Group I, Category 53 Insufficient Vocational Documentation to Determine Work History
ISSUE
The DDS proposes a fully favorable allowance for this claimant with an EOD of 07/01/2013. The evidence in file supports a later onset date.
CASE DISCUSSION & POLICY ANALYSIS (INCLUDING SPECIFIC REFERENCES)
This 53 year old claimant is filing a concurrent claim alleging disability due to tear or lateral cartilage or meniscus, chondromalacia of the patella, synovitis and tenosynovitis a of 07/01/2013. The medical evidence shows the claimant had twisting injury to left knee with lateral meniscus tear on 7/1/13. He was also noted to have preexisting osteoarthritis of the left knee. The claimant underwent arthrosopic partial meniscectomy on the left knee on 2/27/14 with some symptomatic relief. An orthopedic report on 1/13/14 noted ongoing left knee pain. The physical exam showed tenderness; pain with flexion and extension; positive McMuray's test and negative Drawer's test. X-rays of left knee on 1/13/15 showed mild left knee osteoarthritis.
The DDS assessed a RFC for 50/25/4/6. The evidence in file indicates the claimant is capable of 20/10/6/6. The DDS proposed a
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The Misc Non Disability Development worksheet in file indicates the claimant was unable to recall the exact dates he worked but he failed to return the 821. A POD of 7/1/15 was recommended. At an office visit on 1/13/14, the claimant indicated he was still working 34-48 hours a week but was performing modified duties and missed work often due to his condition. At an orthopedic evaluation on 3/26/15, the claimant stated he has been off work on temporary disability 2/2014 to the present. These statements conflict and should be resolved before to a finding a disabled can be
Zamudio, Human Resources Administrator and acting custodian of personnel records of the Domino Realty Management Company who allowed access, and copies in support of any relevant information pertaining to any injuries, had located a “Work/School Status Report” under the name of the “Talbert Medical Group.” The document had placed the claimant off from work from 2-5-01 through 2-5-01 for pain to the claimants left knee, and yet, according to Ms. Zamudio, the document did not state that a work related injury occurred as there were no other documentation in support of an injury. Furthermore, the witnesses had not cited any job related incidents where the claimants left knee from 2001 had been injured were the alleged 2001 left knee had been irritated or exacerbated in any
On Thursday, 10/22/2015 the claimant stated he reported for work pain-free and was not suffering from any pain or discomfort from four other work related injuries that he reported as claims and received judgments. The claimant was unable to account for the real dates of his past work-related injuries that occurred between 2010 and 1/2013. The claimants past industrial-related injuries ranged from a left wrist injury, head injury and two separate right wrist injuries which he says did not include any injury to any other body parts.
DDS proposed a denial determination using Vocational Rule 203.15 as a framework for the determination. The evidence in file supports a more restrictive RFC, which results in an allowance.
The anomalous claim (DIB) filed on 08/03/2017. We obtained the necessary document form the NH on 09/15/17 and completed the subsequent requirements on 10/12/17. Please let me know
The DDS proposes an adverse onset allowance. A review of the file shows a fully favorable onset is warrented. The prior determination was incorrect and a re-opening is warranted.
Note: The Claimant said his intentions is to return to work and does not have any intentions to sue or to gain full disability for his medical condition. The Claimant is using Medi-Cal to cover the costs of his
The claimant was a 49 year old female who alleged disability because of post-traumatic stress disorder (PTSD), panic disorder, and major depression. She reported that she had difficulty with her personal care because of problems with a knee and thighs. She had difficulties with mobility and with doing house chores. She also had blurry vision and difficulties with memory, concentration, understanding and following directions, and completing tasks. She was anxious being around people. It seemed that she did not speak English and needed a translator. She used to work as a teacher assistant with the Head Start Program (no dates submitted) and as a janitor with a cleaning company in 2002.
Admittedly, my file on this matter is fairly limited. We were recently joined into this claim as a co-defendant. I believe we are in the process of securing additional records (i.e., medical records and medical-legal records) from our co-defendant, Employer Assurance Fund, who is administering this claim.
Dillon is an 18-year-old male patient who is seen at the medical clinic today in regard of requesting for a newer and better knee sleeve for his left knee. The patient stated that there is no pain, no swelling. He already has knee sleeve but he stated that knee sleeve can pinch his skin sometime, so he requests for having a better knee sleeve. He stated that when he plays sports with the knee sleeve he feels his knee is more stable, not causes a popping sensation. Otherwise, he is doing fine. He has no medical concern at this visit.
Per OMNI, she had a right knee strain, and derangement of the medial meniscus. Per OMNI, she was diagnosed with derangement medial meniscus and sprain/strain of right knee/leg.
As you know, this case involves multiple Applications with different dates of injury. Below are my comments and permanent disability valuation of each date of injury:
DOI: 3/3/2015. Patient is a 49-year-old male supervisor mechanic who sustained injury to his right knee when he stepped down from a ladder. Per OMNI, patient was diagnosed with right knee complex medial and lateral meniscus tears, articular cartilage damage of medial and lateral joint lines. Treatments include post-operative PT, and transcutaneous electrical nerve stimulation unit.
The above named patient visited our facility in March 22, 2016 on account of left knee pain, swelling, difficulty with walking and a sense of weakness in the left lower limb. She accidentally injured her left knee in August 4, 2015 while she was on a plane. Imaging studies were obtained in the United States, and the results showed a partial tear of the ACL, MCL, LCL and a low-grade sprain of the PCL. She had physical therapy for 5 months both in the United States and Nigeria before visiting our facility. Her major complaints were general limitations in her daily activities. These included pain which got worse with activity such as prolonged walks; difficulty with squatting, stair climbing and stooping; recurrent left knee swelling and occasional buckling.
The diagnosis may be made without recourse to radiographic or laboratory investigations in the at-risk age group with typical symptoms and signs. (8)