Question:
In one of your answers you mentioned an Oct 12, 07 position paper on Handling Injuries. I cannot find it on the ussf web site.

USSF answer (March 13, 2008):
From the U.S. Soccer Communications Center:

To: National Referees
National Instructors
National Assessors
State Referee Administrators
State Directors of Instruction
State Directors of Assessment
State Directors of Coaching
From: Alfred Kleinaitis
Manager of Referee Development and Education
Subject:  Handling Injuries  
Date:  October 12, 2007

An incident at the first U.S. Soccer Development Academy Fall Showcase tournament led to extensive discussions regarding the correct referee actions to be taken when a goalkeeper and opponent are injured. The lack of a single clear answer among the many experienced observers gathered there is the reason for this position paper.

Injuries pose numerous difficult decisions for the referee. On the one hand, soccer is a game of continuous action in which stoppages are and should be infrequent. On the other hand, player safety is an obvious matter of concern. Since stopping play may be beneficial for one team, an added issue is the possibility of a player simulating an injury or its degree of severity in an effort to gain that benefit.  

Law 5 establishes several basic principles regarding player injuries:

If, in the opinion of the referee, the injury is serious, play must be stopped.
If, in the opinion of the referee, the injury is not serious, treatment of the injury is delayed until play is stopped for some other reason.
If the referee stops play for an injury, the injured player must leave the field and cannot return until play is restarted and the referee gives permission.
The International Football Association Board (IFAB), in its Additional Instructions and Guidelines (AIG) which accompany the Laws of the Game, has clarified certain issues:

An injured player may not receive treatment on the field unless the injury is “severe” (immediate medical attention is needed).
An injured goalkeeper is not required to leave the field and may receive treatment while on the field.
The refusal of an injured player to leave the field despite being required to do so is a cautionable offense (unsporting behavior).
The removal of an injured player must be swift but safe.
The referee may signal permission for medical personnel (including stretcher-bearers) to enter the field to assist in the player’s removal from the field (or to provide emergency first aid).
Referees should keep in mind the following additional guidelines regarding the handling of player injuries:

A player may seek assistance and treatment off the field during play if given permission by the referee to do so (permission is also needed to return to the field, which may occur during play).
A player who is injured may leave the field for treatment and return to the field before play resumes if the stoppage was not solely for that player’s injury and if medical personnel were not called onto the field by the referee to aid the player’s removal.
“Medical personnel” for purposes of these guidelines includes any team official who has responsibility for the player in the absence of available trained medical staff.
If a goalkeeper is seriously injured as a result of a collision with a teammate or opponent and the teammate or opponent is also injured, all players injured in the collision may be treated on the field and are not required to leave the field.
A player for whom the referee has requested medical personnel to enter the field at a stoppage is required to leave the field and may return with the referee’s permission only after play has resumed even if the stoppage was not expressly for the injury.
Evaluating and balancing these factors must be done quickly and fairly, with appropriate regard for the age and skill of the players. In all cases of doubt, the safety of the player must be the referee’s primary concern.

Question:
[An instructor asks:] Can the referee prevent a youth player from continuing to participate in play, or return to play, after he has suffered an apparent concussion? I am looking for a general guideline from a referee’s position.

The California Youth Soccer Association-South “Rules and Regulations” state:
2.5. Player Safety
2.5.1. No player should be allowed to play in any regularly scheduled league or tournament game with an injury which can be aggravated by playing or which constitutes a danger to others. Can the referee prevent a youth player to continue to participate in play, or return to play, after he has suffered an apparent concussion? I am looking for a general guideline from a refereeÕs position.

I will follow up with Cal-South for an elaboration, e.g., does the referee have authority to enforce this rule, and why is the word “should” used instead of “shall”. And how does the referee judge if the injury can be aggravated, etc.

p.s. – it would be fantastic if one could do a search on ALL of the “Ask A Referee” articles, without opening each archive and repeating the search. That way I would know if you had touched on this before.

USSF answer (December 19, 2007):
1. The first portion of this answer repeats an answer of September 27, 2006:

In reading this answer, please remember that the U. S. Soccer Federation has no authority over games not played under its aegis, nor over the referees who officiate them.Under the Laws of the Game, the referee has no direct authority to prevent a player from participating for unspecified reasons. While the spirit of the game requires the referee to ensure the safety of the players, it does not give the referee the right to prevent the further participation of a player who has been treated for injury and cleared to play by a trainer or medical doctor. The only possible reason would be that player was still bleeding or had blood on his or her uniform.

If there is a trainer and/or medically trained person officially affiliated with the team or the competition authority (including, where relevant, the tournament), the referee should defer to that person’s decision as to whether a player’s return to the field following a serious injury would be safe. In the absence of such a person, the referee retains the authority under the Law to determine if a player is still seriously injured and, if necessary, to stop play and to require that player to again leave the field. The Law does not allow the referee to prevent the return of the player to the field, but once play resumes with that player on the field, the referee reverts to his or her original duty to stop play if, in the referee’s opinion, the player is seriously injured. As always, the referee must use common sense in making such a potentially controversial decision and must include full details in the match report.

Once the player has been required to leave the field, the referee remains in complete control of the situation by virtue of the fact that the player cannot return until and unless he or she receives the permission of the referee — simply withhold it if you are convinced the player remains seriously injured. It takes courage to do this but, if the referee is certain of the state of the player, so be it.

For additional information on this matter, see the USSF position paper “Handling Injuries,” dated October 12, 2007.

2. As to searching for old answers, many have tried and none has succeeded in finding a way to search the archives.…

Question:
On two occurrences I have stopped play because of an injury to the head of a player, both times players and coaches were yelling to “kick the ball out” however no one did. With play stopped and the ball still in play and in the possession of one team, is the correct restart a drop ball with both teams participating or only the team that was in possession? Where does possession come into play when the match has been stopped for injuries? I have had a coach complain that the drop ball should be one sided in the “spirit of the game” and another coach argue that his team had possession and that his team should have the ball.

Answer (October 29, 2007):
Many major competitions throughout the world have instructed their players not to follow the traditional “kick the ball out of play” procedure when a player appears to be seriously injured. And the Law instructs the referee to stop play only when he or she believes the player is indeed seriously injured.

The only possible way to restart play after stopping for an injury is a dropped ball. There is no alternative under the Laws of the Game.

With regard to your question of possession, there is no such thing in the Laws of the Game once the referee has stopped play. Possession by one team or the other does not enter into the picture at all. (Maybe you are thinking of high school soccer?) The referee must make his or her own decision as to how to manage the dropped ball after having stopped play for the injury. The intelligent referee will remember that there is no requirement that players from both teams – or that any player at all – must take part at a dropped ball.…

Question:
I was looking to get some information on the rules that are enacted when a player is down on the field. Specifically, if team A is in clear possession of the ball (for example, if team A’s goalie has the ball safely in his arms) and the referee stops the game because a player is down on the field, what is supposed to occur when the player finally gets up or is helped off the field? I saw a game where this occurred and the referee called for a drop ball at the location where the player went down (even though it was at mid field and Team A’s goalie had the ball in his box). Despite playing for over 25 years, I did not know what the rules governing this situation were and wanted to know.

Answer (June 6, 2007):
First things first: The referee should NEVER stop the game solely because “a player is down on the field.” Law 5 (The Referee) clearly states that the referee stops the game only for serious injury, not simply because a player is down. We might point out here that the definition of “serious” can vary with the age and skill levels of the players concerned.

When the referee does stop play for serious injury — and did not determine that this serious injury was caused by a foul or serious misconduct by another player — play is restarted with a dropped ball from the point where the ball was at the moment play was stopped. This applies even if the ball was in the possession of the goalkeeper. You will find this restart under Law 8 (The Start and Restart of Play):
Dropped Ball
A dropped ball is a way of restarting the match after a temporary stoppage that becomes necessary, while the ball is in play, for any reason not mentioned elsewhere in the Laws of the Game.…

Question:
During course of play, a player from Team A slides into player from Team B and is hurt. Referee allows play to continue for 5 seconds until he determines that the player is not getting up. Team A has ball in their possession when Referee stops play and stops the clock. He calls out that Team A will re-start play with indirect kick from where they had the ball in their possession.The teams clear the field while the injured player is attended to. During break, Referee confers with Assistant Referee and determines that the injured player deserved a Yellow Card for sliding into the play with spikes up from behind. So, after the injured player is carried off the field, Referee goes to Team A’s bench and gives the player a Yellow Card.

Team A re-starts play with indirect free kick which is played behind Team B’s defense and Team A scores immediately.

Coach from Team B is upset. After the goal is scored but before the kick-off, he asks two questions of the Referee:
1) If you stop play for injury, shouldn’t the game have been re-started with drop ball? 2) If referee gave a yellow card to Team A, how could Team A restart play with indirect free kick? Shouldn’t Team B have received possession of ball at the point of the foul?

If Coach from Team B is correct on either of these points, is there anything that can be done or is it too late?

Referee determined that he may or may not have made an error but it didn’t matter because it was too late.

What is your opinion?

USSF answer (April 10, 2007):
ANSWER CORRECTED APRIL 18, 2007
If the referee was aware of the misconduct, applied advantage, and waited for the next stoppage (which happened to be the injury), the restart should have been a DB.

If the referee decides that the reason (determined after the fact) for the stoppage was NOT the injury but previously missed misconduct by Player A that had happened before the injury but which was brought to his attention ex post facto by the AR, then the proper restart should have been an IFK for team B.

If, as really should have been the case, the referee recognized that the misconduct was serious, then the card should have been red and the restart would still have been an IFK for team B.

If the referee had been totally on top of things and recognized that the red card misconduct was the result of a foul which endangered the safety of an opponent, then the restart should have been a DFK for team B.

There is no scenario here under The Laws of the Game which could result in an IFK for team A.…

Question:
now i am grade 9 ref im going to get upgraded but my question is when i ref games and there is a player down cause this happens a lot on minor injuries instead of blowing my whistle all the time i try to get players to play the ball out you know fifa fair play and then get the other team to throw the ball back to them is this bad?USSF answer (December 12, 2006):
No, this is not bad, but neither is it sanctioned under the Laws of the Game. The referee has no authority to direct the players to put the ball out of play or to tell them to play it back in to the other team to restart.

It is the job of the referee to stop play for injury, regardless of what players may or may not do, only if a player is, in the referee’s opinion, seriously injured–keeping in mind the age of the players. There are considerable practical differences between the referee stopping play for a serious injury and players stopping play for what they believe is an injury. If the players do it on their own, there is little the referee can do to control it, at least as the Laws read now.…