Andrew Rider of Michigan Insurance Company referred this file for medical case management. Instructions were given to meet with William Russell and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery.
INTERVIEW SETTING
On 9/9/16 I met Mr. Russell at the Covenant Occupational Medicine clinic. He arrived alone. He is alert and oriented. Mr. Russell is cooperative and open to working with a nurse case manager.
MEDICAL FACTORS
Mr. Russell said he was working laying 12 inch blocks. He said he had one at his feet bending over and picking them up. He reported that he has to twist and that the ground was uneven. He said he felt a pain in his low back. He reported to his supervisor. He was taken to the Covenant Russell reported he smokes, he was educated on smoking and spine health. He denies drug use and only occasional alcohol use.
EDUCATIONAL HISTORY
Mr. Russell graduated from high school in 1977.
EMPLOYMENT HISTORY
1. Place of Employment: McMath Masonry Inc. • Job Title: Bricklayer • Start date: February 2007 Stop date: current • Hours per week: 40 hours per week • Job requirements and physical demands: Climbing, carry, bend, twist, reach, push, pull, walk on uneven surfaces, and walk on scaffolding.
CURRENT EMPLOYER CONTACT INFORMATION
I spoke with Shannon Jacoby on 9/8/16, and also provided an update after the appointment on 9/9/16.
WORKERS’ COMPENSATION HISTORY
Mr. Russell did not think he had any other prior work injuries.
FAMILY/SOCIAL/FINANCIAL FACTORS
Mr. Russell said he has a very supportive family and they have given him additional support. Emergency Contact – Mr. Russell is a widower and denied an emergency contact.
PHYSICAL DESCRIPTION
Height: 5 foot 10 inches Weight: 169 lbs Hair: Brown Eyes: grey Dominant hand: right
