Michael P. Santa Maria, Ph.D. Board-Certified Neuropsychologist; Diplomate, Clinical Neuropsychology (ABPP-CN) DeGraff Memorial Hospital 445 Tremont St., Room 331 PO Box 750 North Tonawanda, NY 14120-0750 phone: (716) 690-2560 / fax: (716) 690-2585 April 29, 2019 Ms, Sandy C. Baisden Provider Network Coordinator Il NFL Concussion Seitlement BAP Benefits Administrator Garretson Resolution Group 4064 Colony Rd.; 2 Floor Charlotte, NC 28211 Re: Mr. Jeff Nixon Date of Exam: 4/29/19 Dear Ms. Sandy Baisden: Mr. Jeff Nixon, a 62 year-old Caucasian man (DOB: 10/13/56), was cognitively and psychologically evaluated on your kind request. Mr. Nixon came to the exam alone, Reason for Referral/Medical Necessity: This evaluation took place in the context of the National Football League (NFL) Baseline ‘Assessment Program (BAP) and there are questions regarding current cognitive and adaptive functioning, diagnosis and treatment planning Mr. Nixon reported that he views memory functioning as pretty good in many regards but with some difficulties with short-term memory/learning and remembering new information which he indicated seemed to have gradually worsened/changed over about the past 5 years. He indicated to some extent he feels he is compensating by writing more things down and by being very particular about where he sets things down so as not to misplace them. He specifically indicated that during recent past years he has noticed some inereased difficulty remembering some details of conversations or other personal events. Mr. ‘Nixon indicated that about 2 years ago he had participation in a study through Mayo Clinic, Arizona which he indicated involved cognitive testing, brain imaging and lumbar puncture (LP), in the context of a research protocol, but he indicated he never received any individual results from that workup. Structural neuroimaging of brain was not available. Mr. Nixon denied any history of TBI with associated LOC at any time. He indicated that during his high school, college and pro playing career there were not any incidents in which he was hit during play and ‘was unable to leave the field under his own power, and he indicated there were not instances in which he had to sit out for one or more plays or had to leave the game or was checked out by a team medical professional ot at a hospital. He reported that in 1979 during his rookie year he was playing in a game for the Buffalo Bills against the Miami Dolphins and he sustained a blow in which he felt shaken up but he indicated he got up and got into the team huddle after the play and continued to play. He also indicated there was some occasion when he was playing for the Buffalo Bills against the New York Jets in which he felt shaken up but he does not recall specifically during which season this was.Jeff Nixon 2 Mr. Nixon was born in Farstenfeldbruck, West Germany. His father had been serving in the US Air Force. ‘Asan infant he moved to USA, then back to Germany, then back to USA. Both parents are alive and in ‘g00d health, He had a brother who died with cancer. He has 2 other brothers who are living and 2 sisters ‘who are living, All are full siblings. He graduated from Garfield Senior High, Woodbridge, VA in 1975 reportedly with a high school grade average of around 2.8, He repeated kindergarten. He denied history of remedial education. He indicated he completed a bachelor’s degree in health/phys ed from University of Richmond; Richmond, VA in 1979 with a college GPA of around 3.0. He denied history of military service. He indicated he was a pro football player with the Buffalo Bills 1979-1984. He indicated that in 1983 he was put on the PUP (Physically Unable to Perform) list and thereafter was placed on Injured Reserve (IR). He reportedly worked as a director with Erie County Youth Bureau 1988-2000 full time. From 2001-present he has worked full time with Buffalo Employment and Training Center as youth employment director. He married in 1983, divorced in 1993 and married his second wife in 1997. He has 233 year-old daughter, Jena, and a 31 year-old son, Jeffiey. He also has 3 stepchildren. He lives with his wife in Buffalo, NY. He denied history of arrest. He reportedly remains independent in bathing, dressing, cooking, laundry, housekeeping, medication management, grocery shopping, medication management and driving, He enjoys playing guitar and regularly performs gigs with his wife, who sings. He indicated he has a blog, NFL Retired Players United. Examination Data: ‘Mental Status Exam/Behavioral Observations: Mr. Nixon was alert and ambulatory without any assistive device. He made eye contact well. He had a mustache, He was oriented to person, place, and time. He ‘wears regarding glasses. Some hearing compromise was evident; occasionally he asked for statements or questions to be repeated. However, hearing appeared to be adequate for the purposes of the present evaluation. Speech was fluent, clear and goal-oriented. Mr, Nixon evidenced a strong conversational vocabulary. He accurately made 4 of S serial 7 subtractions from 100 and 5 of 5 serial 3 subtractions from 50. He accurately repeated 3 of 3 words presented to him and recalled 1 of those 3 words after a brief delay. He accurately completed 3 steps in a 3-step command presented to him. He indicated typically he has been a happy person over the course of his life including of late and he added that he remains quite socially active. He denied current or past plan or intent to seriously harm himself or others and there was not evidence to the contrary. Sleep and appetite are reportedly adequate, There is not evidence of any history of manic symptoms or any Specific or Social Phobia, PTSD or psychotic symptoms. Mr. Nixon was very polite and easy to work with, Mr. Nixon appeared to give consistently good effort throughout the examination. Neuropsychological Test Data:TEST General Mini Mental State Exam (MMSE) Sensory & Motor Funetioning ‘Visual Acuity (corrected) Grooved Pegboard (GPT), dominant (right) Grooved Pegboard (GPT), nondominant Barona Equation (BE) ACS TOPF Word Reading ACS TOPF Complex Demographic Estimate ACS TOPF Combined Estimate Intelligence WAIS-4 Verbal Comprehension Index WAIS-4 Perceptual Reasoning Index WAIS-4 Working Memory Index WAIS-4 Processing Speed Index WAIS-4 Full Scale 10 WAIS-4 General Ability Index WAIS-4 Block Design WAIS-4 Si WAIS-4 Digit Span WAIS-4 Matrix Reasoning. WAIS-4 Vocabulary WAIS-4 Arithmetic WAIS-4 Symbol Search WAIS-4 Visual Puzzles WAIS-4 Information WAIS-4 Coding WAIS-4 Letter-Number Sequencing, WAIS-4 Cancellation Academic Abilities WRAT-5 Word Reading WRAT-5 Spelling WRAT-5 Math Computation WRAT-S Sentence Comprehension WRAT-5 Reading Composite Language BDAE-3 Complex Ideational Material (CIM) Boston Naming Test (BNT) Controlled Oral Word (COW-FAS) SCORE, 27130 20/20 61,5" 6" 118. 107 113 14 108 19 86 108 108 1s 13 n 8 4 12 1 2 3 12 i 8 9 107 102 99) 0. 109 nz 55/60 46 Controlled Oral Word (COW-animal naming) 22 Spatial Abilities Rey Complex Figure Test (RCFT), copy Learning and Memory 'WMS-4 Logical Memory I Recall 31136 19/50 %ile 7 90 96 88 68 81 83 70 90 18 70 70 84 84 63 28 91 18 16 cH 84 15 63 25 37 68 35 47 6 B 19 2B 68 6 50 Jeff Nixon INTERPRETATION borderline normal high normal high normal high average average high average high average average high average low average average average high average high average average average superior high average low average high average high average high average average average average average, >12.9 grade level average, >12.9 grade level average, 9.1 grade level high average, >12.9 grade level average normal normal normal normal normal normal