Timely medical reports remain a challenge for NFL’s concussion settlement program

At the heart of the NFL’s billion-dollar concussion settlement program lies a basic formula: If a retired player is found to have developed certain neurocognitive illnesses after absorbing countless brain-rattling collisions playing football, he‘s entitled to compensation.

The path to actually receiving a payment, though, is one that many ex-players have sometimes struggled to navigate due to an array of disheartening denials and delays.

A recent report, filed in Philadelphia federal court, shows that the settlement program has grown more efficient but is still hindered by some systemic flaws.

Former players have long complained of waiting years to meet with doctors who conduct baseline neurological assessments for the program, or to receive the results of those tests, slowing their quests to be paid.

Time is money; as ex-players grow older, their potential payouts get smaller.

The settlement program has reduced the average amount of time ex-players wait for an appointment to 134 days, two court-appointed special masters noted in their report, which was filed May 12 in U.S. District Court for the Eastern District of Pennsylvania.

But getting doctors to submit their assessments quickly “has proven a harder problem to resolve,” wrote the special masters, David A. Hoffman and Jo-Ann M. Verrier.

The report — which summarizes their oversight of the program as it nears its 10th anniversary — doesn’t speculate as to why there has sometimes been a lag in test results being shared.

But Hoffman and Verrier wrote that they and BrownGreer LLC, a third-party company that administers the program, have made “vigorous attempts” at convincing doctors to file their assessments. Some who didn’t comply have been removed from the network, according to the report. (The special masters previously disqualified 11 doctors after questions were raised about the accuracy of their diagnosis. An updated total is not yet available.)

A 2024 Inquirer investigation, The Final Penalty, found that a dozen starters from the Philadelphia Eagles’ 1980 Super Bowl team have developed neurological problems later in life, including memory loss, personality changes, and movement disorders.

Some, like former star running back Wilbert Montgomery and linebacker Frank LeMaster, were diagnosed with neurocognitive impairments but had their settlement claims rejected after the program’s doctors disagreed about the severity of their illnesses. Each was ultimately paid more than three years after they filed their initial claims.

The ex-Eagles had a steady advocate in their former coach, Dick Vermeil, who has worked behind the scenes to connect some of his old players with reputable doctors. Vermeil has lobbied the NFL — which reportedly saw its revenue reach $23 billion in 2024 — and the players’ union to do more to help aging former athletes obtain financial assistance.

“There‘s no shortage of resources,” he told The Inquirer last year. “There‘s a little bit, sincerely, a lack of concern.”

NFL officials have repeatedly stated that the league has done considerable work to help its alumni.

But the settlement program will soon begin a new outreach effort, mailing and emailing former players with information about a variety of NFL benefits that are available to retired players.

“It is about time,” Vermeil told The Inquirer in a text message.

The settlement program has faced intense scrutiny since its inception.

In 2011, dozens of former NFL players filed lawsuits against the NFL in California and Pennsylvania, accusing the league‘s leaders of minimizing the risks of repeated brain injuries. The number of plaintiffs climbed into the thousands, and the cases were consolidated in Philadelphia federal court.

Attorneys for the players and the NFL agreed to settle the case in 2014. A year later, the terms were approved by Judge Anita B. Brody.

The NFL admitted no wrongdoing but agreed to fund a 65-year program that would pay retired players between $25,000 and $5 million if they had neurocognitive impairment, Alzheimer’s disease, Parkinson’s disease, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease).

Only players who had retired prior to July 2014 were eligible to submit claims. Independent neurologists, meanwhile, argued that the program’s neurological assessments differs from the evaluations that are traditionally used by dementia specialists and neuropsychologists.

Hoffman and Verrier described the program as “exceptionally complex.”

Since 2017, the program has paid more than $1.3 billion to 1,846 former players — nearly double what the NFL initially proposed spending to settle the case.

Hoffman and Verrier noted that the program’s early years were marked by instances of attorneys and doctors who submitted fraudulent records and commercial lenders who offered high-interest loans to players as an advance on payments they hoped to be awarded. (The court later offered lenders direct repayments in exchange for capping interest rates at 10%.)

Another controversy emerged in 2020, when a lawsuit filed by two former NFL players revealed that the settlement program’s doctors had used “race-norming” in neuropsychological screenings.

The evaluation tool, used in a variety of medical settings, presumed that Black players had lower preexisting cognitive abilities, making their declines seem less pronounced than those of their white peers.

That practice was ended in 2021, and 308 ex-players qualified for additional benefits.

Some ex-Eagles, meanwhile, came to believe that the program’s extensive rules and appeals processes were designed to wear down their resolve.

“Delay, deny, hope you die,” former linebacker John Bunting said.

It is an accusation that both the NFL and BrownGreer have strenuously denied.

LeMaster, a Pro Bowler who started 136 consecutive games during his Eagles career, was diagnosed by the settlement program’s doctors with a neurocognitive impairment in 2020. But they disagreed about the severity of his illness, and his settlement claim was initially rejected.

He went through the evaluation process a second time and was approved for a payment that amounted to $134,000, minus legal fees.

A final chunk of the money that LeMaster was owed arrived at his house in late March 2023 — a few days after he had died, at age 71.

LeMaster and two other members of the 1980 Eagles, center Guy Morriss and punter Max Runager, were each found after their deaths to have had the degenerative brain disease chronic traumatic encephalopathy.

Hoffman and Verrier wrote that the settlement program now allows for payments to arrive to former players on a faster timeline.

“The program has levels of complications,” said LeMaster’s widow, Marylou Robinson. “Frank was very focused — he wanted justice. But it‘s very arduous to work through this process."