Subrosa Letter Sample

Decent Essays
Please consider this letter a brief status update and follow-up to your email from May 1, 2017 regarding the above-referenced worker’s compensation matter. At this time, I note you have forwarded applicant’s attorney with your proposed supplemental request to the Panel Qualified Medical Evaluator, Dr. Mohan Nair.

In your proposed supplemental request, you raise the issue of AOE/COE with reference to the “sign-in” sheet revealed in the subpoenaed records from California Family Fitness as well as a subrosa video conducted on March 24, 2017. At your direction, we have forwarded the subrosa video to the applicant’s attorney’s office on May 3, 2017. The applicant’s will have 10 days to object to any non-medical records to the PQME.

Certainly, the evidence revealed by the subpoenaed records and the “sign-in” sheet works strongly in our favor. As you correctly pointed out in your proposed supplemental request, the applicant’s credibility is most likely going to be subject to attack. The “sign-in” sheet revealed the applicant has been consistently going into the gym since her date of injury. More absurdly, the applicant also went into the gym at around 5:00 p.m. on the date of injury, contrary to what was described to Dr. Nair. Also, I would like to point out at the applicant’s last evaluation with Dr. Nair on January 10, 2017, the applicant indicated she has been reluctant to return to gym, but this is contrary with the “sign-in” sheet from California Family Fitness.
…show more content…
She was able to participate in a Zumba course for almost two hours. She apparently exhibited no symptoms of pain when she was

Related Documents

  • Decent Essays

    Thank you Madeline for the response. Also I review the claim for the patient Williams,Elmira DOS 02/29/2016 and I see that the claim missing the authorization number since the patient have as a payer St.Francis Life. Would you please review and add the missing information on claim. Please email back so I can add the authorization number on the original claim that I will Hold in Trizetto.…

    • 66 Words
    • 1 Pages
    Decent Essays
  • Decent Essays

    Jon M. Espinoza's Case

    • 408 Words
    • 2 Pages

    Ms. Espinoza stated that throughout the claimant’s probationary period from 8-3-2015 through his LDW on 11-25-2015, the claimant never reported any injuries or illnesses either to her or to Supervisor Mr. Gerardo Navarrete. Ms. Espinoza checked her personnel records and the claimant’s personnel file and did not find any injuries leading up to the claimant’s current claim of injuries that allegedly occurred on 11-20-2015. Ms. Espinoza stated that after the claimant’s termination on 11-25-2015, when the claimant was terminated for cause, approximately two weeks after she was served with legal documentation via the mail from the claimant’s attorney at the Law Offices of Jon M. Woods. The service was conducted on 12-14-2015. The claimant and…

    • 408 Words
    • 2 Pages
    Decent Essays
  • Improved Essays

    We represent the self-insured employer, Niskayuna Central School District, and its third-party administrator, Benetech, Inc., in the above reference matter. Please accept this letter as the self-insured employer’s appeal of a Supplemental Decision filed in this matter on 07/13/17, which directs a deposit into the Aggregate Trust Fund. It is respectfully submitted that no deposit into the Aggregate Trust Fund is required of a self-insured employer under Section 27(2) of the Worker’s Compensation Law. At all times since the date of this accident the Niskayuna Central School District has been a self-insured employer and all payments have been made to the claimant by the self-insured employer through its third-party administrator. BACKGROUND…

    • 609 Words
    • 3 Pages
    Improved Essays
  • Great Essays

    Melisa Redmond of Pioneer State Mutual Insurance Company referred this file for medical case management. Instructions were given to meet with Whitney Kononchuk and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING On 9/20/16 I met Ms. Kononchuk and her mother at Royal Oak Beaumont hospital. Ms. Kononchuk was in a hospital bed.…

    • 853 Words
    • 4 Pages
    Great Essays
  • Improved Essays

    Harvard Business Law Case

    • 883 Words
    • 4 Pages

    -Case D267744 Exhibit A June 15, 2016 Selena Ives Attachment for Response Declaration My basis for this Writ of Execution for money judgments, is that Respondent, Mr. Hunter, has failed to comply with his court order regarding the medical co-pay for the past 16 months, pursuant to code 4062 and 4063. Exhibit A- The FOAH filed November 18, 2014 page 2-5 2.1-states starting July 1, 2014 installments of $100.00 a month In the event any such payment becomes more than 10 days overdue, the entire unpaid balance shall become immediately due and payable without further notice.…

    • 883 Words
    • 4 Pages
    Improved Essays
  • Improved Essays

    Patrick Duff Case

    • 413 Words
    • 2 Pages

    The insured’s HR Manager, Emily Lee became knowledgeable of Claimant Patrick Duff’s alleged workers’ compensation injury on 11-24-15 after he voluntarily quit his job as a Dishwasher on 8-8-2015. Ms. Lee said after the claimant had quit she unexpectedly received a phone call from the claimant who wanted to report an injury that he had already reported to General Manager Tom Harbaugh sometime in July 2015. Ms. Lee claimed when the claimant returned the workers’ compensation DWC-1 that was mailed to his residence, the claimant alleged within the DWC-1 that he been treated for Carpal “Tunnel Syndrome and Tendonitis to his right hand and his arm. While at the same of having an inflamed right hand to his wrist and elbow that travelled up to his right shoulder.” Ms. Lee supplemented us with two employee statements from GM Harbaugh and GM Hillman.…

    • 413 Words
    • 2 Pages
    Improved Essays
  • Decent Essays

    Regardless of the settlement offer reached by the codefendants with the plaintiff’s attorney, it was the position of HAPI (CRC Panel), their defense counsel and the insured to defend this claim. Moreover, and taking into account favorable testimony from defendants (Sandusky & Pearce) on behalf of their insured, it was defense counsel’s position the insured had a 75% chance of a successful outcome at trial. However, even with defendants (Sandusky & Pearce) testifying on the insured’s behalf, the jury awarded the claimant’s spouse $2.7 million, noting all defendants failed in the standard of care provided to the claimant. HAPI is now reviewing their options to consider filing an appeal on the potential of reversible errors (defense counsel…

    • 145 Words
    • 1 Pages
    Decent Essays
  • Decent Essays

    As an Eligibility Technician (ET) from 05/2015 to present in the, CalFresh and Medical programs, I have gained experience both in the Intake and Continuing case processing. As an Intake Case Maintenance Eligibility Technician (Intake CMET) my duties include determining eligibility for Assistance Programs by interviewing customers with the use software programs that include: CalWIN, MEDS, CalHEERS, OnBase, WMS, and Microsoft Office to determine eligibility for: MAGI Medi-Cal (MAGI; TLICP; MCAP;MCAIP) Classic Medi-Cal(Non-MAGI, SOC), and Aged Blind and Disabled (MSP-QMB,SLMB,QI-1; Craig v.Bonta; DDS Waiver; DAC; Pickle; 250% Working Disabled Program) as it pertains to the policy and procedure. In addition, my duty is to explain rights and responsibilities, fraud and perjury, reporting responsibilities, and work requirements, if applicable, to…

    • 344 Words
    • 2 Pages
    Decent Essays
  • Decent Essays

    The applicant requests a change to the separation code and narrative reason of his discharge in order to rejoin the Army. The applicant contends that he when on sick call and the attending physician places him on quarters. The applicant states that he was never informed nor did the AIT Memorandum mentions how many academic hours he can be missed during AIT.…

    • 62 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    This worker spoke with the service provider on 2/13/2017. According to the service provider, there were no recommendations for services. The service provider reported that Lamyia may have been slightly deceitful during her assessment. This worker has received the assessment as of 3/9/2017. There were no recommendations.…

    • 1033 Words
    • 5 Pages
    Improved Essays
  • Improved Essays

    The claimant has a past medical history of depression and anger. He had suicidal thoughts and felt desperate but unable to function. He reported obsessive repetitive thoughts and hopelessness. He had tried Lexapro, but had a negative reaction, including uncontrolled rage and attacking his girlfriend. He was unable to make some follow-up visits and to have psychiatric evaluation due to insufficient funds.…

    • 597 Words
    • 3 Pages
    Improved Essays
  • Improved Essays

    Employee Violation Report

    • 938 Words
    • 4 Pages

    The Indiana Family & Social Service Administration (FSSA) believes Vickie Stinson has committed an Intentional Program Violation (IPV) by intentionally making a false or misleading statement or misrepresenting, concealing, and/or withholding facts from the FSSA at the time of interview. In the following narrative, I will outline the evidence we have compiled against Vickie. An Application for Assistance was signed on April 20, 2016. The application interview was completed with Vickie on May 12, 2016. During that interview, the State Eligibility Consultant (SEC) reviewed the Rights and Responsibilities with Vicky.…

    • 938 Words
    • 4 Pages
    Improved Essays
  • Superior Essays

    On examination, the patient has normal strength and tone. No involuntary movements are noted. Her movements appear purposeful and normal, specifically there is no tremor or shaking and they are not slow. No fasciculations are noted. Tapping muscle tendons elicits a normal…

    • 1545 Words
    • 6 Pages
    Superior Essays
  • Decent Essays

    Good evening Bob, I just wanted to give you an update from my doctor's visit today. The doctor has stated that I am not ready to return to work yet due to another issue that I have developed, which will require physical therapy due to a pinched tendon causing pain. Because of this pinched tendon, I am not able to fully extend my foot to walk straight and the doctor feels that this problem would best respond to physical therapy. Enclosed with this email I have sent you a copy of the medical request form with the explanation that I have been sent to Cigna. I start physical therapy on Monday, March 28, 2016 and my follow up with the doctor for this is on April 12, 2016.…

    • 141 Words
    • 1 Pages
    Decent Essays
  • Improved Essays

    Reasonable Accommodation

    • 463 Words
    • 2 Pages

    In review of the Request For Reasonable Accommodation Information and Instructions (CDCR 855) form, the following information was requested, and the following substantive answers are provided after having reviewed Mr. Finley’s On-File Medical Information: • Documentation of the medical condition/disability that includes, unless the disability is patently obvious, a medical recommendation for reasonable accommodation. Having reviewed Mr. Finley’s medical information, as his primary care physician over the past five years, I can verify, without providing a definitive diagnosis, that Mr. Finley suffers from an ongoing and permanent, lifelong disability which substantially limits the following major life activities as defined by the ADA Amendments Act of 2008: Performing manual tasks, concentrating, sleeping, thinking and working. Additionally, the prescribed medical treatment he receives to mitigate the aforementioned results in side effects which substantially limit the very same major life activities for a period of 7 to 8 hours following treatment. The side effects caused by medication and/or treatment that a patient must take because of a disability are limitations resulting from the disability. Reasonable accommodation extends to all limitations resulting from a disability.…

    • 463 Words
    • 2 Pages
    Improved Essays