It’s been four years since the NFL reached an estimated $1 billion settlement in the landmark concussion lawsuit brought by former players. The vast majority of those players are still waiting for the league to make good on its agreement.

Former players sued the league over the long-term impacts head injuries have had in their lives. These men have developed Alzheimer’s, Parkinson’s, and symptoms consistent with CTE. The league assured the former players that payouts from the settlement would be swift. That has not been the case.

Of the 1,400 players awarded damages from the league as part of the settlement, only 140 have gotten any sort of payout from the NFL, according to Ken Belson of The New York Times.

Settlements move at a snail’s pace, and that’s part of the reason for the delay. The league just began accepting claims against the settlement about eight months ago. But according to the families of former players included in the settlement, the NFL has also created a bunch of bureaucratic hoops to jump through in order to secure payment.

Orrin Brown, who was appointed by the court to administrate the settlement, said that the NFL has moved the goalposts in terms of the paperwork players are required to file to receive their share of the settlement. Players are being asked to submit raw scores from neurocognitive tests, which wasn’t spelled out in the initial agreement. That was four years ago, and some families are scrambling to track them down.

Brown says that the NFL is trying to prevent fraud.

“It does seem people feel they are being nickeled and dimed on paperwork,” Brown said. “But there’s nothing nefarious or conspiratorial in this. The goal is to make sure everyone gets paid for legitimate claims.”

The NFL has officially denied that there have been any changes to the the settlement agreement or the standards for claims to be approved. But former players and their families don’t see it that way.

Andrew Stewart, a retired defensive end who spent one season with the Browns and one with the Bengals and spent a little time with the 49ers, now suffers from Parkinson’s disease. He expected to receive a payout of approximately $2.8 million from this settlement. The league gave him the runaround, and now he’s being offered less than one-third of that amount.

Stewart filed his claim, and the league informed him he would have to have a second doctor confirm the diagnosis. His original claim was filed when he was 48 years old. Once he got the second diagnosis and the league started to process the paperwork, he was 51. Awards are calculated at a lower rate for older players. The time it took to move things along cost Stewart significantly. His estimated settlement is around $750,000.

“Players will be shorted what they earned,” Stewart said. “This is not a settlement. This is about paying sick men as little as possible.”

Anita Brody, the federal judge who oversaw the settlement, will meet with representatives for the NFL and the plaintiffs on Monday to try to find better, more efficient solutions for processing these claims.

Recent research from Boston University’s CTE Center found signs of CTE in 99 percent of the former NFL players’ brains they studied. Even though these brains were donated by families of players who exhibited signs of chronic traumatic encephalopathy, that high percentage leaves no doubt that the repeated head trauma players experience can have lasting, debilitating effects.

This settlement was supposed to be one step toward the league making things better for players who are suffering because of their time on the field. That can’t happen if the NFL won’t pay out claims fairly and in a timely manner.