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HomeMy WebLinkAbout95-04163 , I ~ -.J 1 lJ oJ r '..1 I ,I,~ ,', ":1 ,'I,:" J: ",,\ 'I ld I . ,'~ , " , ~ F J , ,'" t'j r:! .,~)~ I'" ,}' li~ .il rf) '" - :::r "~ " ,it ,\~ :l ~ ,~~t " ",', " , hlf ":)r. '~ \, II I , '-i :1 f, " I \ 'I 139 DIANE LINGLE, plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSVLVANIA v. CIVIL ACTION LAW JOY C. CRUTTENDEN, Detendant 95-4163 CIVIL TERM IN RE: PRE-TRIAL CONFERENCE A pre-trial conterence was held in the chambers ot Judge Oler in the above-captioned case on Wednesday, October 22, 1997. Present on behalt ot the Plaintiff was Archie V. Diveglia, Esquire. Present on behalf of Defendant was James G. Nealon, III, Esquire. This is a negligence action arising out of a motor vehicle accident occurring on March 9, 1995, on Route 11/15 in Camp Hill, Pennsylvania, when Defendant's vehicle skidded on some ice and rear-ended Plaintiff's vehicle. This will be a jury trial in which each party will have four peremptory challenges for a total of eight. The estimated duration of trial is one day. Issues which may arise at trial include the question of whether Defendant may present evidence as to the amount of monetary damage done to the Plaintiff's vehicle, and whether the Dafendant may present evidence regarding the non-deployment of air bags in Defendant's vehicle, in the absence of expert testImony as to whether such deployment would be expected given the point of impact in this case. Plaintift is directed to file a brief on these. issues at least 10 days prior to the commencement of the trial term, and Detendant is directed to file a responsive briet at least ti"e days prior to the commencement ot the trial term. An additional ieeue which may be expected to arise at trial. is whether Detendant's accident reconstruction/engineer expert, Craig Depken, will be permitted to testify on the subject of the forces involved in the collision. This question is expected to be the sUbject ot a motion in limine to be tiled by the Plaintiff, and a ruling upon it will be lett to the trial Court. To the extent that any videotape or other deposition testimony will be shown or read to the jury and contains objections to be ruled upon by the trial court, counsel are directed to turnish ~ copy of the transcript of such deposition with the areas of objection being pursued highlighted and brief memoranda on the objections at least five days prior to the commencement of the trial term. Plaintiff has indicated at the pre-trial conterence that the witnesses to be called on behalf of the Plaintiff will be Dr. Robert Dahmus, patricia Cook, and the Plaintitt. The names ot these witnesses were inadvertently omitted from Plaintiff's pre-trial conference memorandum. With respect to settlement negotiations, the parties are only a few hundred dollars apart, but at thi. point neither is willing to compromise further. The Court has strongly encouraqed counsel to settle tha case if possible. By the Court, . i' , r' rl.: 11 ~ r " ,- " -.J '--; 'I i. I , " , I l' ;'1 1 r ( I I t i ) , >'i \ " .', J , , " !,I/ ." ./ ~ r, , II , I t K ! <:' ., 3. Oemeges. If eny, which the Plelntlff Is entitled, III. WlTN':SSES ., 1. Joy C. Cruttenden; 2. Curtis Fleck; 3, Craig A, Depken; and 4. Bernard Bacevich IV. $EnLEMENT Defendant has offered $3,000 to settle the claim. Respectfully submitted, NEALON~VER '- .U.\.. ---;J/} ('I .~r {Y By: ,-- James G. Nealon, III, Esquire Atty. I,D, #46457 301 Market Street -- 9th Floor P,O, Box 865 Harrisburg, PA 17108-0865 (717) 232-9900 DIU. LIIIGL., I III THI COURT or COKKOII PL'" I CUMIIRLAND COUMTY,P.".YLvaMIA Plaintiff I I 110, u-uu v, I I CIVIL ACTIOII - LAW JOY C, CRUTTBIIDIII, I I Defendant I PLAIIITIrr'S PRE-TRIAL ~.RBNCB BRIBr I. rACTS or THB CASB This is a motor vehicle accident in which the Detendant slid into the rear of a piCk-Up truck which in turn struck Plaintitt's vehicle causing injuries to the Plaintiff. n, CLAIMS or PLAIIITUr This accident occurred in the course of Plaintiff's employment and therefore, her Worker's Compensation insurance carrier is making a claim for subrogation for wages of $1,441.41 and medical expenses in the sum of $1,766.24. In addition to the special damages, Plaintiff has incurred pain and suffering trom the soft tissue injuries to her back and is seeking compensation for these injury. III. LIGAL I.,UI. PR.,IIITID A. ..ITHI. nlrlllDAIIT MAY CALL U IIP.aT TO THI ITAIID TO T.,TIry TO A MATTI. TBAT II W.LL WITHIII Ta. UIID..,TAXDIIIG or A TYPICAL JUROR, CI.TI.ICATI O. .I.VICI AND NOW, this loth day of October, 1997, I, Bethany A. Wenrich, for DIVEGLIA & KAYLOR, P.C., hereby certity that a copy ot the foregoing Plaintiff'. Pre-Trial Conferenoe Brief was served via first class mail, postage pre-paid, and addressed to the following: James Nealon, Esquire NEALON & GOVER P.O. Box 865 Harrisburg, PA 17108-0865 DIVEGLIA , KAYLOR, P.C. /!)r'/ lit! fI t ( (1. A/nil/Ch Bethany A./~enrich tor Diveglia & Kaylor, P.C. 3 DIAIm LINGLI, I IN Tal COURT or COIOCON 'LIAS I CtJIIIlIRLAND COUNTY, 'INNSYLVAHIA 'ldDUU I I CIVIL ACTION . LAW v. I I NO. 95-4163 CIVIL TIRM JOY C. CRUTTINDIN, I I Def8DcSaDt I JURY TRIAL DZMANDID NOTte. TO 'LZAD TO: Plaintift, Diane Lingle, and Archie V. Diveglia, Esquire, her attorney YOU ARB HBRBBY NOTIFIED, that the New Matter set torth herein contains averments against you to which you are required to respond within twenty (20) days after service thereof. Failure by you to do so may c~nstitute an admission. CALDWIILL . ItIlAJlNS . I /' By: ~,-- t!. ,N'f'4~'>1 J s G. Nealon, III, Bsq. Attorney's I.D. #46457 3631 North Front Street Harrisburg, PA 17110 (717) 232-7661 Attorneys for Detendant Dated: I()~II.~~ 59024-1 C.S.A. 11701, et seq. Respecttully submitted, CALDQLL . ItDUS By \ (~""'4 C:". tJJ! cdlY\/7 Jame G. Nealon, III, Bsqu re Atto ney's 1.0. 46457 3631 North Front Street Harrisburg, PA 17110 (717) 232-7661 Attorneys tor Defendant 0'" Dated: 10 ~1I~7!::' JGNIIl/tck 59024-1 .- '--" '_'-'-'~~~"""'t.--'-'~.' .....-.'~ . -.. ~:.:.~-..~.~~;, C..T].I~~ O. S..VIe. tl. AND NOW, this II - day ot October, 1995, I hereby certify that I have served the toregoing Answer with New Matter on the following by depositing a true and correct copy ot same in the United States mails, postage prepaid, addressed to: Archie V. Diveglia, Esquire ARCHIE V. DIVEGLIA, P.C. 119 Locust Street Harrisburg, PA 17101 a--.. G. N.t.CI..~ s G. NeB on, III, Bsq. JGNIII/tck 59024-1 , CAL.DWEL.L. & KEARNS A lIi1tOIl'ISIIONAL. C:OltIlOfil'..TION ATTOIlNEYS AT LAW - 3.31 NO"rM "'ONT $TIIII[r HAIlIlIS.UIlG, PENNSYLVANIA 17110 d I "I 1." "C~ III .,J" , ,. " rear ot the Plaintiff's vehicle also came to a stop, but the Defendant driving to the rear of that vehicle struck it in the rear and pushed it into the vehicle of the Plaintiff. 5. That as a result of the aforesaid accident, Plaintiff suffered injuries to the thoracic region of her spine in the form of muscle spasms, strain and sprains. 6. That as a result of the aforesaid accident, Plaintiff was disabled from her employment from the date of the accident until April 4, 1995 and lost earnings as a result thereof. 7. As a result of the aforesaid accident, Plaintiff incurred medical expenses to the sum of $445.53. 8. That the above-described medical expenses and lost earnings are claimable and collectible in that Plaintift was within the course of her employment at the time of the motor vehicle accident and the 1994 amendments to Pennsylvania's Workers' Compensation Act specifically provides for the subrogation of said amount. 9. That in addition to above described injuries and tinancial losses, the Plaintiff also incurred pain and suffering, as well as inconvenience and disruption of her life. 10. That the above described injuries and losses were the result ot the negligence of the Defendant whose negligence 2 0J ~r;c .J :1 02 PH '95 \1,,', i' ,1 (t h'J' lrq_ ,7" () -), -" I r: sv If-7. . Ct!-. .JCtCl4- ~I't- ) 5'3 j' I (9 .J. ~ J3 ...bcAfe, 1~ qj(O(~a, fiJ. (l ArTORNIV AT VOW (717)23&-&98& 119 LOCUBT STRUT HARRISBURG. F'ENNSVl'iANIA 17101 ." -- " NEALON & GOVER A ""O"...IONA1. C:O"~"ATION ATIORNEYS AT LAW - 301 "'''''KET .""EET . 8TH "LOO" ,",0. eOK 11115 HAIlI"'I..U"O, ~ENN.YLVAN'A 171 o&oee!l : ",1 ,f '1 , 1 , " . '.' ')/," ({Nil \'1/It'r" r/' (jJ~ i)~:tjll/' a/it J .c;f~J /0/') f /, ,/) C/" /, " "CI'.'.'",' '. ./,,'0, ':11/,'." . 'I. f <'i7/' I (J:i"II,Ull" .~'L .1J.,.:;;'d)/t . (I,.."":,.,,, .,/ loNr) r:t("" ,<) .' 'I") - .~. ".". . ,\ J '/U"; (1:/r,b,'l'a//"". I ' 'i" I)' . t. f ,"'l (('I"" I I'l'flt,..W .',: ) I' /':/7 _~l, ~'I - . l\\ '.If september 17, 1996 '/' " I('} .foOM/I. 1."1"'" ,'/(,;l'n~;''''.''7. !lJ.llnf'lA,t/It/;, IllVI (7/7) !MI/i'.'f'IIP,f ':,:"~E; Nealon, Esquire . '..J\LC~ & GOVER ,'.0. Box 865 ",:rls~ur~, PA 17108-0865 ne: I,ingle v. Cruttenden .1:: d'im: , :c vI~orously opposp. your' attempt tc off 01' Into evld(mce the cc~o~t of International Hoalth Car~ Con$~ltants under Rule l305. ,'n'.! t. docum.ent it-; Exh IbIt, A and clearly it is not a bill, record, ""co~.t of hoclpital, doctor, dentist, registered nurse, or. : Lcentiud practical nurse, nor is it a bill for a~ythirg ralatln~ m"dlcal expenaes, Alti10ltgh it does contain estL1latos fot" ':~::,l i r,3, re[.la irs are not a'~ issue. Further, tha o""h",r Items i'l re ,'. ;.\Jm~ssible and therefore, Exhibit A mu'st be modified ")i'dingly. I '"rould request that you file a r.ew Tw,mt'l Day Notice of '~cnt to Offer Documents tnat elImInates the first nire p~ges of '.ibi~ A. Although, In the first ni~e pages there is a document ','Lt.;:,\ the name Bernard Bacebich, i'!, D. .::ppears I tha'~ doc:l:ment L, a:30 inadmissible in thAt it clearly makes references to an "lysis that 19 not admIssible, T~ere;~ra, Sr. 3~cebich is ..:, :~r acting :,s a candu it for lnadn 1.S5 ibIe hearsay cUI,crary t:o 1 'r'n_Y_._XnnlMI, 653 A.2d 1249, l2%1 (199'5). l'urthor, C'/EH1 if ~. Bacebich did testify at the Arbitration, : woald o~po5e any .',.:timony by him that referenced the report of ~~. J0~ken since "i,' ",)IIIJ be In,3JmIsslble he,n'say. r~ ragard to the potontlalto~timo~y of ~r, Depken, it is "e, junk science and I will object to his tesUt,;ony on that ';' L ~;., . I b,~l ieve that sllbm ltt ing s\lch m:.ted,.l '''.18 I?l'<r.jud k.l.al and :;l1,:,u ld immediately bC1 h,,,!rted j nt,) all elWEllc~),., bi the ,:o';,r;,'.nctnry a.1d l!l(!al~,d. I ru::thp.t' b<);.ie'f'~ that, t:llo i\rbit:rlltot'a J\( l:.l.:ul.~ (n1 thi~j issue: J'\ that t.'lC mere rulin'1 CJn J.:r.e iGsua ""noS06 t.o the Arbitrftt.orA the content ot uh'.It in ,.,o~':i',in.Jct in ,,', report and that, in itsulf, w0uld he prejudioial. It you are ~ willing to voluntarily dolQto thea. tCAMS ~,d 6~hmit a new .bit, I will have no choico hut to tlla a Motio~ in Limine to ',:l~de thene documents and ruquust a continuance ot the h.~ring ~ll a ruling is made. Even if the COU1.t rules in your t.1'Ior that th'1Y are ",i,nisslble, it is my opinion th.lt that will b'.l an .'rro"aous ,"ling and I will appeal an adverse finding by t~~ Arbitrators. J::I, your intent to submit these documents will only rvsult in ""'~,en,led Litlgi'ltion. By the Wi'lY, I nevpr' dirt receive a tormal nct.ico from Mr. "llams that the Arbitration was going to be held on October 8th - 2: 00 p.m. at the second floor hearing room. I cont, '.l3 to .","llmo, however, that we are qoing to have the hearing at t:,at '"e and place. I would hope that Mr. Williams would advise us , '/OCJrdingly. Very truly yours, Arohie v. Diveglia , :','1k \ I ,~ ",,': IJak '-.. Tom Wil:iams Prothonotary , 'rtLlI\DATA11LI\MJJC\AU.TIW LrN Plaintiff. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTy, PENNSYL V ANlA DIANE LINGLE. vs, No, 4163 CIVIL 1995 r I, JOY C, CRUTTENDEN, Defendant TO: Archie V, Diveglia. Esquire DIVEGLIA and KAYLOR, p,c. 119 Locust Street Harrisburg, P A 17101 James G. Nealon. m. Esquire NEALON &. GOVER 30 I Market Street Harrisburg, PA 17108 RE.NOTICE OF HEARING YOU ARE HEREBY NOTIFIED that the undersigned aribtrators appointed by the Court in the above captioned mailer will meet for the purpose of their appointment on Tuesday, October 8, 1996. beginning at 2:00 p.m, in the Second Floor Hearing Room of the Old Courthouse. Carlisle. PeMsylvania, at which time and place you may appear and be heard. together with your witnesses and counsel. if you so desire, DATED: July 24. 1996 ," -... " \ . ' ',t...nV\ (i,(,. /; ~V ....L~-- Thomas J. wIfliams. Esquire - Chairman Stephen Lipson, Esquire William C, Vohs. Esquire cc: Stephen Lipson Esquire William C, Vohs, Esquire Court Administrator's Office Cumberland County Courthouse " ~ ~R ~ , ,,!.. , , ~ ", r ~ ~ '3"' . -~! 1""1 ~ :E'-, ~, ....i ,.-; , " ~ , I'. ) I'-' - " "I ::t ~ , ,) "T'- ......... ", ",) ':l,l) ~\ . " CERTIFICATE OF SERVICE AND NOW, this 18th day of September, 1995, I hereby cenify that I have sen.ld the foregoing Entry of Appearance on the following by depositing a true and correct copy of same in the United States mails, postage prepaid, addressed to: Archie V, Diveglia, Esquire ARCHIE V, D1VEGLlA, p,c. 119 Locust Street Harrisburg, PA 17101 .~, J'" k;:, (,'" ;J tl y es G, Nealon, 111, Esquire CALDWELL & KEARNS A !'IItOl'llltONAI.. CONPO'UTION ATTOANEYS AT LAW - 3e3t NOATH rAONT STREIT HAAAlsaUAa. ttENNSnVANIA 11110 SFP I ~J L Sb PII '95 ~ ' :' " ,., 1;,[,',' jl', , i' Section 3361, Driving Vehicle at Sate Speed Ko per eon eball drive a vebiole at a epeed vreater tban ie reaeonable and prudent under tbe conditione and bavinv reVard to the actual and potential haearde then existing, nor at a speed greater than will permit the driver to bring his vehicle to a stop within the assured clear distance ahead. Consistent with the toregoinq, every person shall drive at a safe and appropriate epeed whftn approaching and crossing an intersection or railroad grade crossing, when approaching and going around curve, when approaching a hill crest, when traveling upon any narrow or winding roadway and when epecial ha..rde exiet with respect to pedestrian8 or other traftic or by re.eon of weather or hi9hway conditione, (emphasis added) 1976, June 17, P.L. 163, No, 81, Section 1, etfective July 1, 1997. Numerous Pennsylvania cases have dealt with weather conditions, and the rule in Pennsylvania is that the motorist must be able to st.op his vehicle within the distance he can clearly see and as wp.-ther and road conditions change he must adjust his speed according. Fish v. Goshnell, 463 A. 3d 1042, (1983); LathroD v. Henkels and McCoy, 351 F. sUPP. 1052 (1973) Furthermore, where there are known icy conditions and the skidding might reasonably have been anticipated, a driver owes a duty to the vehicle ahead to operate hie vehicle in a caretul and prudent manner 80 that it would not go out ot control and collide. gjst v. Allentown Wholesale Distributor8, 158 A. 2d 777, 780 (1960) Failure ot the detendant to maintain control ot her vehicle is negligence per ee. BRlarinq v. Starcher, S32 A. 3d 36, 39 (1987) and the 14 cases cited therein. The mere fact that the detendant skidded does not exculpate her. She must stat. why despite knowledge ot icing in the area she was the only one who skidded and was unable to avoid the accident, campbell v. Fiorot, 191 A. 2d 657, 660 (1963); Pascale v, V-ons, 178 A. 2d 549, 552-553 (1962) , LJ r , I I , , I , i I r i 1 I I I I r, I OCT II ",5 e3: 31ilPM I H C P.2 ~ u..--.eon.aIrIM,1nc. [I He] '.0.", '02t, MlrlIll.. GA 3O....IIJt mil tautG '.0. ... 4272f, C\MlIuII, OK U1A2.072f (lU) .n.un ',0, ... "tll, w..hlallaola,PL ))'IIUMI(407)5IH4't ',0.'" "159, ftaalll, AI U07HUI (t42) *4HJ ',0, I.. 4I2S0, PI, Wo4, TX ,,,...QZJO (II" 42&.U20 HS. PATRICIA A. HOrfHAN ALLSTATE INS, CO. 6345 FLANIt DRIVE SUITE 1000 HARRISBURG, fA 17112 Date RI CLAIK /; IHC . 10/10/95 DIANE LINGLE 155UOUOtlMl 01-0043385 Dear MS. HOfFMAN I On sep 05 19951 w. ~.ceiv.d the above r.f.~enced con.ultation r.que.t to~ Impact Ana y.i., Thi. evaluation i. ba..d on the dOCWDentation provided to us and oen.r.l p~inciple. of accident recon.truction and phy.ic.. The medical a..e..m.nt i. additionally ba.ed on the v.neral .t.nda~d. ot car. in the prote..ion, and it the prOVider wi.h.. u. to con.ider additional information conc.rning the clinical .tatu. of the patient, h. .hould .ubmit copieR of tho.. pertinent document. to be torwa~ded to u. tor evaluation during the app.al pe~iod. Thi. 41-year-old woman wa. involved in a motor vehicle accident on 3/9/95. Thi. w.. an accident involving two other vehicle., and her car wa. the fir.t of three vehicle. in a line. There i. a very d.tail.d impact analy.i. .tudy .howino that Diane Linole wa. in vehicle one and that there waR mlnimal it any noticeable damaoe to the ~ear bumpe~ of the Omni. Vehicl~ two wa. .topped and wa. .truck in the r.ar by anothe~ v.hicle throwinv him torwara into the o.ni. Again, the photoo~aph. and r.pai~ eltimat. .how that there wa. .ivnificant rear bumper damage but there wa. no r.cord.d damao. to the front bumper and there were no in1u~ie' to the driver of that vehicle (vehicle .~). The third vehicle .howed front end damave and there wa. a mi.match b.tween the bumper. b.tw..n that v.hicl. and the pickup truck Ivehicle .2). The' airbag .y.t.. did not deploy and th.re were no njuri.. to the driver of th.t vehicle Ivehicle '31, HI. Lingle ~.port.d to the Capitol H.alth Sy.tem and th.re i. .n Employ.e Incid.nt Regort till.d out on 3/13/95 d..c~ibin9 the accident. She had an ccupational Injuxy Report dated 3/'1'51 .nd at th.t time, .he wa. advi.ed to .tay oft wor~. She wa. p ace, on ..dlcation that could CaUte drow.in.... Two day. l.ter on 3/11 '5, h.r medication w.. Changed from Norv..ie ,orte to Anaprox end Robaxin. Avain, with the Robaxin po..ibly cau.ing drow.lne.., Ihe wa. advi.ed not to d~iv. or work. A tollow-up appointment wa. .cheduled thxee day. letert which wat don. on 3/14. At thet t~e, eh. wa. placed into phya e.l therapy three time.~a-w.ek .nd k.p' on the .ame a.dication. and .till advi.ed not to do any drivinv. One concern th.t I have i. how thi. patient wa. att.ndinv phYlical the~apy three day.-a-week and making the.. regular office vi.itl i' 1 10tll '&5 15:36 OCT 11 '9::; 1<l3: 3.HI r H C P.3 IllIaa1ioNl ~ CmI\:lIanII,~. [I B~) '.0,'" ?Oat, Mar...... GAl '001$0"31 ('770) 'SW041 '.0,101141716. ClIlo:lDIIIIl, OH 4'241.0716 <, IS) ,.,.,m ',0. "1"'9, W.lPalm IIcIo:II,n.SW1~9'9<4a7)11~1W9 ',0, lOll 56"9, ~ AZ ,1'07~6\l9 (601) 14~96J P,O.lIoa 412'0. fl. WIlI1ll, TX "141-C210 (117) 421.1310 Date RIl CUIM j tHe * 10/10/95 DIANE LINGLE I55190B6091lKI Ol-0043385 Ihe was not driving herlelt. It would certainly be helpful to KnOW whethe~ lomeone wal driving her or whether Ihe wee not following medical advice and wal actually driving a car hers.lf. There are no physical therapy notel to reflect that Ihe did attend phrBical therapy. Except for the no driving, the limitation. on 3/ 4/95 were that she could return to work with modifications including no twilting, no lifting over 50 pounds, and no overhead worl<.. Certairlly, it would ',ppear that ehe WIB able to return to limited work on 3/14/95, and one could find it reasonable for her to take the mUlcle relaxant medicatione after work so that driving would not b. contraindicated by eide effect. from ~edication. On 3/21/95, her medication wae reduced down to only two Advil four timee a day and I teel that Ihe could, moet likely, work at that time. Unfortunately thil medical record doel not contain any objective informAtion from the phyeical examination etandpoint. The diaqnoli. of a thoracic back .train hae been given. Certainly, it would be unueual for . thoracic back .train to occur with the accident being of luch low force and with her blck being .upported by the automobile .eat itlelf. In conclulion, thi. file doe. not contain objective information to eubetantiate a period of dieAbility trom 3/9/95 through 4/5/95. Kedication that cau.e. drowsinele can be adjusted so the patient doel not take it when they are to be driving, and therefore, it i. not a .trict contraindication to pU%luing work activiti.'. Again, baeed upon the impact ana1y.il, with .uch a low torce of acceleration in conjunction with the tact that ahe Wll wearing re.traint. and had an adequate back relt, one would not expect any type of .1gnificaAt loft tialue injury to the thoracic are. of the epine. Bernard Bacevich, M.D. Orthopedic Surgeon S1vnea copy available upon reque.t. u-a :I 10/11 '96 15:36 , , DIUI LI.ClLI, I I. 'l'II1 COUR'l' 01' COIOIO. .LIU I CUJlBDLIIID COUll'l'Y, .....YL9UIA nelaUff I I .0, tI-un v, I I CIVIL ACTIO. - LAW JOY C. CRU'l''l'I.DI., I I Defeadant I TWiny DAY DI'1''1''' .MICI 01' In11ft' '1'0 OWWI. DOCUXlns 'ORSU..., '1'0 'A, a.c... 1101 AND NOW this day of September, 1996, pursuant to Pa.R.C.P. 1305(b), the Plaintitt intends to ofter the tollowin9 documents into evidence: 1. capital Health System Records. (Exhibit A) 2. Report ot Dr. Jason Litton dated 04/10/95. (Exhibit B) 3. Records ot Dr. Dahmus ot 11/03/95 and 02/27/~. (Exhibit C) 4. Medical Expenses and Management Services. D) indemnity payments of Claim. (Worker's Compensation) (Exhibit 5. Time record chart for 1995 and statement of Waqe., Submitted, Dateell '7 - l/_ 'i I{ 'l,e. Attorney for Plaintiff I [] Fi'IC"'C''''''loIpn!l''''''1118~-2Y~~... e" ~~d1..FIr"C.,."I"I717t5--M50 ~ , g ....,~. ,,,,,,11." Ernorgency, 111 n In-seat [] Em"",," 1'lIl1h_.. '.0' ,0000.lIonol'II."'S"",,CO,II'n 71~-"210 , , 0111oo II i, , , 'r\l!...ul' J '1,''- i..:_ Nit""' 0' Eiij)1OY" /. JMr i.,"J "'It " "I \ C~.,\. I'll) I Nom. ~nd J hone umbo' 01 Supervl,or Or Au'horltod Emplo Of R. . C;'" '-l I : .! bo"of'nju,,:~,' " D... 01 Tm"'... ' , TIm. I.: TIm.OuI: _ . , 75"' .. , -.:r:;- .!G:.. OCCUPATIONAL INJURY REPORT . jf~If.f~,;r:: Ill. IF- OQcupe "' 0 . Ihr.ll~h().n(lJ... /<:., Em 10 .. N.rn. "..lanv. fit -/'-0(' f0 D.scription ollneldon" 111" I,' ,,' l.= Il.!(, "J J I/'r, III I rFCl' JJ(( c.~ c.p".. Hoollh S,.'.m: Comploto ",. 1011owl.g, SERVICES PERFORMED/DISPOSITION O!tr1nlti., Tre.lm.nl 'b Follow-up Villi [] Adlnlllod tv HOlpllol [J OIleh.,god o Rel.trod to Comp.n, Docto,/Nu,". 0, 0 R.,."od to '!', " Phq~' .: . , . ~potn""onID.II: __'_'_ . J AIlJlo!i>W,on' TIm., ~ ".IlJM Ioj loIlowi'1i 0 ~ ., i' ..i:l_fli'~_'_LLJ_:LL Tlrn.: 11tl',l1r [] !len' lor RohBblllllllon WORK STATUS .8.. R.III,. to wort<: no IIltricnon. .of ../L"'A, ).!! U.lble IoII'um IoWOltl (),4/r7/ K#~""_'" o AbI. 10 telllm '0 wort< willi modne.IIo.., IIIVllllbl., II Indlellod o I, No prolongod II."dlng or wollcJng o 2. No bonding, '1Oop1ng or IwIdng o 3, llmllod u.. 01 rtght.1lft o 4, No UII 01 rlghUlII. o 5, No work n... moving mlChlnery o 5, No "dng groll.. III..: 0 to 1110, 0 20 1110, 0 50 1110, 0 100 lb., o 7, No climbing or ttbovB ground IIv.1 wort< o .. No ,*II"ng o g, SiIttng WOItl 0fII, o 10, 0., WOItl 0"" o Oth.. Q' '" ~:\?l / 0 It' EIllrnllod'lIumlollllcll,,: '"..DIAdWOSIS: l ~y" &1'1: fim-,f :i'4A,.-'<. ;fI1.JU.i~ .:n./i'.tI , . COMMENT/lNSTRlICTIONS/MEDICATIQNS' (J:> A/JlrY (~ //(I'....J (7,-., J?~ "R-' 7?V, :RtI, ""/~ 11',/ /5- ;0"/,,,.$. ,f'#MY ) /11!t.t;(,. ,('77A ~#~.s )--o(,l'+./y .JiIn7'r// ~' //,.",.... ~ ,5'1;1Ar ~.~ ~'''''.vr ff.#?1I' ~bY. ...MJ'd /1';1',11I ""/r/"'~ ..Yl~~""~ ,!..tlp '/Ill', . '!t..,-,,,,lj.' 7;/-*'7 ,AI,!);' ("-fW !J,IN.'.I/I/I'.sS IV.., , d~r /I.> A'(I~I 115- ~/NL /'IOllIII' /g',,(JI ,1,1/ /1.#.$ 1M ~Mf'A' /"r' J-f't~ Shf'A't~ U)' t'.M.:;c iJ M.dcadon 1."""'Non. glv...: o The 1n"""I.1Ion 01 ,our "-fl' I. ani, I prl.mlnl" rlflOl', Thl rldologl.1 wi' ,._ .... 11m.. If .....,. . ell....... IhI dBllno.I.. lie" Inform you. I luthorlzl Capftal H..fth Syst.rn 10 lurnlsh to my .mployar and InNurlnee corrler. .lllnIormation r'Vlrdlng my conclftlon IIld If'llmlnl, I he,eby Icknowl.<ftj. rac.lpl 01 Ih.~1 Inst,uctlonN Ind uncl...t.nd thlm, I und.rNt.nd thai I h.ve hid .m..o.ney 'raa.m.nt anlv Ind Ihlll mar b. llie..iId b,'m. III m.dle.1 p,obl.m. .r. known or .r.lltd. I wlll.".no. 10' follow-up ell'. .a , hey. blBIllnllrucftd, .\. \ t , . ' (. :~'. 'Ill"" Heallh Cer. PrO'lh... . DI ANI V 20144..OS I ?'"I j01SS03 03 n .lJ n41 2Z N 2ND ST. WORRLYSBURG PA R08lRTSON JOANNI R J 0 IIwORK COMP 207 44 ~.OS 71' ", ~17' 01 08'. R/rIRN CLA' 003125 J IWI Oct'llOlltonal ~.._" S.,.,1I1 lit SCOTN '"0N' !lflllIU HARnIS.URO, 1'. "'01+101I 11'71 7112-">> ('MII'1- UIIIII~r:~Ir)W'" p",_ - I'1It1"I\'ICGfl' ~' FI.or_COIonI~r"'UI"'(117)182-~~. ,', , .' ""'hlC",,,('1717lll-1ISO ' . o """"bIJ.,IIo,,,,"I,f__, (1171 7U- \ o f..pOoyMlloollh_ ,; OcCllp.lIon"".llIh 1!Ierv4t>>, (717) 112-3<210 om.. ~ I , ,1f.'l ' "I . if 0 I J I, /1 \ I j'('/ J 'i!t ~' Employ.. - ,'. .) . --' -~. ' Nom. nnd Phon. Hum '01 SUporvilor 0' Au'horized Em ,~. 'I, o"'oIln~ry:L,l~/I!5 -' .'''' 0.. 01 T~~I :.:!.L I ,JL::i;JJ:. . tIm.'n: .4-.IJ~ l1me OUI " OCCUPATIONAL INJURY REPORT o er Repr"""IU"1 - I Em 10 .r N.m.....~-..' . DoocripKon 01 Incldenl' .. I I ) I,' '.v /, '1 , ' " ,L II( :J ' I I ('j 1....1.) h.J Clplll' Hllllh SYI""': Compll"tho loIlowlnv, SERVICES PERFORMEDIDISPOSITION C1 (nlKnl T'II""on' iii(r oIlow-lJp \'II" [j Admllled 10 HOlp11l1 o Ollchorgod o R.r."1Id to Company OoclOrlNu;.. o Rlferred 10 Phon..: ' Appoln"""n'OoIO: ~' ~11 :-- Appoln"".n'llme: . )( n;tum fo, loIlow-lJ , ". ... .'~... I u- TIme: ,~... o S.n. 'or Ihlbllll.lIon WORK STATUS o Return to work; no ..Ilrtctlonl W,)nlbfe m Ntum 1ft WftIk tJ AbI. to ..lIlm 10 work willl rnodIftc,lIonl, IlIVlIlt,bI., "lndIcIled o " No pnllonged II_ng or wllllllng o 2, No binding, llOopln. Of' IwII'ng o 3, llmllod UII 0' rlt.ihlllln o 4, No UII 01 ri.hl.1.n o 5, No work n... movln. m""'lnIry o ., No Kiting ....Iar Ill..: 0 to Ibl, 0 20 Ibl, 0 50 Ibl, 0.00 lbo, o 7, No c!mbln. 0' .bOVl VlGUnd levtl work o ., No cttvlng o I, Slnlng _k only o to, DryllOlll only o 0IhIr .>lit1..., ~... _..9 !J.' .!~'!'!'l~~'~~_\l!,fu~~,!E:: '-, fo/r,.'~N'" I....,.,e I~: , ,. (j) ,,;') 01 " '.- o Medication 'nl""'tionl vl-: o f14 Inltrpr.1l1lon 01 you, "".y II only. pr,H",In,ry reporl Tb,..dloIoglllwtl"_ III Rlml, 11....11. ell.... In ... "..nolll. ..wtllnlorm you. I authorlzl C,pltll HuMh Systlm to lurnlsh to my .mploy.. ,nd Insurance ca"Ie" .n Inlolmlllon IBQlrdln9 my condlllon Ind trl1ltmlnl. I h...by .cknowl.do. ,.c.lpl 01 thIS. Inst,uctlons .nd und..st.nd thlm, 'undll1tlnd thai I havl hid Iml,glney "lItmlnl onlY Ind .h.,l may b. ..1..~iId b,'OI. ./1 m,die.' p,obl.m. .r. known 0' t,..IId. I will ."'no. 10' lollow-up car. ..1 hAY. blllllnttruclld. 'X , II' "I, . \ , I' I '"1.,,1 Htllm Car. PrO't'tdtf .....~~IIwIIl.. ~'e ' ...... , ~~I' '''41 .1,.1, Pi ,,~ ,!JA I " .. '1111.... n"t,.i,I....~k ......"". n-.r.".. '"'''' ''\1\ lH 141'" ~lIfI"~..llft hrvlt. 111 BOUTH '''0'''' S1nllT 1-l"'''''ISlU''O, 'Ii ItUII.1Ot'I "', (117111;P..W /':""4'" ......lllnr~IrJ,.' PlI<lI.""u,,"COD' II N GI [ OI.N~ y 20144..0] C'n 31J1b112 OS II .5 22 N 2ND ST, "ORRLTSIURO "'LUll JlIIES I JOI/WORll CORP 201,44 .'03 717 737 8173 03 08 54 M/'ERM eLl' 00.2.] J "WI '~ . . ,',/. . ~, I,. , '"ti''' -, ;, n f'.IC...CoIonIIlP....M..,I7II).S2-211e ., r): s..d., ,,,.ICIt', 1"7) 7K-eeso : ,/ [J .tn........'pllIl,Em..Vf"CY,1711)1I2-11e ';'" o Emr>loyH'IoIl1~_OI , o."".lIonolllolltll 51M0I, 1117) 112-3210 . 01""'_ ..'..... '~. ffJ'!'~" ,.'," 1.'I"",.,....~'"'.Lf."~I':,,--:!".1 ':' \:; ~.ltolln/V,.,:M, :. , D... Of T...",..., j' , . , lime In' 11m. eM: ; , . . " .:" ,/' , ,Ii OCCUPATIONAL INJURY REPORT , jt1/ii.-' /1/ly{L_ . . o~poY" . 1 '..-' If ('l ,.',. 7,' /11/1 ,.~"'.J .....J 'r;,~ J 1'\ iL. N.... d Pllonl Number 016upo",I.., 0' Aulho,lzod Emplo or Fl.p"..n'.... o.lerlp'on .IIneldon' . 14. " . -r: ,', ( - C.p'"' HOIIIII S,II.m, Comp'.te th.loItowino SERVICES PERFORMED,DISPOSITION O. 1 ''!!IIn II T"~Im.nl i!l'1""oItow-uplllsll o Admlll.d 10 Ho.pll.1 n Oi,ell.rgod o Fl.I."od to Compon, Ooctor/Nu,.. \~, n R.re"od 10 ~ Phon. I: ,:"",. AppollJJlTllnIO.te: _,_,_ . ~,",,"Imenl TIm.: ~"fU'n for foltow;!JJI t1 r , O.JJ--:':.:i.,..iz!L' ~ Tlmo: ~nl 101 .h.billl.lon, ~ . ~J. ""'-'1~) OccUPOlonlPolllon ) '% n /, I)I.I"C (,j I.I,.-r#~ 1>-1; 1,_/ Em 10 .rN.me . ,- . '-'1:.';' r I' JI ,;,0..1 , -"7.:.. zl/i:.,.. ~' .. WORK STATUS o Fl.turn 10 wort<; .. ,,"trtctton" o Un~ 10 relurn 10 wort< OJlIlIoto retum 10 wort< wllh modllcBlon., "..IIII.bl., ulndlclled OJ, No prolonged .I..dng 0' wBlldng ~2, No .........0,....... or IW.dng o 3, Limited u.. 01 rlghl.1oft ' o 4, No UI. 01 r!gh11.,. o ~ No _k n... moving mlClllnery U'I. No Nfting ...ter fllRI 6 18Ib.... 0 DO 1-' 0 eo Ibl. 0 100 Ibs o 7,,Jo cHmblng 0' Ibove ground level wort< ~No dltvlng o 9, Sifting _k onI, o t~ 0,., wort< only 11 r /1 . /J Ir"tllh" ~ ~ -~ - ~ I..I~ --' ,A"t t.(.LUY~ o 11, E,IIm.1ed ,.tum 10 ruN ell": L.;/~ d~~. IL f:/t::f/ ' J'\A ~J ~~ "'\..J :.l.iV'.,^.~ ", \ , , o Med..... 'nltucf..1 glv.., -0 The interpr...lIon 01 ,OU' H" II only. preNmln.,., repOlI. Th. rodolOV'I' wiN re_!he ftlm., II........ ch.,ga in IhB dill...... we wtllnform you. 'lulho,lzl C.phl H.lhh Sysllm 10 lurnlsh '0 my .mploy., .nd Insu,.nce ce,rI... IN Info,mallon ,egallllno my condlllon and '..alm.n" I h.reby ,.knowl.dOI ,...Ipl 01 Ihl.. Insl,uellons .nd und.rsl,n<l Ih.m, I und.,.'.nd Ihat I h.v. h.d em.rgency I,..'m.n' only .nd Ih..1 may bl ,.I.lIed b.'or. .11 m.dlc.1 probl.m. ... known 0' "..led. I will .".nOI 10' follow-up ce,. .. I h.v. be.n inllrueled, ,.tlenl ~...hh el" P,ovIdtf Physlcl.n 01 P'","o,,", . x ,t' CAPrrM. HWTH l I' _1- _, 1 L _ ,1 L I - .~.) .... . IIN~L[ Z0144b.03 rW4' ~\,jN\~O 1~11~OR~~1~:U:: Pi 22 N 2NO ~, M[" l108rRtSOM JOAN JOliwORK COM' 117 131 1113 201 ".~.03"/r[RM eLl1 I , Q3 08 ~ J IW . bOllcH8 ~ 'J I. f . ~ OtC'UNlIoftIi H.d" "Nit. "' SOUTH '''''NT 'T"II' HAAAI8Iuno. P.11101~1OII 1'17)'tII'-'MIW r.".,..,. M",ltl'l""l\In~"'t PIMIl . P..UIt"'Ir,I'\fI, W"~" . 1""..\" 1ll~" lJlI'dlt." "11I:011' r...tml\'" 01 14 'IN, .~4- "Ill ..-.... ~ ~1I'''''''"'I1'''.''.J''~'O. ~.' i'.----,...._......If'I'l. ...... n Fk,1\;...CohlnIIlPMtM",lm"5Z-ZIlllZ~, ;: ~d10,F~.lCII0,1"1)71ll1-"50' f . r,J .lIIri......,Io.pI..r,f_ooncy,C7.1)7.Z-H "" " o fmploye' Hoolth S...lctl Q' . ""'0110"1111..,,,, 10M,", (717' 7QZ-3Z10 lIm. Oul: , '* ,.~ --- OCCUPATIONAL IN.JURY REPORT I ":"'r";~l". \), 0..... e. L\ ":.j \ ... \,.."'-q",,(1 (.('CO!. \'-\',0 Q.. No"", 01 rnip!o,oo 0CiCiiPi30~11ilOri \<'O.:\"-.;.{L 2.,.", ......."'"'-C..,' \2.... , C"-;-\u.\ \\.,,\'\'\1 '-..s.t- Nome and F'hon. Number of SUperviSC; or AUlhorized Employer R.",..,"I.tlve .. r ~ Employer N.m. ~ . Do""lp~on 01 ,ncldon" r=/'-' ~\c..'I~'. " . . , Copllo' Hoolth SYII.m: ComplOl' t'..loIlowlng, SERVIC,"S PERFORMED/DISPOSITION o ~r..trn.nl !;rfollow-<Jp Villi o Admltt.d 10 Ho.pllll o Ollcho'ged , ' 0 Rofoned to Compony Dacio,/Nu"o (1",' Rof.ned 10 " :" ~. I .1. '" i . Phon.': ":':"..~' AppolnlmontOIIl: _'-,--1_ . ~lnlmenl Tlm.: ~olllm fo' follow-<Jp - 7..... 1'...'\ 0-,11 .3-'~/n= TIml: ''''~S" g;son~1:h""liiiIroii. ~ vu1l (/. , _d..J~ ",,,,...,, ~'...j.1 t:Jr- 1 i AGNOSIS: '--z..&~ . .,L . , COMMENT/INSTRUCTIONS/MEDICATIONS' l . ~Iniury: 03'~1 Cf S" OIr..llmonl: a.3-1~q5 .In: " i '( ...... .,,' WORK STATUS o Rolllm 10 work: no """'ctlon" o l,IpabIB 10 re'um 10 work " ~b1.1O relllm 10 work wi'" modllclllonl, IIIVIUobll, II Indleoled o J,. Ho prolonged IIB1ldng o. wllldng """'-2, No bending, ltooplng 0' IWfI~ng o 3, limited UI. 01 r1ght.1oR o 4, No UII 01 rlghl/l.1I o ~ No work n'" moving mllChln.ry W""e.. Nolttlno'fllt.r~ln [S11'1t!.~. ~ [6Ib... e9 80*_, 610811>... o ~o climbing o. obovo ground IIvol wo"' Qo"[' lIo driving , o ., Sll1tng work only o 10, D,y work only o 0Ih.. (, ,. ,I f' , 011, . <lily: ' .._j'\.",~,"'I'Iil"';'.,.,.....".,..-. .",. ._................_..... ~ ~~:~~.1~:~f".~;~,~~~, ~O " "" /,;~ J./' / s--.... I o Medle.ltlon Inltrucdons glv.n: 11 Tho Int""oll~on of you, .-,oy II onl,. ,.llImlnlry 'oport. Thl redologlll wll..Yiow the filml, ""'''''" I chonge In \he dogno"'", ... wllln'""" you, I lu'horlzo Clpltl' H.ollh Syst.m 10 lurnlsh to my .mploy.. Ind In.ur.nce c.rrt... .11 Inlo.mlllon 'BQ..dlng MY ccindlllon Ind t...tmlnl. 1 h..lby Acknowlldg. "cllpt 01 Ihlsolnslruc1lonS And undOls'.nd Ih.m, I und.rs'and thBl' hI.. h.d .mlrg.ncy Ir..lm.nt only .nd Ihl" moy b. ,,'.ued b.lo.. .11 mldic.' p,obllms ... known o. "..ted, 1 wlll.".ng. for tollow-up c... ..'1 h... bIBn InllruclBd, ~ \,', ...)" \ r"II"1 ....lIh C." P'O'o1d., OcMlllOIllI H,."" S~It" 111 "':)lIT'" '''ONT ,'''"T f.4~""IS'lJ"O,'. "101-2011 11I7)1U.1'" "l~" . ,:'.1U"~" rl)ft~ I) ~ Ff( 7~d/ k::? .... ".... ~IIGLE, 1074."0! ~H"~02'tlS't OS.." rUI fl . lib 1'1 VORIL,.IU.G Pi 10'.~TSO. Jolll. . 10llVORl COIP 107 44 UOJ 711 137 1111 ~, 08 ,. I,rlll CLl' 0031 n J "". .i a ,t',) \~ ","11 '" ... -- ,.,. (lRD!> If II ;"1) '"11,1 14 J . I. t: 'jAI ~H ~ PloitliM/'o . HII'tIH-,IIW I)"SrIMS, INC PI '''I,ll'''''' ~" ro 'UI)~.Jt:'~ '~AL.. TUI.I. I'HIiJ, 1jl)<l.I5IEtPHiItO ,CA, 'II. [IjOHI :1'\11 """'1 'U'IAI " MIIII/ll""'/I"~II'A", tltr,1l""IHllIAII'I"II"'11 """IU..'....H.""IJ '"I', hll,ll, 'WIll,41111/W1I ''''1', 1l1t',ln'tlllll >>11 JUlIhI'''''''ll'llnl "'.' .lilt... 'oil ,~t". "II trrIIH"'I'A,",,',I,II'I,'" " ./JlIJlUI'IIIIU) UII,'IMJ n'II"."D '" IlAMbJ .....L "D \"""""''''''D ''''I'~..U 11"''"'''0 ..1,'..II..'AUIl"....D ORTHOPEDIC INS TIT UTE 0 F P E II II ~.; Y L V A N I A -,.- ..7~~..-.-~."1.~~.__~~!'~.~.:..-. ..~"..~-,,,,._ '.:.:.~.:~_~.:.:.:':.-.."~.t:.; ','. t fll'I't1'JtIl"lI,'17"I'.'.11I . tllUllp'HAn2fl . '^XIIII.'" 11'1,' :".- - April 10, 1995 Lisa Davis, 4470 Valley Enole, PA ~I. 0, Rood 17025 Dear Dr, Davis: 1bis morning, April 6, 1995, I saw Diane Lingle 'lU1238 of 22 North 2nd Street in I~ormleysburg in my office initinlly. She is a 41-year-old woman, who has upper thoracic bock pain. She hod no history of back pain until she was driving her vehicle at work for HealthReach Homecare when she was stopped on Route 11/15 and hit from the rear on an icy day by another vehtcle. Within a short time she noted the onset of upper thoracic back pain without upper or lower extremity symptoms, She was seen at Seidle Memorial Hospital and there she was given prescriptions for Advil, muscle relaxants and physicll therapy was begun. Her activities were restricted and she WIS not allowed to drive I vehicle or return to work, Her symptoms Ire somewhat subsided, but she still has constant bothersome upper thoracic back plin. She has taken little medication. Some days the physical therapy helps her, other days it makes her worse, When I examined Mrs. Lingle today, I found that she had full range of motion in her neck and neck motion did not cause any upper extremity symptoms. She had no trapezius tenderness but did have slight muscle tenderness to either side of the midline of her upper thoracic area. She had no tenderness to percussion of her thoracic spine. She had full range of motion in her low bock. She hod intact neurovascular function ill her upper extremities, She had full range of motion in all joints of her upper extremities. I reviewed the radiographs of Nrs, Lingle's thoracic spine taken at Seidle Memorial Hospital on the 4th of April of this yell' Ind I see some minor degenerative changes without evidence of tumor or fracture or dislocation. ~MP HILL O"IU 'tt".III'NUU'11t .. .." .......4.. ._....~._........._,_~_,.___...... Ahl)ll'.i,\11 '('1/"""1"1."" r II' 1',P',lI'lrlllll '~I)\II,f \'"''''''lIt.I'', '/'111 1I,.IIU"l""f!'lll' r w' IIf II'lm, '~III"f 1""'1"1"."1., 1111. II"t II' "."." II""'" 'I' '1 CAMP IIILL or'IC!, ",'. ...tiI'IAII'..ttrt..,lI, I.INC:U:, 11111I11' H 101 ~,1~ ^I'ril 10, l')'lJ Page Two I feel that Dione Lin.le strained her upper thoracic spine in her vehicle occid<!nt of ~llIrch 9, L9\15,' I cxplninel! tu het that I treat this very lIIuch os L would if she strained /I leg muscle or her foot if she were in 0 sports activity, She hns not h~d a dangerous injury, and 1 don t (eel thnt !She hns to lilkc medication. 1 dou't, fCld lhat Curther physicol thcl'apy will be of benefit to her, and l 011I not placing any restrictions on her activity. I think that even if she returns to activities and has discomfort, lhat those lIcllvilies arc not, prolonglnl\ her disability or Pllin syndrollle. L nlll, there(orl'l, rlll."IIHinp, her to normal activity including her full-time job without restriction, I told her that I do not know when her symptoms will subside, but will see her in (011011-UI' exom.Lnotion one lIIonlh (rolll now. Sincerely, Jason J, Litton, H,D. JJLlclv cc: Employer ,,' " , , .. ,.. O"OIR . aO.1":"" ..J. 1.1 GAL 'ILI "'1',8 TIM". '.11811'10 S't'IITI""a, INC , 1I'I','ALUM/Il, eA TO "[O'fOlft CAll TOLL '''11 ~OO'.IBIU""O r(;', 'lit ,tlU<.h l&..,.a..o IUS"'1 ..., , ' . """'"-t DIANE V. LINGLE 22 North 2nd street Wormleyeburg, PA 11043 951353 - 1 - 11-3-95 SECOND OPINION EVALUATION HERSHEY (DR. DAHMUS) REI BACK Dhme is e forty-one year old female who comel in today f01 a aecond opinion regarding her back pain, The pain i. all in the mid thoracic spine. This all .tarted back in March of this year when ahe waa rear-ended in an auto accident, She wal treated at Seidle ,fint and then by Dr. Litton. BasicallY .he Will told that .he would get better with time and to 1u.t hang in there, She is a little worried that she i. .till having trouble and she is here for another opinion. She denies any numbness, tingling or weakne.. anywhere. The pain , i. basically from about T-IS down to T-12 and only right down the middle of her back. It doe. not go into her rhomboid., it doe. not go into either shoulder and doe. not go down to her lumbo.acral .pine. She has no neck pain, no low back pain and no arm or leg trouble. She has no bowel or bladder complaintl by history. She only has mid thoracic back pain. She i. not takin7 anti- inflammatories exc~pt tor the fir.t two w.ek. after her injury and .he has not been in any therapy and doe. not do any rehab now. She i. presently doing her normal job and normal activities at home, although she hasn't been riding her motorcycle or riding a horse lately. On physical exam, .he has tenderne.. right trom about T-IS to about T-IO right on the Apine itself, She ha. a little bit of pain right next to the spine but only about an inch out, She ha. no pain in the rhomboid., .he has a normal range of motion of her .houlder., .he ha. no tenderness to her neck to exam and .he has a normal range ot motion of her neck. She ha. great fl.xibility in her lower back and no tenderne.. .t .11 to .xaminaticn in the lumbo.acral .pine or pelvis area. She h.. good rotation of her back and basically the only abnorm.lity I c.n g.t i. the tendernes. in the middle of her thoracic .pin.. I have reviewed the x-rays that .h. brought with her and she indeed does have some degenerative disc di..... in the middle ot her thoracic spine but otherwi.e everything look. ju.t tin.. Basically I think .he has a re.olving thoracic .pin. .prain and this will only take time to get better. I told her it could be . ye.r or two until it i. compl.t.ly 90n. but there ie no r.a.on to think it won't go away. She h.. no .vidence of any di.c di..a.., no evidence of any .tructural damage and b..ically we .re d.aling with a mu.cle contu.ion that will t.k. ti.. to get bett.r. Th.re i. nothing more to do .xcept u.. .0.. ic. and h.at .nd .0.. anti- inflsmlllatorie. on . PRN b..i. .nd ju.t l.t n.ture run it. cour... (ckzl (CCI Barbar. Darcy, capital Nur.inv) .. -- ,.. " OHCIR , ;lI).1"lJJ &, J . t E'iAL 'IU !)Vf\Tl 1\4"-. ft,'B'H 11I<) ttYlloTllilflo, INC. "."AlUM. CA TO "'OROIiA r.:ALL ")Ll ""Iii !lQ(} l:ulfHERO tCA, ',II ,.tf~), 11'11t 1t;l4C ,U"'A, , , " IIIlIIII " , , '1 :1,"" :1 i , " ~- I- 'I ' 1'1 ;' II -'~ I " ~ II-.r. ':1 ~ ~ i"'" - - - - - - - OUf9TAIiIDINrnl!lllA\II8"~f-.r...:w ~":"--;'-'..- -.. ., ,.. . , - .. - -... - .. - - PAID TO DATE 1'1 .~':-'-, .. - - .. - - - TOUJI INDEMNITY MEDICAL IMPL LIAD EXPENSE TOTAL INCUR~~ .02~:~= .~~~~:~~;;~g:,~g~~~~~~i=-rj~'012 ~k ~ ...r ,.I,' , .. " .---.-------.1' . ._. _""'_""_'" . ,. ,..I' Jt '-" .,./ CLAIMS MANAGIMENT -,HARRISBURG CLAIM NO 94e4~37 SUF'.n.~~l NAME LINGLE. DIANE '.r!'" r '{" ~ ' , ... '207.44.....03 .TATUI Q . ~D...t .:,j sEcolliir .. .' "" 'H5N~ ,",' ADDRESS .' ~2 NDRTH " " , ADDRESS :i! _.!.E,X...,r...~~RI.TA~_.._. :i 1,:lflli' ~'..i 'I I, ., j~;.I"',' '.1',' ". CITV WORMLEYSBURQ 'TATI'!A ZI' .'Q4~ DIV ill .. UNlf U2Q.-OPf"'~"iO''10eC\JIIATfON: . "...--.... , : 1\ ' ~ '. : ., , , ,Ace. DEBC.VEHICULAR ACC~DE~TI DACK"!1USCLEBTRAI~_!'IT,.fA " 1', " t.O".Iu..'''~;;() :l~~ll"'.',i EMPLOYI'IENT;:'d; ACCIDINT ,..~~,""'QRT'DWQtM"1,,^D.."I<<tT PAV 1 1 " ,03/09/9!t o:a/~~l1e Oa'U(.,~._. <, I ,'I 1'\ "rRI'" fl\N. ,'Ii\ft AGE DEATH SUBROGATION'l CDf'lP RATE' i ;," !.l. 1 1 :r. 265. 44 . '---r;l'-'fi!-"I1;:~UF.N-" ,\","OC/i< rT";T--( :-i " ., LDCATlON '__ DAY Q,111'11 -Wl CL.OCK)...."" l.'] 1~ ' -;- '" AO!Ne~;:---'JlATUArll,.-"AAT._. SOURCE TYPE HAZARD AGENCY PART CAUSE. INJURY, 'Of BODY - - .-..----" 1(.. Mc~1rn-i~:;.FT.-;;-ll,..,!.. LAST INDEMNITV PAID 04'.110/95 oT/WTO',IND INDICATOR tt BI RTH 03/0S/~4 OPERA'toAtClbE m--'---;ADJUITI,,-caDI'""'lA!'i'--- ...... ~"ll ) JI. ! "If. ' 1 TICKLER DATE 10/14/96 CLOSED _ 1 1 . . . .. ". '--~'---f'~)'li7ijfEii,rlii' , ,~'-;';-'''.'~ C:) 101 1 9.!. .~ ,! il . ._~M_ . -1":-:- ~l(. J ~'f..ri:;~-'; t;- -~--.-.-_._-'-~. ,;. . "1 ',1': I. '1:: / ~"i . ',' :,~ -,I -... .--,.. ....... , ,.. L ~.~i'f7i-r~.i-r;:j --,,\'l~;~'-"Y-;-j -..."..-.. O~/04/q~ ~0 ~6 . .... ~ ~ ,~",,,"""'--'-'--'-'---'-"--"--"'. ,." ." . ,,-_..._~ ... ..-.. ... : .. 'I" P,l "-"',""r','!t'.~:'\"-""-"-''''''''- - t. I () hi IIA. i!lffi:i1i:~r:,r---..-.-p;-;-;::- ()4/:l0/(!~ 1 ,i~ 1b ..__,_, 'tl.,_. , ~ r \ Il t~ " " ~'-():1, ~ .." ... .... , .... .... ,I , 1,,1 I'. ..., " , ~ ~ J CLAIMS MANAGEMI~T'- HARRIBBURG CLAI~ NO 9454537 Sl)F'F'H...1... ' N.~li~_~~~~IIi.: ._DIANIl '" PAGE 1, - -'l: ~ " i OD/O"l." I; '" .,. .._--tt1"-lO'" aA:rHOilt.i~ic IUAOIRy"eINTER : 1 q41,l"!,t., ,31, 4~. I' '" .,.......'-C.--l0 -.CINGLi-;- DiANE.'."......--. '" ,. 04/,11196 U5.9:il. SEG, CHECK 1 CHICK DATE :o!1 .. :il0 0003'65 04/18/96 03/:il5/96 1041696 ' 19 000375. 04/\7/9. 04/17/9. WRONG AMT ....: I ...- I ~J .; 17 00039:il3 04/11196 ,.m_ "--;.r'.-{(;--TllTlfAtrlllsoeune-- i i 0:il/:il7/96 1:il9689431 04/10/.. H.65 l 16 00038El1 04/04196' ..,-, -,. ..N .""1()-HCetmrIi-AllIOC1ATII"leHJ" ;: 03/18196-3/:2:2196 ILINGDIO . , 04/04"'. 141. 4" I' ...- 15 000381.3 04/01/91. ,.- -----l'I..-IO--UNOlr.-IHANI----....... r 03/01I9b-0:U:il5I9b 04/01196 63,88 I: ...- , 14 0003848 03/~7/96 . -"-N.-.l~.-P1ccultn,-AlllloerATlI-Ce~U r ) 03/01/96-3115196ILINGDIt:-' 03/11I"J," 435.'1 I: ...-j 13 000375~ 03/1419.'-'" jIj.-10"t:TNOLIIDIANE-'-" 03/08/9. PT HRS 03/14196 U5.9:2 1'1 ; I -'~ 1'1 ' l:il 0003754 03/01196 ' ... .m,_,.'" '1 O-'WA!f1\'" DAllev. fiN . , 0:2/:il7196 EXPENSES 03/01'" 9, II I' I ,,;- 11 000320. 11/:il:2195 -- , .-'-N--H5--r;"T'HlI'Alim-sOROlillY.e!N'tIA J 11/03/95 1036593 H/Il:il/95 1:20,00 ;] -' 10 000:il403 06/~:ill9li "--'-N'--'lO"-t..m;~IMCIItI"L-Ha'l'nAL.' t. 'I 03/ I "'5-4/5/95 1:213019391 M" ~;, .'~06lIn ",<;0&::... 440:~ ,", ..' ~ '-' 9 000:il283 0!l/2~195' '--.-'N"-'-IO-"1I1KI"14IHOIUAn,IO.flrTAL " 03/:o!1/95-4/4/95 12030:il4154. 05/a5/.5 14:il, 51 IS 0003935 o4/Ji/'.'-'-- 'N. -i()-....O-,~y-MID.eT"-uJal.v) QI/R7I.")I~ult"",,\;a~~,.,~""iL ~~ao_lIn.Il'/.~ ,,~'.7!~'.' '>' ~ ~ e 0002175 '05/04195 . 04/04/9& ISM 9896.4 ) --" 7 00000000S/02/9S RES. INDEMNITY CHANGE ~-,..~._--,-..-....~_.....-..~..- - .--..- _...._--~"--_.. I I 37.1:il .J 6 000209~ 04/~0/'5---N--- ur"lIIIKr-MlHOIUAL-HOlfllfAl. 03/09195-3/14 1:il03105503. 04/801911 ' . 111. .. -' --" - ,-.; ... -.-...--- ------...._- -' 'I" " " ~ ;, " ~: J r' ;; ~ , , " ' " .. . : . , " llrll! ...J,Lq ClDC".'u-.. .-., . f' . ...~:&NC { 1\';;~;ll~~;C=t N~':j~~"~~'- :~~-~'~~.~_. ,m f: -' I' I, . I" -j t t I . CLAIM ND 94'4~37, SECI, CHECK' CLAIMS MANAO~~t~~~,ir HA"R\,lI.I~",JO)r, '.' .!Y~I.!....1 t:'~~l!~. DIA.~~ CHIC'" DATI '''ANI TVI" COD " 'AVa - "" f;Y"'TU~ C! , "'''1' " . , .' 1:UTIO' , ,,,,, ,._.~, 'j,' 04/10/.5' ~4\' "'loll, '.0" .' \ ' ' 4 0061il02~ -'- 04/1 O/9S 03/09/9S-4i:'I9S TTD ' . ~......i, , -. ," '" 3 0000000 04/01/95' ", , RES, MEDICAL CHANQE '-'U'-H"'" 'A- r'ilNAI'*p.!'laf"j(jttl''''l''' . . ""-~_....... IV ..~. ....,.-. U .. 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HAIII_, NllltnVIIIU '"~ 1'- SOCIAL SlCUIIN NO.: 207-4'-"-" ..,UTIIIIIT leU"'" AIlI ""11II"' .... INJUIY DATI'~ DATI: A"I~ ..LGftI-INIUII'1 "'.1 M!I4SJf W., tho """...t"'..., ..,.. upon the followt", f.c" .. to tile tftjurt.. _utlMld .., tilt undtrlt..,. ....'oy. 'ft 'h. ....'oy of hto ..",oy." I, h) .hted "ee.: . wI.kLy: . _'My: . ~'lyz · (bl ...."".,: Toto' _ego. f,o. .11' occupatl"". du.t", tl ..,...... _tho P...tIItlll ...t...t I Ccl Y". ft.... by day, Ilou. Of output, du.IIII '1 WMIl. or '1 ~ ""'111I .I.tdllltl -.. -, no .... ... ... :IIl= itift=: i ~t. i~ C~d 'ft~t.., ........ _tt.' ,. 1. ,. 7. lu.t"... of ""1~~Ai' D... of .c.tdont '1... of ...1don' D""'p.t"" of ... ont ..tUlO 0 "U,y T 11 "'e. J .. ,,.. .:r. ~ Ill, p..tod 01/01/9. i~: =~:= j~~!~ Cd) '.176.12 dt_tclod by 13 _t. ...1 I ..1' -. WMIlly .... I Toto' ..'"I",. l.u "'" _,.Ud calonder .,..UrI ~ d'vtdld by ~ "",ked ""'., d.lly ..... 01 I 7.. 7. 8Ult'pllid~. vtIIlII' .... _ IDTI: - n. lit.,.. Wltly .... .. ....,t.. INn __..... .. lilt,. .. . ..Id .."loyer ""'II ,." to IBId .."Ioy. ~lOtttll .t tilt ..te of I~ pt. vttl, """"'''' --.l1ILlI!.l!L poy.bl. -I9I 3 6/7 Y,IKI 0IId ....t.., Oftd lIo.pu., tllptlI"" ..jut .i'lIii1liliiOf u. ... _t prov~ 'on'''ylviiili Yo,ier. co,"ru,tOll IoBrd 0' ....., ....'". CO_IO't"" to ,."ob'. for _to for tilt ,... of undt. ...U... 'DUll. ,."ther BOU". ",ood upon A 7 W HI.1' C_u.'"", I -. ....'oy.. 9. 10. 11. " 12. "'" (dot. I dol. -, tllll.... ".,. _tot' 3 " ..." other ....,.-., 1)\I\!'l\Q.~1 ~. t..tu . ....'oy. wttn...'t Addr... UlnA&. HIlUM IYltql --Iiji'OYII P. Q. _ IJlIII. HAlII~. 'A 11101 lijl_ . iiiI.... ~ CLAINII!MMIBIIILlUVC'I. INC. Of PA. aut"'-"M","t or Ift"'.",ct t'rtll. '~----i"t:"l."~ or l!lI'IP 0)'." I I DUNI UNGLI (cl.tunt) Iftlu...'1 of It.. t. whl.~ eo....pondInl. ,...rdt.. ,~t. ..._t 10 10 bI ."'.: II NOITH SICONO ST~IIT h"..1I IIO~NUpIUIG Ic tyl C.ountyl 'A 1704:1 C".UI CUI"' IWIIIUIII' SlIVICI.. llC. Of ,. '.0. au 2iD , I I L.___ ~ LlIImlII.,a 1'1063 111..10..'rttP ...IAU COOl ~ 52]4 .....--..- 'I. . " - I~ ,-I J .j I~ (.) a C U. dJ ... ....., y ><: 'ON .x .~ IX 1.It.~ ~ M :r- " k ~ -or, :x~ ~~ ""I: " .. 'll.~ 1~ .' . ,- :,; ':.~ ~ )< r,~ ~ .~ :#" ~ ~ 1:,,"" ~ I.,~ ~ .0.: .... ~ -""a:l~ . "".' 'C' "'- ~ ~ -~ ~ ...J ..., :> ~ ~cn . ~ ~"<<) ..::s .. .~~ t;! '::' ... - 16 '~ ~. 'O-:t . .j ~ :; .'",,= 'f~ - ;: .:a l,"-~ lr ~ '0 ~ ~ tiJ') 14:1: )~ ,~ . u:) ...... .) ,~ ' .... ~ .~ 1-~ ..,. I" ~ Cl'J...... ,.~ ~:., ,. '(I l'J "0 .'.~ ,'\ 1"<":. ~!:: ~ 'I' 13') ') .... . - ~vo or ;. I... '..... ~ ~.:.1 to- ~; . '\. i>;~ "!:. "'- - oj) '1L ' : ~I.~ C" ..; .... - ... " ''''j, s= ~ t dj) \' N -',~ ~ ,-~ ..~ .."\ .... ::. ~ " ~ -:".~"; ,_: en ..a, f7~ .0:7) .~ ~ .. :3 -..,.' ;:.. .,c.. ... 'J, .:.i CD --1. .~ ot> ~ o I;,) ~'> ..~ -;.;;.; .. ~ ...~ ... J; ~ .... "'-: ,':;, ,~ ~.~ -:;:j - ,'!; . ... ,.~ .. !! ... ~ ~ I' SJ7 UI ro~ '''\ f>~ .'!l ~ .~ .,~ .- It) ~':& l-:<'ll' , l~ &~ ~-"~I ..... ,~ ... ~r.;. ivi ..,. .:~ .-;; ., ...., -0;: .. ~ i7 ...~ ~,;; , '. ... ClCI .;. ~ ..- .... M ~ ..;;;.: .\ .- _ 0 . ,~. " ~ "~lwS '::: ... - ';::.1 .;;J N ',,-: k .~ . t . c-: ~ .':, ...~ fl'.>~.. - - r- ... -)~ I- "'r~ , 'iJ '. . ~ ':& KIi '1.:s. :. OJ - rr- r.::..... \.:\ .. Q I." J ,~ .. , '-': .,,~ ~ ;;:th. ~ - ~ ~ ' ,. ' en ~ .> ...-:' .... -:P.-> . , , ~ ~ ol~ J.~ -::" .... :+ . ....-' CD ~ ..~ , .1'... I' _ : -ff.,.--..rr .J.!:i '\~ ~ ,.. .14 " '.~ -.~ ~~ ~ .~ !;I .." .u .~ ..~ II ~ ..~ UI "- l. ~ ~ .-0 I~~ 'Il ~ ':~ ..~ '" i!& W- It) " s. ,~ f" ~ -".(0 ~, ~4 . ;! .., !l IL ... ~ pr-~ '.~I ,f; M- F! ..~ I~ I':' :'_' ..~~ - ,"~ )IS:; ~ N - .!1 I a:' i .Jo ~C "'6> ~ ~,.~ " ~I ,7 ..' ,.... - ...~ .0 ~i1: ~~ ~ ~][ )A~ )~I :'-'- i J , j J I J J . t J I " I ~ I ~ I ! ht ~ II i Jlj ! IJ I.) "J.t ~IH & '-II i I!f ;i j .5 .. . I ~ f I c ~ J , " I " l I ~ II If, .11 I h I ~ I,. I I I ~~~ ~ .. J I dJ Jt' .J~ I I I I I ilia.. ill .. I J I t I uJt I I I I III"~.. IfJ , "t 1ge~ J Ii: I f li~ }I DIUI LXllelLI, I III THI COURT O. CONNOII PL'" I CUJIII.LUD COUll'1'Y, ,.n8YLVUlIA plaintiff I I 110. t5-un v. I I CIVIL ACTIOII - LAW JOY C, caUTTIIlDIII, I I Defendant I T1fIIl'1'Y DAY nITTI.. NOTICI O. IIITIII'1' TO O..IR DOCUXIll'1'8 PURSUANT TO PA, R.C,P. 1305 AND NOW this day of september, 1996, pursuant to Pa.R.C.P. 1305(b), the Plaintiff intends to otfer the following documents into evidence: 1. Capital Health system Records. (Exhibit A) 2. Report of Dr. Jason Litton dated 04/l0/95. (EXhibit B) 3. Records of Or. Dahmus of 11/03/95 and 02/27/95. (Exhibit C) 4. Medical Expenses and Management Services. D) indemnity payments of Claims (Worker's Compensation) (EXhibit 5. Time record chart for 1995 and statement ot Wages. submitted, Datedl_ '7 .l(- ';,', 'il", / By:_ ); _u, '- 't, Arc~e / . Dive 11 , Esquire Attor~ey I.D. ~17 40 119 Locust street Harrisburg, PA 17101 (717) 236-5985 Attorney tor Plaintitt r1 ,..IC...CoIonlll P."'M", CII1I152-2!l1:C.. i; ~'~d1., r".IC.,",17' 7) 7....50 I 'tlllllri,""'g.Io.p1t,',E_goncy,ClII)112-H .1, [J !mployH II..lth S."",.. 0, o."",.l1onll ....,'" So....., 1"1) 112-3210 , '0"" I " , , , -r\" \ ,~' III ,,~, ic_ NAm. of Employ... I J,b.ll1.- .:;'~.I11Ili', \. I Ii" I\. \.' II ). Nl1mo Ind Phon. Number ot Supervilor or Authonzed Emplo ., R.prell.nl.Uve , . p. ~'... l", """" ;01;."., . ~,., '\' , ,: i, llIIBO"nlury:~!.2.I " 01" 01 T......"" ' , TIm. In: TlmlOut: /.l5~ OCCUPATIONAL INJURY REPORT ,Jf~I~J2/;'" 1-11. If- Oc>cUp.I nI 0 n I ht1l1 J,I').n( I J... J Jolt:: I Em 10 Ir NI,"I J I/"/-, fI~ .It- Ll (I koJ J)l( (PC-I' ,- I,l... D'8Cltpllon 0' Inr.ldtnl' l j II I I I: c I' t;;i;",I ()(1 '-J III C.pll.IIII.llh S,,"m: Compl.'. Ih. tollowlng SERVICES PERFORMED/DISPOSITION ~nl~AI r,..rm.nl U Follow-up VI.II [J M"III.d Iv Ho.pltal U Ol.chorged o R.t.mtd 10 Com""ny Doctor/Null. 0" ,0 R.ferred 10 , "', . P.hq~I'; " -il~potn\m""1 0.,. __,_, ~ AilIlc>l"W..nl TIme: '. b"::'~s:.~"JL I !is: TIm. 711t " Pr o SOnI;o. Rehob~ltllllon WORK STATUS o RllUm 10 work; no ".frictlon. .of . ,U#oA ,)8'Un.bItlo,.turnIrlWOrk (,.Jlml K#'~"'-'" , 0 AbI. 10 ,.lUm 10 work with modIlIcIlIonl, If Ivelllbl., II Indiclled o I, No prlllonged lI."dng Of wilking o 2, No binding, .Iooplng Of IwIIK"O o 3, l...lIed UII 01 rtgh""~ o 4, No UII 01 rlghlllln o 5, No work n,", moving mlChlnery o e, No NI"ng greIIBrIll.,,: 0 10 lb., 0 20lbs, 0 50 Ibs, 0 tOO Ibl, o 7, No cHmblng 0' .bove glllUnd 1lve1 work o e, No cttvtng o g, 91"1"0 work onl, o to Dry work only o Other 'ODlA~~6sIS: l ~y" , COMMENTIINSlRUCTIONS/MEDICATIQNS ~ I) ~,;' (~ /l(l'l'j (14 .7? ~ 'n.' 7711' ~, ""FA 1'1''' /S- .))k/,A,S. MMY ) /ll'l"'!io. ?'TI'A .;l~#~j YoGI ~"Y .PU'Tr// ~' /1,.,,.,. C1.,; ~",- 7.y.{ AI""N.fo/1' ,;;;."J1' iFhY- ..M~d /1;1',Il "'J,/.r~ ..YJt?'".M'("t /,t1Jl /"'1(1. ('".It/T//,(j.. 7;/~?, ,+./y ("~ ~N.I$/IA'.$S (M lA.r /kIll.. \ G RI;.r //> ~QN '" 5. ""'~/NL (0 ;(',Ot/ll/ /~;,(" ,1-'<" ,l1..f>'~ M ~....,.""..... J.?t.." .9-Jf'Ar~ eU~ "".N~ o M.dlco""" In.trucHonl glv.n: o Tho 1n1l",11I1Ion 01 'OU, .-flY I. only I ....Hmlna,., ,_., Thl ,ldolOOIIl wll ,"vlow .. I...., 11....,.. chBnglIn !hi d"llnolle. we wlIlnform you, IIUtho"ZI c.pnll HIIKh Systlm to furnish to my Imploy., .nd In.uran.. ..,rIe" .ft Info,mltlon '1Olrdlng my oondltlon Ind '..llmlnl. I her.by .cknowlldg. rlcllpt ollhlSI Inst,uctlon! .nd undl..'.nd thlm, 'und.."lnd 'hI! I hi'" h.d Im.,g.ncy ',..'mint onlY .nd th., I may bl ""1111I bllo'l .11 mldlc.1 probllm. .'1 known 0' t,,,'IIl, I wlll.lllngl fo, lollow-up "'I .. I h.vI bI.n Inllruclld. I' , I "\., ("' ,', ~ ' . /J~ / . 0 It) E.t1m.,edrelUrn 10 '"I clI,.,: o;r~/ fi/7F4' ..x/lAy~ Avt.iiv .:J;&,Aj 'IUIn' .".lIh c.. P,ovldtf _~l nLE _L. L DIAMI V 201446603 I ?fI j01SS03 03 n 95 '"41 22 N 2ND ST. WORRLTSOURO " ~08[RfSON JOANN[ R JOl/wORK COR' 207 44 "OS 117 7S7 ~173 03 08'4 R,'tRN CLAY 003125 J "WK '.JcC\lDlrlO/llfu..nh ServiCI 111800flot'AONfS"1lI11' ...AIIIAIIIIIUAO"I\ 11101-:MII 11"lfUH'M:W W"f~ r1",~", ",,~h ".<1",41 "'r."'I1 F",ml~l,n'I'M", r"n""'1.1J",IIl'J"""ln,.., 1'1,,_ . r"tIItnl' Cnfl~ \ 1 n'1l'...c.,IonI~~""M"'(1111.5B~" . "." .i"'" OeIBoIlnJu,,:-L, 9 ,?.5 .... ~"',FhlC.,t,II7)~_ ",W D 1I00T 1m I' ~~ '"-lL::i~ rJ Ilorri.blllllolpl'tl,f_gtney,(7I7)I82_ "'" ;" 1 ' 4'"U";" n fmploy.....tlth~...... . n, _ _ _ , ~' OrtlJo.""n.,...."" s......, (117) 112-32'0 TIrnB Oul: " 01,., " )' , III I j , 'j '/ OCCUPATIONAL INJURY REPORT ( I J I, . / I, J), '1./ / t~t ! ;mprQr.. ) ) . -), . -...... . · ''"'-. /.....l.i.JJ .., ,Y J '"-" ..It . IImlJ IInd Phonl, Num , of Supervisor or Authorized Employer R.pr...nlltlve WORK STATUS o ReMn 10 worll; no rollrictlont lidJn.bIB '" ....... ........ fJ Abr.1O r.lum 10 worll will> modlllcllfonl, lI.v.lI.blt, ..Indicated o 1, No prolonged .'.ndlng or w""'na o 2, No bending. .lOoplng or IWtdng o 3, Limited UI. of rlghllltlt o ., No u.. 01 righlll." o 5, No woric n..r moving mlChlnl/y o ., No Nlting ....,.. "'Ill; 0 10 lb., 0 20 lb., 0 SO IbI, 0 100 rbi, o 7, No cHmblng or BbovB ground ...... worll o ., No ctIvtng o I, SlUing _k only o 10, Dry -" only o Olhtr Descriptio" 0' Ineldlnl' " I I /, I ,l.; / .'1 ) I.! C.plllll/.tlth Sylltm: Complole Iht 'oI'owlnl SERVICES PERFORMED/DISPOSITION o 'nld,,1 r,e"tm.,nl ~oIlow-up ",.11 ti Admlllod 10 HOlpllal o Ol,chorgtd o R,',rred to CampI"Y OoclOr/Nur.. o Rttarred 10 Phon..: -'-- Appolntmen' Dale: -~I ~:;:; ~APpolnlmtnl nmo:, ':... ttum lor 'oIlo~ 4 ~ .. .Ie ~' 't...L..-, TIm.: ,it.... o 50nllor "'"bllll.tion .>/r/.., ~J,~~ 1" t;:.~l!;~;;~.:J.-;it~~'~"-" . COMMENTIINSTRUCTIONS/MEDICATIONS:..- . I /)(c NYlbi< r~ . , ,. /I., ~ I/t..I ~ bJ' . ... .-. -'. ~ \.,- ",I. . {j) ,,!i'1 '" II '.- o Mocfcation In'blJction. given: o Ttlt Inllrpl"lfon 01 your .-roy I. only . pr.Hmlnl" roporl, Th. ..dloIog'.I.... rovllw III Alml, ".....11. ell.. In IhB "agno.". ... WilInIorm rou, , .u1ho,12. CepN.' H..~h Sy.t.m 10 lurnllh 10 my .mploy.r Ind Inlurenee C8rrl8r. IN In'orm.tlon ragerdlnv my condition end tre.tm.nt. I horeby .cknowfBdg. rec.lpt 0' Ihu. Inst,uc1lons end und.ro'.nd th.m, I undll"lnd thlll I h_ h.d emerG.ncy ".Ilmln' only Ind th.t I mlY be r.''',I~ belo.. .)1 m.dlc.1 probl.m. .,. known or Ir..'ed, 'will."lnaelo; Iollow-up C8re ..-, h.y. been In,'rucI.d, ')1 1 ,i,' 1\ I ." . I ' _ PilI,." .....Ith Clfl Pro~der Physlclln or r tillonor ~nl' ..;r,.'rf' J Ai"; /lr ~ /'. X ~ I"~ O'~rr:,~:;~pr~titiOMr , ' - WllrlJl. "itl"I"",~" U""'t',,1 ""'ldld """"1""''''''''''' OmINl"ul ....."" lieN.' HI SOUf... '''ON' Sf"", t-I,AlII.-tIlIU"O, ,,, "IOI4101t (117) 711I-1131 r."""'\I-M..,llnl!'"",,,,,., ,,"'_ - ll'IlU""l'CItO., "', II N 01 [ O'AH~ V 20144b60J C'11 301b 112 os 1\ .~ 22 N 2ND ST. MORRLYS8URO "llI[R JUfS A "JOI/1I0U COIIP 201,44 6'OJ 717 7S7 8173 OJ 08 ~4 1I/'IRM CLAY 006nS J lilt I .. ,.. :f I _:4. , '''41 1'1:, Pl "~~ ':~A , " " ',:,14 '.~ ,t,/J' " '. , . ~~.. "",~" . '," . ~".'''''l''-''.lP'''''''';''''.:''': " \ ; ";b_oItn~,.,'.M, " , ," 0... Of r......"'.: , '11m. In' nm.OUI: "tJ " 11 tJ fO.te... CoIllnIIl P"IIIIIIII, I" I) '~~-~III~ Ii Sol"., F~IIC"" lItn 111I-_ : ,i o '''"''''''''''~181, r__, (11 Il 112-11I ::' o fmployHHt..'h_ o<"",.llanll'lo.ilhS","IlI, (111) m.mo llI"",_ ,. "., . " /' , //_lJf./L OCCUPATIONAL INJURY REPORT 1m. I I ' ,,~ I JI .1' ~. . J ~, 'J~ d Phon. Num"', 016upo,vl,or 0' AUlhorlrod En,p1o " - OQcupollonlPollllon ,I l' ;(..,. . ,~, . ...ntatlYl' ,-' I r; o.lCription of Incidenl , '~~,r .. .r,' .' (. /.. :". . '--.{;" r /' JI ,1.d.1 , -''7.:.. ?fa.,. ~' J ClplI.t H..lth ',I'.m, Compl.18 tho IoIlowlng SERVICES PERFORMEDIOISPOSITION WORK STATUS r,J''lllI.1 r...Im.n' 0 R.lum to wo,h: no ...Mellon. ~oIlow.up Vllil 0 Vn~ 10 telum 10 worh o AdmllltdlO HOlpll.' ~Io ilium IOwolhwilh modllcallonl, IIlvllllbl.. tI'ndicBltd o OII.h,'go<l 0 J, No ptOlongtd lI.ndng or wllldng o R.,."od 10 Compan, Doclor/Nu". ~2, No "'-g, ....,In. ollwtaSng o R.rerrod 10 0 3, llmllod UIt 01 right.1Bft ' 0, ", , g ~ ~: =h~:r.=~g mtcltlnlly " , ;~ Phone.: re. No Mlth" IllIltlr "an! eg 18 fL.... 8 DO '" 0 SCUba. 0 tOO Ibl, ',','" Appeln onID..., _1_,_ 0 7JocHmblngo'BbovBglllUnd.....wolh A nlm.nl TIm. ~ No cttYlng .lUm 10, 'oIIoW~' t? .L" 0 g, 811ttng worh only . D....--~I I_~ Tlml: 0 1~ Drywolhonlr ,,(" /1 ~onlIOf F:\ehlbllll.lIon, , .4 " /J i9"'01h" """,....'~" ~ . ;.,;/ I ~ ~ .-/ ~,y.""_,,f ~I..... q"l :::.f-."l. l{,LU.V<.:.- ... . 1 I f J 0, I '. ' 0 II. Eltlmllodrtlum,ofuMWIy: . DIAGNOSIS: /! 1../) /1' A -~ ",,- " ...,(, /'\A..b~/~~ ~'t.~::l.,r.t..~.~. ~'_ A-oP;~~ ,'I".. . COMMENTflNSTRUCTIONS/MEOICATlONS:.... .t. , o Mtdetdon 'nlllueltonl glYon, o Tho In.."".IBtton 01 you, H" II only. proMmlnl,., ropart. Th. rtdolog'" WI' IIYIoW !hi M...., II..... IB . cllBnge In tho dBgno.IB, we wt.1nIorm yeu, l,ulho,lz. Clp".' H..hh Sysl,m 10 furn'sh 10 my .mplOYIr Ind InSUllnee Clr~Ir.1N Inlormlllon rllllrd1no my condition end t'.I'm,n\. I h..lby acknowlBdQ. ,.c.lpl of thiS. 'nslructlan" .nd undl/Sl.nd th.m. I undl"'lnd thall hlYl hid .mlrgtney 1,.lIm.n' only Ind th.,1 ml)' b. r.II..Id b.lor. .11 medic.' probl.ml .,. known 0' 1,...Id, I wlll."lng. fo, I~ ce,. II I h.v. be.n Inltrucl.cr, '"lfnl .-.llmC"",OVltfltr , l. I II Nlil.[ Z0744U03 01 AN(. ~ 18318 03 14 <<11$ fW:' (I) 30 1 WORIIUUURG , 22 N 2ND SJOAMIIl II ROUAHOM JOIIIIOIIK CollP 1\1 n1 1113 207 ...~.O'lI/f[RM eLl1 I , Q3 0& ~ J IW " bO<<l<<l3& ~ " , i , t" CN'rrM. HEM.TH . ~ VI"~" . ~"t.1I" *~t! ....,W'1l1 ""Ct'lld r"rm 1\1'1 /1114,"" 0mINl1Dn1l ....11'1 I""t, III 8OUT'" Fno....' If"If" ~..RllltS.Uno,'. "10l.2OM 1711) 11t~-1I11 rAM.., .....,It"'''''''''yltl "kI" . PAnlllnlI e"", .~A.~T'--._. ~,~...,.............,4.'~~~I...--r"',.... __."1..--....._ .~"... o rk,C...Cotonlol Pn MoII,C7l7)'S'.'se, ~,ia'f- ]:: '8aoidIo,'.,OC.0,1"7)7K-1ISO '~ r;I HonI,IIu,.,toopIrol, r_goney, (/17) 71f-5Itli "" .' o '",pIDw.. Hoollh_" ,~o~nolllo'I"'S"""" C7t7i7U-3210 OCCUPATIONAL INJURY REPORT W \)\()on~ l\,,:.j\'" \.\-...nco.(Il.rQ. ~'\~t;L Name or EmpfO~.. ~.Itlon \(~~ . Q.. N.",. .nd Phono Number 0' SUporvi' I In/llIY O'?, OS, CJ r- OfTIII_I' a3..,.,~q5 In' nmBOUI: .r "" olonllU.. Em 10 .. Nom. ~ ,r . OooeripUon 01 Ineldon' FIlA . . ~ i~ ' , , , ' I I' ~ "," . , C'pI'o' Hoollh SYI'o"., Complote rho 'oIlowlng, SERVICt:S PERFORMEOIDISPOSITION Cl 'J>>MI'i,.lIJtm.nl !:r101low-tJp Villi o Adm,nod 10 HOlpll.' o Dlochorged : , ' 0 ""'o,,ed 10 Company Doclor/Nu..o 'a"" . b, ""Io,,ed 10 .j" ~. ,-- :" \ 1 'Phon..: '.::"I"'~" AppolnlmenIOI'e: I. I , ~lnlmenITlm.: - - - ~lUm'o"oIlow-tJp - 7.... fJ"1 D.JIO -3-' .l.R'_' n= Tlmo: ".' - S- ~""~"h.bilii8nOn. ~ ~ (j" (. _....jl f>r1.. ~~'-tT , AGNOSIS: ..." ",' WORK STATUS o Rollin' 10 \110",: no ..slrlcllonl o lJII,tbIB 10 ilIum 10 wo", " ~b1B 10 ilIUm'" worll wi'" modllclllons.IIBVBnlblo, IIlndlcoled o Jo No prolonged ..."dlll\l or ,,"Ildog 1r2, No bending, slooplng or IWlIUog o 3, Limned .11 ohlghllloh o 4, Noullolrighllloll o ..Jt' No WOIk n.or moving mochlnory liW"'"e.. No"'~ng"""'f1'n1 8 1'''.. ~ (Slh.., ~ ell".!. o ~o efI"'blng 0' Bbove ground Iovol wo", 9""r.- lla ctI~ng - o g, SIItIng_konlv o '0, D<y worll onlv o OCher rzJ 118 It. /'" ...!... 0\1, .',' ..~......._~._... ~. . ...l"""'.,....I'lrAllf!4.,__.".,.. , . , tOMMENTIINSTRUCTIONS/MEOICATIONS' o . ~.. .. ,'. ','" - d/~:'~ 7.'~~ ~~~'j~ - C.u ^ \...t ;) ". 0 II'\( d. ' y"" I h~,_, vf o Modlca"on InltrucUon. given: o Tho InlilrptOli1i1on 01 you, I.rey It only 0 proKmlno'V report. Tho redologll' wtI IIvtow tho Rlml, 11.....10 I chango In the dognollo, ... wllln'""" you 10ulho,IzB Capilal Hoahh Svsl.m 10 furnish fo mv omployer and InsurBnce ea,ri... III Inlormltlon ,ooardlng my condition Bnd II..tmBnl. , h..oby leknowlBdgO roeBlp' ollh..o Insl,uctlon, .nd undorelBnd thom, I und..I'"nd that I hlVB hBd BmorgBney "Bllmlnt only Ind fh.' I may be 'Blolliod befo'B oil modicol p,obloml oro known 0' t,Uled. I ..1II',,"ng. '0' 'ollow-up eBre II' hBVB beon ,,"t,ueted. ..,i:. ~),,' _. \ l '1f1.,,1 I .t..tth Clfl rro....d.' I ~ t'1t~,;/ k? _ --- Ocrwlnonll ~,,'~/'1 !tr'1lCI It! SOUlH "~ON' SHI"l ~."PU5'U"O. ,. j'I~I.2OII f'11l'lI:P.]U'l r"n",.,. U""lto!f"'OIG.,ltr ~I,,_ ,",'lI,,",~rOfl" "IUU . 107..U03 ~IU~ '2'tlS't 03 I' " '''41 IP" I~O 11'1 WOUL ,null " lOu"nOI Julin . tOl/WOU co., l07 U un 111 U1 1171 ~, 08'4 .,rl.. CLl' 00) I n J ..,1 j " ( .,' , ,I . ,,',) " . '\J . ,.. Mil'''' ,,,,'ttll Mil I~' W"..ltltl'"AU'~1t ~I' JMUt N~""~IU "'0 '_I', WIlllA, __ F),",Il' 1"'0' _I', II It ".In. 111'11 "''' .101''11I1 p...~I'MtIlHI "'I' ~... \~ '''MW "Ii W II~~" J "AI II ~'''''I, lItD .,. 1'111111'1''''0. 1",'IAU'ttJ(IIA _D ""'IlfJ'''''1 "D 'ItvIH" ,It ND '~I',t""'''I''''''''UiD ....",...""U1IU "'D ORTHOPEDIC INSTITUTE OF P [ r I II ~~ Y L V A N I A ;+"~-'.-. ~~~--:.~:-:"'_"":".'":"'-;--:-. ..-....~-_-.:_..:.:.e-:-..::.;.-=--.:.;..~.-.-::-:-. ~:.:' '," ~ 1111'1'1111111',111111,,1"',111 . 1/IIIIII""'~n2n , '^.XIIIII/lI/I": :.... - April 10, 1995 Lisa Davis, 4470 Vslley Enoh, PA ~I.D, Road 17025 Deal' Dr. Davis: This morning, April 6, 1995, I saw Disne Lingle IlU1238 of 22 North 2nd Street in I/ormleysburg in my office initinlly, She is a 41-year-old womun, who has upper thorscic back pain, She had no history of back pain until she was driving her vehicle at work for lIealthReach 1I0mecare \~hen she was stopped on Route 11/15 and hit from the rear. on an icy day by another vehIcle. Within a short time she noted the onset of upper thoracic bock pain without upper Qr lower extremity symptoms, She was seen at Seidle Memorial Hospital and there she was given prescriptions for Advil, muscle relaxants and physical therapy was begun, Her activities were restricted and sh, was not allowed to drive a vehicle or return to work. Her symptoms are somewhat subsided, but she still has constant bothersome upper thoracic back pain, She has taken little medication. Some dsys the physical therapy helps her, other days it makes her worse, When I examined Mrs. Lingle today, 1 found that she had full range of motion in her neck and neck motion did not cause any ~fper extremity symptoms. She had no trapeziu~ tenderness but Q d have slight muscle tenderness to either side of the midline of her upper thoracic area, She had no tenderness to percussion of her thoracic spine. She hod full range of motion in her low bock. She had intact neurovascular function in her upper extremities. She had full range of motion in all joints of her upper extremities, I reviewed the radiographs of Hrs, Lingle's thoracic spine taken at Seidle Memorial Hospital on the 4th of April of this year and 1 see some minor degenerative changes without evidence of tumor or fracture or dislocation. ~!'" HiLL OHlct ''''1\ Ikl,....' I'" . ... .... -- . ... ^lJIJI-I',i,'df "'1.1",".,'11111"1 'II I'H'jH~lrrt"1 '~')\t',f\'-"I'I'UI.I",t,'lf. IP'!U,'q""'i'" r I'" ''''''.", ",",.'(' , "''1''1'' "", lit! "lit 1'1 "".,11 """"! '1' ., C^", IIILL O"ICI II",' '''1 "'~, ,",,,., "I" . . QItOIJlt , ;to ,e Sol A,'. IIlE:i.AL ~ ll. f ""'fHI ~1" . .'IIIY"f(j !ly"rIMe, INC ~l TALUM" CA TO InO"Ol" CALL'TOLl ~Htl IIQU..,lU.."O 'CAI 'lit .Jt()l)'ll'jlJ Ma..o 'USA, .... . "'-.., DIANE V. LINGLE 22 North 2nd street Wormleysburg, PA 11043 951353 - 1 - 11-3-95 SECOND OPINION EVALUATION HERSNEY (DR. DAHHUS) REI BACK Dillne is a forty-one year old female who comel in today for a second opinion regarding her back pain. Ths pain is sll in the mid thoracic spine. This all started back in March of this ysar when she was rear-ended in an auto acoident, She was treated at Seidle . first and then by Dr. Litton. Basically Ihe waa told that she would get better with time and to just hang in there. She is II little worried that she is sUll havIng trouble and shs is here tor another opinicn. She denies any numbness, tingling or weaknsls IInywhere. The pain is basically from about T-6 down to T-12 and only right down the midd Ie of her back. I t does not go into her rhomboids, it does not go into either shOUlder and does not go down to her lumboeacrlll spine. She has no neck pain, no low back pain and no arm or leg troubl~. She has no bowel or bladder complaintl by history. She only has mid thoracic back pain, She i. not takin9 anti- inflammatoriel oxcept tor ths fir.t two week. lifter her injury IInd she hilS not been in any therapy and doe. not do any rehllb now, She is preBently doing her normal jOb IInd normlll IIctivities lit home, although she hasn't been riding her 1II0torcycle or riding II hor.e lately. On physical exam, she has tendernee. right trom about T-6 to about T-10 right on the epine iteelf. She has a littls bit of pain right next to the spine but only IIbout IIn inoh out, She has no pain in the rhcmboids, she hilS a normal rsnge of motion of her shoulder., she has no tenderness to her neok to exam end Ihe hilS a normal range ot motion of her neck. She ha. great fllxibility in her lower bllck and no tenderne.. at all to .xalinlltion in the lumbosacral spine or pelvis IIrsa, She ha. good rotation of her back and basically the only IIbnorlllality I can get il the tenderne.. in the middle ot her thoracic spine, I have reviewed the x-ray. that .he brought with her and she indeed does have some degenerative dilo dleell.e in ths middle ot her thoracic spine but otherwise everything look. jUlt fine. Basically I think ehe has II relolving thorecie Ipine .prein IInd thil will only take time to get bett.r, I told hlr it could be . year or two until it i. cOlllpl.taly 90n. but there il no re..on to think it won't go IIWllY. She h.. no .videncs of Iny di.c dilea.., no evidence of any structurll dllllag. and balieally we are de.ling with I lIIuscle contulion that will take tile to get better, Ther. is nothing 1II0re to do except u.e 10.. iel and hlat Ind 10.. anti- intlammlltories on II PRN bllli. and jUlt let nature run it. cour... (ckz) (CCI Barbllrll Darcy, capital Nur.ing) ~ .. CLAIMS MANAGIKlNTI~,HARRI8IVRQ .. CLAI:E:~ :::::3: ':~::':~~~"N~;=~:~'C~"::~'f1~VII' NAM~"h" Pli1GE.: ..lo' REASON "OR TRANSACTION. _ ~., all 0004062 05109/''6 N; 1 IAR . D ~N f; 03/25/96 EXPENSES 0,8/0.'/.", ". 9. :28 I; .. 200003965 04/18/96 .'----.N'..-l();-f1"~HO.."'E~le iiUItOERY'UJliTER I' 03/25196 1041696 Q4(1~,", 1 :'11\ 4~~ I .. 19 00037&6 04/17/96 ""---'c'--lo'-'LfNGLi;DiANE '.'--' I' 04/17/96 WRONQ AMT 04/1119" 1111.92 ' , 18 000393& 04/&1/'6 ' n.t("' 'IO"kIO-'OI.YHI~'eflr('OLY) I i -' Oa/Sl7l9.1l111'-"94:1~""".I.j..~iUi~~04J.AO_"""'''r''''~ 17~.', .... t ,I -' , 17 0003923 04/&1/96 - "--'-N'---lo-TIITIfAOSSDCIAfte-- I I 0iJ./27196 129689431 04/10'" 11. It, i' -' "..---.N-h-10--..eCUlN"T"AIlIlCl~IAfll<<C~)' .1. it 16 0003891 '04/04/'h 03/19/'6-3/22/96ILINOD10 04/04/" 141.4' 1& 0003863 04/01/96-- --'-H'-lO-LINOL'-,-')lAN~--'--'--' 03/01/96-03/iJ.&/96 04/01/'6 63.98 ", e 000211& 'O!/04"! u ----;-'"ltIO-' A:r.-llmHANh AIIaC.'-INe 04/04/9& ISH 989694 0&/04/" 40." "0000000 05/0~/~S h... .----.-----..-.--"-..--- ., RES, INDEMNITY CHANGE I 1 31,12 '1 J :, J~ I . 1'1 r. -," II ,. 'h-:--'~'-'lOU'AnAO-DA"eV,'''N' .', " ':' . 03/0'''' ,_ .. III U .J" .. -----.N---. 6 -'"Mf'HO'AiIH c" sUIlOlJ"'h cENtllil H 11/S1R195 120. 00 r'; -' I d l' I -' << 4'tk)) t _' -' . 14 000394S 03/21196 ....--N.----ns'~"MeeulN"'.-A.ICllnATllne~) . 03/01196-3/15196 ILINGDU,', 03/11719'~'i" 4311.'1 . 1300037&6' 03/14/96 .. --'N-ll)-i:INOlIrDIANI!-"'-' ....,- 03/08/96 PT HRS 03/14/96 115,92 12 0003754 03/01196 02/27/96 EXPENSES 11 0003:i!06 "II/:i!2I95 ' 11/03/9& 1036&93 10 0002403 '06I:1a/'9!-'- '--""No -:-a07m1K.rMIMORfAl.tmuI TAL-- 0311 &/95-4/11/9& l:Zl30I'~"~~"""/"~.-' 440;'.o'~ ., 9 000:2293 O!l/;l~/~5 ...-...---.-'... . to' IIIDL:IPII!HOAUCHOIJlITAL 03/iJ.1195-4/419~ 1203024lS4. O&/n", 14:Z, III -" 6 0002092 ' 04/:Z0/9S"---"--"N--' lO....IIIDL:.-MIHOlnAl-HaIfIITAl. 03/09/95-3/14 120310&&03. 04/110/".. 11111." -' ,_ '--0- ________.~~__.__ -' - '..J . , . !: -" ., - CLAIMS I'IANA~~~!N1N-r H~~IH~,'.U"~" ,..!Y~l!.~ !l~~,"_ QI~ ,CHICK DATI T"ANI TV'" COD '''VI' NAMI .\ PAGE ---....,. .., ~ "..., .. " , I'" ".1 , nUTI or '.' ,.,,J,,)lJ04/IOlt5'"'' "1011.'0 ",' _ I' ...- I I . , , CL~IH ND 94'4'37. BEG. CHECK' 4 ooo:tO:l:2 -- 6'4/1019!1 03/09/95-4/.4/.5 fTD . ' '. -.----M...,.."..-"NOL-r...-,.......' , ",-",._,., .-.....v..'.'... .f' U ..1'4& . .., "'_,_~_~ ~,,1~'L~/" ,t.'rO~~' ~I~. , 3 0000000 04/0'/95 RES. MEDICAL CHANGE ';'" 1>~-4, Ir, ricO i"lt" !I.O(lO,~O I" - Ii: -, a 0000000' "04/01198' -. .:..mt~f;tti'-"It%.!.\.~~tlVlAi~ "'t!1("I-+...t t;.;, .............."l't......,c , Ir061~'.-,.', , ".. ., ,.' ......,.., ...... "",.J, ,.",ill f A1 . ._~ .__.. _..:-..~~'.#!IuIlto'...,'_-:- :-l',~ "I;.. "', ~~ - 1Id"__"~'I."'''\' ~: .... ( . ,~ '!' Jot...' I:.. ~ " " ~. :1 , -.- '-:-:-:; -.--...--:;dt..~.. ' . .. ,. ~ ,~ ut"t..~ eLL1!;"'. ____ .--.....-- ._~ " ' i Nt,r' "':E~K,' 1";,[; r ',~IJ'!l: IN ~,,;;;;:;;..._';;;~~ . ~-:--:. ,'I ,:F:l~,' y , J "1 1,1' r" -. :',_-:t t ," ---~', ~ r: :: .J " d I .' P '-I' ,. 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'l'J"::: ~ I , ;J ., . ~ .L' ~I- ~..4i!t:"~ ~ S CO) - j::;! '~ "~ ~ ~~; .....D .. ~ -:i:'~1 ~ ~~ ... iJ I)'. J N~? .~ 19: -,.. -or r" ~ ...,,~ ~ , t ] i f 'j'; I ~'; t ;" ~ J .tr,li~ jl I , I i If, ~ J I i IIJ ! II I.J "... ~II! ., ." 'I i f~J ~ I. ~ i t c ~ J I }, 'j~ ,..- " I, I~ II ..J o J C .-1 C t ~ IJ ')1 J~ f III Jfj~ IJ I]~ II t If, J 1.. ~ } I 1 I i J t-.. Plalntlff ( 1\ ) ) ) ) ) ) \ C\ab.r1aDd Covot" 'eftDl,l".Di. lllANE LINGLE. JD 'nit Collrt of C~D '1... of VH. 110.41 (d , - CIVlI 1'9'; ,IllY C, CHUTTENDFN. Dl' r l~lIJ.ltlt OATH VI do lolemul, IVlar (or affi~) that VI viII .upport, oblY and dlflnd tbe CoDatitlltlon of thl Voited Statl. aDd thl ConetltvtloD of thia Common- v.alth and thlt v. vill di.char,e the dutil' of our officI vitb fldllity. I Itn""".. } i1/.Jl 4..-v\ Thomas.l, Wllll.lOll:l. ES'lu.ire . Chairman r . " .' . . . . .Ci~r" a :. lhH AIlAJU) ~MJ(/IJ ~b Va. thl undlrailDed arbitrator., haviDI bllD duly appointld and aworn (or .afflrmld), mati thl folloviDI award: (Notl: If dama,la for dllay arl awardld, thlY ahall bl aaparatlly atatld.) ~ ('Y-I.~ ~: W~e: LllSS l\'I~/) ilAL S 6~,\J E(2A L .- -. to\AL 1.4&.41.4 \ \,l~" ~'t \\ OO~ .00 - Ii ,~ 07 1 ~r;; Arbitrator, dis.ent.. (Insert name if applicable. ) f"/~11jJ.~) t~)Li cJ...:__ Thomas .I, WI\.JA"Ol~. Esquire' . C.halrman ~.. .]W~..~lr., Will lam C, Vohs. E'''julr<, NOTICI OF ENTRY or AWARD Nov, the'i3',h day of OC:\u\)\(( ,19'/(.0. at1't.J0, P.M., tbe abovl 8Vard va. IDtarad upon tba docket and notice thlreof liven bY-mail to the parti.. or thair attornay.. . ATbUratou' complnsaUon to be ~~lLl'le,]u. r. LUttJ..,r paid UpOD appeal:, Prothonota . d(oO. D) By: ~~')'A_I) YIlHIIll(1,},"). }-&., Deputy SaeriDI: I D / ~ / q '" Award: ~..kL.. Dau of Data of DIANE LINGLE, Plaintiff : IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNA Y. . . : CIVil ACTION. LAW : NO. 911-4183 CIVIL TERM JOY C. CRUnENDEN, Defendant : JURY TRIAL DEMANDED NOTICE OF APPEAL FROM AWARD OF BOARD OF ARBITRATORS TO THE PROTHONOTARY: Notice is given that Defendant, Joy C. Cruttenden, appeals from the award of the Board of Arbitrators entered in this case on October 8, 1996. A Jury trial is demanded [ x J. (Check box if a jury trial is demanded. Otherwise jury trial is waived.) I hereby certify that: (1) the compensation of the arbitrators has been paid. Respectfully submitted, NEALON & GOVER By 'i' ~ James G. Nealon, III, Esquire Atty. 1.0. #46457 301 Market Street -- 9th Floor P.O. Box 865 Harrisburg, PA 17108-0865 (717) 232-9900 , ~. I CER1'IFICA TE OF SERVICE AND NOW, this 4th day of November, 1996, I hereby certify that I have served the foregoing Notice of Appeal on the following by depositing a true and correct copy of same in the United States malls, postage prepaid, addressed to: Archie V. Diveglia Diveglia ar,d Kaylor 119 Locust street Harrisburg, PA 17101 ~ James G, Nealon, III, Esquire DATED: November 4, 1996 " NEALON & GOVER A ~"O'IlIl.10"'AL. C:O"II'O.....TION ATTORNEYS AT LAW - 301 MAIlIMET STREET. ItTH 'LOO" ,.0. 80X 6.a HA"'''I..UIltO, PENNSYLVANIA 17108-088e r-u, ED..{JrFlCE ri: 11'" "',"";r',t'OTM1'( SSI'r-:'!-G rJllO~16 . .\' "j .J ,,) ."".i";: I. b'{':~~ YL\',t.j .:1:\ I.)" it .i 1 If .) 60. ()d pJ. tlt"4-. tk tF- /6'18 7lJ.t- '* '1,,0' . ., ., ~' .~ c:;;l 'n ::1 ~n, M'I ,iifR. . rt"1 .-0, .\'1' (~~; N ~~ ...." \') _',i --I - ,./, ':!J 1~ ~. ~" ' -- I..J ~ ;(.' , 'CI - 6 ,po ~; .. ~ ;~ "" ~ . , w " ' (') C:.' C. ., .. r. ~. "'TJr/:': , t:>',o' ..... ';>';.1 ~ /r k r-::(, ...., - . j.' ~.-. 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