Brain Injury Lawyer - New York

New York State Traumatic Brain Injury Coordinating Council Meeting

On Wednesday, September 26th, I will have the honor of presiding as the new Chair of the New York State Traumatic Brain Injury Services Coordinating Council at our meeting to be held at the offices of the New York State Department of Health at  161 Delaware Avenue, Delmar, New York.  Delmar is just outside of Albany.  The meeting is scheduled from 10:00 AM until 2:00 PM and is open to the general public.  We will have a public comment period at the conclusion of the meeting.

The Council was created by the New York State legislature and given the responsibility to make recommendations to the Health Department on long range objectives, goals and priorities on issues pertaining to traumatic brain injury.  The Council is also charged with providing advice to the Commissioner of Health on the planning, coordination and development of needed services.

I am pleased that at this first meeting as chair we will have the participation of Mark Kissinger who is the First Deputy Commissioner of Health for Long Term Care as well as representatives of the Department of Veteran's Affairs and the Superintendent of Insurance.  It is vitally important that these agencies participate in the discussions concerning needed services for victims of brain injury and their families.  We will also hear a report on the current status of the New York State Traumatic Brain Injury Waiver program.

This first meeting will be a working session to formulate both short and long term goals for the Council as well as to establish working committees to investigate a wide variety of issues that need to be addressed in New York State. We will also formulate a plan so that future council meetings are held in different regions of the state enabling more individuals and professionals to participate.

I look forward to public participation at this meeting and future meetings.

New York City Epilepsy Conference Scheduled

SAVE-THE-DATE FOR MAJOR CONSUMER EPILEPSY CONFERENCE

FACES (Finding A Cure For Epilepsy) the New York University sponsored epilepsy foundation is sponsoring a Epilepsy Conference on Saturday, October 27th 2007 from 9:00am to 5:00pm at NYU Medical Center.

Featuring Epilepsy 101, Adult, Parent and Spanish Lectures! Admission is FREE!

Lunch will be served and Childcare will be available.

As further details and registration information becomes available, I will post the details on the Brain Injury News and Information Blog.

Thank you for brain injury legal advocacy award

I was honored to receive the Advocate of the Year award for my "advocacy in the filed of brain injury rehabilitation" which was presented to me following my lecture yesterday at the New York, Mid Hudson brain injury rehabilitation symposium sponsored by the Northeast Center for Special Care.

In my talk today I emphasized the need to treat all persons with brain injury and family members with RESPECT.  I also discussed the need to refocus are approach to brain injury and be more concerned with quality of life issues for those suffering the life long affects TBI.

Once  again, thank you for this award. I take great pride and satisfaction in the legal  assistance that I provide to many individuals with traumatic brain injury and their family members. Knowing that I have helped a person with TBI and their family obtain necessary services, obtain proper insurance reimbursement, deal with the bureaucratic maze, obtain proper legal compensation and justice within the legal system makes my job a joy. Advocating for persons with TBI in my eight years as president of the Brain Injury Association of New York State was a very moving and meaningful part of life.  As the new chair of the State traumatic brain injury services coordinating council, I look forward to working with the State of New York to further improve services for those suffering from a TBI.  I look forward to continuing my private as well as pro bono legal efforts on behalf of the brain injury community.   

Brain Injury and the Military: Report from Washington DC Town Hall Meeting

Yesterday's town hall meeting on brain injury and how the military is responding to the ever growing needs of our returning service members was well attended by all members of the brain injury community. Well over 100 individuals and groups participated ranging from wounded service members and concerned family members to consumer advocates from many state brain injury associations and other disability advocacy groups, members of the military from both the armed forces and the VA and brain injury rehabilitation experts from around the country.

The program consisted of several panel discussions which included audience participation.  These discussions attempted to set forth the multiple issues that need to be confronted in dealing with the epidemic of traumatic brain injury in our troops returning from Iraq and Afghanistan.

Interestingly, the issues discussed have been well known in the civilian population for many years and come as no great surprise to family members who have been waging the battle for needed brain injury rehabilitation services for their loved ones. What was encouraging was the general consensus that brain services must be more than a "medical model" and that quality of life issues must play a central role in determining services and outcomes.  This change in attitude has been long in coming and hopefully will lead to more patient and family centered services.  Above all, the need to treat those with brain injury and their families with RESPECT was also repeated on multiple occasions.

What follows are my notes taken during the course of the day.

Before a true plan can be developed to deal with TBI in the military, we still need to know the true number of returning service members with traumatic brain injuries.  This is difficult because of the lack of good screening prior to discharge and poor tracking of returning vets.  In fact, we heard that State VA offices are not even given the names of discharged troops so they are unable to contact them and offer screening or services.   We also need to know where these troops are returning to following discharge so that the entire array of services can be offered within these communities.

The current number of identified soldiers suffering from TBI is approximately 3,904.  However this number does not include those suffering from mild TBI and who never received diagnosis or services at the major military trauma centers.  Without question, if these troops were included, the numbers would be staggering.  The preliminary screening programs that have been undertaken estimate that between 20 to 25 percent of returning troops suffer from some level of traumatic brain damage.  Why they haven't been diagnosed and why they are not receiving any type of assistance must be addressed.

Their is a tremendous amount of red tape that impedes the ability of brain injured troops from receiving necessary services.  Entry into the rehabilitation and services system must be streamlined. The amount of paper work and the time it takes to get authorization for needed services must be decreased.

Their is a failure on the part of the military to properly document soldier exposure to potential brain injury.  Soldiers who have been exposed to "IED's" may not know they have a traumatic brain injury for many months.  Often the symptoms are only understood once they return home.  When they attempt to get disability connected services, it become difficult for them to prove their exposure since events are not properly documented in their service record.

Many service members find themselves becoming homeless since their health issues will impact their ability to sustain employment, their lack of skills and their inability because of brain damage to learn new skills impedes their ability to obtain gainful employment and the lack of affordable housing.  These homeless veterans need to rescued and assisted.

Although the military has limited experience with brain injury rehabilitation, their is a reluctance to send these brain injured vets to private facilities who have the experience to work with the person. It was repeatedly pointed out how crucial the involvement of family members is to the brain injury rehabilitation process.  Since civilian rehab centers are located in closer proximity to where veterans and their families actually reside, it is much easier for these family members to participate in the rehabilitation process if they are treated closer to home. Treatment at VA centers limits opportunities for family involvement which becomes impractical or impossible.

The federal government has not provided adequate funding for TBI rehabilitation services.

Their is poor integration between military brain injury services and civilian services making transition very difficult.

The military lacks sufficient numbers of medical personal with the necessary knowledge and skill to diagnose and treat traumatic brain injuries.

The military must establish goals for the rehab process.  These goals must include the return of individuals to a productive life; addressing and dealing with the psychiatric disability of family members as a result of their loved one's brain damage; dealing with the injured vet's psychiatric disability as a result of their brain injury and addressing the long term needs of this population.

Other speakers touched on the need for better ways to screen troops and identify the mild traumatic brain injuries and concussions to prevent further brain damage from occurring; and the need for pre-deployment base line screening.

The services available in each State vary widely.Their must be a better allocation of resources. 

The veteran's administration disability rating system does not adequately address and capture the disabilities and cognitive impairments associated with TBI.  As a result service members receive service disability rating which do not fairly reflect the true extent of their disability related to their brain damage.

I welcome further discussions, but more importantly, I hope that the message from this meeting gets heard by Congress, the armed forces and the VA and important reforms get instituted  without any further delay.

 

Veterans With Traumatic Brain Injury: Is America Meeting Their Needs

I'm still in Washington, DC, scheduled to participate today in a national town hall meeting convened to answer the pressing questions of how to respond to the immediate and long term needs of returning service members suffering from traumatic brain injury.

Some of this issues scheduled to be discussed in this all day program include important issues of how to identify returning vets suffering from brain damage; evaluation of proposed legislation; community reentry including vocational rehabilitation,education reentry and access to transportation.

Scheduled to participate in today's meeting are the leading policy maker's involved in public policy issues surrounding traumatic brain injury including members of Congress, representatives of the Center for Disease Control, members of the military and veteran's affairs as well as the leading groups in this Country that shape the debate regarding brain trauma including the Brain Injury Association of America, the National Association of State Head Injury Administrators, the Defense and Veterans Brain Injury Center and state brain injury associations.

I look forward to a lively discussion of the issues especially in light of the conclusions of a separate panel which was part of a day long Washington Defense Forum sponsored by the U.S. Naval Institute and the Military Officers Association of America.  The meeting which took place on Tuesday, concluded that the bureaucracies that are supposed to help brain-injured war veterans are too complex for them to navigate.  Specifically, the departments of Veterans Affairs and Defense need better coordination of their programs, according to the panel.

Mid Hudson, New York Brain Injury Conference

I look forward to participating this Thursday, September 20th in the 2007 Mid Hudson Brain Injury Rehabilitation Conference sponsored by the Northeast Center for Special Care.

I have been asked to provide the lead off presentation on the important topic of Ethical Considerations in Dealing with the Brain Injured Population.  It is a presentation that I enjoy giving to clinicians, lawyers and other professionals on the need to treat persons with a brain injury with RESPECT and an understanding of their cognitive strengths and weaknesses.  Some of the points that I will be making include the need to schedule appointments with extra time, the need to provide written information for individuals to take home so that they can go back and refer to the conversations that you had, the need to understand some of the unique challenges that face persons with a brain injury such as sensitivity to bright lights and distracting back ground sounds and the accommodations that need to be made, the need to understand that at times, behavior may not be what one is used to, the need to repeat and reinforce information presented and perhaps schedule follow up appointments. 

Other speakers throughout the day will focus their discussions on issues such as post traumatic stress disorder and brain injury, issues of addiction following a brain injury, biofeedback programs and visual disturbance following a traumatic brain injury.  You can get further information about the conference by downloading the conference brochure by clicking here.

The conference is scheduled to begin at 8:00 AM and run to 5:00 PM at the Holiday Inn in Kingston. You can register by telephone by contacting Deborah Muise at 845 336 3500 xt 3262

More Double Talk Today at Senate Hearing Examining NFL Disability Plan

I was privileged to attend the United States Commerce Committee oversight hearing today on issues pertaining the National Football League's Disability Plan and a follow up press conference hosted by Gridirons Greats, an organization of retired players headed by Mike Ditka and dedicated to achieving fairness and fair dealing for disabled players..

Unfortunately, what I heard was a lot of double talk.  While I commend NFL Commissioner Roger Goodell for his willingness to discuss the issues surrounding the plan, take the heat and pledge reform,I really didn't hear anything that was new or different.  The true issue is how the plan gets the final say on whether or not the player has permanent brain damage.  At the conclusion of the hearing I had an opportunity to meet with Gene Upshaw, head of NFL Player's Association.  I offered to meet with him in New York or anywhere else to discuss the serious issues of traumatic brain injury and the devastating nature of this condition.  He seemed interested.  Let's hope he contacts me so we can have a serious discussion and open a dialog.

They can change all the definitions of disability they want, but when the league gets to pick its own medical consultants who have the final say and the player gets no opportunity to challenge the decision, no matter how arbitrary or capricious it is, that violates fundamental principals of fairness and due process.

I have sadly been asked to review files of former players whose have been turned down by the league despite overwhelming evidence of brain damage suffered while playing professional football.  The league will keep looking until it finds a doctor to disagree with the multiple medical experts who have already concluded that a disability exists.  They will then chose to follow the recommendation of their bought and paid for, so called medical expert.

As I have previously said, When it comes to concussions and legal determinations as to whether a player has sustained brain damage, the league's position is heads I win, tails you lose.  It is outrageous that the league has stacked the deck against its retired and disabled players. It's time for Congress to act and rectify the injustices that have deprived victim's of brain trauma their legal rights.    They must allow players access to Court's of Law to review these determinations and take away the unfettered discretion that the league now enjoys.

Senate Hearings on NFL Disability Plan

I will be in Washington, DC this Tuesday, September 18th to participate in the hearings conducted by the Senate Commerce Committee on the way that the National Football League and Player's association disability plan manages claims of disabling brain damage.

Having personally been consulted by numerous football player's who have been wrongfully turned down by the league, I can personally attest to the way that the deck is stacked against brain damaged players by the league.  The disability plan consistently ignores the evidence of brain injury presented by players; ignores prevailing medical opinions about brain injury, its cause and consequences and instead chooses to rely on "experts" bought and paid for by the league who improperly claim that the player is not brain injured or has no permanent disability. 

These so called "experts" wrongful state that their is no evidence of brain injury either because the player was never knocked unconscious or because the MRI and CT scans are normal or because they player can pass a mini mental status exam. It's time that these professionals be subject the rigors of cross examination.  The "heads I win, tails you lose attitude of the disability plan when it comes to evaluating evidence of concussions needs to change and it may be the time for Congress to step in and fix what the plan itself is incapable of correcting on their own.

Scheduled to testify on Tuesday are Commissioner Roger Goodell and NFL Players Association executive director Gene Upshaw as well as Hall of Fame tight end and former Chicago Bears coach Mike Ditka, a critic of the plan as well as several players who claim they have wrongfully been denied disability benefits despite overwhelming evidence of brain damage.

High School Football Players Fail to Recognize the Seriousness of Concussions

A fascinating story appeared in yesterday's New York Times. High School Players Shrug Off Concussions, Raising Risks. 

The lengthy story explored the troubling prevailing attitude and culture that permeates high school football.  Namely, high school players minimize their injuries, especially their concussions; they do not have any clear idea what the symptoms of a concussion are or the dangers of continuing to play while symptomatic following a concussion.

These players are not alone in failing to appreciate the serious and life long consequences of a concussion.  Not only must they be educated, their parents, trainers and coaches need to understand the issues surrounding concussions and the dangers of minimizing any type of brain injury. 

The article quotes players as saying some really dangerous things like, "It's not dangerous to play with a concussion. You've got to sacrifice for the sake of the team.  The only way I come out is on a stretcher" and "our coaches would take us out in a second. So why, would we tell them?" 

As Robert Sallis, president of the American College of Sport's Medicine said, "Poor management of high school player's concussions "isn't just a football issue.  It's a matter of public health"

Some states are beginning to require specific training for players and coaches regarding the dangers of concussions.  Sounds like a great idea that should be explored by all school districts and states.

You can read the full article by clicking here.

Virginia Faulted on Care to Brain Injured

A report issued by a Virginia legislative review commission concluded that tens of thousands of people in Virginia with traumatic-brain injuries lack adequate residential facilities, access to therapy, transportation or occupational help. 

Further jeopardizing the already taxed system of brain injury care in Virginia is the prospect of returning veterans with brain damage who will also require care with no plans on how to deal with this growing epidemic. 

Unfortunately, Virginia is not the only State that lacks the proper resources to adequately care for the thousands of individuals who must live with a traumatic brain injury on a daily basis. Most states do not maintain proper statistics on the number of individuals who sustain brain injury in a give year and lack proper support services for brain damaged individuals and their families.  Rehabilitative services in many places are fragmented and not easily accessible.  Most states have improper levels of funding to support brain injury services and most individuals do not receive the services they deserve.

In Virginia, most if not all facilities will not accept Medicaid to pay for residential care.  In fact, the only facility in the state that does accept Medicaid payments for residential care for traumatic brain injury victims will stop accepting these patients later this month.

But, Medicaid funding is not the only issue.  Issues of private insurance and why these health insurers are not paying for brain injury rehabilitation services needs to be addressed.

You can read more about this 130 page report by clicking here.

Learn more about Chris Benoit's Brain Injury Tonight on Geraldo At Large

Just learned that tonight at 8 PM and 11 PM EST, Sports Legacy Institute founding members will discuss their neuropathology findings and opinions concerning Chris Benoit brain damage.

Taking on the VA For Brain Injury Rehabilitation

The Boston Globe in an important article reports on the success and failures of returning veterans and their families in obtaining brain injury rehabilitation services outside of the Veterans Administration network.

I have been saying for a long time that I can't understand why the VA will not allow brain damaged vets to obtain services in facilities that are not only close to their home but provide expertise that the VA still is incapable of providing.  It simply makes no sense that the VA is trying to reinvent the wheel.  Why not use the available services that are available in the community to provide care to returning vets.  The adamant attitude of do it our way or not at all simply needs to change!

Read the full story Families wage fight for brain injured.  Thanks to the Going Through the Motions blog for alerting me to this story.

The Plight of the Brain Injured in Ireland

According to an article in the Irish Times, the rehabilitation of those with brain damage in Ireland is woefully inadequate.  Although some 10,000 people suffer head or brain trauma every year in Ireland, traumatic brain injury is still not recognized as a distinct or unique disability by the health authorities and there is no national strategy for support services according to the Peter Bradley Foundation a victim's rights group. 

Interestingly, the Irish public health authorities do not yet recognize traumatic brain injury and the disability that it causes as a separate disease entity and fail to provide direct funding for TBI support services.

The foundation charges that the the waiting time to obtain needed services  can be three to six months depending on the complexity of the brain injury and, for minimally conscious brain injury patients, waiting times average 18 months!

Brain Autopsy of WWE Wrestler Benoit Shows Extensive Brain Damage

In a Manhattan press conference today, physicians associated with the Sports Legacy Institute announced their findings today concerning the examination of the brain of pro wrestler Chris Benoit who killed his wife, son and then himself.

Not surprisingly, the examination of his brain showed extensive areas of brain damage.  All four lobes of his brain showed extensive cell death which is consistent with the multiple concussions he sustained while engaged in professional wrestling.

Benoit's brain was examined by the research team which included noted neurosurgeons Julian Bailes and Robert Cantu who along with retired pro wrestler, Chris Nowinski, author of Head Games, established the Sports Legacy Institute to look at the mounting evidence of permanent brain damage caused by concussions sustained by athletes.  Head Games is an excellent source of information on the dangers and long term effects of concussions

The brain experts had not problem concluding that the brain damage they found were due to the multiple concussions that Benoit sustained. But, the physicians could not say with absolute certainty that this brain damage was the cause of Benoit's erratic behavior on the night of the murders. They did say however, that the this type of brain damage can cause depression and irrational behavior in an individual.  Similar brain abnormalities were also found on autopsy of the brains of other athletes who committed suicide including pro football player, Andre Walters.

A full report of the press conference can be found at ABC News. 

More Congressional Hearings Scheduled on NFL Disability Plans

Following a House Judiciary Subcommittee meeting in June on the sorry state of the NFL players disability plan and the unconscionable way that disability determinations are made in areas of brain damage and other disabilities, the United States Senate Committee on Commerce, Science and Transportation announced that they would be holding hearings on September 18th.

Let's hope that league officials attend this hearing and answer the tough questions of why players with obvious brain damage are consistently denied disability benefits and why the league's disability plan ignores the opinions of the players treating health care professionals. 

The league should not be allowed to now hide behind the vague and arbitrary standards of the social security administration in determining disability for brain injury.  Social security doesn't have any real standards for determining disability for a traumatic brain injury.  Instead social security bundles this unique condition under the term "mental disorder".  If an individual can perform any job in the economy, anywhere in the United States, social security does not consider the individual to be disabled. No consideration is given to the number of hours that an individual can work following a brain injury, that they may not be able to keep a job and may be terminated because of their social and emotional difficulties.

The NFL needs to do better than the social security administration in determining disability following brain trauma.