Medical Hardship/Disqualification for a NCAA athlete, what to do?
When the collegiate student-athlete suffers an injury or illness that will limit or prevent their athletic participation for the remainder of a competitive season or longer, the issue of medical hardship or disqualification comes up. The NCAA has specific rules governing these medical situations. Health care professionals who take care of collegiate student-athletes need to be familiar with these rules because their assessment and disposition is often pivotal in whether the student-athlete’s request for additional athletic participation time is granted.
There are many terminologies for these situations such as medical exemption, medical extension, medical hardship, medical non-counter, and medical disqualification. The difference in terminology is due to the length of time a student-athlete is incapacitated and the timing of the injury or illness.
The medical hardship waiver can be requested to the appropriate conference or to the NCAA if the institution is an independent. The following situation must be met per NCAA rules: a) the incapacitating injury or illness occurs either during the senior year of high school or during one of the four seasons of intercollegiate competition, b) the injury or illness occurs prior to the first half of the playing season that concludes with the NCAA Championship in that sport, and c) the student-athlete has not participated in more than two contests or 20% of the scheduled contests (whichever is greater).
A similar request is to waive the five-year period of eligibility and extend a sixth year. This requires two out of five years of circumstances beyond the control of the student-athlete. An incapacitating medical circumstance would be one example of a qualifying condition. A voluntary redshirt year would not.
A medical disqualification or medical non-counter is a different situation. This involves a medical condition in which the student-athlete is advised to not ever further participate in intercollegiate athletics. If this situation is approved, the student-athlete may retain their grant-in-aid at the discretion of the institution for the remainder of their four to five year college experience. The next academic year, the student-athlete doesn’t count toward the maximum number of grants allotted to a team. If the student-athlete subsequently practices or returns to competition at that institution, he or she will “count” the entire inactive period unless a waiver is granted by the NCAA Management Council.
Providing contemporaneous medical documentation is essential to any of these situations. What does contemporaneous medical documentation mean? The NCAA defines this documentation as; a) including a diagnosis or description of the student-athlete’s injury or illness at the time of the injury or illness, and b) demonstrating that the injury or illness is incapacitating. This documentation has become increasingly confusing to institutions, conferences, and the NCAA reinstatement committees.
Which records are needed? It depends on the situation. That is where the vagueness resides. There has been discussion at the committee level at the NCAA to create a standardized medical documentation threshold. The goal of this would be to encourage consistent medical documentation at the time of injury or illness and the subsequent decision to medically restrict or disqualify the student-athlete.
Trying to go back sometimes years and find documentation to support an extension request can be difficult to impossible. Situations that required immediate surgery are easy. Its illnesses including mental illness, and injuries that surgery was delayed that are more difficult to properly describe.
Good record keeping, particularly in the training room is critical. Documentation inconsistencies or lapses can undermine the best of intentions. How participation during the convalescent phase is documented is of the utmost importance. The term “full participation” or “full clearance” implies that the student-athlete has healed and is ready for competition. Just because the coach doesn’t play the student-athlete means he or she is still incapacitated if the student-athlete is fully cleared by the medical staff. Return to play documentation in the medical chart should be reserved for the sports medicine staff, not consultants or students working in sports medicine. Designating one individual on the staff such as the director of sports medicine or the head team physician to review all cases to be submitted for medical redshirt or disqualification can create consistency in reporting.
When the student-athlete suffers an incapacitating injury or illness be it temporary or permanent, it’s a stressful time for all involved. Health care professionals need to be prepared in not only these situations but all situations to deliver accurate, precise medical documentation that will not only assist in the treatment of the student-athlete but possibly help them regain some of the missed time from their sport.
Just last night, the greatest player in the game suffered a serious injury, Kobe Bryant. Kobe after the game went on his Facebook account and posted this;
This is such BS! All the training and sacrifice just flew out the window with one step that I’ve done millions of times! The frustration is unbearable. The anger is rage. Why the hell did this happen ?!? Makes no damn sense. Now I’m supposed to come back from this and be the same player Or better at 35?!? How in the world am I supposed to do that??
I have NO CLUE. Do I have the consistent will to overcome this thing? Maybe I should break out the rocking chair and reminisce on the career that was. Maybe this is how my book ends. Maybe Father Time has defeated me…Then again maybe not! It’s 3:30am, my foot feels like dead weight, my head is spinning from the pain meds and I’m wide awake. Forgive my Venting but what’s the purpose of social media if I won’t bring it to you Real No Image?? Feels good to vent, let it out. To feel as if THIS is the WORST thing EVER! Because After ALL the venting, a real perspective sets in. There are far greater issues/challenges in the world then a torn achilles. Stop feeling sorry for yourself, find the silver lining and get to work with the same belief, same drive and same conviction as ever.
One day, the beginning of a new career journey will commence. Today is NOT that day.
“If you see me in a fight with a bear, prey for the bear”. Ive always loved that quote. Thats “mamba mentality” we don’t quit, we don’t cower, we don’t run. We endure and conquer.
I know it’s a long post but I’m Facebook Venting LOL. Maybe now I can actually get some sleep and be excited for surgery tomorrow. First step of a new challenge. Guess I will be Coach Vino the rest of this season. I have faith in my teammates. They will come thru.
Thank you for all your prayers and support.
Much Love Always.
Bryan W. Smith, M.D., Ph.D., FAAP
Bryan is the medical consultant for the Atlantic Coast Conference