(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.)
At first, the thought was just a quick flash across Kyle Turley's mind. Maybe they would be better off without me. He quickly dismissed it. But the thought lingered and gained more potency the longer he sat in the darkness. Look at me, just fucking look at me. I'm sitting in a fucking parking lot in the middle of the night because I got into a fight with my wife over nothing. Of course they would be better off without me. Turley searched for a way out of this downward spiral. There was one solution. The answer was in the glove compartment.
On this mild fall night in 2012, the former All-Pro NFL lineman, an eight-year veteran, had been set off by a fight with his wife about something unimportant. And yet these fights, over trivialities, were the most difficult for him to face. These instances forced him to see that the anger was inside, releasing at unpredictable times, which made Turley afraid of himself. The fear was not in the arguing, but in where the anger would take him.
Shortly after the fight, Turley got into his truck and drove to an empty gas station parking lot. He figured he would just cool off, and let the rage dissipate. In those moments, he thought about how he completely loved his wife and kids. He wondered if his presence brought them pain they didn't deserve. He knew exactly how to end it, their pain and his.
As Turley eyed the glove compartment, he remembered the NFL Life Line, a free, 24/7 confidential phone number for current or former players to call in times of distress, a service he helped create for moments exactly like this. He figured he couldn't be a hypocrite. So he dialed the number, put the phone on speaker and rested it against the center console. As the phone rang, he leaned back in his truck seat and tried his best to relax.
Turley just wanted someone to talk him out of his irrational anger and depression. He needed someone to talk some sense into him, to keep him from reaching into the glove box. Instead, he was put on hold for 30 minutes.
About four months before Turley sat in that parking lot, Hall of Fame linebacker Junior Seau committed suicide by shooting himself in the chest, which reignited the conversation about what football does to a person's brain.
Speaking to USA Today shortly after Seau's death, Turley said, "If Junior could wake up today, he wouldn't have done it. But something at that moment got severely crossed in his brain that allowed him to make that decision that life wasn't worth living anymore." Later in the interview, he issued what could easily have been perceived as a warning: "I do feel my brain is a ticking time bomb."
Shortly after Seau's death, Turley called Shannon Jordan, his contact at Gridiron Greats, an independent non-profit that assists former players in dire need. Turley wanted a resource for players in great emotional distress, something that could have potentially saved his friend and, perhaps one day, save himself.
Jordan coordinated with the NFL and, two months later, they announced NFL Life Line, operated by Link2Health Solutions in partnership with crisis center experts at Centerstone and the Mental Health Association of New York City.
But now, when Turley needed it, the Life Line wasn't there for him. Ironically, being put on hold gave Turley a purposeful anger which took him out of his suicidal trance. He almost fell asleep waiting for someone to pick up. When someone finally got on the line, Turley asked the person on the other end if this was the NFL Life Line. The person had no idea what he was talking about.
Turley hung up and called back. This time, he spoke to an operator who had no idea what the NFL Life Line was, but who talked him through his problems for over an hour. "So in the end the hot line did its job," Turley recalls on a sunny July day as he sips from a glass of ice water and vapes marijuana. "But I'll chalk it up to God."
To this day, Jordan vividly remembers getting a call from Turley shortly after he had spoken with the call center operator. He was still in his truck in the gas station parking lot when he told her about the NFL Life Line experience. "I was mortified," she recalls. After all, Turley is not just a partner with Gridiron Greats, he's also her friend. "I mean, I'll never forget that moment."
Jordan immediately called everyone involved in the program and told them Turley's story—without using his name, since the call was confidential. Jordan says everyone on the line agreed this was unacceptable.
"Since 2012, the program has grown with experience and continues to improve through feedback from calls they have received and education," an NFL spokesperson told VICE Sports. "Today there is more NFL culture specific knowledge and training from their work with the NFL family since 2012. They have also enhanced customer service by adding follow-up services, for example, to try to connect callers with the best resources and encourage them to do so if they don't connect initially."
The NFL declined to make any members of the Life Line staff available for comment.
Jordan has never heard a similar story, and no one has ever told her what went wrong, how it happened, and what was done to fix it. "I didn't get a full explanation on that. I just said it can't happen again."
The league and union combine to offer dozens of programs to help former NFL players, ranging from vocational training to health-related initiatives to financial benefits. A fact sheet provided by the NFLPA lists 22 different programs, some with their own sub-programs or guides to other programs.
Many players feel as if they're on their own navigating these complexities, because leaving the NFL is a paradoxically sudden yet gradual process. Thanks to non-guaranteed contracts that can be terminated at any time with virtually no penalty, most NFL players don't consciously retire. They are met in the parking lot by a security guard with a garbage bag filled with their personal belongings or the training staff with a banker's box. Even then, for months they cling to the hope of being picked up by another team; sometimes the wait can last years. It is only after prolonged silence and, often, at the urging of agents and loved ones, that many players finally admit their career is over.
"Your agent kinda helps a little bit, maybe some older players. You start asking questions," former Broncos and 49ers tight end Nate Jackson and author of Slow Getting Up: A Story of NFL Survival from the Bottom of the Pile, told me. "They [the NFLPA] may have said something to us here or there when we played, but really no one understands what's waiting and understand what our options are and what the process is going to be like."
By the time players are finally ready to accept their retirement and survey the landscape of programs available, it can be hard to know where to turn. First, the sheer number of different programs, operated by several different entities, can be intimidating and confusing, especially for players with memory or cognitive issues. This is something Shannon Jordan of Gridiron Greats sees all the time when players first reach out. "Who does what? What are the programs for the league? What are the programs for the union? They're familiar that there are things out there but they really don't know kind of how to navigate through all of them."
Gridiron Greats was founded in 2007 with seed funding from former players and coaches to help fill this gap. Since then, the organization says it has helped over 1,500 former players. Its two full-time staffers receive an average of five calls per week from former players seeking assistance.
When a player calls, the first thing they do is give him a checklist of programs to call to find out if they're eligible for any assistance. Even their simplified checklist—the most concise and accurate summary of benefits to former players available—is two pages long and lists nine different organizations to call, all affiliated with the NFL or NFLPA. (Gridiron Greats does receive money from the NFL—$575,000 over the last two years—but Jordan emphasized these are no-strings-attached donations.)
If players don't have someone helping them parse all the various programs and their eligibility requirements—whether they have to be vested, specific medical needs or illnesses, time since last game played, a particular bar of financial distress, or some combination therein—they can spend months or even years learning for which programs they're eligible.
"As it stands, they create all these programs, this shell game," Turley said. "You have to deal with their fucking bureaucracy."
Jordan doesn't believe the NFL and NFLPA are being purposely cheap or nefarious. "I think both entities believe they are addressing those issues and that they are helping these guys." Nevertheless, many players still end up going to the independent Gridiron Greats—proof the NFL and NFLPA aren't doing enough to take care of former players. Without Gridiron Greats, players must contact several different offices to survey the full landscape of all available programs. The NFL provides the following section on its Player Engagement website, which provides an overview of the offices to contact to get an overview of the benefits offered.
However, most of these offices can only speak to the programs they offer, not the entire benefits landscape.
"We have all felt from the beginning, when we just wanted to be an advocacy group, we shouldn't be in existence at all, right?" Jordan said.
Whether the programs work or not, the NFL puts big money behind them. As part of 2011's new CBA, the NFL and NFLPA agreed to contribute $55 million, increasing by five percent each year, to retired player initiatives. Twenty-two million was earmarked for "healthcare or other benefits, funds, or programs for retired players," $11 million for medical research, and another $22 million for "charities as determined by the NFL, including NFL charities and/or Youth Football or successor organizations." Of course, dumping $22 million into youth football does nothing for former players, but plenty for the NFL's marketing efforts and to boost youth football participation.
On paper, it sounds like more than enough for former players to get a leg up on post-football life or to deal with lasting damage from their playing days. But some of its programs are of questionable value. For example, the NFLPA's vocational training programs had 204 participants in the last calendar year, 143 of whom attended a coaching symposium held during a coaching convention.
Some of the programs do help. The Player Care Foundation (PCF) claims on its website it has "assisted" 823 players and provided 3,505 medical screenings since its inception in 2007. The PCF has received $8,205,507 from the NFL over the past two years, more than 14 times as much as Gridiron Greats, which has assisted twice as many former players. This is why many former players, such as Kyle Turley on that fall night in 2012, find the programs are there, but don't help enough.
Turley is now dealing with, not only the NFL's benefits bureaucracy, but also a much larger, more complex bureaucracy: Obamacare. Former players who played at least three games in three different seasons get only five years of post-NFL healthcare coverage. Afterward, they're on their own.
After his NFL insurance expired, Turley signed up for Obamacare and bought a BlueCross BlueShield policy for which he pays $981.57 per month. Shortly thereafter, Turley experienced mind-melting pain in his back, which he had injured on several occasions during his playing days. He went to the hospital and a doctor recommended an MRI. Turley knew from previous experiences with back problems that he needed an MRI with contrast; a regular MRI wouldn't show the injury. Turley never had a scan, medication, or any other form of treatment denied under the NFL plan. But under Obamacare, his insurance wouldn't approve an MRI with contrast.
Turley knows he will need back surgery, hip replacements, and ankle surgeries in the future. But he also knows it will be a battle with Obamacare to get them. According to Obamacare's charts, he is obese and won't be approved for these surgeries unless he loses 30 pounds. But the chart is based on the BMI index, a height/weight ratio and doesn't take into account shoulder breadth, wing span, or other ways in which Turley's athletic frame naturally adds healthy weight. To wit: J.J. Watt, the paragon of modern fitness, has a BMI of 33.5, which puts him in the most obese category according to the National Institute of Health.
Turley knows this is a problem many former linemen face. "You've got guys that have been told they need to be 300 pounds their whole life, since Pop Warner." For them to lose this weight is a massive Catch-22: losing this amount of body mass requires intense exercise, the kind that injured limbs and muscles aren't able to handle.
Jim Acho, a disability attorney in Michigan who works with former NFL players, ran for NFLPA executive director* last year—he did not win—under the platform of lifetime health insurance coverage for former players until age 65. Based on conversations with people in the insurance world, Acho estimates this would cost roughly $100 million per year. This may sound like a lot of money, but it's a little over $3.1 million per team per year, hardly a dent for most NFL owners considering 18 of them are billionaires, and the NFL generated $12 billion last year. Acho believes this is a worthwhile effort because Obamacare is inadequate for player needs. In addition to the lower quality of care, he says, "the deductibles are $6,600 per person annually under Obamacare and $13,500 per family. So if he needs surgery, deductibles can drain him."
Obamacare was never designed to cover individuals this battered. Yet, it's safe to say that many, if not most, NFL players get their health insurance through various government programs, whether it's Medicare after getting social security disability or turning 65 years old, or Obamacare, like Turley. In other words, the taxpayer pays for far more former NFL players' health care than the NFL does.
To help alleviate the cost of Obamacare's premiums, Turley filed for disability—for both orthopedic and neurocognitive injuries—under the NFL's plan last year. He knew he could only be awarded one; the NFL disability plan considers impairments individually and has no way to multiply payouts for players suffering several debilitating impairments.
In addition to the financial benefits, Turley wanted to have documentation from the NFL on the neurocognitive issues. Turley knew he had all the symptoms of the worst case scenarios, including early onset Alzheimer's. He wanted to make the NFL's disability plan either acknowledge his situation or, worse, deny it.
Sitting in his Riverside, California home, Turley brings out the neurocognitive reports from what the disability plan calls "neutral" physicians, although it's the NFL who selects them and often makes players fly across the country for their appointments—even if the player lives in a major metropolitan area with many capable doctors.
As he goes through the report, page by page, Turley points out inaccuracies, misrepresentations, and errors. They range from the inept to the offensive.
On the first page, the examining doctor didn't list all of Turley's symptoms. He only documented memory loss, headaches, and "neurocognitive issues." No mention of the light sensitivity, vertigo, dizziness, depression, suicidal thoughts, and rage issues, even though Turley insists he mentioned them.
Next to each of those three symptoms the doctor did list are check boxes: illness, injury, or unknown. The doctor checked "unknown" next to all three.
The next question asks, "Has the impairment persisted or is it expected to persist for at least 12 months from the date of its occurrence?" The options: yes, no, or cannot be determined. To answer this question, one need only do a quick Google search: The 2013 San Diego Tribune article or even the 2009 New Yorker article extensively detailed his neurocognitive issues, including an episode in August 2009 when Turley passed out, went into convulsions, projectile vomited, and lost all control over his body and mind. Nevertheless, the doctor selected "cannot be determined."
Following these remarks are seven pages of medical records that simply list doctor visits—not the actual medical records, which would be a stack of paper approximately a foot thick—including several references to neurologists and psychologists.
The doctor also noted that Turley was "gainfully employed," which is factually incorrect, and stated that Turley is "not restricted" in what type of employment he can be engaged in.
Turley then flips the page and grimaces. On this page, the doctor lobbed thinly-veiled insults at Turley, dismissing any difficulties he had with the examination as products of him being, essentially, a raging asshole, and not because of neurocognitive issues, despite him being diagnosed by other doctors with neurocognitive issues:
"Poor motivation and effort. Effect was constantly flat and mood was variable as well as unpredictable. During this evaluation he was very confrontational and quite frankly non-directable. Secondarily, due to his variable mood, not due to cognition. Mr. Turley stated to me that he suffers from a frontal lobe injury and he has been diagnosed by Robert Cantu in Boston as well as Dr Oscar Mendes in Tennessee. Both MDs saw him in private practice. His speech characteristics were low for volume, reduced and with adequate speed."
The report then urges Turley to look into "past mental health issues," a claim which has no merit, given the battery of tests Turley was put through before being selected seventh overall in the 1998 NFL Draft.
Turley ended up winning his claim on orthopedic grounds—he has bad hips, knees, ankles, and back—which awards him $120,000 a year, but still doesn't provide any healthcare or medical coverage, which will far surpass that amount.
Even more important, perhaps, is the direct denial by medical professionals of Turley's mental health condition. It makes Turley—and other players like him—think what they're experiencing is just their brain working normally, which legitimizes the thoughts they have at their darkest hours. The suggestion is that if there's nothing wrong with their brain, then maybe they should listen to it.
At this point, Turley begins speaking to me about the NFL's treatment of former players more broadly, mainly how players regard the system as antagonistic: the litany of programs and the humiliating feat of having to go through an administrative process. The NFL's lawyers provided a 2007 Congressional subcommittee, which was assembled to shed light on serious issues with the NFL's disability plan, with data showing 64 percent of the 1,052 applicants were denied at the first stage of review (the NFL and NFLPA declined to provide updated figures). Thirty-two players ultimately sued the retirement board, including Brent Boyd, Dave Pear, and Dwight Harrison, attempting to get their benefits.
"The majority of guys, all they want is respect," Turley emphasizes. "I don't want to go have to fight for all this shit. It should have been given to me. That I already played for. I already fought on the field for these things. Why do I have to fight you now?"
To this day, Turley is still extremely insulted by the "poor motivation and effort" note in his report. "You have this report that is glaringly showing there's a problem here. You've got a guy on the verge of fucking suicide here. You're going to lose another." He starts tapping on the report with his index finger. For a split second, as he's tapping away, no words come out. Then his finger stays on the page and the tapping stops. "This is Junior Seau, right here. This is Junior Seau."
In early 2015, Turley sunk into another depression after he had his NFL disability claim on neurological grounds denied. He shut himself in the house. "I was like, you know what, nobody gives a fuck, man."
At the time, Turley was taking a battery of prescription drugs to battle his various symptoms including Divalproex for seizures, bipolar disorder, and migraine headaches, along with Budeprion and Sertaline for anxiety and depression. But they weren't working. Over the years, he had built up a tolerance and required thousands of milligrams a day across the medicines, which produced some nasty side effects. His depression, migraines, bipolar disorder, and suicidal thoughts were all worse than ever before. It was almost as if the pills would harness and contain the symptoms, only to unpredictably release a fiercer version of them.
Watching TV one day, Turley saw a commercial for a new medication. Half of the ad was the voiceover listing side effects. The next commercial was about a class action lawsuit for another medication. He began to think that the pills he had been taking were poisoning him. He was only getting worse because of these medications, not better. Nothing was working for him. Not the NFL's litany of piecemeal programs, not Obamacare, not prescription medication, nothing. He decided it was time to try something else.
Many former players face a similar crossroad, where they venture into uncertain territory outside of the verified medical establishment. Some find relief in hyperbaric chambers. Turley opted for a different treatment. But first, he had to go cold turkey.
"It was the hardest fucking thing," said the former All-Pro lineman, who knows a thing or two about physical pain and discomfort. It took him two months just to get off the drugs.
Then, it was time for him to get on his new regimen: marijuana.
Turley didn't pull this solution out of thick, smoky air. In 2012, Nature published a study showing that a cannabinoid, a similar compound to those found in marijuana, protects mice from brain injuries. The compound was shown to reduce swelling and the release of toxic chemicals inside the brain. These cannabinoids or THC have never been administered to humans in a controlled trial, so the research is still speculative. But, it could work, and Turley knew the prescription meds didn't. He had to try.
After finding this research, Turley decided to conduct a one-man trial of sorts. "I just stayed fucking stoned all day on good weed," he recalls. He searched for the strain that worked best for him with mixed results, but eventually settled on the Jack Herer setiva strain, which doesn't get him high.
Marijuana works for Turley. We spoke for four straight hours on a bright July day, the sun shining through the windows in his kitchen, Turley vaping every once in awhile. Six months ago, his light sensitivity was so bad, this would have given him a spiraling headache, to say nothing of the periodic onset of all his other, nastier symptoms. Now, he doesn't think about suicide. Ever. He doesn't even get depressed.
Nate Jackson, the former NFL tight end and author of Slow Getting Up, also believes marijuana can help many former players, and that there's room for the NFL to be progressive. "If the NFL were to relax the restrictions on marijuana," Jackson says, "maybe raise the threshold of cannabis that's allowed in the bloodstream, then test some of these products on former players and a lot of ailments they're going through, they could really appear ahead of the curve."
Turley is now advocating for research into marijuana as a potential treatment for brain trauma. He believes the prescription drugs only make things worse. He wonders if he ever would have needed to make that call to the NFL Life Line if he wasn't on his battery of medications. It's an apt metaphor for his post-career life: finding solutions in spite of the league and union's help, not because of it. "I didn't need what they were giving me," he says, before holding up his vaping pipe. "I needed this."
*A previous version of this article stated that Jim Acho ran for NFLPA president. He ran for executive director.
Read the entire Battle for Benefits series here.
Contact the writer: firstname.lastname@example.org
(Editor's note: filing for disability through the NFL's system can be frustrating, opaque, and confusing. The graphic below details the process and the various pitfalls.)