My Player May be Hurt . . . What Do I Do?

Process to Follow When There is a Potential Head Injury (Follow the Flow Chart)

  1. When there is a possibility of a potential head injury or potential concussion, the player is immediately removed from ALL Scottsdale Soccer activities.  In order for any player to return to practices, games or team activities, they will have to be seen and cleared by a Medical Doctor (MD) or Doctor of Osteopathy (DO) with the Club supplied paperwork completed, signed and turned in.  This includes potential head injuries or potential concussions where ever they may have occurred (Examples: at home, during high school soccer, ODP, when traveling) even if it was not at or representing Scottsdale Soccer activities.

  2. Immediately notify the Scottsdale Soccer VP of Competitive, Brad Clement, at soccerhooha@cox.net of the potential injury.  It is important that notification is made immediately as there are insurance timelines and specialist care options available to injured players should you choose to utilize them.  Please include in your email:

  • The player's name
  • The player's team name
  • The date / place / time of the potential injury
  • The contact information (email & phone) of the player's parents
  • The particulars and circumstances of the player's potential injury
  1. Upon notification, you will receive the Scottsdale Soccer Concussion Injury PacketPlease print it out and bring it to all of your medical appointments.  You will need to have the Medical Doctor (MD) or Doctor of Osteopathy (DO) complete (initial and signthe appropriate section(s) of the Scottsdale Soccer Concussion Program:  Physician Clearance Form at each appointment.  You will need the Scottsdale Soccer Concussion Program:  Physician Clearance Form at each step throughout the process in order for the player to begin soccer activities again.

  2. Upon notification, you will also receive the Wells Fargo Play It Safe Supplemental Concussion Insurance Claim Form if the potential concussion injury occurred during Scottsdale Soccer approved events.  Scottsdale Soccer provides this concussion specific supplemental insurance to all of our Blackhawks Competitive Program players.  It works as a supplemental policy to your primary insurance, has no deductible and a $25,000 yearly limit.  The Scottsdale Soccer Concussion Injury Packet includes a Healthcare Provider Letter and Approved Procedure (CPT) Codes List to submit to any medical provider you see to activate the billing portion of the policy.  You must fill out the Wells Fargo Play It Safe Supplemental Concussion Insurance Claim Form, every question and every box in all sections, in its entirety and submit it yourself via fax to AIG at the number on the upper left of the form.  You have twenty (20) calendar days from the date of the incident to submit the claim form

IMPORTANT:  Please confirm insurance information with all providers you work with to manage coverage and expectations when an injury situation occurs.  Always ask your provider(s) what procedures / therapies / services may or may not be covered by this insurance as this insurance is a supplemental (limited pay) policy and does not cover all procedures / therapies / services / facilitiesOnly the procedures / therapies / services listed in the Approved Procedure (CPT) Codes List are covered with this policy.  Emergency room visits and transportation are not covered with this policy.

  1. Scottsdale Soccer has a working relationship with the Banner Concussion Center and they are specialists that deal with concussion injuries and concussion treatment.  They are very familiar with Blackhawks athletes and our supplemental insurance program.  Their information is also located within the Scottsdale Soccer Concussion Injury Packet and on our Club website, www.scottsdalesoccer.com, in the Concussion Program tab on the left side of the home page should you choose to use their medical services or would like to contact them with questions or for more information.  You are under no obligation or requirement to use their services and are free to choose the medical providers that fit your family's needs and insurance.

  2. If the Medical Doctor (MD) or Doctor of Osteopathy (DO) concludes that the player HAS NOT suffered a concussion and the player can return to athletic activities without restrictions, the Medical Doctor (MD) or Doctor of Osteopathy (DO) notates the finding, with the return date, in the Initial Evaluation Section of the Soccer Concussion Program:  Physician Clearance Form and signs the form.  The family brings the signed Scottsdale Soccer Concussion Program:  Physician Clearance Form back to their Coach at practice and submits a copy, via email, to the Scottsdale Soccer VP of Competitive, Brad Clement, at soccerhooha@cox.net and to Polly Robinson, the Club Registrar, at pollyrobinson1997@gmail.com.  The Coach or Team Manager can do this as well but it is important that we get this signed form back before a player will be allowed to return to any normal activities with the Club.  The player can then resume practice / game / team activities as advised by the Medical Doctor (MD) or Doctor of Osteopathy (DO) once the paperwork has been received.  This concludes the process.

  3. If the Medical Doctor (MD) or Doctor of Osteopathy (DO) concludes that the player HAS suffered a concussion, the Medical Doctor (MD) or Doctor of Osteopathy (DO) notates the finding, with a follow-up appointment date, in the Initial Evaluation Section of the Soccer Concussion Program:  Physician Clearance Form and signs the form.  The family keeps the Scottsdale Soccer Concussion Program:  Physician Clearance Form and uses it to notate the Follow-Up Evaluation Section at each follow-up appointment and throughout the treatment process.  Depending on the individual and the severity of the concussion, this process can take a significant amount of time and encompass multiple follow-up visits with a provider. 

  4. When the Medical Doctor (MD) or Doctor of Osteopathy (DO) concludes that the player has reached the second box in the Follow-Up Evaluation Section on the Scottsdale Soccer Concussion Program:  Physician Clearance Form, the Medical Doctor (MD) or Doctor of Osteopathy (DO) is stating that the player is ready to return to a segmented and sequential level of activity by following the Scottsdale Soccer Return to Play Progression (5 Stages), starting with Stage 1. 

IMPORTANT:  Players cannot start the Scottsdale Soccer Return to Play Progression (5 Stages) until they are cleared to do so by their Medical Doctor (MD) or Doctor of Osteopathy (DO) and not before the date the Medical Doctor (MD) or Doctor of Osteopathy (DO) lists on the form.  Each Stage will last a minimum of twenty-four (24) hours between each Stage without symptoms.  If symptoms remain or occur, there is no advancement to the next Stage until there is twenty-four (24) hours between each Stage without symptoms. 

On the Scottsdale Soccer Return to Play Progression (5 Stages) Form, each Stage must be initialed by the adult who supervised its completion, the date the Stage was completed and the location where the Stage was completed.  To help in player participation and compliance, all Stages should be administered during the player’s normal practice schedule and at the practice location with their team, when appropriate.  The player's Coach would communicate and / or set-up the appropriate Stage activities (walking, jogging, running, skill-work, etc . . .) for the player to complete independently (Stage 1, 2 & 3), non-contact practice for the player that is communicated to the team (Stage 4) and full contact, normal practice activities after medical clearance (Stage 5).  Before reaching Stage 5, the player must be seen by their Medical Doctor (MD) or Doctor of Osteopathy (DO) to be cleared to move on to Stage 5.  Stage 4 and Stage 5 must be completed in a practice session.  This may extend the Return to Play timetable if the player's practice session has been concluded for the week before reaching one or both of these Stages.  Game warm-up is not an acceptable alternative to a practice session. 

  1. Only when the Stage 5 progression has been successfully completed will the Medical Doctor (MD) or Doctor of Osteopathy (DO) clear the player, with a return to full athletic activity without restrictions date, in the third box of the Follow-Up Evaluation Section on the Scottsdale Soccer Concussion Program:  Physician Clearance Form and sign the form. The family brings the signed Scottsdale Soccer Concussion Program:  Physician Clearance Form AND the signed Scottsdale Soccer Return to Play Progression (5 Stages) Form back to the Coach at practice and submits a copy, via email, to the Scottsdale Soccer VP of Competitive, Brad Clement, at  soccerhooha@cox.net and to Polly Robinson, the Club Registrar, at pollyrobinson1997@gmail.com.  The Coach or Team Manager can do this as well but it is important that we get both of these signed forms back before a player will be allowed to return to any normal activities with the Club.  The player can then resume practice / game / team activities as advised by the Medical Doctor (MD) or Doctor of Osteopathy (DO) once the paperwork has been received.  This concludes the process. 

 

 

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