Tuesday, September 30, 2014

Brain Injury Association seeks amicus status in NFL Concussion Litigation

The Brain Injury Association of America has moved to intervene as a friend of the court in the NFL concussion litigation.  Federal District Judge Anita Brody must approve the proposed settlement as fair for the agreement to become effective. -gwc

In its Memorandum of Law supported by the declaration of Doctors Brent Masel and Gregory O'Shanick two specialists in traumatic brain injury, the BIAA offers its aid to the court.  The Association is skeptical of the proposed settlement on two counts:

1) Numerous physical and behavioral consequences of TBI are excluded
from the list of qualifying diagnoses for treatment and compensation
under the settlement.

The physicians explain that a "mild TBI, also known as a concussion, is a complex pathophysiological process induced by biomechanical forces to the head or to another part of the body that transmit to the head. The injury produces an alteration of brain function that results in a wide range of neurological, physical, cognitive, and neuropsychological impairments. These impairments can appear on an intermittent or persistent basis immediately or as many as ten or more years after injury."

2) The settlement’s approach to diagnosis of neurocognitive impairment
is deeply flawed and will serve to exclude retired NFL players and
limit their access to medical benefits and compensation.

Masel and O'Shanick explain that the
"determination of eligibility is heavily weighted towards those with severe memory dysfunction and/or evidence of neuromuscular abnormality, which is reflected in the reliance on neuropsychological evaluation in isolation from other indices of functional impairment in day-to-day settings (including information from reliable family members, etc.). In addition, the specification of a basic neurological evaluation excludes the abundance of literature on the multiplicity of other neurological abnormalities potentially present after mild TBI that would be undetected by a “basic” neurological examination. To be maximally effective at identifying those players with residual deficits, it is well accepted by the brain injury professional community that an approach that is more holistic, human-based, and less linguistically reliant is preferred. A more broadly based performance assessment that will not under-estimate pre-morbid intelligence for a personal baseline TBI comparison is needed. Such subtleties reinforce the need for clinical experience to make proper judgment in these assessments."

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