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Why The NFL's Concussion Settlement Isn't Easy To Navigate

May 16, 2018
Originally published on May 16, 2018 8:06 pm
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AUDIE CORNISH, HOST:

Four neurologists have diagnosed retired NFL player George Andrie with dementia. He's one of thousands of former players suffering from a brain condition that in theory should qualify him to receive money under the NFL's concussion settlement. But his claims have been denied twice. In fact, 70 percent of the more than 1,300 claims so far have not been approved.

The settlement was reached after a class-action lawsuit filed last year on behalf of former players, alleged that the NFL knew about the risks associated with repeated brain injuries and ignored them. Deadspin writer Dom Cosentino has written about all of this. Welcome to the program.

DOM COSENTINO: Hi. Thanks for having me.

CORNISH: For a little bit of background, remind us of George Andrie's history at the league.

COSENTINO: George Andrie was drafted in the sixth round in 1962 by the Dallas Cowboys. He played 11 seasons for them. They played in the fifth Super Bowl against the Baltimore Colts and lost. And in that game, one of the plays Andrie made was where he knocked out Johnny Unitas, the famous Hall of Fame quarterback for the Colts.

The following year, the Cowboys won the Super Bowl for the first time. Andrie was a part of that team. He then retired and worked for a beer distributorship and set up an advertising business and lived out his life raising seven children with his wife, Mary Lou.

CORNISH: And as we mentioned, George Andrie has been assessed by four doctors. Each say that he is currently suffering from dementia. But he was denied. So what did the NFL panel say?

COSENTINO: Well, the explanation was somewhat confusing because it seemed to mix up the results of a cognitive test he had done with one doctor and attribute it - by attributing it to another doctor entirely. It made references to his appearance, making an assumption that because he was presentable and was cleaned up, that he was capable of doing that by himself, when in fact he has a 24/7 caregiver, and his family makes sure that he doesn't leave the house without looking like a person who's well-kempt. That was the first denial.

The second one then used a very specific set of criteria in evaluating what the - his doctors had to say versus what the settlement criteria are for making this determination. And it's supposed to be a general standard, but - according to the settlement, but a very specific one was used where it appeared that a lot of cherry-picking was done in terms of what the doctors had to say to deny the claim.

CORNISH: So he's in the middle of an appeals process. What's life like for him trying to cover these costs, his family trying to cover this cost on their own?

COSENTINO: George Andrie is not someone who is financially burdened, let's say. And that's what's sort of unique about this story. His daughter, Mary Brooks, who I interviewed at length for this story, has made it clear to me that they're not in any financial straits unlike a lot of others who are - who wish to file claims.

But the reason that his daughter was willing to put all of this out there and share her father's medical records with me is to show the process that a lot of families filing claims, particularly families with - of former players with dementia, are going through in trying to get their money because so few of them have been paid out.

CORNISH: And you said these families are scared to go public because they fear it'll affect the claims process. How complicated is it? I mean, do you need four doctors? And why do you have to go to a panel again with all of these notes?

COSENTINO: It is very complicated, and it depends on the timing of the diagnosis. Someone like George Andrie, who was diagnosed before the settlement was finalized was allowed to submit those diagnoses that he got prior to the settlement and have them reviewed by an appeals panel. Those that came along afterward that still want to file claims can be evaluated by doctors under a program that's established by the settlement that was approved by both parties, both the claim side as well as the NFL. So a lot of it depends on timing. And then it's a matter of which documents to submit.

You can see how complicated this all gets. And now you can imagine trying to be a family member of a former player with a brain injury trying to navigate this yourself. Or even trying to do it with a lawyer can be very difficult. That's what a lot of these people have encountered.

CORNISH: What has the NFL said in response to your story?

COSENTINO: Nothing.

CORNISH: So the NFL is also doing audits of people's applications. They're accusing people of basically trying to game the system. Are they right? Is there fraud?

COSENTINO: I don't doubt that there's some going on, but I think to the degree that the NFL has said there is, I have my doubts. And I don't know that the NFL can be taken at face value with anything they have to say on this topic given their history of manipulating and denying a link between repetitive head trauma and long-term brain disease.

You know, the burden of proof will ultimately be on them. There's - this is getting hashed out in court in front of the judge, who is overseeing a settlement. But, you know, I for one, knowing the NFL's history on this topic, am not willing to take them at face value.

CORNISH: Dom Cosentino - he writes for Deadspin. Thank you for sharing your reporting with us.

COSENTINO: You're welcome. Thank you.

CORNISH: NPR asked the NFL for comment. A spokesman says claims are being approved every month, writing, quote, "we are ensuring that legitimate claims are processed and paid in a timely way to those individuals and families who deserve these benefits. We believe that it is entirely appropriate to continue to oppose fraudulent and unsupported claims. No legitimate claim has been rejected." Transcript provided by NPR, Copyright NPR.