(Editor's note: In this three-part series, VICE Sports examines the difficulties former NFL players face in obtaining medical care and adequate benefits after retirement. Click here for Part 1: "Why Must I Fight You Now?".)
There are many versions of George Visger, all manifestations of the man raised in a garage with his two older brothers in Stockton, California, the son of a beer truck driver, the boy with little athleticism and spaghetti-thin arms who swore to his grade-school teacher that he'd be an NFL lineman one day. Somehow, he was right. This Visger impressed teachers and coaches alike, and got recruited by Notre Dame but chose Colorado because of their biology program. He's the one who swore he could beat his older brothers at anything, and it was true more often than not.
There was also the George Visger off the football field, the nicest kid around who enjoyed nature's solitude and discovered a penchant for schoolwork. Then there was the George Visger on the football field, your token mean son of a bitch who would make you forget every other mean son of a bitch you ever went up against, the one who knocked you down and helped you up just to make sure he had something to knock down again. He's the one who fell hard for every football cliche in the book.
Then there are the George Visgers that could have been. The George Visger who goes on to be a renowned biologist and successful environmental consultant. The one who has a wife and three kids. The one who wins multiple Super Bowls with the 49ers under Bill Walsh and keeps the rings in a case underneath his bed; easy to find but also forget. This George Visger might even be in the Hall of Fame because he was the kind of player his high school and college coaches swore was the best they ever saw. Maybe there's CEO George Visger, too. There's probably even a semi-retired George Visger somewhere in there, spending his days hunting and fishing with his best friend and big brother Bob.
But these George Visgers aren't real because the only version of George Visger that matters now suffered a brain injury in 1981 as a member of the San Francisco 49ers. As quickly as the fluid rushed into his skull and he was prepped for emergency surgery, the other George Visgers ceased to exist.
For the last three years, Visger has slept either in his truck or in an attic above the hyperbaric clinic where he receives treatment, surrounded by bare walls and the notebooks he uses to remember his life because his brain won't allow him to do so. The real George Visger doesn't live in NFL history books or in a serene, picturesque wilderness. He lives in those notebooks where he writes down every detail: where he goes, what he's done, who he's seen. Otherwise he has no clue.
Visger lives off social security disability because he's no longer fit to work. For the last two years, he's been fighting Travelers, the 49ers' workers' compensation insurer, for treatment to which he is entitled as a result of injuries he suffered as a player. While he was litigating with Travelers, his wife filed for divorce.
The real Visger has much in common with other former NFL players, who rely on the workers' compensation system to cover the medical care associated with disabling injuries from football because of the gaps in the NFL's benefits system.
But, in practice, the workers' compensation system is only available to a tiny fraction of the players who need it. Even if they get a favorable award, former players are usually in for a lifetime of fighting for their earned benefits.
And just like there are different versions of Visger, there are also countless versions of other retired players who are simply fighting to get some semblance of their former lives back.
Because if you were to meet Visger, talk to him, see how he still tries to piece his life together, you can't help but think about whether, maybe, just maybe, the other Visgers are still in there, somewhere.
During the 1980 season, Visger played three games as a substitute defensive lineman for the 49ers. On October 6 against the Dallas Cowboys, Visger took a helmet crown to the ear. In order to keep playing, Visger went through 20 smelling salts throughout the course of the game. During another game later that season, his nose got so bloody the trainers had to cut tampons in half and shove them up his nasal passages. The Niners finished 6-10 and missed the playoffs. He would never suit up in a game again.
In May 1981, Visger tore his ACL during minicamp, which required surgery, ending his season before it even began.
Later that summer, Visger was hanging out with his brother Bob who noticed Visger's eyes bulging out of his head like a bad cartoon animation. Visger told Bob he had been feeling weird lately: pounding headaches, seeing lights at all times of day and night. The team trainers told him it was high blood pressure, but Bob doubted that was true.
Not long after that, in September, Visger spent an entire night projectile vomiting while coming in and out of convulsions. The next morning, he went to see the team trainers. Visger says one of the trainers told him to drive to Stanford Hospital. When he got to the hospital, the doctor told him his brain was hemorrhaging and he needed to go into emergency surgery. Visger told the doctor he had to move his truck first. The doctor looked at him, wide-eyed: you drove here?! You could die at any minute.
Officially, Visger was on the injured list during the 1981 season because of the knee injury. Visger appeared in that year's team photo, wearing No. 74, but there is no mention of him across any newspaper or wire service at the time of his brain hemorrhaging or at the time of the surgery to treat his hydrocephalus, a condition where his skull floods with fluid. As far as anyone was concerned, Visger only had a torn ACL.
During the fall, Visger had a shunt placed in his brain, which drains fluid from his skull to his stomach. He'd need that shunt for the rest of his life. "Four months after the  Super Bowl, my shunt failed when I was in Mexico. My brother brought me home in a coma. I had two more brain surgeries, one day apart. I was given last rites. I have no memory for the next year-plus. My first memories were, I was getting these hospital bills for my last two brain surgeries." After the player strike ended in 1982, Visger and 148 other NFL players became free agents. No team signed him.
Visger was not eligible for any NFL benefits even though his injuries were obviously football related. At that time, a player needed to have played at least three games in five different seasons in order to be eligible for the NFL disability plan or pension. Visger had only played three NFL games.
The NFL Players Association (NFLPA), which represents active NFL players, told Visger there was nothing they could do for him. They simply recommended him a lawyer so he could sue the Niners for dismissing his symptoms as high blood pressure and failing to properly treat him. The lawyer did not end up taking the case.
But, the NFL and NFLPA might argue that their benefits package was never meant for cases like Visger's. Instead, they'd say his is a classic workers' compensation case: an employee injured on the job who is no longer able to work. So, let the workers' compensation system, which is available to employees in any line of work, take care of him.
But this reveals a clear conflict of interest for the NFLPA. Only active players have a vote in union matters, so the NFLPA functionally operates as an active player's union, with former players represented in name only.
The NFL's collective bargaining agreement stipulates that virtually every NFL player benefit, including workers' compensation premiums for players, come out of the portion of NFL revenue allocated to active players. A 2007 Congressional report on disability and workers' compensation options for former NFL players explains that every dollar teams spend on workers' compensation insurance—and almost every other player benefit, including medical care, pensions, life insurance, meal allowances, moving and travel expenses, medical costs, tuition assistance, and health reimbursement accounts—is a dollar taken away current NFL players. That is, the NFL determines the players' share of the pie, subtracts all benefits, then sets the salary cap. The more benefits paid out, the lower the cap. The NFLPA has no incentive to help players like Visger. Their concern is to keep the current crop of active players happy and well paid.
From April 2006 through March 2007, players paid $34.1 million to fund workers' compensation coverage, according to the report the NFLPA submitted to Congress. Even allowing for 15 percent league-wide player turnover during the season, that's $17,050 per active player per season out of their pocket to cover workers' compensation insurance. The players pay good money for this benefit precisely so people like Visger can use it.
Given his limited options, Visger did what any other employee for any other company in America would have done: he filed a workers' compensation claim against the San Francisco 49ers. As Visger recalls, the 49ers' insurance carrier, Travelers, wanted to settle for a "compromise and release," so called because it releases Travelers of any further fiduciary obligation, such as continued health care for the injury. Visger and his brother Bob said Travelers offered him a $35,000 lump sum in exchange for never having to pay a dollar of medical bills. Visger rejected the offer and ultimately won the claim. Travelers did not respond to numerous requests for comment.
Eventually, Travelers was forced to pay for all medical care related to his brain injury as well as fund vocational training for a new occupation. At 23 years old, with a shunt in his head and a bum knee, Visger started over.
The next 35 years of Visger's life would feature lots of starting over, on things big and small. Visger's memory—especially short term—has never been the same as it was before the brain trauma. For Visger, it's a bit like losing your keys five times a day for 35 years.
To cope, he's been filling out little yellow graph paper notebooks, similar to the ones used for college test-taking, with his daily activities since the early 1990s. These notebooks, which he keeps stored in numerous places, create a bizarre relationship with time and memory. Anything that Visger doesn't write in the notebook may quickly flitter out of existence, even within a few minutes. But, due to his meticulous cataloguing, Visger can tell you what he was doing on, say, December 21, 1997 at 10:41 a.m.
Despite his memory issues, Visger was determined to make a new life for himself. He enrolled in Sacramento State's biology program to earn his Bachelor's in Biological Conservation while working for Bob's construction and restoration company. He lived in run down apartments, the only ones he could afford. Sometimes, Visger would forget weeks of lessons at once and have to go back and re-learning everything. It took him nine years, but he got his degree and became a wildlife biologist.
To this day, Bob still can't believe Visger earned his degree, partly because he saw how the little quirks of Visger's existence would lead him down strange paths. One time, he showed up to work just as everyone else was leaving. Another time, Visger couldn't remember where he parked his truck at Sac. State. He walked around the sprawling campus for eight hours. One time while on the job, he disappeared after taking a wheelbarrow out of a garage. Hours later, Bob got a call from the police saying Visger was driving the wrong way on a one-way street. Or there was the time when Visger once framed a wall upside down, tore it down, then built it upside down again.
George Visger lived multiple lives: in the notebooks, in his faulty memory, in repeating the same tasks over and over. But now, the different versions of Visger were all just manifestations of his failing brain.
After getting his degree, Visger worked for a few environmental consulting firms. For a time, he led a good life as a wildlife biologist. In 1995, he was part of a team that was asked to evaluate the presence of desert tortoises on a large parcel of land in Southern California that was being proposed as the site for a corrections facility. His notebooks blended in with everyone else's field journals.
On the first day, Debra Percy, who was overseeing the project, gave the group instructions and then asked if anyone had any questions or comments. Visger chimed in, and told the group what to do if they found him passed out. All they had to do, he said, was jam a four-inch syringe into his shunt and drain as much fluid from it as they could. Percy, who has remained friends with Visger ever since, says he was a "very good wildlife biologist."
Visger got married, cared for his three kids, and bought the "dream home," the nickname the kids gave to the modest house in Grass Valley, California that had a big yard and small workshop for Visger. The family wanted to stay there forever. Visger had a deep connection to the small community.
In the late 2000s, Visger decided to open up his own consulting firm, which worried Bob. With his memory problems, how could Visger run a business? Still, Bob helped his brother with his taxes and with keeping up with invoices. But it was still too much for Visger. He'd bill some clients twice, others not at all. He was a great biologist, but, because of his memory, not a good businessman.
Percy and another former colleague, Kim Erickson, agreed to help Visger straighten out his books. They met with Visger once a week for around nine months, recovering some $60,000 in unpaid invoices. Still, it wasn't enough to save the dream home, to save his business, to save his family. Everything Visger painstakingly accomplished since the injury faded away, as if a subject of his faulty memory, relegated to the pages of his notebooks.
By 2011, Visger's life turned to ruins. The unpaid bills and back taxes piled up. Visger lost his business and the bank took the dream home. His memory got worse. He couldn't remember how to get to a restaurant where he'd been meeting Bob for years. He would show up at jobs that had been completed four years prior. His wife and kids moved in with her mother in Sacramento, over an hour away, forging a divide that would never be repaired. One time, his wife burst into tears in a doctor's office because she and the kids were terrified of Visger. He had a temper, mood swings. You never knew which of the many George Visgers you were going to get.
To deal with the mood issues, doctors put Visger on a host of prescription medications: antipsychotics and antidepressants to go with the various other pills for his seizures and brain injury. In some ways, the medication made him even less predictable. It certainly didn't make him better.
Not long after, Visger saw a neurologist. The doctor told him he had dementia and early onset Alzheimer's and should get his affairs in order. Visger immediately called Bob. Visger couldn't believe he was left with nothing: no home, no business, nothing to leave his kids, nothing at all. Just him and his notebooks. "He got emotional," Bob recalls. "and I have never, ever, in my life seen him like that."
The doctors don't know what they're talking about, Bob told his brother—the only way he knew how to console a man who has nothing and is about to lose even more. Bob refuses to believe his brother has Alzheimer's until he stops recognizing familiar faces. Bob wants Visger to try being himself again. "They don't know who the hell you are," Bob told him. "You need to go back to being George Visger."
In 2012, not long after receiving his Alzheimer's diagnosis, Visger met Chris Asvar, a workers' compensations lawyer based in Los Angeles, at a conference. Asvar told him that there might be something he could do to get his life back on track. Visger liked the idea of fighting for his life back, but Travelers had never offered him anything except buyouts and settlements.
By law, Travelers was responsible for all care as long as it related to the original brain injury. Visger wanted to get better, but he had also been fighting for 35 years just to function. It had been 35 years of lost keys, wrong turns, and a whole slew of notebooks to document it all. More than anything else, Visger was just tired of all the bullshit.
He told Asvar that he didn't want to spend another minute fighting Travelers. Asvar replied that he would handle everything. And so Asvar got to work.
In early 2013, Travelers hired a company called Paradigm to assess Visger's case. Travelers' adjustor had not only requested Paradigm, but they had also asked for a specific case person: Registered nurse Douglas Ardley, who would meet Asvar and Visger, assess his medical files, and recommend treatment.
On April 10, 2013, the three of them met at Zachary's Pizzeria in Berkeley, where Visger told him about his memory issues, mood swings, unemployment, and homelessness. Asvar recalls that Ardley, the case assessor, said he was going to recommend Visger spend 30 to 60 days at an in-patient brain injury treatment program, a drastic move that had potential to partially rehabilitate Visger's mind.
Visger hadn't even known there was such a thing as an in-patient brain injury treatment program. In the past, he likely would have scoffed at such treatment; he was a self-made man. But he was desperate. Visger agreed, saying he'd do whatever it took to get better.
But several weeks passed and Asvar never received any report from Paradigm. Considering Paradigm's entire business is to generate these reports, Asvar wondered what was taking so long. In early June, he finally called Ardley. "Where's the report?" He asked.
Ardley apologized and said he was told to hold the report. This came as a tremendous shock. How could they do that? Asvar wondered.
As per company policy, Paradigm's staff had indeed created the report, which was obtained by VICE Sports. On May 29, 2013, Ardley had called Travelers to relay the following recommendation that would be listed in the report:
"Paradigm recommends a multidisciplinary evaluation including physical medicine and rehabilitation, neuropsychology and occupational speech and physical therapies as well as a social worker. Anticipation of an in-patient stay at a post-acute multidisciplinary facility such as the Center for Neuroskills in Bakersfield, CA for approximately 2 months followed by placement in a residential community-based assisted living center would then be optimal. The purpose of the assisted living center would be to carry over compensatory strategies learned in this post-acute setting in order to ensure that those strategies are learned and become habitual. Assisted living placement should be expected for 6 months." [emphasis added]
In order to find out the details of what happened, Asvar had to subpoena the report and Ardley's case notes. In the resulting deposition, Asvar found out that on the same afternoon Ardley had called with his recommendation, he later received a call from Angeli Roy, a Travelers employee who works on what's called a major case unit. Roy told Ardley to bury the report, according to the deposition. That's why nobody would give it to Asvar.
Ardley stated in his deposition that in 20 years of case managing hundreds of patients, he could not remember another instance of an insurance company asking him to withhold a report he was hired to generate.
In some ways, Visger's case is unique. His specific type of brain injury isn't common among NFL players, and it occurred very early in his career. Also, his injury was somewhat sudden and severe. Most NFL players leave the game with a plethora of lingering, chronic injuries, with neurological symptoms gradually worsening over time. But, his frustrations with the California workers' compensation system and its inadequacies in helping former NFL players, who rely on it due to the NFL's spotty post-career benefits, are quite typical.
Until recently, California was a popular state for athletes to file workers' compensation claims for two reasons: first, California was one of few states that allowed athletes to file for cumulative trauma—wear and tear over an athlete's careers.
Second, almost every other state requires that an employee file within one year of the injury. California's law allows the statute of limitations to be suspended until the worker is notified or learns of his right to file. This is an exception athletes often utilize; imagine having to inform a player of his right to file a workers' compensation claim after every single injury. Although this is a loophole professional athletes have exploited, it is also a counterbalance to the system's shortcomings when it comes to professional athlete wear and tear.
However, while Visger tirelessly rebuilt his life following the injury, the workers' compensation landscape in California changed dramatically. What used to be one of the most worker-friendly states is now a haven for big business and special interests. A new law, AB 1309, which passed in October 2013, blocks the vast majority of professional athletes from filing in California for cumulative trauma.
Furthermore, the NFL has a provision in every contract stating that players can only file workers' compensation claims in the state in which their team is based. Until recently, the NFL has never enforced the contract provision in court. But in 2011, they did and won, further restricting players' options. The following year, 12 former players sued the NFL and their former teams claiming their right to file in California. Several other lawsuits ensued, including a 2013 lawsuit involving seven different former NFL players, who had their claims denied due to a combination of AB 1309 and the clause in their contracts permitting them to file only in their team's home state. The peculiarities of AB 1309 are still being sorted out in the courts—there may be various exceptions for players based on residency or where they agreed to their contracts—but much is still uncertain.
For the time being, a lot of players are left without recourse, according to NFL Hall of Famer Ron Mix, a lawyer who has worked on athlete workers' compensation cases in California for over ten years. "An awful lot of these guys, they don't have a lot of the really bad cognitive problems, really bad arthritis, the need for hip replacements, etc., until five, six, seven, eight years or more after they've left the NFL. And the state workers' comp won't cover that. Workers' comp laws in the 50 states don't properly contemplate the kind of injuries and disabilities that NFL players typically experience."
Combine this with only five years of health care after retirement—for players who have played three games in three different seasons—and flawed programs like the NFL's only benefits package, and players are often left with few options.
The problems don't end there. If a player actually files a workers' compensation claim in the right state within the appropriate window and wins, as Visger did, they still have to battle insurance companies for their benefits. An extensive investigation by ProPublica and NPR revealed that since 2003, 33 states have altered their workers' compensation system to reduce or deny benefits to injured workers. They also found that insurers and employers increasingly control medical decisions, California included, to the benefit of insurers, who had their most profitable year in 2013 with an 18 percent rate of return.
Due to California's insurer-friendly reforms, Ardley's revelation of the buried report wasn't enough for Visger to get his treatment. Instead, Travelers sent the case to a for-profit company to evaluate the report. Bizarrely, California's workers' compensation system has no treatment guidelines for brain injuries. As a result, Visger's entire case was viewed through the absurdly different prism of chronic pain management, for which in-patient care at a neurocognitive rehabilitation center is not an appropriate form of treatment. Because of this miscategorization, the review company rejected any form of care whatsoever.
Incredibly, Visger caught a break. There was an error and the company's report was filed months late. This delay allowed Asvar to claim a procedural error, which took the claim out of the insurance company's hands and into a judge's purview.
On March 12, 2015, almost two years after Ardley recommended Visger enter an in-patient brain injury care center, after two years of more notebooks and financial floundering, the case finally reached a judge, who approved Visger's treatment. Asvar called the Center for Neuroskills in Bakersfield, the one Ardley specifically recommended in the very first report. Get a room ready, he instructed. We have a patient ready.
But, before Visger could go, Travelers appealed the ruling—citing yet another procedural error—which has put Visger's treatment on hold again.
Many NFL players, professional athletes, and everyday American workers rely on this failed system when they're injured on the job. In particular, this system plays a vital role for those NFL players who suffered years of football injuries just to get to the pros, but didn't play long enough to be eligible for the NFL's disability or benefit system. For players like Visger, it's a brutal catch-22: they can't access the NFL's benefits for players with injuries because they suffered an injury too early in their NFL career.
In theory, that's where the workers' compensation system is supposed to plug a gap. But as of this writing, more than two years after Douglas Ardley wrote that George Visger was in such poor health that he needed to enter a facility for neurocognitive treatment, Visger is still waiting for treatment. Asvar said the case could easily extend into 2016.
"If this had been done," Asvar told me as he holds the initial report, "Visger's life, his suffering, his level of cognitive impairment would be vastly different today than what it is."
It's difficult to relate to Visger's daily experience, the frustration that surely comes from having to write every single event into a notebook. But if you took the two-year battle over his workers' compensation claim—with all of its errors, restarts, do-overs, buried evidence, constant confusion, and random gaps of logic—condensed it into a day, and then repeated that day, every day, for 35 years, you might approach what it is like to be George Visger.
So Visger is back to starting over, reinventing himself, again. He'll have more restarts, more do-overs, and many more notebooks, because that's who he is now, and he's accepted that.
As a result of accepting his condition, Visger has taken on a new challenge: raising awareness for traumatic brain injuries. He founded the Visger Group and, with the help of Renee Shull of Integrated Play, an organization that helps former athletes with their career transitions, he consults on traumatic brain injuries with legislators, medical professionals, youth groups, and the media. There's still a chance for him to do some good, to limit the amount of lives ruined for a game. Maybe a few lives are saved because of Visger's efforts. Maybe none of the other George Visgers would have saved them.
This new mission has re-invigorated him in spurts, but he is still tired. He rarely sees his kids. His wife filed for divorce. He's still in the attic and unemployed. There is no professional accomplishment or monetary reward that can mitigate the profound, irrevocable loss Visger has experienced.
"I've got a fricking little lamp next to me," Visger says while sitting in the attic. "Remember the lamp in A Christmas Story with the ladies' leg in the nylons? OK, well I have that lamp right next to me that the kids got me for Christmas years ago. I take the shade off cause I can't see, it's too dark. So I've got my little leg lamp next to me and I'm laying here right now on my bed against the wall with my sleeping bag propped up behind me. And I'm looking around at this shit, the stuff I have left, just scattered and shoved all over up here. You know? This is how I've been living."
Read the entire Battle for Benefits series here.
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