NFL Collective Bargaining Agreement

Article 39
Players’ Rights To Medical Care and Treatment

Section 1
Club Physician

(a)Medical Credentials.

Each Club will have a board-certified orthopedic surgeon as one of its Club physicians (“Head Team Orthopedist”), and all other physicians retained by a Club to treat players shall be board-certified in their field of medical expertise. Each Club will also have at least one board-certified internist, family medicine, or emergency medicine physician (“Head Team Primary Care Sports Medicine Physician”). Each Club shall designate either its Head Team Orthopedist or its Head Team Primary Care Sports Medicine Physician as the “Head Team Physician.” Any Club medical physician (internist, family medicine or emergency medicine) or any Head Team Physician (orthopedic or primary care sports medicine) hired or appointed to that role after the effective date of this Agreement, must have one of the following:

  • i. A Certification of Added Qualification (CAQ) in Sports Medicine; or
  • ii. Certification by a current NFL Head Team Physician that the physician has:
    • a. Three (3) years affiliation with an NFL Club’s medical staff, during which the physician must have attended and participated in Training Camp(s), NFL Scouting Combine(s), and a minimum of sixteen (16) games (including preseason and away games); and
    • b. Comprehensive knowledge of the NFL Head, Neck and Spine Committee’s Concussion Protocol, the NFL Policy and Program on Substances of Abuse, the NFL Policy on Performance-Enhancing Substances, the NFL’s Behavioral Health Program, the NFL’s Pain Management Guidelines, the NFL’s policy on spinal injuries, the NFL Emergency Action Plan, the prevention, diagnosis and treatment of Heat-Related Illness; and the DICON Program for Infection Prevention in the NFL.

(b)Team Consultants.

All Clubs shall have consultants with the following certifications:

  • (i) Neurological: All Clubs are mandated to have a neurological consultant. The Club neurological consultant must be board certified in neurosurgery, neurology, sports medicine, emergency medicine, or physiatry (physical medicine and rehabilitation). If the designated physician is board certified in physiatry (physical medicine and rehabilitation), he/she must demonstrate extensive experience in mild and moderate brain trauma;
  • (ii) Cardiovascular: Board certified in cardiovascular disease;
  • (iii) Nutrition (athletes): licensed;
  • (iv) Neuropsychologist: Ph.D and certified/licensed;
  • (v) Behavioral Health Specialist (as set forth below); and
  • (vi) Pain Management Specialist (as set forth below).

Other physicians who may not meet the requirements set forth in Sections 1(a) and 1(b) of this Article may serve as Team Consultants, provided that they work under the supervision of an existing, qualified physician as set forth in Section 1(a).


The parties shall jointly appoint an independent, third-party credentialing organization to verify that the medical professionals appointed satisfy the requirements of this Article 39 possess the respective required medical credentials.

(d)Head Team Physicians.

Within an individual Club, either the Head Team Orthopedist or the Head Team Primary Care Sports Medicine Physician, as applicable, shall have the exclusive and final authority to determine whether a player is cleared to return to participation in football activities. All Club personnel involved in performance optimization activities and/or other health-related issues (e.g., strength and conditioning coaches and sports performance staff) shall keep the Head Team Physicians fully informed regarding their activities with Players and shall in no event take any measures inconsistent with Players’ medical care and management overseen by the Head Team Physicians. If the Head Team Physicians determine that any such areas involve medical care and management, the Head Team Physicians shall have the final authority to make, modify or override decisions in such areas. For the avoidance of doubt, this Subsection is not intended to impact a player’s right to obtain a second opinion as provided in this Article, the Grievance procedures in Article 43 and Article 44 of this Agreement, or the Injury Protection and Extended Injury Protection procedures in Article 45 of this Agreement.

(e)Medical Providers and Allegiance.

The cost of medical services rendered by Club physicians, Club Athletic Trainers, Physical Therapists, and other medical providers (together, “Club medical personnel”) will be the responsibility of the respective Clubs, but the Club medical personnel’s primary duty in providing player medical care shall be not to the Club but instead to the player-patient regardless of the fact that he/she or his/her hospital, clinic, or medical group is retained by the Club to diagnose and treat players. The Club medical personnel shall not disclose confidential player health information except as permitted. In addition, all Club medical personnel shall comply with all federal, state, and local requirements, including all ethical rules and standards established by any applicable government and/or other authority that regulates or governs the medical profession in the Club’s city. All Club physicians are required to disclose to a player any and all information about the player’s physical condition that the physician may from time to time provide to a coach or other Club representative, whether or not such information affects the player’s performance or health. If a Club physician advises a coach or other Club representative of a player’s serious injury or career threatening physical condition which significantly affects the player’s performance or health, the physician will also advise the player in writing. The player, after being advised of such serious injury or career-threatening physical condition, may request a copy of the Club physician’s record from the examination in which such physical condition was diagnosed and/or a written explanation from the Club physician of the physical condition.