Andrew Stewart: Benefits Denied

Sep 6, 2010

Andrew Stewart recently went through an application process for his NFL Total & Permanent Disability Benefits. After playing in the NFL, he went on to play for several more years in the CFL (Canadian Football League). Andrew currently lives in Vancouver BC Canada.
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From Andrew:

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Hi Dave,

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Here are copies of the documents from start to finish.

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They like to say that I am in CANADA as if I am on a foreign planet but I live here as I have been married to a Canadian girl for I2 years and I have full health care here. In their decision, they also allude to the fact I would not provide my x-rays but those x-rays are the ones taken by their neutral physician and they have always had access to them through him. Just prior to the board meeting, I received a surprise call from Paul Scott asking me to drive an hour (each way) to the hospital and get the x-rays for him and he would reimburse me the cost. He said he’d called the hospital and they would not give them to him. Keep in mind Dr. Bach had already written his letter saying I was not disabled at all without even reviewing my films. Every letter Dr. Bach has written has been written without him ever seeing me. The mystery physician that they used to bolster Dr. Bach’s views also never saw me. How do you use two Doctors who have never examined me to overrule their own neutral physician who has? In one of their letters, it states Dr. Bach’s decision is not binding on the board? Really?!! When I spoke to a Woman at the NFL office she told me they were not happy with Dr. Meek’s Neutral physician findings and that Dr. Bach had chosen him and was in discussion with him about changing his opinion. They fired off a letter saying she did not speak for them but I was grateful for his honesty.

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Their final letter with me being turned down is like a ridiculous resume of their unethical doctors. I don’t know the resume of the neutral physician they sent me to but I do know he has ethics, he is honest and by the tone of his letter he is disgusted and offended what is taking place. The board says they do not like the tone of his letter but they have lost sight of what the plan is there to provide and just plain human decency. They have changed the rules so much to deny players they don’t even know what is fair anymore.

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Why even bother to send me to a neutral physician? Just deny me as they have done by two doctors that never seen me! I’m sure if the neutral physician’s report was favourable to them, he would have been an excellent doctor but now he has been painted as an unqualified doctor who is not familiar with how to do an NFL disability exam! Their own doctor says I am disabled and then they ignore him and use two other doctors who have never even seen me! I still can’t wrap my head around that. My injuries were on an NFL field and my surgeries were performed by NFL doctors!

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They had no reason to turn me down other than they just wanted to.

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The NFL claims it is a family who takes care of their players but the veterans are denied and overlooked every day. We are long forgotten after our last game. I feel that I’m the one following their rules and they’re changing their own rules to suit themselves. On the field, there is a definite goal line – at least you can get there and the rules stand. With the NFL and the NFLPA, the goal line is constantly being moved back and the rules changed while the game is in play. I don’t want to play this game with them – I just want to be treated fairly, with respect and then acknowledged I was hurt while killing myself on the field for them. I followed their rules and did my job and now I want them to do theirs.

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For the all the other players fighting – Remember: great people always encounter violent opposition from mediocre minds.

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Thanks, Dave, for your perseverance. Thank you for not being neutral and for standing up!

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“Take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented.”

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- Elie Weisel – 1928

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Sincerely,

Andrew Stewart

Vested Retired NFL Player

Cleveland Browns, Cincinnati Bengals, San Francisco 49′ers

(drafted in 1989, 1990 in Cleveland, 1991 in Cincinnati, 1993 with the 49ers)

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We’ve posted Andrew’s paperwork on Scribd for easier reading. Click on the FULL SCREEN button to enlarge it for easier navigation – hit the ESC key to close. You can also click the DOWNLOAD button to save a PDF copy for printing and reading:
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Here’s Dr. Meek’s initial letter and support documents:
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Andrew Stewart Disability Dr Meek First Letter
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Then the response from Paul Scott for The Bert Bell/Pete Rozelle Administrators:
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Andrew Stewart Disability Documents Bert Bell Response
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A second letter from Andrew’s reviewing doctor, Dr. Meek in Vancouver BC:
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3 Andrew Stewart Disability Dr Meek Second Letter
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And then the denial letter from Sarah Gaunt, Plan Administrator:
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4 Andrew Stewart Disability Sarah Gaunt Letter
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Comments from disability attorney John Hogan:

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Add Andrew to the list of those screwed by the Plan!

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He now lives in Canada, after ending his football career in the CFL. It is my understanding that originally, the Plan wouldn’t even let him file or told him he wasn’t eligible but he is a vested NFL retired player. Because he lives in Canada, the Plan arranged for him to be examined by a Canadian Ortho Surgeon and I have to say, it was one of the most complete exam reports I have ever read. This doctor clearly distinguished Andrew’s NFL injuries from his CFL injuries and explained why he was disabled just from the NFL injuries! OMG! The Plan can’t have that! A doctor who knows what he is doing and not on the payroll and speaks the truth! So, they sent his FILE – not him – to Dr. Bach who has been turning guys down on behalf of the Plan for decades. I don’t know that I have seen all of the documentation but from what I saw, Dr. B said that Andrew wasn’t disabled – BUT MADE NO ATTEMPT TO EXPLAIN WHY!

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I think it would be a great idea to post the two reports – any objective, clear-thinking person should be able to see that he has been screwed!!!

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ADDITIONAL COMMENTS FROM JOHN POSTED MONDAY MORNING:

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These are some additional comments now that I have read the denial letter from Sarah Gaunt.

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You will notice that the denial letter states that they also consulted Plan medical director Stephen Haas MD on the issue, and he said it’s “not even close.” What does that mean? What criteria is he using? More importantly, the Plan itself provides that the Medical Director is NOT supposed to opine on particular cases – but they’re doing it anyway. Do you remember that the hiring of a Medical Director was supposed to be an IMPROVEMENT to the disability system?

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I have long argued/complained/shouted that in the proper world of disability adjudication, it is improper for a medical doctor to state whether a person is employable or whether there is any particular type of work that someone might perform. Their job is to set forth various limitations which someone with vocational expertise then uses to determine whether any such jobs exist. However, Dr. Meek is the first doctor I have seen who actually knew what he was talking about – and his opinion is consistent with Social Security disability policy: That if an individual is limited to “a sitting position” (sedentary work) where he cannot use his dominant upper extremity to do things like take tickets and make change, HE IS DISABLED!

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Furthermore, now – more than ever – we need a Department of Labor audit of this
system run-amok. Who was it who was unsatisfied with Dr. Meek’s fully favorable opinion? Paul Scott? Sarah Gaunt? Dr. Haas? Doug Ell? The Plan is charged by law to act in good faith and while they have “discretion” they cannot act in an arbitrary manner. Who decided there was something wrong with Dr. Meek’s report? (Other than it was favorable!) What was it that was wrong? What deficiency did they find which would cause them to even contact Dr. Bach?

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As Andrew stated in his e-mail, they go out of their way to bolster the opinion of Dr. Bach and his long association with the Plan. I would like to know how many guys he has examined and how many he felt were “totally disabled”? What is the criteria he uses? I do know of one former “neutral” physician who issued favorable opinions in several different cases and it is my understanding that he was “dropped” from the panel. THE DEPARTMENT OF LABOR NEEDS TO INVESTIGATE NOW!

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John Hogan
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6 Responses so far | Have Your Say!

  1. Greg Davis
    September 7th, 2010 at 7:21 am #

    Greg Davis
    Hey Andrew,

    I share your frustration and would also like to say that the game is fixed when the parameters of that game are set by the ones with the checkbook. The only way to beat the opposition fairly is to control both sides.

    Has anyone noticed how they only use X-rays in their diagnosis and will not order MRI’s? They know that the soft tissue pics will tell the tale. The human body consists of more than a skeleton and you can bet your sweet Aunt Suzy’s a** that if you were a starter and there was a question of injury, you would endure the most rigorous battery of diagnostics known to man. My physical for the Blesto combine in ’87 consisted of over 50 doctors and 7 hours! My entrance physicals before camp were 2 hours on average and consisted of everything from eye tests to Psych evals. My exit physical was, “How ya doin’? What ya got planned for the off season?” Rotator cuff tears, tendon, cartilage, muscle tears and damage to your CNS don’t show up in an X- Ray.

    Best of luck to you moving forward, I have also been denied benefits. I guess we were supposed to just go away quietly and be stoic troopers taking another one for the League…

    Greg Davis
    Atlanta Falcons, New England Patriots, Arizona Cardinals
    Minnesota Vikings, San Diego Chargers, Oakland Raiders
    1987 – 1998

  2. Dave Pear
    September 7th, 2010 at 10:45 am #

    Dave at Home
    To all retired NFL players who have been turned down for disability benefits from the NFL:

    SEND US YOUR STORIES. (Please – there’s no need to remain silent any longer.)

    We want the fans and the general public public to know that this is a consistent pattern of fraudulent behavior and they are doing it to each and every one of us. We’re not the ones who should be slinking off in shame! You are NOT alone.

    This disability debacle that was designed and created by the Groom Law Group (Doug Ell is their leader) is illegal and continues to violate ERISA Law.

    These greedy “traveling merchants” better known as the NFL are motivated by their love of money and their ONLY concern is profit.

    How low will these scummy and corrupt merchants go as they continue to scam their injured retired employees and their families from access to their earned disability benefits?

    Scam and scum are separated by a single vowel.

    The NFLPA Leadership should be the first to step up to the plate to defend Andrew Stewart and his family.

    Where are they?

    Remember the Players Inc scandal? The NFLPA Leadership was convicted in Federal Court of, “Breach of Fiduciary Duty” and “Breach of Contract” and ordered to pay $28,100,000 in damages to over 2,000 retired players they swindled even though they had signed contracts called “Group Licensing Agreements” (GLA).

    NOTE: After 2 years retired players are still waiting for their final payment from this crime.

    Jurors in that trial found the NFLPA Leadership to be guilty of “malicious and oppressive conduct with evil motive,” and “conduct that was outrageous and grossly fraudulent.” (THEIR words, not ours.)

    Certainly the NFLPA Leadership is just as guilty of “Breaching their Fiduciary Duty” on disability benefits for this same conduct. The silence is deafening. Saying nothing and doing nothing makes you equally culpable.

    Nothing has changed. Nobody represents retired players. And I mean NOBODY!

    When will this fraud cease and when will disabled retired players receive access to their full disability benefits along with restitution and punitive damages?

    Regards,
    Dave & Heidi Pear

    PS – Thank you, Andrew Stewart, and Disability attorney for (35 plus years) John Hogan for having the courage to step forward and confront these greedy and evil cowards.

  3. Andrew Stewart
    September 7th, 2010 at 3:21 pm #

    Andrew Stewart

    Thanks for posting my story!

    I have to tell you that I also received a surprise phone call yesterday afternoon from Virginia – on Labor Day! It was from the NFL’s Harold Henderson trying to offer me some advice. He actually suggested that there were other options open to me for assistance such as the various Dire Need Funds. I politely declined as I believe that I have earned the disability benefits that are now owed to me for my vested years of service to the NFL. Period.

    There would be no need for any Dire Need Funds if the owners would just get out of the way and allow us to get what we all rightfully earned.

    Andrew Stewart

  4. Bucky Dilts
    September 7th, 2010 at 9:53 pm #

    Bucky Dilts
    Dave,

    Is there a way to get this on 60 Minutes or some other investigative report that would shed light on this; not only Andrew’s denial of benefits but how all ex-players are being treated and the League’s attitude as a whole.

    Thanks
    Bucky Dilts
    Denver Broncos, Baltimore Colts
    1977 – 1979

  5. Dave Pear
    September 8th, 2010 at 9:16 am #

    Dave & Heidi.jpg
    Dear Harold Henderson,

    You are an NFL VP. And currently sit –at the designation of Commissioner Goodell – as the non-voting chair of the Retirement (Disability) Board.

    If I am wrong, please correct me.

    Your phone call to Andrew Stewart on “Labor Day” September 6, 2010 is a desperate move.

    Andrew and his family were denied their disability benefits for no valid reason.

    Andrew was ambushed by NFL Dr. Bach who is now the new Dr. “NO.”

    How low will you “traveling merchants” go to increase your bottom line?

    Regards,
    Dave & Heidi Pear

  6. Eric Smedley
    September 8th, 2010 at 12:55 pm #

    Eric Smedley
    Hey Andrew -

    Just wondering if you applied for the Line-of-Duty Benefits? If so, what was their ruling on that?

    Regards
    Eric Smedley
    Buffalo Bills, Indianapolis Colts
    1996 – 1999
    Buffalo Bills

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