ERISA Fiduciary Status and Medical Advisory Physicians: New Jersey Court Dismisses Breach Claims Against NFL Disability Plan Doctors

In Glaud v. NFL Player Disability and Survivor Benefit Plan, No. 25-cv-15373-ESK-EAH, 2026 WL 2664386 (D.N.J. Sept. 10, 2026), United States District Judge Edward S. Kiel dismissed with prejudice two ERISA breach-of-fiduciary-duty claims against the physicians who reviewed a former NFL player’s neurocognitive disability claim. The court held that the plan’s medical advisory physicians (MAPs) are not ERISA fiduciaries because they exercise only medical judgment on discrete referred questions, while the plan’s disability board retains exclusive discretion over benefit entitlement and plan interpretation. For anyone with an ERISA-governed disability claim who suspects that a medical reviewer drove the denial, the decision draws a sharp line between advising a plan and administering it.

When is a medical reviewer an ERISA fiduciary?

ERISA defines a fiduciary in functional terms: a person is a fiduciary to the extent he exercises discretionary authority or control over plan management, renders investment advice for a fee, or has discretionary responsibility in plan administration. A party not named as a fiduciary can still qualify as a functional fiduciary if he has authority to grant, deny, or review claims. But fiduciary status does not attach to someone who merely performs ministerial duties, processes claims, or advises the plan’s trustees. To cross from advisor to fiduciary, a professional must exercise an unusual degree of influence over the plan.

What authority did the plan give the medical advisory physicians?

Plaintiff applied for neurocognitive disability benefits, and after the initial claims committee denied the claim, he appealed to the disability board. The board is the plan’s administrator and named fiduciary, with full and absolute discretion to interpret the plan and decide benefit claims. When at least three board members identify a medical issue bearing on benefits, they may refer that discrete issue to a MAP. Here, the board referred to Dr. William Garmoe and Dr. Silvana Riggio the question of whether Plaintiff acquired neurocognitive impairment. The two physicians issued a written report finding Plaintiff’s neurocognitive scores invalid and uninterpretable, concluding they could not determine whether he met the impairment criteria. The board later voted to deny the appeal and adopted that conclusion in its final denial letter.

Why did the court hold the physicians were not fiduciaries?

The court found no factual dispute about what authority the plan assigned to the MAPs, which made fiduciary status a question of law. The plan gives the board, not the MAPs, authority to administer the plan and decide benefit claims. The MAPs decide only the medical issues submitted to them, and although a MAP’s decision is final and binding on that referred medical issue, the plan reserves to the board full and absolute discretion over plan interpretation and benefit eligibility. The court reasoned that Garmoe and Riggio did not determine whether Plaintiff’s claim would be approved or whether plan assets would be paid. They resolved only the discrete medical question referred to them and served as medical consultants advising the board. Courts have consistently refused to treat professionals as fiduciaries when all they have done is advise the trustees of an ERISA plan.

Did the physicians’ alleged pattern of denials change the analysis?

Plaintiff argued that Garmoe and Riggio wielded undue influence because they co-authored the orientation manual for the plan’s neutral physicians and routinely ignored evidence of neurocognitive impairment. The court rejected both points. It found it unclear how authorship of a manual governing neutral physicians established fiduciary authority in the physicians’ distinct capacities as MAPs, noting that the plan itself sets the eligibility criteria. As for the alleged history of unfavorable determinations, the court held that such conduct concerns how the physicians exercised medical judgment; it does not expand the authority the plan conferred or create discretionary authority over plan administration.

What was the outcome?

Because fiduciary status is a threshold prerequisite to the breach claims, the court granted the motion and dismissed counts two and three with prejudice, without reaching the defendants’ remaining arguments about plan-level loss, the sufficiency of the alleged breaches, or the futility of amendment. Count one, Plaintiff’s claim against the plan for payment of benefits, was not before the court on this motion and remains pending.