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17
Initial Evaluation of Claimant
lPersonal Information
–Family dynamics and home situation (detailing only those factors which relate to claimant’s return to work)
lJob History
–Description of the injury
lMedical History
–Current medical status
–History of previous injuries
–Non-Injury related medical conditions
–Current Medications
–Physician(s) contacts and conclusions
lNursing Care Plan
–Potential problems
–Recommendations
–Planned services for the next 30 days.