Tests to Determine Traumatic Brain Injury (TBI)

Medical providers can test for TBI and the severity of damage it causes using a variety of procedures.

Traumatic brain injury (TBI) is a serious and potentially life threatening condition. Even a minor bump or blow can result in a brain injury that leaves the victim with permanent impairments. TBI testing has become more advanced in determining the parts of the brain impacted and the extent of the damage done. The following outlines some traditional testing doctors use to diagnose TBI, along with some of the latest developments in the field.

Testing for Traumatic Brain Injury

The National Institutes of Health (NIH) outlines a variety of tests that doctors use to diagnose TBI and to determine the level of brain or nerve functioning. Among these, the Glasgow Coma Scale (GCS) provides a basic assessment of the person’s condition. It measures the ability to speak, to open the eyes, and to move, assigning a numerical score for each. Numbers of 13 or higher indicate a mild TBI, while a lower score indicates a more severe injury.

In addition to the GCS, imaging tests also play a key role in treating brain injuries, allowing doctors to see the exact areas affected and the extent of the damage. These include:

Other TBI tests focus on speech, language, and cognitive abilities. These evaluate the patient’s ability to communicate and the strength and coordination of the muscles that control speech. This can impact the patient’s ability to swallow and indicates whether feeding tubes or supplements are needed. Cognitive tests, which are usually administered over a number of hours by a neuropsychologist, evaluate the impacts a brain injury has on the person’s memory and ability to reason or make judgments. These often involve interviews with family members to uncover personality changes which occurred due to the brain injury.

Additional Testing For TBI

An additional, yet less common method of TBI testing listed by the NIH is diffusion tensor imaging (DTI). This uses water molecules to contrast with magnetic resonance images, and can help quantify the amount of damage directly attributed to the brain injury. This can be particularly helpful in personal injury lawsuits. While not routinely provided by doctors, it can be requested through your attorney.

An additional, less common method of TBI testing is Functional MRI (fMRI) which tests impact of an injury on particular areas of the brain. Thisese tests can be particularly helpful in personal injury lawsuits. While not routinely provided by doctors, it can be requested through your attorney.Another procedure which could hold promise is blood testing, which monitors protein levels in those with suspected brain injuries. The Food and Drug Administration (FDA) approved this procedure in early 2018, and claims it could help to ensure patients at risk get the additional testing and treatment they need.

Austin Brain Injury Attorney Stephen G. Nagle Is Here to Help

If you or someone you care about has suffered a brain injury as the result of another’s reckless or negligent conduct, contact Austin attorney Stephen G. Nagle. Request a consultation to discuss your options in seeking the compensation needed to recover from these injuries.

During Distracted Driving Month in April, Take the Pledge to Be More Aware

April is National Distracted Driving Awareness month, which highlights potential dangers while encouraging drivers to pay more attention behind the wheel.

Most of us lead busy lives, in which we rush to get from one location to the next in order to fulfill our duties and obligations. As a result, it is easy to get into the habit of multitasking, dividing our attention between multiple items on our to-do list. This can be dangerous when behind the wheel, increasing the likelihood of serious car accidents and injuries. April is designated as National Distracted Driving Awareness Month, which encourages drivers to pay more attention to actions which could put them and other motorists in danger.

Distracted Driving Accidents in Texas

According to the Texas Department of Transportation (TxDOT), distracted driving was a factor in over 100,000 car wrecks that occurred over the course of 2016 in our state. To raise awareness, TxDOT initiated the Talk, Text, Crash campaign. Its aim is to highlight the potential dangers that distracted driving poses, while encouraging drivers to be more diligent in paying attention.

Distracted driving involves any activity that diverts your attention from the important task of driving or causes you to take your eyes off the road and your hands off the steering wheel. While texting and driving is prohibited in Texas, there are other distracted driving behaviors that endanger you and your passengers. These include:

Even if an activity diverts your attention for only a few seconds, it is long enough to decrease reaction times and make car accidents more likely to occur.

National Distracted Driving Awareness Month

The National Safety Council (NSC) reports that nationwide, distracted driving claims more than 40,000 lives each year in accidents that were largely preventable. To increase the public’s knowledge, the NSC has designated the month of April as National Distracted Driving Awareness Month. Working with state and federal traffic safety officials, they provide a variety of tools to call attention to the dangers. These include:

The NSC also encourages everyone to take the Distracted Driving Pledge. This is an online resource you can share with friends and family members, in which you promise to avoid those types of behaviors which put you and others at risk.

Austin Car Accident Stephen G. Nagle Is Here to Assist You

When distracted driving accidents do occur, you need experienced Austin personal injury attorney to help you get the compensation you need to recover from your injuries. Reach out and contact attorney Stephen G. Nagle to request a consultation to discuss your case.

How Long Do You Have to File an Injury Lawsuit in Texas?

In Texas, you have up to two years after an accident or injury to file a lawsuit against the at-fault party.

Accidental injuries often happen suddenly, while the impacts you suffer linger for years into the future. Even relatively minor accidents can result in personal injuries that are severe, resulting in lost wages, ongoing medical costs, and potentially permanent disabilities. Fortunately, Texas law allows up to two years for you to file a personal injury lawsuit seeking compensation for your damages. While this may seem like a long time, you should not wait. Evidence can disappear. To be safe, if you even suspect you may have a serious injury, you need an experienced attorney on your case right away to help ensure the best possible outcome.

The High Cost of Personal Injuries

Personal injuries are often referred to as ‘accidents’, but they are generally the result of negligent and reckless behavior on the part of others. Common ways in which these injuries occur include:

Any of the above can leave you suffering injuries that take weeks, months, or even years to heal. During this time, you will likely continue to incur medical expenses, lost income, and other out of pockets costs. For car accidents alone, the Texas Department of Transportation (TxDOT) estimates the financial toll at more than $38 billion each year.

Filing a Personal Injury Claim In Texas

Depending on the circumstances surrounding your injury, you may be entitled to compensation through the at fault party’s insurer. This may be an automobile insurance company, or policies put in place by homeowners or business property owners. Unfortunately, dealing with insurance companies can be challenging. As a business, their bottom line is profits, which gives them a financial incentive for denying or undervaluing a claim. An experienced Austin personal injury attorney can help you in these negotiations, helping you get the maximum amount you are entitled to.

In cases where an insurance settlement cannot be reached or the amount fails to compensate you for all of your losses, your best bet may be to file a personal injury lawsuit against the at fault party in court. Under the Texas statute of limitations, you have up to two years to file your claim.

In addition to allowing time for collecting evidence and insurance negotiations, this also allows time to determine whether your injuries are likely to result in permanent disabilities. Compensation you may be entitled to through a personal injury lawsuit includes:

Austin Personal Injury Attorney Steven G. Nagle Is Here to Assist You

To ensure you get the maximum amount you are entitled to for your injuries, contact Austin attorney Stephen G. Nagle. Request a consultation to discuss the options in your case and the amount of compensation you need to recover.

Do Texas Truck Drivers Need a Good Driving Record When Operating Semi Trucks and Other Big Rigs?

A history of previous truck accidents or traffic violations creates liability for trucking companies and could jeopardize the truck driver’s license.

It takes specialized knowledge, skill, and experience to handle a semi tractor trailer, 18 wheeler, or other big rig. Between the large size and bulk of these trucks, navigating through different traffic and road conditions can be treacherous. When truck accidents do occur, it can result in severe and potentially life threatening injuries for other motorists. To protect themselves against liability in these accidents, trucking companies generally require a clean driving record. Too many violations or a history of truck accidents could put the truck driver’s commercial license in jeopardy.

The Impact of a Bad Driving Record on Obtaining a Commercial Driver’s License

In order to be a truck driver, you first need to obtain a commercial driver’s license (CDL). In Texas, requirements listed by the Department of Public Safety (TXDPS) include passing vision and driving skills testing, along with submitting a criminal background check. As part of the licensing procedure, your driving record will be pulled, disclosing any past offenses or violations you have.

If you have a history of moving violations, such as speeding, reckless driving, or driving under the influence, your CDL license will not be approved. Depending on the violation and when it occurred, your rights to this type of license may be suspended for a period of months or even years. This is true if you already have a CDL. Too many violations could result in a complete revocation of your commercial driving privileges.

Why Your Driving Record Matters When Obtaining a CDL

According to the Federal Motor Carrier Safety Administration (FMCSA), close to 90,000 people are injured as the result of truck accidents each year in the U.S., while more than 4,000 others die as the result of their injuries. In the majority of these cases, it is other motorists involved who suffer the most severe impacts. While road, traffic, and weather conditions are often a contributing factor, the leading causes of truck accidents are the reckless behaviors of the driver. These include:

When trucking companies hire truck drivers with a poor driving record, they are increasing their own liability when truck accidents occur. Trucking Truth reports that in most cases, carriers will not hire a driver with moving violations on their record from any time over the previous three years.

When Truck Accidents Occur, Contact Austin Accident Attorney Stephen G. Nagle

Truck wrecks can result in catastrophic injuries that prevent you from working and providing for yourself and your loved ones. When these types of accidents occur, contact attorney Stephen G. Nagle and request a consultation to discuss how you can get the compensation you need to recover.

Churches, ERISA and the Supreme Court: A question of exemptions

On behalf of Stephen G. Nagle & Associates posted in ERISA Claims on Friday, April 14, 2017.

The Employee Retirement Income Security Act of 1974 (ERISA) is essentially a statute that regulates the management of pension plans and imposes a federal fiduciary duty to those tasked with their management. This federal statute is designed to help better ensure that workers’ interests are protected.

ERISA applies to most insurance plans that are offered by employers. However, like most laws, there are some exceptions. One currently under scrutiny is an exemption involving churches.

Generally, churches qualify for an exemption from these requirements. A recent case questions the extent of the exemption. The question has risen to the highest level and will be decided upon by the Supreme Court of the United States (SCOTUS).

What are the details of the ERISA issue? The case, Advocate Health Care Network v. Stapleton, questions whether or not the church exemption to ERISA requirements extends beyond church employees to also cover organizations that are affiliated with the church.

More specifically, do these exemptions apply to hospitals that are affiliated with churches?

How has this exemption been handled thus far? Over the past three decades the Internal Revenue Service (IRS), Department of Labor and Pension Benefit Guaranty Corporation, the three federal agencies that administer this statute, have treated hospitals that are affiliated with churches as exempt from ERISA.

What are the arguments for and against the exemption extending to church affiliated organizations? The hospitals argue that a 1980 extension to the original ERISA plan covers affiliated groups. The language of the extension states that a “plan established and maintained for its employees … by a church … includes a plan maintained by an organization … controlled by or associated with a church.” The hospitals point specifically to the “established and maintained” language to support their argument.

Hospital employees counter that this language was set out to relax the requirement that churches must establish and maintain the pension plans while still keeping the exemption within the confines of the church employees.

What will the court decide? SCOTUS has yet to rule on the case, but experts in the field expect the high court to focus on the specific language of ERISA to continue the current extension of the exemption and encourage Congress to change the statute if it disagrees with the interpretation.

What does this mean for those with ERISA claims? If SCOTUS rules as experts expect, it will likely not impact ERISA claims. However, if SCOTUS decides that hospitals are not part of the exception it could result in an increase in ERISA based claims from hospital employees.

This case provides an example of the intricate nature of ERISA claims. Not only can the claims themselves be difficult, but the law governing the claims can change. As such, those who believe they may have an ERISA issue are wise to seek legal counsel to better ensure their interests are protected.


New tool could help determine extent of damage from brain injury

On behalf of Stephen G. Nagle & Associates posted in Brain Injuries on Thursday, March 9, 2017.

Researchers out of Wake Forest University in Winston-Salem, North Carolina have developed a tool that aids in determining the extent of brain injury when other factors, most notably advanced age, need to be taken into account.

How does the tool work? This “tool” is a compilation of a review of the patient’s “age, gender, and the Glasgow Coma Scale (GCS),” according to a recent report by Science Daily.

The GCS provides the patient with a grade based on his or her responses to eye, verbal and motor skill tests.

Although researchers admit that this is not the first test designed to determine recovery from traumatic brain injuries (TBIs), it is unique as it focuses on the TBI alone – separate from other injuries.

Why is this tool important? TBIs peak at two different periods in our lives. First, when we are young adults ranging in age from 15 to 24, then again as seniors over the age of 75.

As such, this tool is important to aid in conversations between physicians and loved ones of the injured senior.

What can the tool tell patients and loved ones about the TBI? The tool is touted to provide health care professionals with the ability to discuss the likelihood of a return to independence after an elderly patient suffers a TBI. The results can help guide this discussion and increase the likelihood of a positive resolution for both the victim and his or her loved ones.

Are these tests expenses? Unfortunately, any form of medical care can become costly. As a result, those who suffer a TBI due to another’s negligence are wise to hold the negligent party responsible through a personal injury suit. This lawsuit can lead to monetary awards that can help cover the costs of treatments like the one discussed above.

Do you work for a church-affiliated medical facility?

On behalf of Stephen G. Nagle & Associates posted in ERISA Claims on Thursday, January 12, 2017.

More than 30 states have allowed companies to make changes to their workers’ compensation coverage in recent years. Those changes put employees in difficult positions when they suffer injuries at work.

Texas requirements for workers’ compensation coverage

The basic idea of workers’ compensation is a trade-off. Employees can’t easily sue their employers for job-related injuries. In return, injured employees are supposed to get timely medical care and partial payments for their wages.

In Texas, employers can opt out of using workers’ compensation insurance and provide the care needed by their employees directly. These private employee plans mean that if you are injured while working for a self-insured company, you must rely on your employer to pay your medical bills and lost wages. This can lead to fewer protections for workers who suffer injuries or workplace illnesses.

Employee rights advocates claim that employers who self-insure have too much power to deny injured employee claims. Fortunately, the Employee Retirement Income Security Act (ERISA) sets minimum insurance coverage standards for employers. Even private employee plans that cover health, dental and retirement are supposed to meet basic funding standards established by ERISA.

Do you work for a church-affiliated medical facility?

The IRS, Pension Benefit Guaranty Corp. and U.S. Department of Labor provide health coverage exemptions for medical facilities with religious associations. This means that certain health care providers do not need to comply with the minimum standards established by ERISA. A number of lawsuits between health organizations and their employees have brought the issue to the forefront.

Will the High Court side with employers or employees?

Later this year, the U.S. Supreme Court will be hearing arguments on both sides for a lawsuit between church-affiliated hospitals and their workers. Three health organizations want to overturn lower court decisions that forced them to follow ERISA standards.

If the U.S. Supreme Court agrees with the lower courts, the employers will have to follow minimum regulations set by federal law. This would be a win for workers. However, if the court reverses the lower courts, employees of church-affiliated medical facilities have a lot to lose.

If you are an employee who has suffered a job-related loss, seek the advice of an experienced ERISA attorney.

Related Posts: Making a claim against your employer-provided on the job insurance?

Traumatic brain injury: Advances in diagnosis

On behalf of Stephen G. Nagle & Associates posted in brain injuries on Thursday, February 2, 2017.

Although traumatic brain injuries (TBIs) are well-known, medical professionals continue to struggle with a simple method of diagnosis. Diagnosis is important, as it can play a role in holding those who cause these injuries financially accountable.

What exactly is a TBI? A TBI is generally defined in the medical field as “an acute brain injury resulting from mechanical energy to the head from external forces with loss of consciousness less than 30 minutes, posttraumatic amnesia less than 24 hours, and Glasgow Coma Scale (GCS) score of 13-15 after 30 minutes post-injury or on presentation for healthcare.”

How are TBIs diagnosed? At this time, medical professionals generally use the definition above to determine if a patient has suffered a TBI. Additional research is underway to develop a more concrete form of diagnosis.

One such method, recently discussed in an article in Medscape, involves measuring a protein released in the brain during an injury. If the research proves successful, the protein could be measured instead of using head CT or brain MRIs to aid in diagnosis, both of which can result in exposure to potentially dangerous radiation.

How common are TBIs? TBIs are likely more common than reported, and reports are staggering. There are 1.7 million people in the United States that visit emergency departments, are hospitalized or die due to TBIs every single year.

This number is likely inaccurate, as an additional 30 to 45 percent of victims of these injuries are estimated to never seek treatment from a healthcare provider.

Why is diagnosis important? TBIs can result from a number of different accidents, including bicycle accidents, car crashes and construction accidents. Having a diagnosis can help hold others responsible when these accidents are the result of another person’s negligent or reckless actions.

TBIs can result in additional medical care, rehabilitation costs and other expenses. By holding responsible parties accountable for their actions, victims can receive monetary awards to help cover these costs and others associated with these injuries.

Related Posts: New tool could help determine extent of damage from brain injuryWhy is the brain so susceptible to injury?When Crashes Cause TBIs in Children3 ways a traumatic brain injury can happen on the job

Why is the brain so susceptible to injury?

By Stephen Nagle of Stephen G. Nagle & Associates posted in brain injuries on Tuesday, December 6, 2016.

Nowadays, sports fans can’t watch a game without hearing the phrase “concussion protocol.” What does this mean? A player enters the concussion protocol after showing symptoms of a traumatic brain injury (TBI). 15 percent of NFL players display symptoms of TBI over the course of a season. As of 2010, a TBI was diagnosed in one out of every 20 emergency room visits related to an injury.

TBI can happen to anyone.  It can happen in a simple car wreck, or in an ordinary slip-and-fall injuriy.

Why is the brain is so prone to injury?  The composition of the brain provides some answers.

Jell-O in your head?

The brain is made up of 60 percent fat and uses the most water of any organ in the body. Its consistency is described as like gelatin.   inside your skull. To protect this potentially fragile organ, you have a thick skull, and, within teh skull, your brain is surrounded by spinal fluid.  This protects your brain from injury during most everyday activities.

However, if your body or head sustain a forceful blow, the spinal fluid within your skull may be unable to protect your brain from drastic movement. This force can cause your brain to impact the inside of your skull, and this can result in TBI.

This type of trauma inside your head is potentially quite gruesome and serious, but, thankfully, most TBIs are mild concussions, and cause no permanent damage. However, any impact to your body or head outside of normal body movement can cause TBI that results in permanent damage. Therefore, it is important to understand the signs and symptoms.

Seeing stars

Immediate signs and symptoms of mild TBI can include “seeing stars,” confusion, amnesia for the traumatic event, or a temporary loss of consciousness.  For a few days or weeks after a TBI the victim may feel foggy brained, or a little out of it.  Over longer periods of time, TBI sufferers can experience changes in short term memory, changes in thinking processes, or changes in personality.  If you believe someone has suffered TBI, your primary care before medical treatment is available can minimize symptoms and speed recovery.

First, check the person for any other injury that could worsen upon movement like a sprained ankle or broken bone. If they cannot move on their own, it is usually best to wait for EMTs to arrive, and just keep talking to the person.  If the individual is able to move on their own, lead them to a quiet, darkened room away from noise and light sensations. You can ask them simple questions like “What day is it?” or “What did you have for breakfast?” to determine their state of consciousness, and whether they know who and where they are.

One of the most visible signs of a serious concussion or TBI includes dilated or uneven pupil size of the eyes. If a person has lost consciousness, or has one or more dilated pupils, stay with them and keep talking to them.  If those signs are present, it is important to try to not let the person fall asleep until medical care can be provided.

If you or a loved one has suffered TBI, you may be entitled to compensation under the law. Through understanding the causes, symptoms and treatment of TBI, we can better prevent long-term injury and reoccurrence.

Related Posts: When Crashes Cause TBIs in Children3 ways a traumatic brain injury can happen on the jobKnow the risks and signs of traumatic brain injuries

When Crashes Cause TBIs in Children

On behalf of Stephen G. Nagle & Associates posted in brain injuries on Friday, November 25, 2016.

Approximately 30 percent of injury deaths in the United States are the result of traumatic brain injuries (TBIs) When a person suffers a TBI due to a blow, bump, or jolt to the head, their injuries may range from a mild concussion to more serious injuries that result in the loss of consciousness. Both minor and more serious TBIs may affect a person’s mental and physical ability to function and earn a living for the rest of their lives.

Childhood bicycle accident risks

A staggering number of TBI victims are children, teens and young adults. In order to help keep their children safe, many parents restrict their children’s involvement in sports, such as forbidding them from joining the football team.

However, the sport that is most likely to lead to a head injury is not football — it’s cycling. According to the American Association of Neurological Surgeons, cycling was responsible for over 40,000 sports head injuries in 2009, nearly twice the number experienced during football. One of the reasons why cycling has such a potential for injury the risk of TBIs caused by collisions with motor vehicles.

Brain injuries are often worse in children

While some have hypothesized in the past that traumatic brain injuries might be less consequential in a child whose brain is still developing, further study has shown the opposite to be true. When a brain injury occurs early in life, it can affect personality development, and prevent a child from learning and understanding social boundaries that are key to their success later in life. It can impede their ability to learn and retain many basic skills, such as reading and math, and eat away at the foundation that should be setting the stage for the rest of their lives.

TBIs happen to kids for a variety of reasons, including falls, sports injuries, physical abuse, and motor vehicle accidents. Those brain injuries lead to hospitalization for a heartbreaking number of American kids each year according to The Centers for Disease Control and Prevention. Overall, when kids under 14 suffer from TBIs, 435,000 visits to the Emergency Room, 37,000 admitted to the hospital, and nearly 2700 deaths occur annually.

Next steps

Navigating the aftermath of a childhood TBI is never easy. If your child has suffered a TBI, you are likely feeling overwhelmed. Once your child has received necessary medical care, please consider speaking with an attorney experienced in childhood TBI cases. An attorney’s assistance may help you to secure financial compensation that will be necessary to his or her future care. In addition, allowing an attorney to advocate on your behalf will allow you to focus on your child’s wellbeing and your own needs as opposed to the financial side of this situation.

Related Posts: Why is the brain so susceptible to injury?3 ways a traumatic brain injury can happen on the jobKnow the risks and signs of traumatic brain injuries