit payors, not the players.
Who Decides to Approve or Deny Line of Duty Disability Benefits?
ERISA law gives the NFL (an already powerful opponent) the discretion to make your disability benefit decision, with literally no legal risk or penalty if they get it wrong.
Eligibility is determined by the NFL’s Initial Claims Committee or the Retirement Board. A line-of-duty disability will be considered permanent if it has persisted or is expected to persist for at least twelve months from the date of its occurrence.
How Are NFL Line of Duty Benefits Determined?
You can apply for LOD disability benefits if you suffered a “substantial disablement arising out of NFL football activities.”
- Players Must Meet the Substantial Disablement Criteria. This means your disability has lasted or can be expected to last at least 1 year from the date of its occurrence, or is expected to result in death within 12 months. This definition is very much like the Social Security Administration’s definition of disability.
- The “NFL activities” are any NFL game (including a pre-season or post-season NFL game, or any combination thereof), or out of NFL football activities supervised by a Club, including all required or directed activities.
- A line-of-duty disability is not caused by NFL football activities if it results from other employment or athletic activity for recreation.
NFL Tactics to Deny Line of Duty Disability Claims
Independent Medical Exams (IME) – to determine the scope of your injuries and level of disability, the NFL will have you undergo an independent medical examination. Costs are paid by the league. The medical examiners come from a pool of physicians who “are instructed to examine applicant players fully and fairly.” But sometimes this is not what happens. Some IME examiners predictably find in favor of the league, concluding that you have the capacity for light or sedentary work and therefore do not warrant disability benefits.
Cherry picking evidence – LOD claim denials often result when the NFL defers to the Plan-selected doctors’ opinions and findings, with no mention of your treating physicians medical reports and determinations.
Latent disabilities – An injury’s depth of damage is not always immediately apparent. Old head injuries can surface decades later as progressive and latent brain injuries. Musculoskeletal and soft tissue injuries may not manifest as disabling until years have passed.
Latent injuries often surface after the Line of Duty statute of limitations for eligibility. The NFLPA Benefits Book states that to apply for the line-of-duty disability benefits, as a player you have whichever is greater: (1) a 48-months window, or (2) the number of years equal to your Credited Seasons. Deadlines are figured from the date you cease to be an Active Player.
These are not simple matters. Disabled NFL players are up against an often biased law and league. If you even suspect an improper denial or misapplication of law, you should contact an attorney immediately to figure out the next step.
Consult with Us at No Charge
We work with NFL athletes who were injured on the field or in practice get the disability benefits they are due. Don’t hesitate to call our disability attorneys at (800) 562-9830 or contact us online to discuss your case.
Although Line of Duty disability benefits are considered short term, a player’s personal life and well-being hang on the Retirement Board’s use of discretion when deciding claims.
Don’t let the NFL blindside you. If you have questions, or if you are having trouble getting your LOD or other NFL disability benefits, see how we can help you:
- File an application for NFL Line of Duty benefits – this includes obtaining medical records and preparing a well-developed claim explaining every injury and all relevant medical treatments, reports and physicians statements;
- Prepare you for and guide you through the Independent Medical Examination;
- Ensure you are properly classified and getting the full and correct disability benefit amount you are due;
- Appeal a denied disability claim through the internal NFL appeals process.
- Our attorneys are also Board Certified in Social Security Disability Insurance law, and will assist in all matters of Social Security Disability benefits.
It is not only what information you submit with your claim; it is also how you develop and present your evidence that will successfully resolve your case. You want a law firm with the resources and experience to protect you from unfair ERISA laws and potential industry abuse of discretion.
The current CBA expires at the end of the 2020 NFL season, with the next CBA to be negotiated in 2020. Stay tuned for updates for this and other important NFL disability news.