Last May, a 31-year-old former NFL player was diagnosed with early-stage dementia after reporting to a doctor that he had memory problems and difficulty helping his son with homework. That month, the same man received a master’s degree in business administration.
The doctor who made the diagnosis, Serina Hoover, frequently evaluated other NFL retirees seeking to receive payments under the league’s landmark concussion settlement. But Hoover, a California neuropsychologist, later was disqualified from making evaluations after her reports were found to contain irregularities, including that she had spent 273 hours working on cases in less than a week.
Those allegations and others were made by lawyers for the NFL in court documents last month, part of a broader assertion by the league that its historic deal to compensate former players for long-term effects of head injuries had been “hampered by the extraordinary number of fraudulent claims clogging the system.” The concussion settlement agreement does not have a collective ceiling, meaning the league is on the hook for any claim deemed legitimate, a total that the NFL estimates could exceed $1 billion.
The allegations of “widespread fraud” — which lawyers representing the players downplayed, saying the incidents were unusual examples and never paid out — got an additional airing Wednesday in federal court in Philadelphia, as attorneys for the league and the players argued over whether to appoint an independent investigator to help identify and handle potential instances of deception.
The issue, argued before U.S. District Judge Anita Brody, was not resolved during the hearing. But the debate shows how even a high-profile legal matter involving a rich and powerful sports league can resemble the most byzantine class-action court battle.
Brody, for her part, said Wednesday that it was “not surprising” that a complex settlement agreement with many potential claimants had experienced a less-than-perfect rollout. She is expected to issue a ruling on whether to grant the NFL’s request for a new investigator, or to stick with the auditing system currently governing the settlement agreement.
It was not immediately clear when Brody might rule on the issue. And although she questioned lawyers from both sides during the hearing, she did not indicate which position she might take.
The dispute is not the first obstacle in implementing the agreement, which provides compensation to former players who have a range of neurological problems. It opened for registration in January 2017. The agreement was the result of a settlement that resolved thousands of lawsuits accusing the NFL of hiding what it knew about the risks of repeated head injuries.
In September, lawyers for the players reported that many were being taken advantage of by predatory and deceptive businesses seeking a cut of beneficiaries’ cash. Other players or their families also have described the claims process as expensive or time-consuming to navigate.
In the latest development, the league described the claims process as plagued by “deep and widespread” fraud. In court documents filed in late April, lawyers for the league reported that 46 percent of the 2,000 or so total claims submitted had been placed into audit due to “red flags or other signs of potential fraud.” About 400 claims had been denied, and 230 remained under review, according to the league’s complaint, written by attorney Brad Karp.
The complaint accused some former players, law firms, and doctors of committing various fraudulent activities, and NFL attorney Richard C. Tarlowe expounded on the allegations in court Wednesday. Players were not named. Among the allegations were that:
- A Philadelphia-area law firm, Acosta & Associates, coached players on how to answer questions during medical evaluations, and instructed at least one player to show up for an evaluation hung over and on painkillers.
- Several retired players claimed in medical exams to be incapable of working or performing basic tasks due to cognitive impairments, but subsequently coached football, delivered speeches, or held other jobs, including as a wealth manager.
- A Florida-based pediatric neurologist, Ena Andrews, submitted reports with identical vital signs for 21 players, and made an Alzheimer’s diagnosis for a “staggering” percentage of patients, many represented by the Florida-based law firm Smith & Stallworth.
In an interview Wednesday, Michael Acosta of Acosta & Associates denied the allegations against his firm, saying: “Anyone saying that is completely lying” and “all of the truth is going to come out very shortly.”
Attempts to reach Andrews and representatives from Smith & Stallworth were not immediately successful.
Tarlowe said that these instances proved “undoubtedly, indisputably, evidence of fraud,” and that another class of investigator was needed to help “unclog the system” and ensure that players with valid claims get paid quickly.
Christopher Seeger, one of the lead attorneys for the players, said he did not oppose taking steps to prevent distributing funds to fraudulent claims. But the instances cited by the NFL, he said, were detected before money was paid out. And he disagreed with the league’s interpretation that the fraud was widespread, noting that many of the troubling examples appeared to have been engineered by law firms or doctors, some of whom can no longer participate in the process.
“The audit protocols have worked,” Seeger said in court. He pointed out that nearly $440 million had been awarded for 432 claims deemed legitimate in the agreement’s first 17 months.
Another players’ attorney, Gene Locks, said he believed problematic instances were certain to decrease as the program moved forward, and that an independent investigator was unnecessary.
“You don’t need another cop hired by the NFL,” Locks told the court.