Page 4 - September 2020 Newsletter ClassMembers Edition

To seek a
Claims for Supplemental Monetary Awards
nder Section 6.8 of the Settlement Agreement, a Retired NFL Football
UPlayer who receives a Monetary Award based on a certain Qualifying
Diagnosis and is later diagnosed with a different Qualifying Diagnosis may
be entitled to a Supplemental Monetary Award.
If you use an online portal with us and have
previously been paid a Monetary Award, you
will see a “Create New Supplemental Claim”
button you can use to submit a claim for a
Supplemental Monetary Award. If you have
not yet been paid, you will not see this button
in your portal. You also can download and print
materials on the Forms page of the Settlement
Website or ask us to send you blank forms by
email or mail.
Remember, a new Qualifying Diagnosis must
have occurred after the Qualifying Diagnosis
for which the previous Award was paid, and
the amount payable for the new Qualifying
Diagnosis must be more than the Monetary
Award already paid, before you can make a
Supplemental Claim. If a claim qualifies, the
4 INSIGHTS Class Members Edition September 2020
Supplemental
Monetary Award,
a Player (or his
Representative
Claimant) must submit
a Supplemental Claim
Package containing:
1. A complete Explaining Work and Social Activities
Supplemental Claim
Form, signed by the here are many forms available on the Settlement Website
Player or Representative Tto support your claim for a Monetary Award. Retired NFL
Claimant; Football Players may use the Employment History and Social
2. A complete Diagnosing and Community Activity of Retired Football Player Form to
Physician Certification provide information to Qualified MAF Physicians about their
Form, signed by the work history and other social, community, recreational or other
diagnosing physician; and activities they engage in outside the home. If a Player relies on
3. Medical Records another person to provide information about his condition, that
person - an “informant” – may use a different Employment History
reflecting the Player’s new and Social and Community Activity of Retired Football Player
Form. This form is in addition to the SWS-3 Third-Party Sworn
Qualifying Diagnosis. Statement: Functional Impairment and is not to be used in place
of that document. A Player and any informant must provide the
information requested in these forms to a Qualified MAF Physician
Supplemental Monetary Award will be the during an MAF exam. Click here to read more about
difference between the Monetary Award this in an FAQ. As you are considering how to complete
already paid and the amount payable for the any form, please note that your honest answers are
new Qualifying Diagnosis. Click here to read required.
Section 6.8 of the Settlement Agreement, which
has a sample calculation (use the bookmark To safeguard the integrity of the Settlement Program,
function to go to Section 6.8, found at page 40 we carefully assess all claims before the payment of
an award. This assessment may include consultations
of the Settlement Agreement PDF). with employers, review of tax filings and other publicly
available information, and assessment of the Player’s
Supplemental Monetary Awards engagement in daily living. We have investigated some
(As of 9/28/20) claims where the facts presented to the MAF Physician
Claims Received 12 did not match up to results of the assessment. By using
the Employment History and Social and Community
Activity of Retired Football Player Form and completing
Claims Paid 9 it with accurate information, you can avoid delays in the processing
of your claim or a possible audit of your claim.
Amount Paid $882,152
September 2020 INSIGHTS Class Members Edition 5