ŠĻą”±į>ž’ bdž’’’_`a’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ģ„ĮM šæB`bjbjā=ā= )š€W€WB\’’’’’’lęęęęęęęś k k k k k,śÖ¦īNqNqNqNqNq)r)r)rU¦W¦W¦W¦W¦W¦W¦$ħ 䩆{¦ę)r)r)r)r)r{¦’węęNqNqŪ¦’w’w’w)rZęNqęNqU¦’w)rU¦’wJ ’wIęęINqBq `0y2”ėÉśj kƒvII %¦¦0Ö¦IjŖ”w^jŖI’wśśęęęęŁDATETreatment & CONCLUSIONSDATECorrespondence & Actions TakenCONTACT INFO27 Aug 2007Hurt on job. Reported verbally to Chris Henry27 Aug 2007Chris Henry SSA 508.693.1600 X zero (0)1 Sept1 SeptFilled out Workman’s Compensation form // transmitted to SSA6 SeptWent to Dr Jacobs. // Ordered Absent from work for 5 days 6 Sept. – 10 Sept. Note received for submittal to SSA // Payment from workman’s Comp refused. Bill submitted to Insurance company // Sent to MV Hospital ER for x-rays and treatment6 Sept Went to MV Hospital for x-ray // visit billed to Workman’s Comp. // Registered as outpatient // Given Brace // no breaks or fractures // Physician – Dr. Judith Fisher 6 Sept6 SeptBriefed Chris Henry - SSA14 Sept14 SeptMet with Terri Lee from Dr. Stuart Kendall’s Office and Jen from Dr. Jacobs’s office. Jen will send my records to Terri Lee and Terri Lee will get my records from Dr. Fisher’s office14 Sept14 SeptBriefed Sue Paris (SSA HR office) on status of injurySue Paris 508.693.9139 X20314 Sept14 SeptBriefed Chris Henry- SSA18 Sept18 SeptSpoke to Christine Pica (One Beacon Insurance- workman’s Comp claim adjuster) // Told of visit chronology // Briefed on how accident happened // Current state of injury ( ok, as long as I don’t take brace off) // Chuck will call and leave a message after Fri visit 21 Sept with Primary Care Physician //Christine Pica 866.867.6551 FAX 888.332.97882 1 SeptSaw Dr. Kendall // refereed to an orthopedic doctor. Possibly Dr. Monto of West Tisbury. // Wrist disability note received for transmittal to SSADr. Stuart Kendall - MV Hospital 508.693.4676 Fax 508.693.360021 Sept21 SeptWrist disability note given to Chris Henry SSA21 Sept21 SeptAppointment made with Dr. Monto for Oct 1stDr. Monto 508.693.5949 Fax 508.693.0319DATETreatment & CONCLUSIONSDATECorrespondence & Actions TakenCONTACT INFO21 Sep21 SeptCalled Christine Pica (One Beacon Insurance- workman’s Comp claim adjuster) // briefed on injury and other developments // offered to fax documents24 Sept24 SeptHaving heard less than stellar reports re: Dr. Monto, I decided to see if it was possible to make an appointment with a Dr. Wilsterman of Cape Cod Orthopedics24 Sept 24 SeptCalled Dr. Wilsterman’s office for possible appointment // talked to Cheryl S., who asked for personal info, explained process, asked for claim adjuster Christine Pica - One Beacon Insurance- workman’s Comp claim adjuster) // Suggested that I call C.P. for insurance carrier name and fax # // Appointment will be made after C.S. talks to C.P.Dr. Wilsterman – Orthopedic Specialists, Falmouth Ma. 508.548.942324 Sept24 SeptCalled Christine Pica for Info and briefed her on Cheryl S. briefing24 Sept24 SeptCalled Cheryl S. and briefed her on Christine Pica’s answers // Cheryl S. said that she would call C.P. immediately24 Sept24 SeptBriefed Chris Henry25 Sept25 SeptCall from Sue Paris (SSA HR) RE: a call from a Nurse Case Manager ( One Beacon Insurance) for me25 Sept25 SeptCalled Nurse Case Manager ( Donna) Left message and Phone # // Donna called back and was briefed on events so far // Chuck will call Donna after appointment date is finalized and after the visitNurse Case Manager One Beacon Insurance Donna Bowden (800.203.9600 X9705) Fax 866.717.980326 Sept26 SeptCheryl S. (Dr. Wilsterman’s office) called // Appointment on Oct 2 at 2 pm26 Sept26 SeptDonna – Nurse case manager briefed26 Sept26 SeptChristine – Claims adjuster briefed1 Oct 1 OctForms mailed to Beacon InsuranceDATETreatment & CONCLUSIONSDATECorrespondence & Actions TakenCONTACT INFO2 OctSeen by Dr. Mark Colluchi (Physicians Assistant) His verbal conclusions: 1) Accident aggravated a pre-existing arthritic condition 2) Work may aggravate the injury 3) Dr. Colluchi will write a report and send it to Donna (One Beacon Insurance) and will send a copy to me 4) Softer brace was issued 5) Wrote note for SSA stating “Out of Work until further notice” 6)Requested that I schedule Hand Therapy // gave me 2 referrals on Island 7) Next Appointment scheduled for Oct 30 @ 2:20 pm 8) May recommend seeing a hand specialistDr. Mark Colluchi – Orthopedic Specialists, Falmouth Ma. 508.548.9423.2 Oct2 OctBriefed Donna (One Beacon Insurance)2 Oct2 OctBriefed Christine Pica (One Beacon Insurance)2 Oct2 OctBriefed Chris Henry (SSA)3 Oct3 Oct“Out of Work” note submitted to Chris Henry - SSA3 Oct3 OctCalled Donna – she will call referral Hand Therapists and if they are not suitable will check for other hand therapists in the area3 Oct3 OctCall form Donna – recommends Cape Cod Hand Therapy, Falmouth // Chuck will make an initial Evaluation appointment and get a Treatment Plan and fax it to Donna at 866.717.98033 Oct 3 Oct Appointment made with Cape Cod Hand Therapy (Annette) for 16 Oct @ 11:30Cape Cod Hand Therapy 508.540.55593 Oct3 OctBriefed Donna (One Beacon Insurance)3 Oct3 OctBriefed Christine Pica (One Beacon Insurance)3 Oct3 OctBriefed Chris Henry (SSA)DATETreatment & CONCLUSIONSDATECorrespondence & Actions TakenCONTACT INFO6 Oct Cape Cod Hand Therapy Initial Appointment16 Oct Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise25 Oct Cape Cod Hand Therapy Ultrasound, Massage, Hot Wax, Exercise26 Oct 26 Oct Letter from Genex Letter of Introduction30 Oct Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise30 OctDr Collucci, Office Visit, Prescription (Naprosyn (Naproxen Tab 500 MG) 1 TAB BOD fpr 30 days30 Oct30 OctRequest from 1 Beacon to Dr. Collucci for info Report indicates lifting limited to 0 lbs, Carry/Pull limited to 0 lbs., Position limitations 0 use of R hand, 0 repetitive movement R wrist/hand//evaluate for tear1 Nov Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise5 Nov Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise7 Nov Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise14 Nov Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise DATETreatment & CONCLUSIONSDATECorrespondence & Actions TakenCONTACT INFO16 Nov Cape Cod Hand Therapy Evaluation, Ultrasound, Massage, Hot Wax, Exercise CONCLUSION- Possible Scaphord-Lunate Ligament tear16 Nov 16 Nov Letter from Genex, Outpatient Approved Determination Letter for disapproval of additional therapy sessions21 Nov 21 Nov Request from 1 Beacon (Donna Bowden) 1 Beacon Ins. for information30 Nov 30 Nov Letter from Genex, Outpatient Approved Determination Letter for contrast x-ray of wrist27 DecMRI, Falmouth Hospital – MRI IMPRESSION: Probable partial tear of the scapholunate ligament27 Dec3 Jan 2008 Orthepedic Specialist – Dr Collucci CONCLUSION – Probable partial tear of the Scapholunate ligament//Not able to progress with Therapy, pain is worse with OT, improves with rest and immobilization brace  20 FebDr. Mitoli – Initial EvaluationDr. Mitoli 508.495.716020 FebXray – Falmouth HospitalFAX 508.495.715218 Mar18 Mar 2008Letter from Genex, Outpatient Adverse Determination Letter- Explore/treat wrist joint – arthrotomy wrist joint w/out biopsy joint exploration w/o removal of foreign body – not approved Appeal process paperwork included21 Apr21 AprLetter from 1 beacon (Donna Bowden) discontinuing medical case management servicesDATETreatment & CONCLUSIONSDATECorrespondence & Actions TakenCONTACT INFO8 May8 MayLetter from MES Solutions – Medical evaluation requested by 1 Beacon Is. At Howland Place-Rear Door, New Bedford ( Dr. William Donahue, M.D. Orthopedic SurgeonDr. William Donahue, MD Orthopedic Surgeon, 781.933.17829 MayDr Mitoli – Received injection to reduce inflammation and give temporary relief form soreness while awaiting surgery22 May22 MayReport from Dr. Mitoli, (Waiting for agreement from Workers Comp for debriding procedure & report of Celestone injection24 MayBriefed Robert Townes, Agent, SSA. And Robert Townes was given copies of letter from MES Solutions and the report from Dr. Mitoli29 MayReported to Dr. Donahue, MES, New Bedford at the request of Beacon Insurance for medical exam.6 MayReceived a call from Donna Bowden, 1 Beacon Ins., reopening her administration of Nurse Practitioner Service. She reported that Christine Pica has approved my surgery on the recommendation of Dr. Donahue. I briefed her on all that had happened during the interval when she had been removed from my case. We spoke firefly about the possible ramifications of my upcoming Prostae Cancer treatmen5t on my claim but she referred me to Christine Pica.Donna Bowden 1 Beacon 800.203.9600 X9705Called Dr. Mitoli’s office and reported that surgery had been approvedRepported surgery approval to Robt. Townes, SSA26 JuneReceived call from Donna Bowden, 1 Beacon requesting info on surgery date27 JuneCalled Dr. Mitoli re: schedule date. I was told that they were awaiting a schedue date form the Falmouth OR27 JuneReported Dr. Mitoli’s response to Donna Bowden3 JulyCalled Dr. Mitoli re: surgery schedule. Mitoli still waiting for a op room date31 JulyReceived call from Donna Bowden re: progress. She has called Dr. Mitoli’s office re: Surgery date and is not satisfied with the progress that Dr. Mitoli is making. She suggested that I call Dr.Mitoli31 JulyCalled Dr Mitoli . Told that Secretary is out and they will call me tomorrow31 July Called Donna & reported results of call.27 AugReceived call from Donna. She said that my surgery had been scheduled for sept 11. I told her that I was sorry but that I was leaving for my cancer treatment in California on Sept 1st. She asked me when I would be back and I told her that my treatment would take 45 days and she said tht would put it sometime in Noivember and I agreed. I asked her if she wanted me to call her while I was out in California and she said that it wasn’t necessary and that I should call her when I get back.27 AugI notified Dr. Mitoli’s Office (Lauren) that Donna had called me to tell me that my surgery had been scheduled for Sept 11th and asked if that was correct. Lauren said yes. I explained that I had told Donna that I would need to be rescheduled because I was leaving for California for cancer treatment that would last until mid November. Lauren told me to call when I got back and that they would then schedule the surgery.31 Oct Received letter from Christine Pica requesting surgery date status, my present location, and informing me that she would have to cancel pmt if response was not received by 10 Nov The letter was forwarded to me and I received the letter on 12 Nov12 NovLeft message with Christine telling her my return date12 NovReceived a message from Donna Bowden asking for info13 NovCalled and left message for Donna that I should leave Ca. in first wk of Dec. Left CA. Phone number13 NovCalled Dr. Mitoli for an appointment. Spoke to Katherine. They told me that Dr. Mitoli was booked up for Dec.; Surgery in January. Will call me next week w. Appt date. Will need pre-op exam, EKG, etc.13 NovBriefed Donna by message14 NovDonna acknowledged message5 DecCalled Dr. Mitoli’s Office and was told that the Surgery had not yet been approved by Workmen’s Comp.6 DecCalled Donna and left a message re: message from Dr. Mitoli’s office re: surgery not yet approved8 DecDonna left me a msg that said that she called Dr. Mitoli and faxed a note re: Surgery had been approved in Aug and that they should set up an appointment as soon as possible and let her know and also that if I hear anything that I should let her know19 DecReceived letter from Dr. Mitoli-arrangements made for Pre-op visit on Jan 14,2009/// Surgery on Jan 22/// Post op visit on Jan 28 & Feb 4th21 DecLeft msg for Donna Bowden re Surgery schedule date of Jan 22.14 Jan 09Pre-op visit - Dr. Mitoli22 JanSurgery completed – 3 bones removed23 JanLeft msg for Donna Bowden re Surgery completion28 Jan Post op visit-Wound reviewed / oxycodine prescribed – expect 12 weeks recovery// more swelling than anticipated discovered28 JanCape Cod Hand – Therapy –Falmouth Hosp Splint removed /// CCH splint made and installed – hand massaged-glove installed28 JanLeft msg for Donna Bowden re progress4 FebDr Mitoli visit / Bandage removed, wound inspected, stitches removed, wound taped/// some swelling has disappeared but more than expected remains, skin on fingers appears dry & flaking, patient reported some numbness in finger tips, Dr. tested ends of fingers w. 1 and 2 prong instrument for patient differentiation/// diagnosed w. dystrophic changes(dystrophy) RSD (Reflex Sympathetic Dystrophy) / Dr. will schedule appointment w. Injection Doctor for a Sympathetic Nerve Block / Dr. Andrew Shane, Falmouth Anestesia and Pain Management, PC // 39 Edgerton Dr., N. Falmouth, Ma 02556 508.296.1005 F. 508.296.12344 FebCCH – splint modified/// Hand Massaged/// Hand exercised6 FebCCH – splint modified/// Hand Massaged/// Hand exercised /// Game Ready Massage machine used9 FebDr. Mitoli visit /// Still concerned about swelling /// reinstituted attempt to get workman’s comp to approve treatment for RSD // retested fingers with probe /// suggested that I call Work Comp to speed up the process because procedure needs to be done ASAP9 FebCCH – Hand Massaged/// Hand exercised /// Game Ready Massage machine used /// Glove changed10 FebCalled Donna Bowden re: RSD treatment request./// Donna said that the original request had been forwarded to Genex and has queried them again yesterday but hasn’t heard anything back yet. /// Donna also asked if Dr. M is relating this request to the original injury and I said yes.10 FebLeft msg -Reported conversation w Donna to Dr. Matoli (Catherine)10 FebDB called and said that Genex had approved the RSD treatment and that she would notify Dr. M11 FebCCH – Hand Massaged/// Hand exercised /// Game Ready Massage machine used13 FebCCH – Hand Massaged/// Hand exercised /// Game Ready Massage machine used16 FebCCH – Hand Massaged/// Hand exercised /// Game Ready Massage machine used18 FebVisit Dr. Mitoli, Hand examined, Doc reissued request for nerve block appointment. Next visit Mar 1318 FebCCH – Hand Massaged/// Hand exercised /// Game Ready Massage machine used25 FebCCH – Hand Massaged/// Hand exercised /// Game Ready Massage machine used/// 1 month goal tooth brushing, car shifting & 25 FebReceived appointment date from Dr. Shane for Mar 4Dr, Shane 508.296.100527 FebReceived query from Donna Bowden1 MarBriefed Donna Bowden re: progress4 MarCCH –Paraffin bath/// Hot Pack///Ultrasound///Hand Massaged/// Hand exercised /// Game Ready Massage machine used///4 MarVisit to Dr. Shane for Nerve Block evaluation6 MarCCH – I cancelled due travel difficulties cause by snow.9 MarCCH – Paraffin bath/// Hot Pack/// Ultrasound ///Hand Massaged/// Hand exercised /// Game Ready Massage machine used///12 MarCCH – Paraffin bath/// Hot Pack/// Ultrasound ///Hand Massaged/// Hand exercised /// Game Ready Massage machine used///13 MarVisit Dr. Mitoli, Hand examined, Hand still swollen, Advised to use splint only for driving, Advised to start strength exercise///Next visit Fri April 3rd20 MarVisit Dr. Shane, Nerve block administered20 MarCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised /// Game Ready Massage machine used/// Exercise machine used/// External and internal scar is healing nicely, Given strength exercises to do at home with 1 lb wt., advised to use splint when heavy use is performed, Advised to continue to wear Isotonic glove//Given putty to strengthen grip25 Mar CCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised /// Game Ready Massage machine used/// Exercise machine used, improvement seen////// Advised to continue to wear Isotonic glove as swelling has decreased somewhat but is still swollen more than is to be expectedNOTE: 29 MarAm exercising at home every day with 1 lb weight and putty/// incidents of pain are becoming more frequent and pain levels are increasing 2 AprCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen//////3 AprVisit Dr. Mitoli, Hand examined, Hand still swollen///Dr. advises to have another nerve block done- her office will make appt with Dr. Shane, I will call her at the end of the week if I have’t heard from Dr. Shane/// advised to try to hang a 10 lb wt from hand, twice a day/// sent to hospital for xray/// next appt – 4 May3 Apr Xray taken at Falmouth Hosp7 AprCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///Hand and wrist bandaged with elastic taping, use for 3 to 5 days, don’t wear glove///Increase daily exercise regimen weight from 1 lb to 2 lbs///7 AprBriefed Robbie Townes at SSA re: current developments8 AprCalled Dr. Shane’s office re: nerve block – office told me that paperwork for nerve block injection has been submitted to workmen’s Comp.///9 AprCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///9 AprReceived call from Donna Bowden re: Dr. Mitoli/Dr. Shane request for authorization to perform a second nerve block injection. Donna said that she would approve and that I should follow up with a call for appointment. I said that I would do that tomorrow. Several questions were asked about my progress which I answered.111517 AprDr. Shane – Second Nerve Block performed , much more difficult to perform due to patient tenseness17 AprCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen/// 20 AprCCH – Patient cancelled appointment –Patient overwhelmed by life 24 Apr17 Apr – Provider cancelled appt28 AprCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///30 AprCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///30 AprilReport of CCH///patient progressing slowly///Intermittant pain still and issue but definitely better after each block///Swelling also noticeably better///Patient still can’t open jars, is ok in self care, except for perineal care///unable to lift heavy objects, can’t hammer or use tools///Plan to continue care and exercise to strengthen and increase function4 May Report of Dr. Matoli///Subjective Complaints Weak and occasional pain/// Objective findings: Decreased grip strength, residual swelling, and decreased Range of Motion/// estimated length of treatment: 1 to 3 months more/// Next Appt June 5 @ 10507 MayCCH – patent cancelled due to emergency doctor’s Appt for Tick bite11 MayCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///15 MayCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///19 MayCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen/// Patient reports pain while doing 1 of the 3 lb wt exercises, CCH recommends suspending weight exercises for a week28 MayCCH – Hand and wrist measured for swelling – hand & wrist have increased swelling///Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen///CCH recommends resumption of weight exercises2 JuneCCH – Paraffin bath/// Hot Pack///Ultrasound ///Hand Massaged/// Hand exercised/// Electric stimulation machine used /// Exercise machine used, improvement seen/// Patient reports pain while doing 1 of the 3 lb wt exercises///CCA tells patient that Workers Comp will no longer pay for Physical Therapy///CCH writes letter to Dr. Mitoli with latest results and recommendations (Letter on File) – Letter states that patient is not ready to return to work and is still has some swelling and pain. Strength is still below normal limits but is increasing slowly. Range of motion is also increasing, albeit slowly. – There is a clicking in the wrist that the Dr. needs to be aware of /// CCH strongly recommends patient continue daily exercises at home5 JuneDr. Matoli – Examined patient, took measurements, and examined wrist for click (click is from the bone still trying to make a place for itself), ///Dr read letter from CCA /// Patient relates disapproval of more Physical Therapy by approval agency – Dr Matoli explained that the approving authority did not realize the extent of the patient’s RSD /// Dr. Matoli said that she would write a letter explaining the need for additional Physical therapy. ( it is unknown if this is an actual appeal or just a letter) /// Dr. suggested that there is a high likelihood of not being able to move or manipulate heavy loads and that there was the likelihood of not being able to return to current duties /// Not ready for work for 1 to 3 months /// Next appointment June 8, 1140 am5 JuneBriefed CCH /// CCH will wait to hear form me regarding any change in physical therapy status9 JuneReceived letter from Dr. Matoli re: resumption of Physical Therapy ( Letter on File)9 JuneBriefed Donna Bowden /// Donna said that she had received the letter from Dr. Matoli and has sent it on to the appropriate agency /// Donna asked me how I felt about the news that I may not be able to resume my current duties. I told her that I was a military man and that I don’t think that way. I told her that “what ever is …is and that you deal with it”. /// She told me that she talked to Sue Paris at the SSA to see if there was some other j0b that I could do and Sue said that she would talk to Phil Parent about it. /// Donna said that she would call me if there were any changes.11 JuneCCH – Received word from CCH that Workman’s Comp had approved 8 more sessions. Wanted to schedule appointments. Patient was not able to get to his schedule at the time of the call and told CCH that he would call back. NOTE: Patient had filled schedule for the week of 8 June upon learning on 2 June that no more Physical Therapy would be authorized.  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