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The Concussion Files
The ‘landmark’ deal promised payouts for suffering players. But strict guidelines, aggressive reviews and a languishing doctors network have led to denials for hundreds of players diagnosed with dementia, including many who died with CTE, a Washington Post investigation found.
When Irv Cross applied for money from the NFL concussion settlement in 2018, his dementia was obvious to anyone who spent more than a few minutes with him.
At 78, the former NFL player and trailblazing sports broadcaster struggled to speak coherently, forgot to change his clothes and suffered from urinary incontinence, his wife told doctors. Cross had been diagnosed with dementia by another doctor months before he was evaluated by two NFL settlement doctors, his medical records show.
But the settlement doctors concluded they couldn’t diagnose Cross with anything, their reports state. While Cross’s symptoms met the standard definition for dementia in American medicine, they agreed, his test scores didn’t meet the NFL settlement’s definition.
“He does not appear to qualify for any diagnosable conditions through the NFL program,” a settlement neurologist wrote. Cross died three years later, of what his doctors thought was just Alzheimer’s disease. An autopsy found he also had suffered from severe chronic traumatic encephalopathy (CTE), a brain disease linked to football.
When Al Bemiller filed his settlement claim in 2019, his children hoped for a quick approval and money to help with his care. He had been diagnosed with dementia four years earlier and needed round-the-clock assistance preparing meals, showering and getting dressed.
But a doctor on the NFL settlement’s review panel responded to Bemiller’s records with skepticism. Perhaps depression was actually causing his dementia symptoms, the review doctor suggested. Claim denied. Bemiller died two years later of dementia.
And when Don Maynard applied in 2019, his doctor was so alarmed he said he would file the diagnostic paperwork right away, Maynard’s son recalled. But that paperwork went into a bureaucratic black hole for more than two years. The letter informing Maynard that settlement doctors diagnosed him with dementia arrived in January 2022 — three days after he died of dementia.
Finalized in 2015, the NFL concussion settlement resolved the most serious threat America’s most popular and lucrative sports league has faced. While the NFL admitted no wrongdoing, it promised to pay every former player who developed dementia or several brain diseases linked to concussions. Players suffering from CTE, the league pledged, also would get paid once they developed symptoms of dementia. The league even agreed to fund a nationwide network of doctors to evaluate players and provide those showing early signs of dementia with medical care.
Irv Cross, a former player and pioneering broadcaster, was diagnosed with dementia but still didn't qualify for benefits. When he died, an autopsy showed severe CTE. (George Rose/Getty Images)
In seven years since the settlement opened, the NFL has paid out nearly $1.2 billion to more than 1,600 former players and their families — far more than experts predicted during settlement negotiations. The league points to these figures as evidence of the settlement’s fairness.
But behind the scenes, the settlement routinely fails to deliver money and medical care to former players suffering from dementia and CTE, a Washington Post investigation found, saving the NFL hundreds of millions of dollars, if not more.
The Post reviewed more than 15,000 pages of documents relating to efforts by more than 100 former players to qualify for settlement benefits, including thousands of pages of confidential medical and legal records. The Post also interviewed more than 100 people involved with the settlement — including players, widows, lawyers and doctors — as well as 10 board-certified neurologists and neuropsychologists for their expertise on how dementia is typically diagnosed.
The settlement’s definition for dementia requires more impairment than the standard definition used in the United States. Several doctors who have evaluated players told The Post that if they used the settlement’s definition in regular care, they would routinely fail to diagnose dementia in ailing patients. “I assumed this was written this way, on purpose, just to save the NFL money,” said Carmela Tartaglia, an associate professor of neurology at the University of Toronto.
At least 14 players, including Cross, have failed to qualify for settlement money or medical care and then died, only to have CTE confirmed via autopsy. Eight of these players were diagnosed in life with dementia or a related memory disorder but still failed to qualify for settlement benefits.
In more than 70 cases reviewed by The Post, players were diagnosed with dementia by board-certified doctors, only to see their claims denied by the administrative law firm that oversees the settlement. While the NFL has often blamed denied claims on fraud, none of the denials reviewed by The Post contained allegations of fraud. Instead, records show, settlement review doctors simply overruled physicians who actually evaluated players, often blaming dementia symptoms on other health problems also linked to concussions, including depression and sleep apnea.
The NFL’s network of settlement doctors has been beset by systemic administrative breakdowns since its inception. Former players suffering from dementia wait, on average, more than 15 months just to see doctors and get the records they need to file a claim. Maynard was one of two players The Post found who waited more than two years to get paperwork and died before they could get paid.
In total, court records show, the settlement has approved about 900 dementia claims since it opened in 2017. It has denied nearly 1,100, including almost 300 involving players who were diagnosed by the settlement’s own doctors.
The collective value of denied dementia claims, based on the average cost of approvals, could exceed $700 million. And that figure doesn’t include cases such as Cross’s, in which players diagnosed with dementia never bothered to file claims because they were told they didn’t meet the settlement’s requirements.
In August, the NFL and the top lawyer for the players, Christopher Seeger, asked the judge overseeing the settlement to replace the company that managed the league’s network of doctors. The change, which the judge quickly approved, came weeks after The Post began discussing its reporting with Seeger. The NFL and Seeger both said the change was unrelated to The Post’s reporting.
The NFL declined to make any league executive available for an interview and deferred all questions about the settlement to its attorney Brad Karp, who also declined interview requests. Karp, in an email, disputed The Post’s findings and argued the amount the settlement has paid proves it is managed fairly.
“I just don’t understand how this is legal,” said Scot Maynard, whose dad, Don, received a letter after he died saying he qualified for benefits. (Paul Ratje for The Washington Post)
“Absent the Settlement, many of these now-compensated retired players and their family members would have received nothing at all,” wrote Karp, who also emphasized the settlement is overseen by an independent administrative law firm and a federal judge.
Karp claimed the settlement’s dementia definition isn’t more difficult to satisfy than the standard in American medicine. It’s just more objective, he said, which he called a “necessity … in the context of a compensation-for-diagnosis Settlement Program.”
But Seeger, in interviews, contradicted Karp, acknowledging that the settlement’s dementia definition is more difficult to satisfy than the regular one used in American medicine.
“It’s a notch above,” Seeger said. “We explained that to anybody who’s ever asked.”
This was news to one of the two lead clients in the settlement who helped Seeger build support for it among thousands of former players. Shawn Wooden, a former safety who served as a class representative, said in an interview that neither Seeger nor any other lawyer ever explained that the settlement had its own definition for dementia.
Attorney Christopher Seeger, center right, and class representative Shawn Wooden, center left, in 2014. (Matt Rourke/AP)
“Hell no, I didn’t know anything about this,” said Wooden, now a financial adviser. “And I would not have been cool with it if he had told me.”
The only other class representative in the settlement died in 2016 of amyotrophic lateral sclerosis (ALS).
This is not the first time a top client or firm in the case has taken issue with Seeger, one of the nation’s leading attorneys in complex settlements, whose firm has collected more than $65 million from the case. In 2018, several firms representing thousands of players asked the judge to appoint a new lawyer to represent them; she rejected the request. And in 2020, Seeger initially dismissed accusations of racial bias in settlement payments raised by other attorneys before reversing his stance and publicly apologizing to Black players for not acting sooner.
In two interviews with The Post, Seeger defended his advocacy for players in the case.
“A whole bunch of people to this day don’t understand the victories that we’ve had in the deal that have caused [the NFL] to now be at almost $1.2 billion,” he said.
Two experts in class action settlements told The Post they were troubled by allegations lawyers didn’t explain terms to a lead client, and they expressed outrage about administrative breakdowns in the NFL’s network of doctors.
“This is a systemic failure, at every level,” said Adam Zimmerman, a professor at USC Gould School of Law. “For this to have been going on as long as it has … and players are dying while waiting for their benefits … I’m having trouble wrapping my brain around this.”
Medical disputes over who qualifies for money in complex settlements are commonplace, these experts said. But they were unaware of another case in which lawyers took a well-known medical condition with a commonly accepted definition — such as dementia — and created their own criteria.
As the NFL and Seeger sold the settlement a decade ago, they often described it as “landmark” and “historic.” Some players and their families who have actually gone through the settlement, however, use another phrase to describe it.
One is Sallye Benecke. Doctors diagnosed her late husband, former NFL player Freeman White, with Alzheimer’s disease in 2013 and treated him as his condition worsened until he died of cancer five years later. His claim was denied because a settlement review doctor suggested his symptoms were caused not by Alzheimer’s but by something else: a vitamin deficiency.
“When we started this whole thing, the lawyers said if you were diagnosed with one of these diseases, you’d get a check,” Benecke said. “This whole case feels like a bait-and-switch.”
Brad Karp, attorney for the NFL, said in 2018, “Cognitive impairment as a risk of playing professional football is one of those rare existential threats to this particular client.” (David Richard/AP)
The lawsuits began in 2011. Seventy-five players sued the NFL in state court in California, then seven more in federal court in Philadelphia. Those lawsuits inspired hundreds more involving thousands of players, all accusing the league of deceiving them about the dangers of concussions. The federal court system consolidated the lawsuits and sent the case to Philadelphia, to be heard by U.S. District Judge Anita Brody.
Players blamed a long list of health problems on their NFL careers, including Alzheimer’s, Parkinson’s and ALS. But the main reason they sued was CTE, the once-obscure disease that had been discovered in the brains of dozens of former NFL players. The lawsuits sought financial damages as well as money for medical care, including for healthy players in case they developed problems later in life.
Publicly, the league dismissed the cases as baseless. But privately, the league’s top outside lawyer later acknowledged, he believed they posed a serious threat.
“Cognitive impairment as a risk of playing professional football is one of those rare existential threats to this particular client,” Karp explained at Columbia Law School in 2018.
As he rose to chairman of the Paul, Weiss firm, Karp developed a reputation as a trusted adviser to billionaires and corporations in crisis. He steered Wall Street firm Smith Barney through a sex discrimination scandal in the 1990s and Citigroup through entanglements to Enron in the 2000s.
“Many lawyers come to speak in owners meetings,” New England Patriots owner Robert Kraft later told Business Insider of Karp. “… He is the only one I know that, when he’s up there talking, he commands the respect of the entire room.”
NFL lawyer Brad Karp said the settlement's dementia definition is not more difficult than what is typically used in American medicine, just more objective. (Matt Rourke/AP)
In complex cases, judges select lawyers to serve in the crucial — and often lucrative — role of lead counsel, representing the plaintiffs. At a hearing in 2012, Brody announced she wanted two lawyers leading the case for the players. The first could be selected by the top firms involved in the case. But Brody said she had someone in mind for the other: Seeger.
Several firms had hundreds of former players as clients. Seeger represented about 20. But while he lacked clients, Seeger had a wealth of experience leading negotiations in complex settlements.
Seeger’s online biography on the website of his firm, Seeger Weiss, emphasizes his blue-collar background and passion for fighting large corporations. The son of a union carpenter, he worked his way through law school and fought as an amateur boxer before entering private practice.
Seeger specializes in class actions and other cases in which he typically represents hundreds or thousands of people against the same defendants. It’s a system designed to unburden the courts, but some legal scholars have expressed concerns that a diminished role for clients in these cases can lead to inadequate settlements that deliver exorbitant legal fees.
“In a typical lawsuit, you hire the lawyer and you have oversight. You can get them on the phone, and if you’re not happy with the job they’re doing, you can fire them,” University of Georgia law professor Elizabeth Chamblee Burch said. “Class actions are kind of the other extreme. A lot of times, the clients have no idea what the lawyers are doing.”
From left, former NFL player Kevin Turner; Mary Ann Easterling, widow of former NFL player Ray Easterling; and ex-NFL player Dorsey Levens after a 2014 hearing in Philadelphia. (Matt Rourke/AP)