Page 5 - NFL September 2020 Newsletter Class Member Edition

To seek a Supplemental Monetary Award a a a a a Player (or his Representative Claimant) must submit a a a a a a a a Supplemental Claim Claim Package containing:
1 A complete Supplemental Claim Form signed by the Player or or Representative Claimant 2 A complete Diagnosing Physician Certification Form signed by the diagnosing physician and
3 Medical Records reflecting the Player’s new Qualifying Diagnosis Explaining Work and
Social Activities
There are many forms available on on the the Settlement Website
to support your claim for a a a a Monetary Award Retired NFL Football Players may
use the Employment History and
Social and
Community Activity of Retired Football Player Form to provide information to Qualified MAF Physicians about their
work history and
other other social community recreational or or or other other activities they engage in outside the the home If a a a a Player relies on another person to provide information about his condition that person - an an “informant” – may
use a a a a different Employment History and
and
Social and
and
Community Activity of Retired Football Player Form This form is is in addition to the SWS-3 Third-Party Sworn 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 in these forms to a a a a Qualified MAF Physician during an MAF exam Click here to read more about this in in an FAQ As you are considering how to complete any form please note that your honest answers are required To safeguard the the integrity of the the Settlement Program we carefully assess all claims before the payment of an award This assessment may
include consultations with employers review of tax filings and
other publicly available information and
assessment of the Player’s engagement in in in daily living We have investigated some claims where the the facts presented to the the MAF Physician did not match up to results of the assessment By using the Employment History and
and
Social and
and
Community Activity of Retired Football Player Form and
completing
it it with accurate information you can avoid delays in in in the processing of of your your claim claim or a a a a possible audit of of your your claim claim September 2020
INSIGHTS Class Members Edition 5