Participating in sports is fun, healthy and can be lucrative. But there is an inherent risk that should be addressed at any level.
Author: Attorney Lonnie Roach
Over the last several years, the danger associated with professional sports has received more attention, particularly in light of the NFL Concussion Settlement.
Plaintiffs sued the National Football League, claiming that Retired NFL Football Players received head injuries during their careers which caused long-term neurological problems and accused the NFL of being aware of the risks to players, but failing to protect them.
Inherent in the job of a professional athlete is the high risk of serious injury with long-term physical or mental impairments. Not only can such injuries as brain damage end an athlete’s career, in some cases, the lasting effects of an injury permanently disable an athlete and prevent them from returning to any job.
Some athletes receive long-term disability protection through their professional association, but these benefits do not compensate for what an athlete could have earned.
The National Football League offers three type of disability benefits.
- Total-and-Permanent Benefits. This category provides a minimum benefit of $22,084 per month for active players and $13,750 per month for inactive. Payments continue for life or until the player has recovered. This benefit is available to active and inactive players who are unable to engage in any occupation.
- Line of Duty Disability Benefit. If a player incurs a “substantial disablement arising out of NFL football activities,” they are eligible for a minimum benefit of $3,500 per month for as long as the disability exists, but not more than 90 months
- Neurocognitive Disability Benefit. This benefit created in 2011 assists players who suffer from mild or moderate neuro-cognitive impairments, regardless of the cause for such impairment. Monthly disability payments ranging from $2,625 to $4,500 per month are paid to retired players and reimburse players for medical expenses. Payments continue for 15 years or until a player reaches age 55.
Because the NFL program is considered a “group” program, it is governed by ERISA.
An NFL player claiming disability first applies to the Disability Initial Claims Committee. If their claim is denied, they may appeal to the Board, a panel composed of three owner representative and three member representatives. When all appeals are exhausted, the player may sue in federal court.
Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from a sport related injury. If you have been denied disability don’t give up!
The NFL has adopted the same standards as the Social Security Administration for determining disability, that is, a claimant must prove they are unable to maintain any work in the national economy, not just the job they performed over the last 15 years.
Most disputes arise over:
- whether the player’s injury meets the definition of disability;
- if the disability can be traced to football); or
- the date the player became disabled (within 15 years or after 15 years of last credited season).
Purchasing private long-term disability insurance is also an option for athletes, but does not make applying for disability easier.
The application process can be frustrating, incorporating delay tactics and focusing on discrediting claims. There may be extensive requests for information and multiple calls to doctors, as well as requests for exams by “independent” physicians.
While most professional football players don’t purchase private long-term disability insurance, most National Hockey League players do.
The National Hockey League guarantees contracts when players are hurt during a game, but hockey players, leaving nothing to chance, purchase disability insurance for coverage when they are off the ice. The contracts of baseball and basketball players are also guaranteed, but players often purchase insurance just before their contracts end to prevent an injury from lowering their value in free agency.
Serious injuries are not just a threat to professional athletes.
For college athletes who expect to be drafted by a professional team, a disability can mean millions in lost income or the end of their athletic career. In 1990 the NCAA began offering student athletes in football, men’s hockey, and men’s and women’s basketball and baseball, insurance through the Exceptional Student-Athlete Disability Insurance program. Students must be projected to be picked in the first three rounds of the NFL or NHL drafts or the first round of the NBA, WNBA or MLB drafts to qualify and allows these student-athletes to purchase insurance to cover injuries that could affect their careers. The program allows athletes to borrow money to pay for premiums on these policies which pay out only in the event of an injury or illness that ends a professional career before it starts. It does not pay out if an athlete is able to play despite an injury that lowers their skill, lowers their position in the draft, or causes the loss of a pro season while recovering from injury. The NCAA is not the policyholder; the policyholder is a subsidiary of Lloyds.
Although disability insurance for student athletes sounds like a good idea, in reality, few of these policies have paid out and the policies are unaffordable for many, averaging $8000 for $1 million in coverage.
Additionally, the NCAA has been reluctant to give out information on the number of policyholders, number of claims and actual payouts preventing athletes from making informed decisions. In response, some colleges are taking advantage of a loophole in NCAA policies and using funds from the NCAA’s Student Assistance Fund ($300,000-$350,000 per school) to pay for premiums for select students, but this practice is viewed by many as unfair to other students.
Student Athletes can purchase still disability insurance on their own and many insurance companies are now marketing “Loss of Value” polices to college students: if a student is not drafted or receives a less valuable contract due to an injury, the policy pays a benefit.
But these policies are relatively new and again, only a few have paid out benefits. There are huge financial incentives to deny benefits for insurance companies who can afford to spend years in litigation.
Whether an athlete is insured privately or through their association, proving disability is not easy.
An injured player who is still able to perform another job, will not be considered disabled. Advances in medical technology, new surgical techniques and improved rehabilitation therapies have made disability determinations rare. Applications should be complete and thorough, allowing few reasons for rejection. Applying for Social Security Disability Income is recommended as approval for SSDI can support an insurance claim – though not guarantee it.
If you are an athlete and considering purchasing a disability insurance policy, it would be wise to consult a qualified disability attorney before signing on the dotted line.
Disability benefits are an important source of income for those who are unable to work. If you not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.
Your Free Initial Consultation
At Bemis, Roach and Reed, if we can't help you, we will try to find the right attorneys for you.
We offer each of our prospective clients a free no obligation one hour phone or office consultation to see if we can help you and if you are comfortable with us. We know how difficult a time like this can be and how hard the decisions are. If we can be of assistance to you and help you find a solution to your issue we will even if that means referring you to another attorney.
Or simply call 512-454-4000
to schedule your
Let's get you Started:
If you could provide us with some basic information about your claim we will get right back with you with a free case evaluation and schedule your Free Consultation Today.