Brain and Spine Injury Law Blog

Brain and Spine Injury Law Blog

Brain Injury Legislative Update May 2016

Posted in Brain Injury News and Event Update, Las Vegas Injury Attorney, Personal Injury, Psychiatric & Psychological Issues, Spine Injury, Back Injury, Neck Injury and Bone Injury, The Human Brain, Traumatic Brain Injury (TBI), Uncategorized

This is from the Brain Injury Association of America’s latest legislative update.  Note Dr. O’Shanick, Medical Director of the Center for Neurorehabilitation Services, spoke to Congress.

  •  House Committee Holds Hearing on Youth Sports Concussion Act

Dr. Gregory O’Shanick, President and Medical Director of the Center for Neurorehabilitation Services in Richmond, Virginia and the Medical Director Emeritus of the Brain Injury Association of America testified before the House Energy and Commerce Committee, Subcommittee on Commerce, Manufacturing, and Trade on Tuesday, May 24 to discuss the Youth Sports Concussion Act, H.R. 4460. The hearing, Legislative Hearing on 17 FTC Bills, covered a variety of legislation that will impact the Federal Trade Commission (FTC). The Subcommittee on Commerce, Manufacturing, and Trade is chaired by Congressman Michael Burgess (R-Texas) and the ranking member is Congresswoman Janice Schakowsky (D-Ill.)

The United States Senate Committee on Commerce, Science, and Transportation, chaired by Senator John Thune (R-S.D.) passed the Youth Sports Concussion Act, S. 2508 out of the committee on Wednesday, April 27, 2016. The Youth Sports Concussion Act is sponsored by Senator Tom Udall (D-N.M.) and in the House of Representatives, Reps. Bill Pascrell, Jr. (D-N.J.) and Thomas J. Rooney (R-Fla.), co-chairs of the Congressional Brain Injury Task Force.

The Youth Sports Concussion Act expressed the sense of Congress that the Consumer Product Safety Commission (CPSC) and the Federal Trade Commission (FTC) should review the National Academies’ report on sports-related concussions and future research in such area for any matter that may impact products under the CPSC’s jurisdiction or inform the FTC’s efforts to protect consumers.

The bill makes it unlawful to sell or offer for sale in interstate commerce, or import into the United States for such purposes, athletic sporting equipment for which the seller or importer makes any deceptive claim with respect to the safety benefits of such an item. Violations shall be treated as unfair or deceptive acts or practices under the Federal Trade Commission Act. The bill sets forth the enforcement authority of the FTC. States may bring civil actions in federal court to obtain injunctive relief on behalf of state residents unless a civil or administrative action has already been instituted by the FTC. The FTC may intervene and appeal in state actions.

The Youth Sports Concussion Act is an important piece of legislation because it will protect our nation’s youth who participate in sports related activities from concussions and other injuries by discouraging false advertising claims regarding protective equipment used in competitive sports. BIAA and NASHIA recently spearheaded a letter of support to the House Energy and Commerce Committee to include the Youth Sports Concussion Act in the next executive session. Thirty six organizations signed on in support of moving this important legislation through the committee process. BIAA thanks Chairman Fred Upton (R-Mich.) and Ranking Member Frank Pallone, Jr. (D-N.J.) for moving this important legislation through the committee process.

  • Congressional Report Finds NFL Improperly Attempted to Influence NIH on Brain Injury Research
    On May 23, Congressman Frank Pallone, Jr. (D-N.J.), ranking member of the House Energy and Commerce Committee, released a report concluding that the National Football League (NFL) improperly attempted to influence the grant review process for the National Institutes of Health (NIH) brain injury study that the NFL had agreed to fund as part of a $30 million donation. The report states that the integrity of NIH’s grant review process was preserved. The report also concludes the Foundation of NIH (FNIH), a non-profit charitable organization whose mission is to direct funding from public and private donors to NIH projects, did not adequately fulfill its role of serving as an intermediary between NIH and the NFL. You can read the full report here.


  • Pediatric Trauma Caucus Launched
    House Energy and Commerce Committee members Rep. Richard Hudson (R-N.C.) and Rep. G.K. Butterfield (D-N.C.) officially launched the Pediatric Trauma Caucus on Tuesday, May 24. NASCAR Team Owner, Motorsports Hall of Fame Inductee, and Co-Founder of the Childress Institute for Pediatric Trauma, Richard Childress led the briefing discussion. Other panelist included Bob Gfeller, Executive Director, Childress Institute for Pediatric Trauma, Dr. Valerie Maholmes, Ph.D., Chief, Pediatric Trauma and Critical Illness Branch, Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health, Dr. David Adelson, Director, Barrow Neurological Institute, Chief, Pediatric Neurosurgery/Children’s Neurosciences, Phoenix Children’s Hospital, Diana Fendya, R.N., Trauma/Acute Care Specialist, EMSC National Resource Center, Children’s National Medical Center, Dr. Barbara A. Gaines, Clinical Director, Pediatric General and Thoracic Surgery, Children’s Hospital of Pittsburgh of UPMC, Dr. John Petty, Director, Pediatric Trauma Program, Brenner Children’s Hospital/Wake Forest Baptist Health. BIAA thanks Reps. Hudson and Butterfield for taking the lead on this important issue.


Congress will be in recess next week in honor of Memorial Day, Monday, May 30 therefore the next Policy Corner will be released on Friday, June 10.
© 2015 Brain Injury Association of America.
All Rights Reserved

BIAA December Update

Posted in Brain Injury News and Event Update, Traumatic Brain Injury (TBI), Uncategorized

On Wednesday, December 16, 2015, Congress released the Consolidated Appropriations Act of 2016, the fiscal year (FY) 2016 omnibus appropriations bill *, which totals $1.15 trillion in discretionary spending in compliance with the Bipartisan Budget Act of 2015. The bill appropriates $1.067 trillion in base discretionary budget authority, pursuant to the two-year budget agreement enacted in November 2015, including: $548.091 billion in base defense spending; and $518.491 billion in base non-defense spending. The bill funds the government through September 30, 2016.

Today the House and Senate passed the omnibus appropriations bill and sent it to the President. Congress already passed a continuing resolution (CR) which funds the federal government through December 22, 2015.

Congress is also working on a massive $680 billion permanent tax extenders bill, which is also being referred to as a tax cuts package. This bill was released on December 16 and was passed by the House on December 17, by a vote of 318 to 109, with 241 Republicans voting in favor. The Senate passed the tax package today.

Funding for Traumatic Brain Injury Federal programs are listed below:

TBI Act: $9.321 million. This is level funding from Fiscal Year (FY) 2015. The bill also includes specific language to move the program’s funding from the Health Resources Services Administration (HRSA) to the Administration for Community Living (ACL).

  • Centers for Disease Control and Prevention, Injury Prevention Center, TBI: $6.75 million. This is an increase from FY 15’s $6.548 million.
  • BRAIN Research Initiative: $150 million. This is an increase of $85 million from FY 15.
  • Defense Health Program TBI/Psychological Health: $125 million. This is the same funding level as FY 15. The initial Defense Appropriations bill that the House considered earlier this year cut funding for this program to $100 million. Rep. Bill Pascrell, Jr. (D-NJ), co-chair of the Congressional Brain Injury Task Force successfully passed an amendment restoring the funding to $125 million.

*An omnibus spending bill is a type of bill that packages the 12 smaller appropriations bills into one large single bill that could be passed with only one vote in the House of Representatives and the United States Senate. There are 12 appropriations bills that need to be passed each year to fund the federal government and avoid a government shutdown, an omnibus spending bill combines these bills into a single bill.

Brain Effects Holiday Choices

Posted in Brain Injury News and Event Update, Psychiatric & Psychological Issues, The Human Brain, Traumatic Brain Injury (TBI), Uncategorized
Model Skull

If you’re pondering whether to buy a Windows Phone or an iPhone this holiday season, (I am a Windows Guy), a part of the brain called the dorsomedial prefrontal cortex might  ultimately determine your choice. Results of a new study suggest that this region of the brain plays a critical role in making choices.

A New Brain Study by Avinash Vaidya and Dr. Lesley Fellows, researchers at the Montreal Neurological Institute and Hospital (The Neuro), suggest that this region of the brain,  dorsomedial prefrontal cortex, plays a critical role in making choices.

Dr. Fellows stated recently “A big question is how and where value information is represented in the brain, and what goes into that representation.”  Dr. Fellows is  a neurologist and researcher in the expanding field of decision neuroscience. “Our research confirmed what savvy marketers already know: the longer you look at one of two objects, the more likely you’ll choose that object even if you initially valued the other one more. But we went further and identified a region of the frontal lobe that is crucially involved in this phenomenon.”

The study involved 60 participants, half of whom had suffered localized injury to the frontal lobes due to a stroke or tumor. Participants looked at hundreds of different pieces of art and rated their desire for each of them. This provided an estimate of the subjective value that each piece held. In a later test, the participants chose between pairs of these artworks. Participants were inclined to select the artwork that they examined longer even if in the earlier test they gave a higher value rating to the other object. Participants behaved as though the value of an option increased the longer it was observed.  Seeing is believing!

Participants with damage to a particular sector of the frontal lobe, the dorsomedial PFC, showed an exaggerated tendency to be drawn to the object at hand. The study shows that the dorsomedial PFC plays a critical role in mediating the balance between prior value assessment and an object’s immediate appeal.

So as you shop this Holiday, remember there is more to your choices than meets the eye.

Brain Injury Association of America Survey

Posted in Brain Injury News and Event Update, Las Vegas Injury Attorney, Traumatic Brain Injury (TBI)

BIAA Survey

The Brain Injury Association of America has asked me to forward this message on to my reader

Affordable Care Act Consumer Survey

The Brain Injury Association of America is conducting a survey to better understand whether the Affordable Care Act (ACA) is meeting the needs of individuals with brain injuries. If you have health care coverage through private insurance provided by your employer or by one of the health care marketplaces or “exchanges,” please take a moment to fill out the survey here. The survey is also under news and announcements on BIAA’s website,

 BIAA Comments On NIH Research Priorities

BIAA, along with the Disability Rehabilitation Research Coalition (DRRC) submitted comments on the proposed research priorities of the National Institute of Health’s National Center for Medical Rehabilitation Research (NCMRR). Through basic, translational, and clinical research, the NCMRR aims to foster development of scientific knowledge needed to enhance the health, productivity, independence, and quality-of-life of people with physical disabilities. The NCMRR supports research on the following topics: pathophysiology and management of chronically injured nervous and musculoskeletal systems (including stroke, traumatic brain injury, spinal cord injury, and orthopedic conditions); repair and recovery of motor and cognitive function; functional plasticity, adaptation, and windows of opportunity for rehabilitative interventions; rehabilitative strategies involving pharmaceutical, stimulation, and neuroengineering approaches, exercise, motor training, and behavioral modifications; pediatric rehabilitation; secondary conditions associated with chronic disabilities; improved diagnosis, assessment, and outcome measures; and development of orthotics, prosthetics, and other assistive technologies and devices. The comments will be posted to BIAA’s website soon under Legislative Priorities, Research.

BIAA Meets With CDC To Discuss TBI Research
BIAA met with leadership from the Centers for Disease Control and Prevention (CDC), Division of Unintentional Injury Prevention this week as follow up from a letter BIAA sent CDC regarding research priorities which did not include Tier I Research for TBI. BIAA is concerned that the Injury Center is shifting away from research on secondary and tertiary prevention of traumatic brain injury (TBI), as reflected in the Injury Center’s Research Priorities for the next 3-5 years.

In the letter, Susan Connors, president/CEO of BIAA noted that Tier 1 priorities, identified in the CDC Injury Research Agenda 2009-2018, reflect, “the most immediate TBI-related research needs and those that should be supported first as resources become available.”

These include:

Improving identification, assessment, and management of TBI;
Developing and applying methods for calculating population-based estimates of the incidence, costs, and long-term consequences of TBI;
Identifying methods and strategies to ensure that persons with TBI receive needed services; and
Developing and evaluating interventions for reducing TBI-related disability.


BIAA Update October 2015

Posted in Las Vegas Injury Attorney, Traumatic Brain Injury (TBI)

The Brain Injury Association of America asked me to pass along this new information:

BIAA Meets with Leadership at ACL

As reported in Policy Corner, U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell relocated the Federal Traumatic Brain Injury (TBI) State Grant Program from the Health Resources and Services Administration (HRSA) to the Administration for Community Living (ACL). The move took place on October 1, 2015. HRSA and ACL are working together to make a seamless transition. BIAA’s president and CEO, Susan Connors and Amy Colberg, director of government affairs, met with leadership from ACL on Friday, October 23 to discuss the relocation of the Federal TBI State Grant Program, specifically a National plan for brain injury.

Injury Violence and Prevention Meeting

BIAA attended the fall Injury Violence and Prevention (IVPN) Meeting in Washington, D.C. on Thursday, October 22. During the meeting, recent IVPN activities were reviewed and meeting attendees participated in breakout session to plan strategies with policy staff from CDC’s National Center for Injury Prevention and Control. The group worked to identify and prioritize IVPN activities for 2016. BIAA serves on the Injury Violence and Prevention Coalition which meets monthly throughout the year and educates to the Administration and Congress about injury and violence prevention issues and the importance for increased funding.


BIAA Presenting at NASHIA’s State of the State Conference

Amy Colberg, BIAA’s director of government affairs will be presenting at NASHIA’s State of the State Conference, Thursday, October 29 in Denver Colorado. Ms. Colberg will be participating in the This Week in Washington panel at 8:30 am. Please stop by and introduce yourself if you will be attending the NASHIA conference as well.


Recovery From Concussion Slower in Older Population

Posted in Las Vegas Injury Attorney, Psychiatric & Psychological Issues, The Human Brain, Traumatic Brain Injury (TBI), Uncategorized

Mild traumatic brain injury (MTBI), or concussion, accounts for 75 percent of all TBI and represents an important public health problem. Difficulty in working memory is frequently reported in patients after concussion. Now new research suggests that older individuals may have a more difficult time recovering from concussion. However, neuropsychological tests, computed tomography (CT) and conventional magnetic resonance imaging (MRI) generally fail to reveal abnormal findings in these patients. Functional MRI (fMRI) has been increasingly used in assessing patients with MTBI.

According to a new study published online in the journal Radiology,  Dr. Chen and colleagues,  from the Department of Radiology at Shuang-Ho Hospital, Taipei Medical University, in New Taipei City, Taiwan, used fMRI to evaluate the effect of age on working memory performance and functional activation in the brain after MTBI

In comparing the patients in initial and follow-up study, the young patients had significantly reduced post-concussion symptom score at follow-up than at the time of the initial exam, but no significant change of the post-concussion symptom score was observed in the older patients.

The researchers hope that these findings might eventually lead to the development of separate management strategies for different age groups following concussion.

For further reading please refer to Chi-Jen Chen, Chih-Hsiung Wu, Yen-Peng Liao, Hui-Ling Hsu, Ying-Chi Tseng, Ho-Ling Liu, Wen-Ta Chiu. Working Memory in Patients with Mild Traumatic Brain Injury: Functional MR Imaging Analysis. Radiology, 2012; 264 (3): 844 DOI: 10.1148/radiol.12112154

American Association for Justice Invitation

Posted in Brain Injury News and Event Update, Las Vegas Injury Attorney, Personal Injury, Psychiatric & Psychological Issues, Spine Injury, Back Injury, Neck Injury and Bone Injury, Traumatic Brain Injury (TBI)

American Association for Justice 2016 – Tim Titolo

I am once again honored to be invited to give a presentation at the 2016 Mid-Year American Association for Justice.  The conference will be in Boca Raton Florida from February 26 to 29, 2016.

My topic will be “Inadequate Security Involving Third Party Crime.”  I wish to thank the folks at AAJ for inviting me to present.  Below is more information about the conference.



Posted in Personal Injury, Psychiatric & Psychological Issues, Soldiers, Veterans and Military Issues, Spine Injury, Back Injury, Neck Injury and Bone Injury, The Human Brain, Traumatic Brain Injury (TBI)

Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) can have devastating consequences. Both are associated with high rates of disability and suicide, and although they are separate conditions, they commonly co-occur. For example, a soldier who has developed PTSD as a result of a traumatic experience may have also sustained a brain injury during that experience.

Significant research has been conducted to understand the brain mechanisms underlying PTSD and TBI, but there has still been a lack of knowledge regarding exactly which brain networks are disturbed in these disorders.

To fill this gap, Dr. Jeffrey Spielberg and his colleagues at the VA Boston Healthcare System examined brain networks in veterans with trauma exposure using functional magnetic resonance imaging and graph theory tools. As the authors explain, graph theory is a sophisticated analysis that allows us to understand brain networks at a level of complexity that was previously impossible. It permits examination of the patterns of brain connections, as opposed to examining individual connections.

The researchers recruited 208 veterans of Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn, all of whom had experienced a traumatic event. They found that veterans who had more severe PTSD re-experiencing symptoms (e.g., flashbacks or reliving the event) showed weaker connectivity in two networks.

The first altered network includes the hippocampus and prefrontal cortex, and is involved in providing contextual information. This suggests that perhaps the hippocampus may be overgeneralizing trauma-related memories, and therefore, fails to correctly classify non-threatening cues as “safe.”

The second network, which was identified only in veterans with comorbid mild TBI, includes the basal ganglia and prefrontal cortex, and plays a role in working memory.

Because the veterans studied here had already experienced a traumatic event, this research cannot identify with certainty whether the observed brain network disturbances were present in these individuals before the trauma occurred, or whether they occurred as a result of the trauma exposure. Future research of at-risk individuals, perhaps examining soldiers before and after military deployment, will be necessary to clarify this point.

“It may never be possible to fully distinguish the role of the severity of stress, the capacity for resilience to stress effects, and the presence of mild TBI in PTSD-related distress and disability because these factors are so complex and intimately entwined,” said Dr. John Krystal, Editor of Biological Psychiatry.

“However, this study suggests that there are subtle but important differences in brain circuit functional connectivity related to the impact of traumatic stress among individuals with and without TBI. These data provide additional evidence that TBI may complicate the capacity for recovery from traumatic stress-related symptoms.”

Story Source:

The above post is reprinted from materials provided by Elsevier. Note: Materials may be edited for content and length.

Journal Reference:

  1. Jeffrey M. Spielberg, Regina E. McGlinchey, William P. Milberg, David H. Salat. Brain Network Disturbance Related to Posttraumatic Stress and Traumatic Brain Injury in Veterans. Biological Psychiatry, 2015; 78 (3): 210 DOI: 10.1016/j.biopsych.2015.02.013

BIAA Brain Injury Conference in November 2015

Posted in Brain Injury News and Event Update, Personal Injury, Psychiatric & Psychological Issues, The Human Brain, Traumatic Brain Injury (TBI)

The Tortuous Path to TBI Recovery: Mapping the Punch-Drunkard’s Walk

Mitchell Rosenthal Memorial Lecture Live Webinar 

Tuesday, November 10, 2015

3:00 p.m. eastern/12:00 p.m. (noon) pacific

William Kearns, Ph.D., University of South Florida


Those with dementia or traumatic brain injury often walk in ways describable by the statistical “drunkard’s walk”. Using a spatial mapping technology describable as a hyper-precise indoor GPS, we have quantified “drunkenness” in patients’ natural locomotion using fractal mathematics and correlated changes in it with improvements in clinical measures. The clinical implications of this new spatial measure for practice will be discussed.


Please Note:

Registration ends at 5:00 p.m. eastern two business days prior to thedate of the live webinar. If you miss the registration deadline for live webinars, you may purchase the recordings on a CD. They can be found in our bookstore, here.

Cancellation Policies Cancellations received in writing by 5 p.m. ET two business days prior to the webinar will be refunded, less a $5 administrative fee; after that time no refunds will be issued. You may substitute a registrant or may apply the live webinar fee to the purchase of the CD & Handout package for the webinar, provided that you notify BIAA ( in writing no later than 5 p.m. ET the day before the webinar. No Shows: There are no refunds and the webinar price cannot be applied to the CD & Handout package for those missing the webinar.

Congress Avoids Government Shutdown

Posted in Age & Alzheimer's Issues, Brain Injury News and Event Update, Las Vegas Injury Attorney, Personal Injury, Psychiatric & Psychological Issues, Spine Injury, Back Injury, Neck Injury and Bone Injury, The Human Brain, Traumatic Brain Injury (TBI)

The Brain Injury Association of America has asked me to post the below information.  Read on…

Congress Avoids Government Shutdown

On Wednesday, the House cleared, with a 277-151 vote, a two-month stopgap spending bill (Continuing Resolution-CR) that will avert a government shutdown. Earlier in the day, the Senate passed the measure with a 78-20 vote. The bill, which will keep the government funded through Dec. 11, was signed by President Barack Obama.  The CR will fund the government at Fiscal Year 2015 spending levels. The end of the fiscal year was Wednesday, September 30, therefore the government would have shut down if Congress did not come to an agreement on how to fund the government. Congress kicked the can down the road by only extending the spending bill until December 11, 2015. This will be the new deadline for Congress to come to an agreement on how to fund the government.

Leadership Change in the House of Representatives

Speaker John Boehner (R-Ohio) announced this past Friday he will step down as Speaker of the House of Representatives. The Speaker of the House is third in line to the President. Speaker Boehner will leave Congress on October 30. He announced this week the Republican majority in the House of Representatives will vote on new leadership October 8. The next in line to the Speaker of the House of Representatives is the Majority Leader. The current Majority Leader is Kevin McCarthy from California. To learn more about the leadership in the House of Representatives click here.

Congressional Briefing on Medicaid

This week, BIAA staff attended a congressional briefing,

Medicaid Equal Access: Making the State/Federal Partnership Work. Congressional staff from the Senate Finance Committee and the House Committee on Energy and Commerce gave remarks. The briefing highlighted the provision Congress included in the Medicaid Act requiring that payments to providers must be “consistent with efficiency, economy, and quality of care” and “sufficient” to ensure that Medicaid recipients have equivalent access to services as privately insured patients (known as the equal access rule). After proposing guidance in 2011, the Department of Health and Human Services (HHS) has not yet finalized its guidance on the equal access rule. In June, members of Congress urged HHS to release it to ensure that essential services for millions of Americans are not disrupted without guidance, technical assistance, and active and ongoing oversight of the program. BIAA will be sending an action alert next week in collaboration with other organizations leading this issue.