Dwc Form Rfc Case Summary

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Pages: 4

01/22/15 DWC Form RFA for Diclofenac Sodium 1.5 % 60 grams: DOS 12/29/15

12/29/15 Progress Report noted that the patient called the office for medication refill. She has been compliant with the use of her medication. Verbal instructions were given and the medication was dispensed and mailed. Current Medications included Topical Diclofenac 1.5 % cream applied to the affected area three times a day, Acetaminophen-Hydrocodone, Albuterol, Gabapentin, Clonazepam, Duloxetine, Fluticasone, Levothyroxine, Quetiapine, Microgestin, Propranolol, Sumatriptan, Qbar, and Omeprazole. Plan: Prescription diclofenac sodium cream.

08/26/15 Notice of Denial of Northern California Functional Restoration Program additional 80 hours

08/19/15 DWC Form RFA for Northern California Functional Restoration Program

07/31/15 DWC Form RFA for retro Transportation to and form the FRP

07/14/15-07/15/15, 07/17/15 Weekly Progress Report, Babak Jamasbi,
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Prior to the program, the patient expressed that her chronic pain In the neck and both shoulders was significantly affecting her quality of life, as well as her ability to function and interact with others; at that time, the patient was at a loss as to how to move forward with her painful condition, The patient was not equipped with the ability to cope with her chronic pain. After this week's participation at the Northern California Functional Restoration Program, the patient has expressed that she feels that the program treatment has given her hope and motivation to functionally improve. The patient has begun practicing the self-management pain coping techniques learned in the program thus far and has reported improvements in her physical