Northtowne Chiropractic
Dr. Larry Van Such, DC, BE
Dr. Rick Horsfield, DC
Jamie Ike, LMT

2240 Morse Road
Columbus, Ohio 43229

Office Hours
Mon & Wed   9am - 12pm
  3pm - 6pm
Tue & Thur   12pm - 6pm
Fri   9am - 3pm
Sat   By Appt Only

(614) 428-9310


Welcome!  You have reached my examination report page. These are actual medical reports submitted to the Ohio BWC on behalf of my patients.  The ankle sprain report is shown below these images and links.

Chances are, you might be more interested in other information on this site instead of these technical papers.  If that is the case, simply click on a link and/or review the menu items on the left.


Spinal Decompression

Back Pain

Neck Pain

Headaches

Chiropractic Adjustment

Sciatica Leg Pain

Car Accident

Herniated Discs


Dr. Larry Van Such, DC, BE, EE
2240 Morse Road
Columbus, Ohio 43229
(614) 428-9310
 
 
 
 
January 5, 2009

Law Offices of Jones and Jones
J. R. Jones
Attorney at Law
1234 South High Street
Columbus, Ohio  43215
Telephone:  (614) 555-5555
Facsimile:  (614) 555-5556

Re:  John Doe
Claim Number:  05-555555
D.O.I.:    10/27/2005
Allowances:  SPRAIN ANKLE LEFT
ACHILLES TENDONITIS LEFT
Employer:  CLASSIC SOLUTIONS
Date of Birth:       01/08/1972
Social Security #:  555-55-5555
 
 
Dear Mr. Jones:

The following is in regards to your client, John Doe, who presented to our office on January 5, 2009, for examination in regards to the above-mentioned industrial related incident in reference to percentage of Whole Person Permanent Partial Impairment, utilizing AMA Guides, 5th Edition.

HISTORY AND MECHANISM:

John Doe presented with ongoing complaints of left ankle pain.  He states that these complaints have been present since being involved in an industrial related accident that occurred on the above-mentioned date.  He described the mechanism of the injury as when he tripped over steel track and twisted his ankle.  The first doctor he saw after the accident was Dr. Mason.

CURRENT COMPLAINTS AND STATUS:

John Doe explained that he no longer works for the above-mentioned employer. The patient states that he did not miss any work due to the injury.  Mr. Doe states that the pain is constant.  He states that his pain is 7/10 on the VAS scale.  He describes the pain as a sharp, burning, throbbing, stiffness, and aching sensation.  The patient states that he has limited mobility of his left ankle.  He states that this injury interferes with his work, sleep, daily routine, and recreation.  With limited use of his left ankle, it is difficult or impossible for him to perform the following activities:  climbing stairs, standing, walking, playing sports, running, sleeping, standing, and hiking. 

All of the above mentioned complications fall under the chronic pain category where up to 3% impairment is given/added to this claim based on the ongoing burden of illness disrupting activities of daily living.  John is given 2% WPI today.  Reference AMA guides, 5th edition, Chapter 18, Tables 18-1, 18-3, 18-4, 18-5, 18-6 and page 584 item 5b.

OBJECTIVE:
Musculoskeletal

Deep tendon reflexes were not performed due to pain.  Medial and lateral stress tests produced pain.  Heel/toe walk was unstable and weak in the left ankle.  No swelling was detected at the time of the examination.   Tenderness was elicited in the gastrocnemius muscle in the left due to Achilles tendonitis. Talofibular ligament was painful upon palpation indicative of ligament sprain.  Tibial-calcaneal ligament was painful upon palpation of indicative of ligament sprain.

Left ankle range of motion

MOTIONS
MEASURED
NORMAL
PAIN NOTED
Dorsiflexion
 8 degrees
10+ degrees
At posterior/medial calcaneous
Plantar Extension
 15 degrees
20+ degrees
At posterior/medial calcaneous
Inversion
 10degrees
20+ degrees
At posterior/medial calcaneous
Eversion
 8 degrees
10+ degrees
At posterior/medial calcaneous

LEFT ANKLE IMPRESSION: 

A.)  Dorsiflexion = 7% impairment.
B.)  Plantar Extension = 7% impairment.
C.)  Inversion = 2% impairment.
D.)  Eversion = 2% impairment.

AMA Guides, Chapter 17, page 537, table 17-11 and 17-12, reveals an 18% LEI of the left ankle.

Sensory Testing

Sensory Testing:  Patient was unable to discern between two sharp point of contact at a distance of 50 mm (<5mm is normal) across the L5 and S1 dermatomes of the left ankle.  Reference AMA Guides, Chapter 15, page 424, Table 15-18, this equates to a 5% LEI.

Total LEI Calculation
Using combined values chart page 604

18% combined with 5% = 22%LEI
 
Total WPI Calculation

A 22% LEI = 9% WPI.  Reference Table 17-3, page 527.
9% WPI plus 2% WPI (Pain/ADL’s) = 11% WPI

 

DISCUSSION AND OPINION: 

The following impairment rating has been given to John Doe after a thorough history, orthopedics, neurological, and range of motion examinations were performed on January 5th, 2009.  It is my professional opinion that Mr. Doe has sustained a 11% Whole Person Impairment.

This impairment rating falls into the Range of Motion category, November 2000, 5th Edition AMA Guides to the Evaluation of Permanent Impairment.

Respectfully Submitted,
 
 
 
 
 
Dr. Larry Van Such, D.C., B.E.
Chiropractic Physician