Brain Injury Lawyer - New York

Support the Heroes at Home Act of 2007

The Brain Injury Association of America has requested that you urge Members of Congress to cosponsor the Heroes at Home Act of 2007.

This important legislation, which has been introduced in both the House and Senate, recognizes the critical role played by family caregivers in facilitating recovery from brain injury, and addresses the pressing need to increase support for these caregivers.

This legislation would establish a Traumatic Brain Injury Family Caregiver Personal Care Attendant Training and Certification Program, which would train and certify family caregivers of TBI patients as personal care attendants, enabling them to provide quality care at home while also qualifying for compensation from the VA. The legislation specifies that the curricula for the TBI Family Caregiver Personal Care Attendant Training and Certification Program “shall incorporate applicable standards and protocols utilized by certification programs of national brain injury care specialist organizations.”

The legislation would also expand telehealth and telemental health services within the Department of Defense and VA to help meet the health care needs of returning service members with TBI.

Here is some sample text that you can use when writing to your congressional representative and Senator:

I am writing to ask you to cosponsor S.1065/H.R. 3051, the Heroes at Home Act of 2007, which represents a critical move forward in meeting the rehabilitation and emotional adjustment needs of traumatic brain injury (TBI) survivors of Operation Iraq Freedom (OIF) and Operation Enduring Freedom (OEF).

This legislation, introduced by Senator Hillary Clinton (D-NY) and Rep. John Salazar (D-CO) in their respective chambers, recognizes the critical role played by family caregivers in facilitating recovery from brain injury and is endorsed by the Brain Injury Association of America.  This legislation is also supported by both Co-Chairs of the Congressional Brain Injury Taskforce, Rep. Bill Pascrell (D-NJ) and Rep. Todd Platts (R-PA).

This critically important legislation addresses the pressing need to increase support for returning service members with TBI and their family caregivers by establishing a Traumatic Brain Injury Family Caregiver Personal Care Attendant Training and Certification Program.  This program would train and certify family caregivers of returning soldiers with TBI as personal care attendants, enabling them to provide quality care to their loved ones at home and at the same time qualify for compensation from the VA.

Again, as a constituent of yours, I urge you to cosponsor the Heroes at Home Act of 2007, to proactively address one of the most important issues related to the War on Terror, the unanticipated high incidence of traumatic brain injuries among America’s brave soldiers returning from combat.

Army Institutes Educational Campaign to Recognize Traumatic Brain Injury

The Army in recognition of that many, if not most brain injuries are invisible to the casual and even medical observer, is launching an education program to teach 1 million soldiers how to recognize symptoms of brain injuries and Post Traumatic Stress disorder.

The program is designed to educate the Army about the signs and symptoms of traumatic brain injury and concussions and to encourage troops to get treatment.

The program will include the active military, the Army Reserves and the Army National Guard, both here and abroad.

Everyone is to receive a one-hour briefing on brain injuries and stress, in which teachers will be equipped with videos, slides and a list of expected questions and answers. It will be done through a rarely used "chain teach" program, that is, the subject is taught to leaders, who then teach it to soldiers, continuing down through the Army's chain of command.

I wonder if this program can be modified and used at all emergency rooms in the United States to train doctors, physician assistants, nurses and others about the hidden and invisible signs of concussion and brain injury?

Soccer Players Show Brain Shrinkage

College-age soccer players may show some degree of brain-tissue shrinkage, according to a study published in the July 2007 issue of the Clinical Journal of Sports Medicine.   

Using high-resolution MRI brain scans, researchers found evidence of reduced gray matter in the brains of 10 male college soccer players, compared with 10 young men who had never played the sport.

Gray matter refers to the brain tissue that controls thinking and memory. The significance of the relatively smaller gray matter volume and density seen in these players is not yet clear, the researchers say.

However, some past studies have found that professional and even college-age soccer players are more likely to show problems with memory and attention than non-players.

Among players in the current study, reduced gray matter was seen in a part of the brain called the anterior temporal cortex -- which is consistent with effects from repeated knocks to the front of the head, John Adams and colleagues at the University of Cincinnati College of Medicine in Ohio report in the Clinical Journal of Sports Medicine.

Senate Passes Major TBI Legislation to Assist Wounded Veterans

On Thursday the United States Senates passed the "wounded warrior" legislation by voice vote which includes the Dignified Treatment of Wounded Warriors Act (S. 1606), as well as major TBI provisions contained in S. 1233 and S. 1349.  S. 1233, The Veterans Traumatic Brain Injury and Health Programs Improvement Act of 2007, was sponsored by Sen. Akaka (D-HI) and Sen. Craig (R-ID), and S. 1349, The Military and Veterans Traumatic Brain Injury Treatment Act, was introduced by Sen. Durbin (D-IL).  Both S. 1233 and S. 1349 were endorsed by the Brain Injury Association of America. (BIAA)

Earlier this spring, BIAA provided recommendations to Senate Committee staff regarding ways to improve S. 1233.  Many of these recommendations were incorporated into the bill and have now been included in the Senate’s “wounded warrior” legislation. S. 1233 takes steps to ensure that service members have access to non-governmental facilities when necessary to meet the goals of individualized TBI rehabilitation and community reintegration plans.  The bill also instructs new TBI research programs within the Department of Veterans Affairs to be pursued through collaboration with existing TBI research programs receiving grants through the National Institute on Disability and Rehabilitation Research of the Department of Education. 

S. 1349 requires the Department of Defense (DoD) and the Department of Veterans Affairs (VA) to implement a comprehensive program to diagnose, treat and rehabilitate service members and veterans who have suffered a service-related traumatic brain injury.  It also contains provisions developing a standard of care for TBI cases, establishing that each individual in the program “shall be rehabilitated to the fullest extent possible using the most up-to-date medical technology, medical rehabilitation practices, and medical expertise available.”

S. 1606 also contains several important provisions relating to providing care for returning service members with TBI.  The bill would create an overlap of DoD and VA benefits for a period of three years to enable wounded warriors to benefit from the strengths of both systems, allowing increased access to TRICARE, which in turn could potentially facilitate enhanced access to civilian TBI care providers.  In addition, the Brain Injury Association of America worked alongside other advocacy groups to help ensure inclusion of a provision in the bill requiring the DoD to adopt a pre- and post-deployment cognitive assessment tool to help diagnose TBI and PTSD in returning service members.  The bill also explicitly authorizes DoD to enter into partnerships, agreements, or other arrangements with the VA, institutions of higher education, and other public or private entities to prevent, diagnose, mitigate, treat, and rehabilitate service members with TBI.

S. 1606 further authorizes $5 million for the creation of a Center of Excellence in Prevention, Diagnosis, Mitigation, Treatment and Rehabilitation of Traumatic Brain Injury, as well as $50 million relating to the improved diagnosis, treatment, and rehabilitation of members of the Armed Forces with TBI and PTSD.  $17 million of this $50 million is designated specifically for the Defense and Veterans Brain Injury Center.

The House of Representatives has already passed its version of “wounded warrior” legislation, and it remains to be seen how the House and Senate versions will be reconciled. 

I urge you to contact your congressional representative and Senator to insure that the conference committee meets and comes to a quick agreement. 

Let's hope that our commander in chief then quickly signs this important legislation.  Maybe he can then answer Bob Woodruff's question of last week which he so shamefully dodged!

Woodruff dissed by President Bush

I can't believe the way that President Bush brushed aside Bob Woodruff's question at President Bush's news conference last week during which he received the report from the commission he established to investigate the medical care that returning vets are receiving.

Bush first graciously acknowledged Bob Woodruff and the injuries he received in the blast incident in Iraq.

Then, incredulously, when Bob asked President Bush,  a very straight-forward question --- one for which we all deserve an answer --- as to whether our Nation is moving quickly enough to address the needs of our wounded Service Members and Veterans, our President just brushed him aside!

The question that Bob Woodward asked about the way that brain injured vets are being treated is a legitimate questions that deserves an answer from our commander in chief. 

Let's up that Congress and the press demands a straight forward answer to this question.

View the short video (less than 3 minutes after the 30 second ad at the beginning) by going to the ABC news website.

You can also read Bob Woodruff's web blog to get his spin on all of this.

Thank you to my friend and fellow Brain Injury Association of New York State, public advocate, Ralph Shields for bringing this to my attention.

Update

You may have wondered where I have been for the last two weeks.

I've just returned from the American Association for Justice convention in Chicago where I gave a presentation to the Traumatic Brain Injury Litigation Group on the effective use of medical literature in the trial of a traumatic brain injury case.  I am a former chair of this litigation group made up of brain injury lawyers from across the country.

My presentation included a review of the current medical literature on concussions, mild traumatic brain injury and the lasting consequences following brain trauma. I also taught the audience effective strategies for the use of medical literate in both direct and cross examination in the trial of a brain injury case.

For brain injury attorneys this is an extremely important topic as it helps to validate the concussion and post concussion syndrome that affect our clients.  Frequently we encounter defense counsel and their insurance company experts who attempt to argue that our client could not have sustained a brain injury because there was no loss of consciousness or because MRI and CT scans were normal or because the impact was minor.  Of course, this is all nonsense and is contrary to the accepted medical literature but non the less, they still attempt to pull one over in the courtroom. 

By effectively using the medical literature in a brain damage case in both the direct case and through cross examination, these and other myths of brain injury can effectively be rebuked.

I am also pleased to report that during the annual meeting of Public Justice (formely Trial Lawyers for Public Justice, TLPJ) also held in Chicago, I was reelected to a second term as a member of the Board of Directors.

Public Justice opened its doors 25 years ago to pursue an inspiring vision -- building the trial lawyers' public interest law firm. We have done that and more. Over the past quarter century, no public interest law firm in the country has been involved in a broader range of high-impact, cutting-edge litigation. firm.

Public Justice fights for justice through precedent-setting and socially significant individual and class action litigation designed to enhance consumer and victims' rights, environmental protection and safety, civil  rights and civil liberties, workers' rights, America's civil justice system, and the protection of the poor and powerless. Our Access to Justice Campaign  keeps the courthouse doors open to all by battling federal preemption of injury victims' rights, unfair mandatory arbitration, class action bans and abuse, unnecessary secrecy in the courts, attacks on the right to counsel and jury trial, and unconstitutional legislation.

I am also pleased to report that my partner, Shana De Caro was elected to be a trustee of the Civil Justice Foundation.

The Civil Justice Foundation was established to provide grants to grassroot consumer advocacy groups.  Since its inception in 1986, the Foundation has awarded over one million dollars to over 100 organizations.

The Foundation is committed to preventing consumer injury and defending consumer access to justice by donating grants to worthy organizations. The Foundation is especially interested in organizations or projects that have difficulty obtaining funding either because of the organization is newly formed, small or because of the controversial nature of the important issues it tries to address.  You can go to the Foundation's web site for further information if your organization is interested in applying for a grant.

Now that I am back in town, I look forward to continue blogging about important news and information on traumatic brain injury. 

The Best Cure For A Brain Injury Is Prevention

Because I feel so strongly about the need to prevent future brain injuries in are student athletes, I am reproducing an editorial Tackling football's silent killer that appears today in the Sun Chronicle:

High school sports may be safer now than they've been in years, as a recent article reported in tandem with a profile on a serious spinal injury suffered by King Philip wrestling star Donald McNeil.

However, the risk of a certain type of injury is climbing ever higher on the radar screen of school and professional sports. That's concussion, a traumatic injury to brain tissue as a result of a violent blow, shaking, or spinning. It is a sometimes nearly silent assault to the body that, without heightened awareness by coaches, teammates and parents, could go unnoticed until complications arise.

The National Football League is closely scrutinizing the injury, educating players and ensuring that concussion is reported by instituting a whistle-blower system at training camps this month.

"And if anyone feels they are being forced onto the field when they are not ready to play, we want to know about that and look into it," NFL commissioner Roger Goodell said after a conference last month in Rosemont, Ill., with medical personnel from every team in the league.

This initiative should be an added heads-up to high school coaches who soon will be starting a new season of play. Any hint of concussion must be taken seriously since longterm repercussions may be devastating.

The heightened awareness by the NFL comes amid studies indicating that players who suffered multiple concussions might be susceptible to neurological disorders later in life, reported the the Pittsburgh Tribune-Review.

The decision by parents to permit their children to play sports lies there, at home. Risks are everywhere in life. But it can pay for everyone to be educated about a brain injury that is real, common and drawing closer examination than ever.

"The real danger is when they have an injury and they continue to play and that creates a greater degree of danger in terms of their recovery," said Dr. Mark Lovell, director of the sports concussion program at the University of Pittsburgh Medical Center and director of the NFL neuropyschology program.

"Parents should be on the lookout if their kids are (suffering) symptoms like headaches, dizziness, nausea, balance problems. Difficulties with memory, if there is a sudden change in a child's personality, they should start asking questions and maybe call the coach up and ask, 'Did my son get hit today and what happened?' It's the stuff we don't know about that is really dangerous."

Football is a signature sport in this area, but there's no reason that zealousness about winning cannot co-exist with an equal passion for enhanced safety measures and vigilance.

Hopefully, parents, coaches and students themselves will take this advice to heart.

Brain Injury and Proposed Changes to NFL Disability Plan

I am pleased to be participating in an on line talk radio show tonight featuring a discussion of how the NFL disability plans deals with brain damage and proposed changes to the plan.

We are gong to be discussing the NFL proposal to use the social security disability definition of brain injury as well as the league's own definition.

Unfortunately, traumatic brain injury is poorly defined by the social security administration which does not have a specific category for disability due to traumatic brain injury.  Instead brain injury is grouped under a very confusing category entitled, "Organic mental disorders".  The grouping and the social security administration really are not looking at the extent of injury and the life long consequences to the individual and his family, but is instead focusing on what they consider to be residual functional capacity. 

The social security administration tends to focus on the physical limitations that the individual has rather than the day to day difficulties and the behavior and social limitations that are associated with traumatic brain injuries.   

The Internet broadcast can be heard at 8 pm eastern standard time on sportsmavericks.

Another Guest is Bernie Parrish, former Florida Gator Football Player and Cleveland Brown in the 1960's. Bernie was one of the professional players that strengthened the NFLPA (NFL Players Association) with the dream of making it the most powerful union in sports. Bernie is at the forefront of the Congressional hearing on the fight to restructure the NFL Pension and Disability program.

In addition, Mel Owens, former Linebacker for Los Angeles Ram who is presently a Workers Compensation and Disability Attorney will share his prospective. 

We hope to also have Sylvia Mackey, the wife of John Mackey to call in and discuss "Plan 88"

High School Football Most Dangerous For Brain Injury

The number of catastrophic head injuries in high school football far exceeds the number of such injuries in college football, a new study finds.

In addition, the number of high school players who receive such head injuries and then play with residual effects is "unacceptably high," according to the report in the July issue of The American Journal of Sports Medicine.

High school players have more than triple the risk of sustaining catastrophic head trauma compared to college players, the researchers found. High school athletes suffered 0.67 such injuries per 100,000 players compared with 0.21 injuries per 100,000 for college players.

What is particularly troubling is that about 40 percent of the injured players continued to play even though they had symptoms from the earlier head injury. Catastrophic head injuries resulted in 8 deaths, 46 permanent brain injuries and 36 serious injuries where the patient had a full recovery, the researchers found.

The study author believes high school football players should be discouraged from "leading with the head" -- using their heads to tackle. Of all the catastrophic head injuries, 81 percent resulted from helmet-to-helmet collisions and helmet-to-body collisions, he noted.

In addition, players who have received a concussion should be encouraged to report symptoms to the training staff and should be withheld from play until medically cleared.

The study also found that many catastrophic head injuries resulted not from a major blow to the head but from multiple minor collisions.

You can read more about this study by clicking here .

State to screen returning troops for brain injury

The state of Illinois has announced that it would begin mandatory screening of their National Guard members who were deployed to Iraq and Afghanistan for traumatic brain injuries.

Reportedly, Illinois officials have become increasingly frustrated with the screening procedures of the federal government and the services and support available made available to returning vets with brain damage by Washington.

So, state veteran affairs officials have taken matters into their own hands.  They will require mandatory screening for brain injury of all returning members of their national guard and offer brain injury screening to other veterans of the state.  They will also provide a 24-hour hot line for psychological counseling services for brain injury victims.

Medical professionals in Illinois recognize the difficulties in detecting mild traumatic brain injury and are directing special attention to the symptoms of mild brain injury including irritability, headaches, dizziness, memory problems, feeling tired or feeling groggy.  The screening program includes a written questionnaire and an assessment by a trained brain injury professional.  Any soldier with a suspected brain injury would then be referred to a veterans center for further evaluation and treatment.

Hopefully, more states will follow the Illinois example and establish traumatic brain injury screening programs themselves.

You can read the full story in the New York Times, Screening for Brain Injury Is Set for Illinois Veterans, by clicking here.

Understanding Traumatic Brain Injury Video Available

The Defense and Veterans Brain Injury Center's (DVBIC) documentary, "Understanding Traumatic Brain Injury," is now available for viewing on their website.

"Understanding Traumatic Brain Injury" is a 29-minute program, introduced by General Colin L. Powell, USA (Ret.).  It offers an introduction to traumatic brain injury, a health issue affecting at least 1.4 million Americans each year.  It features the recovery journeys of several service personnel and their families.

Click here for a link to view the video.

Viewers can also visit  the DVBIC web site and click on the education tab at the top of their home page. 

Two related products are also available on the same page at their website:

1) a fact sheet on traumatic brain injury (TBI) awareness and prevention, and

2) a "Documentary User's Guide" for organizations that plan to use this documentary as part of their educational efforts in 2007.  See the website for ordering details.

Final NABIS Legal Conference Program

The North American Brain Injury Association, (NABIS) an organization for brain injury professionals including attorneys and those involved in providing brain injury rehabilitation is holding their annual conference on September 27-September 29 in San Antonio, Texas.

I have been invited to be a guest speaker at each of the legal conferences sponsored by NABIS.  This year I have been asked to give the lecture on Opening Statements in Brain Injury Cases.

The final brain injury legal program can now be viewed on the NABIS web site.