Fourth Court of Appeals
San Antonio, Texas
MEMORANDUM OPINION
No. 04-25-00377-CR
Billy Joel GRAHAM,
Appellant
v.
The STATE of Texas,
Appellee
From the 81st Judicial District Court, Atascosa County, Texas
Trial Court No. 24-04-0115-CRA
Honorable Jennifer Dillingham, Judge Presiding
Opinion by: Velia J. Meza, Justice
Sitting: Rebeca C. Martinez, Chief Justice
Lori Massey Brissette, Justice
Velia J. Meza, Justice
Delivered and Filed: August 5, 2026
AFFIRMED
Billy Joel Graham appeals his conviction for aggravated assault causing serious bodily
injury. Graham argues that the evidence is legally insufficient to support his conviction. Because
we conclude that the evidence is legally sufficient to support his conviction, we affirm.
04-25-00377-CR
BACKGROUND
In the early morning of January 13, 2024, an argument arose between Graham and his
estranged wife, Bianca. 1 This argument escalated until Graham pushed Bianca, resulting in a
fractured ankle.
On April 12, 2025, a grand jury indicted Graham for aggravated assault causing serious
bodily injury, a second-degree felony. TEX. PENAL CODE § 22.02(a)(1). A one-day bench trial
commenced on March 28, 2025. At its conclusion, the trial court found Graham guilty, and on
May 16, 2026, sentenced him to 16 years’ confinement in the Texas Department of Criminal
Justice Institutional Division. This appeal followed.
DISCUSSION
On appeal, Graham argues that the evidence is legally insufficient to support his conviction.
Specifically, Graham contends that the State failed to establish that Bianca’s injury constituted
serious bodily injury. We disagree.
1. Standard of Review
Under Jackson v. Virginia, we review “the evidence in the light most favorable to the
verdict and determine whether any rational trier of fact could have found the essential elements of
the offense beyond a reasonable doubt.” Carrizales v. State, 414 S.W.3d 737, 742 (Tex. Crim.
App. 2013) (citing Jackson, 443 U.S. 307, 319 (1979)). Direct evidence is not necessary to prove
the defendant’s guilt; instead, circumstantial evidence alone can be sufficient to establish guilt and
is just as probative as direct evidence. Id. Because this standard recognizes the trier of fact as the
sole judge of the weight and credibility of the evidence, we determine whether their drawn
1
We refer to the victim by her first name.
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inferences are reasonable based on the cumulative force of all of the evidence. Adames v. State,
353 S.W.3d 854, 860 (Tex. Crim. App. 2011).
In this case, the State was required to prove beyond a reasonable doubt that Graham (1)
intentionally, knowingly, or recklessly (2) caused serious bodily injury to Bianca. Serious bodily
injury is defined as “bodily injury that creates a substantial risk of death or that causes death,
serious permanent disfigurement, or protracted loss or impairment of the function of any bodily
member or organ.” TEX. PENAL CODE § 1.07(46). No wound constitutes serious bodily injury per
se. Whether a wound is serious enough is a fact question resolved on a case-by-case basis. Wade
v. State, 663 S.W.3d 175, 183–84 (Tex. Crim. App. 2022).
2. The Evidence is Legally Sufficient
At trial, the State offered evidence establishing that on the night of the incident, Bianca
visited Graham’s residence after a night of drinking with her friends and sister, Lorayna Soliz. She
and Graham were in a heated argument, which reached its flashpoint when Graham utilized both
hands to push Bianca. Bianca fell off Graham’s porch—which was raised roughly two feet above
ground level—and broke her ankle.
Bianca testified that Soliz and Graham took her to the hospital in Jourdanton; however, she
was transferred to San Antonio for emergency surgery. According to her medical records, Bianca
was diagnosed with a grade I open fracture. Although there were no photos or expert testimony
describing the injury, Graham stated during his custodial interrogation that “whenever [he] was in
the hospital and they were taking [Bianca’s] boot off” to assess her injury he noticed “it kind of
like poking out” and that seeing “it f—ked [him] up” and he “almost [] threw up.”
When asked about the extent of her ankle injury, she was not “exactly sure if [the surgeons]
were able to put [her] ankle back together because of how bad the fracture was.” However, she
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knew that “a metal plate with six screws” was attached “just to hold [her ankle] in place.” She
stated that “[t]he main bone would never heal” and at the time of trial “there[ was] still a fracture”
which “cause[d] a lot of nerve damage.” As a result, Bianca’s ankle became “stiff,” causing her to
limp and making it “difficult to walk.” Due to the nerve damage, she now experiences numbness
in her leg which can cause her to fall.
Viewing the evidence in the light most favorable to the judgment, we conclude that a
rational trier of fact could have found Bianca’s injury was serious enough to constitute a serious
bodily injury. Carrizales, 414 S.W.3d at 742. The record shows she suffered an open fracture
requiring emergency surgery, a metal plate and six screws to hold the bone in place, a main bone
that will never fully heal, ongoing nerve damage, and a permanent limp. This evidence shows
protracted loss or impairment of the function of her ankle. See TEX. PENAL CODE § 1.07(46)
(defining “serious bodily injury” to include an injury that causes “protracted loss or impairment of
the function of any bodily member”); see also Allen v. State, 736 S.W.2d 225, 227 (Tex. App.—
Corpus Christi–Edinburg 1987, pet. ref’d) (holding that a broken finger which “still had some
disfunction . . . and was a little stiff” three-and-a-half months after the incident constituted serious
bodily injury).
Graham argues that the parties and trial court should have used the term “serious bodily
injury” during trial. He cites no authority for this proposition, and we are aware of none. We decline
to adopt it. Graham also argues that expert testimony was required to establish that Bianca’s injury
rose to the level of “serious bodily injury.” The Court of Criminal Appeals has rejected any such
requirement. Garcia v. State, 667 S.W.3d 756, 763 (Tex. Crim. App. 2023).
Finally, Graham contends that the poor medical care Bianca received—rather than his
actions—caused the protracted loss or impairment of her ankle. A defendant remains criminally
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responsible despite a concurrent cause unless that cause alone was “clearly sufficient to produce
the result” and the defendant’s conduct was clearly insufficient.” TEX. PENAL CODE § 6.04(a). Even
if we assume that Bianca’s poor medical treatment contributed in some manner to her injury, the
evidence does not establish that the medical treatment, standing alone, was clearly sufficient to
cause her injury and that Graham’s conduct was clearly insufficient to do so.
Graham’s sole issue on appeal is overruled.
CONCLUSION
Accordingly, we affirm the trial court’s judgment
Velia J. Meza, Justice
DO NOT PUBLISH
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