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GSG11444_proc_cde6a7d6-76c9-4007-bfe1-9148453b926a_14
1,758,720,405
Write a macro for an IME. Thank You.
00:06:18.306
00:06:20.146
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_0
1,758,782,623
Now dictating a letter to V T Medical Incorporated Attention Rosemarie Chidichimo that is regarding R O S A U R A last name CASADO-DeMendez insured is Macy apostrophe s claim number 202412090000690 your file number Vas in victory Tas in tom-29Eas in edward 07753
00:00:00.160
00:00:28.995
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_1
1,758,782,623
date of loss is 12/09/2024 cc goes to Biancamano and DiStefano and that should be attention to Joseph Biancamano, Esquares regarding Rosaura Casado-DeMendez verses Macy's CP number 2025-415 date of injury 12/09/2024 the claim number is 202412090000690
00:00:29.490
00:01:01.030
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_2
1,758,782,623
your file number is 60006-40392 space Jas in john Vas in victory Bas in boy date this September 10, 2025 we gonna address this to Rosemarie Chidichimo comma new parahraph Rosemarie Chidichimo comma New paragraph.
00:01:01.270
00:01:14.575
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_3
1,758,782,623
I had the opportunity to evaluate Rosaura Casado-DeMendez in my office on September 10, 2025 for the purpose of an Orthopaedic Independent Medical Evaluation based on a work-related accident she was involved in on December 9, 2024, period. At the time of the evaluation, Ms. Casado-DeMendez was a 44-year-old right-hand ...
00:01:15.135
00:01:42.220
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_4
1,758,782,623
She stated while at work on December 9, 2024, she has been going down the stairs, she slipped and fell, injuring her mid back, low back, left shoulder, and left foot. She states she did notify work of the accident and was seen the following day at the ImmediCenter on December 10, 2024. It comments that she slipped down...
00:01:43.325
00:02:08.920
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_5
1,758,782,623
There was some pain in her thoracic and lumbar spine. There was no loss of consciousness. Physical examination of the neck was normal. There was no ecchymosis in the lumbar or thoracic spine. Neurologically, she was intact. There was no mention of shoulder pain or left foot pain, period. X-rays performed at that time o...
00:02:08.920
00:02:38.750
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_6
1,758,782,623
X-rays of the left foot was also performed at that time were interpreted as no fracture or dislocation, period. It is interesting. They do x-rays on her left foot, but they make no mention of an injury involving the left foot. And there was no physical examination of the left foot, period. New paragraph. She was next s...
00:02:39.815
00:03:06.010
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_7
1,758,782,623
I reviewed notes from January 10, 2025 through February 4, 2025. It comments on low back, shoulder, neck, hip and pelvic area pain. It does not mention foot pain. It comments she was involved in a fall on December 9, 2024. There was no radicular pain, but there was some pain in the left buttocks. Physical examination o...
00:03:07.175
00:03:31.490
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_8
1,758,782,623
Examination of the left foot and ankle shows a normal physical examination. Shows a normal physical examination. Examination of lumbar spine revealed some tenderness present. neurologically she was intact. The diagnosis was strain of the lumbar spine and left shoulder strain, period. There is no mention of a thoracic i...
00:03:31.490
00:04:03.620
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_9
1,758,782,623
Paragraph. The next evaluation at Concentra was on January 15, 2025, now approximately five weeks after the original accident, period. There were still complaints of pain in the left shoulder and the low back, period. Physical examination of the lumbar spine showed some tenderness present, otherwise normal with some li...
00:04:04.225
00:04:33.015
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_10
1,758,782,623
No examination of the left shoulder. No examination of the foot, period. The diagnosis remained left shoulder strain and lumbar strain, period. New paragraph. The next evaluation at Concentra was on January 21, 2025. She was there for a followup for her left shoulder and low back, period. There were no complaints of lo...
00:04:33.015
00:05:04.735
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_11
1,758,782,623
Examination of the lumbar spine showed some tenderness present. Otherwise, some pain with range of motion. Neurologically intact. No examination of the left shoulder or left foot though the diagnosis remains left shoulder and lumbar strains, period. MRIs of the left hip, left shoulder and spinal canal with lumbar spine...
00:05:05.055
00:05:30.055
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_12
1,758,782,623
I reviewed extensive physical therapy notes from Concentra dated January 21, 2025 through February 21, 2025, period. New paragraph. The next evaluation was on January 24, 2025 at Concentra with regard to complaints of pain in the low back and the left shoulder, period. Physical examination of the lumbar spine showed so...
00:05:30.055
00:05:58.405
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_13
1,758,782,623
Diagnosis remains left shoulder strain and lumbar strain. She was placed on cyclobenzaprine. New paragraph. MRIs of the left shoulder and lumbar spine were performed on January 31, 2025 at New Jersey Imaging Network in Belleville
00:05:58.485
00:06:24.575
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_14
1,758,782,623
with the MRI of the left shoulder commenting on suspect distal clavicle osteolysis and subchondral fracture. Rotator cuff was normal. The MRI of the lumbar spine was interpreted as disc bulge anteriorly at L1-L2 and L2-L3 with no disc herniation, no central or foraminal narrowing, no compression upon the neurologic str...
00:06:24.575
00:06:50.605
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_15
1,758,782,623
She was next reevaluated at Concentra on February 4, 2025 with complaints of low back and left shoulder pain. They commented on the MRI of the lumbar spine, the MRI of the left shoulder and physical examination of the left shoulder showed some tenderness in the distal clavicle. This is the first examination of the left...
00:06:50.605
00:07:20.415
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_16
1,758,782,623
The diagnosis was left shoulder strain, lumbar strain and an orthopedic evaluation was recommended. Paragraph. The next evaluation was with Dr. Doidge, an orthopedic surgeon on February 11, 2025. He comments on the work-related injury and he was seeing her for the left shoulder. Comments on the results of the MRI of th...
00:07:20.415
00:07:44.570
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_17
1,758,782,623
Physical examination of the left shoulder shows normal range of motion, positive crossover test with some tenderness in the AC joint and some mild tenderness in the biceps. Examination of the lumbar spine is normal. The diagnosis was left shoulder strain and he thought possibly a cortisone shot in the AC joint might be...
00:07:44.915
00:08:14.775
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_18
1,758,782,623
Doidge the second time and had a cortisone shot in the AC joint for which she states there was no relief whatsoever. I asked Ms. Casado-DeMendez whether Dr. Doidge recommended any additional medical care. Ms. Casado-DeMendez was also seen by Dr. Grob, a spine specialist, reviewed his note of February 12, 2025.
00:08:14.775
00:08:37.090
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_19
1,758,782,623
He comments on the work-related injury, physical examination was pretty much normal, neurologically intact and the diagnosis was a lumbar strain with some back pain. He could not correlate her MRI findings with her complaints. He thought putting her on some prednisone, possibly some physical therapy may be helpful and ...
00:08:37.090
00:09:03.120
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_20
1,758,782,623
At this point, she has no complaints of pain in her thoracic spine, lumbar spine, left foot, and she has some mild discomfort in her left shoulder. She has no complaints of lower extremity radiculopathy. She denied bowel or bladder abnormalities. She has no trouble standing, bending, walking, squatting, pushing, pullin...
00:09:03.120
00:09:25.970
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_21
1,758,782,623
She is not under the care of any doctor, not looking for any medical care, she takes no pain medication not even Tylenol, aspirin, Advil, muscle relaxer, or narcotics based on the accident of December 9, 2024. PHYSICAL EXAMINATION: Ms. Casado-DeMendez is 5 feet 6 172 pound woman in no acute discomfort. No acute discomf...
00:09:26.130
00:09:56.240
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_22
1,758,782,623
There is no tenderness over the sternoclavicular or acromioclavicular joint. There is no tenderness over the posterior, lateral, or anterior rotator cuff. She had full, pain-free, symmetric range of motion of the left shoulder as compared to the right shoulder with 140 degrees of abduction and forward flexion, 65 degre...
00:09:56.240
00:10:23.300
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_23
1,758,782,623
Arm and forearm circumferences were within 1 cm of symmetry, period. Paragraph. Examination of the thoracic spine and lumbar spine revealed no muscle spasms, no tenderness, no trigger points, no ecchymosis, erythema, abrasion, discoloration, or edema, period. Range of motion was excellent. Forward flexion, she could pu...
00:10:24.100
00:10:55.170
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_24
1,758,782,623
She was able to toe and heel walk and get up and down off the table without discomfort, period. New paragraph. Examination of the left foot as compared to the right foot. There was no tenderness or swelling over the medial or lateral malleolus, over the deltoid ligament. Homan test was negative. Thompson test was norma...
00:10:55.170
00:11:28.570
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_25
1,758,782,623
New paragraph. X-RAYS: AP. lateral x-rays of the thoracic spine demonstrate some mild scoliosis, period. Otherwise, normal. Foot is lumbar spine. The more I say AP, the pelvis, the apex of lumbar spine, left oblique, lumbar spine, demonstrates a minimal osteophytes present. Age appropriate. There's no fracture, no disc...
00:11:29.125
00:11:59.290
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_26
1,758,782,623
Apiolateral is the left shoulder of my office to demonstrate small calcification of the greater tuberosity, period. New paragraph. Apiolabicography is the left foot demonstrating a small posterior calcaneal spur, otherwise normal, period. Prior my impression, Rosar Tessado Toumenez was involved in a trivial work of the...
00:12:00.625
00:12:31.025
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_27
1,758,782,623
I think her treatment today was appropriate, period. She underwent physical therapy rehabilitation exercise, period. She underwent an MRI of her left shoulder, which commented on possibly some distal clavicle problems, and she underwent an MRI of lumbar spine, which showed no evidence of disc herniation, no enterochmen...
00:12:31.345
00:12:57.765
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_28
1,758,782,623
I have one note from Dr. Doidge of February 11, 2025 who comments he thought Ms. Casado-DeMendez might benefit from a cortisone shot, but I have no additional notes. Ms. Casado-DeMendez states Dr. Doidge gave her a cortisone shot at a later office visit. So if that office visit note is available, I would be more than w...
00:12:57.845
00:13:22.360
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_29
1,758,782,623
Considering Ms. Casado-DeMendez' MRI report of January 31, 2025 performed at NJIN in Belleville showing suspected distal clavicle osteolysis, cortisone shot would have been appropriate, period. Considering Ms. Casado-DeMendez states she had no improvement from the cortisone shot whatsoever that clearly documents that t...
00:13:22.600
00:13:51.635
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_30
1,758,782,623
And considering there was no improvement whatsoever that clearly documents that there was no injury to the AC joint of the left shoulder based on the accident of December 9, 2024. Obviously, if you could send me the actual MRI performed at NJIN in Belleville on January 31, 2025, I can comment whether there was any inju...
00:13:51.635
00:14:19.130
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_31
1,758,782,623
muscle relaxers or narcotics based on the accident of December 9, 2024. She has no complaints of thoracic pain, lumbar pain, or left foot pain, period. New paragraph. Plan. Based on Ms. Casado-DeMendez' work-related accident of December 9, 2024, she is at maximum medical benefits from treatment. There is clearly no ind...
00:14:19.835
00:14:47.160
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_32
1,758,782,623
She has absolutely no objective evidence of any restriction of function involving the left shoulder, thoracic spine, lumbar spine, and left foot based on this accident of December 9, 2024. The non-work activities she was able to do prior to this accident are the same activities she has been doing at this point. There i...
00:14:48.015
00:15:09.630
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_33
1,758,782,623
If the actual MRIs that were performed of the low back and left shoulder at NJIN in Belleville on January 31, 2025 could be forwarded to my office, I would be more than willing to review those and send an addended report. If the MRIs are interpreted accurately, the MRI of the left shoulder comments on a suspected dista...
00:15:09.630
00:15:36.300
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_34
1,758,782,623
Casado-DeMendez' recollection, though I do not have a note that actually says cortisone shot was performed. So, if cortisone shot was performed and the MRI of her left shoulder was interpreted accurately, then based on Ms. Casado-DeMendez' work-related accident on December 9, 2024 involving her left shoulder, she would...
00:15:36.300
00:16:04.780
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_35
1,758,782,623
With regard to the lumbar spine, if the MRI of the lumbar spine on January 31, 2025 is accurate with minor disc bulges at L1-L2, and L2-L3, but no disc herniation. no neurologic encroachment, then Ms. Casado-DeMendez would have a 1% partial permanent impairment of total involving her lumbar spine. With regard to Ms. Ca...
00:16:05.820
00:16:34.930
GSG11455_proc_7fbe372a-ffcc-4817-90b0-6640311debd5_36
1,758,782,623
write a macro for IME thank you.
00:16:34.930
00:16:36.850
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_0
1,758,787,440
Now dictating a letter to V T Medical Incorporated Attention Rosemarie Chidichimo Insured 11th Street Workshop Incorporated claim number 2440356664001 your file number is Vas in victory Tas in tom-29Eas in edward-07624 date of loss is 06/14/2022
00:00:00.240
00:00:29.005
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_1
1,758,787,440
and cc goes to Biancamano and DiStefano address and that should be Attention Robert Klausner, Esquares and that regrading Henderson Vargas verses 11th Street Workshop Incorporated claim number 2440356664001 C P number 2023-10145 date of injury 06/14/2022 your file number 60075-38610 space Ras in roger Has in henry Kas ...
00:00:29.460
00:00:59.830
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_2
1,758,787,440
date of loss is 06/14/2022 space Ras in roger Has in henry Kas in kangaroo date this September 10, 2025 we gonna address this to Rosemarie Chidichimo comma new paragraph I had the opportunity to reevaluate Henderson Vargas in my office on September 10, 2025, for the purpose of an Orthopaedic Independent Medical Evaluat...
00:00:59.830
00:01:27.735
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_3
1,758,787,440
At the time of the evaluation, Mr. Vargas was a 29-year-old right-hand dominant currently unemployed male who states while working as a maintenance worker for 11th St. Workshop Incorporated on June 14, 2022, he was lifting up a box from the back of a truck and felt a crack and a sharp pain in his right shoulder, period...
00:01:28.430
00:01:57.375
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_4
1,758,787,440
He notified his supervisor the same day and was seen at Concentra a couple of days after the accident, period. I did review records from Concentra that were dated June 16, 2022 through August 17, 2022, period. The notes comment that he fell while unloading trucks, had a tingling sensation in the outer elbow and forearm...
00:01:57.375
00:02:25.205
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_5
1,758,787,440
Later in the report it comments in the first week of June about one to two weeks ago he fell while standing inside the truck and injured his right shoulder, period. He did not see the doctor. He applied ice on his shoulder, period. He comments he was lifting a box on June 14, 2022 when he felt some clicking and pain in...
00:02:25.205
00:02:53.995
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_6
1,758,787,440
He had some x-rays taken and placed on ibuprofen. The x-rays were interpreted as normal, period. Paragraph. The next evaluation at Concentra was on June 20, 2022. There are still some complaints of pain in the right shoulder, period. Physical examination of the right shoulder reveals normal appearance. He is wearing a ...
00:02:54.075
00:03:19.785
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_7
1,758,787,440
He has a positive Hawkins test, positive painful arc, positive Neer test, positive empty can test, period. Diagnosis is right shoulder strain and physical therapy was recommended, period. New paragraph.
00:03:20.370
00:03:37.175
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_8
1,758,787,440
I did review physical therapy notes from Pro, PRO, Motion, and t I n physical therapy in Woodhaven, WODHAVN, New York, dated 06/28/2022 through 04/13/2023, period. New paragraph. The next note from Concentra was dated 07/11/2022. Now about four weeks after this alleged injury, there were still complaints of pain in the...
00:03:37.895
00:04:07.485
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_9
1,758,787,440
There was still tenderness present, decreased range of motion, some weakness, and the diagnosis strains of the right shoulder. An MRI of the right shoulder was recommended, period. Paragraph. The MRI of the right shoulder was performed at Ocean Radiology in Brooklyn, New York on 07/27/2022 and interpreted as distal sup...
00:04:07.485
00:04:32.045
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_10
1,758,787,440
Increased signal consists with a partial tear, low lying acromion with evidence of impingement, period. Paragraph. The next evaluation was at Concentra on 08/10/2022. There are still some complaints of pain in the shoulder. His MRI showed some mild abnormalities, and additional physical therapy was recommended, period....
00:04:32.045
00:05:01.135
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_11
1,758,787,440
Does comment on pain in the right shoulder, that there was a possible tear of the rotator cuff based on the MRI and an orthopedic evaluation was recommended, period. New paragraph. The next evaluation was with Dr. Deramo, an orthopedic surgeon, on August 24, 2022, two and a half months after the original injury, period...
00:05:01.855
00:05:28.915
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_12
1,758,787,440
He comments on the MRI as showing a partial of the rotator cuff and evidence of impingement. On physical examination, he had a positive Neer and Hawkins test. He had some weakness present, limited range of motion, and Dr. Deramo recommended surgery, period. This is a little unusual because most people with this type of...
00:05:28.915
00:05:57.765
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_13
1,758,787,440
That surgery was performed at Hudson Crossing Surgery Center in Fort Lee on September 13, 2022. The surgical procedure was right shoulder arthroscopy with a SLAP repair, subacromial decompression, and arthroscopic distal clavicle excision and limited debridement. I reviewed the operative report and it appeared that eve...
00:05:57.765
00:06:26.835
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_14
1,758,787,440
now about five weeks after the surgery, and he had not been consistently taking the anti-inflammatory medications, He had only started with physical therapy, so he was not doing what was necessary to make his shoulder better. The next evaluation was on November 2, 2022, now about seven weeks after the original surgery....
00:06:27.315
00:06:55.705
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_15
1,758,787,440
He had been doing physical therapy in Brooklyn and Dr. Deramo did not have any postoperative notes. Physical examination showed some limited range of motion. Dr. Deramo recommended that he go back to physical therapy, he should take the Naprosyn, and work on a strengthening program. The next evaluation was on February ...
00:06:56.985
00:07:21.035
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_16
1,758,787,440
It is little unclear why we have a note of November 2, 2022 and we do not have another note until three and a half months later on February 22, 2023. Dr. Deramo comments of continued complaints of pain in the shoulder. He had gone to the Dominican Republic for an emergency and he had not done any physical therapy and m...
00:07:21.755
00:07:43.600
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_17
1,758,787,440
Physical examination showed some limited range of motion and Dr. Deramo again recommended physical therapy, a Medrol Dosepak, and taking the Naprosyn. New paragraph. The next evaluation was on 03/22/2023, which would have been five months after excuse me, six months after the shoulder six and a half months after should...
00:07:43.600
00:08:11.800
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_18
1,758,787,440
Physical examination was relatively benign. Had a positive knee and positive Hawkins test and some limited range of motion. He'd been sent back to work light duty, but it's unclear whether he actually went, period. Doctor. Comayano comments on how much physical therapy mister Vargas had missed, period. A cortisone shot...
00:08:12.575
00:08:41.270
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_19
1,758,787,440
Now seven seven months after the surgery of March excuse me. Sept thirteen thousand twenty. States cortisone shot worked a little bit. Physical examination still showed some limited range of motion and there was some tenderness in the AC joint, period. Dr. Dr. Deramo states that he did the surgery including arthroscopi...
00:08:41.270
00:09:08.055
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_20
1,758,787,440
Deramo recommended a repeat MRI of the shoulder for further evaluation, period. That repeat MRI of the right shoulder was performed at South Brooklyn Radiology on June 9, 2023 and interpreted as mild AC impingement, posterior labral tear. No fracture or contusions seen, period. The next evaluation with Dr. Deramo was o...
00:09:08.055
00:09:36.845
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_21
1,758,787,440
And he went over the MRI findings. Physical examination showed he has tenderness over the AC joint. And again Dr. Deramo comments that he performed surgery on the right shoulder previously on September 13, 2022 and he thought part of the issue was that the AC joint was not bothering him at the time of the surgery, so i...
00:09:37.005
00:10:08.185
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_22
1,758,787,440
If you look at the operative report of September 13, 2022, he did an arthroscopic distal clavicle excision. So, yes, he thought there was pain in the AC joint prior to the surgery, he did a distal clavicle excision at the time of the surgery. And now Dr. Deramo in his note of June 14, 2023 apparently completely forgot ...
00:10:08.185
00:10:35.535
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_23
1,758,787,440
I think Dr. Deramo is a little bit confused or forgot that he performed a prior surgery. Paragraph. Mr. Vargas was next seen for a need for treatment evaluation by Dr. Bernstein on July 25, 2023.
00:10:35.535
00:10:55.150
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_24
1,758,787,440
Dr. Bernstein also comments that yes Dr. Deramo had already performed the distal clavicle excision so performing another surgical procedure makes no sense whatsoever. I would agree 100% with that. He already did a distal clavicle excision so Dr. Deramo probably forgot that he did that and is now recommending that proce...
00:10:55.230
00:11:15.540
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_25
1,758,787,440
All Dr. Deramo has to do is look at his medical records that show he already did a distal clavicle excision and is clearly not a candidate at this point. There is also a comment on a posterior labral tear but Dr. Deramo already repaired the superior labral anterior-posterior tear at the time of the initial surgery. Dr.
00:11:15.700
00:11:33.485
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_26
1,758,787,440
Bernstein did not think additional surgery would be helpful, but he did comment that the salvage procedure for SLAP repair is for biceps tenodesis so Dr. Bernstein is not recommending that. Dr. Bernstein is also not recommending any type of distal clavicle excision. New paragraph. Mr. Vargas continued to complain of so...
00:11:33.485
00:12:02.685
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_27
1,758,787,440
He has been out of work since June 14, 2022 but he is no longer being reimbursed by Workers' Compensation after last seeing Dr. Deramo.
00:12:03.000
00:12:15.080
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_28
1,758,787,440
Mr. Vargas states he has done various jobs since leaving his maintenance job for 11th St. Workshop but he is not working at present. He is not under the care of any doctor. The only medication he takes based on the accident of June 14, 2022 is an occasional Tylenol.
00:12:15.080
00:12:44.955
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_29
1,758,787,440
He states he never injured this area previously, and he has had no subsequent injuries. PHYSICAL EXAMINATION: Mr. Vargas is a 5 feet 7 and 200 pound male in no acute discomfort. Examination of the right shoulder reveals no redness, swelling, ecchymosis, abrasions, discoloration, edema, muscle spasm, or trigger points. ...
00:12:45.035
00:13:14.935
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_30
1,758,787,440
yet pulse remains 78. He can only abduct and forward flex about 100 degrees. He had about 40 degrees of external rotation, about 35 degrees of internal rotation during the examination, but at the end of the examination when I told him to get dressed, he has his clothes on a hook on the back of a door. He now abducts an...
00:13:14.935
00:13:42.685
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_31
1,758,787,440
He had a negative impingement test, negative drop test, negative sulcus sign, no subluxation, negative belly press test, negative lift-off test, negative Speed test, and negative O'Brien test. New paragraph. AP and lateral x-rays of the right shoulder done in my office demonstrate he is status post excision of the dist...
00:13:42.685
00:14:08.315
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_32
1,758,787,440
He had an MRI which showed evidence of rotator cuff tendinitis. though no specific labral tear. When Dr. Deramo did the surgery on September 13, 2022, he found a SLAP tear, and he did a SLAP repair, He did a subacromial decompression, excision of the distal clavicle.
00:14:08.315
00:14:29.150
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_33
1,758,787,440
Then when Mr. Vargas does not get any better Dr. Deramo then recommends on June 14, 2023 that when Mr. Vargas originally had his problem and when Dr. Deramo did the surgery of September 13, 2022, he did not address the AC joint. I think Dr. Deramo is just confused and just forgot that he already addressed the AC joint.
00:14:30.835
00:14:54.850
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_34
1,758,787,440
So, Dr. Deramo in his report of June 14, 2023 recommending a distal clavicle excision makes no sense whatsoever, because he already had a distal clavicle excision. His x-rays show that. Mr. Vargas was next seen for a Need For Treatment Evaluation by Dr. Bernstein on July 25, 2023.
00:14:55.085
00:15:16.170
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_35
1,758,787,440
And he also comments that Dr. Deramo just probably forgot that he did a distal clavicle excision because his operative report clearly comments he did the distal clavicle excision. So when Dr. Deramo mistakenly comments that he did not address the AC joint at the time of the surgery on September 13, 2022, it is just not...
00:15:16.650
00:15:42.890
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_36
1,758,787,440
Dr. Bernstein also comments that there was a SLAP repair and the salvage procedure for a SLAP repair is a biceps tenodesis. But considering Mr. Vargas' complaints he did not think any additional surgery on Mr. Vargas' right shoulder will be appropriate, and I would agree with that, period. Paragraph. I was not sent the...
00:15:42.890
00:16:12.760
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_37
1,758,787,440
Those MRIs could be forwarded to my office. I would be more than willing to review those and send an addended report, period. New paragraph. Plan based on Mr. Vargas' work-related accident of June 14, 2022 involving his right shoulder. he is at maximum medical benefit from treatment. There is absolutely and clearly no ...
00:16:12.840
00:16:37.950
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_38
1,758,787,440
Dr. Deramo in his last report of June 14, 2023 where he recommends a surgery on the right shoulder to include a distal clavicle excision, he just forgot that he had already done that operation, period. I think Dr. Deramo is a little confused. All he has to do is look at his operative report of September 13, 2022 where ...
00:16:37.950
00:17:04.385
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_39
1,758,787,440
So doing that same procedure again because he forgot he did it the first time makes no sense whatsoever, period. Mr. Vargas at this point has significant symptom magnification involving his right shoulder, period. I really see no objective evidence of any restriction of function involving the right shoulder based on th...
00:17:04.800
00:17:26.325
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_40
1,758,787,440
I do not see any need for any type of temporary or permanent work restrictions and I clearly see no indication for the surgery recommended by Dr. Deramo in his last report of June 14, 2023. My opinion is further corroborated by Dr. Bernstein's Need For Treatment Evaluation of July 25, 2023, period. Paragraph. Paragraph...
00:17:26.325
00:17:55.155
GSG11456_proc_71fe6476-598b-47fe-8fe0-9cb91e608ba5_41
1,758,787,440
total involving the right shoulder, period. His prognosis otherwise remains excellent period. new paragraph write a macro for an IME thank you.
00:17:55.155
00:18:02.835