Page 7 - December 2020 Newsletter - Lawyers Edition

Reasons in Notice of Denial

The Settlement Agreement requires documentation of functional impairment
the Claims Administrator to provide “the that is generally consistent with a Level
reasons for the adverse determination” 1.5 Diagnosis. It may

in the Notice. On December 4, 2020, then either issue an
the Special Master issued this decision, Award, provide the

concluding that the Notice of Denial is Player an opportunity

Published Decisions by the Special Master ambiguous as to whether this Player’s to remedy any
functional impairment was a reason for
deficiencies it finds, or
the adverse determination. On remand, re-issue a revised Notice of Denial of the
e post all decisions the Special Masters designate to be published on the
WSettlement Website (under “Documents” click “Special Master” below the Claims Administrator shall evaluate Player’s Claim.

“Published Decisions”). To preserve confidentiality, we remove all personal identifying whether the Player has provided
information before making them available on the website. Click here to read the

decisions published so far. We encourage you to check the Settlement Website often
and read any new decisions because they serve as guidance for the consideration Substance Use
of the same or similar issues and principles in later decisions. Three recent Special

Master rulings that affect Monetary Award Claims are now on the site: The NFL Parties appealed the without further detail on (1) the dosage
Claims Administrator’s award for and frequency of use of the substance;
Functional Impairment benefits, asserting that a Player’s and (2) whether and how the neurologist

neuropsychological test results were considered the use of marijuana in her
A Retired NFL Football Player appealed 2020 opinion, the Special Master upheld invalid. The Player regularly consumed ultimate Diagnosis. On

the Claim Administrator’s denial of his the denial, determining that the Claims marijuana, including on the morning of his remand, the Claims
claim for benefits based on a Qualifying Administrator was not clearly wrong neuropsychological evaluation. The NFL Administrator may solicit

Diagnosis of Level 1.5 in finding defects in the Parties emphasized that marijuana was from the doctor the
Neurocognitive Impairment. process by which the CDR in the Player’s system during his testing dosing information and

The Denial noted problems was performed (including regimen, and that his neuropsychologist frequency of marijuana
in the process by which a failure to conduct a semi- did not adequately consider the impact use and an analysis of why a Diagnosis

the CDR was performed, structured interview), and of his regular marijuana consumption of Level 1.5 Neurocognitive Impairment
raised concerns about the in relying on evidence and psychiatric conditions on his alleged is appropriate despite the potential
Player’s retained function, contemporaneous with the cognitive impairment. In this December impacts marijuana may have had on

and stated that the doctor relevant clinical exam that 2, 2020 decision, the Special Master neuropsychological exam and on his daily
failed to explore alternative bases for the undermined its conclusions about the found that the record was incomplete cognitive functioning.

Player’s disabilities. In this December 15, Player’s retained function.

6 INSIGHTS Lawyers Edition December 2020 December 2020 INSIGHTS Lawyers Edition 7