The NFL players’ disability policy is one of the more complex insurance policies in regards to all of the terms and conditions that are in it. There were some significant changes that were implemented to this policy around May 2020. Mainly, it was the fact that NFL players will be going from a maximum benefit of around $22,000 a month as a maximum in the event that they were qualified for disability to what now appears to be a maximum of $4,000.
This is a significant cut that minimizes the value of this particular policy, considering the fact that NFL players make very significant salaries and put themselves at risk throughout their careers. In addition, they encounter injuries while playing and then subsequently, later in life, as a result of these injuries, are unable to do any work at all due to their disability.
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There are many different aspects of this, and in the video above and article below, attorney Stephen Jessup touches on some of the key points to consider when filing a disability claim as an NFL player. The facts and circumstances are different for everybody depending upon years of service that you’ve been in the league, how many credits you’ve obtained, the type of injury you had, whether you were injured while playing or not playing, neurocognitive disorders, a lot of concussion cases, and so on. However, you will find several helpful pointers and tips on how to best navigate your disability insurance policy and what can you do to make sure your NFL disability claim is handled as best as possible.
Filing a Disability Claim as an NFL Player
When an NFL player is looking to see if they’re going to be able to file a disability claim, the first most important thing is to determine what is going on medically. The definition of what the medical problem is and what is the strength of the medical information supporting the benefit entitlement will be the deciding factor. Any time you’re looking at a disability claim, regardless if it’s through the NFL plan, social security, or through any insurance company, medical is always the first thing that gets evaluated.
Is it going to raise to a level of impairment? In addition, there are other factors that this policy requires in order to be eligible for the benefits. First and foremost, however, it’s always going to be the medical diagnosis and the strength of the medical records and treatment.
How Is the NFL Policy Unique?
The medical records you submit are going to be analyzed very thoroughly, whether it’s an initial application or it’s a claim that’s been denied and you’re handling an appeal. Ultimately, it is going to be decided by the NFL. They have a board that reviews everything; generally speaking, if social security disability has approved you, you’re going to be approved for total and permanent disability.
However, there are caveats where four members of the board review all the information and they determine that they don’t think you’re disabled despite having social security disability. They can then deny you the total and permanent disability benefits under the NFL’s plan.
Once a claim has been denied and you submit an appeal, the board from the NFL is going to be required to review all of the additional evidence. They will look at everything that’s going to be submitted, because it may have been in the initial application providing the information; perhaps there were items that were missing. You have to take a look at perfecting it, just like most insurance companies, and there is going to be a reliance on their own doctors more than anything.
There are some changes that are coming to this plan following a recent collective bargaining agreement mentioned earlier that’s going to impact this even worse, where they don’t have to give weight to social security, and it’s just going to be, essentially, their own internal analysis and review of your medical records.
That is a tremendous change in the policy, because we know the national statistics that with social security disability claims, only 15% of the people who initially apply for these social security benefits get approved. So it’s already an extremely high threshold to get social security disability. The NFL players’ policy used to say, if you got approved for Social Security disability, we’re going to accept that, and then you’re going to get approved for our benefit. This basically put the burden on the government to do the work for them and say whether or not the person was unable to do any occupation.
Now, they are saying it’s not enough, and we are going to do it on our own. Somewhere along the lines, the NFL felt that the government (which is hard to believe for Social Security disability, knowing what we know about how many people get denied) was not doing a good enough job, and they felt that from now, they were going to do it on their own.
It certainly wasn’t costing them any money to have Social Security review the file for them. However, now, they feel that by doing it on their own, it’s going to be a method where they’re going to deny even more NFL players than were potentially eligible for the policy, which is a big concern.
The other factor to consider in this policy is the total and permanent disability threshold they have, which is unique. A lot of disability policies that we handle for most employees in other industries have an elimination period where they say, within 90 or 180 days, if you’re totally disabled, then you’ll be eligible. But the NFL policy is very unique in the sense that they talk about a permanent disability and that that permanent disability is similar to Social Security.
Is the Disability Claim Approval Permanent?
If you get approved initially, it does not necessarily mean that they’re going to approve you forever and you will have to continue to prove that you are still disabled.
There is no consistency in how they’re going to continue to pay benefits – we have received calls for denials following being on claim – and there are also other state income components. This NFL plan has three different types of disability claims, but on its total and permanent disability, they also talk about how you can earn up to $30,000 a year and still get benefits.
There is a weird gray area in ways where they can find grounds for denying, because it’s an idea of permanence, and it’s really left open as to how they may interpret it. There may also be future changes, as the collective bargaining agreement and the NFL Players Association are revisiting provisions of this policy.
Can You Still Work Outside Your Role as an NFL Player and Continue Receiving Benefits?
When it comes to the total and permanent disability component of this disability policy (not the line of duty section of this policy), the fact is that many players get out of the league and end up doing other jobs, whether it’s coaching or retraining to get another career. Most NFL players are ending their careers sometime in their 20s, if not early 30s, and they don’t make these claims until they’re in their mid forties or even years after.
For an NFL player to get support and prove to the NFL doctor review board that these are the particular reasons why they have been able to work for this many years, and this is the particular reason why now they cannot work at all, it all comes down to documenting the medical issues.
In a lot of ways, it’s going to be like any other disability insurance policy and claim. It does happen a lot: people work with injuries for a period of time, and as they age, a lot of the injuries that caused a disability from former players get worse. When you are younger and play in the NFL, your genetic potential is definitely much better than the average person’s, you have a higher pain tolerance, but with age, you will succumb to the body’s natural deterioration and the exacerbation of those problems.
So it’s very important to document that you have had these problems for this many years and you were able to work, but it has gotten worse. It’s key to work with the doctors and make sure your medical records are documenting the problems that you’re having, how they’re impacting you in a work setting, and also in your activities of daily living. Building that record is crucial because ultimately, it’s always going to be your medical records that are going to get scrutiny more than anything.
If you don’t have a strong medical file, it’s going to be that much harder to receive benefits. In addition, a lot of former NFL players get into other industries – insurance, finance, wherever the case may be -and a lot of times, they may even have group disability providers’ insurance policies through those employers. So it may be that you have multiple claims that can be made at any given time; if you are a former player, don’t just think about the policy you’re carrying as a former NFL player, but other insurances you may have through your current employer as well.
One of the things within the NFL player policy proposed with this new change coming in April of 2021 is that Social Security Disability is going to be a deduction from the benefit. So if the benefit does indeed go to $4,000 and an NFL player qualifies for $2,500, now, they’re looking at maybe $1,500 from this policy, and they could have worked for another employer who has group coverage, which could also be a setoff.
Unfortunately, it appears this entire NFL policy is extremely controversial, and there are some people whose benefits may be affected as of possibly 2015 and later who didn’t file until after that date.
There are a lot of technicalities that we’re happy to discuss with you: no matter what stage of your claim with the NFL players policy, feel free to call us and we will be happy to provide you with an initial free consultation. We represent NFL players all over the country, and we look forward to the opportunity to discuss your potential claim with you.