CTE Cannot Be Confirmed Until After Death — Here Is What That Means for Your Family

If someone you love played college football and is now struggling with memory loss, mood swings, or cognitive decline, you may have wondered whether CTE is the cause. The honest answer is that no test available today can confirm a CTE diagnosis in a living person. Understanding why — and what options do exist — is the first step toward getting answers and knowing whether a legal claim is worth pursuing.

Why CTE Can Only Be Diagnosed After Death

Chronic traumatic encephalopathy is a progressive brain disease caused by repeated head trauma. The defining feature of CTE is an abnormal accumulation of tau protein in specific patterns throughout the brain tissue. Currently, the only way to observe those patterns with certainty is through direct examination of brain tissue under a microscope — which means a post-mortem autopsy performed by a neuropathologist with expertise in this disease.

 

This is not a limitation of any single hospital or research center. It reflects where the science stands today. No blood test, MRI, or CT scan can yet confirm CTE in a living person with the specificity required for a clinical diagnosis. Families are often left managing real, worsening symptoms without a confirmed name for what is happening.

What a Post-Mortem CTE Diagnosis Actually Involves

When a former football player dies, a CTE diagnosis can be established through a specialized neuropathological examination of the brain. This is not a routine hospital autopsy. It requires a facility with trained neuropathologists who know what they are looking for and how to prepare and stain tissue samples correctly.

 

The process generally involves:

 

  • Removal and preservation of the brain at the time of death
  • Fixation of the tissue over several weeks before examination
  • Sectioning and staining of brain tissue to reveal tau deposits
  • Neuropathological grading of CTE severity (Stage I through Stage IV)
  • A written report confirming or ruling out the diagnosis

 

The Boston University CTE Center, affiliated with Boston Medical Center, has examined more than 1,000 donated brains and remains the most widely recognized institution for this work. Their findings have been published in peer-reviewed journals and have been cited in litigation, legislation, and federal policy discussions.

How to Donate a Brain for CTE Research

Brain donation is a decision families make in advance — ideally while the former player is still living and can express his own wishes. The process is straightforward, there is no cost to the family, and donation does not prevent an open-casket service.

 

If your family is considering brain donation:

 

  • Contact the Boston University CTE Center or the VA-BU-Concussion Legacy Foundation Brain Bank directly to register
  • Inform the treating physician and hospital in advance so staff know to contact the brain bank immediately at the time of death
  • Time matters — the brain should be removed and preserved within hours of death for optimal tissue quality
  • Families typically receive a written neuropathological report within several months of donation

 

Registration can be completed online through the Concussion Legacy Foundation's brain donation program. Donation serves both science and, in many cases, the family's legal case — a confirmed post-mortem diagnosis is among the strongest forms of evidence in NCAA concussion litigation.

In-Life Diagnosis: Traumatic Encephalopathy Syndrome

Because families cannot wait for a post-mortem confirmation to seek help — legal or medical — researchers developed a clinical framework for diagnosing probable CTE in living patients. That framework is called traumatic encephalopathy syndrome, or TES.

 

In 2021, a panel of neurologists and neuropathologists published consensus diagnostic criteria for TES in the journal Nature Reviews Neurology. TES is diagnosed based on:

 

  • A documented history of repetitive head impacts (such as years of college or professional football)
  • Progressive neurological or psychiatric symptoms including memory loss, impulsivity, depression, aggression, or cognitive decline
  • Ruling out other conditions that could better explain the symptoms
  • Specific patterns of symptom onset and progression consistent with known CTE pathology

 

A TES diagnosis does not confirm CTE with certainty. It identifies a clinical presentation that is consistent with the underlying disease. In litigation, TES diagnoses from qualified neurologists — combined with documented exposure history — have been used to establish that a living plaintiff is more likely than not suffering from CTE-related brain disease.

What Families Should Document While a Player Is Still Living

If you are caring for a former college football player who is showing symptoms, there are concrete steps you can take now that will matter both medically and legally.

 

  • Keep a written log of behavioral and cognitive changes, including dates, specific incidents, and who witnessed them
  • Request neuropsychological testing through a neurologist or memory specialist — results become part of the medical record
  • Gather football records: game programs, newspaper clippings, team rosters, athletic department correspondence, and any medical records from the playing years
  • Preserve any communications from the NCAA, the player's university, or team medical staff regarding head injuries or return-to-play decisions
  • Ask treating physicians to document the player's exposure history — years played, position, number of concussions reported — in the clinical notes

 

This documentation serves multiple purposes. It supports a TES or related clinical diagnosis. It establishes the exposure history that sits at the center of any NCAA brain injury claim. And it protects the family's legal options if the player's condition worsens or if he does not survive.

How a CTE Diagnosis — Post-Mortem or Clinical — Affects a Legal Case

A confirmed post-mortem CTE diagnosis is powerful evidence in litigation against the NCAA. It establishes the disease that the NCAA's own internal research acknowledged as a risk of repeated head trauma — and it directly connects the player's history of college football to a recognized, progressive brain disease.

 

A clinical TES diagnosis in a living player is not the same as a confirmed CTE diagnosis, but it is not without legal weight. Our attorneys have worked with leading neurologists and neuropathologists to present in-life clinical evidence in NCAA concussion cases. The Geathers v. NCAA verdict — the first jury verdict against the NCAA for latent CTE in a former college football player — was built in part on the kind of clinical and scientific evidence families can begin gathering today.

 

Courts have also addressed when the limitations clock starts running on these claims. The Ohio Supreme Court's decision in Schmitz v. NCAA established that a player's awareness of in-career head injuries is not enough to start the statute of limitations for a latent CTE claim. That ruling protects families who did not know — and could not have known — that the symptoms appearing years later were connected to football.

Frequently Asked Questions About CTE Diagnosis

  • Can families sue the NCAA after a loved one receives a posthumous CTE diagnosis?

    Yes. If a former college football player is diagnosed with CTE after death through neuropathological examination, surviving family members can bring wrongful death and survival claims against the NCAA. The posthumous diagnosis is often the clearest evidence of the disease, and we have significant experience building these cases on behalf of families.

  • How long does a CTE lawsuit against the NCAA take?

    These are complex cases that typically take several years from filing to trial. Case development involves gathering medical records, athletic department records, game film, and deposition testimony. We are transparent about timelines from the start, and we do not file cases we are not prepared to take to verdict.

  • Does CTE have to be confirmed before we can file a lawsuit?

    Not always. We evaluate cases involving dementia, ALS, Parkinson's, and Alzheimer's in former college football players, even without a confirmed CTE diagnosis. The underlying mechanism — repetitive head impacts during a player's college career — is the same, and the NCAA's failure to protect players is equally relevant.

  • What does it cost to hire Langfitt PLLC for a CTE lawsuit?

    We handle these cases on a contingency fee basis. There are no upfront costs and no fees unless we recover on your behalf. Because we invest substantially in case development, we evaluate each inquiry carefully and accept roughly one in ten cases.

  • Is it too late to file if the player has been symptomatic for years?

    It depends on the state and the specific facts. The discovery rule — affirmed for NCAA concussion cases by the Ohio Supreme Court in Schmitz v. NCAA — means the limitations clock often does not start until a player or family knew or reasonably should have known about the connection between football and the brain disease. Contact us before drawing your own conclusions about timing.

  • What if the player competed in college football but never played professionally?

    College-only players are precisely who these lawsuits are designed for. The NCAA's duty to protect players ran to everyone who competed under its rules — not only those who went on to professional careers.

  • How long do I have to sue the NCAA for a concussion or CTE-related injury?

    There is no single answer — it depends on the state where the claim will be filed and, critically, when the discovery rule clock started running for your specific situation. In most states, the limitations period is one to three years from the date of discovery. Because CTE and related diseases are latent injuries, courts have consistently held that the clock does not start until the player or family knew or reasonably should have known about the injury and its cause. Contact us to discuss the specific facts of your case before assuming time has run out.

  • My husband played college football in the 1980s. Is it too late to file a lawsuit?

    Not necessarily. The discovery rule exists precisely for situations like this. If your husband has recently been diagnosed with CTE, dementia, ALS, Parkinson's, or Alzheimer's — or if he has been experiencing symptoms that are now being connected to his football career — the limitations period may not have begun to run until recently. The Ohio Supreme Court's decision in Schmitz v. NCAA confirmed that knowledge of in-career hits alone does not start the clock for a latent brain injury claim.

  • What is the discovery rule and how does it apply to football brain injury cases?

    The discovery rule is a legal doctrine that delays the start of the statute of limitations until the injured person knew or reasonably should have known that they had a compensable injury caused by another party's conduct. In football brain injury cases, this typically means the clock starts when a former player or his family connects a neurological diagnosis to the head trauma he sustained during his playing career — not when the hits occurred, and not when the first vague symptoms appeared.

  • My father passed away and was diagnosed with CTE after death. Can we still file a lawsuit?

    Surviving family members may have both wrongful death and survival claims, and those claims carry their own limitations periods. A post-mortem CTE diagnosis is significant evidence, and the discovery rule may apply to the family's claims based on when they received that diagnosis and understood its cause. These cases are time-sensitive, and the analysis is fact-specific. We encourage families in this situation to contact us as soon as possible.

  • Is it too late to file a CTE lawsuit if the player never received a formal diagnosis during his lifetime?

    A formal CTE diagnosis is not always required to pursue a claim, particularly where a player exhibited clear symptoms consistent with CTE or a related neurological condition. Courts have allowed claims to proceed based on clinical evidence of neurological decline tied to a history of repetitive head trauma. The limitations analysis in these cases focuses on when the player or family had enough information to connect the symptoms to football-related injury — and that question requires a careful, case-by-case review.

  • Does the Arrington NCAA settlement pay money to former players for brain injuries?

    No. The Arrington settlement established a medical monitoring program — it pays for neurological screenings, not for damages caused by brain injuries already suffered. Former players who participated in the class did not receive individual compensation for cognitive decline, dementia, lost income, or pain and suffering.

  • Can I still sue the NCAA individually if I was part of the Arrington class?

    It depends on your specific circumstances, including the scope of the release you agreed to and when your neurological condition was diagnosed. Participating in medical monitoring does not automatically bar an individual personal injury lawsuit, particularly if your diagnosis came after the settlement was finalized. This requires a case-specific legal analysis.

  • What does the discovery rule mean for my statute of limitations?

    The discovery rule holds that your limitations period begins when you knew — or reasonably should have known — that your neurological condition was caused by football-related head trauma. In Schmitz v. NCAA, the Ohio Supreme Court held that a player's mere knowledge of in-career hits was not enough to start the clock. For many players receiving recent diagnoses, the limitations period has not yet run.

  • What is the difference between the NCAA concussion settlement and an individual lawsuit?

    The Arrington class settlement provides medical monitoring — periodic neurological screenings at no cost. An individual lawsuit is a personal injury action seeking compensatory and punitive damages for the harm already done: medical expenses, lost income, pain and suffering, loss of consortium, and more. The $18 million Geathers verdict is an example of what individual litigation can achieve. No class settlement offers that.

  • How do I know if I have a viable individual claim against the NCAA?

    The core factors are a documented neurological diagnosis connected to a college football career, a timeline that survives statute of limitations analysis, and facts sufficient to establish the NCAA's duty and breach. We evaluate every inquiry carefully and will tell you directly what we believe. Contact us to start that conversation.

  • Can I sue the NCAA if my husband played college football and later died by suicide?

    Yes, in many circumstances. Research has established a documented link between CTE and impulsive behavior, depression, and suicide. If your husband played college football, exhibited neurological or behavioral symptoms in the years before his death, and his brain was examined or his history is consistent with CTE, a wrongful death or survivor claim against the NCAA may be viable. The statute of limitations question is fact-specific and depends on when the connection between his condition and his football career was or should have been discovered — which is something we assess in every intake.

  • My father was never formally diagnosed with CTE. Can we still file a claim?

    A formal CTE diagnosis is not required to file a lawsuit. CTE can only be confirmed after death through neuropathological examination, so the absence of a clinical diagnosis during a player's lifetime is expected, not disqualifying. Claims can be built around documented symptoms, medical records, family testimony, and expert opinion. If your father's brain was not examined after his death, that does not automatically foreclose a claim — it changes how the case is constructed.

  • How long do we have to file after a former player dies?

    The statute of limitations for wrongful death and survivor claims varies by state and depends heavily on when the family knew or should have known that the player's death or decline was connected to his football career. The discovery rule — which our firm helped establish as controlling law in the Ohio Supreme Court's Schmitz v. NCAA decision — means the clock does not necessarily start at the time of death or even at the time of diagnosis. We urge families not to assume their time has passed without speaking with us first.

  • What damages can a surviving spouse or family recover?

    Damages in wrongful death and survivor claims can include loss of consortium and companionship, loss of financial support, medical and care expenses incurred during the player's decline, funeral and burial costs, and in appropriate cases, punitive damages aimed at the NCAA's institutional conduct. The $8 million loss of consortium award to Debra Geathers in the Geathers v. NCAA verdict illustrates what juries are willing to award when they understand the full human cost of the NCAA's failures.

  • Do we need to have the player's brain examined for CTE before contacting you?

    No. If the player has already passed away and brain donation was not pursued, that decision does not bar a claim. We work with families from wherever they are in this process. If brain examination is still an option and the family is open to it, we can discuss how that intersects with litigation. If it is not, we evaluate what other evidence exists. Contact us before drawing any conclusions about what your family's options are.

  • What is the earliest documented evidence that the NCAA knew about concussion dangers?

    The NCAA's own 1933 medical handbook addressed head trauma in football. By 1958, the NCAA Sports Injury Committee was formally studying the relationship between repeated head impacts and lasting neurological harm. These are the organization's own records, not outside critiques.

  • Did the NCAA ever admit it had a duty to protect players?

    In sworn deposition testimony across multiple cases, NCAA executives — including Chief Medical Officer Brian Hainline — have acknowledged the organization's awareness of the concussion problem. Those admissions are part of the evidentiary record we have built over more than a decade of litigation.

  • Did the NCAA hide the dangers of concussions from players?

    The evidence shows a sustained gap between what the NCAA knew institutionally and what it disclosed to players and enforced through its rules. Whether that gap constitutes fraudulent concealment is a question resolved case by case, but the underlying pattern — awareness without action — is documented across decades of internal records.

  • How does the NCAA's history of knowledge affect my legal claim?

    It is foundational. Negligence requires proving that the NCAA had a duty, breached it, and that the breach caused your injury. The organization's documented awareness of head injury risks, combined with its failure to implement enforceable protections, goes directly to duty and breach. The longer and more clearly documented that awareness is, the stronger those elements of the claim become.

  • What is the statute of limitations for an NCAA concussion lawsuit, and does the NCAA's concealment affect it?

    The limitations period varies by state, but the discovery rule — confirmed by the Ohio Supreme Court in Schmitz v. NCAA — holds that the clock does not start running until a player knew or reasonably should have known that their neurological condition was linked to their football career. If the NCAA's failure to warn contributed to that delay in understanding, it is relevant to the limitations analysis. We evaluate the timeline carefully in every case we review.

  • Do I need a CTE diagnosis to file a lawsuit against the NCAA?

    No. A formal CTE diagnosis is not required to pursue a claim. Because CTE can only be confirmed definitively at autopsy, courts have recognized that living players can file based on clinical symptoms and documented neurological decline. A diagnosis of dementia, cognitive impairment, or mood disorders consistent with CTE — documented by a physician — can support a viable case.

  • My father played college football in the 1970s and died two years ago. Is it too late to file?

    It may not be. The statute of limitations for latent CTE claims typically runs from the point when the family knew or reasonably should have known that the condition was connected to football-related brain injury — not from the date of death or the end of the player's career. We assess each family's timeline individually and will tell you directly whether a claim appears viable.

  • Does it matter what division or position my family member played?

    Division I, II, and III players are all potentially eligible. Position matters less than people expect — linemen and special-teams players who absorbed years of repetitive sub-concussive hits are among our most compelling cases. What matters is the combination of a college football history and a qualifying neurological condition.

  • We already accepted benefits from the NCAA class-action medical monitoring settlement. Can we still file an individual lawsuit?

    Accepting medical monitoring benefits from the class settlement does not automatically bar an individual lawsuit, but the answer depends on the specific terms of what was signed and when. Contact us before assuming your rights have been waived — the analysis is fact-specific and the stakes are significant.

  • What does it cost to have our case evaluated?

    There is no charge to contact us and discuss your situation. We handle NCAA brain injury cases on a contingency basis, which means we are paid only if we recover for you. An initial conversation carries no obligation and no cost.