Navigating NFL Disability Insurance Claims 

by | Jan 12, 2023 | Articles

Professional football players can have a career-ending injury on any given Sunday. The National Football League (NFL) average player’s career lasts just over three years, according to the NFL Players’ Association. Every week, players put themselves at risk for physical harm. In exchange, they are paid well, but compensation for health benefits should be much more extensive and easier to access.

 Many players may have an injury or disability when they leave the league. Most NFL franchises provide basic group disability benefits that may entitle players to a percentage of their salary for a short-term injury, to claim pension benefits, or to claim total-permanent disability benefits from the NFL. 

The NFL Plan has two main disability categories, “Line of Duty” and “Total and Permanent.” A player cannot receive both at the same time but will receive the more significant benefit and can receive Total and Permanent benefits after the Line of Duty (LOD) benefits end. There is also the highly-publicized concussion settlement. I’ll get to that in a minute.

Understanding the league’s disability benefits can be challenging. The medical standard for LOD benefits is that players must have incurred a substantial, permanent disability from NFL football activities. While that sounds straightforward, applying for these benefits can be difficult and frustrating. When paying out these benefits, the league will deny them and delay providing them to the degree I find unacceptable. It can take several years for players and their families to receive the payouts they deserve.

Getting the runaround can be frustrating for players. Many abandon their fight for disability benefits when the red tape becomes too much. The NFL knows this. The league nickels and dimes players and former players while earning billions of dollars a year. NFL management should streamline the process of applying for benefits. The league asks a lot of players but does not reciprocate when players are hurt and need crucial healthcare.

The best example of this is the landmark NFL class-action concussion lawsuit settlement. The NFL used race-norming algorithms used to determine their claims. That process made it harder for Black players to qualify for benefits in a settlement for concussion litigation. It assumed Black players had a lower cognitive ability before playing than their White counterparts. Nearly 70 percent of NFL players are Black. I find this unconscionable. 

Fortunately, those algorithms have been abolished—adding millions of dollars to the NFL’s payouts for concussion-related brain injuries. But it took lawsuits and public shaming for the league to do the right thing, and it happened at the expense of players’ health and well-being.

It also serves as a great example of the lengths the NFL goes to in its attempt to thwart players from getting the health care they deserve. There is a real sense of anger and frustration among players and their families. For me, it hits close to home.

My son Jordan played in the NFL for four seasons. He suffered on-the-field injuries that led him to apply for LOD, Concussion, and Total and Permanent benefits. Jordan was denied twice before asking for my help. We did not seek out an attorney for help. Hiring an attorney to advocate for your health benefits can be expensive. Many attorneys charge a percentage of the award and other fees. Attorneys have their place; however, applying for your benefits is simple if you know what you’re doing. 

Jordan came to me for help, not only because I’m his mother but because of my extensive medical background. Along with being an NFL mom, I am a registered nurse and former executive for a regional office of a major medical professional liability insurance company, and I founded and owned an independent medical-legal nurse consulting business. I assumed P&L responsibility for the regional insurance office to include the claims, underwriting, and risk management departments. As a legal nurse consultant, I gave expert opinions on plaintiff and defense cases for attorneys whose clients were either pursuing medical professional liability claims or attorneys hired to defend their clients, such as hospitals, nursing homes, physicians, and nursing staff. 

I saw many claims denied because the applications needed to contain adequate information. I want people to know that having a medical claim denied isn’t the end of the line. Typically, you have the right to appeal a decision and have it reviewed. Find out why your claim was denied and how you can dispute it.

But before you get there, I can’t overstate how critical it is to keep a detailed record of your injuries. As a professional athlete, you must be your own medical advocate. That means having a file (paper and electronic) that includes all of your medical expenses, physician visits, injuries, checkups, requests for benefits, and other critical information. Secure it in a safe place.

Players and their families should also hold the NFL accountable. The league is a lucrative business and should pay what it owes to the people who make money for it every week.

In terms of their long-term healthcare policies, the NFL should do more to care for its players after they leave the field. 

According to Sportico, the NFL set a record with $11 billion in revenue generated this past year. The league makes enough money to support players. If they are vested in the league when they exit, they only get five years of health insurance. This lack of support is ridiculous! I think former NFL players should have lifetime benefits similar to military veterans. 

Like veterans, these players are on the battlefield every week, and many suffer long-term health issues. Both are voluntary. The least the NFL can do is approve legitimate medical injury claims that players rightly deserve.

Players should feel supported by the league when they stop playing. To that end, I am creating a workshop of modules to serve as a resource for players before they apply for disability benefits. It will walk them through the process and include documents, player medical history, and other information supporting their claims. I know firsthand what it takes to get these kinds of claims approved.

 I want former NFL players and their families to benefit from my years of experience. That means knowing how to protect yourself when it comes to getting the benefits you deserve.