CentraLogic/tmp-dataset-5 · Datasets at Hugging Face

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GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_0	1,758,693,949	Now dictating a follow up note on Maria Tojal T O J A L Age 60 Date of injury August 5 2025 Referred by Doctor Osorio OSORIO 217 Chestnut Street Newark New Jersey 07105 addresses to Jorge J O R G E date this September 02, 2025	00:00:01.520	00:00:21.935
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_1	1,758,693,949	This is an office visit of this 62-year-old right-hand dominant self-employed woman who I had taken care of years ago. She had some calcific tendinitis/bursitis of the right shoulder. I gave her a cortisone shot back in January of 2023 and did great. The pain recurred couple of months ago. She was seen by Dr. Osorio.	00:00:22.015	00:00:48.415
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_2	1,758,693,949	He did recommend an MRI of the right shoulder that was done in NJRC, North Jersey Radiology Center, on July 23, 2025, which was interpreted as high-grade partial thickness tear with full thickness tear of the supraspinatus tendon and arthrosis of the AC joint, period. Ms. Tojal states Dr. Osorio gave her a cortisone shot, She points to the lateral aspect, which helped her, but most of her pain she points to the AC joint.	00:00:48.415	00:01:14.835
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_3	1,758,693,949	She states she is better today but not perfect. There was no injury, no accident. Nothing happened to her. The pain just started bothering her. At this point, she has some pain with the extremes of motion but is definitely feeling better from Dr. Osorio’s cortisone shot. New paragraph. I went over her past medical history. She takes no medication routinely. No known allergies. She never had surgery. Family history is positive for cancer on her mother and father’s side. I went over her review of systems. Head and neck, negative; Heart and lungs, negative;	00:01:14.835	00:01:47.365
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_4	1,758,693,949	Stomach and intestine, negative; Urinary tract, positive For one pregnancy. Muscle and joints, negative. Nonsmoker and nondrinker. PHYSICAL EXAMINATION: Ms. Tojal is a 5 feet 4 150 pound pleasant, cooperative woman. She has most of her tenderness directly over the AC joint. She lacks the extremes of all motions, maybe lacking 5-7 degrees. She had weakly positive impingement test, negative drop test, negative sulcus sign, no subluxation, no tenderness over the anterolateral aspect of the shoulder.	00:01:47.365	00:02:16.665
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_5	1,758,693,949	Negative belly press test, negative lift-off test. Neurologically intact. New paragraph. X-RAYS: AP and lateral x-rays of the right shoulder demonstrate degenerative arthritis of the AC joint with an ossicle over the superior aspect of the AC joint. She has small calcification at the greater tuberosity, period. I also went over the actual MRI of the right shoulder. done at NJRC on July 23, 2025, which she brought on the disc showed significant hypertrophic changes at the AC joint, shows small calcification excuse me.	00:02:17.225	00:02:47.835
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_6	1,758,693,949	Also shows a high-grade partial thickness tear of the supraspinatus tendon. New paragraph. Impression. Right. Pressure. Maria Tojal has had pain on her right shoulder for years. I gave her a cortisone shot years ago. which resolved her calcific bursitis, and that was dating back to January 9, 2023, which she did great. She started getting the pain again in July. She was seen by Dr. Osorio.	00:02:47.835	00:03:13.345
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_7	1,758,693,949	He sent her for an MRI of the right shoulder, which showed partial thickness tear, full thickness tear of the rotator cuff. He gave her a cortisone shot, which helped her significantly, and she is much better at this point, though she is still little uncomfortable, period. The problem is most of her pain is not over the torn rotator cuff region, but as a result of the arthritic changes and ossicle over the AC joint. I told her I can give her another cortisone shot, but she states the cortisone shots just make her little hyper, make her nervous. At this point, she does not have much pain,	00:03:13.345	00:03:43.145
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_8	1,758,693,949	so she states at this point, she will live with this. So, Ms. Tojal has typical small calcific tendinitis of the right shoulder, hypertrophic changes of the AC joint, which is overriding complaint and she has a near full thickness tear of the rotator cuff, but it does not appear to be bothering her to a large extent. I think Dr. Osorio’s treatment including MRI of the right shoulder, the cortisone shot has improved this significantly. At this point, she is 85-90% better.	00:03:43.145	00:04:10.435
GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_9	1,758,693,949	I told her I can give her a cortisone shot in the AC joint to resolve majority of her pain, but she states the cortisone shots make her little anxious. She feels much better at this point. She will live with this, and if it gets worse in the future, then she will come back and talk to me. I told her that is fine. So, I would avoid forceful activity, just be gentle with the shoulder, And if it gets worse, then she is welcome back. A letter goes to Doctor Osorio in Newark address to Jorge J O R G E	00:04:10.435	00:04:37.691
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_0	1,758,694,110	Now dictating a letter to Biancamano & DiStefano Attention Joseph Biancamano, Esq. Regarding Irving Coreas-Guandique vs. Jack Williams Tire Company, Incorporated Claim number A00427380 CP number 2022-7190 (re-opener) Date of Injury March 1, 2022	00:00:01.360	00:00:31.020
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_1	1,758,694,110	Your File number 60049-37241 JVBJ as in john V as in victory B as in boy and cc goes Great American Strategic Comp at Post Office Box 4080 Clinton, IA 52733-4080 Attention Hugh Spieglman date this September 5, 2025 addresses to Joseph Biancamano, Esq.	00:00:31.020	00:01:00.670
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_2	1,758,694,110	new paragraph. I had the opportunity to reevaluate Irving Coreas-Guandique in my office on September 5, 2025 for the purpose of an Orthopaedic Independent Medical Evaluation based on a work-related accident he was involved on March 1, 2022. I had evaluated Mr. Coreas-Guandique previously in my office on November 15, 2022 and provided you with an independent medical evaluation report, period. Mr. Coreas-Guandique states that he did receive a settlement couple of years ago.	00:01:00.910	00:01:31.840
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_3	1,758,694,110	He is doing regular duty working as a truck driver without any restrictions. He complains of occasional low back pain, occasional left lower extremity radiculopathy. He has no difficulty standing, walking, bending, squatting, pushing, pulling, sleeping, driving, or doing forceful activities. He has not sought any medical care since I saw him on November 15, 2022. He states if he has any discomfort, he may take an occasional Tylenol, period. Paragraph.	00:01:32.000	00:01:56.560
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_4	1,758,694,110	There has been no change in his status since the last evaluation in my office on November 15, 2022 or since his permanency rating states there has been no change in his status whatsoever, period. He has had no additional injuries and he is happy about the results, period. new paragraph. PHYSICAL EXAMINATION: Mr. Coreas-Guandique is a 5 feet 7 inches, 260-pound pleasant, cooperative male, in no acute discomfort, period. His temperature in the office is 97.7, period.	00:01:56.560	00:02:24.940
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_5	1,758,694,110	Examination of the lumbar spine reveals no muscle spasm, no trigger points, no ecchymosis, erythema, abrasion, discoloration, tenderness, or edema, period. There was no tenderness over the sciatic notches. No tenderness over the sacroiliac joints. Range of motion was excellent in forward flexion. He could put his fingertips 2 inches from the floor. He could put his fingertips 2 inches from the floor. He had good extension. good left and right bend. Sensory, motor, and reflexes were normal. Babinski’s were downward going. No clonus present. No trouble toe and heel walking. No trouble getting up and down off the examining table. His gait was entirely normal.	00:02:25.020	00:02:52.720
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_6	1,758,694,110	Thigh and calf circumferences were within 1 cm of symmetry. X-rays of the lumbar spine done in my office AP of the pelvis, AP of the lumbar spine, left and right oblique of the lumbar spine were completely normal. My impression is that Irving Coreas-Guandique was involved in a work-related accident on March 1, 2022, where he sustained a lumbar strain, some left lower extremity radiculopathy. He did have an MRI of his lumbar spine performed at NJIN in Menlo Park on April 7, 2022, which was interpreted as L4-L5 central disc herniation.	00:02:53.040	00:03:23.080
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_7	1,758,694,110	I had an opportunity to review that actual MRI and it did show slightly left-sided disc herniation, but no neural foraminal stenosis. Mr. Coreas-Guandique’s treatment was appropriate. He underwent couple of epidural steroid injections, which improved him. and he was seen by Dr. Giordano, an orthopedic spine specialist, who recommended the epidurals by Dr. Yanow and then subsequently discharged. I asked Mr. Coreas-Guandique Is he able to do his regular household and recreational working activities without restrictions. He states he is.	00:03:23.465	00:03:54.855
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_8	1,758,694,110	Has there been any change in status since that last evaluation in my office on November 15, 2022 or since his permanency rating, and he states there has been no change whatsoever. Mr. Coreas-Guandique’s diagnosis at this point is resolved lumbar strain with a normal physical examination and normal x-rays based on his accident of March 1, 2022. PLAN: As a result of Mr. Coreas-Guandique’s work-related accident on March 1, 2022,	00:03:54.855	00:04:19.500
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_9	1,758,694,110	he remained at maximum medical benefits from treatment since that last visit in my office on November 15, 2022. There is absolutely no indication for any additional doctor visits, physical therapy, chiropractic visits, x-rays, CAT scans, MRIs, EMGs, bone scans, pain management, medications, or surgery. He can continue with the regular duty without restrictions. His prognosis remains excellent. He has absolutely no objective evidence of any restriction of function involving his low back or left leg.	00:04:20.185	00:04:44.540
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_10	1,758,694,110	Based on the accident of March 1, 2022, All the non-work activities he was able to do prior to this accident are the same activities he is doing at this point. There has been no lessening to a material degree, period. There is no need for any type of temporary or light duty status based on Mr. Coreas-Guandique’s accident of March 1, 2022, period. Mr. Coreas-Guandique, since I evaluated him in my office on November 15, 2022.	00:04:44.780	00:05:07.760
GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_11	1,758,694,110	has told me that he takes no increase in medications, he has not sought any medical care, he has had no change in his status since that evaluation in my office on November 15, 2022 and no change in his status since his permanency rating, period. Mr. Coreas-Guandique’s case does not need to be re-opened. His previous permanency rating remains unchanged, period. His prognosis remains excellent. new paragraph. write a macro for an IME. Thank You.	00:05:07.760	00:05:35.521
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_0	1,758,695,308	Now dictating a follow up note on Allen A L L E N Riley R I L E Y Age 83 Date of injury Last couple of months. Referred by Self. date this September 02, 2025 This is an office visit of this 83-year-old right-hand dominant male who I know quite well. I happened to be _____. He has had problems with his low back, some left hip, and just uncomfortable for the last few months. He had fallen down a few months ago did not really think much about it. It did not bother him until he started getting some back pain.	00:00:01.280	00:00:32.540
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_1	1,758,695,308	He states the pain got pretty bad. He thought it might be a kidney stone, so he went to John F. Kennedy Medical Center. They did a CAT scan to rule out a kidney stone. There was no kidney stone, that was in June of 2025, and he was discharged the same day. He has been utilizing heat pads. He states the heat pad helped him. He definitely has less discomfort now as compared to a couple of months ago, period. PAST MEDICAL HISTORY: I went over his past medical history.	00:00:33.020	00:00:58.605
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_2	1,758,695,308	He takes amlodipine, metoprolol, levothyroxine, and statin, period. Surgery in the past include rotator cuff, heart bypass, hernias. He has high blood pressure, no diabetes. Nonsmoker and nondrinker.	00:00:59.260	00:01:28.310
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_3	1,758,695,308	Mr. Riley is a 5’10”, 180-pound He has a mild tenderness in his back, mild tenderness in the left sciatic notch, some mild tenderness over the greater trochanteric bursa. Most of his tenderness is in the left sciatic notch. His straight leg raise is negative. Sensory was normal. Motor definitely has weakness of the extensor hallucis longus on the left and he had trouble heel walking on the left side. Babinski’s were downward going. No clonus present, period. He walked with a grossly normal gait, period. X-RAYS:	00:01:29.190	00:01:57.400
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_4	1,758,695,308	X-rays of the lumbar spine, AP of the pelvis, AP of the lumbar spine, lateral view of the lumbar spine, and AP and lateral of the left hip. Lumbar spine shows grade I anterolisthesis L4 anterior to L5. There is diffuse degenerative disc disease and osteophytes present significantly at T11-T12 and T12-L1 and mildly at L5-S1. X-rays of the left hip demonstrate some mild degenerative changes. small osteophytes present. no significant joint space narrowing.	00:01:57.400	00:02:27.320
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_5	1,758,695,308	My impression is that Allen Riley. looks like he has lumbar strain with some left lower extremity radiculopathy. He has weakness of the extensor hallucis longus. He has a little bit of pain in the left buttock, probably sciatic nerves and he has some very minimal arthritic changes in the left hip, period. I think his overriding problem is probably lumbar radiculopathy, period. New paragraph. PLAN: So, I explained to him because of his hypertension and cardiac disease, he is not a candidate for anti-inflammatories, so I told him I would take occasional Tylenol.	00:02:27.320	00:02:59.520
GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_6	1,758,695,308	I recommended outpatient course of physical therapy. I gave him some home exercises to do. I told him he just has to be a little bit careful with this. And if he does okay with this, it does not bother him much. I would do nothing. If it gets worse, then potentially an MRI of his lumbar spine may be indicated, period.	00:02:59.925	00:03:15.125
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_0	1,758,695,580	Now dictating a letter to V.T. Medical, Incorporated Attention Rosemarie Chidichimo Regarding Kurt Phillips vs. Princeton University Claim number W004330079 VT File number VT-29 E07741 Date of loss April 24, 2024 cc goes Biancamano & DiStefano	00:00:00.800	00:00:29.480
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_1	1,758,695,580	DiStefano, and that should be Attention Joseph Biancamano, Esq. Regarding Kurt Phillips vs. Princeton University. CP number 2025-5848. Date of Injury April 24, 2024. Claim number W as water 004330079. Your File 6007 60073-40559. J as in John V as in victory B as in boy. Date this September 5, 2025.	00:00:29.480	00:00:59.190
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_2	1,758,695,580	so you're gonna address to Rosemarie Chidichimo. New paragraph. I had the opportunity to evaluate Kurt Phillips in my office on September 5, 2025 based on a work-related accident he was involved in on April 24, 2024. At the time of the evaluation, Mr. Phillips was a 56-year-old right-hand dominant currently unemployed male who worked as an arborist for Princeton University.	00:00:59.190	00:01:26.820
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_3	1,758,695,580	He states while at work on April 24, 2024 cutting trees, he started having some pain in his neck. He states he was already having some neck pain before it became worse on April 24, 2024. I asked him if there was an injury, an accident, or something happened to him. He states "no." There was no injury, no accident, nothing happened to him. He states he did notify work and he was seen at Princeton Occupational Health.	00:01:26.820	00:01:55.380
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_4	1,758,695,580	He states he went on April 24, 2024, but I have notes from Princeton Occupational Health dated April 30, 2024 through December 10, 2024. It comments on worsening neck pain radiating up and down his neck that started on Thursday. He denied trauma. Considering there was no trauma, it is unclear whether this was even taken care of through Workers' Compensation. He denied radicular pain. There was some limited range of motion of his neck.	00:01:55.380	00:02:22.310
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_5	1,758,695,580	Physical examination showed some tenderness present but no erythema, no swelling, no ecchymosis, no muscular atrophy. Range of motion was limited secondary to pain, period. The diagnosis was strain of the muscles of the neck, period. He was placed on cyclobenzaprine. He was kept out of work, and physical therapy was recommended, period. New paragraph. The next evaluation was on May 1, 2024 at the Occupational Health location, period.	00:02:22.470	00:02:55.330
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_6	1,758,695,580	It comments his neck was improved with cyclobenzaprine. He had radiating pain up and down the neck, limited range of motion, period. Again, physical therapy was recommended, period. Again, it is unclear why this would be considered Workers' Compensation. You need an injury in Workers' Compensation, yet there is no injury here whatsoever, period. Paragraph.	00:02:55.410	00:03:17.860
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_7	1,758,695,580	I did review extensive physical therapy notes from HPTS in Trenton, New Jersey that were dated May 1, 2024 through March 17, 2025, period. New paragraph. The next evaluation at the Occupational Clinic was on May 6, 2024. There continued to be neck pain, upper back pain. No complaints of upper extremity radiculopathy, period.	00:03:17.860	00:03:43.980
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_8	1,758,695,580	He had been taking ibuprofen and physical examination showed some limited range of motion, period. There was a question mark with regard to whether work related and it was undetermined, period. This clearly should not have been taken care of through Workers' Compensation considering there is no mechanism of injury. I asked Mr. Phillips was there an injury at work, did something happen to him, if there was an accident. He states there was no injury, no accident, he just started having neck pain.	00:03:43.980	00:04:09.820
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_9	1,758,695,580	He was already having neck pain before he complained to the Occupational Clinic on April 24, 2024 where he states he never had treatment for this area. New paragraph. The next evaluation was with Dr. Levin from Comprehensive Spine Care New Jersey. I reviewed his notes of May 17, 2024 through June 10, 2025.	00:04:09.820	00:04:32.785
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_10	1,758,695,580	Dr. Levin comments on Mr. Phillips working at Princeton University for the last 14 years. He was being referred for evaluation of the cervical spine from a work-related injury of April 24, 2024. Dr. Levin comments that he was doing repetitive activities and again no mention of any specific injury. This treatment should have gone through his private health insurance. Obviously Mr. Phillips was having problems with his neck but there is no injury at work. Dr.	00:04:32.785	00:05:02.660
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_11	1,758,695,580	Levin comments on limited range of motion of the cervical spine. X-rays showed degenerative changes and he found no evidence of neural compression with neurologically being intact. He was given a prescription for Medrol Dosepak. New paragraph. The next evaluation with Dr. Levin was on May 28, 2024, period.	00:05:02.660	00:05:28.785
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_12	1,758,695,580	There were still some complaints of neck pain, some stiffness, neurologically normal, and again it was recommended he take a Medrol Dosepak, Tylenol and he could perform light duty activities, period. New paragraph. The next evaluation with Dr. Levin was on June 7, 2024. No meaningful improvement from the treatment. An MRI and CT scan was recommended for further evaluation, period. New paragraph.	00:05:28.785	00:05:55.235
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_13	1,758,695,580	I reviewed a note from Capital Health Emergency Room dated June 13, 2024 with regard to worsening symptomatic neck pain from arthritis, period. A CT scan of the cervical spine was performed CT scan of cervical spine was performed on June 13, 2024 at Capital Health Center in Hopewell.	00:05:55.235	00:06:20.825
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_14	1,758,695,580	interpreted as degenerative disc and facet disease most significant at C5-C6 and C6-C7, period. Paragraph. Another CAT scan was performed at Princeton Healthcare on June 24, 2024 and interpreted as disc herniation at C3-C4 and C4-C5. disc space narrowing and degenerative changes seen at C5-C6 and C6-C7 with uncovertebral joint hypertrophy and neural foraminal stenosis, period. Paragraph.	00:06:22.265	00:06:49.975
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_15	1,758,695,580	The MRI of the cervical spine was also done at Princeton Healthcare on June 24, 2024 and interpreted as C2-C3 mild facet arthropathy. No spinal canal or neural foraminal stenosis. C3-C4 small diffuse disc bulge which does not cause significant spinal canal stenosis, Bilateral uncovertebral joint and mild facet joint hypertrophy seen which causes moderate bilateral neural foraminal narrowing, period.	00:06:49.975	00:07:17.985
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_16	1,758,695,580	C4-C5 small diffuse disc bulge which does not cause significant spinal canal stenosis, comma, mild uncovertebral joint facet hypertrophy seen which causes mild right-sided and no left-sided neural foraminal stenosis. C5-C6 small diffuse disc bulge which does not cause significant spinal canal stenosis. There is mild uncovertebral joint facet joint hypertrophy seen which causes bilateral foraminal narrowing, period. C6-C7 no evidence of spinal canal stenosis,	00:07:18.065	00:07:46.625
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_17	1,758,695,580	Mild uncovertebral joint facet joint hypertrophy which causes moderate right-sided neural foraminal narrowing. Left neural foramen is patent, period. C7-T1 was normal, period. New paragraph. New paragraph. The next evaluation was on June 25, 2024 with Dr. Levin. He comments on the MRI and CAT scan. He found C5-C6 and C6-C7 motion segment abnormalities and he thought an epidural steroid injection would be appropriate.	00:07:46.625	00:08:16.615
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_18	1,758,695,580	New paragraph. The next evaluation was with Dr. Lester who is a physiatrist. I reviewed his notes of July 2, 2024 through August 29, 2024. The note of July 2, 2024 comments on the date of injury of April 24, 2024. There is no specific injury, but he comments that Mr. Phillips thinks it is related to work. It does not make any sense to me.	00:08:16.615	00:08:43.245
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_19	1,758,695,580	Just because Mr. Phillips thinks it is related to work, why should it be work related. There is no injury, no accident nothing happened to Mr. Phillips. He's getting treatment that may very well be appropriate, but he should have gone through his private health insurance, period. Doctor Lester comments that diagnosed cervical spondylosis without myelopathy. He had multiple co more comorbid COMRD cardiovascular issues, period. New paragraph. The next evaluation I'm sorry.	00:08:44.220	00:09:14.310
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_20	1,758,695,580	Before doctor pardon. The next evaluation on 07/18/2024 with doctor Lester, and he getting comments on the neck problems for cervical spondylosis, and he recommended an injection, period. New paragraph. The next evaluation was doctor Lester performed an epidural steroid injection on mister Kurt's cervical spine and center for him through surgery in Mountain Sign on 08/08/2024, period.	00:09:14.310	00:09:44.290
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_21	1,758,695,580	That everything went well, period. New paragraph. The next evaluation was with doctor Lester on 08/29/2024. I'm sorry. The next evaluation was with doctor Levin on 08/16/2024, a week after the epidural steroid injection, and there was minimal improvement from the injection, period. Paragraph. The next evaluation was with doctor Lester on 08/29/2024. Any comments?	00:09:44.290	00:10:09.680
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_22	1,758,695,580	There was no relief from the epidural through ingestion that he performed, peer New paragraph. Doctor. Lester performed another performed a facet block slash medial branch block at c five, c six, and c 67 at the center for and for surgeon mountainside on 09/20/6024, period. Paragraph.	00:10:09.680	00:10:33.105
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_23	1,758,695,580	A cervical facet radiofrequency ablation was performed at C 5 and c 6 C seven by doctor Lester at the Hudson Crossing Surgical Center Fort Lee on 10/22/2024, period. A radiofrequency ablation was performed on by Doctor. Lester at Dawson Crossing Surgical Center on 10/29/2024, period.	00:10:33.105	00:11:01.075
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_24	1,758,695,580	Mister Phillips states he had minimal improvement from these injections, period. New paragraph. The next evaluation was with doctor eleven on 10/11/2024. He comments on the injections did not help any great extent. There was significant problems with the c five, c six, and c six seven level, period. New paragraph.	00:11:01.395	00:11:26.185
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_25	1,758,695,580	Another evaluation with Dr. Levin was on November 8, 2024. He comments all the injections had been performed, and there was no improvement from these injections. Dr. Levin thought Mr. Phillips was a candidate for surgery of the cervical spine. New paragraph. Next evaluation with Dr. Levin was on November 22, 2024.	00:11:26.185	00:11:53.095
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_26	1,758,695,580	He still complains about neck pain and again surgery on the cervical spine was recommended. New paragraph. Surgery on the cervical spine was performed on January 7, 2025 by Dr. Levin. The surgery was C5-C6 and C6-C7 anterior radical discectomy and foraminotomies with fusion. I reviewed the operative report and it appeared that everything went well. New paragraph. The next evaluation with Dr. Levin was on January 31, 2025.	00:11:53.735	00:12:25.615
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_27	1,758,695,580	About four weeks after the surgery, X-rays showed good position and a fusion present. There are no complaints of neurologic abnormality. He was told to continue with his collar. "" The next evaluation was on February 28, 2025. Seven weeks after the neck surgery. He continued to be symptomatic and he had some functional improvement. Neurologic examination was normal. He was told he could wean off the collar. New paragraph.	00:12:26.015	00:12:55.405
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_28	1,758,695,580	The next evaluation with Dr. Levin was on April 8, 2025, three months after the neck surgery. He had completed his postoperative physical therapy. He had good balance. No evidence of myelopathy or neurologic abnormality and he thought putting him on some light duty restrictions would be appropriate. New paragraph.	00:12:56.550	00:13:20.065
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_29	1,758,695,580	The last evaluation I had was a quick note from Dr. Levin dated June 10, 2025, which put Mr. Phillips on light duty restrictions and he was found to be MMI at that time. new paragraph. Mr. Phillips states he is much better as a result of having the surgery in his neck. He has no upper extremity radiculopathy but he has stiffness in his neck. He tried to return to work but there was no light duty available for him.	00:13:20.065	00:13:48.815
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_30	1,758,695,580	Therefore, he is not working at this point. He states he had no prior history of injury of the neck prior to the accident of April 24, 2024. , no subsequent injuries. He denied ever being involved in a motor vehicle accident. PHYSICAL EXAMINATION: New paragraph. Mr. Phillips at this point is not under the care of any doctor, not looking for medical care. He takes occasional muscle relaxant if he has pain. Physical examination. Mister Phillips, five foot six, hundred and forty pound plus club male. His temperature in the office is ninety eight four, period.	00:13:48.815	00:14:20.035
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_31	1,758,695,580	Examination of cervical spine, feels a barely visible three centimeter anterior transverse scar. There's no redness, swelling, tenderness, abrasions, discoloration, edema, muscle spasm, trigger points, period. He had decreased range of motion, including 25 degrees of extension, 15 degrees of flexion, 15 degrees of left right lateral tilt, and 45 degrees of left and right rotation, period. Neurovascular status, both upper extremities are intact. His Hoffman test was negative.	00:14:20.540	00:14:47.165
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_32	1,758,695,580	His cross shoulder abduction test was negative, and his Spurling SPOELIA test was negative, period. New paragraph. Arm and forearm circumferences were within 1 cm of symmetry. Label this X-ray. X-rays of the cervical spine done in my office, AP lateral, left and right obliques demonstrate anterior plate and screws present at C5 through C7 with metal fusion in cages in good alignment. New paragraph. Mr. Phillips also brought four disks with him.	00:14:47.580	00:15:14.285
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_33	1,758,695,580	First disk was from McCosh Health Center in Princeton which included x-rays of the cervical spine AP, two open mouth views, left and right lateral oblique x-rays. It showed degenerative disc disease at C5-C6 and C6-C7. C6 was anterior to C5 on the lateral extension view and the lateral flexion view showed no subluxation. AP lateral x-rays of the thoracic spine	00:15:15.250	00:15:45.630
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_34	1,758,695,580	I'm sorry. showed minimal scoliosis, some diffuse degenerative disc disease, and osteophytes present. Berger. Second disk had the CAT scan of the cervical spine performed at Princeton Radiology on June 24, 2024. C2-C3 was normal, period.	00:15:45.790	00:16:04.075
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_35	1,758,695,580	C3-C4 showed a broad central bulge present. It did cause some compression upon the ventral aspect of the spinal cord, period. C4-C5 showed central bulge present which did indent the ventral aspect of the spinal cord. There was no narrowing of the neural foramen or compression upon the exiting nerve roots, period. The C5-C6 disc showed disc degeneration.	00:16:04.075	00:16:31.145
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_36	1,758,695,580	There was also noted to be bilateral uncovertebral hypertrophy with some right foraminal stenosis, period. The C6-C7 disc showed degenerative disc disease. There is bilateral uncovertebral joint hypertrophy and some mild right neural foraminal stenosis, period. C7-T1 was normal. Paragraph. The third disk was an MRI of the cervical spine performed at Princeton Radiology on June 24, 2024, period.	00:16:31.305	00:16:58.685
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_37	1,758,695,580	It showed degenerative disc disease at C2 through C7. C2-C3 disc showed no disc bulge, no disc herniation or neurologic encroachment, period. C3-C4 small disc bulge. it did touch the anterior spinal cord. There is mild facet hypertrophy and mild bilateral neural foraminal stenosis, period. The C4-C5 disc showed disc bulge present. There is no significant pressure upon the spinal cord.	00:16:59.420	00:17:27.080
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_38	1,758,695,580	There is some uncovertebral facet joint hypertrophy and some very mild bilateral foraminal stenosis. The C5-C6 disc showed disc bulge present with no significant compression upon the spinal cord. There is mild bilateral uncovertebral joint hypertrophy along with facet joint hypertrophy which caused minimal neural foraminal stenosis.	00:17:27.080	00:17:51.755
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_39	1,758,695,580	The C6-C7 disc showed degenerative disc disease, moderate right neural foraminal stenosis. New paragraph. The fourth disk was on January 31, 2025 from the University of Radiology in Bridgewater. X-rays of the cervical spine AP lateral show a fusion with screw and plates present at C5-C6 and C6-C7, and there is evidence of two metal fusion cages between C5-C6 and C6-C7. IMPRESSION: My impression is that Kurt Phillips was complaining about neck pain on April 24, 2024.	00:17:51.755	00:18:22.695
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_40	1,758,695,580	Kurt Phillips was complaining about neck pain on April 24, 2024. There is no injury, no accident. If you look at his medical records, there is no mention of anything happening to him. As far as a work-related injury, you need to have a specific episode. All of his medical records clearly document that there was no specific injury. He obviously had preexisting degenerative disease in his cervical spine. His treatment was medically appropriate but it should have gone through his private health insurance and not through Workers' Compensation.	00:18:23.015	00:18:53.650
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_41	1,758,695,580	He had an arthritic condition in his cervical spine and that is not causally related nor aggravated as a result of the accident of April 24, 2024, but apparently work took responsibility for this. new paragraph.	00:18:53.650	00:19:03.250
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_42	1,758,695,580	Mr. Phillips did undergo extensive treatments including MRIs, CAT scans, multiple injections from the pain management doctor, and then eventually surgery on his cervical spine to include a C5-C6 and C6-C7 anterior decompression discectomy and foraminotomies and a fusion. He has done very well postoperatively, period.	00:19:03.250	00:19:29.110
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_43	1,758,695,580	He has some stiffness in his neck which is typical after having surgery, he is entirely neurologically intact. Dr. Levin put him on light duty and there was no light duty available. Therefore, he has not been able to return to work, period. Paragraph. I think Mr. Phillips' treatment to date has been medically appropriate but there is no causal relationship between the accident of April 24, 2024 and his complaints of neck pain. Therefore, all this treatment should have gone through his private health insurance and not through his Workers' Compensation, period. Paragraph. PLAN:	00:19:29.110	00:19:59.480
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_44	1,758,695,580	Based on Mr. Phillips' alleged work-related accident involving the cervical spine on April 24, 2024, he is at maximum medical benefits from treatment. There is no indication for any additional doctor visits. physical therapy, chiropractor visits. x-rays, CAT scans, MRIs, EMGs, bone scans, pain management, medications, or surgery, period. Dr. Levin Levin put him on permanent light duty restrictions which would probably be appropriate after two levels of cervical spine fusion, period. Paragraph.	00:19:59.480	00:20:27.960
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_45	1,758,695,580	Mr. Phillips' does have some objective evidence of restriction of function involving the cervical spine but he remains neurologically intact, period. Regardless of cause involving Mr. Phillips' cervical spine, he has a 12% partial permanent impairment of total, period. Again, I would not consider any of these problems to be causally related to work nor aggravated from work, period. This treatment should have gone through his private health insurance, period. Nonetheless, it apparently went through Workers' Compensation, period.	00:20:27.960	00:20:58.710
GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_46	1,758,695,580	New paragraph. Write a macro for an IME. Thank You.	00:20:59.291	00:21:02.491
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_0	1,758,696,769	Now dictating a note on Lawanda L A W A N D A Coxson C O X S O N Age 52 Date of injury multiple months Referred by self Date this September 2, 2025 This is an office visit of this 52-year-old right-hand dominant Claims Intake representative who complains of pain in both hands for multiple months, period. There is no injury, no accident, nothing happened to her.	00:00:01.760	00:00:29.550
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_1	1,758,696,769	Nighttime is worse than daytime. It wakes her up at nighttime. The left hand is worse than the right hand, period. She has had a history of tendonitis. She had a cortisone shot, but this does not feel like this, period. She complains of numbness of thumb, index, long, ring fingers. She states her pinky finger is okay, period. It is aggravated by activities. PAST MEDICAL HISTORY: I went over her past medical history. She takes no medications routinely. She is allergic to penicillin and sulfa. She has no known allergies. She has no known allergies. She is not aware of her family history.	00:00:29.870	00:01:00.450
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_2	1,758,696,769	I went over her review of systems, head and neck negative; heart and lungs negative; muscle and joints negative. She is a nonsmoker and drinks alcohol occasionally. She is a nonsmoker and drinks alcohol occasionally, period. PHYSICAL EXAMINATION: Ms. Coxson is a 5 feet 2 165 pound woman. She has numbness in the median nerve distribution of both hands, thumb, index, long, and radial aspect of the ring finger, period. It is only on the volar side, period. No triggering of the A1 pulleys. No subluxation of the extensor tendons. No evidence of active Boutonnière, swan neck or mallet finger deformities.	00:01:00.450	00:01:30.150
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_3	1,758,696,769	Tinel and Phalen tests were negative, period. The paragraph X-RAYS: AP, lateral and oblique x-rays of both hands and wrist done in my office were normal. AP, lateral x-rays of both hands done in my office. Were normal. IMPRESSION: My impression is that Lawanda Coxson looks like she has typical bilateral carpal tunnel syndrome, period. It wakes her up at nighttime. She has numbness in the typical median nerve distribution. She has no complaints of neck pain. No complaints of elbow pain, period. Tinel and Phalen tests were negative, but she has the typical numbness in the median nerve distribution especially waking her up at nighttime, period. Paragraph. PLAN:	00:01:30.150	00:01:59.720
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_4	1,758,696,769	So, I put her on Naprosyn as an anti-inflammatory medication, period. I recommended bilateral cock-up splints. You wear them when you go to sleep at night. Otherwise, take them off, period. I gave her an appointment to see me in a few weeks. We will check on her and see what is happening. If she is doing better, having less pain, we will keep her up with the nighttime splints. If the problem resolves, then we will just keep up with the nighttime splints.	00:01:59.720	00:02:22.250
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_5	1,758,696,769	If the problem does not resolve and she is miserable and the cock-up splints do not help her, then potentially an EMG/nerve conduction study to evaluate her carpal tunnel syndrome would be appropriate. Obviously, severe carpal tunnel is a bad situation. Sometimes, it requires surgery. Maybe we will be lucky with mild-to-moderate carpal tunnel. the cocktail splints might help, and we will just wait and see how she does with these splints. Again, you only wear these at nighttime and she was fine with this.	00:02:22.250	00:02:49.898
GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_6	1,758,696,769	I told her where she could buy these on Amazon that are very inexpensive.	00:02:49.898	00:02:53.898
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_0	1,758,696,787	Now dictating the report. It's gonna be addressed to Biancamano & DiStefano and that should be Attention Joseph Biancamano, Esq. Regarding Kyle Parker-Hall vs. Wakefern Food Corporation CP number 2024-10606 Date of Injury July 11, 2020 Claim number 007745-158787-WC-01	00:00:00.960	00:00:30.630
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_1	1,758,696,787	your File number 60034-39653 J as in john V as victory B as boy The address is Joseph Biancamano. The report itself is gonna be sent to Leidos QTC Health Services. QTC Health Services 1700 Paoli Pike Malvern, PA 19355. Attention Liz Narrigan. Last name is Narrigan. That's regarding Kyle Parker-Hall.	00:00:30.630	00:01:00.170
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_2	1,758,696,787	Date of accident, July 11, 2020. The employer's Wakefern Food Corporation Claim number 007745-158787-WC-01. Again, you're gonna date this September 5, 2025.	00:01:00.330	00:01:16.545
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_3	1,758,696,787	You're address this to Joseph Biancamano , Esq. but you're gonna send it to Leidos I had the opportunity to evaluate Kyle Parker-Hall in my office on September 5, 2025, for the purpose of an Orthopaedic Independent Medical Evaluation based on a work-related accident he was involved in on July 11, 2020. At the time of the evaluation, Mr. Parker-Hall was a 40-year-old right-hand dominant currently unemployed male, who states while working as a selector for Wakefern on July 11, 2020,	00:01:16.545	00:01:43.755
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_4	1,758,696,787	on July 11, 2020, he was lifting an empty pallet when he felt some sharp pain in his low back and some numbness down his right leg. Mr. Parker-Hall states he already had a very significant problems in his low back based on a prior work-related accident he was involved in on September 2, 2019. Mr. Parker-Hall stated the accident on September 2, 2019, was very significant.	00:01:44.155	00:02:13.935
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_5	1,758,696,787	He went to the hospital, underwent extensive treatment by consent, and his pain never completely resolved. He was still having severe back pain and lower extremity radiculopathy at the time of his accident on July 11, 2020. Mr. Parker-Hall states there was really no accident on July 11, 2020. He was just doing his routine job, and his back just flared up. He was already having significant problems, period.	00:02:14.175	00:02:39.530
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_6	1,758,696,787	I asked him if this alleged accident of July 11, 2020, caused or further exacerbated the condition. He states it did not, period. Paragraph. He was following the accident of July 11, 2020. He was seen at the Pivot Onsite Innovations Clinic on July 13, 2020, and it comments he was lifting a 50-pound box at work and felt back pain and right lower extremity radiculopathy.	00:02:39.775	00:03:05.700
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_7	1,758,696,787	He had already had similar problems back in a work-related accident in August through October of 2019, had received two injections, had an MRI showing two disc herniations, and was still treating at the time of this accident of July 11, 2020. Physical examination showed some tenderness present and a magnified response with a light palpation, period. New paragraph. The next evaluation was on July 20, 2020.	00:03:05.780	00:03:34.515
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_8	1,758,696,787	The back was much improved. He denied numbness, tingling, weakness, and difficulty ambulating. He completed his therapy sessions, and he could return to work without restriction on July 21, 2020. Paragraph. The next evaluation at the Pivot Onsite Clinic was on July 24, 2020, first day back to work. He was having difficulty lifting products and walking. He had completed his physical therapy. He had been treated by his family doctor for chronic back problems.	00:03:34.755	00:04:03.710
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_9	1,758,696,787	Physical examination showed some limited range of motion, positive straight leg raise on the right, otherwise, neurologically intact. Therapy was recommended, but the therapy was refused. The final evaluation was on July 29, 2020, at the Pivot Onsite Innovation Clinic. And the notes comment they reviewed his symptoms over the phone and made him aware that his problems appeared to be from a previous condition, not an acute event on July 11, 2020.	00:04:04.185	00:04:31.300
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_10	1,758,696,787	The patient agrees, although he feels the pre-existing condition was work-related, I could not confirm that. But as per the July 11, 2019, injury, his back pain is related to his pre-existing chronic condition. He was discharged from care. Paragraph. Mr. Parker-Hall states that is all the treatment he underwent based on the accident of July 11, 2020. All the other treatment he underwent was a result of his previous accident of September 2, 2019. Paragraph.	00:04:32.075	00:05:02.185
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_11	1,758,696,787	I did review extensive medical records with regards to the accident of September 2, 2019. He was seen at Trinitas Regional Medical Center on September 2, 2019, complaining about back pain. He was subsequently seen at Concentra where they evaluated him on September 10, 2019, through October 2, 2019, with back pain as a result of lifting a heavy object. Diagnosed with lumbar strain. He was given multiple medications.	00:05:02.185	00:05:28.140
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_12	1,758,696,787	I also reviewed notes from Twin Boro Physical Therapy from Newark, New Jersey, dated September 12, 2019, through April 6, 2022. Paragraph. Mr. Parker-Hall went back to the emergency room at Trinitas Regional Medical Center on September 21, 2019, with regards to back pain.	00:05:28.140	00:05:52.800
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_13	1,758,696,787	An MRI of his lumbar spine was done at University Radiology on September 24, 2019, which was interpreted as degenerative changes at L3-L4, L4-L5 and L5-S1 with left-sided L3-L4 foraminal disc herniation touching the exiting left L3 nerve root, left-sided L4-L5 severe foraminal stenosis, and left-sided L5-S1 severe stenosis with moderate right-sided L5-S1 foraminal stenosis, period.	00:05:52.800	00:06:23.040
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_14	1,758,696,787	Paragraph. He was next seen at Tri-County Orthopedics by Dr. Klein who comments on a work-related accident on October 8, 2019. He comments on a work-related injury, that there was back pain, there was some tenderness present, and a decreased sensation of the right L5 dermatome, period. He was given a Medrol Dosepak, gabapentin. Paragraph.	00:06:23.040	00:06:51.330
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_15	1,758,696,787	He was next seen by Dr. Wendel, pain management specialist at Tri-County Orthopedics. I have reviewed his notes of October 17, 2019, through December 15, 2020, period. The visit was on November 11, 2019, back pain, right lower extremity radiculopathy, neurologic abnormalities, and he was told to wean off the gabapentin and naproxen. He could return to regular duty and follow up in two weeks, period.	00:06:51.330	00:07:16.880
GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_16	1,758,696,787	All of these problems were causally related to the work-related accident on September 2, 2019, period. Paragraph. I have reviewed a report from an epidural steroid injection performed by Dr. Wendel at Tri-County on November 16, 2019, period. New paragraph. An ER report from University Hospital Emergency Room dated December 29, 2019, gives no information with regards to the cause of the ER visit, period. Paragraph.	00:07:16.960	00:07:45.800

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_0

1,758,693,949

Now dictating a follow up note on Maria Tojal T O J A L Age 60 Date of injury August 5 2025 Referred by Doctor Osorio OSORIO 217 Chestnut Street Newark New Jersey 07105 addresses to Jorge J O R G E date this September 02, 2025

00:00:01.520

00:00:21.935

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_1

1,758,693,949

This is an office visit of this 62-year-old right-hand dominant self-employed woman who I had taken care of years ago. She had some calcific tendinitis/bursitis of the right shoulder. I gave her a cortisone shot back in January of 2023 and did great. The pain recurred couple of months ago. She was seen by Dr. Osorio.

00:00:22.015

00:00:48.415

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_2

1,758,693,949

He did recommend an MRI of the right shoulder that was done in NJRC, North Jersey Radiology Center, on July 23, 2025, which was interpreted as high-grade partial thickness tear with full thickness tear of the supraspinatus tendon and arthrosis of the AC joint, period. Ms. Tojal states Dr. Osorio gave her a cortisone shot, She points to the lateral aspect, which helped her, but most of her pain she points to the AC joint.

00:00:48.415

00:01:14.835

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_3

1,758,693,949

She states she is better today but not perfect. There was no injury, no accident. Nothing happened to her. The pain just started bothering her. At this point, she has some pain with the extremes of motion but is definitely feeling better from Dr. Osorio’s cortisone shot. New paragraph. I went over her past medical history. She takes no medication routinely. No known allergies. She never had surgery. Family history is positive for cancer on her mother and father’s side. I went over her review of systems. Head and neck, negative; Heart and lungs, negative;

00:01:14.835

00:01:47.365

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_4

1,758,693,949

Stomach and intestine, negative; Urinary tract, positive For one pregnancy. Muscle and joints, negative. Nonsmoker and nondrinker. PHYSICAL EXAMINATION: Ms. Tojal is a 5 feet 4 150 pound pleasant, cooperative woman. She has most of her tenderness directly over the AC joint. She lacks the extremes of all motions, maybe lacking 5-7 degrees. She had weakly positive impingement test, negative drop test, negative sulcus sign, no subluxation, no tenderness over the anterolateral aspect of the shoulder.

00:01:47.365

00:02:16.665

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_5

1,758,693,949

Negative belly press test, negative lift-off test. Neurologically intact. New paragraph. X-RAYS: AP and lateral x-rays of the right shoulder demonstrate degenerative arthritis of the AC joint with an ossicle over the superior aspect of the AC joint. She has small calcification at the greater tuberosity, period. I also went over the actual MRI of the right shoulder. done at NJRC on July 23, 2025, which she brought on the disc showed significant hypertrophic changes at the AC joint, shows small calcification excuse me.

00:02:17.225

00:02:47.835

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_6

1,758,693,949

Also shows a high-grade partial thickness tear of the supraspinatus tendon. New paragraph. Impression. Right. Pressure. Maria Tojal has had pain on her right shoulder for years. I gave her a cortisone shot years ago. which resolved her calcific bursitis, and that was dating back to January 9, 2023, which she did great. She started getting the pain again in July. She was seen by Dr. Osorio.

00:02:47.835

00:03:13.345

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_7

1,758,693,949

He sent her for an MRI of the right shoulder, which showed partial thickness tear, full thickness tear of the rotator cuff. He gave her a cortisone shot, which helped her significantly, and she is much better at this point, though she is still little uncomfortable, period. The problem is most of her pain is not over the torn rotator cuff region, but as a result of the arthritic changes and ossicle over the AC joint. I told her I can give her another cortisone shot, but she states the cortisone shots just make her little hyper, make her nervous. At this point, she does not have much pain,

00:03:13.345

00:03:43.145

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_8

1,758,693,949

so she states at this point, she will live with this. So, Ms. Tojal has typical small calcific tendinitis of the right shoulder, hypertrophic changes of the AC joint, which is overriding complaint and she has a near full thickness tear of the rotator cuff, but it does not appear to be bothering her to a large extent. I think Dr. Osorio’s treatment including MRI of the right shoulder, the cortisone shot has improved this significantly. At this point, she is 85-90% better.

00:03:43.145

00:04:10.435

GSG11418_proc_47e02e9b-36fe-46ed-83ac-34fa2b82335a_9

1,758,693,949

I told her I can give her a cortisone shot in the AC joint to resolve majority of her pain, but she states the cortisone shots make her little anxious. She feels much better at this point. She will live with this, and if it gets worse in the future, then she will come back and talk to me. I told her that is fine. So, I would avoid forceful activity, just be gentle with the shoulder, And if it gets worse, then she is welcome back. A letter goes to Doctor Osorio in Newark address to Jorge J O R G E

00:04:10.435

00:04:37.691

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_0

1,758,694,110

Now dictating a letter to Biancamano & DiStefano Attention Joseph Biancamano, Esq. Regarding Irving Coreas-Guandique vs. Jack Williams Tire Company, Incorporated Claim number A00427380 CP number 2022-7190 (re-opener) Date of Injury March 1, 2022

00:00:01.360

00:00:31.020

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_1

1,758,694,110

Your File number 60049-37241 JVBJ as in john V as in victory B as in boy and cc goes Great American Strategic Comp at Post Office Box 4080 Clinton, IA 52733-4080 Attention Hugh Spieglman date this September 5, 2025 addresses to Joseph Biancamano, Esq.

00:00:31.020

00:01:00.670

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_2

1,758,694,110

new paragraph. I had the opportunity to reevaluate Irving Coreas-Guandique in my office on September 5, 2025 for the purpose of an Orthopaedic Independent Medical Evaluation based on a work-related accident he was involved on March 1, 2022. I had evaluated Mr. Coreas-Guandique previously in my office on November 15, 2022 and provided you with an independent medical evaluation report, period. Mr. Coreas-Guandique states that he did receive a settlement couple of years ago.

00:01:00.910

00:01:31.840

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_3

1,758,694,110

He is doing regular duty working as a truck driver without any restrictions. He complains of occasional low back pain, occasional left lower extremity radiculopathy. He has no difficulty standing, walking, bending, squatting, pushing, pulling, sleeping, driving, or doing forceful activities. He has not sought any medical care since I saw him on November 15, 2022. He states if he has any discomfort, he may take an occasional Tylenol, period. Paragraph.

00:01:32.000

00:01:56.560

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_4

1,758,694,110

There has been no change in his status since the last evaluation in my office on November 15, 2022 or since his permanency rating states there has been no change in his status whatsoever, period. He has had no additional injuries and he is happy about the results, period. new paragraph. PHYSICAL EXAMINATION: Mr. Coreas-Guandique is a 5 feet 7 inches, 260-pound pleasant, cooperative male, in no acute discomfort, period. His temperature in the office is 97.7, period.

00:01:56.560

00:02:24.940

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_5

1,758,694,110

Examination of the lumbar spine reveals no muscle spasm, no trigger points, no ecchymosis, erythema, abrasion, discoloration, tenderness, or edema, period. There was no tenderness over the sciatic notches. No tenderness over the sacroiliac joints. Range of motion was excellent in forward flexion. He could put his fingertips 2 inches from the floor. He could put his fingertips 2 inches from the floor. He had good extension. good left and right bend. Sensory, motor, and reflexes were normal. Babinski’s were downward going. No clonus present. No trouble toe and heel walking. No trouble getting up and down off the examining table. His gait was entirely normal.

00:02:25.020

00:02:52.720

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_6

1,758,694,110

Thigh and calf circumferences were within 1 cm of symmetry. X-rays of the lumbar spine done in my office AP of the pelvis, AP of the lumbar spine, left and right oblique of the lumbar spine were completely normal. My impression is that Irving Coreas-Guandique was involved in a work-related accident on March 1, 2022, where he sustained a lumbar strain, some left lower extremity radiculopathy. He did have an MRI of his lumbar spine performed at NJIN in Menlo Park on April 7, 2022, which was interpreted as L4-L5 central disc herniation.

00:02:53.040

00:03:23.080

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_7

1,758,694,110

I had an opportunity to review that actual MRI and it did show slightly left-sided disc herniation, but no neural foraminal stenosis. Mr. Coreas-Guandique’s treatment was appropriate. He underwent couple of epidural steroid injections, which improved him. and he was seen by Dr. Giordano, an orthopedic spine specialist, who recommended the epidurals by Dr. Yanow and then subsequently discharged. I asked Mr. Coreas-Guandique Is he able to do his regular household and recreational working activities without restrictions. He states he is.

00:03:23.465

00:03:54.855

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_8

1,758,694,110

Has there been any change in status since that last evaluation in my office on November 15, 2022 or since his permanency rating, and he states there has been no change whatsoever. Mr. Coreas-Guandique’s diagnosis at this point is resolved lumbar strain with a normal physical examination and normal x-rays based on his accident of March 1, 2022. PLAN: As a result of Mr. Coreas-Guandique’s work-related accident on March 1, 2022,

00:03:54.855

00:04:19.500

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_9

1,758,694,110

he remained at maximum medical benefits from treatment since that last visit in my office on November 15, 2022. There is absolutely no indication for any additional doctor visits, physical therapy, chiropractic visits, x-rays, CAT scans, MRIs, EMGs, bone scans, pain management, medications, or surgery. He can continue with the regular duty without restrictions. His prognosis remains excellent. He has absolutely no objective evidence of any restriction of function involving his low back or left leg.

00:04:20.185

00:04:44.540

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_10

1,758,694,110

Based on the accident of March 1, 2022, All the non-work activities he was able to do prior to this accident are the same activities he is doing at this point. There has been no lessening to a material degree, period. There is no need for any type of temporary or light duty status based on Mr. Coreas-Guandique’s accident of March 1, 2022, period. Mr. Coreas-Guandique, since I evaluated him in my office on November 15, 2022.

00:04:44.780

00:05:07.760

GSG11431_proc_c62a0b93-0b5d-43ea-8008-cbe8dfc1a38f_11

1,758,694,110

has told me that he takes no increase in medications, he has not sought any medical care, he has had no change in his status since that evaluation in my office on November 15, 2022 and no change in his status since his permanency rating, period. Mr. Coreas-Guandique’s case does not need to be re-opened. His previous permanency rating remains unchanged, period. His prognosis remains excellent. new paragraph. write a macro for an IME. Thank You.

00:05:07.760

00:05:35.521

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_0

1,758,695,308

Now dictating a follow up note on Allen A L L E N Riley R I L E Y Age 83 Date of injury Last couple of months. Referred by Self. date this September 02, 2025 This is an office visit of this 83-year-old right-hand dominant male who I know quite well. I happened to be _____. He has had problems with his low back, some left hip, and just uncomfortable for the last few months. He had fallen down a few months ago did not really think much about it. It did not bother him until he started getting some back pain.

00:00:01.280

00:00:32.540

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_1

1,758,695,308

He states the pain got pretty bad. He thought it might be a kidney stone, so he went to John F. Kennedy Medical Center. They did a CAT scan to rule out a kidney stone. There was no kidney stone, that was in June of 2025, and he was discharged the same day. He has been utilizing heat pads. He states the heat pad helped him. He definitely has less discomfort now as compared to a couple of months ago, period. PAST MEDICAL HISTORY: I went over his past medical history.

00:00:33.020

00:00:58.605

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_2

1,758,695,308

He takes amlodipine, metoprolol, levothyroxine, and statin, period. Surgery in the past include rotator cuff, heart bypass, hernias. He has high blood pressure, no diabetes. Nonsmoker and nondrinker.

00:00:59.260

00:01:28.310

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_3

1,758,695,308

Mr. Riley is a 5’10”, 180-pound He has a mild tenderness in his back, mild tenderness in the left sciatic notch, some mild tenderness over the greater trochanteric bursa. Most of his tenderness is in the left sciatic notch. His straight leg raise is negative. Sensory was normal. Motor definitely has weakness of the extensor hallucis longus on the left and he had trouble heel walking on the left side. Babinski’s were downward going. No clonus present, period. He walked with a grossly normal gait, period. X-RAYS:

00:01:29.190

00:01:57.400

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_4

1,758,695,308

X-rays of the lumbar spine, AP of the pelvis, AP of the lumbar spine, lateral view of the lumbar spine, and AP and lateral of the left hip. Lumbar spine shows grade I anterolisthesis L4 anterior to L5. There is diffuse degenerative disc disease and osteophytes present significantly at T11-T12 and T12-L1 and mildly at L5-S1. X-rays of the left hip demonstrate some mild degenerative changes. small osteophytes present. no significant joint space narrowing.

00:01:57.400

00:02:27.320

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_5

1,758,695,308

My impression is that Allen Riley. looks like he has lumbar strain with some left lower extremity radiculopathy. He has weakness of the extensor hallucis longus. He has a little bit of pain in the left buttock, probably sciatic nerves and he has some very minimal arthritic changes in the left hip, period. I think his overriding problem is probably lumbar radiculopathy, period. New paragraph. PLAN: So, I explained to him because of his hypertension and cardiac disease, he is not a candidate for anti-inflammatories, so I told him I would take occasional Tylenol.

00:02:27.320

00:02:59.520

GSG11419_proc_d8a98838-fd0f-4f42-bf33-20229395f422_6

1,758,695,308

I recommended outpatient course of physical therapy. I gave him some home exercises to do. I told him he just has to be a little bit careful with this. And if he does okay with this, it does not bother him much. I would do nothing. If it gets worse, then potentially an MRI of his lumbar spine may be indicated, period.

00:02:59.925

00:03:15.125

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_0

1,758,695,580

Now dictating a letter to V.T. Medical, Incorporated Attention Rosemarie Chidichimo Regarding Kurt Phillips vs. Princeton University Claim number W004330079 VT File number VT-29 E07741 Date of loss April 24, 2024 cc goes Biancamano & DiStefano

00:00:00.800

00:00:29.480

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_1

1,758,695,580

DiStefano, and that should be Attention Joseph Biancamano, Esq. Regarding Kurt Phillips vs. Princeton University. CP number 2025-5848. Date of Injury April 24, 2024. Claim number W as water 004330079. Your File 6007 60073-40559. J as in John V as in victory B as in boy. Date this September 5, 2025.

00:00:29.480

00:00:59.190

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_2

1,758,695,580

so you're gonna address to Rosemarie Chidichimo. New paragraph. I had the opportunity to evaluate Kurt Phillips in my office on September 5, 2025 based on a work-related accident he was involved in on April 24, 2024. At the time of the evaluation, Mr. Phillips was a 56-year-old right-hand dominant currently unemployed male who worked as an arborist for Princeton University.

00:00:59.190

00:01:26.820

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_3

1,758,695,580

He states while at work on April 24, 2024 cutting trees, he started having some pain in his neck. He states he was already having some neck pain before it became worse on April 24, 2024. I asked him if there was an injury, an accident, or something happened to him. He states "no." There was no injury, no accident, nothing happened to him. He states he did notify work and he was seen at Princeton Occupational Health.

00:01:26.820

00:01:55.380

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_4

1,758,695,580

He states he went on April 24, 2024, but I have notes from Princeton Occupational Health dated April 30, 2024 through December 10, 2024. It comments on worsening neck pain radiating up and down his neck that started on Thursday. He denied trauma. Considering there was no trauma, it is unclear whether this was even taken care of through Workers' Compensation. He denied radicular pain. There was some limited range of motion of his neck.

00:01:55.380

00:02:22.310

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_5

1,758,695,580

Physical examination showed some tenderness present but no erythema, no swelling, no ecchymosis, no muscular atrophy. Range of motion was limited secondary to pain, period. The diagnosis was strain of the muscles of the neck, period. He was placed on cyclobenzaprine. He was kept out of work, and physical therapy was recommended, period. New paragraph. The next evaluation was on May 1, 2024 at the Occupational Health location, period.

00:02:22.470

00:02:55.330

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_6

1,758,695,580

It comments his neck was improved with cyclobenzaprine. He had radiating pain up and down the neck, limited range of motion, period. Again, physical therapy was recommended, period. Again, it is unclear why this would be considered Workers' Compensation. You need an injury in Workers' Compensation, yet there is no injury here whatsoever, period. Paragraph.

00:02:55.410

00:03:17.860

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_7

1,758,695,580

I did review extensive physical therapy notes from HPTS in Trenton, New Jersey that were dated May 1, 2024 through March 17, 2025, period. New paragraph. The next evaluation at the Occupational Clinic was on May 6, 2024. There continued to be neck pain, upper back pain. No complaints of upper extremity radiculopathy, period.

00:03:17.860

00:03:43.980

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_8

1,758,695,580

He had been taking ibuprofen and physical examination showed some limited range of motion, period. There was a question mark with regard to whether work related and it was undetermined, period. This clearly should not have been taken care of through Workers' Compensation considering there is no mechanism of injury. I asked Mr. Phillips was there an injury at work, did something happen to him, if there was an accident. He states there was no injury, no accident, he just started having neck pain.

00:03:43.980

00:04:09.820

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_9

1,758,695,580

He was already having neck pain before he complained to the Occupational Clinic on April 24, 2024 where he states he never had treatment for this area. New paragraph. The next evaluation was with Dr. Levin from Comprehensive Spine Care New Jersey. I reviewed his notes of May 17, 2024 through June 10, 2025.

00:04:09.820

00:04:32.785

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_10

1,758,695,580

Dr. Levin comments on Mr. Phillips working at Princeton University for the last 14 years. He was being referred for evaluation of the cervical spine from a work-related injury of April 24, 2024. Dr. Levin comments that he was doing repetitive activities and again no mention of any specific injury. This treatment should have gone through his private health insurance. Obviously Mr. Phillips was having problems with his neck but there is no injury at work. Dr.

00:04:32.785

00:05:02.660

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_11

1,758,695,580

Levin comments on limited range of motion of the cervical spine. X-rays showed degenerative changes and he found no evidence of neural compression with neurologically being intact. He was given a prescription for Medrol Dosepak. New paragraph. The next evaluation with Dr. Levin was on May 28, 2024, period.

00:05:02.660

00:05:28.785

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_12

1,758,695,580

There were still some complaints of neck pain, some stiffness, neurologically normal, and again it was recommended he take a Medrol Dosepak, Tylenol and he could perform light duty activities, period. New paragraph. The next evaluation with Dr. Levin was on June 7, 2024. No meaningful improvement from the treatment. An MRI and CT scan was recommended for further evaluation, period. New paragraph.

00:05:28.785

00:05:55.235

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_13

1,758,695,580

I reviewed a note from Capital Health Emergency Room dated June 13, 2024 with regard to worsening symptomatic neck pain from arthritis, period. A CT scan of the cervical spine was performed CT scan of cervical spine was performed on June 13, 2024 at Capital Health Center in Hopewell.

00:05:55.235

00:06:20.825

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_14

1,758,695,580

interpreted as degenerative disc and facet disease most significant at C5-C6 and C6-C7, period. Paragraph. Another CAT scan was performed at Princeton Healthcare on June 24, 2024 and interpreted as disc herniation at C3-C4 and C4-C5. disc space narrowing and degenerative changes seen at C5-C6 and C6-C7 with uncovertebral joint hypertrophy and neural foraminal stenosis, period. Paragraph.

00:06:22.265

00:06:49.975

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_15

1,758,695,580

The MRI of the cervical spine was also done at Princeton Healthcare on June 24, 2024 and interpreted as C2-C3 mild facet arthropathy. No spinal canal or neural foraminal stenosis. C3-C4 small diffuse disc bulge which does not cause significant spinal canal stenosis, Bilateral uncovertebral joint and mild facet joint hypertrophy seen which causes moderate bilateral neural foraminal narrowing, period.

00:06:49.975

00:07:17.985

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_16

1,758,695,580

C4-C5 small diffuse disc bulge which does not cause significant spinal canal stenosis, comma, mild uncovertebral joint facet hypertrophy seen which causes mild right-sided and no left-sided neural foraminal stenosis. C5-C6 small diffuse disc bulge which does not cause significant spinal canal stenosis. There is mild uncovertebral joint facet joint hypertrophy seen which causes bilateral foraminal narrowing, period. C6-C7 no evidence of spinal canal stenosis,

00:07:18.065

00:07:46.625

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_17

1,758,695,580

Mild uncovertebral joint facet joint hypertrophy which causes moderate right-sided neural foraminal narrowing. Left neural foramen is patent, period. C7-T1 was normal, period. New paragraph. New paragraph. The next evaluation was on June 25, 2024 with Dr. Levin. He comments on the MRI and CAT scan. He found C5-C6 and C6-C7 motion segment abnormalities and he thought an epidural steroid injection would be appropriate.

00:07:46.625

00:08:16.615

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_18

1,758,695,580

New paragraph. The next evaluation was with Dr. Lester who is a physiatrist. I reviewed his notes of July 2, 2024 through August 29, 2024. The note of July 2, 2024 comments on the date of injury of April 24, 2024. There is no specific injury, but he comments that Mr. Phillips thinks it is related to work. It does not make any sense to me.

00:08:16.615

00:08:43.245

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_19

1,758,695,580

Just because Mr. Phillips thinks it is related to work, why should it be work related. There is no injury, no accident nothing happened to Mr. Phillips. He's getting treatment that may very well be appropriate, but he should have gone through his private health insurance, period. Doctor Lester comments that diagnosed cervical spondylosis without myelopathy. He had multiple co more comorbid COMRD cardiovascular issues, period. New paragraph. The next evaluation I'm sorry.

00:08:44.220

00:09:14.310

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_20

1,758,695,580

Before doctor pardon. The next evaluation on 07/18/2024 with doctor Lester, and he getting comments on the neck problems for cervical spondylosis, and he recommended an injection, period. New paragraph. The next evaluation was doctor Lester performed an epidural steroid injection on mister Kurt's cervical spine and center for him through surgery in Mountain Sign on 08/08/2024, period.

00:09:14.310

00:09:44.290

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_21

1,758,695,580

That everything went well, period. New paragraph. The next evaluation was with doctor Lester on 08/29/2024. I'm sorry. The next evaluation was with doctor Levin on 08/16/2024, a week after the epidural steroid injection, and there was minimal improvement from the injection, period. Paragraph. The next evaluation was with doctor Lester on 08/29/2024. Any comments?

00:09:44.290

00:10:09.680

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_22

1,758,695,580

There was no relief from the epidural through ingestion that he performed, peer New paragraph. Doctor. Lester performed another performed a facet block slash medial branch block at c five, c six, and c 67 at the center for and for surgeon mountainside on 09/20/6024, period. Paragraph.

00:10:09.680

00:10:33.105

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_23

1,758,695,580

A cervical facet radiofrequency ablation was performed at C 5 and c 6 C seven by doctor Lester at the Hudson Crossing Surgical Center Fort Lee on 10/22/2024, period. A radiofrequency ablation was performed on by Doctor. Lester at Dawson Crossing Surgical Center on 10/29/2024, period.

00:10:33.105

00:11:01.075

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_24

1,758,695,580

Mister Phillips states he had minimal improvement from these injections, period. New paragraph. The next evaluation was with doctor eleven on 10/11/2024. He comments on the injections did not help any great extent. There was significant problems with the c five, c six, and c six seven level, period. New paragraph.

00:11:01.395

00:11:26.185

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_25

1,758,695,580

Another evaluation with Dr. Levin was on November 8, 2024. He comments all the injections had been performed, and there was no improvement from these injections. Dr. Levin thought Mr. Phillips was a candidate for surgery of the cervical spine. New paragraph. Next evaluation with Dr. Levin was on November 22, 2024.

00:11:26.185

00:11:53.095

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_26

1,758,695,580

He still complains about neck pain and again surgery on the cervical spine was recommended. New paragraph. Surgery on the cervical spine was performed on January 7, 2025 by Dr. Levin. The surgery was C5-C6 and C6-C7 anterior radical discectomy and foraminotomies with fusion. I reviewed the operative report and it appeared that everything went well. New paragraph. The next evaluation with Dr. Levin was on January 31, 2025.

00:11:53.735

00:12:25.615

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_27

1,758,695,580

About four weeks after the surgery, X-rays showed good position and a fusion present. There are no complaints of neurologic abnormality. He was told to continue with his collar. "" The next evaluation was on February 28, 2025. Seven weeks after the neck surgery. He continued to be symptomatic and he had some functional improvement. Neurologic examination was normal. He was told he could wean off the collar. New paragraph.

00:12:26.015

00:12:55.405

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_28

1,758,695,580

The next evaluation with Dr. Levin was on April 8, 2025, three months after the neck surgery. He had completed his postoperative physical therapy. He had good balance. No evidence of myelopathy or neurologic abnormality and he thought putting him on some light duty restrictions would be appropriate. New paragraph.

00:12:56.550

00:13:20.065

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_29

1,758,695,580

The last evaluation I had was a quick note from Dr. Levin dated June 10, 2025, which put Mr. Phillips on light duty restrictions and he was found to be MMI at that time. new paragraph. Mr. Phillips states he is much better as a result of having the surgery in his neck. He has no upper extremity radiculopathy but he has stiffness in his neck. He tried to return to work but there was no light duty available for him.

00:13:20.065

00:13:48.815

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_30

1,758,695,580

Therefore, he is not working at this point. He states he had no prior history of injury of the neck prior to the accident of April 24, 2024. , no subsequent injuries. He denied ever being involved in a motor vehicle accident. PHYSICAL EXAMINATION: New paragraph. Mr. Phillips at this point is not under the care of any doctor, not looking for medical care. He takes occasional muscle relaxant if he has pain. Physical examination. Mister Phillips, five foot six, hundred and forty pound plus club male. His temperature in the office is ninety eight four, period.

00:13:48.815

00:14:20.035

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_31

1,758,695,580

Examination of cervical spine, feels a barely visible three centimeter anterior transverse scar. There's no redness, swelling, tenderness, abrasions, discoloration, edema, muscle spasm, trigger points, period. He had decreased range of motion, including 25 degrees of extension, 15 degrees of flexion, 15 degrees of left right lateral tilt, and 45 degrees of left and right rotation, period. Neurovascular status, both upper extremities are intact. His Hoffman test was negative.

00:14:20.540

00:14:47.165

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_32

1,758,695,580

His cross shoulder abduction test was negative, and his Spurling SPOELIA test was negative, period. New paragraph. Arm and forearm circumferences were within 1 cm of symmetry. Label this X-ray. X-rays of the cervical spine done in my office, AP lateral, left and right obliques demonstrate anterior plate and screws present at C5 through C7 with metal fusion in cages in good alignment. New paragraph. Mr. Phillips also brought four disks with him.

00:14:47.580

00:15:14.285

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_33

1,758,695,580

First disk was from McCosh Health Center in Princeton which included x-rays of the cervical spine AP, two open mouth views, left and right lateral oblique x-rays. It showed degenerative disc disease at C5-C6 and C6-C7. C6 was anterior to C5 on the lateral extension view and the lateral flexion view showed no subluxation. AP lateral x-rays of the thoracic spine

00:15:15.250

00:15:45.630

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_34

1,758,695,580

I'm sorry. showed minimal scoliosis, some diffuse degenerative disc disease, and osteophytes present. Berger. Second disk had the CAT scan of the cervical spine performed at Princeton Radiology on June 24, 2024. C2-C3 was normal, period.

00:15:45.790

00:16:04.075

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_35

1,758,695,580

C3-C4 showed a broad central bulge present. It did cause some compression upon the ventral aspect of the spinal cord, period. C4-C5 showed central bulge present which did indent the ventral aspect of the spinal cord. There was no narrowing of the neural foramen or compression upon the exiting nerve roots, period. The C5-C6 disc showed disc degeneration.

00:16:04.075

00:16:31.145

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_36

1,758,695,580

There was also noted to be bilateral uncovertebral hypertrophy with some right foraminal stenosis, period. The C6-C7 disc showed degenerative disc disease. There is bilateral uncovertebral joint hypertrophy and some mild right neural foraminal stenosis, period. C7-T1 was normal. Paragraph. The third disk was an MRI of the cervical spine performed at Princeton Radiology on June 24, 2024, period.

00:16:31.305

00:16:58.685

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_37

1,758,695,580

It showed degenerative disc disease at C2 through C7. C2-C3 disc showed no disc bulge, no disc herniation or neurologic encroachment, period. C3-C4 small disc bulge. it did touch the anterior spinal cord. There is mild facet hypertrophy and mild bilateral neural foraminal stenosis, period. The C4-C5 disc showed disc bulge present. There is no significant pressure upon the spinal cord.

00:16:59.420

00:17:27.080

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_38

1,758,695,580

There is some uncovertebral facet joint hypertrophy and some very mild bilateral foraminal stenosis. The C5-C6 disc showed disc bulge present with no significant compression upon the spinal cord. There is mild bilateral uncovertebral joint hypertrophy along with facet joint hypertrophy which caused minimal neural foraminal stenosis.

00:17:27.080

00:17:51.755

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_39

1,758,695,580

The C6-C7 disc showed degenerative disc disease, moderate right neural foraminal stenosis. New paragraph. The fourth disk was on January 31, 2025 from the University of Radiology in Bridgewater. X-rays of the cervical spine AP lateral show a fusion with screw and plates present at C5-C6 and C6-C7, and there is evidence of two metal fusion cages between C5-C6 and C6-C7. IMPRESSION: My impression is that Kurt Phillips was complaining about neck pain on April 24, 2024.

00:17:51.755

00:18:22.695

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_40

1,758,695,580

Kurt Phillips was complaining about neck pain on April 24, 2024. There is no injury, no accident. If you look at his medical records, there is no mention of anything happening to him. As far as a work-related injury, you need to have a specific episode. All of his medical records clearly document that there was no specific injury. He obviously had preexisting degenerative disease in his cervical spine. His treatment was medically appropriate but it should have gone through his private health insurance and not through Workers' Compensation.

00:18:23.015

00:18:53.650

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_41

1,758,695,580

He had an arthritic condition in his cervical spine and that is not causally related nor aggravated as a result of the accident of April 24, 2024, but apparently work took responsibility for this. new paragraph.

00:18:53.650

00:19:03.250

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_42

1,758,695,580

Mr. Phillips did undergo extensive treatments including MRIs, CAT scans, multiple injections from the pain management doctor, and then eventually surgery on his cervical spine to include a C5-C6 and C6-C7 anterior decompression discectomy and foraminotomies and a fusion. He has done very well postoperatively, period.

00:19:03.250

00:19:29.110

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_43

1,758,695,580

He has some stiffness in his neck which is typical after having surgery, he is entirely neurologically intact. Dr. Levin put him on light duty and there was no light duty available. Therefore, he has not been able to return to work, period. Paragraph. I think Mr. Phillips' treatment to date has been medically appropriate but there is no causal relationship between the accident of April 24, 2024 and his complaints of neck pain. Therefore, all this treatment should have gone through his private health insurance and not through his Workers' Compensation, period. Paragraph. PLAN:

00:19:29.110

00:19:59.480

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_44

1,758,695,580

Based on Mr. Phillips' alleged work-related accident involving the cervical spine on April 24, 2024, he is at maximum medical benefits from treatment. There is no indication for any additional doctor visits. physical therapy, chiropractor visits. x-rays, CAT scans, MRIs, EMGs, bone scans, pain management, medications, or surgery, period. Dr. Levin Levin put him on permanent light duty restrictions which would probably be appropriate after two levels of cervical spine fusion, period. Paragraph.

00:19:59.480

00:20:27.960

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_45

1,758,695,580

Mr. Phillips' does have some objective evidence of restriction of function involving the cervical spine but he remains neurologically intact, period. Regardless of cause involving Mr. Phillips' cervical spine, he has a 12% partial permanent impairment of total, period. Again, I would not consider any of these problems to be causally related to work nor aggravated from work, period. This treatment should have gone through his private health insurance, period. Nonetheless, it apparently went through Workers' Compensation, period.

00:20:27.960

00:20:58.710

GSG11436_proc_9ee2b89f-ecf4-4db2-8abc-f4ed826061b8_46

1,758,695,580

New paragraph. Write a macro for an IME. Thank You.

00:20:59.291

00:21:02.491

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_0

1,758,696,769

Now dictating a note on Lawanda L A W A N D A Coxson C O X S O N Age 52 Date of injury multiple months Referred by self Date this September 2, 2025 This is an office visit of this 52-year-old right-hand dominant Claims Intake representative who complains of pain in both hands for multiple months, period. There is no injury, no accident, nothing happened to her.

00:00:01.760

00:00:29.550

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_1

1,758,696,769

Nighttime is worse than daytime. It wakes her up at nighttime. The left hand is worse than the right hand, period. She has had a history of tendonitis. She had a cortisone shot, but this does not feel like this, period. She complains of numbness of thumb, index, long, ring fingers. She states her pinky finger is okay, period. It is aggravated by activities. PAST MEDICAL HISTORY: I went over her past medical history. She takes no medications routinely. She is allergic to penicillin and sulfa. She has no known allergies. She has no known allergies. She is not aware of her family history.

00:00:29.870

00:01:00.450

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_2

1,758,696,769

I went over her review of systems, head and neck negative; heart and lungs negative; muscle and joints negative. She is a nonsmoker and drinks alcohol occasionally. She is a nonsmoker and drinks alcohol occasionally, period. PHYSICAL EXAMINATION: Ms. Coxson is a 5 feet 2 165 pound woman. She has numbness in the median nerve distribution of both hands, thumb, index, long, and radial aspect of the ring finger, period. It is only on the volar side, period. No triggering of the A1 pulleys. No subluxation of the extensor tendons. No evidence of active Boutonnière, swan neck or mallet finger deformities.

00:01:00.450

00:01:30.150

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_3

1,758,696,769

Tinel and Phalen tests were negative, period. The paragraph X-RAYS: AP, lateral and oblique x-rays of both hands and wrist done in my office were normal. AP, lateral x-rays of both hands done in my office. Were normal. IMPRESSION: My impression is that Lawanda Coxson looks like she has typical bilateral carpal tunnel syndrome, period. It wakes her up at nighttime. She has numbness in the typical median nerve distribution. She has no complaints of neck pain. No complaints of elbow pain, period. Tinel and Phalen tests were negative, but she has the typical numbness in the median nerve distribution especially waking her up at nighttime, period. Paragraph. PLAN:

00:01:30.150

00:01:59.720

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_4

1,758,696,769

So, I put her on Naprosyn as an anti-inflammatory medication, period. I recommended bilateral cock-up splints. You wear them when you go to sleep at night. Otherwise, take them off, period. I gave her an appointment to see me in a few weeks. We will check on her and see what is happening. If she is doing better, having less pain, we will keep her up with the nighttime splints. If the problem resolves, then we will just keep up with the nighttime splints.

00:01:59.720

00:02:22.250

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_5

1,758,696,769

If the problem does not resolve and she is miserable and the cock-up splints do not help her, then potentially an EMG/nerve conduction study to evaluate her carpal tunnel syndrome would be appropriate. Obviously, severe carpal tunnel is a bad situation. Sometimes, it requires surgery. Maybe we will be lucky with mild-to-moderate carpal tunnel. the cocktail splints might help, and we will just wait and see how she does with these splints. Again, you only wear these at nighttime and she was fine with this.

00:02:22.250

00:02:49.898

GSG11423_proc_6320ee2c-c3d1-4a29-b2fa-36f4e38b74b7_6

1,758,696,769

I told her where she could buy these on Amazon that are very inexpensive.

00:02:49.898

00:02:53.898

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_0

1,758,696,787

Now dictating the report. It's gonna be addressed to Biancamano & DiStefano and that should be Attention Joseph Biancamano, Esq. Regarding Kyle Parker-Hall vs. Wakefern Food Corporation CP number 2024-10606 Date of Injury July 11, 2020 Claim number 007745-158787-WC-01

00:00:00.960

00:00:30.630

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_1

1,758,696,787

your File number 60034-39653 J as in john V as victory B as boy The address is Joseph Biancamano. The report itself is gonna be sent to Leidos QTC Health Services. QTC Health Services 1700 Paoli Pike Malvern, PA 19355. Attention Liz Narrigan. Last name is Narrigan. That's regarding Kyle Parker-Hall.

00:00:30.630

00:01:00.170

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_2

1,758,696,787

Date of accident, July 11, 2020. The employer's Wakefern Food Corporation Claim number 007745-158787-WC-01. Again, you're gonna date this September 5, 2025.

00:01:00.330

00:01:16.545

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_3

1,758,696,787

You're address this to Joseph Biancamano , Esq. but you're gonna send it to Leidos I had the opportunity to evaluate Kyle Parker-Hall in my office on September 5, 2025, for the purpose of an Orthopaedic Independent Medical Evaluation based on a work-related accident he was involved in on July 11, 2020. At the time of the evaluation, Mr. Parker-Hall was a 40-year-old right-hand dominant currently unemployed male, who states while working as a selector for Wakefern on July 11, 2020,

00:01:16.545

00:01:43.755

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_4

1,758,696,787

on July 11, 2020, he was lifting an empty pallet when he felt some sharp pain in his low back and some numbness down his right leg. Mr. Parker-Hall states he already had a very significant problems in his low back based on a prior work-related accident he was involved in on September 2, 2019. Mr. Parker-Hall stated the accident on September 2, 2019, was very significant.

00:01:44.155

00:02:13.935

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_5

1,758,696,787

He went to the hospital, underwent extensive treatment by consent, and his pain never completely resolved. He was still having severe back pain and lower extremity radiculopathy at the time of his accident on July 11, 2020. Mr. Parker-Hall states there was really no accident on July 11, 2020. He was just doing his routine job, and his back just flared up. He was already having significant problems, period.

00:02:14.175

00:02:39.530

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_6

1,758,696,787

I asked him if this alleged accident of July 11, 2020, caused or further exacerbated the condition. He states it did not, period. Paragraph. He was following the accident of July 11, 2020. He was seen at the Pivot Onsite Innovations Clinic on July 13, 2020, and it comments he was lifting a 50-pound box at work and felt back pain and right lower extremity radiculopathy.

00:02:39.775

00:03:05.700

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_7

1,758,696,787

He had already had similar problems back in a work-related accident in August through October of 2019, had received two injections, had an MRI showing two disc herniations, and was still treating at the time of this accident of July 11, 2020. Physical examination showed some tenderness present and a magnified response with a light palpation, period. New paragraph. The next evaluation was on July 20, 2020.

00:03:05.780

00:03:34.515

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_8

1,758,696,787

The back was much improved. He denied numbness, tingling, weakness, and difficulty ambulating. He completed his therapy sessions, and he could return to work without restriction on July 21, 2020. Paragraph. The next evaluation at the Pivot Onsite Clinic was on July 24, 2020, first day back to work. He was having difficulty lifting products and walking. He had completed his physical therapy. He had been treated by his family doctor for chronic back problems.

00:03:34.755

00:04:03.710

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_9

1,758,696,787

Physical examination showed some limited range of motion, positive straight leg raise on the right, otherwise, neurologically intact. Therapy was recommended, but the therapy was refused. The final evaluation was on July 29, 2020, at the Pivot Onsite Innovation Clinic. And the notes comment they reviewed his symptoms over the phone and made him aware that his problems appeared to be from a previous condition, not an acute event on July 11, 2020.

00:04:04.185

00:04:31.300

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_10

1,758,696,787

The patient agrees, although he feels the pre-existing condition was work-related, I could not confirm that. But as per the July 11, 2019, injury, his back pain is related to his pre-existing chronic condition. He was discharged from care. Paragraph. Mr. Parker-Hall states that is all the treatment he underwent based on the accident of July 11, 2020. All the other treatment he underwent was a result of his previous accident of September 2, 2019. Paragraph.

00:04:32.075

00:05:02.185

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_11

1,758,696,787

I did review extensive medical records with regards to the accident of September 2, 2019. He was seen at Trinitas Regional Medical Center on September 2, 2019, complaining about back pain. He was subsequently seen at Concentra where they evaluated him on September 10, 2019, through October 2, 2019, with back pain as a result of lifting a heavy object. Diagnosed with lumbar strain. He was given multiple medications.

00:05:02.185

00:05:28.140

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_12

1,758,696,787

I also reviewed notes from Twin Boro Physical Therapy from Newark, New Jersey, dated September 12, 2019, through April 6, 2022. Paragraph. Mr. Parker-Hall went back to the emergency room at Trinitas Regional Medical Center on September 21, 2019, with regards to back pain.

00:05:28.140

00:05:52.800

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_13

1,758,696,787

An MRI of his lumbar spine was done at University Radiology on September 24, 2019, which was interpreted as degenerative changes at L3-L4, L4-L5 and L5-S1 with left-sided L3-L4 foraminal disc herniation touching the exiting left L3 nerve root, left-sided L4-L5 severe foraminal stenosis, and left-sided L5-S1 severe stenosis with moderate right-sided L5-S1 foraminal stenosis, period.

00:05:52.800

00:06:23.040

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_14

1,758,696,787

Paragraph. He was next seen at Tri-County Orthopedics by Dr. Klein who comments on a work-related accident on October 8, 2019. He comments on a work-related injury, that there was back pain, there was some tenderness present, and a decreased sensation of the right L5 dermatome, period. He was given a Medrol Dosepak, gabapentin. Paragraph.

00:06:23.040

00:06:51.330

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_15

1,758,696,787

He was next seen by Dr. Wendel, pain management specialist at Tri-County Orthopedics. I have reviewed his notes of October 17, 2019, through December 15, 2020, period. The visit was on November 11, 2019, back pain, right lower extremity radiculopathy, neurologic abnormalities, and he was told to wean off the gabapentin and naproxen. He could return to regular duty and follow up in two weeks, period.

00:06:51.330

00:07:16.880

GSG21432_proc_60bd5b48-a1fe-428d-82cc-7fa07ca73ae8_16

1,758,696,787

All of these problems were causally related to the work-related accident on September 2, 2019, period. Paragraph. I have reviewed a report from an epidural steroid injection performed by Dr. Wendel at Tri-County on November 16, 2019, period. New paragraph. An ER report from University Hospital Emergency Room dated December 29, 2019, gives no information with regards to the cause of the ER visit, period. Paragraph.

00:07:16.960

00:07:45.800