Brain Injury Lawyer - New York

Concussion Insurance Benefits for Student Athlethes

Here is some hopefully, refreshing news from an insurance company for a change.  It has been reported that Wells Fargo’s Student Insurance Division (SID) and the Sports Concussion Institute (SCI) has launched Play It Safe Concussion Care (PSC). According to the insurance carrier, it’s a new concussion management treatment and services solution for athletes nationwide.

PSC includes insurance underwritten by National Union Fire Insurance of Pittsburgh, and provides concussion medical expense benefits for athletes who sustain a covered head injury.

The company stated that the process begins with a baseline assessment by SCI, or its affiliated medical providers, which includes a neurocognitive evaluation administered to athletes pre-season. Athlete suffering a covered head injury would receive a post-injury assessment to compare to their baseline results, helping to evaluate the extent of the injury and inform treatment. 

Let’s hope that the “covered” head injuries is not so restrictive as to make the coverage meaningless. I am hopeful that any concussion or even suspected concussion should be covered for post-injury assessment and any player who is diagnosed with a concussion should receive rehabilitation benefits under the plan.  If not, then the coverage is not very beneficial.

Three Years and Not One Service Member Tested for Subtle Brain Damage

Subtle brain damage is often missed by conventional MRI testing, leading many to falsely conclude that no structural brain damage has taken place.  This false premise has subjected many individuals who have sustained brain injury, including returning veterans to have their claims rejected. 

The absence of proof is not proof of the absence of an injury and the fact that often times brain injury is not detected using MRI Studies does not mean that an individual did not suffer a traumatic brain injury. 

Newer MRI techniques such as the more powerful Tesla 3 MRI machines are now capable of detecting brain injuries that were missed in the past. Other useful techniques for detecting subtle brain injury include functional MRI studies (fMRI)
 
Three years ago, the Department of Veterans Affairs established a laboratory at the University of Texas at Austin with high expectations that it would conduct state-of-the art research into combat-related brain injuries using powerful MRI technology.  However after 3 years no studies have ever taken place!

Last month, the VA announced it was moving the facility to Waco, Texas, after spending more than $3 million without testing a single veteran with traumatic brain injury.  The Waco facility is reported to have the world’s most powerful research MRI machine.

The decision follows a two-year battle between VA and the former director of the Brain Injury and Recovery Laboratory, who has accused his superiors of fraud, mismanagement and wasting taxpayer money.

The uproar has sparked a congressional inquiry, an investigation by the federal Office of Special Counsel and several internal investigations.

Hopefully, research will finally get underway to objectively document subtle brain injuries in returning vets.

You can read more on the controversy and investigation of the Austin facility by clicking a story in the Washington Post , “VA Moves Texas Brain Laboratory After Years Pass Without Testing”

Comparing Brain Damage in Brains of Wounded Vets to Brain Damage in Football Players

The Sports Legacy Institute and the Boston University Center for the Study of Traumatic Encephalopathy have announced that they will be now examining the brain tissue of service members who have passed away after suffering from blast injuries.  They will be comparing the pathological findings in the brain tissue of victims of blast injury to the findings in tissue examined in football players who have sustained multiple concussions. The full story is reported in the New York Times article, "A Chance for Clues to Brain Injury in Combat Blasts".

The researchers hope to determine whether single, non-impact blasts in battle can cause the same type of brain damage found in the brains of football players who have been subject to years of repetitive head injury.

They researchers also are interested in determining whether their are physical changes to the brain in service members who have been diagnosed with post traumatic stress disorder (PTSD) since many of the symptoms associated with this condition, such as depression, erratic behavior , diminished ability to concentrate are all similar to the post concussion symptoms faced by professional athletes and other concussion victims.

Brain Injury Resource Lecture at The George Washington University

I am thrilled to be in Washington DC today to again lecture at the Master's Degree Program in the Center for Education and Human Services Acquired Brain Injury Masters program at The George Washington University.

This semester’s lecture is focused on examining the various sources of information that is available on the internet in the area of traumatic brain injury. We will be exploring government web sites such as the Center For Disease Control and the National Institute of Health, great brain injury resource sites such as BrainLine, web sites that emphasize management of sports concussions, web sites that provide useful information on special education, various neuropsychological accrediting groups, brain injury association pages, brain injury professional societies and of course the brain injury news and information blog and brain law and the brain injury legal guide web site.

The Master's Degree Program in Special Education: Emphasis in Acquired Brain Injury is focused in addressing the national shortage of special education and related service personnel qualified to meet the needs of students with traumatic brain injuries (TBI) and their families. Graduates are uniquely prepared to be educators and systemic improvement specialists in schools, hospitals, rehabilitation programs, advocacy programs, and related organizations. Scholarship support for qualified students is available. You can obtain more information on the GW Acquired Brain Injury Program by clicking here.

Spanish Language Resources for Brain Injury Survivors

Thanks to brainline for providing a tip on where to obtain spanish language information for individuals with brain injury and their families.  The material was prepared by the Defense and Veterans Brain Injury Center (DVBIC) and are Spanish translations of three popular DVBIC handouts. Signs and Symptoms of Traumatic Brain Injury (TBI), Frequently Asked Questions About the Defense and Veterans Brain Injury Center (DVBIC), and the DVBIC Fact Sheet on TBI.  They may be downloaded at the Defense and Veterans Brain Injury Center web site. In Spanish, click here.  To order print copies, you can email your request to the Defense and Brain Injury Center

Weekly Brain Injury Legislative Update

Here is this week's traumatic brain injury legislative update provided by the Brain Injury Association of America (BIAA)

Health Care Reform Update

Currently, the Senate Finance Committee has reached no consensus on major provisions of the anticipated health care overhaul, raising doubts that it will be considered this month.  Committee members remain at an impasse in part because members still lack a clear picture of what potential policy choices would cost.

The Congressional Budget Office (CBO), which estimates what legislation will cost the taxpayers, is scrambling to analyze dozens of policy options the committee is considering. Without cost estimates, lawmakers say it is difficult to decide which provisions they can support. (CQ)

BIAA will continue monitoring the situation closely.

BIAA mobilizes Grassroots Advocates in Support of The conTACT Act

On Thursday, June 4, 2009, BIAA circulated an action alert with the intent to urge members of Congress to sign on to HR 1347, the Concussion Treatment and Care Tools Act of 2009(ConTACT Act). 

The bill would require the Centers for Disease Control (CDC) to convene a conference to adopt official concussion guidelines. The bill would also provide grants to states for the purpose of ensuring that elementary and secondary schools implement these guidelines by funding computerized pre-season baseline and post-injury neuropsychological testing for student athletes.

BIAA Submits Comments to NIDRR in Response to Proposed Priorities for RRTCs

This week, BIAA submitted comments to the National Institute on Disability and Rehabilitation Research (NIDRR) specifically regarding the fourth priority included in the proposed plan for the Rehabilitation Research and Training Centers (RRTCs) entitled, "Developing Strategies to Foster Community Integration and Participation for Individuals with Traumatic Brain Injury." 

BIAA expressed strong support for the inclusion of a brain injury related research priority.  However, BIAA also detailed some concerns related to the strategies used in the priority to foster community integration and participation for affected individuals. As proposed, this priority would develop a classification system based on symptoms experienced by individuals with TBI who are living in the community.

BIAA explained that no two brains are alike and each and every individual presents with different symptoms, and each injury results in different challenges. Therefore, trying to categorize these injuries could be counterproductive to the priority's goal.

BIAA also suggested several suggestions in lieu of a categorization strategy.  For further reading, the full text will be posted on BIAA's web site shortly.

Concussion Management Bill Introduced in Congress

Urge House Members to Cosponsor HR 1347, The Concussion Treatment and Care Tools Act of 2009 
 
Members of the House of Representatives have introduced the Concussion Treatment and Care Tools Act of 2009 (HR 1347), a bill designed to ensure adoption, dissemination, and implementation by elementary and secondary schools of concussion management guidelines for the purpose of better treatment and awareness of the injuries of the estimated 3.8 million young people that suffer sports and recreational concussions each year.

The sponsors of this Act, Representatives Bill Pascrell, Jr. and Todd R. Platts, have called upon Congress to provide grants to states for the purpose of ensuring that elementary and secondary schools implement these guidelines by funding computerized pre-season baseline and post-injury neuropsychological testing for student athletes.

Because the support of this initiative is vital to the protection of school aged children engaging in sports and recreational activities, it is important for us to urge as many Congressional Members as possible to sign on as cosponsors!
 
 

More evidence that children need to be assessed following a concussion before being allowed to go back to sports or play time activities

Children hospitalized with concussions should wait until they are seen by a clinician in a follow-up exam before returning to regular sports or playtime activities, according to researchers at The Children's Hospital of Philadelphia.

Rather than only consulting a doctor when there are obvious trouble signs after the initial treatment, the Children's Hospital researchers recommend that a qualified healthcare provider perform a formal assessment after hospital discharge but before child resumes exertional activities. The study team used a computer-based testing program created to assess athletes with concussions and determine when it was safe to return to play. The authors found that nearly all the children admitted to the hospital with a concussion had some abnormal brain function during initial testing.

The  article appears in the May issue of the journal Annals of Surgery.

Prior research has demonstrated that children are more likely to sustain another concussion if they return to play or exertional activities prematurely. In addition, high school athletes recover more slowly than college or professional athletes. Presumably the same is true for children with concussion from non-sports related causes.

The study, which looked at 116 children ages 11 through 17 at an urban Level 1 trauma center over two years, set out to determine if measurable impairments existed in children admitted to the hospital with a concussion and if the computer-based testing program could be easily used in the hospital setting. The computer assessment is administered bedside and takes about 25 minutes.

The test results revealed an alarmingly high rate of cognitive deficits in nearly all patients. It tests specific abilities, such as attention span, memory, nonverbal problem solving and reaction time. Almost all patients tested below the 25 percentile in at least one area; the majority demonstrated significant impairment for all four subtests.

The test also assesses the degree of concussion symptoms, and the majority of children with concussions demonstrated an abnormal symptom score. The follow-up group demonstrated significant improvement in neurocognitive performance on all four subtests as well as an improvement in their symptom scores.

New national guideline proposed for sports concussions

A national guideline that young athletes suspected of sustaining a concussion or head injury in practice or games be removed from competition until examined or cleared by a medical professional is at the heart of a multi-organizational call-to-action announced today at the American College of Sports Medicine (ACSM) 56th Annual Meeting in Seattle. ACSM is collaborating with the Brain Injury Association of Washington (BIAWA) and the U.S. Centers for Disease Control and Prevention (CDC) to build national momentum on a new Washington state law protecting young athletes from death or disability caused by premature return to play following a concussion.

The Lystedt Law is named in honor of Zackery Lystedt, a Seattle-area young athlete who suffered a concussion in 2006 during a middle school football game. After returning to the same game, he later collapsed on the field.  The legislation, according to ACSM and its partners, is the standard for a no-cost, highly protective model for national duplication.

In order to replicate the characteristics of the Lystedt Law that will protect young athletes in sports, ACSM says state legislation can work to require:

- School districts to work with their state athletic associations to develop guidelines and informational forms to educate coaches, youth athletes and their parents of the nature and risk of concussion and head injury.

- Information handouts to parents and players on the signs and symptoms of concussion; returned and signed by parents and youth athletes acknowledging the risk of concussion and head injuries prior to practice or competition.

- Removal of a youth athlete who is suspected of or sustains a concussion or head injury from play. "When in doubt, sit them out"

- Written clearance prior to returning to play from a licensed health care provider for a youth athlete who has been removed from play.

- Compliance from private, nonprofit youth sports associations with the policies adopted in that state.

ACSM has a long history of advocating for concussion management, as well as establishing resources and partnerships to support treatment and prevention updates that help coaches and athletes avoid head injuries during play or competition.

In 2006, ACSM published Concussion (Mild Traumatic Brain Injury) and the Team Physician: A Consensus Statement, a guide to help team physicians diagnose and treat athletes with a concussion. The primer outlines best practices in identifying a mild traumatic brain injury; factors that should be considered in making return-to-play (RTP) decisions; the need for a game-day medical plan specific to concussions; the need for documentation, and more.

For more information on the Lystedt Law in Washington state, visit the brain injury association of washington web site. 

Sports Concussions To Be Discussed At Next Meeting New York State Traumatic Brain Injury Services Coordinating Council

The next meeting of the New York State Traumatic Brain Injury Services Coordinating Council will be held this Wednesday, April 22, 2009 in Delmar, New York in the Main Conference Room of the Health Department offices located at 161 Delaware Avenue, Delmar. The meeting is scheduled to begin at 10:30 AM

We are scheduled to discuss the sports concussions and recommendations to the Commissioner of Health.

We have scheduled two nationally recognized experts to assist the council.  They are:

Mark Lovell, Ph.D., Director, University of Pittsburgh Medical Center, Sports Medicine Concussion Program

Brian Reiger, Ph.D., Director, Concussion Management Program & CNY Sports Concussion Center
SUNY Upstate Medical Center

As the chair of the New York State Brain Injury Services Council, I would encourage all those with an interest in this important topic to attend.  The meeting is open to all members of the public.