The USTA’s Medical Appeal Form starts out with a philosophy statement. “Very few medical appeals should be granted, as it is usually better to let the computer determine the NTRP Skill Level based on actual match play.” The opening statement that “Very few medical appeals should be granted” creates a paradox.
That statement is clearly intended to manage player expectations that the medical appeal is likely to be denied. At the same time, it might also cause people with questionable cases to abandon the application altogether. If that regularly transpires, and only the most compelling medical appeal cases are submitted to the Section office, then it could very well be the case that significantly more than “very few” are granted.
The following criteria for filing a medical appeal are printed directly on the USTA’s Medical Appeal form:
Medical Appeal Criteria from the USTA League Medical Appeal Form
- The permanently disabling injury or illness must have occurred after the last match played prior to the publication of the most current Year End or Early Start NTRP rating level.
- The Medical Appeal request and completed USTA League NTRP Medical Appeal Form must be submitted in writing to the player’s USTA Section League Coordinator or designee who will in turn forward to the Chair of the designated Medical Review Committee.
- The Medical Appeal must be accompanied by an Attending Physician’s Statement (APS) that is written by the physician who is treating the player for the specific injury/illness being appealed. The APS must include a current evaluation of the injury or illness, all substantiating information, a prognosis for recovery with a timeline and any permanent limitations the player currently has.
In fact, the medical appeal form itself has brought me to the conclusion that the vast majority of situations that people regard as “ridiculous medical appeals” were likely never granted as such. For example, in “Permanent Injury or Illness” I wrote about a hot rumor from multiple sources that a guy was granted a medical appeal because he wasn’t getting enough sleep due to his newborn baby.
The medical appeal form has a box labeled “Describe the current permanently disabling injury or illness” where the player has to describe their condition. I can’t imagine a person with the chutzpah to write that their permanently disabling injury was an inability to sleep due to a newborn baby in that box. The player is also required to indicate in writing if and how they have been treated for the condition.
Per the criteria published by the USTA, each player’s medical appeal form must have a supporting Attending Physician’s Statement. Otherwise, the application is not complete and will not be considered. A medical doctor is required to describe the condition including separate boxes for both short and long-term diagnoses. The attending physician is also required to describe any permanent limitations of the patient. As if that isn’t enough, there is an explicit “Yes or No” checkbox on whether the patient can ever expect a full recovery.
Getting a medical appeal form that is accepted by the player’s local Section office pretty much requires either a permanently disabling condition or for both the player and the doctor to lie repeatedly. Additionally, per USTA policy the Section office cannot unilaterally grant a medical appeal.
A player’s League NTRP Medical Appeal will be reviewed and considered by the appropriate Medical Review Committee as designated by the player’s Section. The Committee will either deny the appeal or refer it to the USTA League National Medical Appeal Committee for further consideration. If the Section’s designated Medical Review Committee denies the appeal, their decision is final and binding. If the appeal is referred to the USTA League National Medical Appeal Committee, that committee will make the final decision to either approve or deny the appeal. All decisions of the USTA League National Medical Appeal Committee will be final and binding.
Medical Review Committee Procedures from the USTA League Medical Appeal Form
Medical appeals require approval by the Medical Review Committee at both the Sectional and National levels. Considering that, along with the medical information that would have to be submitted, there is simply no way the USTA granted a medical appeal based on inability to sleep due to a newborn baby.
I also have arrived at a similar conclusion about whether actual medical appeals have been granted to players who are overweight even to the point of obesity. I would be shocked to find a competent and ethical physician who would sign off that obesity is a permanent untreatable medical condition.
I think that part of the confusion is rooted in the fact that there are actually three types of appeals that can be granted. The USTA marks appealed ratings with the scarlet “(A)” but doesn’t denote what type of appeal was in fact granted.
Appealed Rating (A): A player receives an Appealed Rating when they are granted a request to play at a higher or lower level of play. Types of appeals include: medical appeals, automatic appeals, and committee reviewed appeals.
Definitions Section from USTA NTRP Questions and Answers Webpage
Automatic appeals are when a player’s new rating is in the NTRP algorithm’s calculated error margin. That appeal is instantly available by simply pressing a button on the player’s profile. Medical appeals involve filling out the forms that I have been yammering about in this post as well as a positive disposition by the Sectional and National Medical Appeal committees.
The third category of appeals is described as “committee-reviewed.” I am not sure exactly what that entails. I suspect that it is related to when a player “corrects” their self-rating. I think that committee-reviewed can also potentially arise from some grievance situations.
I knew this topic would be a can of worms. The more I think about it, the wormier it appears to be.
- USTA League Medical Appeal Form, USTA Hosted Resource Document, Downloaded November 19, 2022.
- Attending Physician’s Statement Form, USTA Hosted Resource Document, Downloaded November 19, 2022.
- USTA NTRP Questions and Answers, USTA Informational Web Page, viewed November 19, 2022.
