The NFL’s Pattern of Disability Claim Denial—With Help from the Union

Four days before Superbowl LVII, The Washington Post published an investigative report that shows a history of the NFL and the NFL Players Association (NLPA) of wrongfully denying disability claims from eligible former players who suffered career-ending injuries. The league and the union jointly manage and fund the NFL benefit plan.

The next day, February 9, a group of 10 NFL players filed a lawsuit in federal court against the league’s benefit plan, board of trustees, and Commissioner Roger Goodell, "seeking redress for the wrongful denial of benefits, the denial of statutorily mandated full and fair review of benefits denials, violations of plan terms or governing regulations, and breaches of fiduciary duty.” The suit seeks class action status on behalf of thousands of former players.

According to the lawsuit, the plan’s board displayed "an overly aggressive and disturbing pattern of erroneous and arbitrary benefits denials, bad faith contract misinterpretations, and other unscrupulous tactics."

The NFL responded that the disability plan "is fair and administered by a professional staff overseen by a board comprised of an equal number of appointees of the NFL Players Association and the league, which includes retired players." The plan was established as part of a collective bargaining agreement by the NFL-NFLPA in 2020 and includes “an uncapped financial commitment to provide benefits for any retired player that meets the eligibility requirements set by the parties. The plan annually provides more than $330 million annually to deserving players and their families.” The players’ union declined to comment.

The estimated 2022 revenue for the NFL is $20 billion. Recent deals with Amazon, Google, and broadcast networks will add about $120 billion over the next 10 years.

Judges in six lawsuits found that the plan wrongfully denied claims. In three additional cases, judges identified problems in how the plan reviewed claims. Multiple federal judges have expressed concern that the plan’s board relies excessively on plan doctors, who have financial incentives to give medical opinions beneficial to the plan, contrary to federal law that requires fair review of all evidence.

NFL spokesman Brian McCarthy dismissed the plan’s losses in court as a small fraction of the thousands of cases it has handled. “There have been roughly 10,000 claims considered since 2008,” he wrote. “Even if those less than a dozen cases were improperly decided—and they were not—the less than one dozen cases hardly amount to a pattern.” In cases in which federal judges ruled that the plan wrongfully denied a claim, the NFL asserted, the judges were wrong.

Texas District Court Judge Karen Gren Scholer doubtless has a different opinion. In June 2022, she ordered the NFL to pay former player Mike Cloud $3.3 million in disability pay. During the trial, the judge forced NFL plan board members to testify about how they review disability claims. She found that the retirement plan’s board had submitted erroneous documents and failed to conduct a fair review—violating federal law. In her ruling, Judge Scholer wrote, “Like many other former players suffering from the effects of head trauma, Plaintiff was forced to navigate a byzantine process in order to attempt to obtain those benefits, only to be met with denial. What has become clear over the course of this litigation is that Plaintiff's claim for disability benefits was wrongfully and arbitrarily denied in a process that lacked the procedural safeguards both promised by the benefits plan and required by law.”

In delivering the order, Judge Scholer remarked, “The defendant seems to argue to the Court that if their system ain’t broke, don’t fix it. Well, based on the mountain of evidence set forth in trial, it is clear to me that the plan is broke and it’s time to fix it.”

If nothing else, The Washington Post article is a reminder that administration of employee benefits can be tricky. The best course is to do so with the help of an employment or ERISA lawyer. If you have questions or concerns about an employee benefit plan, we are happy to help.