Personal Narrative Report

Attend the next appointment with Dr. Taha on 10/24/17 to address work status, bone healing, replacement services, attendant care. Obtain projections for recovery.

The patient is placed on Temporary Total Disability until October 17, 2016 at which time, he will be released to return to work without restrictions.

According to Kings Industrial Occupational Medical Center, applicant was placed off work and on total temporary disability on April 19, 2017. Prior to this date, the applicant has been on regular duties, according to Kings Industrial Occupational Medical Center. The applicant’s next re-check visit will be on May 17, 2017.

The physical capacities assessment says he can never perform heavy or very heavy work, can occasionally perform medium work, and can frequently perform sedentary and light work. He can constantly stand, sit, walk, bend/stoop, reach, grasp, climb, pull, push, and

During this reporting period there have been no appointments to attend. Mr. Rife continues to work without any restrictions. He has pain to the left arm which he is tolerating until the surgery date on 5/3/17. The post operative appointment has not been scheduled yet. Mr. Rife wants to miss as little time as possible from

I spoke with Mr. Naranjo many times since the last reporting period regarding scheduling of occupational therapy and also the MRI. Once the MRI and x-ray were done he declined going back to Dr. Branch for a follow-up appointment on 1/31/8. He has requested to see his primary care doctor’s office.

The patient wants to also update me as far as the arm pain he mentioned last time. He says his left arm is feeling better now. He is noticing that his right shoulder is hurting at times, especially in certain positons such as while he is sleeping and if he has his arm raised over his head while he is lying down. He had no specific injury or trauma. He is not aware of anything that makes it better or worse. He is not using any medication for it thus far. He would be interested in having

I’m writing to inform Holt Renfrew that due to my ongoing intractable medical condition, I will not be able to return to work as originally intended, and I will need to postpone my return indefinitely at this juncture. Unfortunately, despite my best efforts, my health is still nowhere near where it needs to be in order for me to return to work. I’m hoping that between my family doctor and the Wasser Pain Management Centre a new treatment plan can be devised in the foreseeable

Ms. Milton continues to gain weight and become more debilitated. She has just started her intensive therapy program. She also has the new braces ordered for her knees.

Komblatt, the patient underwent extensive chiropractic treatment with 87 sessions from 10/07/11 through 07/11/12. It was opined that it does appear that the IW ha s undergone excessive passive-chiropractic treatment referable to both lumbar spine and right shoulder. It was further opined that the IW has reached MMI regarding the lumbosacral strain and contusion of the right shoulder within approximately 6-8 weeks post injury. Appropriate treatment would have consisted of aggressive right shoulder and low back rehabilitation to include aerobic conditioning, strengthening exercises involving the right upper extremity, lumbar spine and core, and resumption of normal recreational and work activities within 6-8

“The setback is serious enough to warrant close monitoring and treatment," Dr. Tehrany stated. "It will impact his future if it does not completely resolve over time."

The patient notes that the injury happen when he was lifting some metal trash trays into a trash bin when he felt a sharp pain in his shoulders. Treatment history notes that the treatment to date has consisted of medications. Of note, the MRI done showed a large full thickness tear with retraction of the tendon. Physical examination of the left shoulder revealed that the range of motion has forward flexion of 0-175 degrees, external rotation of 0-40 degrees, and internal rotation to T12. There is positive Hawkins’ and Neer’s sign for impingement. There is weakness with abduction testing. Treatment plan notes recommendation, surgical intervention in the form of a left shoulder, subacromial decompression, rotator cuff repair surgery as necessary. A follow up of 2 to 3 weeks if surgery is authorized. As per medical summary and work status dated 6/14/16, it was noted that the patient has not improved significantly and would be needing surgery. The patient’s return to work date is 6/14/16 with no lifting over 10 pounds and no overhead reach. Follow up to clinic date is on

Mr. Rasak is working very hard in therapy especially since his dizziness seems to have subsided. He was able to hop 3 times today with parallel bars. He is able to use a slide board with stand by assistance. He needs help with moving the leg due to the external device being very cumbersome. They are starting to train him in using a walker and being able to non weight bear with the right leg.

Cross-examination was extensive but the doctor did not change his opinion in any way. He reiterated his restrictions, which he felt were fifteen (15) to twenty (20) pounds below chest level and lifting, pushing or pulling above the chest level with the left arm.

*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.