Brain Injury Lawyer - New York

Brain Injury Association and Journal of Head Trauma Rehabilitation Form Partnership

The Brain Injury Association of America (BIAA) and Wolters Kluwer Health/Lippincott Williams and Wilkins (LWW) have entered into an agreement that designates the Journal of Head Trauma Rehabilitation (JHTR) as BIAA's official scholarly journal beginning January 1, 2009.
 
 "As the nationwide voice of brain injury, our goal is to put timely, relevant research findings into the hands of brain injury clinicians and business leaders as well as policy makers and the media," said Susan Connors, BIAA President and CEO. 
 
The partnership with LWW ensures that each new member of BIAA's Academy of Certified Brain Injury Specialists will receive a one-year subscription to the leading, peer-reviewed publication in brain injury.  Renewing certificants will have an opportunity to subscribe to JHTR at discounted rates.  Connors added, "In time, we hope to make JHTR available at discounted rates to members of BIAA's newly formed Business & Professional Council and to individuals who are members of BIAA's chartered state affiliates."
 
 "JHTR has led the way in brain injury treatment research and practice for nearly 25 years," noted Sandra Kasko, JHTR Publisher.  "JHTR is ranked #1 in rehabilitation by the Institute for Scientific Information's 2007 Journal Citation Report.  LWW is pleased to partner with BIAA to provide this essential resource."
 
The Journal is comprised of feature articles, brief reports, pharmacological updates, legislative and public policy news, columns on ethics, book reviews, and more.  Four of the six issues published each year focus on a subject of importance to the practitioner.  The remaining two focus on a variety of clinical practice and research topics.  In concert with BIAA's adoption of JHTR, the Association will introduce the Mitch Rosenthal Memorial Lecture Series in 2009.  The Rosenthal Lectures, delivered via teleconference and webinars, will be drawn from each issue's content.
 
John D. Corrigan, PhD, ABPP, of The Ohio State University, and Nathaniel H. Mayer, MD, of the Drucker Brain Injury Center at MossRehab Hospital and also Temple University School of Medicine, are JHTR's Editors.  Corrigan noted, "BIAA and JHTR are two of the nation's oldest, most respected names in the brain injury field.  This partnership will extend the good work both organizations do to improve care for individuals with brain injury.  Honoring my friend and colleague Mitch Rosenthal makes the collaboration even better."
 
About the Brain Injury Association of America
Founded in 1980, the Brain Injury Association of America is the voice of brain injury.  BIAA and its nationwide network of state affiliates provide help, hope and healing to the millions of Americans who live with a lifelong disability as a result of brain injury, as well as their families and the researchers, clinicians and professionals who provide treatment and long-term care. For more information about the Brain Injury Association of America, visit their web site BIAA.  
 

GW Graduate Brain Injury Programs Still Accepting Applications

The George Washington University (GW) has two excellent programs providing graduate training to serve individuals with traumatic brain injury.
 
I have been privileged to be a guest lecturer for the past several semesters and can attest to the hih quality of the courses offered, the spirit and dedication of the student body and the commitment of the school's administration in improving the quality of life for persons with brain injury.

GW is currently accepting applications for the spring
2009 semester and for summer and fall 2009 semesters.  Although the official admissions deadline has passed for spring, the on-line application process makes it possible to get an application completed in time for consideration if it is submitted right away.

Some very good news is that through several grants from the U.S. Department of Education, GW is able to provide partial (usually 80%) scholarships for eligible US citizens and permanent residents for the following programs:

1.  Graduate Certificate in Brain Injury: Educational and Transition Services.  This is a 15 credit (5 courses) program offered both on-line and at the main campus in Washington D.C. For more information contact Monija Amani or by calling her at 202-973-1032.

2.  A Master’s Degree in Transition Special Education: Emphasis in Acquired Brain Injury. This is a 45-48 credit program, including internships, offered only at the main campus in Washington D.C.  For more information contact Zee Willis or by calling her at 202-973-1082.

You may apply on-line by going to the Graduate School of Education and Human Development (GSEHD) website and then using the Apply Online application process.

Brain Injury Association Legislative Update

The following information comes from the most recent Brain Injury Association of America Legislative Update:

Defense Secretary Gates Responds to Senators’ Letter on Cognitive Rehabilitation:

United States Secretary of Defense Robert Gates has responded to the letter a group of Senators issued on August 4, 2008 calling on him to ensure official TRICARE coverage of cognitive rehabilitation.  As you may recall, BIAA played a crucial role in helping initiate and promote this letter, which was led by Senator Evan Bayh (D-IN).

In his response, Secretary Gates continues to defend TRICARE’s lack of coverage of cognitive rehabilitation, maintaining that there is insufficient evidence from properly structured research protocols to establish the general acceptance of cognitive rehabilitation as a proven medical treatment.
 
Specifically, Secretary Gates states, “The Assistant Secretary of Defense for Health Affairs reports that while the existing evidence is supportive of cognitive rehabilitation, the rigor of the research by which that evidence was produced has not yet met the required standard.”  At the same time, Secretary Gates’ letter does acknowledge that “many organizations and reviews have supported cognitive rehabilitation.”

BIAA strongly disagrees with the argument put forth by Secretary Gates that there is insufficient evidence to justify official TRICARE coverage of cognitive rehabilitation.  BIAA, along with numerous congressional advocates, will continue to press this issue in the new 111th Congress next year.

VA Signs Interagency Agreement With NIDRR-Funded TBI Model Systems:
 
In an exciting development, the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research (NIDRR) recently signed an Interagency Agreement (IAA) with the Department of Veterans Affairs (VA) for the NIDRR-funded Traumatic Brain Injury Model Systems National Data and Statistical Center (NDSC) located at Craig Hospital in Englewood, Colorado to provide consultation, training, and technical assistance to the VA and the VA Polytrauma Rehabilitation Centers.
 
The Agreement calls for Craig and NIDRR to assist the VA to create a new registry of military service personnel and veterans who are returning from Iraq or Afghanistan with traumatic brain injuries (TBI).
BIAA has long been a strong advocate for collaboration between VA and NIDRR’s TBI Model Systems of Care Program, and last year BIAA played a critical role in ensuring the inclusion of legislative language mandating such collaboration in the National Defense Authorization Act for Fiscal Year 2008 (H.R. 4986).  BIAA also played a vital role in obtaining $900,000 in additional funding last year to maintain research capacity within the TBI Model Systems of Care program.

Congressman Pascrell Introduces Bill to Improve Concussion Management in Schools:

In response to the tragic death of Montclair High School’s Ryne Dougherty, U.S. Rep. Bill Pascrell, Jr. (D-NJ), the co-founder and co-chairman of the Congressional Brain Injury Task Force yesterday introduced legislation in the House of Representatives to help schools better protect student athletes from brain injuries. 

The legislation, called the Concussion Treatment and Care Tools (ConTACT) Act, will authorize federal grants to states to be used to help schools invest in concussion screening technology and adopt better concussion management guidelines.

“Providing basic preventative technology and guidelines to mitigate the effects of head injuries can reduce the number of tragic deaths and countless injuries that occur in youth athletics,” stated Pascrell.  “I will push hard with the weight of the entire Congressional Brain Injury Task Force to implement the ConTACT Act.”

Specifically, the ConTACT Act will create a state grant program through the Centers for Disease Control and Prevention (CDC) that will fund computerized pre-season baseline and post-concussion neurological testing for school sponsored sports.  Schools that enroll students from grades 6 through 12 will be eligible for the funding. 

The grant program would be authorized for 5 years and is estimated to cost $5 million in the first year.  It would require a report to Congress within 2 years of enactment regarding the use and results of screening technology. 

Pascrell has long been a strong advocate for expanding concussion management technology to youth athletics.  In August of 2006, Pascrell visited a Nutley High School football practice to announce a new round of grants for New Jersey high schools to implement concussion management technology.

The legislation was developed by Rep. Pascrell, Rep. Todd Platts (R-PA) and the Brain Injury Task Force with consultation from the Brain Injury Association of America, the New Jersey Brain Injury Association, the National Association of State Head Injury Administrators, the Athletic Trainers Society of New Jersey, the International Brain Research Foundation and the New Jersey Office of Disability Services.
A copy of the legislation will be made available on the “Policy & Legislation” section of BIAA’s website

BIAA Testifies at Social Security Administration Compassionate Allowances Hearing:

On November 18, 2008, BIAA Director of Consumer Services, Greg Ayotte, testified in Arlington, Virginia at a Social Security Administration (SSA) Compassionate Allowance outreach hearing on brain injuries.

The purpose of this hearing was to consider views about the advisability and possible methods of identifying and implementing compassionate allowances for children and adults with brain injuries. SSA’s Compassionate Allowance Initiative represents an effort by SSA to consider ways to quickly identify diseases and other serious medical conditions that obviously meet the definition of disability under the Social Security Act (Act) and which can be identified with minimal objective medical information. SSA calls this method “Compassionate Allowances.''

Among other things, BIAA’s testimony focused on illustrating some of the obstacles individuals with brain injuries encounter when trying to access Social Security disability benefits.

BIAA Urges Repeal of Medicare’s Two-Year Wait Period:

On November 12, 2008, BIAA joined the Coalition to End the Two-Year Wait for Medicare - which represents over 75 health advocacy organizations - in launching its campaign to urge the next Congress to end the 24-month wait for Medicare coverage faced by people with disabilities.

At a press conference held on Capitol Hill, people currently caught up in the waiting period described their experiences and Representative Gene Green (D-TX) described legislative efforts to eliminate the waiting period.  In addition, at the press conference Coalition leaders released a letter signed by Coalition members – including BIAA – addressed to Democratic and Republican leaders of the Senate Finance Committee and the House Ways and Means Committee.  The letter calls for health coverage for people with disabilities to be at the forefront of future legislative efforts to cover the uninsured.

The issue this Coalition is working to address is that people who become severely and permanently disabled qualify for Social Security Disability Insurance and Medicare coverage. However, according to federal statute, they must wait two years from their date of eligibility for SSDI before their Medicare coverage begins. About one quarter of people in this waiting period are without insurance for the entire time. Many cannot afford to pay COBRA premiums to maintain coverage from their former employer, and private coverage on the individual market is unavailable or too expensive for this high-cost population, including many individuals with brain injuries.

In a formal statement circulated at the press conference, BIAA noted that, “In causing delay of proper treatment, this unnecessary waiting period promotes increased lifelong disability for individuals with brain injury and significantly decreases cost efficiency in medical and rehabilitative treatment.”
A copy of BIAA’s statement in its entirety, and the Coalition's letter, will be made available on the “Policy & Legislation” section of BIAA’s website  shortly.

New Ways To Demonstrate Mild Traumatic Brain Injury

An article in USA Today, "Mild Brain injuries are now easier for doctors to detect" reports on research presented to the annual meeting of the Society for Neuroscience.

The researchers reported that by combining tow advance brain scanning techniques, MEG (magnetoencephalography) and DTI (diffusion tensor imaging), they were able to discover brain injury that conventional MRI and CT studies had missed. 

According to one of the researchers, "The scan combination is substantially more sensitive than conventional CT and MRI in detecting subtle neuronal injury in mild TBI."

This is very promising research to objectively quantify this "invisible injury".

You can read the full story on brain imaging techniques  by clicking here.

Can a redesigned helmet prevent brain injury?

The brain can be injured in many ways.  Although popular opinion is that direct impact is necessary for injury to the brain, this is not true. Frequently, the brain is injured from indirect forces causing the movement of the brain within the skull.  

One such indirect injury is the blast injury sustained by solders.  Scientists at Lawrence Livermore National Laboratory investigated the mechanics of how blasts affect the brain to see if they could design a helmet that would provide greater protection to the brain. 

Traditionally, armor design, including helmets, focused on minimizing the force of impacts–either from objects striking the soldier or from the soldier being thrown against hard surfaces. But the new study investigates how shock waves from explosions can flex and deform the skull itself, creating internal pressure on the soft brain tissue. Some current helmet designs that maintain a gap between the skull and the helmet wall actually amplify the pressure from blast waves. The research could lead to improved helmet design that protects from projectiles, impacts, and blast waves.

You can read the full story by clicking here.

Decompresive craniectomy following severe traumatic brain injury

A decompressive craniectomy can be a life-saving procedure to relieve critically increased intracranial pressure.  In a paper published in the journal Neurosurgery (October 2008), the author's investigated what the long term clinical results were following this procedure.  

The researchers looked at Thirty-three patients (20 males and 13 females) with a mean age of 36.3 years (range 13-60 years) with severe traumatic brain injury (Grades III and IV) and subsequent massive brain swelling.  

The results of this survey revealed that  one-fifth of all patients died and one-fifth remained in a vegetative state. Mild deficits were seen in 6 of 33 patients. A full rehabilitation (Barthel Index 90-100) was achieved in 13 patients (39.4%). Five patients could resume their former occupation, and another 4 had to change jobs.

The study concluded that  age remains to be one of the most important exclusion factors. Decompressive craniectomy provided good clinical results in nearly 40% of patients who were otherwise most likely to die. Therefore, long-term results justify the use of decompressive craniectomy in this case series.

Care Givers Need To Be Compensated For Their Services

The New York Times had a very important story earlier this week entitled "Veterans' Families Seek Aid For Caregiver Role".

The story explored the difficulties that family members who are acting as caregivers for those who have sustained a traumatic brain injury have in obtaining compensation for their services. 

I am very familiar with the issue that must be confronted in dealings with state Medicaid as well as with private insurance carriers as well as in litigation where proper compensation must be afforded to those injured and their families.

I have always thought the parents need to be parents and spouses need to be spouses.  The care or supervision  that needs to be rendered to those who have suffered a TBI often times makes the role of a parent or spouse into something that becomes strained and inappropriate.  It is far better for these services to be rendered by third parties.

However, those with the dollars always seem to find a way to save money.  They think that it is appropriate to only fund one eight hour shift and then pass the burden of care onto the family for the remaining portion of the day.  Did they forget that these family members have to eat and sleep themselves, that they may have other children to care for at home and other obligations that make it inappropriate for them to act as the sole caregiver for these sixteen hours?

I am glad to see that more and more attention is being focused on the needs of caregivers in caring for those suffering with brain damage.  To often, this is population is ignored and their needs go unmet.

You can read the full New York Times story by clicking here.

Head Injury and ADHD

There has always been a reported connection between attention-deficit hyperactivity disorder (ADHD) in children and head injury.  Researchers have set out to determine if the head injury is the cause of the development of ADHD.

In a paper published in the British Medical Journal this week, the researchers found that it is the trait of excessive risk taking shared by children with ADHD and those who have sustained a head injury and not the head injury itself that is the cause.

For the study, the research group collected data on 62,088 children who were registered in a British health improvement network database. The researchers compared the children with head injuries to two other groups: children with a burn/scald injury before the age of 2, and all the other non-injured children.

"We wanted to make sure that if we saw a relationship between head injury and ADHD, it wasn't just that kids with early injuries were showing behavioral traits that would make them more likely to be diagnosed versus the head injury itself," said the studies lead author. 

The researchers found that children with early head injury did have a 90 percent higher incidence of ADHD diagnosis before they were 10, compared with children in the general population. However, children with a scalding injury also had a higher risk of being diagnosed with ADHD, 70 percent to be exact. "Therefore, the head injury did not appear to cause the ADHD," they concluded.  They think that this may mean that some very young children are already showing behavioral traits that are the hallmarks of ADHD.

Carbon Monoxide Poisoning

Carbon Monoxide poisoning frequently results in brain damage. As the temperature gets colder and more furnaces and portable heaters are used, there is a dramatic increase in carbon monoxide poisoning cases.

The Poison Control Center today issued the following warning and press release pertaining to the dangers of carbon monoxide exposure and poisoning in the winter season:                        

The onset of cold weather greatly increases the chances for exposure to poisonous carbon monoxide (CO) gas as consumers increase their use of appliances such as space heaters andportable generators, warns the American Association of Poison Control Centers (AAPCC).  Every year,hundreds of deaths and many thousands of illnesses result from exposure to CO.

Among the numerous potential sources of CO are furnaces, water heaters, stoves, ovens, space heaters, wood and gas fireplaces, wood-burning stoves, portable generators and automobile engines.

“All fuel powered engines produce CO gas,” explains AAPCC Board Member Edward P. Krenzelok, PharmD, director of the Pittsburgh Poison Center.  “Although such devices are safe if used correctly, a malfunction or improper ventilation can make these common household appliances deadly.” 

Carbon monoxide gas is lethal, even though it is colorless, odorless, and tasteless. It may kill quickly or slowly, and the warning signs specific to carbon monoxide are also common to the flu and food poisoning. Even when it is not fatal, carbon monoxide can cause permanent damage to the brain and other parts of the nervous system.  Symptoms include aches, dizziness, headache, confusion, and other symptoms also found with flu and typical cold-weather viruses.

AAPCC suggest taking some simple steps to prevent carbon monoxide poisoning:

• Have all of your combustion appliances and especially your furnace inspected and adjusted before every heating season.

• Have your chimney, fireplace, and wood stoves, and flues inspected before every heating season.

• Have chimneys and flues repaired as needed.

• Do not use charcoal grills indoors for cooking or heating.

• Do not use your oven for heating your home.

• Do not leave your car’s engine running in an enclosed or attached garage, even if the door is open.

• Install a carbon monoxide alarm outside of every sleeping area in your home.

Poison control centers around the country are prepared to respond with information and treatment advice about CO poisoning.  To reach a local poison center call 1-800-222-1222.  More information about CO poisoning may be found on the AAPCC’s Website.

In many cases the responsibility for carbon monoxide exposure rests with the landlord.  If your family member or yourself as been a victim of carbon monoxide poisoning, the brain injury lawyers at the brain injury law firm of De Caro & Kaplen, LLP

How Brain Science May Change the Way We Live

Thanks to Brain Wave for alerting us to a new article in this month's The Oprah Magazine entitled, The Brain Age.

Cutting-edge neuroscience has escaped from the lab and is suddenly showing up everywhere, changing the way we practice law, go shopping—even, possibly, fall in love.

It's been only a decade or so since the world got hardwired, "Google" became a verb, and texting turned into a lifestyle. But if you're still struggling to thumb a message, brace yourself: A whole new revolution in neuroscience is about to shake up our world. You can read the entire article by clicking here.