The date when the service described on this report was performed. This does not include first aid at the worksite. Select the duration for which the worker has been your patient. This information is useful for claims information. For example an MVA while receiving care for WCB claim.
Diagnosis Provide a text description of the injury diagnosis.
This is an 800-character free form text field for the chiropractor to describe the worker's current situation in the usual fashion clinical notes are constructed. Describe the ability of the worker to fulfill occupational demands in terms of basic activities associated with increased risk of injury at work. Estimate the length of time before the worker can return to the workplace in ANY capacity. For example, the earliest possible return to the workplace if suitable duties were available. It refers to date at which no further improvement in condition is expected.