On a recent Tuesday afternoon in the Twin Cities, Matt Blair was in a doctor’s office with his wife, his neurologist and, sadly, more bad news.

“Well,” the former Vikings linebacker said, “it’s coming. It’s going deeper for me.”

With that revelation, the chiseled 64-year-old broke down in tears, a scene that has become all too familiar for NFL retirees and spouses coming to grips with early signs of dementia.

Meanwhile, in Philadelphia, U.S. District Judge Anita Brody’s final approval of a class-action settlement of NFL concussion claims, despite objections, is imminent.

The league hails the settlement as a landmark moment in its history, an unprecedented 65-year deal with the potential to award $1 billion to thousands who are struggling among the league’s roughly 22,000 current retirees, including hundreds of former Vikings.

On the other side is a strong chorus of critics who believe the settlement allows the NFL to exclude too many ailing players and lacks impact because there is no minimum payout requirement, other than $112 million to the attorneys who orchestrated the deal.

The suit comes amid an intense national focus on head injuries in sports.

“Is it a $1 billion settlement? Heck no,” said former Viking Bob Stein, an attorney who has represented former players. “It is whatever players filter through all of the hurdles of the settlement’s system, which the NFL still controls. I don’t think it puts the concussion issue to bed at all.”

NFL spokesman Brian McCarthy counters that the league has “a high degree of confidence that this settlement — which has been accepted by more than 99 percent of retirees — will provide important and generous benefits to retirees and their families.”

Criticism, even by many who are accepting the settlement, is widespread, however.

Back in that small room in the Twin Cities on Feb. 10, results of Blair’s six-hour psychological testing from December confirmed an earlier brain scan that suggested signs of dementia.

Medicine hadn’t worked. His dose was doubled, and he’ll return in eight weeks. If necessary, he’ll switch to much stronger medicine geared for people who likely have developed chronic traumatic encephalopathy (CTE), a neurodegenerative disease associated with repetitive mild traumatic brain injury and considered by many to be the signature menace in the NFL’s concussion claims.

Mary Beth saw Matt’s tears, but knows she has to stay strong for a 6-foot-2, 235-pound man whose physique hasn’t strayed far from its playing days.

“As spouses, we get stronger because we have to be,” she said. “I realize I can’t get emotional because two of us emotional together would be a mess. At the appointment, when the doctor was talking, I could see Matt’s eyes welling up with tears. I’m thinking, ‘breathe, breathe’ because inside I want to cry, too.”

Neither Matt nor Mary Beth knows what to expect from the settlement’s payout scale and claims process. They know older players aren’t eligible for as much as the younger ones but, as Mary Beth noted, “That’s the furthest thing from my mind right now.”

“I’m not looking to become rich off a settlement,” she said. “I just want what’s right. If he were to get worse because of injuries he sustained while playing football, will they would help pay for his care? I’m not looking for pocket money.”

A matter of trust

Four principal concerns exist for critics of the concussion settlement: CTE symptoms in living players that won’t be covered; insufficient information and/or ability to understand that information for players who had to decide last fall whether to opt out; no compensation for future diagnoses of CTE; and an eligibility system controlled by the NFL that might be restrictive.

“They could promise us everything, but if guys can’t get approved, then the settlement is meaningless,” said former Vikings guard Brent Boyd, a retired players advocate who has testified before Congress about health problems he and his doctors trace to multiple concussions.

“The NFL’s history is they’ll fight us tooth and nail. They’ll delay, deny and hope we die before they have to pay us. I just don’t trust these bastards.”

Brody asked for revisions last week to initial settlement struck last July. Awards are expected to cover time spent in NFL Europe as well as brain-damaged deaths through her final approval. No date was set for her final approval. More than 50 former Vikings, including Hall of Famers Carl Eller and Mick Tingelhoff, were part of more than 200 lawsuits condensed into the consolidated suit.

At least one appeal is expected to be filed, by a group of seven former players including former Gophers All-America center Ben Hamilton. The group filed a detailed formal objection during the settlement process, suggesting an appeal and a possible extension of the litigation process by at least another year.

Only a few hundred of the roughly 20,000 NFL retirees opted out of the class-action suit. They maintain legal rights to pursue future individual suits. As part of the settlement, the rights of active players will be handled in the collective bargaining process for the next 65 years.

Players who have opted out, like Vikings Hall of Fame safety Paul Krause, are vocal in their opposition.

“The NFL is going to win everything, they don’t care anything about the old football players, and you can print that,” said Krause. “They’re waiting for all of us to die. They got everybody on their side. They have the newspapers on their side, they have judges on their side. Everything is going toward the owners. I’ve got nothing good to say about the owners.”

Boyd’s long journey

Some have called Boyd a “father” of the concussion awareness era, a face of the angst among former players who have lost disability claims against the NFL the past 16 years.

He played guard for the Vikings from 1980-86. Now 57, he hasn’t worked since 1999 because of health problems. Boyd said he lives with unceasing headaches and has battled sleep-deprivation, vertigo, depression, fatigue and addiction. After his divorce a couple of years ago, he moved into a small townhouse in Reno, Nev., with a son who later married and moved out.

“I’ve spent 15 years just looking for a decent place to live,” Boyd said. “This is a place college kids would live. Holes in the wall. Dirty carpet and all that. It’s not a place I would ever bring anybody.

“That’s why I call my website dignityafterfootball.org. It’s just a total loss of dignity. The NFL has called us liars for so long.”

Boyd isn’t sure how much of the settlement he’ll receive, doesn’t trust that the NFL will accept his claim and vehemently disagrees with how the CTE issue has been handled in the settlement. But opting out of the settlement wasn’t a realistic option.

“I couldn’t take the risk,” he said. “Once you opt out, to try and fight it out with the NFL on your own, it’s going to be a long, expensive battle. And the chances of winning are pretty slim. I don’t have the money or the energy.

“I’ve been fighting this thing a long time in Congress, through the media and butting heads with [former NFL Players’ Association Executive Director] Gene Upshaw and [NFL Commissioner Roger] Goodell. I’ve had these symptoms. I can’t work. I need money now.”

Future CTE issues

The NFL said it expects about 6,000 of the current retired players to develop Alzheimer’s disease, amyotrophic lateral sclerosis (Lou Gehrig’s disease) or dementia. Under the settlement, payouts would average about $190,000, with diagnoses for younger players reaching up to $5 million.

“The sinister part of this is now they’re putting out these pictures of [former running back] Kevin Turner, who has Lou Gehrig’s disease, and they’re saying, ‘If you’re against the settlement, you’re against giving Kevin Turner his $5 million reward,’ ” Boyd said. “The fact is 99 percent of the guys who have legitimate concussion symptoms aren’t being covered by this. The NFL is saving big money by paying a few guys a lot of money. And they’ll take their pictures with those guys because their symptoms are camera-friendly and visible. CTE symptoms are invisible. And all the invisible symptoms are not covered under terms of this settlement.”

In the seven-player objection that was filed, the primary protest is the future handling of CTE, which has been discovered in the brains of dozens of deceased players, including those who experienced behavior or mood problems in the latter stages of their lives and committed suicide. The settlement would pay up to $4 million only to the families of players who died with CTE between 2006 and the day the settlement is final.

“The greatest of the settlement’s many flaws is its failure to compensate players who are living with CTE or who die with it after [the deadline],” the objection reads. “CTE is likely to be far and away the most common neurocognitive disease suffered by the class. Yet all class members release their claims related to CTE. … Class counsel bargained away the rights of more than 20,000 former NFL players — many of whom are suffering the serious effects of CTE, fairly called ‘football’s industrial disease.’ This alone is reason to reject the settlement.”

PR nightmare looming?

To avoid “incentivizing” suicide, the settlement would not give awards for future deaths involving CTE, which currently can be reliably diagnosed only after death. Critics want to know why the settlement doesn’t make an allowance for the possibility of a reliably acceptable method of testing for CTE in a living brain. In the seven-player objection, Dr. Robert A. Stern of the Boston University School of Medicine stated a “reliably detectable” test to diagnose CTE in the living likely will be available in the next five to 10 years.

“As soon as there is a test approved for CTE in living people, it won’t be used to include players in the settlement; it will be used to exclude them,” Stein said. “If you want to protect the families or the individuals who have brain injuries, why is this in the settlement?”

Stein said the legal liability for the league will disappear for the most part, but he believes the public relations nightmare could worsen when medical advancements enable living players to be tested for CTE. Those results, he says, will become an embarrassing story line for the league and a settlement that may become outdated by technology.

“I guarantee you I’m going to take the test,” Stein said. “Otherwise, especially as you get older, every time you can’t remember where the car keys or your glasses are, you worry that you’re approaching the edge of the cliff.

“It’s practically debilitating it’s so scary. You see teammates and friends who have just circled the drain, and that’s tough.”

The league counters with the argument that the settlement would give awards to several neurological conditions — including moderate and early dementia, Alzheimer’s disease, ALS and Parkinson’s disease — without the presence of CTE.

Goodell last addressed concussions at his “state of the NFL” news conference at the Super Bowl. He was not asked about the concussion settlement, but focused on safety improvements.

“Since 2012, concussions in regular-season games have dropped from 173 to 111, a decrease of more than one-third,” he said. “The real credit goes to the players and coaches. They’ve adjusted to the rules and the challenge of creating a culture of safety for our game.”

An uncertain future

At first, Mary Beth Blair figured her husband, like his peers, was just getting older and forgetful.

“But then it became things like, ‘Really? You’ve known this guy for how long? And you seriously can’t remember his name?’ ” Mary Beth said. “There’s someone he golfs with and has done business with, and has been a friend of Matt’s since he played football.

“He’s been to our house about five times in the last six months. Every time he comes, Matt can’t remember his name and keeps calling him by a different name.”

Matt admits he’s frightened at what lies ahead. Fred McNeill, a former teammate and his best friend on the Vikings, is in a nursing home in California with debilitating dementia at age 62. McNeill, according to Blair, never had a diagnosed concussion, while Blair had two, one of which hospitalized him between consecutive starts in the Vikings’ playoff run to Super Bowl IX in 1976.

“It’s just so hard for me to talk to Fred,” said Blair, a six-time Pro Bowler who played 12 seasons. “I’m in a better position than most players. But I know it’s going to come at me big-time. I just don’t know what all is going to happen to me. All the players I’ve talked to and seen and heard about and what they’ve gone through, if I ever go through that, man, my life is gone.”