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Keys v. Bert Bell/Pete Rozelle NFL Player Retirement Plan

United States District Court, M.D. Florida, Tampa Division

November 12, 2019

TYRONE KEYS, Plaintiff,
v.
BERT BELL/PETE ROZELLE NFL PLAYER RETIREMENT PLAN and NFL PLAYER DISABILITY AND NEUROCOGNITIVE BENEFIT PLAN, Defendants.

          ORDER

          Charlene Edwards Honeywell United States District Judge.

         This cause comes before the Court upon Defendants' Motion to Dismiss Count Three of Plaintiff's First Amended Complaint (Doc. 38) (the “Motion”) and Plaintiff's response in opposition (Doc. 41). In the Motion, Defendants argue that Count III of Plaintiff's First Amended Complaint should be dismissed because a plaintiff cannot assert a claim for equitable estoppel based upon silence under the Employee Retirement Income Security Act, 29 U.S.C. § 1132 (“ERISA”). Plaintiff disagrees, arguing that the Court should allow his claim to proceed because the doctrine of equitable estoppel based upon silence furthers ERISA's scheme and goals. The Court, having considered the parties' submissions and being fully advised in the premises, will grant the Motion.

         I. STATEMENT OF FACTS[1]

         Plaintiff Tyrone Keys (“Keys”) played in the National Football League (“NFL”) for seven seasons as a defensive lineman. Doc. 35 at ¶ 5. He played from 1983 until he had to retire in 1989 due to football injuries to his back, knees, and shoulder. Id. Shortly after his NFL career ended, Keys submitted a disability claim to Defendant, the Bert Bell/Pete Rozelle NFL Player Retirement Plan (the “Plan”), a multi-employer pension and welfare benefit plan. Id. at ¶¶ 2, 6. Keys submitted the claim to the Plan administrators due to his significant football-induced impairments. Id. at ¶ 6.

         At the time Keys submitted his initial disability claim, there were three relevant classifications of disability benefits: (1) Line of Duty Benefits, awarded to players who have a “substantial disablement” due to playing NFL football but who are considered not totally disabled; (2) Football Degenerative Total and Permanent (“T&P”) benefits awarded to players who are considered to be substantially prevented from engaging in any occupation, i.e. totally disabled, due to impairments caused by playing NFL football; and (3) Inactive T&P benefits, awarded to former NFL players who are found to be totally and permanently disabled but whose disability is considered to be unrelated to their NFL football careers. Id.

         The administrators for the Plan (collectively, the “Plan Administrators”) include (1) the Disability Initial Claims Committee (the “DICC”), an entity consisting of two people, one appointed by the NFL Players Association and one appointed by NFL management, and (2) the Retirement Board (the “Board”), an entity consisting of six people, three appointed by the NFL Players Association and three appointed by NFL management. Id. at ¶ 7. The DICC is the initial decision maker and the Board members are the Plan fiduciaries who conduct the fiduciary review of a claim that has been denied. Id.[2]

         In 1991, Keys submitted a claim for Line of Duty benefits. Id. at ¶ 9. Once Keys submitted his claim for Line of Duty benefits, the Plan Administrators sent him to one of its top orthopedic physicians, Hugh Unger, M.D., for an evaluation. Id. Dr. Unger performed his first evaluation of Keys on December 9, 1991, approximately two years after Keys' last season. Id. Dr. Unger noted that Keys suffered a herniated lumbar disc and tore the meniscus of his right knee in 1989, his last season. Id. Dr. Unger also noted that Keys sustained a cracked glenoid rim of his right shoulder while playing. Id. By 1991, Keys had been through knee, back, and shoulder surgeries for NFL-related injuries. Id.

         After examining Keys in December 1991, Dr. Unger reported the following NFL- related impairments to the Plan Administrators, predicting that the impairments would degenerate further with time:

Impression: Chondromalacia of the patella, bilateral Degenerative arthritis of the right shoulder and Glenolabrial disease Osteoarthritis of the medial and lateral patellar facets and of the medial femoral condyle
Status post foraminotomy and discectomy, L4 5

Id. at ¶ 10. Dr. Unger also evaluated the degree of Keys' NFL-related impairments. Id. at ¶ 11. He reported that Keys had a 50 to 59 percent loss of use of his back as a result of playing in the NFL, a 30 to 49 percent loss of use of his shoulder as a result of playing in the NFL, and a 60 to 79 percent loss of use of both knees as a result of playing in the NFL. Id. In the additional remarks section of the report to the Board in 1991, Dr. Unger wrote as follows:

This patient has multiple extremity involvements, with arthritis of the right shoulder, chondromalacia of both knees, and tear of the medial meniscus. It is anticipated that further degeneration in the right shoulder may develop in time and he may develop early arthritic changes in his knees.

Id.

         The Board awarded Keys Line of Duty benefits based upon Dr. Unger's findings and opinions. Id. at ¶ 12. Dr. Unger examined Keys annually at the Plan Administrators' request up until 1999. Id. At each examination, Dr. Unger found the same degree of NFL-related impairments. Id.

         Keys was paid Line of Duty benefits for the maximum period available of five years. Id. at ¶ 13. Prior to those benefits expiring on December 1, 1997, Keys requested that his benefits be reclassified as Football Degenerative T&P benefits. Id. at ¶ 14. That request was denied in 1997. Id.

         On May 7, 2002, Keys was involved in a minor automobile accident. Id. at ¶ 15. His car was hit from behind while stopped at a red light. Id. The accident aggravated his pre-existing professional football injuries but had no effect on the permanent injuries he sustained playing NFL football. Id.

         In September 2003, Keys re-applied for Football Degenerative T&P benefits. Id. at ¶ 16. In his application, he listed his impairing conditions caused by playing NFL football. Id. He relied upon the opinions of his treating physicians, an independent medical examination, and his medical history in attributing the following impairments to his NFL football career:

Condition 1 I have unfortunately cervical spondylosis with upper extremity radicular symptoms referred to as radiculopathy. I am unable to sit for much more than 10 minutes without having to stand. I am unable to stand for more than 5 minutes without having to sit.
Condition 2 I unfortunately have significant spondylosis lumbar spondylosis with facet arthropathy at multiple levels & lower extremity radiculopathy. I am unable to complete a work day because of having to constant alternate between sitting & standing every few minutes to relive (sic) the pain. I herniated my lumbar in the last NFL game.
Condition 3 I unfortunately have degenerative joint disease chondromalacia & osteochondrel defect of the humeral and osteochondrel defect of the humeral & osteochondral defect of the glenoid rim and degenerative tears of the glenoid. I am scheduled to begin pain management consultation next week. I landed on my shoulder & was never told that it was cracked by team doctors.
Condition 4 I have chondromalacia patella in both knees. I am unable to sit for more than 10 minutes without having to stand up to relieve the pain. I also cannot stand for more than 10 minutes because of the pain. I am to begin pain management consultation to include facet injection & ...

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