The Pac-12’s big maybe

Boy, if there was ever a “devil is in the details” proposal, this is it.

The Pac-12 is believed to be the first conference to direct schools to pay post-college medical costs for sports-related injuries that an athlete suffered at their school. What eligibility criteria is used by Pac-12 schools will help determine how much help former athletes receive and at what costs without people abusing the benefit. The new practice could also set a blueprint for the NCAA or other conferences to follow or avoid.

Pac-12 schools must provide direct medical expenses for at least four years following the athlete’s graduation or separation from the university, or until the athlete turns 26 years old, whichever occurs first. The timeframe for coverage was chosen in part because by the age of 26 a person is covered by the Affordable Care Act.

There’s a “but” coming, I can feel it.

Each school will establish its own policies and procedures to determine who is eligible for the benefit. The conference office has no role in oversight, leaving Pac-12 schools to figure out the best approach.

Let the head scratching commence.

“It’s going to be hard to calculate,” Washington athletic director Scott Woodward said. “When was the injury created? How will we do it? We want to do the right thing and try to help out, and wherever it lands I’m going to support it. But I’m not sure right now what that is.”

The Pac-12 bylaw states that a school’s policies to determine eligibility “may include the required disclosure of pre-existing conditions not related to participation in intercollegiate athletics, mandatory reporting of injuries suffered during athletics participation at the institution, required participation in an exit physical upon graduation or separation from the institution, and other criteria that an institution deems appropriate.” In other words, Pac-12 schools are on their own to figure this out.

“It’s such a difficult thing to wrap your head around because what’s continuation of a problem and what’s a new problem?” Arizona athletic trainer Randy Cohen said. “How do you handle people who continue to do activities and maybe you recommend they don’t continue doing that? We really want to take care of these kids. But at what point is it the risk of playing sports and having injuries versus we hurt you?”

Most likely, Pac-12 schools will use exit medical evaluations of players to determine eligibility and buy insurance policies that carry stipulations, such as for in-network and out-of-network coverage. However, Cohen said finding insurance to cover an injury for four years out is difficult because most providers want a condition treated within two years. Cohen said Arizona will likely add four years to its insurance plan at a cost of a couple hundred thousand dollars a year, and require that for athletes to have costs covered they show a preexisting injury, undergo a departing physical when leaving the college, and demonstrate they followed recommendations for their health.

Cohen, who chairs the college committee for the National Athletic Trainers’ Association, rattles off potential challenges to managing the Pac-12 rule. What if an ex-player elects for surgery against the wishes of medical experts who say surgery will only make the injury worse? Is the school responsible for that surgery and if the injury worsens? Does the university get portrayed as the bad guy in the media if the former player tells the public the school wouldn’t pay its costs?

How should caring for mental health related to concussions be treated? If a school agrees with research that shows hits to the head can cause long-term brain damage, that degenerative process might not occur until after the Pac-12’s four-year window. So should there be payments to the athlete if dementia occurs 20 years later?

What if a gymnast tore an ACL in college that leaves her with an arthritic knee, she runs marathons two years later, and tells the school her knee is bothering her and needs to be treated? Then what if a 225-pound football player left college saying his knee felt fine, blew up to 300 pounds after his career ended and has a bad knee while mainly sitting on the couch?

“Do I not take care of the girl when she’s exercising and making it worse, but I take care of the guy who’s doing absolutely nothing and gaining 75 pounds?” Cohen asked. “Most people logically would say if you’re doing something that aggregates the knee, don’t pay them. But on the other end, if the guy does nothing to help his knee, how do I balance those two? We don’t want to encourage people not to have active lives after they’ve stopped playing. I don’t have an answer to that.”

At some point in time, you figure these guys are just gonna throw up their hands and decide it’ll be easier to deal with a players’ union.

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