Fifth Circuit Rejects Former Saint's Disability Benefits Appeal - Injury & Tort Law - U.S. Fifth Circuit
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Fifth Circuit Rejects Former Saint's Disability Benefits Appeal

Gene Atkins played professional football from 1987 until 1996, spending the majority of his time playing with the New Orleans Saints and a few years with the Miami Dolphins. He was well-recognized for his aggressive, hard-hitting play as a defensive back and he sustained a number of injuries resulting from on-field collisions. Now he says those hard-hitting plays have left him disabled, and entitled to increased benefits under the Bert Bell/Pete Rozelle NFL Player Retirement Plan.

Unfortunately, the Plan disagreed, and the Fifth Circuit Court of Appeals can't do anything but sympathize with Atkins, the Times-Picayune reports.

In December 2004, Atkins submitted an application for disability benefits to the Plan administrators, claiming Football Degenerative total and permanent (T&P) disability as a result of three conditions stemming from his football career: right shoulder ailments, chronic neck pain that radiated through his arms and hands, and depression and mood issues that limited his ability to function.

A player's claim for T&P disability benefits is first reviewed by the Disability Initial Claims Committee (DICC). If the DICC members are deadlocked, the claim is denied. DICC decisions are appealable to the Retirement Board. If the members of the Retirement Board are deadlocked, they may vote to submit the matter to a Medical Advisory Physician (MAP) for a determination regarding medical issues.

In the event of a deadlock concerning eligibility or entitlement to benefits, the Retirement Board may vote to refer the dispute for final and binding arbitration.

After both the DICC and the Retirement Board deadlocked on the claim, Atkins was referred to Thomas Boll, a Ph.D. clinical neuropsychologist, for a MAP examination.

Boll concluded that Atkins suffered from illiteracy and borderline mental ability, neither of which resulted from football. He further concluded that Atkins suffered from depression, which could not be determined to be the result of football, and pain which was the result of football.

Specifically, Boll stated that "Atkins' difficulties appear to be primarily in the psychiatric arena and there is no evidence of a neurological disorder" and further concluded that Atkins' limitations are primarily the product of his "extremely limited" literacy. Boll concluded that Atkins was totally disabled and suggested psychological and psychiatric intervention to increase his ability to function adequately on a day-to-day basis.

The Board only approved Inactive T&P disability benefits, as opposed to the more generous Football Degenerative T&P benefits, and Atkins began the appeals process.

Tuesday, the Fifth Circuit refused to overturn the Inactive T&P decision, concluding, "While we are sympathetic to Atkins' plight, the Board's decision does not meet the standard for an abuse of discretion given the mixed collection of evidence that could have been construed to support an award of either Inactive or Football Degenerative benefits ... The mixed bag of medical opinions simply do not provide a clear answer as to whether Atkins' disabling injuries did or did not arise from football and therefore the Retirement Board's discretion cannot be termed an abuse of discretion."

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