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Support to Injured College Athletes

Unequal Financial Support to Injured College Athletes

Peter C. Lillibridge

Luther College

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Abstract

This article will prove that student-athletes do not receive equal financial

support at each university. The NCAA only insures an athlete’s injury when costs

amount to $90,000 or more, therefore the student’s university, immediate family

members, or insurance agencies pay the further expenses below that amount. Not

all members of the NCAA provide care for their athletes and this is not only unfair to

students but it can impact individual’s lives and their families greatly. The article

mentions incidences of athletes who were unequally supported by their school as

compared to their peers involved in NCAA athletics. Student-athletes are often

stuck with out of pocket medical costs for their injuries as a colligate athlete. A

student’s current and future health should ultimately be the main focus in the case

of a severe injury and they should be treated with similar financial support across

the divisions.

Table of Contents

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NCAA POLICIES AND REQUIREMENTS 5

DIVISION I SCHOOLS: REVENUES AND EXPENSES 8

STUDENT-ATHLETE BILL OF RIGHTS 9

STRUGGLING DIVISION I INSTITUTIONS: UNIVERSITY OF MAINE 10

DIVISION III COLLEGES 11

IMPACTS OF UNEQUAL SUPPORT: POSITIVE AND NEGATIVE 11

STORY OF ERIN KNAUER, A DIVISION III ATHLETE 14

UNIVERSITIES BUDGETING THEIR MONEY HOW THEY WANT 15

SHOULD DIVISION III COLLEGES BE REQUIRED TO SUPPORT STUDENTS? 16

SUPPORT FROM THE NATIONAL COLLEGE PLAYERS ASSOCIATION 17

IMPACT OF INJURED STUDENT-ATHLETES AFTER GRADUATION 19

CONCLUSION 21

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Unequal Financial Support to Injured College Athletes

Every year, collegiate student-athletes are responsible for paying medical

bills from their injuries. Athletes participating in colligate athletics often suffer

season or career ending injuries and everyone wonders, who is paying for the

medical expenses. All NCAA athletes require proof of insurance; however in some

cases a student’s insurance carrier only covers part of the costs. The remaining

expenses are paid for by some other source. Division I universities generate

millions of dollars of revenue and can afford to give their athletes the state of the art

care and complete medical coverage. Division III colleges on the other hand do not

accumulate large revenues and are unable to support their injured athletes.

Institutions either cannot or choose not to financially support their injured athletes

and this is where the gap lies. Not all members of the NCAA provide care for their

athletes and this is not only unfair but it can impact individual’s lives greatly. Every

athlete within the NCAA should be equally supported, financially, in the case of an

injury.

NCAA Policies and Requirements

The NCAA has implemented requirements for athletes in hopes to limit the

amount a student-athlete pays for their injuries. All student-athletes are required to

prove that they have medical insurance for athletically related injuries prior to their

participation in practice or competition (Sheely). In the event of an injury, all

athletes in association with the NCAA will be partially covered through their

insurance agencies. To provide an example: If a Luther College student tore his or

her ACL and the cost of the surgery was $25,000, the cost to the family would be the

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deductible prior to the insurance coverage (Lillibridge). The deductible could

amount to around $5,000, which is paid completely out of pocket (Lillibridge).

Outside of the deductible the student’s insurance carrier should cover the entire

medical bill (Lillibridge). The NCAA hopes that athlete’s insurance will cover every

student-athlete to avoid legal matters. The NCAA implemented this policy in 2005

to avoid lawsuits towards the organization regarding out of pocket cost to families.

This is the only requirement of student-athletes implemented through the NCAA.

Why do students still have to pay out of pocket costs?

There are a few circumstances that the NCAA provides coverage to student-

athletes. First, the NCAA has enforced the Catastrophic Injury Insurance Program,

implemented in 1992. Once a student-athlete’s medical expenses reach the amount

of $90,000, the NCAA’s catastrophic insurance program covers all costs (Sheely).

Athletes who become permanently disabled also receive lifetime funding from the

NCAA catastrophic program. Sheely stated, “this program (catastrophic) provides

$20 million in lifetime benefits to student-athletes who become totally disabled

while practicing or playing.” These expenses include medical bills and payments to

go towards disability accommodations such as wheelchairs and handicapped

accessible vehicles (Sheely). The NCAA makes note that the program defines a

permanent disability as: complete loss of sight or hearing, loss of use of at least two

limbs, loss of ability to speak, or severely diminished mental capacity (Sheely). This

program can significantly help the situation of athletes who have become

permanently disability and their families. With this support, medical costs become a

burden lifted off the shoulders of those with bills that amount to $90,000 or more.

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An additional coverage of medical expenses is through the NCAA’s

Participant Accident Program. This program ensures complete coverage of a

student-athlete’s injury while participating in a NCAA championship event for all

divisions (Sheely). “So any injury occurring during an NCAA championship event

would be covered by the NCAA insurance policies from the very first dollar of

expense to the last,” stated Sheely. These two benefits, provided by the NCAA, are

well renowned programs and can impact student’s lives greatly.

Outside of the NCAA coverage programs, the money left to pay for student-

athlete’s medical bills comes from several other sources. For example if an athlete’s

town ACL surgery does not amount to $90,000, then who pays for the bills? The

NCAA believes that accident insurance (required by athletes) will cover all injuries

or illnesses while playing sports (Sheely), however students today are faced paying

thousands, even tens of thousands, of dollars out of pocket for their medical bills

after insurance covers their portion. The total costs come from the insurance

carrier of student, the student’s university, or the family. “The Bylaws (of the NCAA)

do not set other requirements of the accident insurance,” meaning outside of the

student-athlete’s insurance coverage they do not require members of the NCAA to

cover expenses. Also, if a school does provide coverage to athletes, they do not have

to cover 100 percent, which may require the parent/guardian of the student-athlete

to cover out-of-network costs or large deductibles (Sheely). Universities are

responsible to make the decision of whether or not they will cover their athlete’s

injury expenses.

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Division I Schools: Revenues and Expenses

Universities across the country generate revenue for their respected athletic

departments. Division I schools accumulate a higher revenue compared to Division

II and Division III due to higher ticket sales and T.V. broadcast agreements (Bursed).

DI schools (more specifically schools in the “Power 5” conferences: Big 12, Big Ten,

Pac 12, SEC, and ACC) rely heavily on their athletic department revenues to carry

their expenses. Brian Bursed stated, “Of $83.6 million in median total revenues at

the highest-resource schools (Power 5 conferences), 89 percent was generated by

the athletic department” (Bursed). The percentage of revenue generated from the

athletic departments drops in association with the size of the school, for example:

smaller DI FCS (Football Championship Subdivision) schools’ athletic departments

only generate 40 percent of the school’s total revenue (Bursed). In any case, it

seems that Division I programs are able to generate millions of dollars to run their

athletic programs and it only appears logical that they can help out their injured

athletes.

Although DI athletic departments bring in large amounts of revenue for their

schools, they have even greater expenses. Schools like Oregon, Texas, Michigan and

Alabama generated an average of $166.75 million in revenue last year (USA Today).

However, these schools are the lucky few that are able to create positive net

revenue. Only 16% of DI FBS universities had revenues that exceeded their

expenses last year (Bursed). Most schools cannot afford to run their athletic

programs. Expenses for Division I schools jumped 114.6% in the past decade

(Bursed). Those universities that struggle to support their injured athletes should

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be compensated in some way to ensure equal coverage in Division I. The only

institutions that are thriving from their athletic department’s revenues are included

in the nicknamed “Power 5” conferences.

Student-Athlete Bill of Rights

Some DI schools use their revenues to cover their injured scholarship

athletes while others are unable to reach that standard. State legislatures are

weighing in on the issue and taking action to ensure athletes are being protected. In

2012, California passed a law (sponsored by the National College Players

Association known as the Student-Athlete Bill of Rights) requiring that the four Pac-

12 schools in the state pay for sports-related medical expenses (Emmert). These

colleges include: Cal-Berkley, University of Southern California, UCLA, and Stanford

and they all bring in large revenues from their athletic programs from being part of

the Pac-12 Conference. If this trend were to continue it would impact Division I

schools with smaller budgets greatly. For example: Boston recently is considering

making their state scholarship universities pay for athletes medical expenses as well

(Emmert). These schools like Boston College and Boston University have smaller

budgets than the “Power 5” schools. For schools with smaller budgets they would

be paying three to four times more on health care and insurance if laws required

them to support injured athletes (Emmert). It is unfair that some Division I

universities can support their athletes while others cannot or choose not to.

Certain universities are able to offer complete coverage for athletes’ medical

bills, but several fail to find the assets to do so. USA Today reported in 2012 that

only 23 of the 228 Division I schools generated enough money to cover athletic

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programs (Emmert). Those schools provide multi-million dollar coaching salaries

and ultimate athlete perks, like apparel, food, and medical support that several

other schools cannot match. Some other schools are doing as much as they can to

support their injured athletes financially.

Struggling Division I Institutions: University of Maine

University of Maine (DI school) has a lower athletic budget compared to the

Oregon’s and Alabama’s of college athletics. UMaine offers a secondary insurance

policy that covers its athletes after they’ve spent $10,000 (Emmert). Due to the

budget of the school they have no choice but to require athletes to pay a portion of

the deductibles and co-payments. It is not full coverage but it does help students

partially. The policy cost the school $124,000 last year (Emmert). They also offer

free rehabilitation services for their athletes (Emmert). Rehab and therapy costs

can build up for any athlete and it is good that most Division I athletic training

facilities offer this for free. UMaine is making a great effort with the assets they have

and are treating their athletes as fair as possible. They cannot compete with the

perks of the large universities. UMaine Director of Athletics, Karlton Creech, said,

“There is nowhere that I see to come up with that kind of revenue (Power 5 schools

type of revenue) to pay for full medical coverage for athletes under our current

system” (Emmert). Some Division I universities lack the resources to cover athletes

and are forced to elect not to provide support to injured athletes.

On the other end of the spectrum, Division III institutions showcase a large

range of enrollment size, revenues, etc. DIII schools in association with the NCAA

amount to nearly 450 colleges (Bursed). Enrollment sizes can vary from 1,000 to

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20,000 students. This gives the schools an unfair advantage to compete in revenue

not only to Division I programs but with each other as well. The range of revenue

for DIII schools is $275,000 to $14.1 million (Bursed). Similar to Division I, smaller

schools cannot compete with the larger universities. The overall athletic expense

per-student at a Division III institution is $7,100 (Bursed). It is not feasible for

smaller schools afford to pay more for athlete medical coverage on top of their

expenses already. Given the differences in revenue from DI to DIII, different actions

might have to take place, but within one division there should be complete equality.

Division III colleges take on the same amount of responsibility as Division I

programs to decide on their financial support policies for injured athletes.

Impacts of Unequal Support: Positive and Negative

Whether a college covers their athletes or not the decision impacts student’s

lives in a big way. For example: Alabama University completely covers their athletes

and spent nearly $2 million dollars in 2011 on medical bills and insurance for their

athletes (Solomon). Former Alabama football player Tyrone Prothro suffered a

fractured leg in 2005. The school paid for all of his surgeries since then and Tyrone

stated, “It was something I couldn’t afford (Alabama’s costs)” (Solomon). Another

example: a former LSU pitcher never paid any expenses for his two elbow surgeries

(Solomon). He also went under multiple MRIs and X-rays that were paid for by the

school. The pitcher was quoted, “I wouldn’t have underwent the second (surgery) if

the bills were out of my own pocket” (Solomon). These situations show that players

might not have been able to afford the correct amount of care without the financial

support from their schools. They needed the financial support because the families

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could not afford the bills after insurance. It is important that athletes are treated

with the best care possible and supported financially if needed for the medical bills;

otherwise they might have recurring issues later on in life.

Some athletes at the DI level are not so lucky.

The majority of Division I athletes are being paid to attend their specific

university through full tuition and should most certainly be supported financially by

the college in the case of injury. If a college brought a student in and paid for tuition,

books, etc., than it is wrong to abandon them when they are injured. For example:

Kyle Hardrick was a basketball player for the University of Oklahoma and had a

history of knee problems (Solomon). Hardrick suffered a torn meniscus and had to

undergo surgery. Oklahoma, a member of the Big 12 conference, elected not pay for

Hardrick’s medical bills (Solomon). Hardrick’s family estimates they paid $10,000

for Kyle’s injury while the insurance covered the remaining $20,000 (Solomon). The

financial toll becomes difficult for Kyle and his family. Kyle’s mother, Valerie, stated,

“you don't imagine paying those medical bills out of your own pocket when your

child gets a scholarship” (Solomon). When schools cover expenses for travel, food,

and tuition one would expect them to take care of their athletes when they need

them the most. It is unfair that Kyle had to pay for his medical expenses when

students at the University of Iowa for example do not.

Any NCAA institution is able to abandon an athlete once they get

injured and strip their scholarship. The NCAA has no provisions in place, “Nothing

prevents the athletic director from refusing to pay related medical bills,” Meghan

Walsh. There are also no rules for scholarships schools for revoking a student’s

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scholarship the minute they suffer an injury (Walsh). It is unfair to all student-

athletes who suffer financial debt because there are no guidelines enforcing equal

coverage to injured athletes amongst all universities. According to the NCPA DI

schools generally pay for medical costs if the player is “high-profile” (renowned)

and their injury is severe or public (Walsh). For example: during a 2013 March

Madness game Louisville player, Kevin Ware, suffered a gruesome compound

fracture in his leg in front of millions of people. The people watching the game did

not realize that Kevin’s medical bills might not have been completely covered. The

fact that Kevin’s injury was seen by millions of fans and covered by multiple media

Louisville felt obligated to cover him, but they were not required to. Kevin Ware

may also be facing some rehab and possible additional surgeries in the future from

his compound fracture, however Louisville University had no comment on who

would cover those costs (Mohney). NCPA president Ramogi Huma stated, "People

are surprised [the University of Louisville] could have opted to leave him (Kevin

Ware) with medical expenses and leave him off the team… the fact that they (the

university) have that option is outrageous." Even at the Division I level athletes are

not equally supported during their time of need.

The Division III level acts in similar ways. Students are often dealt with

horrible situations.

Story of Erin Knauer, a Division III Athlete

Erin Knauer attended Colgate College, a private liberal arts school, and was

on the rowing team. She suffered a back and leg injury and racked up $80,000 in

medicals bills (Peterson). Erin was not immediately injured, but during a prolonged

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process of seeing numerous doctors and physical therapists and they determined

the severity of the injury. According to the doctors Erin obtained this injury from an

illness she previously had. Colgate athletic director announced, “There has to be

some direct line from the injury to what she’s being treated for” following the

decision that Erin would not receive medical insurance from the school because it

was an illness and not an athletic injury (Peterson). There must be an equal playing

field or a written statement including all athletes by the NCAA that gives some

insurance to athletes and families. The decision should not be up to the athletic

department. Erin, under the college’s insurance policy, would only have to pay a

$1,000 deductible and the rest is paid for, but she is now left on her own with the

$80,000 (Peterson). Her insurance company covered less than a third of the costs

and her family is struggling to pay off the bills (Peterson). Along with being a full-

time student this 21 year old works two jobs in order to meet her monthly medical

bills (Peterson). Knauer’s situation continues to get worse. “Still in physical pain,

Knauer has struggled with the stress of weekly phone calls from bill collectors, some

of whom have threatened to sue her” (Peterson). It is not right to have a 21 year old

be in this much physical and mental pain. She needed additional help because she

did not deserve to pay roughly $55,000 on her own. There ought to be an equal

support system for all athletes that are stuck with debt from medical bills like Erin.

There are a few Division III colleges that feel like that should support their

athletes if possible. At Middlebury College in Vermont all varsity athletes have

accident insurance paid for by the college (Peterson). They can provide the funding

for 29 varsity sports. Other institutions do not offer full medical coverage however,

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but do offer partial coverage. Spalding University, for example, in Louisville, KY

offers secondary coverage, which means the insurance of the family (required by the

NCAA) covers as much as they can and the school pays for the rest. It is positive

that some DIII colleges offer medical coverage to their athletes but the system needs

to be equal.

Although athletes should be on an equal playing field, unfortunately, smaller,

less profitable, schools do not have the budget to provide support to injured players.

Revenues do not exceed expenses at nearly all Division III institutions (Bursed).

Even the Division III schools with enrollment nearing 20,000 students cannot afford

medical coverage. For example, a former University of Wisconsin-Stout student was

faced with $6,000 debt from medical bills post knee surgery (Peterson). Athletic

departments from lower income schools could not support their athletes even if

they wanted to. University of Wisconsin-La Crosse head athletic trainer, Scott

Doberstein, said, “it would cost us 5 if not 6 figures (to cover athletes)…it is too cost

prohibitive” (Peterson). Coverage is not in these schools’ budgets.

Universities budgeting their money how they want

Some reasons for a non-equal playing field for colligate athletes may include

monetary issues, but a school can budget their money to ensure some support to

their injured athletes. Division I institutions do not have small profit margins

because they do not make any money, but that they are spending it all instead

(Strachan). The majority of the money is going to the highly paid coaches that are in

the spotlight of Division I athletics. For example, Duke University brought in nearly

$80 million in revenue last year (2014) from their athletic program but ended up

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with $146,000 in excess revenue (Strachan). DI programs expenses are going

toward state of the art athletic venues and on the paycheck of coaches. Duke

basketball coach, Mike Krzyzewski, makes $14 million a year as a college coach,

which is much more than your typical NBA coach (Strachan). Duke’s budget could

shift slightly and still make an impact on student’s lives if they were to cover injured

athletes, which they do not. The majority of DI schools can reallocate their

resources to support their athletes if they do not already. As for DIII schools they

could budget well enough too if they choose to. “It comes down to the ethics of the

school,” Walsh stated in her article (Walsh). Some institutions strive to keep an

extraordinary coach by offering money and make as large of a profit as possible,

while others find it hard to let students be stuck with leftover medical bills.

Spalding University compliance director, Charlie Just, said, “These young men and

young women are representing your institution…ethically, I think it is the right

thing to do” (Peterson).

Should Division III Colleges be required to support students?

Supporting injured athletes financially in a time of need may be ethically

right, but should Division III schools be obligated to do so. Division III institutions

by rule of the NCAA cannot give athletic scholarships to recruits. It seems logical

that if the school is not losing money on paying for athlete’s tuition then they should

not be required to support them in the case of an injury. A student-athlete, electing

to participate in Division III athletics, is aware that they do not receive additional

bonuses for being on the team than Division I athletes do not receive. It is the

athlete’s choice to take the risk of playing a sport and therefore the institution

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should not feel obligated to pay for their medical bills. Whatever the rules governed

by the NCAA, all athletes competing in the same division should be given similar

financial support and treated equally. If certain Division III colleges are unable to

cover athlete’s medical expenses and some are then the NCAA should compensate

those with smaller revenues to form an equal playing field.

Support from the National College Players Association

The NCPA is certainly involved in this issue and they strongly believe equal

rights for all athletes. “Prevent players from being stuck paying excess medical bills

every year” (NCPA). This statement comes directly from the mission and goals of

the National College Players Association website (NCPA). The NCPA is made up of

17,000 current and former Division I student-athletes and have become a strong

voice for the rights of athletes (NCPA). They believe that students should not have

to pay for medical bills out-of-pocket. In the process of this issue, the NCPA has

sponsored the Student-Athlete Bill of Rights (passed in California and Connecticut

so far) and have eliminated the restrictions on medical coverage for sports injuries

(NCPA). Moving forward, President Ramogi Huma hopes that the Student-Athlete

Bills of Rights will be adopted by other states (Mohney), which brings up some

issues previously mentioned. Huma, strongly believes that because athletes

(particularly Division I) help generate millions of dollars in revenue for schools that

they should be covered with medical bills (NCPA). Huma states, “what they

(athletes) generate in revenue and what they don’t have in protection is just

disgraceful” (Mohney). President Obama said, “You've got to make sure that if they

get injured while they're playing that they're covered” (NCPA). The NCPA will

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continue to push for coverage of injured athletes. Colleges have more responsibility

to student-athletes than they realize. Certainly at the Division I level, scholarship

athletes should be compensated if they bring in revenue like a typical employee at a

company.

However, a court ruling finalized the statement that student-athletes are not

employees to the universities and only student-athletes. The ruling, made

September 2015, denied the proposal made not by the NCAA but for the NCAA to

compensate athletes with a $5,000 stipend for any excess expenses the students

have (Tracy). Whether this is fair or not, the compensation for when a student is

severely injured should most certainly be taken care of. The NCAA enforces their

beliefs to keep college athletes as amateurs and not professionals/employees (Real

Sports). However if Division I scholarship athletes were “employees”, they would

receive full medical care compensation by law for on the job injuries like any other

job in the workforce today (Real Sports). If a university elects to not provide

coverage for their athletes, the only area where those students can rely support is

the insurance company. For students who receive a full athletic scholarship,

compensation for injures should be part of the package.

Impact of injured student-athletes after graduation

Depending on the institution, policies differ when it comes to financial

support after graduation. Most universities will limit the coverage they offer to

students after they graduate. For example, at the University of Alabama-

Birmingham athletes have one year after eligibility to report an injury in seek for

help (Solomon). The University of Iowa covers athlete’s medical bills from surgeries

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and even physical therapy two years after graduation (Maher). The injury must be

linked to the sport he or she participated in at the university (Maher). Other schools

do not support athletes once they are out of the program.

The following story is from The Atlantic of a man who was abandoned by his

school: A former South Carolina football player, Stanley Doughty, put all of his trust

in the university that gave him a chance to play football. Doughty grew up in

poverty in rural Louisiana and could not even afford to purchase his own cleats

growing up. Doughty suffered a several severe spine injuries while at South

Carolina but the training staff and doctors thought nothing of them. During his time

is college the school covered his expenses but once he left the university would not

support him. Doughty’s short-lived NFL career was a result of the South Carolina

training staff not taking Stanley’s injuries seriously. NFL doctors determined from

Doughty’s physical that he had such a severe spine injury that he could never play

football again because the risk of being paralyzed is too high. Stanley’s NFL contract

was terminated and he was sent back to the south leaving him with no medical

coverage. Doughty now is facing a $20,000 surgery that will come out of his own

pocket because he is no longer a scholarship athlete at the University of South

Carolina or an employee of the NFL. Doughty and his family were convinced that the

university, when they recruited him, was going to take care of him 100 percent of

the way (Walsh). Universities that bring in athletes and offer them full-scholarships

should be responsible to take care of them. Now Stanley, 23, has no job, no college

degree (because he entered the NFL draft prior to graduation), and no medical

coverage from South Carolina (Walsh).

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Also a story from the television show Real Sports talked about a man named

Harris, a former Washington University football player, who suffered multiple head

injures while playing. Harris was struggling trying to maintain a normal lifestyle

due to the lack of ability to focus and headaches and therefore went back to the

university for help. After Harris talked with the team doctor about the problems he

was having as a result of his injury, he had to pay out of pocket for the bill.

College athletes find out the hard way that their schools do not support them

after graduation. Some universities do not feel obligated to support athletes during

their college careers and most certainly do support former athletes.

Another athlete from the program came from Illinois State University and is

suffering a long-term spinal injury. He struggles to get up from the coach and has

had five spine injuries and likely will need more. Illinois State covered his injury

during school but after graduating he will not receive the same benefits. This 25-

year-old man is paying $10,000 a year in deductibles for his surgeries. These two

athletes do not deserve to continue to live a life that is constrained with physical

pain and financial problems. Host of the show, Bryant Gumble stated, “For NCAA

athletes typically once you are done with college the college is done with you…you

are not only stuck with the injuries you sustained but also the medical bill” (Real

Sports). This becomes a hard fact to swallow for these former athletes and shows

that equal compensation is needed for an extended period of time after a student

graduates.

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Conclusion

The NCAA may have requirements for athletes to have insurance, but there

are still student athletes that are stuck with excess medical payments. Schools offer

either full, partial, or no medical coverage, which is unfair to athletes because there

is little to no way to know which institutions provide support or not. Medical

coverage in the case of an injured should be given to all athletes during and after

their careers. However the ethical decision to cover athletes either willingly or not,

is made by all institutions and greatly impacts student-athlete’s lives. There needs

to be action taken by the NCAA to ensure equal support to all athletes. It is essential

that schools communicate medical insurance policies with recruited athletes.

Whether it is Division I or Division III, all athletes should be on an equal playing field

when it comes to financial support.

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Bibliography

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“California Governor Signs NCPA Student-Athletes Bill of Rights!” NCPAnow.org.

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Emmert, Mark. “When college athletes get hurt, whose wallet should feel the pain?”

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2015.

Jamieson, Dave. “Obama Calls On NCAA To Rethink The Way It Protects Athletes.”

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2015.

Sheely, Juanita. “Insurance Coverage for Student-Athletes.” NCAA.org. Web. 20 May.

2015.

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