Document YDpqZD6VLXkXmpRX30bkM12Yk

*1 4 (0 - & y State Of Ohio Industrial Commission Claim No. nn 71 ?'?3 97 Claimant --WfTI Lam Prfep - Address ____________________ 4/1/89 Date of Examination o/ii/oy Addendum SPECIALIST'S REPORT Employer Age NOTE: Submit report under following headings: (1) History. (2) Complaints. (3) Examinations, including X-ray and laboratory work. (4) Discussion. (5) Opinion. Sign and mail THREE copies to the MEDICAL SECTION -- Retain one for your file. REPORT OF EXAMINATION TO BE RETURNED FOLLOWING REQUEST. HISTORY EliDUFi TO WILLIAM PRICE m 21225#-22 Date of Exam: 4/18/89 The Industrial Injury does prevent the CLAIMANT JNre?SbS?mS Io hIs^former'position"of"employment. The claimantst' condition jow permanent and he has reached maximum medical improvement. In ADDITIO,., Industrial Injury does prohibit the claimant from engaging in any : OF SUSTAINED REMUNERATIVE EMPLOYMENT. THE CLAIMANT'S CONDITION IS PERMANENT AND TOTAL. ALLAN H. HARRIS, M.D. -'J CO C5 AUw.^O COMPEHSftUO^ ___________________ M.D. (Signature of Examiner) (CONTINUE REPORT ON REVERSE OF SHEET - NOTE INSTRUCTIONS) GENC 002180 Otc 2002 (Rev. 9/83) Med 111 4 l 1 j^_f 3< ^ A (0 'Q>y State Of Ohio Industrial Commission Claim No. nn ?17'?T 77__________ Claimant__ tj-m-tatn Prtna-' '** Address __________ 4/1/89 Date of Examination b/li/Sy Addendum SPECIALIST'S REPORT Employer Age NOTE: Submit report under following Headings: (1) History. (2) Complaints. (3) Examinations, including X-ray and laooratory work. (4) Discussion. (5) Opinion. Sign and mail THREE copies to the MEDICAL SECTION -- Retain one for your file. REPORT OF EXAMINATION TO BE RETURNED FOLLOWING REQUEST. HISTORY ,,.EfJDUf-i 10 WILLIAM PRICE #0D 21225#-22 Date of Exam: 4/18/89 AN ADDENDUM to my opinion; The Industrial Injury does prevent the claimant 'M RETURNING TO his FORMER POSITION OF EMPLOYMENT. THE CLAIMANTS CONDITION NOW PERMANENT AND HE HAS REACHED MAXIMUM MEDICAL 1MPROVEMENT. IJ ADD IT1 Or. / Industrial Injury does prohibit the claimant from engaging in any E OF SUSTAINED REMUNERATIVE EMPLOYMENT. THE CLAIMANT'S CONDITION IS PERMANENT AND TOTAL. ALLAN H. HARRIS, M.D. CO CD JUU 2 ftbd gggggS COMPERSflllOh (Signature ol narT>iner) (CONTINUE REPORT ON REVERSE OF SHEET - NOTE INSTRUCTIONS) OIC 2002 (Rev. 9/83) i M.D. GENC 002180 Med 111