A Rocky Road for Former NFL Player Seeking Full Disability Benefits
Regulated and governed by the Employee Retirement Income Security Act (ERISA), The Bert Belle/Pete Rozelle NFL Player Retirement Plan and The NFL Player Supplemental Disability Plan said it did not breach its fiduciary duties to beneficiaries and participants of the plan, in an attempt to dismiss one cause of action in a lawsuit brought by a former NFL cornerback.
Charles Dimry played for the Atlanta Falcons, Denver Broncos, Tampa Bay Buccaneers, Philadelphia Eagles, and San Diego Chargers during the years 1988-2000. In 1997 and again in 1999, Dimry suffered a major neck injury, resulting in severe radicular symptoms and long-term degenerative complications. Eventually, Dimry’s pain was so severe that he was forced to leave the NFL and work as a training director. Dimry continued to suffer from progressively worsening pain, despite undergoing two cervical fusion surgeries. After being unable to lift, stand, or sit for extended periods of time, Dimry ceased his work entirely.
In 2008, Dimry was deemed eligible for the plan’s monthly Line of Duty disability benefits, due to his neck and spinal pain. After undergoing his second cervical fusion surgery, Dimry applied for the plan’s Total and Permanent disability benefit, payable when a former player, “has become totally disabled to the extent that he is substantially prevented from or substantially unable to engage in any occupation or employment for remuneration or profit, and such condition is permanent.” Dimry submitted two applications for T&P benefits, both of which were denied by The plan. Dimry subsequently appealed both denials.
In accord with ERISA’s stipulations, the plan assigned a “neutral” physician to examine Dimry after his second appeal, in an effort to determine whether Dimry qualified for T&P benefits. The neutral physician ultimately decided that it was possible for Dimry to perform “desk or sedentary work.” However, the plan did not provide the neutral physician with a definition of a “T&P disability.” Moreover, The plan refused to consider diagnoses and medical records from Dimry’s physicians, who had knowledge of Dimry’s work and past medical history. According to Dimry’s counsel, Dimry’s physicians were “experts in their field,” while the neutral physician had no vocational training or education.
Dimry brought three causes of action: 1) recovery of employee benefits and T&P benefits, 2) equitable relief, and 3) production of previously requested documents. Under his second cause of action, Dimry alleged that the plan breached its fiduciary duties to him, both as an individual Plan participant and on behalf of all other participants and beneficiaries of The plan. According to Dimry’s complaint, the plan was obligated “to discharge its duties solely in the interests of beneficiaries and participants for the exclusive purpose of providing beneficiaries and participants with all benefits due, to defray reasonable expenses of The Plan, and to use all prudent skill and diligence in accordance with the documents and instruments governing The Plan.” According to Dimry’s counsel, the plan has been “hiding behind a network of supposed ‘neutral’ physicians, who are set up to rule against the former players and deny benefits.”