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Maximum medical improvement reached
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1 page future medical costs
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1 page future medical treatment NO COST
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Minor future medical costs
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Minor future medical treatment NO COST
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New Short Text Field
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SAD candidate
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SAD candidate NO COST
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General arthroscopy candidate
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General arthroscopy candidate NO COST
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Cervical or Lumbar EAD candidate
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Cervical or Lumbar EAD candidate NO COST
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Cervical ACDF candidate
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Cervical ACDF candidate NO COST
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Cervical disc replacement (TDR) candidate
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Cervical disc replacement (TDR) candidate NO COST
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New Short Text Field
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Cervical RFA candidate
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Cervical RFA candidate NO COST
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Lumbar Microscopic discectomy candidate
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Lumbar Microscopic discectomy candidate NO COST
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Lumbar fusion candidate
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Lumbar fusion candidate NO COST
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Lumbar RFA candidate
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Lumbar RFA candidate NO COST
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Sacroiliac fusion candidate
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SI joint FUSION candidate NO COST
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New Short Text Field
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Carpal tunnel release candidate
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Miscellaneous minor surgery candidate
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Miscellaneous minor surgery candidate NO COST
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Miscellaneous moderate surgery candidate
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Miscellaneous moderate surgery candidate NO COST
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Miscellaneous major surgery candidate
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Miscellaneous major surgery candidate NO COST
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New Short Text Field
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AMA Guidlines
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In addition to any prior permanency rating
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May return as needed
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New Short Text Field
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